浅谈手术室加强质量管理控制医院感染的体会

医院手术室质量管理工作,重点是预防和控制医院感染,提高医疗护理质量,保证手术治疗的预期目的,保障病员安全。多年来,我院手术室建立健全质量管理体系,完善感染管理规章制度,严格执行卫生部颁发的《医院感染管理规范》、《消毒管理办法》和《消毒技术规范》等相关法律法规,有效地预防医院感染,最大限度地保证了手术的安全。     

实施TQC管理，控制院内感染发生

随着医院感染管理工作的逐步开展 ,各家医院按照卫生部《建立健全医院感染组织机构暂行办法》的要求 ,通过上等级 ,建立健全了医院感染管理组织 ,制定了一些规章制度 ,对院内感染进行了监测 ,并将其纳入医疗质量管理中 ,加强了医院感染管理 ,取得了一定成效。但由于缺乏科学有效的管理方法 ,有三级监控网却缺乏必要的质量保证和评价 ,大多单位处于重视不够、认识不高、参与不足、应付检查和存在“过关”思想 ,医院感染监控质量达不到质控指标 ,甚而成为医院住院病人医疗费用超标的首位危险因素。针对上述情况 ,我们探讨性运用ＴＱＣ (即全面…     

医院感染的控制与管理

医院感染威胁着人民群众的身体健康,已成为重要的公共卫生问题,普遍受到世界各国的关注与重视。加强医院感染管理已成为医院实行全面质量管理,有效提高医疗服务质量的重要问题。医院感染不仅给病人的康复带来危害,而且加重了病人和国家的经济负担,造成卫生资源的浪费,直接影响医疗效果和医疗质量,与医院的发展和存亡密切相关。1健全管理组织,完善规章制度,强化医院感染意识按照《医院感染管理规范(试行)》的要求,建立健全医院感染管理体系,明确医院感染管理组织在医院感染监、控、管工作中的职能。制定和完善控制和预防医院感染的一系列规章…     

医院感染的监控与管理

目的:根据医院感染现状及其监控管理存在的问题,提出提高医院感染监控与管理水平的措施。方法:总结医院感染监控与管理的实践经验。结果:医院感染监控与管理的措施包括:加强医院感染管理组织机构建设;依法开展医院感染管理监测;开展医院感染知识的全员培训;加强医院感染控制;医院感染管理计算机网络系统的应用。结论:做好医院感染监控与管理工作,有利于提高医院质量,确保医疗安全。     

规范医院口腔科医院感染管理

为了加强医院感染管理,有效预防和控制口腔科医院感染的发生,保障医疗安全,提高医疗质量,我院重新修订了《沁县人民医院口腔科医院感染管理细则》,使口腔科医院管理有法可依、有章可循,用制度约束规范口腔诊疗全过程各消毒灭菌环节,使口腔科预防医院感染管理工作实现规范化、制度化。     

医疗废物管理现状及对策

目的:规范医院各科室医疗废物的管理。方法:对照《医疗废物管理条例》、《医疗废物管理办法》等法律、法规的要求,查找医疗废物管理中存在的问题,建立健全医疗废物管理组织及医疗废物管理工作的各项规章制度、工作流程、应急处理、明确了各部门的职责,加强协调与合作。结果:采取相应的措施和对策完善医疗废物管理制度及加强职业防护,避免医疗废物流失,保护人体健康。结论:完善医疗废物监控体系,明确各部门职责,可有效预防医疗机构因医疗废物管理工作中存在问题所带来的危害。     

发挥护理部在控制院内感染的职能作用

医院感染是当前医院管理的一项重大课题,是医院管理的重要组成部分[1]。在医院感染管理中,充分发挥护理部在控制院内感染的组织、协调、控制等职能作用,具有十分重要的现实意义,现将管理实践体会介绍如下。1发挥组织职能,加强护理管理1．1建立护理监控网络：根据卫生部颁发的《医院分级管理评审标准》,将医院感染管理列为其中一项重要内容[2]。1994年3月,我院在创三甲医院工作中,在过去原有的基础上,对医院感染管理工作加大了力度,成立了由医院感染管理委员会、院感监控科、科室监控小组的医院感染管理体系。护理工作质量的好坏与…     

