新时期军队精简整编过程中医院的建设重点

军队精简整编工作进入“实质性阶段”,军队总医院面临巨大的挑战和机遇。要求军队总医院从发展的角度、以长远的眼光审视现实,通过调整、改革、开拓和进取等方式,适应新形势下军队精简整编的总要求。本文从形象塑造、信息化建设、技术创新、人才培养和文化内涵建设等五个方面探讨了军队总医院的建设重点,与同行探讨。     

医院药品存货管理的缺陷

药品存货管理研究如何用最低成本来存贮最优数量的药品 ,以满足各临床科室所需。其核心问题有两点 ,即药品存货成本最低化和药品库存量最优化。而我国目前药品存货管理在上述两方面都存在着缺陷 ,具体表现为 :(1)成本方面 :①购置成本过高 ,②贮存成本过大 ,③订购成本难以控制 ;(2 )库存量方面 :①药房管理人员素质较低 ,难以确定科学的库存量 ,②与临床联系不够紧密 ,很难确定准确的库存量 ,③不能根据外界条件变化 ,及时调整库存量。文章就这两方面的问题进行探讨     

铁岭市2005年食品卫生微生物检测结果分析

[目的]了解铁岭市食品卫生状况,进一步加强我市食品生产经营单位的卫生监督管理,提高食品卫生质量。[方法]对本市2005年834份食品样品进行菌落总数、大肠菌群、致病菌检测。[结果]834份样品中,菌落总数、大肠菌群、致病菌合格率分别为86.93%、89.57%、100.00%,样品合格率为85.25%。冷冻饮品受污染最严重,合格率为64.29%。[结论]卫生监督部门应进一步加强食品生产企业预防性和经常性卫生监督管理,特别是夏季应增加监督检测频次。     

湖北省血吸虫疫区部分农村户厕粪便无害化处理效果调查

目的 了解湖北省部分县市血吸虫疫区农村户厕与粪便无害化处理现况.方法 于2007年9月选择血吸虫疫区的6个行政村(4个改厕村、2个非改厕村),每村随机抽查30座农村户厕,对调查对象的户厕建筑与粪便处理情况进行问卷调查,同时采集粪液样品进行实验室检验.结果 120座卫生户厕中,厕屋内无蛆、蛹、成蝇的有114座(95%),而60座非卫生户厕的厕屋内无蛆、蛹、成蝇的有20座(33.33%);卫生户厕粪液经三格式和沼气式的粪池无害化处理后,三格式第三池和沼气池出料口粪液中的蛔虫卵合格率分别为95.6%和98.6%,粪大肠菌值均合格,活蛔虫卵、血吸虫卵、活血吸虫卵均未检出;卫生户厕农户的血吸虫病患病率(8.45‰)比非卫生户厕农户(15.02‰)低43.7%.结论 血吸虫疫区农村的卫生户厕可比较有效地改善环境卫生,且对粪便无害化处理的效果显著,可降低血吸虫病患病率.

Abstract：

Objective To evaluate the current sanitary situation of the rural household latrine and the effects of decontamination of the feces in some epidemic areas of schistosome in Hubei province.Methods Six villages (4 villages with the sanitary latrines,2 villages with the non-sanitary latrines)were chosen for the investigation and 30 latrines were selected randomly in each village in September of 2007.The structure of the latrine and the situation of the faceal treatment were investigated by questionnaires.At the same time,the feces samples were collected and detected according to the related sanitary standards.Results The rate of the sanitary latrines witllout maggots.pupas and flies was 95%,while the rate of the non-sanitary latrines with the same situation was 33.33%.After non-hazardous treatment in the three-case-cesspool and the firedamp latrines,the qualified rates of the roundworm eggs were 95.6%and 98.6%respectively;the qualified rates of fecal coliform were both 100%:no schistosome eggs,the alive schistosome eggs and the alive roundworm eggs were detected.The morbidity rate of schistosomiasis of the villages with the sanitary latrines was 43.7%,lovwer than those with the non-sanitary latrines.Condusion The faecal treatment of the rural household latrine in epidemic areas of schistosome can improve the sanitation and kill the pathogens in faeces effectively.and also can decrease the morbidity rate of schistosomiasis obviously.     

