Objective To evaluate the effects of mass immunization campaign on the epidemiological characteristics of measles. Methods Comparison was made between the incidences of measles before and after the mass immunization campaign in 2007 in Shunqing prefecture of Nanchong city. Results The total number of the reported measles cases reached 460 during 2004 to 2007 in Shunqing prefecture of Nanchong city, and the respective annual rates of incidence were 4.04, 23.53, 11.84, and 33.57, respectively per 100 000 heads. Cases reported from April to July accounted to 73.91% of the total (340/460). Children under 15 were reported to have the highest incidence rate and accounted to 83.70% of the total (385/460), of which incidences of children under 1 accounted to 0%, 10.81%, 13.51% and 25.82%, respectively. Only 20.00% of the subjects (92/460) in this study had a definite history of measles vaccination. After the mass immunization campaign in September, 2007, only 10 cases were reported in 2008 and the incidence rate was 1.58 per 100 000 heads, a 95.29% decrease in incidence rate in comparison with that of the last year. Conclusion The mass immunization campaign has achieved substantial results.
Objective To understand the impact of an infection risk control measures implemented in the non-clinical areas of a hospital on the visitors during the coronavirus disease 2019 (COVID-19) epidemic period, in an attempt to provide scientific evidence for the improvement and optimization of subsequent prevention and control measures. Methods The convenience sampling method was used to investigate and analyze all the personnel who came to the hospital for treatment or work on February 22, 2020. Collect the influence of the personnel coming to the hospital on the sense of security, medical behavior (work) and the acceptance of the measures arising from the implementation of infection control measures such as sub-regional management of people and vehicles, body temperature screening during admission, and sub-channel management of hospital visitors in the non-clinical areas of the hospital. ResultsA total of 1 098 patients/family members were included. 70.13% (770/1 098) of the patients/family members thought that visiting the hospital during the COVID-19 epidemic would make them feel uneasy; 90.26% (991/1 098) of the patients/family members could accept the body temperature screening during admission, 96.99% (1 065 / 1 098) of the patients/family members could accept the sub-regional management of people and vehicles, and 100.00% (1 098/1 098) of the patients/family members could accept the sub-channel management of hospital visitors in the non-clinical areas of the hospital; 71.22% (782/1 098) of the patients/family members thought that the peripheral prevention and control measures had increased the sense of security in medical treatment, and they would continue to choose this hospital for the next time if necessary. A total of 2 543 employees were included. 37.55% (955/2543) of the employees felt uneasy because they were afraid of being infected in the hospital; 93.12% (2 368/2 543) of the employees could accept the establishment of a dedicated channel for staff admission, 99.25% (2 524/2 543) of the employees could accept the temperature screening at the entrance of the dedicated channel, and 97.48% (2 479/2 543) of the employees could accept the subregional management measures. 82.54% (2 099/2 543) of the employees thought that the peripheral prevention and control measures would not affect their work. Conclusions Implementing a series of prevention and control measures in the non-clinical areas during the emergency response state can improve the sense of security of the patients, family members of the patients and employees who come to the hospital to some extent. In the future, measures such as strengthening publicity and education, improving facilities, perfecting the planning and design, providing the complete information, and strengthening supervision, can be taken to further optimize the risk control of infection in non-clinical areas and improve the acceptance of personnel coming to the hospital.
ObjectiveTo explore the application effect of standardized management on video-electroencephalogram (VEEG) monitoring.MethodsIn January 2018, a multidisciplinary standardized management team composed with doctors, technicians, and nurses was established. The standardized management plan for VEEG monitoring from outpatient, pre-hospital appointment, hospitalization and post-discharge follow-up was developed; the special quilt for epilepsy patients was designed and customized, braided for the patient instead of shaving head, standardized the work flow of the staff, standardized the health education of the patients and their families, and standardized the quality control of the implementation process. The standardized managemen effect carried out from January to December 2018 (after standardized managemen) was compared with the management effect from January to December 2017 (before standardized managemen).ResultsAfter standardized management, the average waiting time of patients decreased from (2.08±1.13) hours to (0.53±0.21) hours, and the average hospitalization days decreased from (6.63±2.54) days to (6.14±2.17) days. The pass rate of patient preparation increased from 63.14% to 90.09%. The capture rate of seizure onset increased from 73.37% to 97.08%. The accuracy of the record increased from 33.12% to 94.10%, the doctor’s satisfaction increased from 76.34±29.53 to 97.99±9.27, and the patient’s satisfaction increased from 90.04±18.97 to 99.03±6.51. The difference was statistically significant (P<0.05).ConclusionStandardization management is conducive to ensuring the homogeneity of clinical medical care, reducing the average waiting time and the average hospitalization days, improving the capture rate and accuracy of seizures, ensuring the quality of medical care and improving patient’s satisfaction.
