Epidemiology of CRKP Infection Outbreak in a Neonatal Intensive Care Unit / 昆明医科大学学报

Objective To analyze the epidemiological characteristics of an outbreak of carbapenem resistant Klebsiella pneumoniae(CRKP)hospital infection in the neonatal intensive care unit(NICU),and to explore possible causes of the outbreak.Methods Case analysis,epidemiological studies and environmental detection methods were used to investigate the detection of CRKP in the NICU of a hospital from March 11,2022 to May 3,2022,and the causes and corresponding prevention and control measures were analyzed.Results This CRKP outbreak in the NICU occurred in two phases.The first phase was from March 11,2022,to March 30,2022,during which 3 people contracted CRKP hospital infections.The second phase was from April 13,2022,to May 3,2022,during which 4 people contracted CRKP hospital infections.The source of the hospital infection outbreak was patient No.1.All 13 CRKP cases showed sensitivity only to amikacin and tigecycline,with intermediate sensitivity to levofloxacin,and high resistance to other antibiotics.All 13 CRKP cases carried resistant genes for metalloenzymes.After the outbreak,the ward environment was sampled three times,with 35 samples taken in total,and 14 of them tested positive for CRKP.After strict environmental cleaning,disinfection,and multiple control measures,no new hospital infection cases similar to this outbreak were detected after May 13,2022.Conclusion The outbreak of NICU hospital infections may be due to the contamination of the ward environment,medical equipment,and inadequate hand hygiene of medical staff,leading to its spread.Therefore,strict cleaning and disinfection of the environmental surfaces,strengthening hand hygiene of medical staff,and implementing multiple measures can effectively control hospital infections of CRKP.

Supramolecular solvent (SUPRASs) extraction method for detecting benzodiazepines and zolpidem in human urine and blood using gas chromatography tandem mass spectrometry.

OBJECTIVE: A high-throughput and sensitive method using supramolecular solvent (SUPRASs) for detecting 9 benzodiazepines and zolpidem in human urine and blood by gas chromatography-tandem mass spectrometry (GC-MS/MS) was newly established and applied to authentic human urine and blood samples in this study. METHODS: Urine and blood samples were subjected to liquid-liquid extractions with supramolecular solvent mixture which consists of tetrahydrofuran and 1-hexanol. The solvent layer was evaporated to dryness by stream of nitrogen. The residue was reconstituted with methanol, and subjected to analysis by GC-MS/MS in multiple reaction monitoring (MRM) mode; internal standard method was employed for quantifying of each targeted compound. RESULTS: The regression equation has a good linear relationship with correlation coefficients for all tested compounds were not lower than 0.9991. The lower limits of the quantification ranged from 0.20 to 5 ng/mL for tested compounds in urine; Meanwhile, the lower limits of the quantification in this method ranged from 1 to 50 ng/mL for tested compounds in blood. These results showed that excellent reproducibility and satisfactory extraction recovery rates could be obtained for the established analytical method for 10 drugs in both blood and urine samples. CONCLUSION: The established method in this study was high-throughput, simple and sufficiently sensitive for determining of benzodiazepinesand zolpidem in human urine and blood. Therefore, this newly established method could be of use for qualitative and quantitative determination of such drugs in urine and blood samples either for clinical poisoning monitoring or for forensic identification.

Risk Factors of Nosocomial Infection in 383 Children with Hypospadias after Operation and Nursing Countermeasures / 中国实用护理杂志

