Objectives To analyze the effect of improved oven for defluorination in coal-burning endemic fluorosis areas in China, and to provide evidence for the prevention and control of fluorosis. Methods Electronic databases including CNKI, CBM, VIP and CDMD-D (1989 to 2005), were searched. We also checked the reference lists of relevant articles. We selected relevant articles according to the predefined inclusion and exclusion criteria. The methodological quality was assessed . Data on room heat preservation and the effect of improved oven for defluorination were collected in the surveillance spots of Three Gorges Reservoir. Correlation analyses were conducted between the improved oven and its effect parameters. Results Twelve articles of low quality met the selection criteria, of which 9 were graded C and 3 were graded D in terms of the methodological quality. A negative correlation was found between the decreasing rate of normal oven use and the decreasing rate of dental fluorosis as well as of urine fluorine (Pearson correlation coefficient r = – 0.87, – 0.63, Plt;0.01, lt;0.05, respectively). Analysis also revealed a positive correlation between room heat preservation and the decreasing rate of dental fluorosis as well as of normal oven use (the two Spearman correlation coefficients and P values were the same: r = –1.00, Plt;0.01). Conclusion High-quality studies on the effect of improved oven for defluorination in China are not available. Based on the current evidence, the improved oven for defluorination and the correct use, maintenance and house rebuilding for heat preservation may help to prevent fluorosis.
The article summarized the national and international history and current situation of healthcare-associated infection control, and analyzed the tendency of new technique and progress in healthcare-associated infection control according to the experience in research and practice.
ObjectiveTo optimize procedures of going out for examination for patients with multidrug-resistant organism, strengthen prevention and control management of nosocomial infection, and prevent nosocomial infection.MethodsPatients with multidrug-resistant organism who went out for examination were selected from April to November 2018. April to July 2018 (before implementation) was process construction stage, and August to November 2018 (after implementation) was process optimization implementation stage. In April 2018, process and management system of going out for multidrug-resistant organism patients were formulated, training of transporters was strengthened, and measures such as checklist identification, accompany patients for examination, patient handover, isolation and protection, and disinfection of materials were implemented, to realize the infection prevention and control management in the whole process of going out for multidrug-resistant organism patients. We compared relevant indicators before and after implementation.ResultsA total of 262 cases times of patients with multidrug-resistant organism were included, including 134 cases times before implementation and 128 cases times after implementation. Compared with before implementation, the hand hygiene, wearing gloves, disinfection of inspection instruments and articles, patient transfer, isolation measures in waiting process (special elevator, isolation after waiting for inspection, arrange inspection time reasonably), education and training after implementation improved(P<0.05). Before and after implementation, the Methicillin resistant staphylococcus aureus detection rate difference was statistically significant (P<0.05).ConclusionsThe optimization of procedures of examination for patients with multidrug-resistant organism can increase implementation rate of indirect indicators such as hand hygiene, disinfection of inspection instruments and articles, isolation and protection, education and training in the prevention and control of multidrug-resistant organism in nosocomial infection. And it is important for the prevention and control of multi-disciplinary collaboration of multidrug-resistant organism.
Surgical site infections are the common healthcare-associated infections. This article introduced the guidelines on the prevention and control of surgical site infection in using from background, making progress, and recommendations, to give directions for clinicians and infection prevention and control professionals choosing appropriately for decreasing surgical site infection risks.
Objective To investigate and analyze the epidemic characteristics and factors of pulmonary tuberculosis (PTB) to provide foundation and make prevention and treatment policy. Methods Statistical analysis was conducted to analyze the current existing PTB prevention and control data in the Center for Disease Control and Prevention of Zhushan County and corresponding prevention and treatment policy was proposed. Results Since 1997 when PTB was included into B infectious diseases in Zhushan County, 4 431 cases of PTB had been reported by the end of 2009. Annual reported incidence rate was 74.73 per 100 000 and the disease was found in 17 towns. All seasons witnessed the incidence but winter and summer had more sufferer. The youngest patient was 4 months whereas the oldest was 86 years old. The majority of the patients were from 20 to 59 years old, peasants were the main patients, and the incidence of male was higher than that of female. The use of chemotherapy resulted in a significant decline of PTB death rate. Poor immunity of elder group, population flow caused by poverty, low detection rate of patients and AIDS were the major causes to PTB epidemic. A lack of prevention and treatment in the grassroots hospital and difficulty to fully implement the Directly Observed Treatment, Short-course (DOTS) strategy in remote areas were also bottlenecks to PTB control process. Conclusion The followings should be performed to improve the quality of DOTS strategy implementation: strengthen the government’s commitment, provide policy and funding safeguard, conduct health education and health promotion widely, reinforce management according to the law, fully implement the DOTS strategy, and fortify the prevention and control construction.
