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In the emergency of the outbreak of COVID-19 in December 2019, Shaanxi Provincial Health Committee mobilized several medical teams from major hospitals in the province, and, by relying on Xi’an Chest Hospital, jointly established an anti COVID-19 consortium to control and eradicate the epidemic in a short time. Information support is an important guarantee for winning this battle. In order to realize the efficient cooperation among multiple medical teams, we have carried out some exploratory and innovative information support services on the basis of the original information system of the chest hospital. In this process, we have gone through some detours. Some compromises were made on some problems that could not be solved in the short term. Finally, in an environment full of uncertainty, a set of information support management system with basically smooth operation was built through rapid trial and error adjustment. The system mainly includes the following aspects: support of the organizational structure and operation process of the anti-epidemic consortium, support for medical collaboration related businesses of multiple medical teams, and support for statistical reports and online meetings. Information support has played a very important role in this action, and this practice has also accumulated experience for us to deal with similar situations in the future.
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Objective:To screen the differentially expressed genes on whole expression profiles of the inflammation-related cytokines in mice infected with influenza virus by the gene chip technology, and to explore the intervention effect of Shufeng Xuanfei Jiedu formula.Methods:Male ICR mice were divided into normal group (N group), influenza virus infective model group (M group), Oseltamivir control group (C group) and Shufeng Xuanfei Jiedu formula high, medium and low dose groups (SH, SM, SL groups) according to the random number table method, with 10 rats in each group. A mouse model of influenza virus pneumonia was reproduced by nasal drip of influenza virus strain FM1 (0.05 mL). In N group, 0.05 mL normal saline was used. In SH, SM and SL groups, Shufeng Xuanfei Jiedu formula was used 2 hours after intranasal infection (2 times, equal and 1/2 of the clinical treatment dose, approximately 3.8, 1.9 and 1.0 g·mL -1·d -1) for 4 days. In C group, the dosage of Oseltamivir was 2.5 g·mL -1·d -1. In N group and M group, distilled water was given (0.2 mL once a day). On the 5th day, the whole lung of mice was taken. The lung index was calculated, and the pathological sections were observed. The total RNA of lung tissue was extracted and detected after hybridization with mice whole gene expression spectrum chip to select differentially expressed genes of chemokine pathways. The expression intensity ratio of the chip probe signal in each group vs. M group was calculated, and P < 0.05 and log 2ratio > 1 were up-regulated genes, while P < 0.05 and log 2ratio < -1 were down-regulated genes. Results:Compared with the N group, the lung index in the M group was significantly higher, and pathological changes were found in lung tissue, which suggested that the model of influenza virus infection was successfully established. Compared with the M group, the lung index of mice in C, SH, SM, SL groups was significantly lower (0.96±0.14, 1.45±0.22, 1.14±0.18, 1.22±0.21 vs. 1.72±0.15, all P < 0.05), and the extent and degree of lesions were reduced, however, there was no significant difference among the groups. Gene chip analysis showed that there were more differentially expressed genes in N group vs. M group, SH group vs. M group, SM group vs. M group, SL group vs. M group. It could be used for further signal transduction pathway screening. Compared with N group, the differential gene expression of chemokine C-C ligands (CCL-3, CCL-5) and chemokine C-X-C ligands (CXCL-9, CXCL-10) in M group were significantly up-regulated [log 2 (M group/N group) were 6.64, 3.51, 5.40, 6.64, respectively]. Compared with M group, the gene expressions of CCL-3, CCL-5, CXCL-9 and CXCL-10 were significantly down-regulated in C, SH, SM and SL groups [log 2 (C group/M group) were -3.96, -2.26, -3.12, -2.40; log 2 (SH group/M group) were -5.57, -2.37, -1.57, -1.01; log 2 (SM group/M group) were -4.35, -1.47, -1.26, -1.74; log 2 (SL group/M group) were -2.86, -1.86, -1.23, -1.39, respectively]. Conclusion:Shufeng Xuanfei Jiedu formula inhibits inflammatory damage in mice after influenza virus infection by down-regulating the expressions of CCL-3, CCL-5, CXCL-9 and CXCL-10 on chemokine pathways.
