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.

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.

Pharmacological strategies for Parkinson’s disease

Parkinson’s disease (PD) or Paralysis Agitans was first formally described in “An essay on the shaking palsy”, published in 1817 by a British physician named James Parkinson. In the late 1950’s, dopamine was related with the function of the corpus striatum, thus with the control of motor function. But it was not until 1967, when the landmark study of George C. Cotzias, demonstrated that oral L-DOPA, the precursor of dopamine metabolism, was shown to induce remission of PD symptoms, that the definitive association between the two was firmly established. However, later on L-DOPA treatment began to show a loss of effectiveness and demonstrated to induce a variety of undesirable effects, the most prominent being diskinesia. As a result of this, a variety of alternative or complementary pharmacological strategies have been developed. In this chapter we review the wide variety of strategies that have been used through time, which are geared toward reducing the most disabling symptoms of PD. We additionally make some suggestions as to which are the most promising ones.

Large Cohort Data Based Cost-Effective Disease Prevention Design Strategy: Strong Heart Study

Background and Objective: A multitude of large cohort studies have collected data on incidence and covariates/risk factors of various chronic diseases. However, approaches for utilization of these large data and translation of the valuable results to inform and guide clinical disease prevention practice are not well developed. In this paper, we proposed, based on large cohort study data, a novel conceptual cost-effective disease prevention design strategy for a target group when it is not affordable to include everyone in the target group for intervention. Methods and Results: Data from American Indian participants (n = 3516;2056 women) aged 45 - 74 years in the Strong Heart Study, the diabetes risk prediction model from the study, a utility function, and regression models were used. A conceptual cost-effective disease prevention design strategy based on large cohort data was initiated. The application of the proposed strategy for diabetes prevention was illustrated. Discussion: The strategy may provide reasonable solutions to address cost-effective prevention design issues. These issues include complex associations of a disease with its significant risk factors, cost-effectively selecting individuals at high risk of developing disease to undergo intervention, individual differences in health conditions, choosing intervention risk factors and setting their appropriate, attainable, gradual and adaptive goal levels for different subgroups, and assessing effectiveness of the prevention program. Conclusions: The strategy and methods shown in the illustrative example can also be analogously adopted and applied to other diseases preventions. The proposed strategy provides a way to translate and apply epidemiological study results to clinical disease prevention practice.

Large Cohort Data Based Group or Community Disease Prevention Design Strategy: Strong Heart Study

Background and Objective: A multitude of large cohort studies have data on incidence rates and predictors of various chronic diseases. However, approaches for utilization of these costly collected data and translation of these?valuable results to inform and guide clinical disease prevention practice are?not well developed. In this paper we proposed a novel conceptual group/community disease prevention design strategy based on large cohort study data. Methods and Results: The data from participants (n = 3516;2056 women) aged 45 to 74 years and the diabetes risk prediction model from Strong Heart Study were used. The Strong Heart Study is a population-based cohort study of cardiovascular disease and its risk factors in American Indians. A conceptual group/community disease prevention design strategy based on large cohort data was initiated. The application of the proposed strategy for group diabetes prevention was illustrated. Discussion: The strategy may provide reasonable solutions to the prevention design issues. These issues include complex associations of a disease with its combined and correlated risk factors, individual differences, choosing intervention risk factors and setting their appropriate, attainable, gradual and adaptive goal levels for different subgroups, and assessing effectiveness of the prevention program. Conclusions: The strategy and methods shown in the illustration example can be analogously adopted and applied for other diseases preventions. The proposed strategy for a target group/community in a population provides a way to translate and apply epidemiological study results to clinical disease prevention practice.

Colorectal cancer in patients with inflammatory bowel disease:Can we predict risk?

The inflammatory bowel diseases(IBD),Crohn's disease(CD) and ulcerative colitis(UC),may be complicated by colorectal cancer(CRC).In a recent populationbased cohort study of 47 347 Danish patients with IBD by Tine Jess and colleagues 268 patients with UC and 70 patients with CD developed CRC during 30 years of observation.The overall risk of CRC among patients with UC and CD was comparable with that of the general population.However,patients diagnosed with UC during childhood or as adolescents,patients with long duration of disease and those with concomitant primary sclerosing cholangitis were at increased risk.In this commentary,we discuss the mechanisms underlying carcinogenesis in IBD and current investigations of genetic susceptibility in IBD patients.Further advances will depend on the cooperative work by epidemiologist and molecular geneticists in order to identify genetic polymorphisms involved in IBD-associated CRC.The ultimate goal is to incorporate genotypes and clinical parameters into a predictive model that will refine the prediction of risk for CRC in colonic IBD.The challenge will be to translate these new findings into clinical practice and to determine appropriate preventive strategies in order to avoid CRC in IBD patients.The achieved knowledge may also be relevant for other inflammation-associated cancers.

