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Objective To construct a quantitative evaluation system for professional competency of healthcare-associated infection(HAI)management professionals,and provide scientific basis for the training of professionals through scientific evaluation.Methods Literature and experience summary were adopted to construct evaluation key points.Evaluation key points were selected through expert consultation method,and the weight coefficient of evaluation key points was calculated.The hierarchical evaluation content options for each evaluation key point were designed and assigned score values by expert group.The product of the score of each evaluation key point and its weight was the score for this point,and the total score of the evaluated person was calculated based on the total score of all evaluation points.Results The evaluation system included 25 evaluation key points in 9 dimensions,in-cluding"basic conditions""recognition competency in HAI""monitoring competency in HAI""prevention and con-trol technology application competency in HAI""emergency response competency""organization and coordination competency""quality improvement competency""education and training competency"and"professional scientific re-search competency in HAI prevention and control".Each evaluation key point contained three hierarchical quantita-tive score contents.The internal consistency reliability of the expert's questionnaire consultation Cronbach's a coef-ficient was 0.873,the total scale-level content validity index(S-CVI)was 0.868,and the item-level content validity index(I-CVI)ranged 0.71-1.Conclusion The quantitative evaluation system constructed in this study meets the requirements for reliability and validity.It is scientifically feasible for evaluating the professional competency of HAI management professionals.It can effectively identify weakness in their competency,determine training directions and priorities,and provide a scientific basis for talent development and team building for HAI management profe-ssionals in medical institutions,and promotes high-quality development within hospitals.
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In this study, we investigated the inhibitory effect of SYT-1, a new compound of tetrahydroisoquino-line, on tumor cell proliferation and underlying mechanisms. Cell counting kit-8 (CCK-8) method was used to detect cell proliferation; clone formation experiment was used to detect cell clone formation ability; JC-1 probe was used to detect cell mitochondrial membrane potential; 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA) probe was used to detect intracellular reactive oxygen species; Annexin V-FITC/PI (fluorescein isothiocyanate/propidium) counterstaining method was used to detect apoptosis; Western blot assay was used to detect the expression level of related proteins. The experimental results show that SYT-1 has a significant inhibitory effect on the proliferation of six human-derived cancer cells. Among them, the inhibitory effect on breast cancer MCF-7 cells is the strongest, the half maximal inhibitory concentration (IC50) of SYT-1 of 48 h administration on MCF-7 cells is 5.87 μmol·L-1, which is better than that of cisplatin (8.92 μmol·L-1). Further studies have shown that SYT-1 can dose-dependently inhibit the monoclonal formation ability of MCF-7 cells, and can cause the mitochondrial membrane potential of the cells to decrease and the level of reactive oxygen species to increase. In addition, SYT-1 can significantly inhibit the activation of PI3K-Akt (phosphatidylinositol 3-kinase/protein kinase B) signaling pathway and induce apoptosis of MCF-7 cells. The above research results show that, as a new type of tetrahydroisoquinoline compound, SYT-1 has the potential to inhibit tumor cell proliferation.
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Objective To establish the risk prediction scoring model of central line-associated bloodstream infection (CLABSI) in elderly patients, provide basis for screening high-risk population, and effectively prevent and control bloodstream infection (BSI) in elderly patients.Methods According to the inclusion and exclusion criteria, data of elderly patients who underwent central catheterization during hospitalization from January 1, 2015 to December 31, 2017 were collected, patients were randomly divided into modeling group and verification group according to the ratio of 7∶3 (random seed was 20180708), risk factors of data of modeling group were distinguished, logistic regression model was constructed. The corresponding score of each risk factor was assigned according to β value, infection risk scoring model was established, prediction accuracy of model was evaluated by receiver operating characteristic (ROC) curve; according to the established infection risk scoring model, cases in validation group were scored, prediction accuracy of model was evaluated by ROC curve. Decision curve was constructed using R software.Results Logistic regression analysis showed that the number of operation≥3 times, length of stay in intensive care unit (ICU) ≥2 days, duration of indwelling central venous catheterization≥7 days, and use of antimicrobial agents were independent risk factors for CLABSI in elderly patients; the corresponding points in risk prediction scoring model were 3, 4, 4, and 9 respectively, and the score of 13-17 points were high-risk population of CLABSI; the area of ROC curve (AUC) was 0.74 in the modeling group; ROC curve was plotted based on the risk score of patients in validation group, AUC was 0.70. The decision curve showed that the net benefit of the risk scoring model was higher in the high risk thershold of 0.01-0.05.Conclusion The established risk prediction scoring model has good discriminant validity and application value, and can be used in the identification of susceptible high risk population of CLABSI in elderly patients, so as to achieve early prevention and control.
