Objective To investigate and analyze the epidemic characteristics and factors of pulmonary tuberculosis (PTB) to provide foundation and make prevention and treatment policy. Methods Statistical analysis was conducted to analyze the current existing PTB prevention and control data in the Center for Disease Control and Prevention of Zhushan County and corresponding prevention and treatment policy was proposed. Results Since 1997 when PTB was included into B infectious diseases in Zhushan County, 4 431 cases of PTB had been reported by the end of 2009. Annual reported incidence rate was 74.73 per 100 000 and the disease was found in 17 towns. All seasons witnessed the incidence but winter and summer had more sufferer. The youngest patient was 4 months whereas the oldest was 86 years old. The majority of the patients were from 20 to 59 years old, peasants were the main patients, and the incidence of male was higher than that of female. The use of chemotherapy resulted in a significant decline of PTB death rate. Poor immunity of elder group, population flow caused by poverty, low detection rate of patients and AIDS were the major causes to PTB epidemic. A lack of prevention and treatment in the grassroots hospital and difficulty to fully implement the Directly Observed Treatment, Short-course (DOTS) strategy in remote areas were also bottlenecks to PTB control process. Conclusion The followings should be performed to improve the quality of DOTS strategy implementation: strengthen the government’s commitment, provide policy and funding safeguard, conduct health education and health promotion widely, reinforce management according to the law, fully implement the DOTS strategy, and fortify the prevention and control construction.
To analyse the causes of biliary injuries and summuarize the experience of prevention of biliary injury during laparoscopic cholecystectomy (LC). Twenty-three patients with biliary duct injury were diagnosed and treated at our center between September 1992 and August 1998. The main causes were either misidentification of the bile duct or aberrant right duct as the cystic or injudicious use of thermal energy (cautery) to dissect, control bleeding, or divide tissue. Conclusion: The causes of biliary duct injury are complex. Training and experience of sugeon, the meticulous dissection of the calot′s triangle and preoperative or operative cholangiography are three key factors in prevention of biliary duct injury during LC.
Objective To observe the relationship between the suturing patterns to close the scleral incision and postoperative intraocular pressure (IOP) in 23G minimally invasive vitrectomy. Methods Eighty eyes of 80 patients with vitreoretinal diseases, who were treated with primary 23G minimally invasive vitrectomy, were enrolled in this prospective clinical study. Patients with poor closed scleral incision which need suturing were excluded from this study. The corrected visual acuity ranged from hand movement to 0.2. The IOP ranged from 7.9 to 19.8 mm Hg (1 mm Hg=0.133 kPa), with the mean of (13.9plusmn;1.8) mm Hg. The eyes were randomly divided into three groups: group A (20 eyes), suturing all three scleral puncture after vitrectomy; group B (20 eyes), suturing only two upper scleral puncture, but not the lower infusion puncture after vitrectomy; group C (40 eyes), no suturing for all 3 scleral puncture after vitrectomy. All patients underwent 23G vitrectomy only. The corrected visual acuity and IOP were observed after surgery. Results The corrected visual acuity were 0.1 -0.3, 0.2- 0.5, 0.3 -0.8 in one, seven and 14 days after surgery, respectively. No one in group A, B experienced hypotony in one, three, seven and 14 days after surgery. Thirteen (32.5%), five (12.5 %), two eyes (5.0%) in group C experienced hypotony in one, three and seven days after surgery. Seven eyes (17.5%) experienced severe hypotony (＜5 mm Hg) in 14 day after surgery in group C. The difference was statistically significant compared the incidence of hypotony in group C with group A, B respectively at different time points after surgery (chi;2= 16.82,P=0.007). The difference was statistically significant compared the incidence of hypotony in group C at different time points after surgery (chi;2=11.64,P=0.003). The difference was no significant compared the IOP between group A and B at different time points after surgery (F=1.618,P=0.205). Compared the IOP of group C to group A and B, the difference was statistically significant in one and three days after vitrectomy (F=9.351,P=0.000); but not statistically significant in seven and 14 days after vitrectomy(F=0.460,P=0.633). Conclusions Whether or not suturing the scleral punctures is closely related to postoperative hypotony in 23G vitrectomy. Suturing only the two upper scleral punctures can reduce the occurrence of postoperative hypotony.