Objective To explore the main risk factors of hospital infection in children with hypospadias after operation and to formulate targeted nursing measures so as to provide accurate nursing strategies for effective prevention and control of hospital infection after operation. Methods Totally 383 children who underwent hypospadias surgery in the hospital from January 2016 to December 2017 were selected as the research objects. The clinical data of all cases were reviewed and sorted out. The hospital infection rate, infection site and main risk factors of hospital infection after operation were analyzed to formulate prevention strategies. Results 71 of 383 children suffered from hospital infection, and the incidence rate of hospital infection was 18.5% .The distribution of infection sites was: respiratory tract infection in 30 cases, accounting for 42.25% ;Urinary tract infection was found in 25 cases (35.21% ). Incision infection was found in 14 cases (19.72%).Gastrointestinal infection occurred in 2 cases (2.82%). Logistic multivariate analysis showed that age, length of hospital stay after operation were closely related to hospital infection. Conclusions The major risk factors for postoperative nosocomial infection in children with hypospadias are age and postoperative hospital stay.Nursing measures: The hospital stay of children after operation can be shortened as much as possible by reminding and standardizing the routine maintenance of urinary catheter and strengthening the cooperation between doctors and nurses through charts. Strict implementation of visiting and accompanying system, good environmental control, strengthening hand hygiene, standardization of preoperative skin preparation and other nursing measures are adopted to protect children to the greatest extent.

Risk Factors of Nosocomial Infection in 383 Children with Hypospadias after Operation and Nursing Countermeasures / 中国实用护理杂志

Objective@#To explore the main risk factors of hospital infection in children with hypospadias after operation and to formulate targeted nursing measures so as to provide accurate nursing strategies for effective prevention and control of hospital infection after operation.@*Methods@#Totally 383 children who underwent hypospadias surgery in the hospital from January 2016 to December 2017 were selected as the research objects. The clinical data of all cases were reviewed and sorted out. The hospital infection rate, infection site and main risk factors of hospital infection after operation were analyzed to formulate prevention strategies.@*Results@#71 of 383 children suffered from hospital infection, and the incidence rate of hospital infection was 18.5%.The distribution of infection sites was: respiratory tract infection in 30 cases, accounting for 42.25%;Urinary tract infection was found in 25 cases (35.21%). Incision infection was found in 14 cases (19.72%).Gastrointestinal infection occurred in 2 cases (2.82%). Logistic multivariate analysis showed that age, length of hospital stay after operation were closely related to hospital infection.@*Conclusions@#The major risk factors for postoperative nosocomial infection in children with hypospadias are age and postoperative hospital stay.Nursing measures: The hospital stay of children after operation can be shortened as much as possible by reminding and standardizing the routine maintenance of urinary catheter and strengthening the cooperation between doctors and nurses through charts. Strict implementation of visiting and accompanying system, good environmental control, strengthening hand hygiene, standardization of preoperative skin preparation and other nursing measures are adopted to protect children to the greatest extent.

Study on the current situation and related factors of perioperative pain management for the patients with fracture / 重庆医学

Objective To find out the current situation and related factors of perioperative pain management for the patients with fracture among the top three hospitals in our region.Methods A general information questionnaire was made,to survey the the status and the influencing factors of top hospital nursing work of fractures patients with perioperative pain management.The researchers label the questionnaire with the method of digital label,and the data collected are kept secret,and the statistical method is used to evaluate it.Finally,the conclusion is drawn.Results The working life of the nursing staff,nursing education,nursing staff after underwent fracture perioperative pain knowledge of continuing education is the mainly factors to affect patients surfing with fracture,perioperative pain management cycle of practice the three most important factors.Conclusion Three tertiary hospitals in the area fracture nursing of pain management need to be strengthened.we strengthen fractures patients with perioperative pain management cycle practice by training of clinical nursing staff.

Predictors and scoring system of intravenous immunoglobulin resistance with Kawasaki disease / 国际儿科学杂志

Kawasaki disease (KD),an acute systemic vasculitis with a predilection for Asian children,mainly affects infants and children under 5 years of age.They may develop coronary artery lesions(CAL) if not given treatment in time.Presently the standard therapy of Kawasaki disease is high dose intravenous immunoglobulin (IVIG)combined with oral aspirin,which reduces the incidence rates of coronary artery lesions to 3 ％-5％.However,some KD patients are resistant to IVIG therapy and they are at higher risk of developing coronary artery lesions than responders to IVIG therapy.Owing to the low sensibility of Kobayashi and Egami scoring system,exploring new biomarks such as genes and cytokines is necessary.A high sensitive scoring system based on clinical data should be established to predict IVIG nonresponders.Other therapeutic methods can be adopted for IVIG resistance patients.Predictors and scoring system of intravenous irnmunoglobulin resistance to KD are summarized in this article.