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<p><b>OBJECTIVE</b>To formulate a comprehensive treatment program for rheumatoid arthritis arthralgia by clinical observing the efficacy of Xiaoyan Zhitong Paste (XZP).</p><p><b>METHODS</b>Adopted was stratified, block randomized, double-blinded, placebo parallel controlled method. Subjects were assigned to the treatment group and the placebo group. Those in the treatment group were treated by external application of XZP, one to two pastes each time, covering the painful area, exchange once per 24 h, with one-day interval during a 7-day consecutive medication, two 7-days of treatment consisting of one therapeutic course. XZP placebos were applied for those in the placebo group in the same medication way. Joint pain and VAS were taken as main indices for observing the clinical efficacy of XZP.</p><p><b>RESULTS</b>The improvement of the analgesic effect and the Chinese medical syndrome efficacy of XZP were superior to that of the placebo.</p><p><b>CONCLUSION</b>XZP showed obvious effect in treating rheumatoid arthritis arthralgia with no obvious adverse reaction.</p>
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Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Artralgia , Tratamento Farmacológico , Artrite Reumatoide , Tratamento Farmacológico , Medicamentos de Ervas Chinesas , Usos Terapêuticos , Fitoterapia , MétodosRESUMO
The hip with distinctive anatomical structure and complicated function plays an important role in normal standing and activity. The clinical doctors have paid attention to studies on hip biomechanics of normal structure and reconstruction. It was difficult for us to analyze hip in vivo because of its complex structure. Many examinations were preformed on animal models, but the reliability of results was unavoidably affected. Technology of finite-element analysis as one of the main methods of mechanics had been successfully applied in many fields, especially in analyzing on irregular bodies. The application in the field of orthopaedic surgery, for example the optimal design for prosthesis, stress analysis of grafts etc, had made great progress. The method could help us to improve current thoughts on study of biomechanics and make continuous advance in the future.
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Humanos , Acetábulo , Cirurgia Geral , Análise de Elementos Finitos , Prótese de QuadrilRESUMO
ObjectiveTo synthesize 99Tcm labeled hydrazine-nicotinamide ( HYNIC)-c (RGDfK)and evaluate its biodistribution and imaging in the severe combined immunodeficiency (SCID) nude mice bearing human lung adenocarcinoma.Methods( 1 )Tcm-HYNIC-c(RGDfK) was prepared by a two-step method using tricine and ethylenediamine diacetate (EDDA) as coligands and HYNIC as the dual functional chelator.The bioactivity of 99Tc m-HYNIC-c (RGDfK) was measured by cell binding experiments.(2) The nude mice bearing human A549 lung adenocarcinoma were randomly divided into 7 groups with 5 in each group.The 7 th group was the competitive inhibition control group and was administrated 100 μg HYNIC -c (RDGfK) 30 min earlier before the injection of 99Tcm-H Y N IC-c ( RGDfK ).The nude mice were scanned at 0.5,1,2,4,8 and 12 h respectively after intravenous injection of 7.4 MBq 99Tcm-HYNIC-c(RGDfK).The biodistribution of the agent was measured as % ID/g.The uptake ratio of tumor to muscle (T/NT) was also measured by placing ROI on 99Tcm-HYNIC-c(RGDfK) SPECT imaging.