加强医院感染管理 保障医疗质量安全

目的：加强医院感染预防与控制的管理工作,保证医疗安全。方法：依据卫生部颁发的有关医院感染预防与控制的规定为准则,开展医院感染管理工作,实施质量监控。结果：通过职能部门的依法监督、规范管理,使医院感染工作走向监控管理为一体的管理模式。结论：充分发挥医院感染管理科培训、教育、监督、指导、控制五大职能,保护患者就医安全和医务人员的职业健康。     

乡镇卫生院医院感染管理存在的问题及对策

目的加强基层乡镇卫生院医院感染管理工作,提高医疗护理质量。方法对基层乡镇卫生院感染管理工作存在的问题进行分析并提出对策。结果健全制度、明确职责、加强培训、提高认识,有效预防控制医院感染的发生,推动医疗及护理工作。结论基层乡镇卫生院感染管理工作必须明确责任及职责,强化全院员工感染控制意识,改善基础设施,加强监测、监控和抗生素合理使用。     

社区卫生服务站医院感染管理调查与对策

目的:分析社区卫生服务站医院感染管理现状,提出改进措施。方法:根据卫生部医院感染管理的相关文件、法规、<安徽省社区卫生服务中心规范化建设考核标准>相关内容,对安徽省宿州市27所社区卫生服务站医院感染管理现状进行调查。结果:社区卫生服务站医院感染管理存在规章制度不健全、消毒灭菌管理不规范、医疗废弃物分类处置不规范、职业安全防护不到位、医院感染知识缺乏等问题。结论:重视医院感染管理工作,建立健全感染管理组织,加强对社区卫生服务站医务人员医院感染控制知识培训,是提高社区卫生服务站医院感染管理工作的关键。     

UniPron is A Fully Effective Non-hormonal Reversible Contraceptive in Baboon Model （Papio Anubis）

Objective To determine the safety and efficacy of UniPron as a reversible contraceptive.
Methods Vaginal swabs were obtained before and after UniPron administration, cultured onto appropriate culture media and bacteria identification was done based on type of media used, Gram stain reactions, colony morphology and biochemical tests. Vaginal biopsy tissues were processed using paraffin wax method, stained with hematoxylin and eosin and examined under light microscopy to determine the effect of the product on vaginal tissues. The effect of UniPron on sperm was examined by mixing the product with electroejaculated spermatozoa in vitro at different concentrations. For efficacy studies, male baboons of proven fertility were mated with UniPron treated or untreated females of proven fertility during the fertile stages.
Results All the five females （100%） that were treated with UniPron did not conceive and they regained total fertility when the treatment was stopped while all the controls conceived. At a concentration of 40%, UniPron completely immobilized spermatozoa in an in-vitro system. UniPron mechanism of action was by lowering the vaginal pH and on application in baboon, the pH was lowered for at least 3 h after which it went back to normal.
Conclusions As we plan for a study to test UniPron as a microbicide to prevent STIs including HIV, our current study has established that this novel product is effective in contraception and harmless to vaginal tissues and vaginal microbial flora in a baboon model （Papio anubis）.     

Evaluation of diuretic and laxative activity of hydro-alcoholic extract of Desmostachya bipinnata （L,） Stapf in rats

OBJECTIVE： In continuation to the growing evidence for therapeutical potential of Desmostachya bipinnata （Linn） Stapf, the current pharmacological study was carried out to evaluate the diuretic and laxative activity of its hydro-alcoholic extract in rats. METHODS： The hydro-alcoholic extract of D. bipinnata whole plant was prepared by using Sox- hlet extractor and subjected to analysis by standard preliminary phytochemical tests. Evaluation of both diuretic and laxative activity was carried out using standard methods as reported earlier. Frusemide （20 mg/kg） was served as positive control for diuretic activity and sennosides （10 mg/kg） served as negative control for laxative activity. RESULTS： The hydro-alcoholic extract showed significant diuretic activity and was found to be the most potent in increasing the urinary output at 500 mg/kg when the effect was compared with that of the standard frusemide （P〈0.01）. Moreover, this extract was found to be most effective in increasing urinary electrolyte concentration （Na＋, K＋, and Cl-） at both doses tested. Whereas the results for laxative activity showed minimal increase of feces output at the dose of 500 mg/kg and the increase was negligible when compared with that of the standard drug sennosides. CONCLUSION： Altogether, the above significant findings validate and support its folkloric diuretic use and lend pharmacological credence to the ethno-medical use of this plant in traditional system of medicine, which demands further studies to investigate its active constituents, as well as its use and safety.     