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【Objective】 To understand the current status of medical staff’s awareness of hospital infection prevention and control during the epidemic of COVID-19 in Shaanxi Province and analyze its influencing factors. 【Methods】 The questionnaire was designed on the "Questionnaire Star" website. Based on the WeChat platform, a voluntary sampling method was used to invite online questionnaires. From March 13 to 29, we collected a total of 8037 questionnaires, 30 of which did not meet the requirements and had logical problems, and finally 8 007 valid questionnaires were obtained. 【Results】 A total of 8 007 medical staff were surveyed. Among them, Medical staff of Grade 3A, Grade 3B, Grade 2A, and Grade 2B hospital accounted for 39.6%, 2.3%, 55.3%, and 2.6%, respectively. The average age of the respondents was (32.1±7.2) years old, including 7 199 nurses and 501 doctors. The training effect was statistically significant in different regions, different hospital levels, whether it was a designated hospital and whether there were sensor control supervisors, as well as medical staff of different specialty, professional title, and work area (all P<0.01). The basic cognitive situation of the surveyed subjects showed that most medical staff in Shaanxi Province had a correct rate of less than 30% in whether they needed to disinfect before de-protection and how to disinfect the hospital environment. Multivariate linear regression analysis showed that the cognition level of medical staff in Grade A hospitals was significantly lower than that in Grade A hospitals (P<0.01). The cognition level of medical staff in designated hospitals was significantly higher than that of others (P<0.01). The cognition level of medical staff in hospitals with sensory control supervisors was significantly higher than that of others (P<0.01). The cognition level of people aged 25-34 and 35-44 was significantly lower than those aged 45 and above (all P<0.01). The cognition level of medical technicians and service personnel was significantly lower than that of doctors (P=0.02 and <0.01, respectively). The cognition level of medical staff with intermediate, associate senior, and senior professional titles was significantly higher than the cognition level of those with junior and below professional titles (all P<0.01). The cognition level of medical staff in fever clinics, emergency departments, isolation wards, ICU and other surgeries was significantly higher than that of those working in ordinary outpatient department (P=0.01, 0.03, <0.01, 0.02, and <0.01 respectively). 【Conclusion】 Most medical staff in Shaanxi Province have misunderstandings about whether they need to disinfect before de-protection and how to disinfect the hospital environment. Moreover, we found that the awareness of medical staff in Shaanxi Province of hospital infection prevention and control during the epidemic of COVID-19 was affected by the hospital’s level, whether it was a designated hospital, whether there were sensor control supervisors, as well as the age, specialty, professional title and work area of the medical staff.
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The new type of coronavirus pneumonia referred to as coronavirus disease 2019 (COVID-19), became pandemic globally, causing tens of millions of infections. The establishment of a sound prevention and control system is particularly important for disease prevention and control. In the process of admission and treatment of COVID-19 patients, we have established an effective rapid prevention and control system for special infections in the hospital. Through the establishment of a hospital-level emergency response and first aid training system, the closed-loop communication between hospitals, departments and medical care is quick to respond. We categorize treatment according to patients’ condition, provide rapid feedback and return, implement the specific responsibility system for special personnel, improve the rapid prevention and control system for special infections, and apply it to the prevention and control of the epidemic of COVID-19 patients in the region, and achieve the effectiveness of the anti-epidemic through comprehensive management measures. The control has achieved zero infection among medical staff and within the hospital, ensuring that the hospital can quickly resume daily work at the end of the epidemic, and has certain promotion and demonstration value.
