Objective To design a nucleic acid information early warning system and evaluate the effect of the application. Methods 60 nurses working in the clinical department of Zhongnan Hospital of Wuhan University from August to October 2021 were selected by convenient sampling method, and the included nurses were divided into experimental group and control group. The experimental group used the nucleic acid information early warning system, and the control group used the nucleic acid registration in a common way. Statistical duration of the nucleic acid information, nucleic acid leakage detection rate and nurses job satisfaction after application were compared between the two groups. Results After the application of nucleic acid information early warning system, compared with the control group, the statistical duration of the nucleic acid information in the experimental group was shortened [(2.0±0.4) vs. (3.8±0.7) min; t=25.827, P<0.001], nucleic acid leakage detection rate decreased [1.4% vs. 6.9%; P=0.019]. The job satisfaction of the experimental group was higher than that of the control group (P<0.001). Conclusions Applying the nucleic acid information early warning system could reduce statistical duration of the nucleic acid information, nucleic acid leakage detection rate and improve nurses job satisfaction and work experience. It will provide reference and basis for medical institutions to normalize the management of nucleic acid prevention and control in medical institutions.
Objective To compare the environmental microbiological and physical monitoring parameters between the temporary extended medical area and the normal area during the flexible allocation of ward, summarize the rule and find the potential risk points of infection control. Methods From April 10th to 23rd, 2023, prospective environmental microbial monitoring and physical parameter monitoring were carried out in a ward of Zhongnan Hospital of Wuhan University, and the monitoring results under different scenarios were compared and analyzed. Results In general, the carbon dioxide (CO2) concentration, particulate matter 2.5 (PM2.5) concentration, temperature, and relative humidity in the temporary medical area were better than those in the inpatient rooms (P<0.05), but there was no statistically significant difference in the amount of microorganisms detected on the surface of environmental objects or the hands of medical staff (P>0.05). After the start of the temporary medical area, the amount of microorganisms detected on the surface of environmental objects, CO2 concentration, and temperature in the inpatient rooms were higher than those in the temporary medical area (P<0.05), the PM2.5 concentration in the inpatient rooms was lower than that in the temporary medical area (P<0.05), and there was no statistically significant difference in the amount of microorganisms detected on the hands of medical staff or relative humidity between the two areas (P>0.05). Compared with those in the same area when the temporary medical area was not started, in the inpatient rooms after the start, the amount of microorganisms detected in the air, CO2 concentration, temperature, and relative humidity were lower (P<0.05), the amount of microorganisms detected on the surface of environmental objects and PM2.5 concentration were higher (P<0.05), and there was no statistically significant difference in the amount of microorganisms detected on the hands of medical staff between the two periods (P>0.05); in the temporary medical area after the start, the PM2.5 concentration was higher (P<0.05), the CO2 concentration and temperature were lower (P<0.05), and the differences in the relative humidity and amounts of microorganisms detected on the surface of environmental objects and the hands of medical staff between the two periods were not statistically significant (P>0.05). Regardless of whether the temporary medical area was activated or not, Filamentous fungi had the highest detection rates in air samples, and Staphylococcus epidermidis had the highest detection rates in both environmental surface samples and medical staff hand samples. Conclusion A series of environmental risks such as environmental microbial load and poor ventilation caused by temporary medical areas should be paid attention to.