Effect of the disruption of three cytoskeleton components on chondrocyte metabolism in rabbit knee cartilage

Background Chondrocytes＇ phenotype and biosynthesis of matrix are dependent on having an intact cytoskeletal structure.Microfilaments,microtubules,and intermediate filaments are three important components of the cytoskeletal structure of chondrocytes.The aims of this study were to determine and compare the effects of the disruption of these three cytoskeletal elements on the apoptosis and matrix synthesis by rabbit knee chondrocytes in vitro.Methods Chondrocytes were isolated from full-thickness knee cartilage of two-month-old rabbits using enzymatic methods （n=24）.The isolated cells were stabilized for three days and then exposed to low,medium,and high doses of chemical agents that disrupt the three principal cytoskeletal elements of interest：colchicine for microtubules,acrylamide for intermediate filaments,and cytochalasin D for actin microfilaments.A group of control cells were treated with carrier.Early apoptosis was assessed using the Annexin-FITC binding assay by flow cytometry on days 1 and 2 after exposure to the disrupting chemical agents.The components and distribution of the cytoskeleton within the cells were analyzed by laser scanning confocal microscopy （LSCM） with immunofluorescence staining on day 3.The mRNA levels of aggrecan （AGG） and type Ⅱ collagen （Col-2） and their levels in culture medium were analyzed using real-time PCR and enzymelinked immunosorbent serologic assay （ELISA） on days 3,6,and 9.Results In the initial drug-dose-response study,there was no significant difference in the vitality of cells treated with 0.1 μmol/L colchicine,2.5 mmol/L acrylamide,and 10 μg/L cytochalasin D for two days when compared with the control group of cells.The concentrations of colchicine and acrylamide treatment selected above significantly decreased the number of viable cells over the nine-day culture and disrupted significantly more cell nuclei.Real-time PCR and ELISA results showed that the mRNA levels and medium concentrations of AGG and Col-2 were significantly decreased for     

Liuwei Dihuang,a traditional Chinese herbal formula,suppresses chronic inflammation and oxidative stress in obese rats

OBJECTIVE： To investigate the anti-inflammatory, anti-oxidative stress, and adipokine-ameliorating effects of Liuwei Dihuang （LWDH）, a traditional Chinese herbal formula, in obese rats. METHODS： After 2 weeks of acclimation with free access to regular rodent chow and water, obese-prone-caesarean-derived （OP-CD） rats were fed a modified AIN-93G diet containing 60% energy from fat. Treatment was performed twice daily by gavage feeding with 500, 1 500, or 3 500 mg/kg body weight LWDH suspended in water （n=12 rats per group）. Twelve obese-resistant-CD （OR-CD） rats were fed the atherogenic diet and gavaged with water, and served as the normal control. Blood biomarkers of inflammation, oxidative stress and adiponectin were measured post-sacrifice and used to determine the treatment effect of LWDH and assess the suitability of OR/OP-CD rats for studying these parameters. RESULTS： After 9 weeks of treatment, LWDH lowered serum C-reactive protein （CRP） and tumour necrosis factor-α （TNF-α） levels. Serum interleukin-6 （IL-6） levels showed a tendency towards reduction, but were not significantly different from the OP-CD control. Liver superoxide dismutase （SOD） activity was increased in response to all three doses of LWDH, while the levels of reduced （GSH） and oxidized glutathione （GSSG） and thiobarbituric acid reactive substances （TBARS） were unchanged. Serum adiponectin levels were increased in response to oral administration of LWDH at the dose of either 500 or 1 500 mg/kg body weight. In addition, comparisons between OR-CD and OP-CD rats revealed differential, and for some biomarkers, conflicting characteristics of high-fat diet-fed OP-CD rats in reference to obese human subjects in terms of inflammatory and oxidative stress biomarkers and circulating adiponectin levels. CONCLUSION： The results show, for the first time, the anti-inflammatory, anti-oxidative stress and adiponectin-ameliorating effects of LWDH in obese rats. The suitability of the OP-JOP-CD rat model as     

