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Objective:To analyze the effect of traditional Chinese medicine (TCM) non-drug therapy on all-cause mortality and 12-month readmission in patients with chronic heart failure.Methods:A total 824 patients aged (80±10) years with chronic heart failure admitted to 4 hospitals in Shanghai Pudong New Area from January 2016 to December 2019 were retrospectively enrolled. Propensity score match (PSM) method was used and 602 patients (301 pairs) were successively matched into TCM non-drug group (study group) and control group. The basic information, comorbidities, medication, laboratory test results, imaging findings, 12-month readmission and all-cause mortality after discharge were compared between two groups. Cox regression was used to analyze the influencing factors of adverse events in patients with chronic heart failure.Results:After PSM there were no significant differences in baseline variables between study group and control group ( P>0.05). The one-year survival probability of the study group was higher than that of the control group ( P=0.013). The adverse event incidence rate [43.52% ( n=131) vs. 53.82% ( n=162)], all-cause mortality [15.61% ( n=47) vs. 23.59% ( n=71)], 3-month readmission [10.96% ( n=33) vs. 17.61% ( n=53)], 6-month readmission [16.90% ( n=51) vs. 24.25% ( n=73s)], cardiac function classification, hs-CRP and NT-proBNP levels in study group were significantly lower than those in control group (all P<0.05). The Cox proportional risk model showed that old age ( RR=1.018, P<0.01), decreased cardiac function ( RR=2.200, P<0.01), diabetes ( RR=1.340, P=0.04), NT-proBNP≥7 900 ng/L( RR=1.557, P=0.01) were risk factors, while TCM non-drug therapy ( RR=0.768, P=0.04) was protective factor for the occurrence of adverse events. Conclusion:TCM non-drug therapy has a protective role for the occurrence of adverse events in patients with chronic heart failure. The use of TCM non-drug therapy should be advocated to improve the prognosis of patients, particularly at grassroots level.
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Objective To analyze the epidemiological characteristics of a healthcare-associated infection(HAI) outbreak due to multidrug-resistant Acinetobacter baumannii (AB) in an intensive care unit(ICU), and provide basis for the prevention and control of HAI.Methods Epidemiological investigation and environmental hygiene monitoring methods were adopted to investigate patients who had pulmonary infection after they were admitted to the ICU of a hospital in April 1-26, 2015, risk factors were analyzed and corresponding preventive control measures were taken.Results A total of 15 cases of extensively drug-resistant AB(XDR-AB) healthcare-associated lower respiratory tract infection occurred.15 strains of AB were isolated from 15 patients.No.1, 3, 4, 5, No.6, 7, 8, 9, and No.10, 11 patients were detected AB with the same antimicrobial susceptibility testing results respectively;occurrence time of infection was relatively centralized.A total of 43 specimens from environmental surface and hands of health care workers(HCWs) were collected, detection rates of AB from bedside cabinet, monitor button, and hands of HCWs were 100.00%(1/1), 75.00%(6/8), and 66.67%(4/6)respectively.AB were not detected from specimens of treatment table, infusion pump button, and doctors' nasal swabs.By late May 2015, there were no new such cases in ICU.Conclusion This AB HAI may be spread through environmental surface and hands of HCWs in ICU, AB isolated from patients is extensively antimicrobial resistant, active treatment of patients and strict disinfection and isolation measures can effectively control further prevalence.
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Objective To understand the current situation and existing problems in the training of healthcare-asso-ciated infection(HAI)management,and provide scientific basis for strengthening the management of HAI preven-tion and control system.Methods A questionnaire survey was adopted to investigate situation of training on HAI in 15 provincial-level HAI training agencies in China during the past 30 years,and basic condition of training on HAI management in recent 5 years.Results Among 15 provincial-level training agencies,66.67%(n=10)were respon-sible by HAI management quality control centers,80.00% have already conducted training in each city,53.33%carried out training for 10 to 20 times,33.34% performed training for ≤2 times per year.Of 33 728 trainees in 2011-2015,41.30% were 41-50 years old,61.82% were nursing staff,50.56% had bachelor degree,43.96%were with the intermediate professional title.Most trainers were HAI prevention and control experts in their respec-tive province,accounting for 68.07%,the curriculums were mainly designed on professional course,and only 26.78% were involved in management.Conclusion Professional structure of HAI management personnel is not reasonable,faculty is imbalance,knowledge update is lacking,and HAI training and education system need to be improved further.
