目的 分析药品集中带量采购（集采）政策下医院药品供应保障实况，提出优化政策及保障的对策建议。方法 通过提取重庆市渝北区人民医院2023年1月—2024年12月集采药品供应采购数据，描述性统计分析集采药品供应情况。结果 采购的416个中标药品中，69个在购销合同期内短缺，短缺率16.59%。短缺原因与企业生产能力、季节性需求波动相关，季节性强，以慢性病药和抗感染药为主。结论 建议建立监测平台、完善报告制度、制定应急预案、评估供货能力，保障供应。

   Objective To analyzes the current situation of hospital drug supply guarantee under the policy of centralized and volume-based procurement（hereinafter referred to as “central procurement”），and proposes optimization strategies and suggestions for the policy and guarantee．Methods By extracting the procurement data of drugs supplied through centralized procurement at Yubei District People’s Hospital in Chongqing from January 2023 to December 2024，descriptive statistical analysis of the drug supply situation through centralized procurement was conducted．Results Among the 416 selected drugs purchased，69 were in short supply during the contract period，with a shortage rate of 16.59%．The reasons for the shortage were related to the production capacity of the enterprise，seasonal demand fluctuations，strong seasonality，and mainly chronic diseases and anti-infective．Conclusions It is suggested to build a monitoring platform，improve the reporting system，formulate emergency plans，and evaluate the supply capacity to ensure supply．

       目的 探讨自回归求和时间序列模型（ARIMA）在耐碳青霉烯类肺炎克雷伯菌（CRKP）医院感染预测中的应用，为CRKP感染的科学防控提供策略。方法 选取贾汪区人民医院住院患者2018年1月—2024年12月共7年每月CRKP医院感染率，应用SPSS 19.0建立ARIMA模型，利用该模型对2024年1—12月每月CRKP医院感染数据进行验证，以评价模型的预测性能。结果 用2018—2024年住院患者每月CRKP医院感染率建模、拟合，建立最优模型ARIMA（1，1，1），模型拟合值与实际值较吻合，模型对CRKP医院感染率实际值与预测值吻合度较高，平均相对误差为5.40%。结论 用ARIMA模型可有效拟合、预测CRKP医院感染情况，为CRKP防控提供科学指导。

     Objective To explore the value of auto regressive integrated moving average（ARIMA）model in predicting theinfection rate of carbapenem-resistant Klebsiella pneumoniae（CRKP）．Methods The monthly incidence of nosocomial infection of CRKP in Jiawang District People’s Hospital from 2018 to 2024 was selected，and the ARIMA model was established by19.0 SPSS to analyze the fitting and prediction value of the model．Results The ARIMA was established based on the monthly CRKP infection rate from January 2018 to December 2024．The fitted value of the ARIMA（1，1，1）model was in good agreement with the actual value．The incidence of CRKP infection were in good agreement with the predicted value．The average relative errors were 5.40%．Conclusions The ARIMA model can effectively fit and predict the CRKP infection rate，providing scientific guidance for the prevention and control of CRKP infection．

       目的   探讨医院药房外包代煎代送服务的质量管理。方法   成立中药代煎质量控制管理小组，研究给出完善质量控制体系的策略，涉及建立标准化操作流程、加强人员培训、优化信息化管理系统以及健全监督评估机制。结果   通过对中药库房的采购、入库验收、在库管理、调剂环节的审方、调剂、煎药质量管理以及物流、发药人员全流程管理，提高了患者的满意度，更多的患者选择了中药代煎服务。结论   实施有效的质量控制措施可提高代煎代送服务的质量，为医院药房提升服务质量给予理论依据与实践指导。

       Objective  To explore quality management of outsourced decoction preparation and delivery services in hospital pharmacies．Methods  A quality control management team for traditional Chinese medicine（TCM）decoction preparation was established to develop strategies for improving the quality control system．These strategies involved establishing standardized operating procedures，strengthening personnel training，optimizing the information management system，and improving the supervision and evaluation mechanism．Results  Through comprehensive process management，covering procurement，warehouse acceptance，inventory management，prescription review in the dispensing stage，dispensing itself，quality control of decoction preparation，logistics，and management of dispensing personnel，patient satisfaction was enhanced，leading more patients to opt for the TCM decoction service．Conclusions  Implementing effective quality control measures can improve the quality of decoction preparation and delivery services，providing a theoretical basis and practical guidance for hospital pharmacies to enhance their service quality．

       目的   调查老年人照护服务需求现状并分析其影响因素，为构建基于需求为导向的老年照护服务体系提供参考依据。方法  采用便利抽样法，选取广州市某三甲医院212名老年人作为调查对象，采用日常生活能力量表、Fried衰弱评估量表及自行编制的老年人需求评估问卷进行调查。结果   老年人对运动与营养（1.96±0.90分）、心理慰藉（2.63±0.85分）、安宁服务（2.73±1.07分）的需求水平较高。多因素线性回归分析结果显示养老方式、日常生活活动能力、爱好数量、性别、衰弱等级、有无主要照顾者是照护服务需求的影响因素（P均＜0.05），可解释61.5%的变异量。结论   老年人的照护服务需求受多种因素的影响。应根据老年人的不同特征，构建供需匹配的多元化，多层次照护体系。