2006年钦州市部分餐饮单位卫生许可审查量化评分情况分析

[目的]了解在钦州市推行食品卫生监督量化分级管理制度情况。[方法]2006年4~6月根据《餐饮业卫生许可审查量化评分表》对钦州市60家餐饮单位进行卫生许可审查量化评分;关键项目合格,得分为总分的85%以上为良好,60%~85%为一般,60%以下为差。[结果]60家餐饮单位中,卫生许可审查量化评分良好20家,占33.3%;一般27家,占45.0%;差13家,占21.7%;卫生管理、建筑与布局、食品储存和卫生设施4个环节的总评合格率为78.3%。[结论]钦州市餐饮单位卫生许可审查量化评分良好率较低,各环节的卫生设备设施有待进一步改进。应加强食品卫生监督量化分级管理的宣传和培训工作,做好新建、改建、扩建餐饮单位的预防性卫生监督审查,提高卫生许可审查量化评分良好率。     

无锡市南长区2010年小学生龋齿患病情况

目的了解无锡市南长区小学生的龋齿患病情况,及时科学地采取干预措施。方法以视诊为主,在自然光线直视下,使用探针及平面口镜,按象限顺序逐牙检查,经探诊后方可做出诊断并记录。结果在受检的13 427名小学生中,患病率为35.6%,其中男生35.3%,女生36.0%。低年级龋齿患病率高于高年级。结论该区龋齿患病率较高,应加强对预防龋齿措施和策略的研究。     

安徽省2004年部分医院内镜消毒现状调查

目的了解安徽省医用内镜管理现状及消毒灭菌效果,为预防和控制内镜引起的医源性感染提供依据。方法确定19所三等甲级医院和9所二级专科医院为调查点,采用问卷调查及现场采样进行内镜消毒质量监测。结果共检测内镜50台,其中消毒级内镜33台,除2台胃镜注水瓶细菌总数超标外,其余均合格,总合格率为93.9%;灭菌级内镜17台,无菌检验全部合格,合格率为100%。结论应定期进行消毒监测,加强消毒的监督和管理,提高消毒工作质量,避免因消毒灭菌问题引发医院感染。     

2003年汕头市住院婴儿住院情况分析

目的调查住院婴儿疾病分布情况。方法利用SAS8．0对汕头市2003年住院婴儿2923例病例进行统计分析。结果婴儿住院的病因包括：早产、新生儿窒息、呼吸道及消化道感染、新生儿黄疸以及先天性疾病等；造成婴儿死亡的前5位病因主要是出生窒息、窘迫、先天性肺炎、新生儿吸人性肺炎以及先天性心脏畸形；婴儿的住院时间越长，入院情况越危急，受到医院感染的机会越大；入院婴儿平均住院日为7．089天，平均住院费用3717．834元。结论婴儿发病入院主要由于先天性疾病以及后天感染，这是家庭及社会进行婴儿健康干预与促进的重点。     

2013年上海市奉贤区铸造企业作业场所空气中矽尘浓度检测结果

目的了解上海市奉贤区铸造企业在生产环境中所产生矽尘的职业危害和分布规律,为改善作业环境,保护作业人员健康,提供科学依据。方法对产生矽尘企业进行职业卫生学调查,按国家有关标准和规范对作业工人进行个体采样,并检测生产环境空气中的时间加权平均浓度（CTWA）。结果对63名作业工人进行个体采样,男性55人,女性8人;年龄最小为23岁,最大58岁,平均年龄40.4岁。矽尘浓度范围0.2~9.0 mg/m3,平均浓度为（2.27±1.95）mg/m3,中位数为1.60 mg/m3。矽尘浓度检测合格率为23.8%。各工种在空气中矽尘浓度检测合格率差异无统计学意义（χ2=6.226,P〉0.05）。不同接尘工龄矽尘浓度检测合格率差异有统计学意义（χ2=9.078,P〈0.05）。结论应重点加强对35~49岁组和接尘工龄1~9 a组职业卫生健康监护,进一步加强生产工艺改革和通风排毒防护措施、改善作业环境,有效控制矽肺职业病的发生。     

