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As a sensitive and non-invasive method for assessing changes in renal cortical blood perfusion in the elderly, contrast-enhanced ultrasound (CEUS) can indirectly reflect changes in kidney filtration and reabsorption function, thus providing feasibility for early evaluation of renal function changes. However, significant differences exist among researchers in terms of operational methods, contrast agent selection, post-data analysis, and many other aspects, leading to substantial heterogeneity in results. This hinders horizontal comparisons and greatly limits the clinical application of contrast-enhanced ultrasound for evaluating renal cortical blood flow perfusion. Based on the latest domestic and overseas literature and discussions with clinical experts, this consensus provides recommended guidelines for the evaluation of renal cortical blood flow perfusion using contrast-enhanced ultrasound. It is hoped that this consensus will promote a better understanding of CEUS among medical practitioners at all levels and standardize the examination of renal cortical blood flow perfusion with CEUS.
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Objective:To investigate the diagnostic efficacy of contrast-enhanced ultrasound(CEUS)for renal artery stenosis in elderly patients and the imaging features.Methods:Clinical and imaging data of 1 074 patients aged 60 years or older receiving renal artery CEUS in our hospital between September 2017 and October 2022 were retrospectively and consecutively collected, and the results of renal artery CEUS were summarized and comparatively analyzed.Results:Among the 1 074 elderly patients, 588(54.7%)patients showed normal renal artery imaging on CEUS, while 486(45.3%)patients exhibited renal artery stenosis.Of the 486 patients diagnosed with renal artery stenosis by CEUS, 94 elderly patients with complete clinical data then underwent DSA.Comparison of CEUS and DSA results from the 94 patients revealed that CEUS was in good agreement with DSA in evaluating different degrees of renal artery stenosis( Kappa value: 0.739, P<0.001). Of the 486 patients with renal artery stenosis diagnosed by CEUS, a total of 684 renal arteries had varying degrees of stenosis(including 288 with unilateral stenosis and 198 with bilateral stenosis), of which 55(8.0%)had diffuse stenosis of the main renal artery, and 629(92.0%)had confined stenosis of renal arteries(609 stenosis sites were located in the proximal segment/entry point, 12 in the middle segment, and 8 in the hilar or segmental renal arteries). Ultrasonography of confined renal artery stenosis showed narrowing of the contrast agent sound beam at the stenosis site, with or without enhancement of contrast intensity; ultrasonography of diffuse renal artery stenosis showed a thin contrast sound beam throughout the length of the renal artery, with either continuous linear changes or intermittently punctuated changes. Conclusions:There is a high detection rate of renal artery stenosis in the elderly, and ultrasonography can not only determine the degree of renal artery stenosis, but also show the location of stenosis and the extent of involvement, with fairly clear imaging characteristics.
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The incidence and mortality of abdominal aortic aneurysm in the elderly are high.The poor prognosis of ruptured abdominal aortic aneurysm is in sharp contrast to the good survival after planned surgery.Endovascular repair is the first choice and maybe the only treatment for elderly patients with abdominal aortic aneurysm.Ultrasound is the preferred imaging method for screening and monitoring abdominal aortic aneurysm, with high accuracy and repeatability, and is an effective means for accurate diagnosis and follow-up monitoring in elderly patients with abdominal aortic aneurysm.This paper reviews research progress on ultrasonic diagnosis and postoperative evaluation of abdominal aortic aneurysm in the elderly, and discusses the important application value and prospect of conventional ultrasound combined with new ultrasound technology in this field.
