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留置導尿管相關性尿路感染目標監測結果與分析

目的　了解留置導尿管相關性尿路感染發生率，為制定預防控制措施提供參考依據。 方法　2012年3月－8月在神經內科、神經外科、老年內科、泌尿外科對留置導尿管的患者進行醫院感染目標性監測。 結果　導尿管相關尿路感染發病率為6.46%，感染率最高的科室為老年內科13.95%，其次為神經外科12.96%和泌尿外科3.59%。神經內科導尿管0.00%。 結論　針對監測結果，采取適當的干預措施，可有效降低留置導尿管相關性感染的發生率。

Interventions to screen for human immune-deficiency virus among people donating blood[Protocol]

Background　AIDS (acquired immune deficiency syndrome) has become the most devastating disease which humankind has ever encountered. Human immune-deficiency virus (HIV) is transmitted through blood, sexual behavior and mother-to-baby, with more efficient transmission through blood transfusion. HIV risk among blood transfusion was severe due to lack of effective and correctly applied screening method and rigorous management, especially in some developing countries. Since the first HIV screening reagent was approved by FDA to screen the blood in 1985, the fourth generation test has been produced till now. Initially, HIV test was primarily used to screen the blood supply, it also became an important aspect of HIV prevention, especially screening among people donating blood. Today, HIV testing is seen as an integral part of both the nation’s prevention and treatment efforts. Objective　To assess the effectiveness of any intervention tests for HIV screening among people donating blood, and find appropriate tests for HIV screening to decrease the risk of HIV transmission by blood transfusion. Search strategy　MEDLINE, Cochrane Controlled Trials Register (CENTRAL/CCTR), AIDSLINE, EMBASE, CBM were be searched with the terms: "HIV", "AIDS", "screening", "test", "blood donor", "blood bank" and the detailed screening method. The websites of WHO, UNAIDS, CDC, FDA, and their related links were searched. Letters were mailed to various agencies and experts in this field to acquire unpublished reports. Inclusion criteria　RCT and CCT for screening HIV among blood. donors will be included. Observational studies such as cohort studies, cased-control studies, and historical controlled studies will be used for sensitivity analysis. Method of the review　According to the principles of Cochrane Review, selection of trials for inclusion, quality assessment of studies, data extraction and syntheses were conducted by reviewers.

Analysis and Countermeasures of Low Surgical Site Infection Rate

目的　分析外科手術部位感染率過低的原因，掌握手術部位感染診斷標準，減少醫院感染漏報，及時發現醫院感染流行趨勢，采取控制措施，防止醫院感染暴發。 方法　選擇開展較多、手術部位一旦發生感染對患者安全威脅性較大的手術：包括膽囊切除或（和）膽管手術，結腸、直腸切除術，闌尾切除術，疝手術，乳房切除術，剖宮產，子宮切除術及附件切除術，全髖關節置換術，食道賁門手術，腰椎間盤摘除術，監測時間為2011年1月1日－6月30日及2012年1月1日－6月30日，共監測1 180例手術，對手術部位感染率進行對比分析。 結果　2011年半年監測手術部位感染率1.99%，調整感染率4.74%；比國內報道低6～9倍；通過分析原因，對醫院感染診斷標準再培訓、加強病原微生物送檢等，2012年半年監測手術部位感染率4.68%，調整感染率32.12%；與2011年比較差異有統計學意義（χ2=141.841，P=0.000）。 結論　手術部位感染率偏低的原因是醫生漏報所致；采取整改措施后，提高了手術部位感染的識別能力，減少了漏報，對及時發現醫院感染暴發具有重要意義。