ObjectiveTo explore the distribution of multidrug resistant organism in neonates admitted to the hospital through various ways, and analyze the risk factors in order to avoid cross infection of multidrug resistant organism in neonatology department. MethodsA total of 2 124 neonates were monitored from January 2012 to July 2013, among which 1 119 were admitted from outpatient department (outpatient group), 782 were transferred from other departments (other department group), and 223 were from other hospitals (other hospital group). We analyzed their hospital stays, weight, average length of stay, and drug-resistant strains, and their relationship with nosocomial infection. ResultsAmong the 105 drug-resistant strains, there were 57 from the outpatient group, 27 from the other department group, and 21 from the other hospital group. The positive rate in the patients transferred from other hospitals was the highest (9.42%). Neonates with the hospital stay of more than 14 days and weighing 1 500 g or less were the high-risk groups of drug-resistant strains in nosocomial infection. Drug-resistant strains of nosocomial infection detected in the patients admitted through different ways were basically identical. ConclusionWe should strengthen screening, isolation, prevention and control work in the outpatient neonate. At the same time, we can't ignore the prevention and control of the infection in neonates from other departments or hospitals, especially the prevention and control work in neonates with the hospital stay of more than 14 days and weighing 1 500 g or less to reduce the occurrence of multiple drug-resistant strains cross infection.
ObjectivesTo systematically review the efficacy and safety of controlled hypotension for total hip or knee replacement.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and CBM databases were electronically searched to collect randomized controlled trials (RCTs) on controlled hypotension for total hip or knee replacement from inception to September 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by RevMan 5.3 software.ResultsA total of 15 RCTs involving 854 patients were included. The results of meta-analysis showed that compared with no controlled hypotension during surgery, controlled hypotension could reduce intraoperative blood loss (MD=?267.35, 95%CI ?314.54 to ?220.16, P<0.000 01), allogeneic blood transfusion (MD=?292.84, 95%CI ?384.95 to ?200.73, P<0.000 01), and 24 h postoperative mini-mental state examination (MMSE) score (MD=?1.08, 95%CI ?1.82 to ?0.34, P=0.004). However, there were no significant differences in 96 h postoperative MMSE score (MD=?0.11, 95%CI ?0.50 to 0.28, P= 0.57) and intraoperative urine volume (MD=57.93, 95%CI ?152.57 to 268.44, P=0.59).ConclusionsThe current evidence shows that controlled hypotension during total hip or knee replacement can reduce intraoperative blood loss and allogeneic blood transfusion. Furthermore, there is no obvious effect on the maintenance of blood perfusion in important organs, despite certain effects on the postoperative cognitive function, which can be recovered in short term. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
ObjectiveTo explore the effect of different ventilation modes on pulmonary complications (PCs) after laparoscopic weight loss surgery in obese patients. MethodsThe obese patients who underwent laparoscopic weight loss surgery in the Xiaolan People’s Hospital of Zhongshan from January 2019 to June 2023 were retrospectively collected, then were assigned into pressure-controlled ventilation-volume guaranteed (PCV-VG) group and volume controlled ventilation (VCV) group according to the different ventilation modes during anesthesia. The clinicopathologic data of the patients between the PCV-VG group and VCV group were compared. The occurrence of postoperative PCs was understood and the risk factors affecting the postoperative PCs for the obese patients underwent laparoscopic weight loss surgery were analyzed by multivariate logistic regression analysis. ResultsA total of 294 obese patients who underwent laparoscopic weight loss surgery were enrolled, with 138 males and 156 females; Body mass index (BMI) was 30–55 kg/m2, (42.40±4.87) kg/m2. The postoperative PCs occurred in 63 cases (21.4%). There were 160 cases in the PCV-VG group and 134 cases in the VCV group. The anesthesia time, tidal volume at 5 min after tracheal intubation, peak inspiratory pressure and driving pressure at 5 min after tracheal intubation, 60 min after establishing pneumoperitoneum, and the end of surgery, as well as incidence of postoperative PCs in the PCV-VG group were all less or lower than those in the VCV group (P<0.05). The indicators with statistical significance by univariate analysis in combination with significant clinical indicators were enrolled in the multivariate logistic regression model, such as the smoking history, American Society of Anesthesiologists classification, hypertension, BMI, operation time, forced expiratory volume in 1 second (FEV1), FEV1/forced vital capacity, and intraoperative ventilation mode. It was found that the factors had no collinearity (tolerance>0.1, and variance inflation factor<10). The results of the multivariate logistic regression analysis showed that the patients with higher BMI and intraoperative VCV mode increased the probability of postoperative PCs (P<0.05). ConclusionsFrom the preliminary results of this study, for the obese patients underwent laparoscopic weight loss surgery, the choice of ventilation mode is closely related to the risk of developing postoperative PCs. In clinical practice, it is particularly important to pay attention to the risk of postoperative PCs for the patients with higher degree obesity.
