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.
ObjectiveTo investigate the community residents' awareness of knowledge on cardiovascular disease prevention and control and their access methods to relevant information. MethodsBetween June and August, 2013, the residents aged above 45 who came to community health center for diagnosis or treatment were investigated by questionnaires including the acknowledge of prevention for cardiovascular diseases and the access methods to relevant information. ResultsA total of 1 000 residents were involved in this study, including 394 (39.40%) males and 606 (60.60%) females aged from 45 to 98 with an average of 68.3±10.4. The highest rate of awareness of cardiovascular prevention knowledge was regular physical exercise (89.20%), followed by low salt diet (67.20%) and fried food (6.30%). The highest rate of access to the information was information provided verbally by doctors or nurses (77.50%), followed by television and radio (56.00%). ConclusionCommunity center should strengthen the health education of cardiovascular disease prevention and control. Health education should be practiced in an easy way for the residents.
ObjectiveTo study the relationship between macular pigment optical density (MPOD) and serum concentration of lutein and zeaxanthin in an adult population. MethodsTwenty patients with mild cataract and 39 healthy subjects were enrolled in this study, including 15 males and 44 females. The average age was 43.75 years. Fifty-three subjects were non-smokers and 6 male subjects were smokers. Two subjects preferred meat diet, 22 preferred meat-less diet, and 35 have balanced diet. MPOD was measured using heterochromatic flicker photometry at 0.25, 0.5, 1.0 and 1.75 degrees, and serum concentration of lutein and zeaxanthin was measured using high-performance liquid chromatography. The relationship between MPOD and serum concentration of lutein and zeaxanthin was analyzed. The differences of serum lutein and zeaxanthin between different gender, smokers and non-smokers and subjects with different dietary pattern were also analyzed. ResultsMPOD at 0.25, 0.5, 1.0 and 1.75 degrees were 0.59, 0.48, 0.34 and 0.18, and the average concentration of lutein and zeaxanthin were (0.45±0.16) μmol/L and (0.11±0.04) μmol/L respectively. Serum concentration of lutein and zeaxanthin in males were slightly higher than that in females, but it was not statistically significant (t=1.13, 0.86; P=0.27, 0.40). The differences of serum lutien and zeaxanthin between smokers and non-smokers (t=-0.15, -0.11; P=0.87, 0.91), among subjects of 3 dietary patterns groups were not statistically significant (Flutein=3.87, 4.05, 0.18; P=0.83, 0.81, 0.99. Fzeaxanthin＝0.99, 1.51, 0.52; P＝0.85, 0.68, 0.72). There was no correlation between MPOD and serum concentration of lutein (r=-0.06,-0.02,-0.07,0.03;P>0.05)and zeaxanthin(r=0.02,0.12,0.09,0.11;P>0.05). ConclusionMPOD was not statistically significantly correlated with serum concentration of lutein and zeaxanthin in the studied population.
Healthcare-associated infections are common adverse events in healthcare settings, causing significant morbidity and mortality. There has been a significant increase in the commitment to Infection Prevention and Control worldwide in recent years. This important role and responsibilities are relying on the infection prevention and control practitioners (IPCPs). The competencies of IPCP is thus critical to the success of infection surveillance, prevention, and control program. IPCPs must ensure that they are competent in addressing the challenges they face and are equipped to be competent in fulfilling their duties. Core competencies and professional development of IPCP differ among countries while some are more progressive than the others. This review is aiming to be a reference to develop IPCP core competencies framework and professional development conducive for Asia Pacific region.
In recent years, along with more importance having been given by health care facilities and health administrative departments nationally, the work force of infection prevention and control is constantly increasing. In the new era, to help infection prevention and control practitioners and all health care workers make the right direction in infection prevention and control professional business and make sure the infection prevention and control measures are implemented, what we need is to define the target of infection prevention and control scientifically, identify obligation subjects, and improve the infection prevention and control system and working mechanism from the top-level.
Early onset and high incidence of myopia has caused great concern of the Party and the Government. On August 30th 2018, eight ministries and commissions, such as the Ministry of Education, jointly issued the Comprehensive Prevention and Control Implementation Scheme of Child and Adolescent Myopia, which put forward the actions and specific measures to various aspects, and particularly mentioned that the medical and health institutions should work together with families, schools, etc, to reduce the incidence of myopia. Medical institutions should do a good job in the following items: setting up visual archives for adolescents, so as to prevent and control myopia with pertinence and individualization; standardizing the process of diagnosis and treatment, doing a good job in refractive examination and correction of adolescents, and resolutely combating the commercial "treatment and correction" of myopia; strengthening myopia-related health education, and eliminating erroneous understanding to myopia prevention and control. Optometrists should play an important role in the prevention and control of myopia, speed up the cultivation of optometry talents, and call on the state to establish a professional title system and professional access standards for optometry talents as soon as possible.
The prevention and control of hospital infection should be precise. Otherwise, a lot of medical resources will be wasted. To achieve accuracy, prevention and control should be considered from the microbial level to enhance its scientific nature. It is specifically reflected in the need of having knowledge of microorganisms, understanding the pathogens of infection and their transmission routes, therefore to carry out prevention and control work contrapuntally. Specific measures include infection surveillance at the microbial level, establishing the idea and habits of infection diagnosis from the microbial level, being familiar with microbial perspective to identify infection risks and vulnerabilities, implementing evidence-based prevention and control measures for different pathogens, encouraging researches on infection control and management at the microbial level, and developing precise prevention and control regulations, standards, or guidelines for specific pathogens.
Carbapenemase producing Enterobacteriaceae (CPE) has emerged as a significant global public health challenge and placing infected patients at risk of potentially untreatable infections. When resistance to carbapenems occurs, there are often few alternative treatments available. Numerous international guidelines have performed systematic and evidence review to identify new strategies to prevent the entry and spread of CPE in healthcare settings. Several key strategies have been shown to be highly effective. Firstly a new strategy that is proven to be effective is the early identification of the CPE carrier patients through active surveillance cultures. While waiting for the screening results, suspected CPE carriers will be put on preemptive isolation in single room and healthcare worker will at the same time practice contact precautions. The active surveillance culture and prompt preemptive isolation will limit the entry and spread of CPE from getting into hospital. Secondly, it is of utmost importance to incorporate enforcement of the basic infection prevention and control best practices in the hospital including, full compliance to hand hygiene, appropriate use of personal protective equipment, execute antibiotic stewardship program to control abuse of antibiotics, effective environmental cleaning and decontamination, staff education and feedback, as well as surveillance of healthcare-associated infections. Such a holistic approach has been shown to be effective in inhibiting CPE from gaining foothold in the hospital.
Running an infection control regular meeting is an effective way to develop and improve the communication between the infection control team and clinical units. This paper introduces the infection control regular monthly meeting which is held in the last week of each month in a newly-opened branch hospital of a university teaching hospital in China. Through collecting the issues for discussion beforehand, feeding back the surveillance data of last month including nosocomial infection, hand hygiene, multidrug-resistant organisms, occupational exposure, and medical waste, discussing the current infection control issues from each ward and trying to solve them together, and delivering and sharing new knowledge, skills, and information in terms of infection control, the monthly meeting achieves remarkable successes in the aspects of promoting the hospital infection control-related cultural construction, enhancing the supervision and implementation of infection control measures, and running new projects on hospital infection management, etc. Infection control regular monthly meeting builds up a study and work platform, promotes the multidisciplinary and multi-department communication and collaboration, and improves the quality of infection control eventually.