Objective To investigate the antihypertensive effects of continuous airway positive pressure( CPAP) plus antihypertensive drugs on patients with obstructive sleep apnea hypopnea syndrome ( OSAHS) and hypertension.Methods 82 OSAHS patients with hypertension were enrolled in this study. They were randomly divided into a CPAP treatment group( 44 patients, treated with antihypertensive drugs and CPAP) , and a control group( 38 patients, treated with antihypertensive drugs only) . All the patients were performed polysomnography and 24-hour blood pressure monitoring before and 12 weeks after the treatment. Results After 12 weeks treatment, except the systolic pressure in night time( nSBP) , all the parameters of 24-hour blood monitoring improved better in the CPAP group than in the control group( all P lt; 0. 05) . The blood pressure dropped to normal in 75. 0% ( 33/44) CPAP patients and in 52. 6% ( 20 /38) control patients. In the CPAP group, 8( 18. 2% ) cases were withdrawn from antihypertensive drugs, 13( 29. 5% )cases required single agents, and 9( 20. 5% ) cases required three agents to achieve blood pressure control.But in the control group, all the patients needed two or more antihypertensive agents, in which 23( 60. 6% )patients needed three agents to achieve blood pressure control. After the treatment, the patients with dipping pattern blood pressure increased from10 to 29( 22. 7% -65. 9% , P lt;0. 05) in the CPAP group, and from10to 14( 26. 3% -36. 8%, P gt;0. 05) in the control group. Conclusions Combination therapy with CPAP and antihypertensive drugs controls blood pressure better than antihypertensive medication only for OSAHS patients with hypertension with fewer types of antihypertensive agents or even withdrawal from antihypertensive medication in some patients.
目的 对546株常见病原菌进行耐药分析，为感染性疾病的临床治疗提供依据。 方法 对2012年4月－9月从临床标本中分离的546株常见病原菌进行耐药分析，菌种鉴定及药物敏感试验结果由法国生物梅里埃公司VITEK 2 COMPACT系统完成。 结果 在546株病原菌中，G−杆菌占82.8%，其前3位分别为大肠埃希菌（占22.2%），鲍曼/溶血不动杆菌（占16.5%），肺炎克雷伯菌（占15.4%）。在G−杆菌中，除嗜麦芽窄食单孢菌外，亚胺培南、厄它培南的耐药率最低，其次为丁胺卡那霉素和哌拉西林/他唑巴坦。鲍曼/溶血不动杆菌、肺炎克雷伯菌、铜绿假单孢对氨苄青霉素的耐药率均超过95%。金黄色葡萄球菌的耐药率较凝固酶阴性葡萄球菌低，耐甲氧西林金黄色葡萄球菌占22.00%；而耐甲氧西林凝固酶阴性葡萄球菌占94.44%。此外，金黄色葡萄球菌和凝固酶阴性葡萄球菌对万古霉素、利奈唑胺、替加环素、奎奴普丁/达福普丁、呋喃妥因的耐药率为0.00%。 结论 在该院新院区临床标本分离的常见病原菌中，仍以G−杆菌占优势。在G−杆菌中，除嗜麦芽窄食单孢菌外，亚胺培南、厄它培南的耐药率最低。金黄色葡萄球菌的耐药率较凝固酶阴性葡萄球菌低，且尚未发现对万古霉素耐药的葡萄球菌。
ObjectiveTo study the feasibility of using paper hand towels instead of sterilized hand towels in non-rinse surgical hand antisepsis, and make a hygienic and economic evaluation on sterilized hand towels and paper hand towels.MethodsFrom July to September 2016, a cluster sampling method was used to study the hand samples of all health care workers who performed surgical hand sanitization in the operating room on Thursday. According to their work contents, they were asigned into the intervention group (using paper hand towels to dry hands) and the control group (using sterilized hand towels to dry hands); further, according to the odd or even number of the staff identification number, the intervention group was divided into Group A (using Likang hand towels to dry hands) and Group B (using Qingfeng hand towels to dry hands). The packing specifications and costs of hand-drying items in the warehouse were surveyed, as well as the average number of medical workers performing an operation and the number of sheets of sterilized hand towels or paper hand towels used per person, and the cost of different hand dryers for each procedure was calculated. Finally, the hygienic and economic effects of using paper hand towels were evaluated.ResultsThere were 30, 39, and 30 hand hygiene samples collected in the control group, Group A, and Group B, respectively. The total bacterial count of each group was less than 5 cfu/cm2, which met the hygienic requirements of surgical hand disinfection in the manual hygiene standard for medical personnel (WS/T 313－2019), i.e., the passing rate of each group was 100%. According to the calculation that each operation required at least 4 medical workers, each operation consumed 8 sterilized hand towels at a cost of 15.2 yuan; if using paper hand towels, each operation consumed 16 sheets at a cost of 0.8 yuan.ConclusionThe hygienic effect of surgical hand disinfection is not affected by the use of paper hand towels before applying hand sanitizer, while the operating cost of hospital operating room can be significantly reduced by using paper hand towels instead of sterilized hand towels.