With the dissemination and popularization of EBM around the world, the evidence-based laboratory medicine has boomed gradually. However, the substantial researches in tbe field are still inadequale now. Based on the facts of hospital laboratory medicine, this article discussed the feasibility that apply the rationale and methods to orient the laboratory quality control.
Objective To investigate the current status of occupational environment support, occupational satisfaction, and job competence of hospital infection prevention and control personnel, and to explore the mediating effect of occupational satisfaction on the relationship between occupational environment support and job competence, in order to provide reference and guidance for effectively improving the job competence of hospital infection prevention and control personnel. Methods A survey questionnaire was distributed to various levels and types of medical institutions in Shanghai through the platform of the Shanghai Hospital Infection Quality Control Center. The questionnaire included the Occupational Environment Support Scale, Occupational Satisfaction Scale, and Job Competency Assessment Scale. The mediating effect of occupational satisfaction on the relationship between occupational environment support and job competency of hospital infection prevention and control personnel was analyzed. Results A total of 1027 hospital infection prevention and control personnel from 728 medical institutions participated in this survey, with 989 valid questionnaires and an effective response rate of 96.3%. There were statistically significant differences in the job competency scores of hospital infection prevention and control personnel based on gender, years of experience in infection control work, professional background, highest education level, professional title, job nature, type of medical institution, and annual income (P<0.05). The total score of job competence for hospital infection prevention and control personnel was 301.0 (267.5, 326.0), the total score of occupational environment support was 21.44±3.66, and the total score of occupational satisfaction was 19.25±2.78. The occupational environment support of hospital infection prevention and control personnel was positively correlated with occupational satisfaction and job competence (r=0.373, 0.339; P<0.001), and occupational satisfaction was positively correlated with occupational environment support (r=0.547, P<0.001). The mediating effect of job satisfaction on the occupational environment support and job competence was 0.085, accounting for 22.8% of the total effect. Conclusion Occupational satisfaction partially mediates the relationship between occupational environment support and job competence, and the mediating effect is significant.
Objective To evaluate the effect of releasable sutures on shallow anterior chamber, filtering bleb and long-term intraocular pressure (IOP). Methods We searched MEDLINE (1971 to 2007), OVID (1971 to 2007) and National Science and Technology Library (1971 to 2007). Randomized controlled trials (RCTs) of the effect of releasable sutures on trabeculectomy were collected. Study selection and assessment, data collection and analyses were undertaken and cross-checked by two reviewers. Meta-analyses were performed with The Cochrane Collaboration’s RevMan 4.2.10 software. Results Six RCTs involving 341 eyes were included. Significant differences were observed in the reduction of postoperative shallow anterior chamber (RD –0.23, 95%CI –0.31 to –0.14, Plt;0.000 01) and functional filtering blebs (RD –0.15, 95%CI –0.27 to –0.02, P=0.02). But, no differences were observed for the control of long-term IOP (SMD –0.13, 95%CI –0.37 to 0.10, P=0.27). Conclusion The evidence currently available showed that releasable sutures could reduce the incidence of shallow anterior chamber and has no beneficial effect in controlling long-term IOP. The current evidence is insufficient to define the efficacy of maintaining functional filtering blebs. Further large-scale, high-quality randomized controlled trials are needed.