ObjectiveTo explore the clinical electrophysiology, seizure symptomatology, multimodal imaging characteristics and epileptogenic zone location of the temporal -parietal -occipital junction (TPOJ) epilepsy.MethodsThe seizure symptomatology, head MRI, PET-CT and their fusion manifestations, long-range scalp video EEG monitoring results of 6 cases of TPOJ epilepsy patients from March 2015 to August 2018 were analyzed retrospectively in the Second Hospital of Lanzhou University, and the value of localization of epileptogenic zone was analyzed, and the role of multi-modal evaluation based on SEEG in localization of epileptogenic zone was discussed.ResultsThe first symptoms: 2 of 6 patients were complicated visual hallucination; 3 were head eye deflection (2 were opposite to epileptogenic focus, 1 was ipsilateral); 1 was excessive movement. EEG of scalp: the epileptogenic potentials in intermittent period were all multi -brain regions, but could be lateralized; in seizure period, the electroencephalogram was diffuse in 4 cases, without lateralization, and could be lateralized in 2 cases (1 case was the beginning of one hemisphere, 1 case was the beginning of one posterior head). Imaging findings: MRI was negative in 2 cases, post-traumatic soft focus in 2 cases, and FCD in 2 cases; after fusion of MRI and PET-CT, low metabolic areas in a large area including TPOJ could be found. Six patients were implanted with stereotactic electrodes, and the epileptogenic focus could be identified by EEG monitoring after implantation.ConclusionFor TPOJ epilepsy, the manifestations of premonitory and multimodal images at the onset of seizure can provide important clues for the lateralition of epileptogenic zone; scalp EEG and the first symptoms except premonitory can only provide reference clues; multimodal evaluation based on stereoelectroencephalogram can accurately locate the onset of seizure.
ObjectiveTo preliminarily explore the damage effect of stereo electroencephalogram-guided radiofrequency thermocoagulation after increasing the number of electrodes in the epileptic foci.MethodsEight cases were included from 42 patients requiring SEEG from the Department of Neurosurgery of the Second Hospital of Lanzhou University during June 2017 to Jan. 2019, of which 6 cases were hypothetical epileptogenic foci located in the functional area or deep in the epileptogenic foci that could not be surgically removed, 2 patients who were unwilling to undergo craniotomy; added hypothetical epileptic foci Electrodes, the number of implanted electrodes exceeds the number of electrodes needed to locate the epileptic foci. After radiofrequency thermocoagulation damages the epileptogenic foci, the therapeutic effect is analyzed.ResultsIn 8 patients, the number of implanted electrodes increased from 1 ~ 6, with an average of (4±2.2), and the number of thermosetting points increased by 2 ~ 10, with an average of (7±3.1); follow-up (9±3.2) months, Epilepsy control status: 3 cases of Engel Ⅰ, 3 cases of Engel Ⅱ, 2 cases of Engel Ⅲ; 8 cases of epileptic seizure frequency decreased≥50%. There was a statistically significant difference in the frequency of attacks before and after thermocoagulation (P<0.05).ConclusionsIncreasing the lesion volume of the epileptic foci can obviously improve the efficacy of epilepsy. SEEG-guided radiofrequency thermocoagulation is an effective supplementary method for classical resection.
ObjectiveTo explore the long-term seizure outcome and prognostic factors of patients with frontal lobe epilepsy after surgery, so as to guide the evaluation of treatment and provide clinical reference.Methods This study retrospectively analyzed the clinical data of patients with frontal lobe epilepsy undergoing surgical treatment by multimodal epilepsy surgical evaluation system in the functional neurosurgery of the Second Hospital of Lanzhou University from January 2016 to February 2020, there were 17 males and 13 females, the age of onset of epileptic seizures was (16.30±10.65) years, the age at the time of surgical treatment was (23.98±11.04) years, and the duration of seizures was (7.68±6.37) years. The multimodal epilepsy surgical evaluation system includes phase I non-invasive evaluation and phase II invasive evaluation. The collected research variables were analyzed by descriptive statistics and multivariate logistic regression analysis to evaluate the importance of each research variable to the prognosis of epilepsy surgery, and to determine the potential prognostic factors, so as to explore the epilepsy control situation of patients with frontal lobe epilepsy after surgery and the influence of each variable that may affect the prognosis of epilepsy on the prognosis.ResultsThe analysis of the clinical data of 30 patients with frontal lobe epilepsy showed that the good prognosis rate after FLE surgery (Engel I) was 70%, and the average follow-up was (29.9±14.1) months. The results of multivariate logistic regression analysis showed that the duration of epilepsy, the frequency of seizures, the presence or absence of stereotactic EEG (SEEG) monitoring, whether the lesion was completely removed, and whether acute postoperative seizures occurred were independent predictors of prognosis (P<0.05).ConclusionThis study found that the long duration of epilepsy, frequent seizures, and postoperative acute seizures are significantly related to poor prognosis. The application of SEEG and complete resection of epileptic lesions can significantly improve the prognosis of FLE surgery.