Objective To investigate the current situation of sterile supply management in primary healthcare institutions in Pudong New Area of Shanghai, analyze the existing problems, and provide a scientific basis for formulating and implementing follow-up improvement measures. Methods The primary healthcare institutions in Pudong New Area were surveyed from June to July 2024. The contents of the questionnaire included the nature of the institution, sterile supply mode, personnel, facilities and equipment configuration, quality monitoring and sterile supply management. Results A total of 71 valid questionnaires were collected, including 25 public institutions and 46 non-public institutions; 29.6% used the sterile supply mode outside the hospital, and 70.4% used the sterile supply mode inside the hospital. In primary healthcare institutions with in-hospital sterile supply mode, part-time staff accounted for 46.1%, staff under the age of 40 accounted for 69.5%, professional qualification holding rate was high (94.3%), and their education was mainly junior college (60.3%). Healthcare institutions were all equipped with steam sterilizers, and the configuration rate of cleaning and disinfection machines (92.0%) were high, but the configuration rate of water treatment and drying equipment (70.0%), information traceability system (48.0%) and low-temperature sterilizers (10.0%) were low. Disinfection and sterilization quality monitoring had been widely carried out (96.0%), but the cleaning quality monitoring rate was low (88.0%). The implementation rate of multiple requirements exceeded 96%, but the utilization rate of information traceability system was low (36.0%). The proportion of primary healthcare institutions with out-of-hospital sterile supply mode that conducted quality monitoring, requested quality reports and carried out on-site inspection on the goods provided by the service provider were less than 80%. The proportion of healthcare institutions with full-time personnel, contaminated equipment collection and temporary storage room and sterile goods handover and distribution room did not exceed 80%, and the utilization rate of information traceability system was also less than 50%. Conclusions There are still deficiencies in personnel allocation, equipment and facilities, quality monitoring and system implementation of sterile supply management in primary healthcare institutions in Pudong New Area.
Objective To evaluate the effects of glucose-containing dialysate versus glucose-free dialysate on blood pressure variability and blood glucose variability in maintenance hemodialysis (MHD) patients and to assess safety. Methods MHD patients from 12 hospitals were enrolled between October 2024 and June 2025. According to the randomized block design, patients were randomly divided into the glucose-containing dialysate group (experimental group) and the glucose-free dialysate group (control group). During hemodialysis sessions, blood pressure were monitored at 0, 1, 2, 3, and 4 hours, and blood glucose was measured at 0, 2, and 4 hours monthly for six consecutive months. Hypotension episodes and hypoglycemic episodes were recorded throughout dialysis. Results A total of 244 MHD patients were included, with 122 in each group. Compared with the control group, the experimental group showed significantly lower systolic blood pressure variability [dialysis for 2 hours: 9.92 (7.92, 12.52) vs. 11.95 (9.45, 15.36) mm Hg (1 mm Hg=0.133 kPa), P<0.001; during the 0-2 hour dialysis period: 2.60 (1.24, 3.97) vs. 3.74 (2.03, 6.52) mm Hg, P=0.011], diastolic blood pressure variability [during the 0-4 hour dialysis period: 3.85 (1.49, 6.69) vs. 4.72 (1.99, 8.46) mm Hg, P<0.001], blood glucose variability [dialysis for 2 hours: 0.16 (0.12, 0.20) vs. 0.18 (0.13, 0.23) mmol/L, P=0.002; dialysis for 4 hours: 0.17 (0.13, 0.22) vs. 0.21 (0.17, 0.26) mmol/L, P<0.001; during the 2-4 hour dialysis period: 0.04 (0.02, 0.08) vs. 0.07 (0.03, 0.10) mmol/L, P=0.004], incidence rates of hypotension (32.9% vs. 33.3%, P=0.005) and incidence rates of hypoglycemia (0.42% vs. 4.02%, P<0.001). Conclusions Glucose-containing dialysate reduces both blood pressure variability and blood glucose variability more effectively than glucose-free dialysate during hemodialysis. Compared with glucose-free dialysate, the glucose-containing dialysate demonstrated a lower incidence of hypotension episodes and hypoglycemic episodes.