Methicillin-resistant Staphylococcus aureus is one of the important pathogens of healthcare-associated infections. In order to prevent and control the transmission of the drug-resistant organism in healthcare facilities, the Healthcare Infection Society and the Infection Prevention Society jointly conducted the guidelines for the prevention and control of methicillin-resistant Staphylococcus aureus in 2021. This article introduces the guide from the background, preparation process, main prevention and control measures and further studies, and compares the guidelines with the current prevention and control measures in China, so as to provide a methodological reference for preparation of the guide for domestic infection prevention and control practitioners, and provide evidence-based prevention and control strategies for clinical practice.
目的 总结静脉制剂Ⅰ期临床耐受性试验中的护理要点。方法 2011年10月－12月，采用随机、盲法、安慰剂平行对照试验设计，在健康志愿者中按剂量递增原则，逐组完成8个剂量单次静脉滴注给药耐受性试验。 结果 试验顺利完成。静脉制剂的Ⅰ期耐受性试验中，研究护士在临床试验前需认真学习试验方案，做好试验病房、监护急救设施设备的充分准备，针对可能出现的不良反应制定切实可行的处理预案，试验过程中密切监测，对出现的不良反应做好救治工作。特别针对静脉制剂，须做好受试者的心理疏导，保证静脉穿刺一次成功，减少受试者因情绪紧张、穿刺疼痛等因素干扰对试验药物耐受性的评价。 结论 Ⅰ期临床耐受性试验实施前准备充分，试验过程中为受试者提供良好的试验环境和心理护理，提高静脉穿刺一次成功率，密切监测，可使试验过程顺利，并获得客观、准确的试验结果。
ObjectiveTo evaluate systematically the relationship between obesity and clinical prognosis in acute respiratory distress syndrome (ARDS) patients.MethodsA systematic search was performed in Pubmed, EMBASE, Cochrane databases, Wiley, Ovid, Medline, CNKI, VIP and Wanfang. All studies that reported obesity in the clinical prognosis of ARDS and acute lung injury were included. A meta-analysis was performed using RevMan 5.0 and Stata 10.0.ResultsA total of 28 368 patients from 9 studies were included in this meta-analysis. The combined results showed that obesity was associated with the decreased mortality of ARDS [odds ratio(OR)=0.63, 95% confidence intervals (95%CI) 0.41 to 0.98, P=0.04]. In subgroup analysis, the result showed no obvious relationship between obesity and 28-day mortality in ARDS/ALI (OR=0.92, 95%CI 0.55 to 1.54, P=0.76). However, obesity was associated with lower risk of 60days and 90-day mortality in ARDS/ALI (60-day: OR=0.84, 95%CI 0.75 to 0.94, P=0.002; 90-day: OR=0.38, 95%CI 0.22 to 0.66, P=0.000 5). Compared with normal weight patients with ARDS, hospital length of stay, ICU length of stay, and duration of mechanical ventilation did not differ significantly [hospital length of stay: weighted mean difference (WMD)=3.61, 95%CI –0.36 to 7.57, P=0.07; intensive care unit (ICU) length of stay: WMD=1.52, 95%CI –0.22 to 3.26, P=0.09; duration of mechanical ventilation: WMD=–0.50, 95%CI –2.18 to 1.19, P=0.56], but ventilator-free days was significantly longer in obese patients (WMD=2.68, 95%CI 0.86 to 4.51, P=0.004).ConclusionsObesity is not associated with hospital length of stay, ICU length of stay, and duration of mechanical ventilation in patients with ARDS. However, obesity is associated with a reduction of long-term mortality and increased ventilator-free days in the patients with ARDS. Additional larger randomized controlled studies are needed to confirm the possible role of obesity in the clinical prognosis of ARDS.