Iloprost inhibits fracture repair in rats

Background Previous studies have shown that prostaglandins （PGs） dramatically stimulate healing processes in bone.However,the effect of prostaglandin l2 （PGI2） on fracture healing remains unclear.To investigate the effect of PGI2,a study on fracture healing process in closed tibia fractures was designed.Methods Thirty-six Sprague-Dawley male rats were randomized into two groups.On the first day,their right tibias were fractured by three-point bending technique.The study group （n=18） received a single injection of 10 μg/kg iloprost for 5 days,while the control group （n=18） received saline solution in the same way.On the 7th,14th and 28th days following the fracture,six rats were sacrificed and their right legs were harvested in each group.The progression of fracture healing was assessed for each specimen by the scores of radiography （by Lane-Sandhu） and histology （by Huo et al）.Results On the 7th day,the radiographic and histologic scores were equal.On the 14th day radiographic total score was 6 and histologic total score was 23 in the iloprost group,whereas radiographic total score was 11 and histologic total score was 33 in the control group.On the 14th day radiographic and histologic scores were significantly decreased in the iloprost group compared to the control group （P 〈0.05）.On the 28th day radiographic total score was 12 and histologic total score was 37 in the iloprost group,whereas radiographic total score was 15 and histologic total score was 40 in the control group.On the 28th day although there was a decrease in radiographic and histologic scores of the iloprost group acording to control group,it was not statistically significant （P 〉0.05）.Conclusion Iloprost delays fracture healing in early stage in rats.     

Effect of Shenfu on the Expression of Bcl-2 and Bax of Intestinal Mucosal Epithelial Cells after Ischemic Reperfusion in Rats

Objective To study the effect of Shenfu on the expression of bax and bcl-2 in small intestinal mucosal epithelial cells after ischemic reperfusion injury and explore the effect of Shenfu on small intestinal mucosal epithelial cells apoptosis. Methods 36 SD rats were randomized into three groups, each consisting of 12 rats： Sham group （S group）, Ischemic reperfusion group （IR group）, Shenfu group （SF group）, Ischemic reperfusion models were made by ligated the superior menseneric artery for 1 hour followed by 2 hrs reperfusion. Histological mucosal damage in each group was graded according to Chiu＇s score. Immunohistochemistry detected the expression of bax and bcl-2, and obtained the optical density （OD） value using a color image pattern analysis system, and then calculated the ratio of bcl-2/bax. TUNEL method measured apoptotic intestinal mucosal epithelial cells, and calculated the apoptotic index. Results There were edema and epithelial impairment in part of villus and the integral was higher in SF group than S group （P〈0.05）, but lower than IR group （P〈0.01）. Compared IR group with S group and SF group, the average OD value of bcl-2 and bax had significant statistic difference （P〈0.01）, and the average OD value of bcl-2 in SF group was higher than in S group （P〈0.05）, meanwhile bcl-2/bax was significantly lower in IR group than in S group and SF group （P〈0.01）, but that was higher in SF group than in S group （P〈0.05）. Apoptotic index in IR group was significantly higher than that in other two groups （P〈0.01）, and that in SF group was higher than in S group （P〈0.05）. Conclusion Shenfu can enhance the expression of bcl-2, decrease the expression of bax, meanwhile increase the ratio of bcl-2/bax, inhibit small intestinal mucosal epithetlial cells apoptosis, and protect small intestine mucosal epithetlial after ischemic reperfusion.     