四川省干部人群幽門螺桿菌感染現狀及健康指導需求調查

目的 了解四川省干部人群幽門螺桿菌（Helicobacler pylori，Hp）感染現狀、對 Hp 感染的認知程度及健康指導需求，為 Hp 感染的防治提供參考。 方法 對 2009 年 1 月—2014 年 12 月在四川大學華西醫院健康管理中心進行體檢的四川省干部人群進行碳 14尿素呼氣試驗檢測，并對檢測結果進行分析。隨機抽取部分人群進行對Hp感染認知程度及健康指導需求的問卷調查。 結果 共納入受檢者 285 例，受檢人群的 Hp 總感染率為 43.5%。收集合格問卷 128 份，對什么是 Hp、Hp 感染的危害、Hp 的傳播途徑、Hp 感染的預防措施、體檢篩查 Hp 的意義 5 個問題的了解率分別為 21.1%、18.8%、16.4%、15.6%、12.5%；有上述 5 個方面健康指導需求的人數占比分別為 84.4%、85.2%、78.9%、86.7%、76.6%。 結論 四川省干部人群 Hp 感染率低于全國平均水平，但對 Hp 感染的認知程度低，迫切需要規范的健康指導。

脾部分切除與自體脾移植術后臨床免疫學和殘脾形態觀察(附140例報告)

Analysis of Helicobacter pylori infection and its risk factors among health examination participants in a general hospital

ObjectiveTo investigate and analyze the prevalence and influencing factors of Helicobacter pylori (Hp), to provide scientific basis for the development of Hp infection prevention and control program.MethodsThe Hp infection of healthy population who received 13C-urea breath test in Sichuan Science City Hospital from January to December 2018 were retrospectively analyzed. Medical examination reports were collected and sorted out. We compared the gender and age differences of Hp infection, and binary logistic regression analysis was performed to analyze the risk factors of Hp infection.ResultsA total of 8 093 healthy participants were included, including 5 530 males (68.33%) and 2 563 females (31.67%). The infection rate of Hp was 37.80% (3 059/8 093) in all subjects. The infection rate of males [39.48% (2 183/5 530)] was significantly higher than that of females [34.18% (876/2 563)] (χ2=20.899, P<0.001). The infection rate of 50-59 years old group was the highest (43.87%), and that of <30 years old group was the lowest (30.93%). The difference of Hp infection rate among different age groups was statistically significant (χ2=64.577, P<0.001). Logistic regression analysis showed that male [odds ratio (OR) =1.257, P<0.001], 40-49 years old (OR=1.446, P<0.001), 50-59 years old (OR=1.756, P<0.001), 60-69 years old (OR=1.512, P<0.001), high total cholesterol level (OR=1.221, P=0.003) and obesity (OR=1.403, P<0.001) were risk factors for Hp infection.ConclusionsThe prevalence of Hp infection in the general hospital is lower than the national average level, and male, 40-69 years old, high total cholesterol level and obesity are predictors of Hp infection. Effective measures should be taken to prevent and control the infection of Hp.

Analysis on the Relationship between Reflux Esophagitis and Helicobacter Pylori Infection

目的　探討和分析反流性食管炎與幽門螺桿菌感染之間的關系。 方法　回顧性分析2009年1月－2011年11月間胃鏡確診為反流性食管炎334例，所有患者均行快速尿素酶試驗；其中反流性食管炎合并消化性漬瘍57例，慢性非萎縮性胃炎102例。 結果　反流性食管炎的幽門螺桿菌感染率為21.6% ，在幽門螺桿菌感染陽性的患者中最多見并發消化性潰瘍，而在幽門螺桿菌感染陰性的患者中最多見并發慢性非萎縮性胃炎，解剖結構和動力障礙性疾病絕大多數并發于幽門螺桿菌陰性患者。A和B級反流性食管炎的幽門螺桿菌感染陰性的患者多于幽門螺桿菌感染陽性的患者。在A級反流性食管炎中幽門螺桿菌感染率28.0%，B級為8.4%，C+D級為0.0%。 結論　反流性食管炎中幽門螺桿菌感染率低，幽門螺桿菌陽性的反流性食管炎多并發于消化性潰瘍，提示幽門螺旋桿菌對反流性食管炎發病有一定保護作用。