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Objective:To investigate the imaging characteristics on contrast-enhanced ultrasound(CEUS)of carotid plaque instability and their correlation with histopathological changes in elderly patients.Methods:Twenty-three patients undergone carotid endarterectomy(CEA)at the Department of Neurosurgery of Beijing Hospital from June 2018 to November 2020 were retrospectively enrolled, including 27 males and 5 females, aging from 60 to 87(68.1±6.3)years.They were diagnosed with moderate to severe carotid artery stenosis(50%-99%)based on digital subtraction angiography(DSA).Carotid artery CEUS was conducted before surgery, and HE staining and CD34 immunohistochemical staining were used to record histopathological scores and microvessel density(MVD)counts.Results:The mean pathological score and MVD count were 2.46±0.66 and 37.17±12.88 for 32 cases with hypoechoic patterns, 22.42±0.55 and 38.06±13.66 for 18 cases with mixed echo patterns, and 2.75±0.35 and 23.50±9.192 for 2 cases with strong echo patterns, respectively.CEUS grading was positively correlated with histopathology score and MVD count( r=0.53、0.76, all P<0.01). Conclusions:Low echo and mixed echo plaques are more unstable than strong echo plaques.CEUS can be used to comprehensively assess the vulnerability of atherosclerotic plaques and to decide the optimal surgical time for patients with carotid atherosclerotic plaque stenosis.
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Objective:To deeply understand the real experience of family members of patients in the neurosurgery intensive care unit during the period of accompanying them, and to provide reference for managers to formulate nursing countermeasures to improve the coping ability of family members.Methods:Descriptive phenomenological research method in qualitative research was adopted to conduct in-depth interviews with family members of 12 patients admitted to a neurosurgery intensive care unit in Shanghai, manage the interview data with Nvivo11 software, and use Colaizzi's seven-step analysis method to summarize and analyze the topic.Results:There were four themes: adhere to and do not give up, adhere to was due to the trust and affirmation of the medical care, do not give up was because it was difficult to give up blood kinship, adhere to the hope of life because of patients; timing change of emotional experience, first aid period: helpless to rescue and expecting the condition to stabilize, complication peak: understanding the characteristics of the disease and paying attention to the treatment progress, stable period: uncertain prognosis and desire for emotional companionship.The powerlessness of the future; learn to self psychological adjustment.Conclusions:The family members of patients with severe neurological diseases have both negative experience and positive feelings, and the accompanying experience and needs at different stages of the disease are changing dynamically. According to the cognition and needs of the family members, exploring and developing palliative medicine, tapping the potential of the family members from a positive perspective and improving coping ability are one of the ways to maintain the stable mental health of the family members.
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Objective:To observe the effect of the cortical blood perfusion parameter of wash-in area under curve (iAUC) with contrast-enhanced ultrasound(CEUS) on the effect of short-term outcomes of stent implantation in patients with severe renal artery stenosis (RAS).Methods:Retrospective analysis was performed on 82 patients with unilateral severe RAS who received stent implantation in Beijing Hospital from October 2017 to December 2019. According to the baseline iAUC before CEUS, all patients were divided into the poorly-perfused group (iAUC<850.0 dB×s) (37 cases) and the well-perfused group (iAUC≥850.0 dB×s) (45 cases). Baseline and perioperative clinical-imaging data were analyzed between the two groups. Followed up for 10-12 (11.5±1.7) months, Kaplan-Meier survival curves and Log-rank test were used to analyze the rate of adverse cardiac and renal vascular events and hypertension control rates.Results:Compared with the well-perfused group, the poorly-perfused group showed a longer course of hypertension, more diabetic patients, higher systolic blood pressure, diastolic blood pressure, 24 h average systolic blood pressure, and 24 h average diastolic blood pressure, lower glomerular filtration rate, and severe renal artery stenosis. Besides, the iAUC, wash-out AUC and the peak intensity were lower, the average transit time was longer, and the hypoglycemic treatment rate was higher (all P<0.05). Kaplan-Meier survival curve and Log-rank test analysis showed that the occurrence of cardio-renal vascular events ( HR=0.361, 95% CI=0.144-0.907, P=0.012) and renal function deterioration rate ( HR=0.286, 95% CI=0.090-0.914, P=0.035) in the well-perfused group were significantly lower than those in the poorly-perfused group. The blood pressure results demonstrated that the effective rate of hypertension treatment in the well-perfused group was significantly higher than that in the poorly-perfused group (93.3% vs 59.5%, P<0.001), but the improvement rate of hypertension (60.0% vs 43.2%) and cure rate (28.9% vs 16.2%) were not statistically significant between the two groups(all P>0.05). Conclusions:Severe RAS patients with decreased baseline iAUC often have diabetes, longer duration of hypertension, significantly reduced glomerular filtration rate and more severe RAS, short-term outcomes are worse with stent implantation.