Children with retinoblastoma (RB) typically survive their cancer due to advances in early diagnosis and treatment. Extraocular invasion and metastasis, and secondary malignant tumor carry a very high mortality rate. Prerequisites for metastasis include tumor initiating capacity, altered cellular adhesion and cell motility, resistance to extracellular death signals and disruption of the basement membrane and extracellular matrix. All those changes can be determined by the cell of origin and the genetic instability of the tumor, responding to the multiple layers of pressure such as hypoxia, from the tumor microenvironment or niche. The interaction between tumor cells and the tumor stroma is regulated by several metastasissuppressor proteins and microRNA. This knowledge has important implications for our understanding and the treatment of extraocular spreading of RB.
Objective To survey the current situation of the sharp injury in medical workers, and to provide scientific evidence for the prevention and protection of sharp injury. Methods Through applying the questionnaire of sharp injuries designed by Zhongshan Hospital, Shanghai Fudan University, 10% of the workers in all departments of West China Hospital of Sichuan University were selected as respondents according to their job categories. The main contents of the survey included the general information of respondents, reporting after sharp injuries, training participation, and the exposure sources, operations, premises and equipments related to sharp injuries over the past one year.Results Of 840 questionnaires distributed, 100% were valid. The ratio of male was 23% while the female was 72%. There were 50.20% of all respondents who once got injured, and 75% of the respondents having the history of sharp injury worked less than 10 years. The nurses, house keepers and physicians were in the top three positions of suffering from sharp injury; and the operating room was ranked as the highest risk department for sharp injuries. The known haematogenous exposure sources were 69 cases of hepatitis B, 19 syphilis, 6 hepatitis C, and 3 HIV. There were 62% of the respondents who had ever attended related training, and only 11.61% of the injured respondents reported their sharp injuries. Conclusion The incidence rate of the sharp injury is high, but the report rate is low. The operating room is the high risk department, and nurses, house keepers, and physicians are the high risk population for sharp injuries. The prevention and protection and training for sharp injury in target departments and population should be strengthened.
Objective To suggest the establishment a publication plan for emergency situations in order to better manage and control information to the outside environment based on the experience of front-line hospital of grade III level A in Deyang during the response to the Wenchuan earthquake. Method We systematically collected statistical information published in the forms of news, columns, newspapers, periodicals, statistics, brief massage sent out by China Telecom ans China Mobile and banners in various media (CCTV, Sichuan TV, and inside hospital etc.) after Wenchuan earthquake.Result Within 40 days after the Wenchuan Earthquake, the People’s Hospital of Deyang City had reported rescue information for 181 times, sent 1 600 000 phone messages to the public, issued 7 476 pieces of family-search information, distributed 1 486 earthquake first-aid brochures, distributed 1 750 psychological brochures, compiled 12 periodicals called “Special Report for Earthquake Relief Effort”, and finished 3 periodicals called “Special Issue for Earthquake Relief Effort”; issued 319 articles, over 200pictures and videos on websites inside and outside of the hospital; issued over 60 pieces of news and 7 special topic documentaries in CCTV etc.; and issued over 70 pieces of news on People’s Daily. Conclusion During the Wenchuan earthquake, the People’s Hospital of Deyang City shows the rescue work to the public via effective publication mechanisms. News and information is transmitted fast and effectively between people from both upper and lower levels. However, there are weaknesses in working mechanisms and methods, which requires further study and consideration.
