住院患者医院感染现患率调查

目的了解住院患者医院感染现状,以便完善医院感染监控措施。方法采用横断面调查方法,分别在2009年9月2日和2010年10月19日对青州市人民医院住院患者进行了医院感染现患率调查。结果该医院2009年调查当日应调查住院患者494例,实查率98.99%,医院感染现患率为1.43%。2010年调查当日应调查住院患者514例,实查率99.81%,医院感染现患率为1.95%。2009与2010年度医院感染部位均以呼吸道感染占首位,分别为57.14%和70.00%;当日抗菌药物使用率分别为64.62%和59.65%;标本送检率分别为3.85%和15.08%。结论该医院2次调查的医院感染现患率和抗菌药物使用率均无明显差别,2010年细菌标本送检率明显提高。     

2000例妇女宫颈人乳头瘤病毒普查结果分析

目的:了解妇女宫颈人乳头瘤病毒感染及感染类型。方法:选取参与普查的2 000例妇女为研究对象,在告知受检者实验目的并得到同意的情况下,使用HC-2的检验方式对受检者进行宫颈刮片并对结果进行HPV的DNA检测以确定受检者HPV类型。结果:普查的2000例受检者中检测出HPV感染者一共832例,占普查总人数的41.60%,而在检出的832例感染者中,高危型HPV者617例,占HPV感染总人数的74.16%,低危型HPV感染者占总感染人数的25.84%。单发感染占53.73%,多发感染占46.27%。结论:该次普查结果中发现HPV-16、18、33、56、58的检测阳性率明显多于其他,这与目前外界报道研究结果相符合;广大妇女应定时的进行HPV测定,以及时纠正宫颈病变和预防宫颈癌的发生。     

克罗恩病患者吸烟饮酒现状的调查与分析

目的了解克罗恩病患者吸烟饮酒现状,为给予针对性的生活习惯指导和健康教育提供借鉴。方法采用便利抽样的方法,应用自行设计的炎症性肠病患者吸烟饮酒情况调查问卷对杭州、南京和广州三市多家医院的157例克罗恩病患者进行调查。结果克罗恩病患者确诊后吸烟率为14.01%,且均为男性,其中36.36%患者每日吸烟量大于10支,有超过半数的患者存在不同程度的被动吸烟情况。目前有36.36%的吸烟患者已经戒烟;克罗恩病患者确诊后饮酒率为7.64%,其中38.46%患者每日饮用两种类型酒,23.08%患者饮酒频率超过3次/周,还有部分患者每日饮酒量超过正常人群平均水平。目前,50.00%的饮酒患者已经戒酒。结论部分克罗恩病患者仍有吸烟和/或饮酒的生活习惯,在知晓其具体吸烟饮酒行为的基础上,通过评估其对烟酒与疾病关系的了解程度给予个体化的健康指导,强调戒烟和适度饮酒对疾病的重要性。     

Physiological basis of preoperative cardiopulmonary exercise testing

The use of cardiopulmonary exercise testing (CPET) is gaining popularity as a preoperative functional assessment tool and a useful adjunct to risk stratification before surgery. Determination of the integrated response of multiple body systems (including the cardiorespiratory and peripheral oxygen delivery systems) to exercise stress, adds important prognostic value to pre-surgical assessment, shared-decision making and postoperative management of the surgical patient. Thorough CPET interpretation is complex but may be assisted by an understanding of basic exercise physiology and its application to the preoperative context.     

Impact of polymerase chain reaction results on patient management during a viral meningitis outbreak in Tropical North Queensland

Objectives: Enterovirus is the most commonly isolated pathogen in viral meningitis. We report on the first outbreak of viral meningitis in Tropical Queensland and the effect of polymerase chain reaction (PCR) results on antibiotic use and hospital length of stay. Methods: Retrospective case series of consecutive patients presenting to the Townsville ED with viral meningitis were evaluated by examining hospital medical records. The study period was November 2008 to February 2009. Results: Forty‐three patients were available for full analysis of which 17 (40%) were female and 17 (40%) had a positive enteroviral PCR. Antibiotics were commenced on 37 (86%) of patients. There was no difference in hospital length of stay in patients with a negative versus positive PCR (2.52 vs 2.72 days, P = 0.68) or duration of antibiotic therapy (2.20 vs 1.94 days, P = 0.61). Conclusion: In our study a positive result on PCR was not associated with a shorter hospital length of stay or a shorter duration of antibiotic therapy. This contrasts with previous reports on this topic and requires further evaluation.     