Serum IL-17A, IL-18, and SCD25 (IL-2R) in early diagnosis of Kawasaki disease / 临床儿科杂志

Objective To investigate the acute phase expression of serum cytokines in children with Kawasaki disease (KD) and its association with coronary artery lesions (CALs). Methods Expression of 13 cytokines in serum of 104 KD patients including 11 cases with CALs and 74 febrile control cases admitted to the hospital from October 2016 to March 2017 were retrospectively analyzed. Results Interleukin (IL)-8, IL-1, IL-2, IL-6, IL-10, IL-17A, IL-18, tumor necrotic factor-α and SCD25 (IL-2R) were declined significantly after intravenous immunoglobulin administration (IVIG) in KD patients (all P<0.05). Compared with the fever control group, Pre-IVIG, an IL-17A level ≥ 0.155 pg/mL had a sensitivity of 50% and 93.2% specificity for predicting KD; IL-18 level ≤ 15.43 pg/mL had a sensitivity of 71.2%, and the specificity was 54.1%; SCD25 (IL-2R) ≥ 29475.29 pg/mL had a 65.4% sensitivity and 81.1% specificity for predicting KD. Before IVIG treatment, the level of IL-10 was significantly lower in KD patients with CALs than in those without CALs. Conclusions Determination of various cytokines profile may be helpful for predicting the disease prognosis and targeting treatment strategies in patients with KD.

Help-seeking behavior among individuals with overactive bladder in type 2 diabetes mellitus and its influencing factors / 中国实用护理杂志

Objective To estimate help-seeking behavior among individual with overactive bladder (OAB) in type 2 diabetes mellitus and its influencing factors.Methods This was a cross-sectional survey with a representative sample of 133 patients with OAB in type 2 diabetes mellitus responded the questionnaires,including a self-designed Demographic Data Questionnaire,12-item Short-Form health survey questionnaire,Overactive Bladder Symptom Score,Patient Perception of Bladder Condition,Help-seeking Behavior Questionnaire.Results Among cases,21.8％(29/133) had seen a doctor for voiding problems.In the Logistic model,educational status,Charlson comorbidity index,glycosylated hemoglobin,and OAB symptom bother were found to be associated with help-seeking behavior,OR value(95％ confidence interval) were 3.158(1.511-6.599),2.537(1.327-4.849),0.631(0.430-0.926),1.655(1.126-2.434),P ＜0.01 or 0.05.Conclusions The help-seeking rate of OAB individuals in type 2 diabetes mellitus patients is low.Health care providers should understand the predictors of help-seeking behavior and take actions to improve patient's health care utilization and quality of life.

Distribution of Inflammatory Cells and Expression of PSGL-1 in Infant Brainstem Tissue Related Fatal Brainstem Encephalitis / 法医学杂志

Objective To explore the distribution of inflam m atory cells and positive expression of P-se-lectin glycoprotein ligand-1 (PSG L-1) in infant brainstem tissue from hand-foot-m outh disease related fatal brainstem encephalitis. Methods Tw enty brainstem sam ples from infants suffered from brainstem en-cephalitis w ere collected as the experim ental group. Ten brainstem sam ples from infants died of non-brain diseases and injuries w ere collected as the control group. The distribution of inflam m atory cells and the expression of PSG L-1 in the tw o groups w ere exam ined by im m unohistochem ical m ethod. The characteristics of the positive cells w ere observed. Results In brainstem tissue of the experim ental group, there w ere sleeve infiltrations of inflam m atory cells around the vessels and in the glial nodule. Microglia was the m ost and following was neutrophils around the vessels and in the glial nodule. There was a significant statistical difference am ong m icroglias, neutrophils and lym phocytes (P<0.05). There was no sleeve infiltration in the control group. PSG L-1 protein was expressed w idely in inflam m atory cells in the experim ental group, especially in the inflam m atory cells around the vessels and in the glial nodule. B ut PSG L-1 positive staining could be observed significantly less in the control group com paring with the experim ental group (P<0.05). Conclusion Microglia is the m ain type of inflam m atory cells involved in the progress of the fatal disease. Moreover, PSG L-1 could participate in the pathogenesis of hand-foot-m outh disease related fatal brainstem encephalitis.