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Objective:To establish and validate a prognostic model of a contrast-enhanced ultrasound scoring(CEUS)system for evaluating renal artery stenosis(RAS)in the elderly.Methods:This was a single-center retrospective study.A total of 324 elderly RAS patients admitted to Beijing Hospital from October 2017 to July 2020 were randomly assigned into the model group(n=174)and the validation group(150)in a 1∶1 ratio.Clinical and imaging data of patients on admission including general conditions, previous medical history, blood pressure, blood creatinine, renal artery stenosis and cortical blood perfusion in the affected kidney and renal function(GFR)at 1-year follow-up were collected.Univariate and multivariate logistic regression was used to establish a model of the CEUS scoring system.The receiver operating characteristic(ROC)curve and area under the ROC curve(AUC)were used to evaluate prediction accuracy.Clinical application value of the CEUS scoring system model was evaluated via decision curve analysis using a nomogram.Results:Baseline clinical and radiomic data had no significant difference between the model group and the validation group( P>0.05). Multivariate logistic regression analysis results showed that age( OR=1.242, 95% CI: 1.081-1.427, P<0.01), diabetes( OR=1.545, 95% CI: 1.107-2.156, P<0.05), blood pressure( OR=1.328, 95% CI: 1.056-1.670, P<0.05), renal function( OR=2.374, 95% CI: 1.216-3.887, P<0.01)and cortical blood perfusion parameter( OR=2.646, 95% CI: 1.553-6.369, P<0.01)were risk factors for the deterioration of renal function during 1 year follow-up.Based on these results, a nomogram for the CEUS scoring system model was drawn, and its consistency index, the C-Index, was 0.725(95% CI: 0.653-0.776). The AUC of the CEUS scoring system was 0.824 and the Youden index was 0.711 in the model group, with a specificity of 0.774 and a sensitivity of 0.837.The AUC of the CEUS scoring system was 0.853 and the Youden index was 0.715 in the validation group, with a specificity of 0.684 and a sensitivity of 0.889.There was no significant difference in ROC curve between the two groups( D=1.387, P>0.05). In addition, calibration charts of the two models showed that the calibration curve of the CEUS scoring system was close to the standard curve, with no statistically significant difference( P>0.05). Conclusions:The CEUS scoring system model can be used to predict the risk of worsening renal function in elderly RAS patients during 1-year follow-up.