(3)Gamma imaging was performed in 6 mice including 3 in the competitive inhibition control group at 0.5,1,2,4,8 and 12 h post injection.ResultsThe labeling yield of 99Tcm-HYNIC-c(RGDfK) was more than 90%,and the radiochemical purity was more than 95%.99Tcm-HYNIC-c(RGDfK) can specifically bind with A549 adenocarcinoma cells with a binding rate up to 36.14%.Biodistribution study showed that the uptake in the kidney was above 20 % ID/g during 0.5 - 8 h post injection.The % ID/g in tumor was 10.52 ± 1.48 at 0.5 h,17.26 ±2.81 at 8 h,and 8.93 ±0.90 at 12 h.However,the % ID/g in tumor was only 2.29 ±0.85 in the competitive inhibition control group at 0.5 h.The highest T/NT was 6.87 at 8 h by the ROI analysis.Xenograffted tumors could be visualized at 1 h and delineated more clearly from 4 to 8 h post injection of 99Tcm-HYNIC-c(RGDfK).Conclusions99 Tcm-HYNIC-c (RGDfK) can be readily synthesized.Its binding with A549 lung adenocarcinoma cells is specific and the binding rate is high.
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Intensive care unit (ICU) is a place with high risk of nosocomial infections. Effective control of nosocomial infections in ICU brings both social and economic benefits. This article summarizes ten main points in the control strategy of ICU infections.
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Humanos , Infecção Hospitalar , Economia , Controle de Infecções , Economia , Unidades de Terapia Intensiva , EconomiaRESUMO
<p><b>OBJECTIVE</b>To evaluate the economic loss of nosocomial infections (NI) in patients with cerebral hemorrhage or cerebral infarction.</p><p><b>METHODS</b>We used case-control method to compare the medical expenses between 46 pairs of cerebral hemorrhage or cerebral infarction patients with or without NI.</p><p><b>RESULTS</b>The median hospital stay, total treatment expense, medications expense, examination expense, and treatment expense of NI were significantly higher in the NI group than in non-NI group (all P < 0.01 ).</p><p><b>CONCLUSIONS</b>NI can prolong hospital stay and increase medical expenses of patients with cerebral hemorrhage or cerebral infarction. Effective measures should be taken to control NI.</p>
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Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos de Casos e Controles , Hemorragia Cerebral , Economia , Infarto Cerebral , Economia , Efeitos Psicossociais da Doença , Infecção Hospitalar , Economia , Hospitalização , EconomiaRESUMO
<p><b>OBJECTIVE</b>To evaluate the antibacterial activity of Ciprofloxacin, Amikacin in combination with beta-lactams against Pseudomonas aeruginosa strains in vitro, to optimize treatment regime for antibiotics on the basis of pharmacokinetics (PK)/pharmacodynamics (PD) and drug sensitivity tests. Methods With checkerboard titration method, the minimal inhibitory concentrations (MIC) of a combination of antibiotics in different concentrations for 33 clinically isolated Pseudomonas aeruginosa strains were determined by broth dilution. Fractional inhibitory concentrations (FIC) were calculated for judging synergic effect of antibiotics.</p><p><b>RESULTS</b>The combination of Amikacin and Ceftazidime showed synergic effects (accounting for 57.6%). The combinations of Ciprofloxacin with Ceftazidime, Cefepime, Imipenem/Cilastatin, Meropenem showed synergic or additive effect. In the study with PK/PD, C(max)/MIC was the principal parameters for evaluation of aminoglycoside and fluoroquinolone antibiotics, while T > MIC was the principal parameter to be used to evaluate beta-lactams antibiotics.</p><p><b>CONCLUSION</b>When antibiotics are used in combination, MICs can be reduced significantly and antibacterial activities are enhanced remarkably. The combination of antibiotics results mainly in synergic or additive effect, and no inhibitory effect is observed. PK/PD analysis plays an important role in planning optimal combination regime to raise clinical efficacy.</p>