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Objective To investigate perioperative antimicrobial prophylaxis in thyroid operation at all levels of hospitals in a province.Methods From January 1 ,2011 to December 31 ,2013,all kinds of thyroid operation in a province were conducted targeted monitor,investigated results were analyzed.Results A total of 1 304 cases of thy-roid operation were investigated,1 294 (99.23%)were elective operation;duration of operation of 1 051 cases (80.60%)were ≤2 hours;antimicrobial use rate was 96.70%;196 patients (15.45%)were administered 30 mi-nutes before operation,887 patients (70.34%)used antimicrobial agents for >48 hours;19.53% of patients used the first generation cephalosporins and clindamycin.Conclusion There are some problems in antimicrobial use in thyroid operation in this province,such as inappropriate choice of antimicrobial agents,improper administration time,long time use of antimicrobial agents,and use antimicrobial agents without indications.Management of anti-microbial agents should be strengthened,so as to promote the rational use of antimicrobial agents.
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<p><b>OBJECTIVE</b>To investigate the biocompatibility and degradation rate of crosslinking sodium hyaluronate gel with different ratio of molecular weight, so as to choose the effective, safe and totally degraded hyaluronate gel for aesthetic injection.</p><p><b>METHODS</b>(1) Compound colloid was formed by cross-linking the divinyl sulphone and sodium hyaluronate with different molecular weight (4 x 10(5), 8 x 10(5), 10 x 10(5), 12 x 10(5)). (2) Healthy level KM mice was randomly divided into two groups to receive hyaluronic acid gel or liquid injection. Each group was subdivided into three subgroup to receive hyaluronic acid with different molecular weight. The biocompatibility and degradation rate, of hyaluronate were observed at 7, 90, 180 days after injection. At the same time, different molecular weight of sodium hyaluronate gel is sealed or exposed respectively under the low temperature preservation to observe its natural degradation rate. (3) The most stable colloid was selected as aesthetic injector for volunteers to observe the aesthetic effect.</p><p><b>RESULTS</b>The sodium hyaluronate gel with molecular of 4 x 10(5) was completely degraded 90 days later. The sodium hyaluronate gel with molecular of 8 x 10(5) was completely degraded 180 days later. The sodium hyaluronate gel with molecular of 10 x 10(5) was degraded to 90.0% after 180 days. The sodium hyaluronate liquid can be degraded completely within 7 days. The colloid could be kept for at least 12 months when sealed under low temperature, but was totally degraded when exposed for I d. Sodium hyaluronate gel with molecular 10 x 10(5) was confirmed to be kept for at least 6 months in animal experiment and clinical trials.</p><p><b>CONCLUSIONS</b>Under the same condition of material ratio, the higher the molecular weight is, the lower the degradation rate is. But the liquidity of gel is not good for injection when molecular weight is too large. It suggests that Sodium hyaluronate gel with molecular 10 x 10(5) maybe the best choice in cosmetic injections.</p>
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Animals , Mice , Cross-Linking Reagents , Chemistry , Hyaluronic Acid , Chemistry , Injections, Subcutaneous , Molecular Weight , Random AllocationABSTRACT
Objective To investigate the incidence of sharp injury (SI)among health care workers(HCWs)in dif-ferent levels of hospitals in Gansu Province,so as to improve HCWs’precaution awareness,standardize behavior, and provide guide for making occupational precaution measures.Methods From January to December 2012,HCWs in 38 medical institutes in Gansu Province were selected with stratified random sampling,HCWs were surveyed through questionnaires and interview.Results A total of 11 358 questionnaires were received,the incidence of SI was 9.87%(n=1 121),case rate was 12.60%(n=1 431),the frequency of SI was 1.05 times/(person·month).SI rates of different genders,positions and years of working were statistically different (all P <0.05).The main medical devices cau-sing SI were syringe needle,venous transfusion scalp needle and surgical suture .SI caused by known sources were 1 099 times (76.80%);980 times (68.48%)of SI were induced by contaminated sources,474 (48.37%)of which were blood-borne diseases,bloodborne disease exposure accounted for 33.12%.Among bloodborne disease exposure,hepatitis B virus accounted for 74.25%,Treponema pallidun 13.10%,hepatitis C virus 12.01% ,and human immunodeficiency virus 0.64%.Conclusion There is a high incidence rate of SI among HCWs in Gansu Province,it is a very important public health problem which needs to be solved.