Medical quality and patient safety will be impacted by infection prevention and control directly. There will be many challenges on infection prevention and control, especially in large general hospitals. In the practice of infection prevention and control, the quality control work for infection prevention and control needs to establish a service concept, pay attention to the scientificity and precision of management. Multi-disciplinary team work and evidence-based medical study will also play an important role in infection prevention and control. Overall, quality management of infection prevention and control should be developed scientifically and normatively. Based on the practical experience of infection prevention and control, this article summarizes the experience of infection prevention and control management quality control in the First Affiliated Hospital of Zhengzhou University, in order to provide a reference for the research and management practice of infection prevention and control management quality control strategies.
Objective To explore the interference of recent use of antibiotics in the sensitivities of different methods for the detection of Helicobacter pylori (Hp) in children. Methods From June 2015 to December 2017, children who were highly suspected of Hp infection and required gastroscopy were divided into the antibiotic group and the control group according to the recent use of antibiotics, with 200 cases in each group. The use of antibiotics of children in the antibiotic group was analyzed. The children in the two groups completed five methods of Hp detection, including rapid urease test (RUT), 13C-urea breath test (13C-UBT), pathological Warthin-Starry staining, colloidal gold method for measuring Hp immunoglobulin M (IgM) antibody, and enzyme linked immunosorbent assay method for measuring Hp stool antigen (HpSA). Comparative analyses of data were done. Results The positive rate of RUT was 36.5% in the antibiotic group and 75.0% in the control group (P<0.05). The positive rate and value of13C-UBT were 59.0% and 13.6±4.7 in the antibiotic group, and 78.0% and 41.7±6.6 in the control group (P<0.05). The positive rate of pathological biopsy was 48.0% in the antibiotic group and 68.0% in the control group (P<0.05), and L-forms were found in 80.9% of the Hp-positive specimens in the antibiotic group. The positive rate of IgM antibody was 54.5% in the antibiotic group and 65.5% in the control group (P<0.05). The positive rate of HpSA was 38.0% in the antibiotic group and 69.0% in the control group (P<0.05). In the antibiotic group, only 12.5% of the children used antibiotics for eradication of Hp and 87.5% for non Hp eradication. Conclusions Under the interference of antibiotics use, the sensitivity of 13C-UBT is the highest among the five methods for Hp detection, and the sensitivities of RUT and HpSA are very low. For children who could not cooperate with 13C-UBT, the sensitivity of IgM detection is relatively high. For children who need gastroscopy, prolonged chromogenic time for RUT and multi-point pathological biopsy can reduce misdiagnosis.
ObjectivesTo investigate the citation status of systematic reviews (SRs)/meta-analyses in clinical practice guidelines and consensuses of traditional Chinese medicine (TCM).MethodsWe electronically searched PubMed, CBM, WanFang Data and CNKI databases to collect TCM guidelines and consensus from January 1st, 2009 to December 31st, 2018. Two reviewers independently screened literature and extracted data. Citation analysis method was used to analyze the citation status of SRs/meta-analysis in TCM guidelines and consensuses.ResultsA total of 142 TCM guidelines and consensuses were included, of which 39 (26.5%) failed to provide relevant citations. Of the 103 (72.5%) TCM guidelines and consensuses providing citations, 48 (34.3%) cited SRs/meta-analyses, and 43 cited outdated SRs/ meta-analyses. Four TCM guidelines and consensuses cited Cochrane reviews. In terms of citations, the average citations of guidelines and consensuses were 35.1 and 42.2, respectively; and the average SRs/meta-analyses citations of guidelines and consensuses were 3.8 and 5.5, respectively.ConclusionsTCM guidelines and consensuses citation report rates and the proportion of citation SRs/meta-analyses still require increase. TCM guidelines developers should strengthen the role and significance of SRs, especially Cochrane reviews, in supporting recommendations.
From December 2022 to January 2023, 4 lung transplant recipients (3 males and 1 female, aged 52-60 years, all received transplantation less than 1 year) were hospitalized in the Department of Thoracic Surgery of the First Affiliated Hospital of Xi'an Jiaotong University due to COVID-19 after surgery. The clinical manifestations were mostly characterized by elevated body temperature accompanied by shortness of breath, and indicators such as heart rate, oxygen saturation, and oxygenation index could reflect the severity of the condition. The therapy was timely adjusted to immunosuppressive drugs, upgraded oxygen therapy, anti-bacterial and anti-fungal therapy, prone ventilation, general treatment, and anticoagulant therapy, depending on the situation. Finally, 3 patients were cured and discharged from hospital, and 1 died.