2014年深圳市南山区手足口病流行病学分析

摘要:目的　分析深圳市南山区2014年手足口病（HFMD）流行病学特征,为手足口病防控工作提供科学依据。方法　采用描述性流行病学方法对南山区手足口流行时间、空间、人群分布和手足口病例临床特征进行分析,应用Real-time RT-PCR 技术对手足口病暴发疫情的主要病原体进行检测。结果　2014年南山区手足口病流行每年存在2个高峰,约第17～27周（5-7月）出现全年第一个发病高峰,约第36～40周（9-10月）出现第二个发病高峰。病例人群男性多于女性（1.6∶1）,0～4岁年龄组病例最多,占病例总数的85.6%,病例大多伴发热,出现典型的皮疹,并发症中以神经系统为主。病原体检测中EV71阳性率最高,占43.5%。结论　南山区手足口病流行有夏秋季节高发的特点,病例以0～4岁年龄组幼童为主,以EV71感染多见。因此,需加强手足口病监测,有效预防手足口病流行或暴发。     

2011年大连市医疗卫生机构消毒监测结果分析

目的了解大连市医疗机构消毒状况,找出存在的问题,以便改进和提高。方法采用现场采样检测方法,对医院的不同对象消毒质量进行监测。结果室内空气的合格率仅为74．68％,医护人员手的合格率为94．02％,物体表面的合格率为93．17％,消化内镜的合格率为80．56％,医院污水的合格率为96．OON,透析液的合格率为94．74％,注水瓶水的合格率为69．23％,湿化液的合格率为80．00％,使用中消毒剂、压力蒸汽灭菌器、灭菌物品和反渗水的合格率均为100．00％。结论大连市医疗机构消毒与灭菌质量状况整体较好,但还存在不同程度的问题,应加强薄弱环节的管理。     

日喀则地区2005年健康儿童肠道病毒病毒学监测分析

目的做为中国急性弛缓性麻痹(AFP)病例监测系统和中国维持无脊髓灰质炎(脊灰)状态的一部分,对日喀则地区2005年健康儿童肠道病毒(EV)的携带情况进行监测分析,为西藏自治区维持无脊灰提供实验室依据。方法2005年3月在日喀则地区3个县的0～5岁健康儿童中共采集粪便标本70份,进行EV分离和血清型鉴定。对分离到的脊灰病毒(PV)同时使用逆转录-聚合酶链反应和酶联免疫吸附试验进行型内鉴定,对分离到的所有非脊灰肠道病毒(NPEV)进行VP1区核苷酸序列测定以鉴定血清型。结果从70份粪便标本中共分离到16株PV,阳性率为22.86%。型内鉴定及VP1区核苷酸序列测定和分析结果显示,2005年日喀则地区无脊灰野病毒和疫苗衍生脊灰病毒的存在;共分离到9株NPEV,阳性率为12.86%。结论日喀则地区2005年继续保持无脊灰状态。EV监测为后续研究提供宝贵的资料,也为EV监测逐渐整合到AFP病例监测系统中做了有益的尝试。     

Seroprevalence of toxocariasis in schoolchildren in Trinidad

The seroprevalence of toxocariasis was investigated in 1997/98 in 1009 schoolchildren (aged 5-12 years) throughout Trinidad. Infection, as measured by titre, was found to be high compared to values obtained from children in other countries. Using an excretory-secretory antigen and performing an ELISA test, it was found that 62.3% of children had an IgG antibody titre of > or = 1:100, indicating exposure to the parasite, while 27.2% had a titre of > or = 1:800, indicating a current or recent infection. Relationships were explored between seroprevalence and host factors including age, sex, school location, and other risk factors including geophagia, thumb-sucking, presence of other gastrointestinal-tract parasitism and pet ownership. There was no significant relationship between age and the presence of current or recent infection (P = 0.746). Boys were significantly more commonly infected than girls as were the attendees of rural schools versus urban schools (P < 0.001). The percentage of seropositivity among children varied widely from school to school. Pet ownership and the absence of pipe-borne water in the household were found to be significantly associated with positive serology (P < 0.05). Clinical symptoms mostly associated with positive serology were eczema, seizures and chronic cough. Recommendations derived from this study include health education in order to increase the public awareness on the transmission of the disease, de-worming all dogs and cats periodically and the curbing of stray dogs and cats. Environmental sanitation measures should include keeping children away from contaminated areas and practising proper hygiene after play.     