甘肃省张掖市中老年人骨关节炎流行病学调查分析

目的调查甘肃省张掖市人群骨关节炎流行病学资料,为骨关节炎的防治提供参考数据。方法采用随机整群抽样的方法,在张掖市6个县区40岁以上的人口进行抽样,发放骨关节炎健康状况调查表,并对获得的数据进行统计分析。结果在1 341名资料完整的调查对象中,男性共有653人,平均年龄(60.75±12.33)岁;女性共有688人,平均年龄(53.82±14.35)岁;骨关节炎患者共247例,患病率为18.4%。其中,男性骨关节炎患者75例,患病率为11.5%;女性骨关节炎患者172例,患病率25.0%。女性的患病率比男性更高,而整体患病率随着年龄增大而增高(P0.05)。文职类工作和慢跑为骨关节炎患病的保护性因素,而游泳和武术则会增加骨关节炎的患病风险(P0.05)。结论甘肃省张掖市人群骨关节炎整体患病率较高,应加强骨关节炎的防治工作。     

绍兴地区3~6岁儿童单纯性肥胖的流行病学调查

目的 了解绍兴地区3~6岁儿童单纯性肥胖的流行特征及其影响因素, 为肥胖儿的早期干预提供科学依据。方法 采用分层整群随机抽样的方法选取本地区17 640 名学龄前儿童作为研究对象, 进行相关的体格测量、评价和问卷调查。结果 17 640名学龄前儿童中, 单纯性肥胖检出率为4.92 %, 男童为5.72%, 女童为4.04%, 差异有统计学意义(χ²=50.111, P<0.01);超重检出率为11.05 %, 男童为10.96%, 女童为11.52%, 无性别差异(χ²=1.703, P>0.05)。经多因素Logistic回归分析显示:出生体重, 纯母乳喂养持续时间, 看电视时间, 母亲BMI, 进食速度, 甜食摄入频率与肥胖的发生关系密切。结论 本地区学龄前儿童肥胖和超重的检出率处于较高水平。应加强对肥胖和超重的学龄前儿童的综合管理和早期干预, 降低肥胖和超重的发生率。     

Molecular Investigation of Tularemia Outbreaks,Spain, 1997–2008

Tularemia outbreaks occurred in northwestern Spain in 1997–1998 and 2007–2008 and affected >1,000 persons. We assessed isolates involved in these outbreaks by using pulsed-field gel electrophoresis with 2 restriction enzymes and multilocus variable number tandem repeat analysis of 16 genomic loci of Francisella tularensis, the cause of this disease. Isolates were divided into 3 pulsotypes by pulsed-field gel electrophoresis and 8 allelic profiles by multilocus variable number tandem repeat analysis. Isolates obtained from the second tularemia outbreak had the same genotypes as isolates obtained from the first outbreak. Both outbreaks were caused by genotypes of genetic subclade B.Br:FTNF002–00, which is widely distributed in countries in central and western Europe. Thus, reemergence of tularemia in Spain was not caused by the reintroduction of exotic strains, but probably by persistence of local reservoirs of infection.     

8133例产妇医院感染临床调查分析

目的探讨产妇医院感染的临床特点及相关因素。方法对我院产科病房2010年1月至2011年5月出院的8 133例产妇发生医院感染的情况进行回顾性调查分析。结果产妇发生医院感染48例,感染发生率为0.59%;感染部位前3位是上呼吸道、下呼吸道和剖宫产切口,构成比分别为29.17%,22.91%,22.91%;剖宫产产妇医院感染发生率明显高于顺产产妇(P<0.01);有妊娠合并症的产妇医院感染发生率明显高于无合并症的产妇(P<0.01)。结论产科病房应加强空气的流通和消毒,掌握剖宫产指征,严格无菌操作,积极治疗合并症,从而降低医院感染的发生。