ObjectiveTo explore the distribution of multidrug resistant organism in neonates admitted to the hospital through various ways, and analyze the risk factors in order to avoid cross infection of multidrug resistant organism in neonatology department. MethodsA total of 2 124 neonates were monitored from January 2012 to July 2013, among which 1 119 were admitted from outpatient department (outpatient group), 782 were transferred from other departments (other department group), and 223 were from other hospitals (other hospital group). We analyzed their hospital stays, weight, average length of stay, and drug-resistant strains, and their relationship with nosocomial infection. ResultsAmong the 105 drug-resistant strains, there were 57 from the outpatient group, 27 from the other department group, and 21 from the other hospital group. The positive rate in the patients transferred from other hospitals was the highest (9.42%). Neonates with the hospital stay of more than 14 days and weighing 1 500 g or less were the high-risk groups of drug-resistant strains in nosocomial infection. Drug-resistant strains of nosocomial infection detected in the patients admitted through different ways were basically identical. ConclusionWe should strengthen screening, isolation, prevention and control work in the outpatient neonate. At the same time, we can't ignore the prevention and control of the infection in neonates from other departments or hospitals, especially the prevention and control work in neonates with the hospital stay of more than 14 days and weighing 1 500 g or less to reduce the occurrence of multiple drug-resistant strains cross infection.
Objective To provide baseline data for the Special Healthcare Program of Comprehensive Reform for Coordinated and Balanced Urban-rural Development in Chengdu. Methods We selected 7 township/community health institutions and 6 village health posts /street clinics using stratified sampling to take account of the levels of economic development and the distance from the centre of Chengdu We then performed on-site surveys and secondary research. Data were analyzed by using Epidata or Excel. Results The utilization of health institutions was generally good. The number of visits and number of inpatients in medical institutions increased steadily. The utilization rate of hospital beds and doctors’ workload were higher than the national average. The average medical expense per outpatient /inpatient was far lower than the national level. The overall condition of the health institutions that close to the centre of Chengdu was better. Conclusion We should persist in taking advantage of the rural hospitals’ construction to improve village health posts /street clinics and strengthen the national and governmental compensating mechanism for township /community health organizations (village health posts /street clinics), so as to make the basic condition of current township/ community health organizations (village health posts /street clinics) better.
ObjectiveTo analyze the status and influencing factors of awareness of diabetic retinopathy (DR) knowledge in diabetics in Funing County, Jiangsu Province. MethodsThis is a cross-sectional study. In 2021, a total of 2 125 residents with diabetes in Funing County, Jiangsu Province were recruited using cluster random sampling methods. General examinations were performed and ophthalmological evaluation were conducted including visual acuity in daily life, slit lamp microscope with preset lens, digital non-mydriatic fundus photography. Clinical assessment and classification of DR were according to the international standard clinical classifications of diabetic retinopathy in 2019. DR was classified into no obvious DR, mild non-proliferative diabetic retinopathy (NPDR), moderate NPDR, severe NPDR and proliferative diabetic retinopathy (PDR). Field questionnaire surveys were conducted to show the awareness rate of DR knowledge. Then Chi-square test and Logistic regression analysis were used to investigate influencing factors. ResultsAmong 2 125 subjects, 762 (35.86%, 762/2 125) residents were male and 1 363 (64.14%, 1 363/2 125) residents were female. A total of 444 (20.89%, 444/2 125) subjects were diagnosed as DR. Among which, 438 (20.61%, 438/2 125) subjects were NPDR, 6 (0.28%, 6/2 125) subjects were PDR. A total of 419 (19.72%, 419/2 125) subjects were diagnosed as cataract. The topic awareness rates were all below 45.00%. The overall population awareness rate was 19.45% (4 959/25 500). Awareness rate was correlated with age, visual acuity in daily life, education level, family history of diabetes, diabetic retinopathy grades and the type of treatment for diabetes (P＜0.001). Logistic regression analysis showed that the knowledge rate of prevention and treatment of DR Decreased significantly in patients aged 60-79 compared with those aged under 50 (P＜0.05). Compared with those with visual acuity＜0.1 in daily life, the knowledge rate of DR prevention and treatment in those with visual acuity≥0.1 was significantly decreased (P＜0.05). While primary school to college education, with family history of diabetes, with DR, oral hypoglycemic agents and/or insulin treatment were associated with higher awareness rate (P＜0.05). ConclusionsThe DR knowledge level is low among diabetics in Funing County, Jiangsu Province in 2021. Age, visual acuity in daily life, education level, family history of diabetes, with DR and receiving drug treatments are main influencing factors for diabetic’s awareness.