Application of the health belief model combined with PDCA circulation in preventing DVT of orthopaedic patients / 中国实用护理杂志

Objective To evaluate the effect of health belief model combined with PDCA circulation in preventing DVT of patients undergoing total hip replacement and total knee replacement.Methods Patients who met our inclusion criteria were randomly divided into the intervention group and the control group with 45 cases in each group.The patients in the control group received routine health education.In addition,the intervention group received health education based on health belief model combined with PDCA circulation besides the routine.The intervention results were compared between the two groups.Results The patients' mastery of DVT disease related knowledge,health belief and the implementation of preventive measures in the intervention group were significantly better than those of the control group one week after surgery.The score of the health belief,perceived susceptibility,perceived severity,perceived benefits of action and serf-efficacy in the intervention group were significantly superior to those of the control group.1 patient appeared blood stasis in the intervention group.However,in the control group,there were 2 patients with DVT and 6 patients with blood stasis.The effect of preventive measures in the intervention group was better than the control group.Conclusions Health education based on health belief model combined with PDCA circulation could effectively enhanced the patients' DVT disease related knowledge,health belief and the implementation of preventive measures,thereby reduce the risk of DVT and improve the patients' quality of life.

Effects of Shenqi Fuzheng Injection on the Expression of MMP-3 and TIMP-1 in Rats with Congestive Heart Failure / 中国药房

OBJECTIVE: To observe the effects of Shenqi Fuzheng injection on the expression of MMP-3 and TIMP-1 in congestive heart failure model rats.METHODS: The experimental rats were randomly divided into 6 groups,i.e.normal group,model group,captopril(10 mg?kg-1)group,Shenqi Fuzheng injection low dosage(2 mL)group,Shenqi Fuzheng injection medium dosage(4 mL)group,and Shenqi Fuzheng injection high dosage(6 mL)group.All except the normal group were intraperitoneally injected with adriamycin on the first experimental day.After drug intervention for 8 weeks,the rats were anesthetized and sacrificed,with heart specimen sampled rapidly for pathological examination and semi-quantitative analysis of myocardial MMP-3 and TIMP-1 mRNA by RT-PCR method.RESULTS:In the model group compared with the normal group,MMP-3 mRNA were significantly increased(P

Clinical Observation on Shilin Qinghua Decoction for Treatment of Urinary Calculi / 广州中医药大学学报

Objective To observe the therapeutic effect of Shilin Qinghua Decoction(SQD) for the treatment of urinary calculi.Methods Two hundred urinary calculi patients were equally randomized into two groups: the treatment group received SQD(mainly composed of Herba Lysimachiae,Endothelium Corneum Gigeriae Galli,Radix Paeoniae Alba,Talcum,Radix Clematidis,Poria,Semen Vaccariae,Herba Plataginis,Herba Polygoni Avicularis,Herba Dianthi,Succinum powder),and the control group received uralyt.Twenty days constituted one treatment course,and the treatment lasted 1～3 course(s) according to the illness state.The therapeutic effect was evaluated after 2 months.Results The total effective rate was 96.0% in the treatment group and 81.0% in the control group,the difference being obviously significant(P

MEASUREMENTS OF SERUM FOLATE AND VITAMIN B_12 IN HEALTHY SUBJECTS / 营养学报

Serum folate and vitamin B12 were measured in 171 healthy children under 14 years of age, 30 normal adults and 30 samples of normal cord blood. All the 171 children had been supplied with adequate folic acid and vitamin B12 before measurements. The results -were: 1. The lower limits of normal serum folate values were 6.1 nmol/L under 4 years, 8.4 nmol/L at age of 4-14 years and 5.0 nmol/L in adults. 2. The lower limits of normal serum vitamin B12 values were 459 pmol/L under 1 year and 107 pmol/L at age of 1 year to adults.