Construction and maintenance of the pharmacy intravenous admixture service / 中国医学装备

Objective: The construct a pharmacy intravenous admixture service (PIVAS) for changing configuration of intravenous drugs from decentralized configuration to centralized allocation supply so as to guarantee the safety of clinical drugs of hospital. Methods: Through constructed PIVAS, adopted purified air-condition system and established fluid-layers room of different grade to achieve sterile environment for configuration of intravenous drugs. And the centralized allocation should be implemented as the characteristics of different drugs. Results: The PIVAS could reduce the waste of drugs and decrease their cost. At the same time, it guaranteed the safety of clinical medication of hospital on the bases of enhancing work efficiency of clinical nurse and reasonably resolving allocation of human resources. Conclusion: The PIVAS that changes the configuration of intravenous drugs from decentralized configuration to centralized allocation supply can positively and effectively promote the safety of clinical medication and increase work efficiency of nursing and care.

Retrospective study on the prevention of infection in patients with hematological malignancies after chemotherapy in a class 100 laminar flow ward / 中国感染控制杂志

Objective To explore the value of class 100 laminar flow ward in the prevention of infection in patients with hematological malignancies(HM) after chemotherapy.Methods Patients with HM and received chemotherapy in the department of hematology in a hospital from March 2016 to February 2017 were surveyed retrospectively,according to patients' wishes,those who were admitted to the class 100 laminar flow ward and received chemotherapy were as trial group,and those who were admitted to the common ward and received chemotherapy were as control group.The incidence of infection,duration of fever,antimicrobial use time,length of hospital stay,and index of infection were compared and analyzed between two groups.Results A total of 267 patients with HM received chemotherapy,74 cases in trial group and 193 in control group.During the chemotherapy period,incidence of infection in trial group was lower than that of control group (47.3％ vs 72.0％,P＜0.001).Respiratory tract,digestive tract,and urinary tract were main infection sites in both groups.A total of 45 strains of pathogens were isolated from two groups of patients,7 strains were isolated from trial group and 38 from control group.The isolated pathogens were Escherichia coli,Klebsiella pneumoniae,Stenotrophomonas maltophilia,Pseudomonas aeruginosa,and yeast.Duration of fever,antimicrobial use time,and length of hospital stay in trial group were all lower than control group (all P＜0.05);serum procalcitonin (PCT) and C-reactive protein (CRP) levels in trial group were both lower than control group(both P＜0.01),the time for PCT and CRP to return to normal in trial group were both lower than control group(both P＜0.05).Conclusion Patients with MH and receive chemotherapy in class 100 laminar flow ward can reduce the incidence of infection,shorten the length of stay,and reduce the economic burden,it is worthy of further clinical promotion.

Design and experimental research on mobile class 1000 laminar flow clean field surgery unit / 医疗卫生装备

Object To design a mobile class 1000 laminar flow clean field surgery unit to provide a clean space to facilitate the mobile medical rescue team to execute emergency operations in the field tent, private house and etc.Methods The principle of positive pressure isolation and finite element simulation were involved in the design of two-way air intake channel on the top, flexible isolation laminar flow clean module which could be constructed rapidly, three-stage composite clean air supply module and integrated surgery module with box instrumentation.Results The field surgery unit had all its performances meet the desired requirements, of which, the ventilation rate was 24 times per hour, the relative positive atmospheric pressure value was higher than 5 Pa in the surgical unit, and the cleanness reached level 6 at the operating and surrounding areas.Conclusion The field surgical unit can be deployed rapidly, and has the key indexes accord with the desired requirements for cleanness, ventilation rate and positive pressure difference, and thus can be used for the surgery support of the mobile medical rescue team during wartime operations and emergency medical rescue.

Effect of class 10000 laminar flow ward on the incidence of healthcare-as-sociated infection in patients with initial occurrence of acute leukemia dur-ing induction chemotherapy period / 中国感染控制杂志

Objective To evaluate the effect of class 10000 laminar flow ward on the incidence of healthcare-asso-ciated infection (HAI)in patients with initial occurrence of acute leukemia during induction chemotherapy period. Methods Patients with initial occurrence of acute leukemia admitted to a hematological department of a hospital be-tween October 2013 and June 2014 were investigated retrospectively,patients in class 10000 laminar flow ward was as trial group,in general ward was as control group. All patients received standard induction chemotherapy and the same nursing measures,the incidence of HAI between two groups of patients,and ward air cleanliness were com-pared.Results A total of 79 patients with initial acute leukemia were received (trial group,n= 39;control group, n= 40). The average air cleanliness value in rooms and corridors of laminar flow wards were both significantly dif-ferent with general ward (3.57×106/m3 vs 149.36×106/m3 ,t= 45.80,P<0.001;24.46×106/m3 vs 15854.38 ×106/m3 ,t= 108.70,P<0.001). Incidence of HAI between trial group and control group was significantly differ-ent (23.08% [9/39]vs 45.00% [18/40],χ2= 4.219,P= 0.040). The main infection site in trial group was gastro-intestinal tract (n= 5 ),in control group was lower respiratory tract (n= 8 ). The duration of fever,duration and cost of antimicrobial use in trial group were (6.20±2.10)d,(9.35±2.12)d,and (27113.79±1559.03)yuan re-spectively,in control group were (10.20±2.90)d,(14.15±3.14)d,and (58566.29±2217.54)yuan respectively, difference in duration of fever and cost of antimicrobial use between two groups were all significant(t= 1.021, 1377.45,both P<0.05).Conclusion Laminar flow ward can reduce the incidence of HAI in patients with initial occurrence of acute leukemia,and decrease cost of antimicrobial use.