ObjectiveTo explore the technical feasibility, safety, and short- and long-term efficacy of totally portal minimally invasive thoracoscopic diaphragmatic folding assisted by a stapler for the treatment of symptomatic diaphragmatic eventration in adults. MethodsAretrospective study was conducted on patients with symptomatic diaphragmatic eventration who underwent totally portal minimally invasive thoracoscopic stapler-assisted diaphragmatic folding from August 2021 to February 2025. Surgical time, intraoperative blood loss, postoperative drainage volume, length of hospital stay, and complications were recorded. One month postoperatively, diaphragmatic position, lung function [forced expiratory volume in one second (FEV1), forced vital capacity (FVC) ], and symptom relief were assessed, with extended follow-up to 36 months to monitor long-term efficacy. ResultsA total of 7 patients were included, comprising 3 (42.9%) males and 4 (57.1%) females, with an age range of 34 to 66 years and a mean age of (56.4±12.5) years. All surgeries were successfully completed without conversion to open thoracotomy or intraoperative complications. The average surgical time was (44.29±11.47) minutes, intraoperative blood loss was (25.71±33.09) mL, and the postoperative length of stay was (2.00±0.58) days. One-month follow-up showed that the diaphragmatic position returned to normal anatomical levels, FEV1 improved from preoperative (1.93±0.33) L to (2.36±0.47) L, and the effective rate of clinical symptom relief reached 100.0%. Long-term follow-up (36 months) showed: (1) Pain scores decreased from (1.14±0.38) points at one month postoperatively to (0.14±0.38) points at three months postoperatively, remaining at 0 points at six months and thereafter; (2) All patients had stable diaphragmatic positions with no recurrence; (3) FEV1/FVC was ≥80% at three months postoperatively, with three assessable patients at six months maintaining ≥80%; (4) SpO2 remained ≥95% throughout, with no hypoxic events. ConclusionTotally portal minimally invasive thoracoscopic stapler-assisted diaphragmatic folding is a minimally invasive procedure with rapid recovery, significantly improving lung function and stabilizing diaphragmatic anatomical position. Follow-up at 36 months showed complete pain relief, no recurrence, and long-term stability of lung function, making it a safe and effective surgical option for treating symptomatic diaphragmatic eventration in adults. Long-term efficacy still requires validation with a larger sample size.
ObjectiveTo explore the method for establishing a pig left lung orthotopic transplantation model. MethodsDetailed surgical procedures, including animal anesthesia, tracheal intubation, donor lung retrieval, and recipient transplantation, were thoroughly reported. By examining the histological morphology and blood gas analysis of the transplanted lung 2 hours after reperfusion, the histological changes and function of the transplanted lung were assessed. ResultsThis method was applied to four male Yorkshire pigs with an average weight of (40.0 ±2.5) kg for left lung in situ transplantation, effectively simulating conditions relevant to human lung transplantation. Two hours after the transplantation, arterial blood gas analysis showed PaO2 was 155.4-178.6 mm Hg, PaCO2 was 53.1-62.4 mm Hg, and the oxygenation index was 310.8-357.2 mm Hg. Hematoxylin and eosin staining indicated a low degree of pulmonary edema and minimal cellular infiltration. ConclusionThe pig left lung orthotopic transplantation model possesses strong operability and stability. Researchers can replicate this model according to the described methods and further conduct basic research and explore clinical translational applications.
Objective To evaluate the effectiveness and safety of pure carbon dioxide (CO2) combined with a modified inflation-deflation technique for identifying the intersegmental plane during thoracoscopic segmentectomy. Methods A prospective study was conducted, enrolling 30 patients diagnosed with pulmonary nodules who underwent thoracoscopic anatomical segmentectomy at the Department of Thoracic Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, from March 2024 to March 2025. Patients were randomly assigned to one of two groups using a random number table: A pure oxygen group (O2 group, n=15, 8 females, 7 males, age 28-75 years) and a pure carbon dioxide group (CO2 group, n=15, 8 females, 7 males, age 37-69 years). All patients underwent preoperative three-dimensional computed tomography bronchovascular angiography to reconstruct pulmonary vessels, bronchi, and the virtual intersegmental plane. The time to identification of the ideal intersegmental plane was recorded intraoperatively, along with arterial blood gas measurements before lung inflation and at 5 and 15 minutes after lung inflation on the surgical side. Results The time to identify the intersegmental plane was significantly shorter in the CO2 group compared to the O2 group [(151.1±39.5) s vs. (998.7±78.9) s, P<0.001], and there were no significant fluctuations in intraoperative oxygen saturation in patients in the CO2 group. Furthermore, there were no statistically significant differences between the two groups in terms of operation duration, intraoperative blood loss, postoperative extubation time, total postoperative chest tube drainage, postoperative length of hospital stay, or postoperative complication rate (all P>0.05). Conclusion Pure CO2 combined with a modified inflation-deflation technique can rapidly, accurately, and clearly identify the intersegmental plane, and its safety is non-inferior to that of the pure O2 method, making it worthy of clinical promotion and application.