Wildlife-borne microorganisms and strategies to prevent and control emerging infectious diseases

China is one of the countries with the richest wildlife population.The large variety of widely distributed species act as natural or susceptible hosts for numerous infectious diseases.It is estimated that there are more than 1.2 million unknown virus species in China,and there might be 10,000–30,000 unknown bacteria in wild mammals on the Qinghai-Tibet Plateau alone.There are no less than 600,000 species of animal-borne parasites and approximately 2 million species of fungi worldwide.With rapid economic growth and globalization,humans and wildlife interact more frequently,which enhances the probability of wildlife-borne pathogens infecting humans.The occurrence of animal-borne infectious diseases will become the“new normal”we have to face in the future.Therefore,research should be carried out on wildlife-borne microorganisms and the prevention and control of emerging infectious diseases to establish an analytical framework and an evaluation technology system for risk assessment and early warning of potential animal-borne emerging infectious diseases.This will not only improve our understanding of wildlife-borne microbial communities but also enable in-depth analysis,discovery,early warning,and even prediction of major animal-borne emerging infectious diseases that might occur in the future.Furthermore,this research will reduce response times,minimize the social and economic impact and losses,enable interventions related to the emergence or spread of the disease as early as possible,and comprehensively improve our management of infectious disease outbreaks.

RT-ABCDE Strategy for Management and Prevention of Human Diseases

In this article, the authors summarized the RT-ABCDE strategy for the management and prevention of human diseases, which includes ReTro-ABCDE （Examination regularity, Disease and risk factor control, Changing lifestyle and reducing pathways of infection and spread, Biochemical and Antagonistic index control and therapeutic treatment as well as RT- Routine and Right Treatment）. The RT-ABCDE strategy, a novel concept and an essential method, should be a routine strategy for disease control and prevention, It should be proposed and applied in both clinical and preventive medicine.

Insights from exploring the interrelated dynamics of gallstone disease,non-alcoholic fatty liver disease,and kidney stone disease

This article delved into the comprehensive study by Jiang et al,which meticulously examined the bidirectional relationships among gallstone disease,nonalcoholic fatty liver disease,and kidney stone disease through a multicenter study,systematic review,and meta-analysis.The study provides significant evidence supporting these associations,offering valuable insights into the etiology and potential prevention strategies for these interconnected conditions.The clinical significance of these bidirectional relationships is profound,as they underscore the importance of recognizing these conditions not only as isolated diseases but as part of a complex network that can influence each other.These results highlight the critical need for thorough screening and personalized prevention strategies for individuals with these interconnected conditions.Explicit implications for prevention strategies and early screening practices are crucial,as they can lead to early detection and intervention,significantly altering disease progression and outcomes.Furthermore,identifying potential therapeutic targets within these shared pathways may enhance treatment efficacy and patient outcomes,making this research highly relevant to clinical practice.By comprehending the common pathophysiological mechanisms and applying specific interventions,healthcare professionals can greatly enhance patient care and lessen the impact of these widespread diseases on global health.

A dual-targeted multifunctional nanoformulation for potential prevention and therapy of Alzheimer’s disease

Antioxidation and adjustable treatment strategies are critical for the effective treatment of Alzheimer’s disease(AD).Here,we design a dual-targeted Prussian blue nanoformulation(PTCN)that can cross the blood-brain barrier and target amyloid beta aggregates further exert antioxidant effects.An adjustable gradient dosing strategy with PTCN is used for the first time to design the preventive and therapeutic trials based on the severity of oxidative stress at different AD stages.The results show that PTCN could effectively ameliorate AD-related pathological processes,improve the cognitive decline,and rescue hippocampal atrophy of APP/PS1 mice in both preventive and therapeutic trials.Altogether,PTCN provided here is a successful combination of three traditional biomaterials with good biosafety,which has broad prospects for the early prevention,mild remission,and late treatment of AD,and is expected to be developed into personalized therapeutic drugs and healthcare products for clinical AD in the future.

大鲵养殖健康管理与疾病防治

在当前全球需求不断增长的水产品市场中,大鲵养殖因其独特的生理特征和珍稀性而备受瞩目。随着自然生态系统的压力增大和野生大鲵资源的减少,对其规模化、高效化养殖的需求逐渐上升,然而大鲵养殖面临着各种健康管理和疾病防治的挑战。该文根据养殖实践,围绕大鲵养殖健康管理与疾病防治策略展开探讨,以期为大鲵养殖业的可持续发展提供一定的理论参考和实践经验。