Role of antenatal care in toxemia of pregnancy in alexandria

Pre-eclampsia and eclampsia remain one of the major obstetrical problems in less developed countries. Proper antenatal care (ANC) with regular measurement of blood pressure remains the mainstay of screening for hypertension in pregnancy. The aim of the current study was to identify frequency and characteristics of women with toxemia of pregnancy, assess both the quantitative and qualitative adequacy of antenatal care among cases with toxemia of pregnancy and to evaluate the effect of antenatal care on maternal and perinatal outcome. A cross-sectional case series study design was utilized .The study population was all cases, with confirmed diagnosis of toxemia of pregnancy who were admitted to El-Shatby University hospital during the period from January to May 2005. A structured interviewing schedule was used to collect data on characteristics of cases, maternal and fetal outcome. Site, adequacy and quality of received antenatal care were assessed. Out of total cases (336), 14.29% were diagnosed as mild pre-eclampsia, 83.31% were found to have severe pre-eclampsia while 2.40% were suffering from eclampsia. The severity of the condition was significantly associated with older maternal age, multiple pregnancy, primigravity, nulliparity, low socioeconomic conditions, husband's smoking and excessive caffeine consumption. Three-quarters of eclampsia cases (75.0%) didn't receive antenatal care and 60.0% of severe pre-eclamptics received inadequate antenatal care. The mean percent score of quality care domains of antenatal care content for mild pre-eclamptics was 75.62 +/- 13.80%. This was significantly higher than that for those of severe (59.96 +/- 27.95%) or for eclampsia cases (48.75 +/- 20.04%) where X(2) of Kruskal-Wallis=8.316 (P<0.001). Adverse maternal and fetal outcome occurred in 79.4% of women and 72.3% of babies for those who received poor quality ANC. In conclusion, the complications of pre-eclampsia and eclampsia could be prevented by wide spread use of adequate antenatal care, education and training of primary medical care personnel, prompt diagnosis of high risk patients and timely referral to higher level health care.     

婺城区城乡居民1986—1988年、2004—2005年死亡模式变化趋势研究

目的：比较金华市婺城区城乡居民1986—1988年和2004—2005年全死因模式。方法：按照《全国第三次死因回顾抽样调查实施方案》要求进行回顾性调查。结果：居民死亡率下降了2．06‰；居民期望寿命男性提高了4．38岁，女性提高了5．64岁；前5位死因顺位变化依次为恶性肿瘤（原第二位）、呼吸系统疾病（原首位）、脑血管病（原第四位）、心脏病（原第五位）和损伤中毒（原第三位）；传染病和寄生虫病死亡率下降了59．88％；慢性非传染性疾病死亡构成由63．4％上升到83．0％。结论：两个时期对比居民总体健康水平提高明显；前5位死因死亡率上升迅速；传染病寄生虫病死亡率有所下降；慢性非传染性疾病死亡比例上升。     

上海市29084例羁押人员HIV感染状况分析

目的了解上海市监管场所羁押人员艾滋病感染现状,寻找可能影响羁押人员感染的因素,为制定综合防治措施提供依据。方法对辖区内6家监管场所羁押人员有高危行为的新进人员进行HIV相关行为学调查并做抗体筛查,筛查呈阳性反应者送上海市艾滋病确认实验室确认;并运用EpiData3.1和SPSS13.0对有效问卷进行统计分析。结果 29084例羁押人员中,确认HIV抗体阳性者525例,阳性率为1.80%,男性阳性率为1.90%,女性阳性率为1.11%。被调查人员中男女平均年龄差异有统计学意义。上海市户籍的阳性检出率为0.33%。新疆户籍的阳性检出率最高为59.61%,且25～39岁之间HIV抗体阳性率高于其他年龄组。单因素分析HIV抗体阳性与性别、入所年份、年龄、户籍、入所季度、吸毒、性乱有关。多元回归分析显示影响因素为性别、入所年份、年龄、户籍、入所季度和注射吸毒。结论监管场所HIV抗体阳性检出率呈逐年下降趋势,应重点加强对注射吸毒和部分省市的青壮年人群进行有效的行为干预。     