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Objective To explore the application of adenosine triphosphate (ATP )bioluminescence assay in evaluating cleaning quality of medical devices.Methods Manual and machine cleaned medical devices were randomly selected from central sterile supply department of a hospital in 2011 -2013,cleaning quality was detected with ATP biolumi-nescence assay,relative light unit (RLU)value was determined to assess the cleaning quality.Results A total of 460 pieces of cleaned devices were detected in 2011 -2013,404 (87.83%)were qualified.The qualified rates of manual cleaning and machine cleaning were 70.73% and 94.07% respectively,the qualified rates of general surgical devices and lumen devices were 90.71 % and 81 .76% respectively,there were significant differences in qualified rates of different cleaning methods and different categories of medical devices (both P <0.01 ).The qualified rates of manual cleaning in 2011 - 2013 were 32.35%,79.63%,and 94.29% respectively,machine cleaning were 79.45%,98.15%,and 98.08% respectively;differences in qualified rates of manual cleaning and machine cleaning in different years were significant (all P <0.01 ).Conclusion ATP bioluminescence assay can be used for evalua-ting cleaning quality of medical devices.
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Objective To detect bacterial content on surface of mobile phones of health care workers (HCWs)by adenosine triphosphate (ATP )bioluminescence assay.Methods HCWs in departments of internal medicine,surgery, medical laboratory,and administration were randomly selected,50 in each department,field detection on bacterial content on surface of mobile phones of HCWs was conducted,the relevant data were recorded.Results A total of 200 mobile phones were detected,33 mobile phone surface were qualified,the qualified rate was 16.50%.Qualified rate of mobile phone surface of HCWs in different departments as well as mobile phone disinfected by different modes were different(χ2 =13.46,10.24,respectively,both P 0.05).Conclusion The qualified rate of bacterial content on surface of HCWs’mobile phone is low,the awareness of hand hygiene of HCWs should be strengthened,regular cleaning and disinfection on the mo-bile phone can effectively reduce bacteria on the mobile phone surface.
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Objective To investigate the correlation between serum tumor markers levels with the disease condition activity and the tumor occurrence in the patients with rheumatoid arthritis(RA).Methods Serum tumor marker CA199,CA153 levels were de-tected in 35 patients with RA (RA group)and 31 healthy controls(normal control group).ESR and CRP were examined and the disease activity (DA)was assessed by the DAS28 score in the RA group.The serum tumor markers levels and the positive rates were compared between the RA group and the normal control group.The correlation between the serum tumor markers levels with ESR,CRP and DAS28 score was analyzed.Results Serum levels and positives rate of CA199,CA153 in the RA group were higher than those in the control group(P <0.05).The serum CA153 level had a positive correlation with the ESR,CRP and DAS28 score in the RA group(P <0.05),but the serum CA199 level had no significant correlation with them.Conclusion The serum levels and positive rates of CA199 and CA199 could be increased in the patients with RA,moreover the increase of serum CA153 level is corre-lated with DA of RA.Therefore the serum tumor marker CA153 level may be used as one of reference indexes for evaluating the DA in the patients with RA.
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Objective To investigate cognitive status and influencing factors for hand hygiene(HH)among health care workers(HCWs),and provide basis for scientific management of HH.Methods In April 2013,HCWs in a general hospital were selected by randomly sampling method,questionnaires were used to survey the implementation of HH in recent one month and HCWs’cognition on knowledge about HH.Results A total of 750 HCWs were in-vestigated,652 available questionnaires were collected.The frequency of hand washing and hand disinfection per day among most HCWs were 10 - 19 times,accounting for 46.62% and 47.85% respectively;30.52% of HCWs washed their hands for ≥30 seconds each time,60.58% of HCWs dried hands with paper towel after washing hands,57.21 % of HCWs abided by six-step hand washing method.The overall correct rate of cognition on ten op-portunities that requiring HH in clinical practice was 68.68%.The main factors influencing the implementation of HH were as follows:skin irritation of hand sanitizer and hand disinfectant subjectively considered by HCWs (63.34%),inadequate hand washing facilities(41 .10%);high cost of hand sanitizer ,hand disinfectant,and dry paper towel (38.96%),et al.Conclusion In addition to intensifying education on HH,installing rational HH facili-ties and improving HH standard are key points in strengthening HH in general hospital.