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Objective:To further understand the real experience of the nurse in the rotation of NICU in neurosurgery.Methods:Qualitative research method was used to analyze the reflective diary of 26 nurses and the semi-structured interview data of 8 nurses.Results:Three primary themes and 11 secondary themes were extracted from the real experience of rotation of nurses in the neurointensive care unit: department integration and mental process, role competency and influencing factors, career expectations and coping strategies.Conclusions:At present, the integration process of the nurses in the neurointensive care unit is slow. Influenced by many factors, it is difficult to change their roles. It is the direction that nursing managers should pay attention to establish a diversified discipline training system and create a better organizational commitment
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Objective@#To evaluate the characteristics of renal cortical blood perfusion assessed by contrast-enhanced ultrasound (CEUS) in elderly patients with renal artery stenosis (RAS) and its relationship with renal function.@*Methods@#Ninety-three elderly patients diagnosed with RAS, who were admitted in Beijing Hospital during June 2017 and December 2018, were retrospectively enrolled. According to the degree of RAS, 186 renal arteries were divided into normal renal artery group (n=79), mild RAS group (30% to 49%, n=59), moderate RAS group (50% to 70%, n=33), and severe RAS group (70% to 99%, n=15). Renal cortical blood perfusion and renal glomerular filtration rate (GFR) were measured by CEUS and radionuclide renal dynamic imaging. According to the renal GFR, 186 kidneys were divided into normal renal function group (GFR≥35 ml/min, n=42) and mild renal insufficiency group (35 ml/min>GFR≥25 ml/min, n=51), moderate renal insufficiency group (25 ml/min>GFR≥15 ml/min, n=75) and severe renal insufficiency group (GFR<15 ml/min, n=18). The renal cortical blood perfusion time-intensity curve (TIC) and related parameters were analyzed, including the area under the curve (AUC), the slope of the ascending branch (A), the peak intensity (PI), the peak time (TTP) and the mean transit time (MTT), the kidneys of different RAS groups and patients with different renal function groups were analyzed. Pearson correlation analysis was used to evaluate the correlation between renal cortical blood perfusion parameters and renal GFR.@*Results@#(1) Renal cortical blood perfusion and GFR: CEUS showed that parameter A of TIC was significantly reduced, while TTP was prolonged in the mild renal artery stenosis group compared with the normal renal artery group (both P<0.05), GFP was similar between the two groups. Cortical perfusion parameters, such as AUC, A, PI and GFR were significantly lower, while TTP and MTT were significantly prolonged in the moderate and severe renal artery stenosis group than in the normal and mild stenosis groups (all P<0.05). Compared with the moderate stenosis group, AUC, A, PI and GFR were significantly lower while TTP, MTT were significantly prolonged in the severe renal artery stenosis group (all P<0.05). (2) TIC showed that the renal perfusion parameters, AUC, PI and A were significantly lower, while TTP was significantly longer in the mild renal dysfunction group than in the normal renal function group (all P<0.001). The changes aggravated in proportion with renal dysfunction. (3) Correlation between perfusion parameters and GFR: Pearson correlation analysis showed that the AUC (r=0.774, P<0.05), A (r=0.815, P<0.05) and PI (r=0.772, P<0.05) were positively correlated with GFR; serum creatinine level (r=-0.841, P<0.05), renal function grading (r=-0.731, P<0.05), TTP (r=-0.803, P<0.05) and MTT (r=-0.741, P<0.05) were negative correlated with GFR. The degree of stenosis was negatively correlated with GFR (r=-0.427, P<0.05).@*Conclusion@#Cortical perfusion parameters differ significantly among patients with various degree of RAS and renal dysfunction. The renal cortical blood perfusion parameters are correlated with renal GFR.
