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Objective To investigate the possession of ultrasound equipment and use of point-of-care ultrasound (POCUS) in emergency department of tertiary hospitals in China to figure out the present condition of POCUS in the emergency department. Methods Questionnaire survey was performed through the internet, which included equipment possession, usage, and the sterile technique of the probe in the emergency department of tertiary hospitals. Results Between September and December in 2018, a total of 2 994 questionnaires link was clicked, and 718 survey responses were collected. After removing duplicated and non-tertiary hospitals questionnaires, the final questionnaire survey covered 300 tertiary hospitals, of which 250 were tertiary A hospitals (83.3%). The number of emergency department which own bedside ultrasound machine was 173 (57.7%), 40.6% (122) of the departments had only one ultrasonic machine. The main sources of equipment were new bought machines (119, 68.8%), given (38, 22.0%) or rented old machines from the ultrasound department (42, 24.3%). None of the emergency physicians in 92 (30.7%) departments mastered the POCUS skills, and 52.7% of the response hospital had less than a quarter emergency physicians grasp the skills. Fees of the POCUS could be charged in 52 (30.1%) of them. The main methods to clean or sterilize the probes were to wipe the probe by cleaning dry paper (97, 56.1%), sterile wet paper (69, 39.9%) or special probe disinfector (23, 13.3%), and used probe protective sleeve and sterile gel (12, 6.9%) as necessary; 79 (45.7%) departments had no conventional probe disinfection measures. When the ultrasonic was used to guide the punctures, the prevention of infection policies were the sterile gloves and saline (106, 61.3%), disposable probe protective sleeve and sterile gel (55, 31.8%). Conclusions The propagation of POCUS in emergency department is needed to develop in tertiary hospitals in China. The right way to clean the probes need to be emphasized.
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Objective To investigate the risk factors and outcome of non HIV pneumocystis jirovecii pneumonia (non HIV-PJP) patients complicated with cytomegaloviremia. Methods A total of 101 non HIV-PJP patients treated in Beijing Union Medical College Hospital in 2014 were retrospective analyzed. The cytomegaloviremia was defined as plasma cytomegalovirus DNA (CMV-DNA) ≥ 500 copies/mL, and patients were divided into the cytomegaloviremia group and non cytomegaloviremia group. Demographics, clinical features, endoscopic appearance and treatment of patients in the two groups were analyzed. Chi-square test and other method of univariate statistical analysis were performed. Logistic regression analysis was used to analyze the independent risk factors for non-HIV-PJP combined cytomegaloviremia. Results Of the 93 non-HIV-PJP patients, the incidence of cytomegaloviremia were 44.1％. Univariate analysis showed that risk factors of PJP patients complicated with cytomegaloviremia were female, lymphocyte count, C-reactive protein (CRP), positive hexamine silver staining, positive pneumocystis jirovecii pneumonia DNA (PJP-DNA), and invasive mechanical ventilation. Multivariate logistic regression analysis showed that independent risk factors of PJP patients complicated with cytomegaloviremia were female (OR=4.222, 95％CI:1.453-12.271, P=0.008), coinfection of fungal (OR=10.113, 95％ (OR=10.113, 95％CI:1.38-74.102, P=0.023) and invasive mechanical ventilation (OR=4.62, 95％CI:1.478-14.444, P=0.008). Conclusions During the same hospital stay, the prevalence of non-HIV-PJP patients complicated with cytomegaloviremia was higher, and the independent risk factors were female, coinfection of fungal, and invasive mechanical ventilation.
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Pneumocystis pneumonia ( PCP) is a disease affecting immunocompromised patients.PCP among these patients is associated with significant morbidity and mortality.In this paper, the prevention crowd of prevention, the effective of prevention and means of prevention are reviewed.
