Prevention and Control Strategies of Nosocomial Infection and Effectiveness Evaluation in a Tertiary Teaching Hospital during the Epidemic of COVID-19

Objective: To evaluate the role of prevention and control strategies for nosocomial infection in a tertiary teaching hospital during the sudden outbreak of Corona Virus Disease 2019 (COVID-19). Methods: The hospital initiated an emergency plan involving multi-departmental defense and control. It adopted a series of nosocomial infection prevention and control measures, including strengthening pre-examination and triage, optimizing the consultation process, improving the hospital’s architectural composition, implementing graded risk management, enhancing personal protection, and implementing staff training and supervision. Descriptive research was used to evaluate the short-term effects of these in-hospital prevention and control strategies. The analysis compared changes in related evaluation indicators between January 24, 2020 and February 12, 2020 (Chinese Lunar New Year’s Eve 2020 to lunar January 19) and the corresponding lunar period of the previous year. Results: Compared to the same period last year, the outpatient fever rate increased by 1.85-fold (P P Conclusion: The nosocomial infection prevention and control strategies implemented during this specific period improved the detection and control abilities for the COVID-19 source of infection and enhanced the compliance with measures. This likely contributed significantly to avoiding the occurrence of nosocomial infection.

The status quo and challenges of prevention and control of chronic obstructive pulmonary disease in China

Introduction Characterized as persistent and progressive pulmonary function declining,chronic obstructive pulmonary disease (COPD) can be accompanied by a systemic inflammatory response.A variety of psychiatric and somatic comorbidities can occur to the patients,such as depression,nutritional disorders,cardiovascular disease,and lung cancer.It is imposing great impacts on the quality of patients' life.In 2010 alone,the economic burden of COPD in the world was as high as 2.1 trillion dollars [1].The high prevalence,mortality,and morbidity have made this disease a major public health problem in socio-economic development with a rapidly aging population in China.

Occurrence and Damage Characteristics of Sugarcane Catastrophic Diseases and Pests in Menglian Sugarcane Area and Their Prevention and Control Strategies

In recent years,the conditions of continuous warm winter,more rain and high humidity are very beneficial to the breeding and survival of sugarcane diseases and pests.Coupled with the degradation of single varieties,more attention on new plants and less on ratoon cane and the unscientific and unreasonable use of chemical pesticides,the types of sugarcane diseases and pests in the Menglian sugarcane area are increasing day by day,and the damage is increasing year by year,resulting in a substantial reduction in production and sugar,and a serious disaster threat to sugarcane production.Based on the field survey and the current sugarcane production practice in Menglian,this paper systematically reviewed the occurrence and damage dynamics and outbreak reasons of catastrophic diseases and pests that seriously influence sugarcane production,and proposed corresponding prevention and control strategies and integrated prevention and control technology according to the occurrence and damage characteristics of catastrophic diseases and pests.

Clinical Characteristics and Prevention Strategies of Falls in Hospitalized Patients with Chronic Kidney Disease

Objectives: To analyze the clinical features of falls in hospitalized patients with chronic kidney disease (CKD), and to provide basis for preventing the occurrence of falls in hospitalized patients with CKD. Method: A retrospective study was conducted to analyze the 27 adverse events of falls in hospitalized patients from the department of nephrology in Peking University Shenzhen Hospital during May 2009 and May 2019. Results: Among the 27 patients with falls, people over 65 years old accounted for 55.56%;74.07% of the patients had caregivers;the peak period of falls was from June to August, accounting for 40.74%, mainly occurring from 7:00 to 8:00, 12:00 to 13:30 and 19:00 to 21:00;the locations of falls were mostly near the bed and in the bathroom, accounting for 33.33% and 22.22%, respectively;suffering from anemia, hypoproteinemia, abnormal serum potassium, calcium-phosphorus metabolism disorders accompanied by abnormal parathyroid hormone and hypertension accounted for 88.89%, 85.19%, 29.63%, 96.30% and 81.48% respectively. The inpatients on dialysis therapy accounted for 66.67%. Conclusion: The occurrence of falls in hospitalized patients with CKD was not only related to age, caregivers, time, months, locations or other conventional factors, but also the complications and dialysis therapies. To effectively reduce the occurrence of falls, it’s necessary to enhance the sense of safety and responsibility of caregivers. Besides, nurses should strengthen the inspection of wards for inpatients engaging in some intensive activities, and nurses should also pay more attention to the inpatients with anemia, hypoproteinemia, calcium-phosphorus metabolism disorders and those on dialysis therapies.