Preventive effect of laminar flow bed on hospital infections in patients with leukemia after chemotherapy:A Meta-analysis / 现代临床护理

Objective To compare the effect of laminar flow bed in the prevention of hospital infections in patients with leukemia after chemotherapy. Method The Meta-analyses were done on Meta RevMan5.0 by retrieving the domestic databases from January 1999 to January 2014 to look into and compare the hospital infections in leukemic patients using laminar flow beds and common beds, including of the rate of hospital infection, duration of fever, days for antibiotic use, hospital stay. Results A total of 16 papers were included. The Meta analyses showed that the rate of hospital infection in the wards with laminar flow beds was significantly lower than that in the wards with common beds (RR=0.54,95%CI (0.47, 0.62), P<0.01). The fever duration, time for antibiotics use and hospital stay in patients in the wards with laminar flow beds were all significantly shorter than those in the patients in the wards with common beds [WMD=-3.64, 95%CI (-4.83,-2.46);WMD=-4.13, 95%CI (-5.95,-2.32)];WMD=-5.36, 95%CI (-7.52,-3.20);P<0.01,respectively)]. Conclusion Laminar flow beds are effective in preventing hospital infections among acute leukemic patients having undergone chemotherapy.

Comparison in disinfection methods and flora detection for object surfaces in laminar flow general intensive care unit / 中国感染控制杂志

Objective To compare the bacteriostasis effect of two disinfectants on frequently touched object sur-faces in laminar flow general intensive care unit (GICU),and investigate bacterial contamination on the object sur-faces,so as to provide reference for proper disinfection method and control of infection.Methods Specimens from surfaces of bed rails and bedside tables were taken for bacterial culture before being disinfected.Then object sur-faces around bed units were disinfected with disinfectant containing 500 mg/L of available chloride (routing group) and GammaTM disinfecting wet wipes (control group)respectively,bacteriostasis rate and qualified rate of bacterial count on object surfaces between two kinds of disinfection methods were compared.Results Before routine disinfec-tion,a total of 87 pathogens were isolated from 200 specimens of object surfaces,bacterial contamination rate was 43.50%. Detection rate of gram-positive bacteria was 78.16%% (n =68),the major were Corynebacterium (26.47%,n = 18), Staphylococcus aureus (23.53%,n=16)and Staphylococcus epidermidis (23.53%,n=16);detection rate of gram-nega-tive bacteria was 21.84%(n=19),the major was Acinetobacter baumannii (63.16%,n=12).After a 10-minute disinfec-tion on surfaces,bacteriostasis rate of routine group and control group was (94.89±7.72)% and(96.33 ±12.88)% re-spectively,there was no significant difference between two groups(P >0.05);qualified rates of bacterial count of object surfaces of two groups were both 100%.Conclusion Regular disinfection of object surfaces around bed units,stand-ardization of the manipulation and hand hygiene compliance of medical personnels are simple and effective method of cutting off bacteria dissemination and preventing healthcare-associated infection.

Investigation in current status of nosocomial infection after renal transplantation / 中国实用护理杂志

Objective To understand the current status of nosocomial infection after renal trans plantation. Methods106 patients after renal transplantation were randomly divided into the laminar flow ward group (54 cases)and the ICU group (52 cases).The nosocomial infection situation of the twogroups was compared.ResultsThe rate of nosocomial infection in the laminar flow ward group was lower than that in the ICU group.The number of bacterial colony in laminar flow wards was less than that in ICU.Conclusions The rate of nosocomial infection in the laminar flow ward was lower than that in the ICU after renal tranaplantation.Patients after renal transplantation should he admitted in laminar flow ward in order to reduce the rate of nosocomial infection.

Investigation in job burnout of nursing staff in sterile laminar flow wards and countermeasures / 中国实用护理杂志

Objective To evaluate the job burnout of the nurses in sterile laminar flow wards and offer proposals for improvements.Methods Forty nurses in sterile laminar flow wards were surveyed with MBI-GS.Results The scores of emotional exhaustion,cynicism,job inefficiency were higher after working in sterile laminar flow wards for 3 months than those working in general wards for 3 months.Conclusions The nurses in laminar flow wards are prone to have job burnout.Standardized training,humanized management and positive psvchological intervention can improve the job burnout of the nurses in laminar flow wards.