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Objective To investigate the renal cortical perfusion parameters assessed by contrast-enhanced ultrasound(CEUS)in elderly patients with moderate-to severe renal artery stenosis (RAS),and relationship of those with glomerular filtration rate(GFR).Methods A total of 59 elderly patients with unilateral moderate to severe RAS(50％-99％)admitted into Beijing Hospital during June 2017 to December 2018 were consecutively enrolled in the cross sectional and self-control study.Based on the GFR assessed by radionuclide renal dynamic imaging,patients were divided into the mild-(35＞GFR≥25 ml/min,n=18),moderate-(25 ＞ GFR≥ 15 ml/min,n =37) and severe renal dysfunction(GFR＜ 15 ml · min-1,n =4) groups.CEUS evaluated-renal cortical perfusion parameters,including area under curve (AUC),ascending slope (A),derived peak intensity (DPI),time to peak (TTP) and mean transit time(MTT),were compared among different levels of severity of renal dysfunction groups.Pearson correlation analysis was used to evaluate the relationship between CEUS imaging-evaluated renal cortical perfusion parameters and radionuclide renal dynamic imaging-assessed GFR.Results Compared with the mild renal dysfunction group,the moderate renal dysfunction group showed a reduced AUC and A(P＜0.05),and the severe renal dysfunction group showed more markedly reduced AUC,A,DPI,TTP and MTT (P ＜ 0.05).Compared with the moderate renal dysfunction group,the severe renal dysfunction group showed a reduced AUC,A and GFR(P ＜0.05),while no significant differences in TTP and MTT were found.As far as relationship between renal cortical perfusion parameters and GFR were concerned,Pearson correlation analysis demonstrated that AUC(r =0.804),A(r =0.813) and DPI(r =0.733) were significantly and positively correlated with GFR(all P ＜ 0.05).However,renal function (r =-0.721),TTP(r =-0.744) and MTT(r =-0.743)were negatively correlated with GFR(P＜0.05).And the degree of renal artery stenosis was poorly correlated with GFR (r =-0.462).Conclusions For elderly patients with unilateral moderate to severe RAS,contrast-enhanced ultrasonography can display the changes of renal cortical blood perfusion parameters along with the aggravation of renal function impairment.AUC and A are strongly positively correlated with GFR.The degree of renal artery stenosis is poorly correlated with renal function.And more studies are needed to confirm these findings.
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Objective To explore the clinical value of the contrast-enhanced ultrasound (CEUS) in the diagnosis of renal artery stenosis(RAS).Methods A total of 20 patients(12 males and 8 females) including 40 renal arteries,who were suspected to have RAS were enrolled in Department of Renal,Beijing Hospital.All patients were examined by color doppler ultrasound,CEUS and digital subtraction angiography (DSA).The results of conventional ultrasound and CEUS were compared with the DSA results,respectively.Results All patients had history of hypertension,aged (65 ± 5)years.12 branches (mild 6,moderate 4,severe 2) were RAS by regular ultrasound,17 branches (mild 8,moderate 6,severe 3)were RAS by by CEUS,while 19 branches (mild 9,moderate 7,severe 3) were diagnosed as RAS by DSA.The measure of agreement Kappa between conventional ultrasound and DSA was lower than that between CEUS and DSA (0.77 vs.0.96,P＜0.01).The diagnostic accuracy of mild,moderate and sever RAS with CEUS were 88.9％,94.1％ and 100％,respectively.Conclusions CEUS shows the renal artery more clearly than conventional ultrasound,and has a high consistency with DSA in the diagnosis of RAS.
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Objective To explore the characteristics of renal cortical perfusion with contrastenhanced ultrasound (CEU)in elderly mice.Methods Randomly selected 12 healthy C57BL/6J young mice(aged 1-2 months)and 12 healthy elderly mice(aged 18-20 months)were assigned respectively into the control group and the experimental group.All mice were examined by color Doppler ultrasound and CEU.Renal morphology and hemodynamics were assessed with conventional ultrasound and CEU was used to assess renal microvascular perfusion,analyzing the time-intensity curve(TIC) and related parameters,including slope rate of ascending curve (A),area under curve (AUC),peak intensity (PI),and time to peak (TTP).Results Conventional ultrasound showed similar blood flow dynamics in the renal hilum artery,the renal segmental artery and the renal interlobar artery between the young and elderly mice groups(all P ＞0.05).Moreover,CEU showed slower ascendance of TIC in the elderly mice group(P ＜ 0.05).Furthermore,the elderly mice were associated with significantly decreased A (0.74 ± 0.06 vs.0.89 ± 0.12,P ＜ 0.05) and increased AUC (1420.08± 208.30)dB · s vs.(1261.41± 34.65)dB/s(P＜0.05),delayed TTP(7.75 ±0.88)s vs.(6.93± 0.44) s (P ＜ 0.05),and similar PI (P ＞ 0.05),compared with those in the young mice group.Conclusions Qualitative analysis of CEU is capable of detecting renal perfusion differences between young and elderly nice,which might lay a basis for further study.