The Limits of the Intervention of Public Power in Individual Health Choices——From the Perspective of the Realization of the Right to Health in the Prevention and Control of Chronic Diseases

Noncommunicable chronic diseases have become the most important public health problem in the world today,so the focus of public health services should be shifted from the traditional area of communicable diseases to the prevention and control of chronic diseases.Since bad living habits are the most direct cause of chronic diseases,the most effective measure to prevent and control chronic diseases is to promote healthy lifestyles for the individual citizen.The theories of equal health opportunity,the right to health from the perspective of human rights,and determinants of a healthy society provide justified reasons for the intervention of public power in individual health choices.In the current legal system,the intervention of public power is limited to flexible measures such as health education,which shows respect for individual autonomy.However,it is inconsistent with the needs of current public health practice.We should expand diversified intervention means to encourage individuals to make healthy choices under the guidance of the management model.The“ladder of intervention”outlines a panoramic view of the intervention measures available.However,for the selection of specific measures,it is necessary to consider the public health objectives and the invasion of individual freedom,introduce the“legal reservation principle”and“proportionality principle”as policy analysis tools,and reasonably choose intervention measures at different levels on the ladder to properly handle the tension between public power and private rights.

Future challenges and solutions for safety in China:China CDC’s exploration of injury prevention strategies

As an important component of worldwide injury prevention,China has made great contribution to the development.China is serving as a model for other countries in the world,especially developing countries,and China’s experience has great implications for them.Besides the description of the present situation and trends of China’s injury prevention work and review for its development history,this paper has also introduced the existing issues and the current challenges,and informed the e orts of the sta in related eld to nd solutions from di erent aspects.All of them jointly boosted the development of global injury prevention.

Strengthen national action for the prevention and control of chronic respiratory diseases

Chronic respiratory diseases are chronic diseases of the airways and other structures of the lung.Some of the most common are asthma,chronic obstructive pulmonary disease （COPD）,respiratory allergies,occupational lung diseases and pulmonary hypertension.Hundreds of millions of people suffer every day from chronic respiratory diseases.COPD is one of the most representative chronic respiratory diseases.A population-based,cross-sectional survey of COPD conducted between 2003 and 2004 showed that the overall prevalence of the disease in people aged above 40 years was 8.2%,1 which would result in a COPD patient population of over 43 million.

新发展阶段我国体卫融合的内在逻辑与价值使命

面对人类疾病谱的变化,“深化体卫融合,推动健康关口前移”是应对未来疾病防控的全新趋势,更是实现健康中国、体育强国建设目标的重要支撑。研究认为:依据体育和医疗卫生在健康促进方面的服务侧重点,厘清了处于健康状态时需要以“体育为主、医卫为辅”的主动性预防,亚健康状态时需要“体育与医卫相互调整”的协调性预防或“医卫治疗、体育调节”的沟通性防治,以及不健康状态时需要以“医卫治疗为主、体育康复为辅”的通力配合的体卫融合的内在逻辑;提出了体卫融合的价值使命,即把握健康促进新认知、应对慢性疾病防控新变化、转变医疗卫生新角色、肩负体育责任新使命。

