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.
【摘要】 目的 探讨抗氧化应激是否参与参附注射液预处理诱导的肾脏保护作用。 方法 健康成年雄性SD大鼠21只随机分为假手术对照组（Sham组）、肾脏缺血再灌注组（I/R组）和参附注射液组（SF组）；SF组给予参附注射液10 mL/kg腹腔注射，每日1次，连续给药7d。麻醉下行右肾切除后，用无损伤动脉夹钳夹左侧肾蒂60min，再灌注24 h，制备肾缺血再灌注损伤动物模型。比较各组SD大鼠再灌注24 h肾脏组织中超氧化物歧化酶（superonidedismutase，SOD）水平、过氧化氢酶（catalese，CAT）和丙二醛（malonicalaldehyed，MDA）含量。 结果 与Sham组相比，I/R和SF组肾脏组织SOD和CAT显著降低，而MDA明显升高（Plt;0.05）；与I/R组比，参附注射液能明显增加SOD和CAT水平（Plt;0.05），降低MDA含量（Plt;0.05）。 结论 参附注射液预处理可增强缺血再灌注损伤肾脏组织抗氧化应激，其表现为增强SOD和CAT的活力，减少MDA的生成。【Abstract】 Objective To explore the protective effect of Shenfu injection combined with antioxidant system on rats’ kidney after ischemia-reperfusion injury. Methods Twenty-one male Sprague Dawley (SD) rats were randomly divided into 3 groups: sham operation group (Sham group), ischemia-reperfusion group (IR group), and shenfu injection treated group (SF group). The rats were anesthetized with valebarbitone. Bilateral kidneys were exposed through midline incision. The right kidney underwent the nephrectomy and left renal pedicels were occluded for 60 minutes with a traumatic mini-clamp and then unclamped for 24 hours. Animals in SF group received Shenfu injection (10 mL/kg) through intraperitoneal injection every day for 7 days. About 24 hours after reperfusion, superoxide dismutase (SOD), CAT and malonical aldehyde (MDA) were measured. Results The levels of MDA were lower in SF group than those in IR group (Plt;0.05). The level of SOD and CAT in SF group increased more significantly than which did in IR group (Plt;0.05). Conclusion Our finding suggests that antioxidant system in SF group works more efficiently than IR group to overcome oxidative stress in renal ischemia-reperfusion injury.
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.
Objective To investigate the feasibility of photochemical tissue bonding (PTB) technique in repairing limbal stem cell (LSC) deficiency and the effect on cornea wound healing. Methods LSCs were isolated from limbus of New Zealand rabbits by tissue block culture method, and then the LSCs of 2nd passage were cultured on de-epithelialized human amniotic membrane (HAM) for 3 weeks to prepare the HAM/LSC grafts. The LSC deficiency models of the left eyes were established by 0.5 mol/L NaOH in 24 New Zealand female rabbits, aged 3-4 months and weighing 1.5-2.0 kg. HAM/LSC grafts were used to repair the cornea wounds by sutures (suture group, n=12) or by PTB technique (PTB group, n=12). The gross was observed including the corneal transparency, erythema, and new blood vessel formation after surgery. At 3 and 28 days, the inflammatory cytokine of interleukin 1β (IL-1β), IL-6, and tumor necrosis factor α (TNF-α) were assayed by ELISA method; and the amount of new blood vessels were quantified by immunohistochemistry staining at 28 days. Results All animals survived to the end of the experiment. At 3 days, there was no obvious difference in the corneal transparency between 2 groups; at 28 days, the corneal transparency of PTB group was higher than that of suture group, and new blood vessels decreased. HE staining showed that mass inflammatory cells infiltrated between graft and cornea basal layer at 3 days, and no new blood vessel formed. inflammatory cells infiltration significantly decreased at 28 days in PTB group; the amount of new blood vessels was (2.0 ± 0.8)/ HP in PTB group and was (6.3 ± 1.3)/HP in suture group, showing significant difference (t=7.966, P=0.002). At 28 days, the concentrations of inflammatory cytokine of IL-1β, IL-6, and TNF-α in suture group were significantly higher than those in PTB group (P lt; 0.05); however, no significant differences were observed between 2 groups at 3 days (P gt; 0.05). Conclusion PTB technique can be used to fix HAM/LSC grafts, which can decrease inflammatory cell infiltration and new vessel formation, and improve the outcomes when compared with suture technique.
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.
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.
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.
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。
【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.
目的 观察七氟烷吸入复合骶管阻滞、基础麻醉复合骶管阻滞及单纯静脉全麻在小儿腹股沟区手术的应用。 方法 将2008年5月-2009年8月收治的90例ASAⅠ~Ⅱ级择期手术患儿分为3组：Ⅰ组为七氟烷吸入复合骶管阻滞组，Ⅱ组为静脉麻醉复合骶管阻滞组，Ⅲ组为全凭静脉麻醉组。每组30例，观察3组麻醉效果。 结果 Ⅰ组患儿心率、平均动脉压、呼吸频率变化不明显，Ⅱ组和Ⅲ组患儿术中和术后心率、平均动脉压较术前升高（Plt;0.05），呼吸频率明显低于术前；Ⅲ组患儿苏醒时间明显延长，Ⅰ组和Ⅱ组患儿苏醒期并发症低于Ⅲ组，其中Ⅲ组患儿术后躁动与哭闹多见。 结论 七氟烷吸入复合骶管阻滞用于小儿腹股沟区手术，患儿易于接受，麻醉过程中呼吸循环功能稳定，苏醒快，清醒质量高，苏醒期不良反应少，是临床上值得推广的麻醉方法。