The role of epidemiology in prevention of hypertension in Israel

High blood pressure may be the most important modifiable determinant of severe morbidity and mortality in the adult population in Israel. Because hypertension control can effect a reduction in this morbidity and mortality, programs of secondary--and subsequently primary--prevention can have a far-reaching impact on the state of health in the nation. The primary care delivery system in Israel is structurally well suited to centrally directed initiatives. Major hypertension control programs are being introduced in Israel. The General Federation of Labour Sick Fund (Kupat Holim)--the nation's chief provider of primary care--has recently undertaken a wide-scale initiative for detection and treatment of high blood pressure in its neighborhood primary care clinics. A policy decision has thus been made on a national level; resources for intervention have been made available and activities initiated. The issue in need of resolution, the authors believe, is that of the integration of rigorous epidemiologic methodology into the planning and execution of the programs, particularly in program evaluation and resultant program modification. The authors outline selected epidemiologic characteristics of hypertension in Israel, emphasizing the major role that elevated blood pressure plays as a determinant of mortality; the present status of hypertension control; current programs for control; and the role of epidemiology in preventive programs.     

志贺氏菌属显色培养基在食品检测中的应用研究

〔目的〕考核志贺氏菌属显色培养基对食品中志贺氏菌的检测效果,确认其是否可作为新型快速检测方法。〔方法〕按国标(GB 4789.5-2003)程序比较几种培养基检测食品中志贺氏菌的效果。〔结果〕志贺氏菌属显色培养基与传统平板SS、麦康凯相比对测试菌株有更高的灵敏度和特异性,可提高检出率。〔结论〕用志贺氏菌属显色培养基检测志贺氏菌是一种新的快速途径,可明显提高检测效率。     

淮北市农村初中留守儿童生活质量现状分析

目的了解淮北市农村初中留守儿童生活质量现状，为改善农村留守儿童生活质量提供相关依据。方法运用“学校生活满意度量表”、“家庭亲密度与适应性量表”和“青少年生活事件量表”对淮北市82名农村初中留守儿童和196名非留守儿童进行问卷调查。结果留守儿童与非留守儿童在学校满意度的同伴、教师和学业因子上差异有统计学意义（t值分别为2．89，3．02，2．97，P值均〈0．01）。在学校环境因子、家庭亲密度因子、家庭适应性因子、人际关系和健康适应因子等因子上差异均有统计学意义（P值均〈0．01）。留守儿童生活事件各因子上的性别差异均无统计学意义。在学校环境因子、家庭亲密度和适应性因子上的年级间差异有统计学意义（P值均〈0．01）。不同家庭背景的留守儿童各因子得分差异均无统计学意义。结论农村留守儿童的生活质量普遍低于非留守儿童，留守儿童中的女生、初二年级学生及城镇家庭学生的生活质量更低。     

2008年深圳市轮状病毒感染所致腹泻的调查分析

目的:了解深圳市感染性病毒性腹泻中轮状病毒的感染情况,为制定预防轮状病毒感染的策略提供依据。方法:采用实时荧光RT-PCR,对2008年深圳市606例疑似腹泻患者粪便标本进行轮状病毒的检测。结果:轮状病毒感染率为15.18%(92/606),其中男性感染率为16.41%(54/329),女性感染率为13.72%(38/277)。0~2岁年龄组轮状病毒感染率为28.21%(22/78),3~4岁年龄组感染率为0%(0/5),5~14岁年龄组感染率为18.75%(3/16),15~19岁年龄组感染率为5.71%(2/35),20岁以上年龄组感染率为13.77%(65/472)。结论:轮状病毒感染全年均可发生,冬季尤有较高感染率。基本上各年龄组男女人群都可感染,其中0~2岁婴幼儿感染率最高。应加强对轮状病毒引起的感染监测,尤其是对婴幼儿感染的预防控制。