【摘要】 目的 了解学生对医院感染职业防护的基础知识的认知程度和学习需求。 方法 2010年3月采用自行设计问卷，对参加《医院感染与职业防护》课程学习的医学学生进行摸底调查。 结果 92.73%不知道标准预防措施和锐器伤后的正确处理方法及补救措施；27.27%不知道抽血时应戴手套；25.45%不清楚医务人员“六步洗手法”；90.91%不知晓工作服应交医院统一洗涤。 结论 学生防护知识薄弱，防护行为不全面、不规范。教学应重点帮助学生树立标准预防观念，掌握正确职业防护知识，在临床工作中以避免和减少各种危险因素的侵袭。【Abstract】 Objective To examine and evaluate the students’ knowledge and needs in studying hospital infection control and occupational protection. Methods Using a self-designed questionnaire in March 2010, we did a survey on students who attended the course of hospital infection control and occupational protection. Results Among all the students, 92.73% did not know standard prevention measures, and the correct treatment and remedial measures for sharp injuries; 27.27% did not know gloves should be worn at the time of blood drawing; 25.45% did not know the "six-step" hand-washing; and less than one out of ten students used hospital laundry to wash their uniform. Conclusions The students have a low level of relevant knowledge on occupational protection, and their protection behaviors were not complete or standard. Therefore, the teaching should help and support students to have a concept of standard prevention, and acquire sound knowledge and behavior of occupational protection in order to avoid and reduce the risk factors from their future clinical practices.
Objective To evaluate the clinical result of using osseointegratedimplants to retain removable orbital prostheses in repairing orbital defects. Methods Two patients with orbital defects caused by orbitaltumor were treated. Each of them got 4 implants. After average 6 months, we performed the secondary operation. After 7 weeks, we took impressions to make the implant-retained prostheses. The magnetic attachment was adopted. The prostheses were made of polysiloxane material(Factor II,Lakeside,Ariz). Results Both of the patients got the successful facial prostheses and were followed up 2 and 8 years respectively. All the implants were integrated well. There were no apparent inflammatory reactions in the soft tissue around percutaneous implants. The patients were satisfied with the facial appearance. Conclusion Implant-retained orbital prostheses are safe and effective in repairing orbital defects.
Transthyretin cardiac amyloidosis (ATTR-CA) is a form of restrictive cardiomyopathy characterized by the abnormal deposition of transthyretin in the myocardial interstitium, presenting with clinical manifestations such as heart failure, atrial fibrillation, and cardiac conduction system disorders. The significant individual variability in the symptomatology of ATTR-CA patients poses considerable challenges for precise diagnosis. This study provides a review of biomarkers associated with ATTR-CA and highlights the TTR tetramer as a potential novel indicator. The amyloid deposition in ATTR-CA is closely related to the dissociation of TTR tetramers; however, the TTR tetramer is not included among the biomarkers currently used in clinical practice. Investigating the concentration, profile, and dissociation rate of TTR tetramers holds profound significance for the early detection and prognostic assessment of ATTR-CA. This article synthesizes the research on traditional biomarkers of ATTR-CA and emphasizes the potential application value of TTR tetramers in disease diagnosis and prognostic evaluation.
Objective To assess the protective effects of a new type of leukocyte-depletion filter-1 (LD-1) on red blood cells during cardiopulmonary bypass(CPB). Methods Twelve Mongolian dogs, weight range 25-30kg, were divided into control group and leukocyte depletion group (LD group) with random number table, LD group (n=6) had our new type of leukocyte depletion filter-1 placed in venous line which was used within the first 5 minutes after onset of CPB. The control group (n=6) had no leukocyte depletion filter installed in the circuit. CPB was set up by cannulated with a venous cannula through the right atrium and with an aortic cannula after median sternotomy. Aorta was clamped at 10 minutes of CPB and released at 70 minutes of CPB. Dogs were observed for 2 hours after weaning from CPB. Blood samples were collected prior to, at 10, 40, 75 minutes, end of and 2 hours after CPB to determine circulating leukocytes, erythrocyte fragility and plasma levels of malondialdehyde(MDA), superoxide dismutase(SOD) and free hemoglobin(FHB). Results Leukocyte numbers were significantly reduced in LD group during CPB(Plt;0.01), and lower than those in control group (Plt;0.05). Plasma levels of SOD dropped after 75 minutes of CPB in control group, but those kept normal in LD group, and higher than those in control group at 2 hours after CPB (Plt;0.05, 0.01). Serum MDA and FHB levels increased sharply in two groups (Plt;0.01), but were lower in LD group than those in control group. The concentrations of NaCl when starting and complete hemolysis were also lower in LD group than those in control group at end of and 2 hours after CPB. Conclusion The new type of LD-1 used in venous line only 5 minutes after onset of CPB can decrease leukocyte counts, and reduce erythrocyte injury effectively.