补肾活血方对PCOS大鼠模型卵巢中PAI-1mRNA表达的影响

目的探讨补肾活血方对大鼠PCOS模型卵巢局部纤溶酶原激活物抑制因子-1（PAI—1mRNA）表达的影响。方法选用未成年24d龄SD雌性大鼠60只,随机分为模型组、克罗米酚组、补肾活血方高剂量组、补肾活血方低剂量组、正常对照组5组。用Bogovich法建立大鼠多囊卵巢病理模型。以克罗米酚为对照。用原位杂交法观察补肾活血方对多囊卵巢大鼠局部PAI—1mRNA的影响。结果模型组卵巢局部PAI—1mRNA存在卵泡膜间质细胞显著增高,用补肾活血方高、低剂量与克罗米酚药后,卵巢局部PAI-1mRNA的表达明显降低．差异具有统计学意义（P〈0．05、P〈0．01）。补肾活血方高剂量组与克罗米酚组比较,差异具有显著统计学意义（P〈0．01）;低荆量组与克罗米酚组比较差异无统计学意义（P〉0．05）,补肾活血方高、低剂量组比较,低剂量组卵泡膜间质细胞上PAI-1的基因表达增高更明显,但二者差异无统计学意义（P〉0．05）。结论PAI-1mRNA可能与多囊卵巢综合征的发病机制有关。以补肾活血立法的补肾活血方能降低多囊卵巢大鼠局部PAI—1mRNA的显著增高表达．降低PAI—1mRNA卵巢局部的作用。提示补肾活血方可能通过PAI—1mRNA途径促进卵巢排卵的机制。     

New Mechanism of Herb-herb Interaction between Ginseng and Trogopterus Based on CYPs in Rat Livers

The study was designed to investigate the potential mechanism of herb-herb interaction between ginseng and Trogopterus （Trg） based on Cytochrome P450 isozymes （CYPs） in rat livers. We estimated the influence on CYP1A2, CYP2E1, and CYP3A1/2 activity caused by ginseng and Trg used in combination. The CYP1A2 and CYP2E1 enzyme activity were induced by ginseng and Trg used in combination. And this induction effect was caused via inducing CYP1A2 and CYP2E1 protein expression which was supposed caused by inducing the gene expression of CYP1A2 and CYP2E1.     

益智健脑颗粒联合针灸对阿尔茨海默病大鼠学习记忆的影响

目的观察益智健脑颗粒联合针灸对阿尔茨海默病（Alzheimers disease,AD）大鼠学习记忆的影响。方法将大鼠随机分为假手术组（A组）、模型组（B组）、针灸组（C组）、益智＋针灸组（D组）各10只,B、C、D 3组分别以海马CA1区注射β淀粉样蛋白25-35（Aβ25-35）造模,A组注射等量的双蒸水,各组分别治疗20 d后行Morris水迷宫试验,观察大鼠学习记忆能力变化。结果B组较A组的平均潜伏期明显延长,差异具有统计学意义（P〈0.05）;与B组比较,C组、D组的平均潜伏期明显缩短,过台次数增多,差异具有统计学意义（P〈0.05,P〈0.01）;与C组比较,D组的潜伏期缩短,过台次数增多,差异具有统计学意义（P〈0.05）。结论益智健脑颗粒联合针灸能够提高Aβ25-35介导的AD模型大鼠的学习记忆能力。     

The Targeted Pro-apoptotic Effect of scFv-mediated Delivery of Caspase-6 on HER2-positive Osteosarcoma Cells

Objective To investigate the pro-apoptotic effect of scFv-mediated delivery of caspase-6 fusion protein on osteosarcoma E 10 cells. Methods The expression of human epidermal growth factor receptor-2 （Her-2） in osteosarcoma cell line E10 was examined by flow cytometry analysis. ScFv-mediated delivery of caspase-6 was generated by sequential fusion of the genes of a signal peptide, a single-chain Her-2 antibody （e23sFv）, a PEA translocation domain （PEA aa253-264）, and an recombinant caspase-6. The pCMV-immunocaspase-6 was produced by cloning above mentioned fusion genes into pCMV plasmid, and then pCMV-immunocaspase-6 plasmid mixed cationic liposome was transfected into E10 cells. The expression of fusion gene on transfected E10 cells was detected by immunocytochemical staining, The pro-apoptotic effects of fusion gene expression on morphology and growth status of E10 cells were observed by trypan blue cell staining, electron microscopy and MTT assay. Results The fusion protein was detected in the cytoplasm of the transfected E10 cells. These cells presented typical characteristics of apoptosis as detected by electron microscopy. MTT assay revealed that the proliferation of transfected E10 cells was suppressed than that of non- or mock-transfected cells （P〈0.01）. Conclusion ScFv-mediated delivery of caspase-6 fusion protein can induce apoptosis of Her-2 positive osteosarcoma E10 cells, suggesting the potential of this strategy for the treatment of human high-grade osteosarcoma.