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Objective To investigate the clinical value of contrast-enhanced ultrasonography (CEUS)in evaluating renal cortical perfusion in elderly diabetic patients.Methods A retrospective cross-sectional study was conducted.A total of 70 diabetic patients with chronic renal insufficiency stage 1 to 5 were enrolled.The glomerular filtration rate (GFR)was estimated according to the creatinine level.Based on GFR,patients were divided into a mild-to-moderate chronic kidney disease (CKD)group(n=42,CKD stage 1 to 3)and a severe CKD group(n=28,CKD stage 4 to 5).All patients underwent CEUS for the assessment of renal perfusion and renal dynamic imaging for the assessment of GFR.QLAB analysis software was used to obtain the time-intensity curve(TIC)and related parameters including area under the curve(AUC),the ascending slope(A),the derived peak intensity(DP1) and the time to peak (TTP).The differences in renal perfusion parameters were compared between the two groups.Pearson correlation test was used to assess the correlation between the quantitative parameters of renal cortical perfusion and GFR.Results There was no significant difference in age,gender,history of hypertension,basal blood glucose level,systolic or diastolic blood pressure between the two groups (all P ＞ 0.05).CEUS findings revealed high renal cortical blood perfusion in the mild-to-moderate group.There were significant differences in quantitative perfusion parameters including AUC,DPI,A and TTP between the two groups.Pearson correlation test indicated that TTP and A were significantly correlated with GFR in both groups(r =-0.456 and-0.693,0.432 and-0.529,all P＜0.05),while AUC and DPI had no correlation with GFR(r =-0.003 and -0.057,0.066 and-0.081,all P ＞0.05).Conclusions Diabetic patients with mild-to-moderate CKD have high renal cortical blood perfusion.CEUS findings can indirectly reflect renal function.The perfusion parameters A and TTP have good correlations with GFR.CEUS can be used as a safe and effective method to evaluate renal function,especially in patients with severe renal insufficiency,but more studies are needed to verify the results.
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Objective To evaluate the sonographic manifestations of iliac vein compression syndrome (IVCS)in elderly patients.Methods Sonographic data (including gray scale,color Doppler and spectral Doppler ultrasound)of 26 patients diagnosed with IVCS by venogram were analyzed retrospectively,and their sonographic manifestations were categorized.Results The sonographic manifestations of IVCS can be categorized into three types.Type one presented as iliac vein stenosis and an increase in focal blood flow velocity(5/26,19.2％).Type two presented as masses around the iliac vein and vein thrombosis(4/26,15.4％).Type three manifested thrombosis in the iliac vein and deep veins of lower extremity,without obvious masses or iliac vein stenosis (17/26,65.4％).Of all patients,nine were diagnosed with IVCS by ultrasound(9/26,34.6％).The other 17 patients were confirmed by venogram after suggestive ultrasound signs.Conclusions Ultrasound plays an important role in the early diagnosis of IVCS and can help decide on the need for further diagnostic tests.
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Objective_To investigate the potential effect of bone marrow mesenchymal stem cells ( MSCs) on repai-ring the colon epithelial cell,and on the treatment of rats with ulcerative colitis ( UC) .Methods_Monocytes were purified from bone marrow, amplified and identified as MSCs in vitro.Thirty female Wistar rats were randomly di-vided into 3 groups, the normal control, model and MSCs groups (10 rats/group).The rats in model and MSCs groups were induced colitis with trinitro-benzene-sulfonic acid;The rats in normal control group and model groups were injected with 1mL saline via tail vein, while those in MSCs group with 1 mL MSCs suspension.After two weeks, colon tissue samples were analyzed for histopathology,and the colon tissues were made into serial section for determining the distribution of Y chromosome and CK20 double positive cells,analyzing the mRNA levels of CK20,NF-κB, IL-4 by RT-PCR,and assaying colonic NF-κB protein expression with Westen blot,detecting colon tissues IL-4 content with ELISA.Results_Y chromosome and CK20 double positive cells were found in MSCs transplanted colon tissues.The expression of CK20 increased in the colon tissues of UC rats(P<0.01) and in MSCs group in-creased as compared with model group( P<0.01) .The expression of NF-κB increased in the colon tissues of UC rats (P<0.01), but decreased MSCs group as compared with model group (P<0.01).The expression of IL-4 was decreased in the colon tissues of UC rats ( P<0.01) , while in MSCs group it was increased as compared with model group ( P<0.01) .Conclusions_MSCs may have therapeutic efficacy on colitis in rats through differentiating into colon epithelial cells.