ObjectiveTo develop the questionnaire and test its reliability for investigating route, prevention, and control of SARS-CoV-2 infection in medical staffs.MethodsThis questionnaire was development based on the COVID-19 relevant guidelines, official documents issued by the National Health Committee of the People's Republic of China, and published studies. The development group performed repeated discussions and drafted the first questionnaire, then performed expert consultation and revised the draft according to their suggestions. Eventually, some frontline medical staffs were invited to carry out pre-test investigation of the questionnaire and test its reliability.ResultsThe first draft included 48 items; 18 experts were invited in the first round questionnaire and 10 experts in the second round questionnaire. The positive coefficient of experts in these two rounds was both greater than 75%, and the authority coefficient of experts' opinions was greater than 0.70. The variation coefficient of these items was between 0.00 and 0.35, the coordination coefficient of experts was 0.193 (P<0.05). The experts of above two rounds put forward 14 suggestions for text modification or adjustment options of some items; after the development group held repeatedly discussions, a total of 8 items were performed secondary consultation and finally reached consensus. The final questionnaire included two domains of questionnaire before and after confirmed diagnosis. The domain "before confirmed diagnosis" covered 4 sections and 29 items involving infectious cause, plan and knowledge of prevention and control, and psychological symptoms. The domain "after confirmed diagnosis" covered 5 sections and 21 items, included symptoms, treatment, and psychological status after diagnosis; impact on the surrounding environment and people, and awareness of protection after infection. The pre-test results showed that the total items were considerably numerous, some items were difficult to understand, some laboratory results and treatment conditions were ambiguous, etc. After modification and re-testing, the test-re-test reliability of each domain was between 0.74 and 0.93, and the overall re-test reliability of the questionnaire content was 0.82.ConclusionsThis research has developed a questionnaire for investigating infection process, prevention and control of SARS-CoV-2 infection in medical staff, and the items considered two domains prior to and after confirmed diagnosis. The reliability and practicability of the questionnaire are acceptable.
ObjectiveTo investigate the situation of hospital infection with bacteria producing extended-spectrum β-lactamases (ESBLs), find the source of infection and analyze its transmission route, and take effective prevention and control measures to reduce the incidence of nosocomial infection. MethodsA hospital neonatal ward had six cases of ESBL-producing bacteria infections on February 16 to 26, 2012. According to the processing procedure for hospital infection outbreak, we carried out epidemiological investigation on the patient with suspected hospital infection, including checking the medical records, asking the doctor in charge about the patients'clinical symptoms, collecting sputum samples of the patients and environmental microbiology examination, etc. ResultsFour cases of infection were community-acquired, and two were nosocomial infection. Infection onsets were concentrated (between February 16 and February 26, 2012). Patients had similar clinical symptoms, including fever, cough, cough sputum, and lung wet rales, which showed a lower respiratory infection. Six strains of ESBL-producing Escherichia coli were isolated from the infected children, and their susceptibility reports were not entirely consistent, indicating that they did not belong to the same species and were not homologous pathogens. Through bedside survey, we also isolated from the environmental samples 6 ESBL-producing bacteria, and these bacteria were acquired from the milk countertops, kettle, ventilator tube, two doctors'nasal cavity, and the cleaners'nasal cavity in corresponding wards of those infected children. ConclusionThe infection does not belong to an outbreak of nosocomial infection, and it is only an aggregation event of ESBL-producing Escherichia coli. The symptoms of infection were mainly because of lower immunity of children themselves, plus not so good aseptic technique and management in the department of neonatology. Therefore, strengthening hand hygiene management of medical staffs, and regular environmental sanitation and disinfection can reduce the incidence of neonatal hospital infection.