Objective To provide baseline data for the Special Healthcare Program of Comprehensive Reform for Coordinated and Balanced Urban-rural Development in Chengdu. Methods We selected 7 township/community health institutions and 6 village health posts /street clinics using stratified sampling to take account of the levels of economic development and the distance from the centre of Chengdu We then performed on-site surveys and secondary research. Data were analyzed by using Epidata or Excel. Results The utilization of health institutions was generally good. The number of visits and number of inpatients in medical institutions increased steadily. The utilization rate of hospital beds and doctors’ workload were higher than the national average. The average medical expense per outpatient /inpatient was far lower than the national level. The overall condition of the health institutions that close to the centre of Chengdu was better. Conclusion We should persist in taking advantage of the rural hospitals’ construction to improve village health posts /street clinics and strengthen the national and governmental compensating mechanism for township /community health organizations (village health posts /street clinics), so as to make the basic condition of current township/ community health organizations (village health posts /street clinics) better.
Objectives To analyze the effect of improved oven for defluorination in coal-burning endemic fluorosis areas in China, and to provide evidence for the prevention and control of fluorosis. Methods Electronic databases including CNKI, CBM, VIP and CDMD-D (1989 to 2005), were searched. We also checked the reference lists of relevant articles. We selected relevant articles according to the predefined inclusion and exclusion criteria. The methodological quality was assessed . Data on room heat preservation and the effect of improved oven for defluorination were collected in the surveillance spots of Three Gorges Reservoir. Correlation analyses were conducted between the improved oven and its effect parameters. Results Twelve articles of low quality met the selection criteria, of which 9 were graded C and 3 were graded D in terms of the methodological quality. A negative correlation was found between the decreasing rate of normal oven use and the decreasing rate of dental fluorosis as well as of urine fluorine (Pearson correlation coefficient r = – 0.87, – 0.63, Plt;0.01, lt;0.05, respectively). Analysis also revealed a positive correlation between room heat preservation and the decreasing rate of dental fluorosis as well as of normal oven use (the two Spearman correlation coefficients and P values were the same: r = –1.00, Plt;0.01). Conclusion High-quality studies on the effect of improved oven for defluorination in China are not available. Based on the current evidence, the improved oven for defluorination and the correct use, maintenance and house rebuilding for heat preservation may help to prevent fluorosis.
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.
ObjectiveTo investigate the situation of hospital infection with bacteria producing extended-spectrum β-lactamases (ESBLs), find the source of infection and analyze its transmission route, and take effective prevention and control measures to reduce the incidence of nosocomial infection. MethodsA hospital neonatal ward had six cases of ESBL-producing bacteria infections on February 16 to 26, 2012. According to the processing procedure for hospital infection outbreak, we carried out epidemiological investigation on the patient with suspected hospital infection, including checking the medical records, asking the doctor in charge about the patients'clinical symptoms, collecting sputum samples of the patients and environmental microbiology examination, etc. ResultsFour cases of infection were community-acquired, and two were nosocomial infection. Infection onsets were concentrated (between February 16 and February 26, 2012). Patients had similar clinical symptoms, including fever, cough, cough sputum, and lung wet rales, which showed a lower respiratory infection. Six strains of ESBL-producing Escherichia coli were isolated from the infected children, and their susceptibility reports were not entirely consistent, indicating that they did not belong to the same species and were not homologous pathogens. Through bedside survey, we also isolated from the environmental samples 6 ESBL-producing bacteria, and these bacteria were acquired from the milk countertops, kettle, ventilator tube, two doctors'nasal cavity, and the cleaners'nasal cavity in corresponding wards of those infected children. ConclusionThe infection does not belong to an outbreak of nosocomial infection, and it is only an aggregation event of ESBL-producing Escherichia coli. The symptoms of infection were mainly because of lower immunity of children themselves, plus not so good aseptic technique and management in the department of neonatology. Therefore, strengthening hand hygiene management of medical staffs, and regular environmental sanitation and disinfection can reduce the incidence of neonatal hospital infection.