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Objective To investigate healthcare-associated infection(HAI)prevalence and antimicrobial use in a hospital.Methods HAI prevalence rate,antimicrobial use and pathogen detection in all inpatients on August 21 , 2013 were investigated with cross-sectional survey method.Results A total of 2 238 inpatients were investigated, 104 patients developed 126 times of HAI,HAI prevalence rate and case rate was 4.65% and 5.63% respectively;the top four sites for HAI were lower respiratory tract (28.57%),upper respiratory tract(18.25%),urinary tract (7.94%)and gastrointestinal tract(4.76%).Rate of specimens delivered for detection was 91 .35%(95/104),the main specimen was sputum (26.32%),followed by blood (25.26%)and urine (10.53%).Antimicrobial usage rate was 24.58%,therapeutic,prophylactic plus therapeutic,and prophylactic use accounted for 36.55%,45.09%, and 18.36% respectively;the usage rate of single,combination of 2,and 3 antimicrobial agents accounted for 75.82%,20.91 % and 3.27% respectively.Risk factors of HAI were age (60 years),all kinds of inva-sive procedures (tracheotomy,mechanical ventilation,urinary catheterization,arteriovenous intubation,hemodialy-sis),and anti-tumor chemotherapy.Conclusion Survey on HIA prevalence helps to know the occurrence of HAI and usage of antimicrobial agents,as well as risk factors and high-risk departments of the occurrence of HAI,it also provides basis for subsequent targeted monitor on HAI.
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Objective To study the clinical characteristics of primary Sj(o)gren's syndrome (pSS) patients with dry eyes.Methods Ninety-six pSS patients with dry eyes admitted to the Department of Rheumatology and Immunology,the Affiliated Hospital of Guilin Medical College from August 2009 to August 2011 were retrospectively analyzed.Results In all 96 patients,89 patients had symptoms,23 of whom had two or more symptoms.The tear-film break-up time (BUT) of 154 eyes were Less than 5 seconds,18 were between 5-10 second,and twenty were more than 10 seconds,with the average of 3.7±1.9 seconds.The length of tear flow of 154 eyes'width of tear mocus was less than 3 millimetres (mm),with the average of (0.21±0.10) mm.The average score of corneal fluorescein staining score was 5.2±2.4.The wet lengths of filter paper of 192 eyes were all less than 10 mm/5 min,with the average of (4.6±1.8) mm.The average score of meibomian gland function was 1.5±0.9.Conclusion In patients with pSS,the width of tear meniscus and the wet lengths of filter paper are reduced,which implies less tear secretion.At the same time,BUTs are short,and the Meibomian gland dysfunction are observed.Dry eyes of pSS are mixed in type,not only aqueous tear deficiency.
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ObjectiveTo assess the efficacy of low-dose intravenous cyclophosphmide (IV CTX) in treatmerit of old patients with systemic lupus erythematosus(SLE).MethodsTwenty-three old patients with newly diagnosed, untreated SLE were included.Patients received 3 times fortnightly IV CTX pulses at a fixed dose of 400mg followed by 3 monthly pulses.All patients were orally administered 0.8mg/kg of prednisone.The changes of the indexes were observed before and after 12 weeks treatment including the scores of SLE disease activity index(SLEDAI) and the levels of C3, C4 ,24-hour urinary protein and anti-dsDNA antibody.ResultsAmong 23 patients, 19 were followed up to 24 weeks, SLEDAI 4 weeks after treatment were all significantly lower than those before the treatment (P ＜0.01).At week 8, SLEDAI continued to decrease(P ＜0.05).At week 4,the level of urine protein, the levels of complements C3 and C4 and ds-DNA decreased significantly compared with that before the treatment (P ＜0.05).ConclusionIntensive low-dose CTX plus prednisone was effective in newly diagnosed, untreated old patients with SLE, and could reduce adverse effect.