ObjectiveTo systematically review the effectiveness of outdoor activities in preventing myopia progression, and to provide scientific evidence for myopia prevention and management.MethodsPubMed, MEDLINE, EMbase, CNKI and WanFang Data databases were searched from establishment to October 2017. Two researchers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software.ResultsA total of 10 studies involving 24 667 participants were included. The results of meta-analysis showed that the incidence of myopia in outdoor activities group was lower than that in control group (OR=0.67, 95%CI 0.55 to 0.81, P<0.000 1).ConclusionThe current evidence shows that outdoor activities have protective effects on emmetropia children myopia onset. Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusions.
Objective To evaluate the safety and tolerance of medicinal charcoal enteric-coated tablets in healthy volunteers. Methods A total of 44 healthy volunteers were randomly divided into 6 single-dose groups (0.5 g, 2 g, 4 g, 6 g, 8 g and 10 g) and a multiple-dose group (3 g, 3 times a day, for 14 days). The safety profile and tolerance were evaluated by observing symptoms, vital signs, and laboratory tests. Results No serious adverse event was reported for any volunteer. Abdominal distension occurred in 2 volunteers in the 4 g dose group and the 6 g dose group. One volunteer in the 8 g dose group experienced nausea and vomiting. Transient decrease in white blood cell count was observed in one volunteer in the 10 g dose group. Abdominal distension occurred in 2 volunteers of the multiple-dose group. Conclusion Based on our findings, the maximum tolerated dose of medicinal charcoal enteric-coated tablets in Chinese healthy volunteers is 10 g. The recommended dose for subsequent clinical trials is 3 g, 3 times a day.
Objective To observe the effect of pars plana vitrectomy (PPV) with epiretinal membrane peeling (ERMP) and (or) internal limiting membrane peeling (ILMP) and silicone oil tamponade for highly myopic macular hole retinal detachment (MHRD) with posterior staphyloma. Methods Eighty-five highly myopic MHRD patients (85 eyes) were enrolled in this study. All the patients were examined for corrected visual acuity (CVA), slit lamp microscope and preset lens, indirect ophthalmoscope, A/B ultrasound, optical coherence tomography (OCT) and intraocular pressure examination. The average axial length was (29.1plusmn;1.8) mm. There were 24 eyes with diffuse choroid atrophy and 61 eyes with partial choroid atrophy. The CVA was converted into a logarithm of the minimal angle of resolution (logMAR) for statistical analysis. The average logMAR CVA was 1.93plusmn;0.37. All the patients were treated with PPV and triamcinolone acetonide or indocyanine green (ICG) assisted ILMP and (or) ERMP and silicone oil tamponade. TA assisted ERMP was performed in 21 eyes; with ICG assisted ILMP in 56 eyes and TA assisted ILMP in eight eyes. The duration of silicone oil tamponade was (6.2plusmn;1.6) months. CVA, retina and macular hole status and complications were observed postoperatively. Differences between preoperative and postoperative CVA were evaluated by the t test and correlation analysis. Multiple logistic regression analysis was performed to assess the influence of individual preoperative factors on the initial anatomical success. Differences in the macular hole closure rate between eyes with or without macular schisis were evaluated for statistical significance using corrected chi-square. Results The mean logMAR CVA was 1.34plusmn;0.48 after surgery, which significantly improved compared to that before surgery (t=39.38, P＜0.01). The CVA after surgery was independent of axial length (r=0.142, P＞0.05), choroid atrophy (t=0.23, -0.165,P＞0.05) and macular hole closure (t=0.12, -0.005, P＞0.05). The retina reattached in 79 eyes (92.9%) and recurrence of retinal detachment occurred in six eyes (7.1%). Multiple logistic regression analysis indicated that recurrence of retinal detachment was independent of choroid detachment, proliferative vitroretinopathy, axial length, choroid atrophy and ILMP (OR=1.428, 5.039, 0.815, 2.578, 0.432; P＞0.05). Of these 85 eyes, macular hole closed in ten eyes (11.8%), macular hole did not close in 75 eyes (88.2%). There were 24 eyes (28.2%) experienced high intraocular pressure during the first 2 weeks after surgery, all of them were under control with drugs. There were 12 eyes (14.1%) presented with high intraocular pressure before the silicone oil removal, all of them were under control only by silicone oil removal. Conclusion For the treatment of MHRD with posterior staphyloma, PPV combined with ERMP and (or) ILMP and silicone oil tamponade show a high retinal reattachment rate.