抗-M致胎儿新生儿溶血病实验室检测及预防策略分析

目的分析血清学检测结果在抗-M致胎儿新生儿溶血病(HDFN)诊断和治疗中的应用,探讨HDFN预防策略。方法对2017年1月—2023年12月本实验室确诊的12例抗-M引起的HDFN血清学检测结果进行回顾性分析,包括母亲和患儿的血型鉴定,血清总胆红素、血红蛋白、抗体效价检测,新生儿溶血3项实验。收集患儿和母亲的临床资料,包括妊娠史、输血史、产前抗体检测、宫内输血史、分娩孕周,并随访患儿预后。结果12例抗-M引起的HDFN中,患儿母亲均为RhD+NN表型,患儿均为RhD+MN表型,母子MN血型均不相容。在ABO血型系统中,母子ABO血型不相容占41.7%(5/12)。患儿母亲皆无输血史,在4℃检测效价中位数32,37℃效价中位数4。3例患儿母亲有多次宫内输血史,发生率为25%(3/12)。1例为首胎妊娠异常,占比8.3%(1/12),7例为异常妊娠流产,不良孕产史发生率58.3%(7/12)。6例患儿母亲早产,占比50%(6/12)。3例患儿母亲定期产检,并鉴定抗体特异性,占比25%(3/12)。12例患儿游离抗体在4℃检测效价中位数6,37℃效价中位数2。2例患儿抗-M在37℃检测无反应,阴性率16.7%(2/12)。患儿直抗阳性率8.3%(1/12),放散阳性率16.7%(2/12)。血红蛋白最低值中位数75 g/L,12例患儿均接受了输血治疗。总胆红素峰值中位数157.5μmol/L,均未达到换血阈值。患儿迟发性贫血率16.7%(2/12),患儿出生后死亡率8.3%(1/12),11例患儿预后无生长和神经发育迟缓情况。结论抗-M能引起严重的HDFN,也可发生于第1胎,抗体效价强度与疾病的严重程度不相关,容易引起迟发性贫血,应根据抗-M血清学特征和临床症状定期监测,及时干预治疗。

生命全程路径与慢性非传染性疾病防治

本文通过从慢性非传染性疾病(NCDs)胎源学说和现有探讨生命全程对慢性病影响的因果机制模型,展开对生命全程理论在NCDs防治策略中的作用进行综述。从生命全程的角度总结了慢性病发生和发展过程,强调能够通过早期识别高风险表型和风险标记,在生命早期提供及时的干预措施,支持当前NCDs第一级预防的努力。最后提出WHO倡导的生命全程路径与可持续发展目标协同作用的政策建议。

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。

“治未病”理念贯穿全生命周期健康管理的运用与思考

全生命周期健康管理的提出是基于中国居民疾病谱向非传染性慢性疾病转变的现状。“未病先防”理念是中医治未病思想的首要环节,以“未病养生、防病于先”为重要内涵,以阻断疾病的源头为主要目的,正契合“健康中国”战略的实施。将“治未病思想之未病先防”理念运用并贯穿于生命全周期的管理,对于预防疾病发生具有重要意义。因此,运用治未病思想于“两精相合之胎元期、稚阴稚阳之小儿期,气血充盛之青春期、筋骨长极之壮年期、天癸竭之老年时期、气血精气虚衰之濒亡期”不同时期人群的全生命周期健康管理行动之中,根据人群制订不同时期规范合理可行的健康管理手段,将有助于预防和减少各时期不同人群疾病的发生,提升国民健康幸福感,对于健康中国战略的实现具有积极的指导意义。本研究将以“全生命周期的健康干预策略”为要点,梳理不同时期健康人群的生理特点,根据不同时期人群,提出针对性的健康管理要素,以期构建系统的中医健康管理意识,助力“健康中国行动”战略的推进。

由新型冠状病毒感染管窥肺系疫病之分期分型论治

通过阐释肺系疫病“逆顺传变观”,提出了肺系疫病的潜伏期(未病)、发作期(顺传、逆传)、瘥后期(迁延、新病、恢复)三期演变规律;并结合新型冠状病毒感染病机演化,聚焦肺系疫病分期分型防治,提出了新型冠状病毒感染未病先防发、既病防逆传、瘥后防新病的防治策略。为未来可能发生的肺系疫病提供理论支撑,并进一步指导临床实践。

公共卫生管理在传染病预防中的应用策略

传染病预防工作在近些年备受社会关注,预防传染病的管理方案也越来越多样化,当前比较常见的传染病有艾滋病、流行性感冒、乙型肝炎等,这些病症都具有流行性特征,且病原体传播速度非常快,能够在短时间内产生大量传染病患者,为公共卫生管理工作带来很大负担,而科学预测与防范控制传染病对保障公众健康生命权益极为有利,彰显公共卫生管理的地位。就传染病预防角度分析,公共卫生管理内容具有广泛性,其实施要点在于传染病预防知识宣传与创建应急预案,以全方位疾病防控工作,增强传染病预防成效。所以,对各级卫生机构、疾控预防中心等公共卫生管理机构来说,强化公共卫生管理,可有效控制传染病传播,严格落实传染病预防管理工作,有助于提升公共卫生管理质量。社会实践中,公共卫生管理成效得到很大提升,充分发挥了公共卫生管理对民众身心健康的保护作用,为大众构建了和谐的城乡发展环境。

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。

公共卫生管理在传染病预防中的意义与管理策略探讨

突发公共卫生事件已经成为社会关注的热点问题,其中重大传染病疫情更受到人们的广泛关注。公共卫生管理需要达到国家规定的防控等级标准,应对大规模疫情、聚集性疫情展开针对性地预防和管控,针对传染病重症患者进行救治。可以看出,公共卫生管理可以有效应对复杂和多变的传染病预防工作要求,通过政府统一指挥与各部门的沟通、协调等多个方面的措施,尽可能控制传染病的扩散与传播,本次研究将重点分析公共卫生管理在传染病预防中的意义与策略。