2021-2022年洛阳市涧西区作业场所职业病危害因素的监测结果及具体防控策略研究

目的统计洛阳市涧西区各作业场的职业病危害因素,分析职业病发生的主要原因,并探讨具体防控策略。方法收集洛阳市涧西区内2021年1月—2022年12月期间针对各作业场的职业病危害因素监测信息,录入Excel 2010进行数据统计;随机抽取辖区内200名重点职业从业人员,开展回顾性分析,结合职业健康检查结果,将确认存在职业病的115名从业人员列为病例组,其余未发生职业病的85名从业人员列为对照组,比较2组一般资料、临床资料,经统计学单因素、Logistic多因素回归分析归纳可导致职业病发生的影响因素,结合分析结果,探讨具体防控措施。结果针对辖区内15家厂矿企业,2021年共设立584个监测点,共测得68处锰及其化合物危害、48处矽尘危害、4处苯及其苯系物危害、12处噪声危害,超标率为22.60%(132/584);2022年共设立1575个监测点,共测得158处粉尘危害、154处锰及其化合物危害、10处矽尘危害、13处噪声危害,超标率为21.27%(335/1575);单因素分析结果显示,2组从业人员的年龄、工作年限、职业类型、体检频率、体检结果等比较差异均存在统计学意义;Logistic多因素回归分析显示,年龄≥50岁,工作年限≥10年,从事制造业、采矿业,未规律体检,血常规异常,免疫力差,X线胸片异常,双耳高频听力阈值≥40 dB均是发生职业病的重要原因(均P<0.05)。结论洛阳市涧西区的职业危害因素以粉尘、锰及其化合物为主,高龄、工作年限长的制造业、采矿业人员发生职业病的风险相对较高,优化职业病防治措施并规范上述重点人群的职业健康体检能实现对职业病的有效防控。

健康中国战略下慢性病防控多部门合作评价指标体系构建研究

目的:构建健康中国战略下慢性病防控多部门合作评价指标体系,为多部门合作的评价和改进提供参考。方法:基于D Amour的合作结构模型构建初始指标体系,选择15位公共卫生专家,运用德尔菲法进行两轮专家咨询完善评价指标,通过层次分析法确定指标权重。结果:专家积极系数、权威程度、意见协调程度均较好,最终形成慢性病防控多部门合作评价指标体系,包含5个一级指标、12个二级指标和34个三级指标;一级指标及权重分别为目标愿景(0.2228)、内在认同(0.1587)、治理结构(0.2523)、合作规范(0.1545)、合作效果(0.2118)。结论:本研究构建了适用于县(市/区)的慢性病防控多部门合作评价指标体系,具有较高的科学性及可操作性,为下一步应用及推广奠定基础。

体、卫、教融合的主动健康模式是青少年慢病防控的重要手段

党的十九大以来,我国卫生健康水平已得到显著提升,然而慢性病制约了我国卫生健康事业的进一步发展。主动健康是一种更为积极的健康管理策略,强调通过健康的生活方式以预防疾病发生,对慢性病的防控意义重大。鉴于我国慢性病患病群体已呈现年轻化趋势,从青少年时期即开始进行慢性病预防极为必要,研究显示,在青少年中推行主动健康策略,对慢性病预防和健康促进具有明显成效。体、卫、教融合是推动青少年主动健康理念落实的重要方式,通过将体育、医疗卫生、教育领域相融合的新理念,可更好地促进青少年健康发展,但目前体卫融合、体教融合尚不足,需此3个领域协同发展,共同完善相关措施,方可充分发挥对青少年主动健康的促进效应。

重庆市慢性病防控资源配置适宜程度研究

背景目前,慢性非传染性疾病(以下简称慢性病)成为影响我国人民群众健康的主要疾病。对慢性病防控资源配置的研究多为现况调查或公平性分析,且缺乏代表性强的结果评价指标。目的分析重庆市慢性病防控资源配置适宜程度的变化情况,探讨其对慢性病防控效果的影响。方法按照“穷尽”原则,系统收集政府、卫生健康委及相关部门网站、中国知网(CNKI)、Web of Science等公开数据库发布的重庆市2010—2021年慢性病领域所有文献资料,对文献进行摘录,对慢性病资源配置适宜程度进行量化分析。运用课题组前期构建的适宜公共健康体系定量标准,在系统收集信息资料后,分别从慢性病防控资源配置适宜程度的4个二级指标及13个三级指标展开研究,根据文献中资源配置的相关表述,采用“五分度评分”法半定量对其进行严重性评分,再对评分结果进行公式计算,最终得出资源配置的适宜程度。运用相关分析、线性回归分析资源配置适宜程度对慢性病防控效果的影响。结果2010—2021年重庆市慢性病防控资源配置适宜程度不断上升,由6.64%上升到27.57%;人力资源配置适宜程度从36.49%上升到46.59%,财力资源配置适宜程度从41.06%上升到50.28%,物力资源配置适宜程度从41.40%上升至42.96%,信息资源配置适宜程度从5.73%上升到24.09%。其中财力、物力资源配置适宜程度与重庆市慢性病过早死亡率呈显著负相关,相关系数分别为-0.722、-0.586。结论重庆市慢性病防控资源配置适宜程度逐年提高,但总体处于较低水平,信息资源配置程度较低是制约其发展的主要原因;应加快提升资源配置适宜水平来应对慢性病发病人数的迅速上升。