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Objective To evaluate the comprehensive medical goal appraisal system on hand hygiene compliance rate of health care workers(HCWs).Methods Comprehensive medical goal appraisal system was adopted to inter-vene hand hygiene compliance rate of HCWs in a comprehensive hospital ,hand hygiene compliance rates of HCWs and consumption of instant hand sanitizer per bed-day before (December 2012)and after intervention (January 2013-June 2014)were compared.Results Hand hygiene compliance rate after intervention was higher than before interven-tion (85.17% [18 208/21 379]vs 39.92%[853/2 137]),hand hygiene compliance rate enhanced by 113.35%(χ2 =2 590. 81,P 90%),consumption of instant hand sanitizer before and after intervention was 7.24 mL/bed-day(4 200 L/579 841 bed-day)and 10.54 mL/bed-day(9 323.5L/884 489 bed-day)respectively,the consumption after intervention increased by 45.58% compared with that before intervention. Conclusion Comprehensive medical goal appraisal can effectively enhance hand hygiene compliance rate ,and maintains at a high level;the measure can affect hand hygiene behavior of HCWs by hawthorne effect,and is an effective and long-term measure to improve hand hygiene compliance of HCWs.
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Objective To improve hand hygiene (HH)compliance of health care workers (HCWs)in neonatal in-tensive care units(NICUs)in China through a series of intervention measures.Methods A multicenter study was conducted,17 tertiary first class hospitals in 9 provinces and cities were selected,HH compliance of HCWs in these hospitals were investigated every month according to HH investigation method of World Health Organization.From October 1 ,2013 to March 31 ,2014 was pre-intervention stage;from April 1 ,2014 to September 30,2014 was post-intervention stage,timely feedback and intensified training were conducted at post-intervention stage.Results HH compliance rates of HCWs before and after intervention were 80.29% and 80.85% respectively,there was no sig-nificant difference (P >0.05).HH compliance rates of HCWs in different sizes of ICUs were significantly different before and after intervention (all P 30 beds were significantly lower than before intervention(P <0.001 );HH compliance rate of cleaners increased from 58.82% before intervention to 68.09% after intervention (P <0.05 );Of different hand hygiene indications,except before clean/aseptic task, compliance to the other HH indications were significantly different between before and after intervention(all P <0.05).Conclusion HH compliance is high among HCWs in NICUs in China,intervention measures,such as inten-sified training and timely feedback have certain influence in compliance to HH among HCWs at different sizes of ICUs,of different occupations,and at different HH indications.