Laminar flow activation of ERK5 leads to cytoprotective effect via CHIP-mediated p53 ubiquitination in endothelial cells / 대한해부학회지

Atherosclerosis is readily observed in areas where disturbed flow is formed, while the atheroprotective region is found in areas with steady laminar flow (L-flow). It has been established that L-flow protects endothelial cells against endothelial dysfunction, including apoptosis and inflammation. It has also been reported that extracellular signal-regulated kinase 5 (ERK5) regulated endothelial integrity and protected endothelial cells from vascular dysfunction and disease under L-flow. However, the molecular mechanism by which L-flow-induced ERK5 activation inhibits endothelial apoptosis has not yet been determined. Transcription factor p53 is a major pro-apoptotic factor which contributes to apoptosis in various cell types. In this study, we found that 15-deoxy-Delta(12,14)-prostaglandin J2 induced p53 expression and that endothelial apoptosis was reduced under the L-flow condition. This anti-apoptotic response was reversed by the biochemical inhibition of ERK5 activation. It was also found that activation of ERK5 protected endothelial apoptosis in a C terminus of Hsc70-interacting protein (CHIP) ubiquitin ligase-dependent manner. Moreover, molecular interaction between ERK5-CHIP and p53 ubiquitination were addressed with a CHIP ubiquitin ligase activity assay. Taken together, our data suggest that the ERK5-CHIP signal module elicited by L-flow plays an important role in the anti-apoptotic mechanism in endothelial cells.

Effect of Air Quality in Two Kinds of Operating Rooms on Abdominal Incision Site Infection / 中华医院感染学杂志

4 h,and for class Ⅰ and class Ⅱ operation.

Problems in Cardiac Output Measurement and Clinical Understanding / 대한마취과학회지

Cardiac output measurement is so important that it is widely used in anesthesia and intensive care practice.However, the basic principles for the measurement of each device are not taught for clinicians.This review article describes considerable points for each device; 1) temperature sensors and integration problem for pulmonary artery catheter, 2) angle of ultrasonic probe and meaning of turbulent flow for transesophageal echocardiography, 3) angle of ultrasonic probe and meaning of pulsatile laminar flow for CarioQ, 4) end-tidal and arterial carbon dioxide concentration for Noninvasive cardiac output, 5) the concept of convolution for the arterial pulse wave and arterial resistance for Vigileo, and 6) effect size as a statistical viewpoint of comparison in device effectiveness.As a clinician we should not interpret the value of cardiac output as an absolute meaning, but do as a relative trend considering these theoretical errors.

Air Circumstance in Laminar Flow Operating Room in Beijing:A Crosssection Investigation of 18 Hospitals / 中华医院感染学杂志

OBJECTIVE To investigate the management and sanitation status of the air circumstance in laminar flow operating rooms of grade two and above hospitals in Beijing.METHODS Air surveillance methods,cleaning methods of intakes,cleaning status of pipelines and frequency of renewing filter systems were investigated through interviewing charge nurse of 18 hospitals by questionnaires.RESULTS 50.0% of pipelines had never been cleaned,14.3% of intakes had never been cleaned.Air surveillance method of all hospitals was using sedimentation,with a low sensitivity.The monitoring systems were poor in 50.0% of hospitals.CONCLUSIONS Now there is only requirements of construction standard of clean surgery region,lacking routine regulations and technologies of contamination controlling standard,nor available dynamic contamination controlling system.Potential hazard exists in routine regulations of laminar flow operating room and it demands for making contamination controlling standard urgently in hospitals.

Operation and Maintenance of Horizontal Laminar Flow Cabinet in PIVAS / 中国药房

OBJECTIVE:To introduce the operation instructions and routine maintenance method of horizontal laminar flow cabinet(HLFC) in PIVAS to provide reference for standardized operation of HLFC.METHODS:The standardized utilization and maintenance of HLFC in respects of compositions,operation principle,operation instructions,etc.RESULTS & CONCLUSIONS:The standardized operation and correct maintenance can ensure the dispensation quality of intravenous drugs and extend service life of HLFC.

Hospital infection control for laminar flow operation room / 医学研究生学报

To discuss hospital infection control for laminar flow operation room. Ten measures of hospital infection control have been formulated for laminar flow operation room based on the danger factors of the surgery incision infection and the principle of the air purify process and filtration setting. A set of management system and detailed rules have been founded for the use of laminar flow operation room, to strengthen the notion that the patients are the all. It has met the requirement for the use of air-clean technique and setting, and guaranteed air purity.

A Case of Artifact Mistaken for Cardiac Tumor on Computed Tomography

Laminar flow within large vessels or organs can cause artifact that may simulate thrombus during computed tomographic study. The degree of venous enhancement depends on the size of blood pool and cardiac output in relation to the time of scanning. When venous structures are scanned too fast after injection of contrast material, poor mixing of enhanced and unenhanced blood creates flow artifact that gives an appearance of deep venous thrombosis. As compared with dynamic computed tomography (CT), because of a shorter acquisition time of spiral CT, vascular and organ enhancement on spiral CT scan are more dependent on factor that affect delivery of contrast material into the blood stream. Differentiation from true thrombus can be made by use of delayed scan as well as increased density and finding of relatively poor margination of artifact. In addition, both angiography and echocardiography could complement CT to assure that false-positive results are minimized. We experienced a case of artifact mistaken for intracardiac mass on spiral CT, but it was not noted on echocardiography.