症状管理策略配合三位一体延续护理模式对慢性心衰患者病情控制及居家自我管理能力的影响

目的探究症状管理策略配合三位一体延续护理模式对慢性心衰患者病情控制及居家自我管理能力的影响。方法择取2020年1月至2022年1月收治的90例慢性心衰患者为研究对象,根据床位奇偶数将其分为对照组和观察组,各45例。对照组采用常规护理干预,观察组在对照组基础上采用症状管理策略配合三位一体延续护理模式进行干预。比较两组的干预效果。结果干预后,观察组的Memorial心力衰竭症状评估量表(MSAS-HF)各维度评分均低于对照组(P<0.05)。干预后,观察组的居家服药、居家饮食、病情自我监测、居家心脏康复锻炼评分均高于对照组(P<0.05)。干预后,观察组的左室射血分数(LVEF)、左心室高峰射血时间(LVTPER)高于对照组,左心室高峰射血率(LVPER)低于对照组(P<0.05)。结论症状管理策略配合三位一体延续护理模式不仅能够加大慢性心衰患者病情控制力度,还能提高患者居家自我管理能力,进而有效改善心功能。

三级医院全科医学科中老年住院患者慢性病共病现状及影响因素

目的探讨三级医院全科医学科中老年住院患者慢性非传染性疾病(NCD)共病现状及影响因素,以期为临床相关干预提供参考。方法本研究以2020年1月1日—2023年12月31日就诊于重庆医科大学附属永川医院且在全科医学科住院的2493例患者为研究对象,明确该群体NCDs共病的现状。采用多因素logistic回归分析NCDs患者共病的影响因素。结果在全科医学科的中老年住院患者中,男性1112例(44.6%),女性1381例(55.4%);患0、1、≥2种NCDs的患者分别有131例(5.26%)、389例(15.60%)和1973例(79.14%);患0、1、≥2种NCDs患者的性别、年龄、职业、医疗保险类型、住院时长比较,差异有统计学意义(P<0.05);患病率在30%以上的NCDs包括胃部或消化系统疾病(52.67%,1313/2493)、肺部疾病(43.20%,1077/2493)、高血压(42.20%,1057/2493)、脑血管病(39.83%,993/2493)、心脏疾病(31.13%,776/2493);2种NCDs共病的患者573例(22.98%),3种NCDs共病的患者589例(23.63%)。多因素logistic回归分析结果显示:年龄>59~64岁是中老年住院患者患1种NCD的影响因素(P<0.05);性别为女性,年龄≥60岁,入院方式为门诊,住院时长是中老年住院患者患≥2种NCDs的影响因素(P<0.05)。结论在三级医院全科医学科住院患者中,79.14%的患者处于NCDs共病状态;形成以胃部或消化系统疾病、高血压和脑血管病为核心疾病的3种最常见的NCDs共病组合模式;女性、年龄≥60岁是中老年患者NCDs共病的易发群体和高危群体。全科医学科应加强对患有多重NCDs特别是患有胃部或消化系统疾病、高血压和脑血管病共病模式的中老年尤其是女性群体的早期筛查,针对所在地区不同年龄段“多病共存”的特点,制定有针对性、个性化的中老年NCDs健康管理方案和干预措施。

类风湿关节炎综合防控与管理平台建设研究

目的研究建设适用于现有医疗体制的类风湿关节炎综合防控体系及管理平台,以期为我国类风湿关节炎防控与管理提供借鉴与指导。方法通过对各级医疗机构的相关管理现状进行调研,梳理类风湿关节炎疾病管理情况及相关信息系统建设现状,总结当前面临的主要问题,提出以现有医疗体制为基础构建“六级联动”的综合防控体系,并设计出适用于该防控体系的类风湿关节炎综合防控与管理平台。结果结合各级机构的医疗资源分布现状构建覆盖多级医疗机构的专业诊疗网络,依托社区、患者、家庭完善患者院外管理闭环,通过路径驱动的管理模式构建综合防控与管理平台。结论加强区域医疗资源共享,统筹并充分利用现有信息化基础条件实现数据互联互通,使数字化管理平台成为类风湿关节炎等慢病综合防控体系的有力支撑。