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Objective To investigate the epidemiological characteristics of device-associated infection (DAI)in neonatal intensive care units(NICUs)of tertiary first-class hospitals in China,and provide scientific evidence for the prevention and control of neonatal DAI.Methods Neonates in NICUs at 17 hospitals of 9 provinces from October 2013 to September 2014 were selected for multicenter study,DAI was surveyed prospectively according to the uni-form diagnostic criteria and methods.Results A total of 12 998 neonates were monitored,the total patient-days were 126 125 d,13 cases of central line-associated bloodstream infection (CLABSI)and 70 cases of ventilator-asso-ciated pneumonia (VAP)occurred,central line utilization rate was 15.56%,incidence of CLABSI was 0.66/1 000 device-days;ventilator utilization rate was 7.67%,incidence of VAP was 7.23/1 000 device-days.Utilization rates of central line and respirator in neonates with body weight ≤ 1 000 g was the highest,which were 61 .06% and 29.91 % respectively;In NICUs with 20-30 beds,utilization rate of central line was the highest(16.67%),and res-pirator was the lowest(4.11 %);of hospitals in different regions,central line and respirator utilization rate in south-west China was the highest.Of different sizes of ICUs,VAP per 1 000 device-days was the lowest in NICUs with 20-30 beds(2.36 ‰).Difference in incidence of CLABSI and VAP per 1 000 device-days in neonates at NICUs of different regions were significantly different;incidence of CLABSI and VAP per 1 000 device-days was highest in southern China(2.68 ‰ and 31 .06‰ respectively),followed by southwest region.Of different quarters,incidence of CLABSI,and VAP per 1 000 device-days were not significantly different(all P >0.05).Conclusion Device utili-zation rate and incidence of DAI in China are both high,and are different in neonates of different birth weight,at different sizes of NICUs,as well as different regions,monitoring should be intensified,prevention and control measures should be implemented according to infection characteristics.
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Objective To evaluate the agreement between contrast-enhanced ultrasound imaging and histopathology in rabbit model of abdominal aortic atherosclerosis (AS)in early and development period.Methods Twenty-four healthy Japanese white rabbits were randomly divided into three groups:control group,hypercholesterolemic diet group for 8 weeks and 16 weeks (each for 8 rabbits).Contrast-enhanced ultrasonography for abdominal aorta was performed using sonicated perfluorocarbon albumin contrast agent.Imaging characteristics of abdominal aorta plaque of rabbits were monitored by two-dimensional mode,ultrasound visual grades were analyzed quantitatively before and after injection of contrast agent.Histopathologic changes were observed by HE staining.Results Contrast-enhanced ultrasound imaging allowed early detection of AS and showed gradual progression of atherosclerosis over time.After contrast agent injected,intimal indentification and plaques checking-out ratio were improved.The ultrasound visual grades were increased after contrast imaging in hypercholesterolemic diet group for 8 weeks [(2.26± 0.27)vs.(1.79 ±0.25)] and 16 weeks [(3.54 ±0.43) vs.(3.20 ±0.25)] (all P＜0.05).The plaque detection rate was improved after contrast-enhanced ultrasound imaging than before angiography in hypercholesterolemic diet group for 8 weeks [77.8％ (7/9) vs.55.6％ (5/9)] and 16 weeks [88.2％ (15/17) vs.70.6％ (12/17)](P ＞ 0.05).The imaging of ultrasound agreed well with pathological examination results.Conclusions Contrast-enhanced ultrasonography can effectively improve intimal and plaque imaging,and increase the detection accuracy of early and progressive pathology.
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ObjectiveTo evaluate the applicection value of ultrasonically guided percutaneous puncture and drainage of gallbladder (PPDG) in treating elderly patients with acute cholecystitis.MethodsThe clinical data of 59 elderly patients with acute cholecystitis treated by ultrasonically guided PPDG were retrospectively analyzed and compared with 37 patients treated by cholecystectomy or 13 cases by cholecystostomy.ResultsThe rates of complication and fatality and average hospital days were 32.4 ％ (12/37),5.4 ％ (2/37) and (25.4 ± 16.5 ) d in patients by cholecystectomy and 7.7％(1/13),7.7％(1/13) and (32.0± 12.5) d in patients by cholecystostomy,respectively,while the complication and mortality were not found in patients by ultrasonic ally guided PPDG with average hospitalization of(19.5 ±9.8)d. The rates of the complication and average hospital days were significantly higher in patients by cholecystectomy and cholecystostomy than in patients by ultrasonically guided PPDG (P＜0.05).ConclusionsUltrasonically guided PPDG is effective,safe and convenient for the treatment of acute cholecystitis in elderly patients.