县域慢病管理的探索

随着人口老龄化、国民生活方式的改变,慢性病(如高血压、糖尿病)患病率及死亡率呈现明显上升趋势。慢性病已经逐渐成为一项重大公共卫生问题,标准化的慢病防控可以明显减少慢性疾病的发生率和病死率,具有巨大的社会价值和经济价值。笔者研究县域内依托医共体构建慢性病的闭环管理模式,以提高慢性病管理的效果,为探索“医防融合”的慢性病管理模式提供参考,改善慢性病患者的生命质量,提高人民健康水平,为实现健康中国目标作出贡献。

基于医疗机构为哨点的新发和重点传染病监测预警结果分析

目的以医疗机构为哨点对新发和重点传染病进行监测;增加检测方法及检测种类,加大医疗机构快速检测能力建设,以便及早对目标传染病采取防控措施。方法设置深圳市龙岗中心医院及其下设的社区健康服务中心为监测哨点,将重点科室符合条件的呼吸道感染、感染性腹泻及其他四大症候群病例作为监测对象;同时,增加检测方法及检测种类,加大医疗机构快速检测能力建设。结果2022年11月至2023年6月深圳市龙岗中心医院共送检1323份不同类型监测样本,检出EB病毒等常见病原体及多瘤病毒等罕见病原体。2022年全年和2023年全年分别监测报告3142例和17643例流行性感冒病例,两个年度流行性感冒病例报告例数存在显著差异(P<0.01)。2023年全年深圳市龙岗中心医院共监测报告流行性感冒病例17643例中男性9715例,女性7928例,男女比例为1∶0.82;年龄分布以14岁以下人群为主,占比59.15%;病例职业分布以学生居多(43.59%),其次是托幼儿童(17.16%);全年各月均有流行性感冒病例报告,4月最多,占全年发病人数的35.99%,其次是12月,占23.02%。结论基于医疗机构为哨点的监测体系持续开展新发和重点传染病监测、增加检测的方法及检测种类、加大医疗机构快速检测能力建设,有利于疾病的早期诊断,对当前高发的传染病及时发出预警并提供防控建议。

四川省宜宾市竹林病虫害调查与防控策略

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本文综述了松材线虫病传播特点和发生现状,对防控技术研究进展进行了归纳总结,分析了防控的关键核心问题,对相关策略进行了探索。随着我国松材线虫病防控理论与实践的发展,松材线虫病防控正逐步由粗放、低质量的管控向精细化、高质量的闭环防控方向转变,坚持疫木源头管理、严格控制媒介昆虫虫口密度、改善林分结构,坚持精细化防控举措,松材线虫病完全能够做到可防可控。

猴痘合并HIV感染疾病特征的研究进展

猴痘病毒的传播对HIV感染者构成了巨大威胁。一方面,猴痘病毒在HIV感染者中的感染率居高不下,在其他性传播疾病中的感染率也较高,如梅毒、淋病等;另一方面,尽管猴痘是自限性疾病,但与非HIV感染的猴痘患者相比,猴痘合并HIV感染患者的重症和死亡风险显著提升,尤其是在免疫重建不全的HIV感染者中。此外,在猴痘合并HIV感染的患者中,尤其是在CD4^(+)T淋巴细胞计数小于200×10^(3)/L的免疫重建不全的HIV感染者中,其临床症状比普通猴痘患者更加持久和严重,诊疗难度大。因此,全面了解猴痘合并HIV感染患者的疾病特征对于有效预防及减少猴痘传播至关重要。本文对猴痘合并HIV感染患者的病原学特征、流行病学特点、临床特征、诊断治疗和预防等方面进行阐述,旨在增强对猴痘合并HIV感染患者的全面了解,为针对这一类特殊人群制定精准防控策略提供理论支持。