       Objective  To investigate the status quo of care service needs of the elderly and analyze its influencing factors，so as to provide a reference for the construction of a needs-oriented care service system for the elderly．Methods  A total of 212 elderly people from a tertiary hospital in Guangzhou were selected by convenience sampling method and investigated with the Activity of Daily Living scale，Fried frailty scale and the self-designed elderly needs assessment questionnaire．Results  Elderly patients had higher demands for exercise，nutrition，psychological comfort and hospice services．The results of multivariate analysis showed that the influencing factors of care service demand included pension style，activities of daily living，number of hobbies，gender，frailty level，and having main caregivers（all P＜0.05），which could explain 61.5% of the variation．Conclusions  The care needs of elderly patients are affected by many factors．A diversified and multi-level care system with matching supply and demand should be constructed according to the different characteristics of the elderly．

       目的   对2014—2023年广西梧州市某三级综合医院法定传染病疫情及流行病学特征进行分析，为地市级医院制定传染病防控策略提供科学依据。方法   采用描述性流行病学方法和Excel软件对该院法定传染病报告数据进行统计分析。结果  2014—2023年该院共报告法定传染病29 569例，其中，无甲类传染病报告，乙类传染病12 375例（41.85%），丙类传染病15 479例（52.35%），其他需监测报告的传染病1 715例（5.80%）。报告病例数排前4位的传染病依次为手足口病6 726例（22.75%）、感染性腹泻病6 451例（21.82%）、病毒性肝炎5 539例（18.73%）、肺结核3 552例（12.01%）。报告病例数在2014—2017年逐年增加，2017—2023年传染病报告病例降升交替，每年发病高峰期主要集中在5—10月；男性报告病例多于女性，男女之比为1.64∶1；0～10岁年龄段病例最多（46.89%），其次为40~60岁（26.91%）；职业分布集中于散居儿童（33.90%）、农民和牧民（18.08%）、工人和民工（9.47%）及幼托儿童（8.48%）；患者主要来自梧州市（79.17%）、广东省（17.34%）。传播途径构成比从高到低依次为肠道传染病（46.38%）、呼吸道传染病（26.03%）、血液及性传播传染病（24.92%）、其他传染病（2.66%）。结论  手足口病、感染性腹泻、病毒性肝炎、肺结核是该院传染病防治工作的重点，其中尤其要注重儿童手足口病和感染性腹泻病的预防，根据不同季节、疾病流行趋势，采取有针对性的传染病防控策略。

       Objective  To analyzed the epidemic and epidemiological characteristics of notifiable infectious diseases in a class Ⅲ general hospital in Guangxi Wuzhou from 2014 to 2023，to provide scientific basis for municipal hospitals to formulate infectious disease prevention and control strategies．Methods  Descriptive epidemiological method and Excel were used to sort out and analyze the data．Results  From 2014 to 2023，there were 29 569 cases of notifiable infectious diseases，with category B infectious diseases 12 375 cases（41.85%），category C infectious diseases 15 479 cases（52.35%），and others diseases 1 715 cases（5.80%）．No category A infectious diseases were reported．The top 4 infectious diseases were 6 726 cases of hand-foot-and-mouth disease（HFMD）（22.75%），6 451 cases of infectious diarrhea（21.82%），5 539 cases of viral hepatitis（18.73%）and 3 552 cases of tuberculosis（12.01%）．The number of reported cases increased year by year from 2014 to 2017，and the reported cases of infectious diseases decreased and increased alternately from 2017 to 2023，with the annual peak period mainly presented from May to October．Males reported cases were more than females，the ratio of males to females was 1.64∶1．The number of cases between 0 to 10 years old was the highest（46.89%），followed by 40-60 years old（26.91%）．The occupational distribution was concentrated in scattered children（33.90%），farmers and herdsmen（18.08%），workers and migrant workers（9.47%）and children in childcare（8.48%）．The patients were mainly from Wuzhou City（79.17%）and Guangdong Province（17.34%）．The composition ratio of transmission route from high to low was as follows：intestinal infectious diseases accounted for 46.38%，respiratory tract infectious diseases accounted for 26.03%，blood-borne and  sexually transmitted infectious  diseases accounted for 24.92%，and other infectious diseases accounted for 2.66%．Conclusions  HFMD，infectious diarrhea，viral hepatitis and tuberculosis are the focus of the hospital’s infectious disease prevention and control work，especially the prevention of HFMD and infectious diarrhea in children，and the prevention and control strategies of infectious diseases are adopted according to different seasons and epidemic trends．

       目的  调查深圳地区综合性医院门诊幽门螺杆菌（Hp）对8种常见抗菌药物的耐药情况。方法  采集¹³C呼气试验阳性的患者胃黏膜标本313例，进行Hp分离培养及抗菌药物敏感性试验。结果  313例患者分离培养得到247例Hp菌株，培养阳性率78.91%，不同性别、不同年龄患者Hp分离培养阳性率比较差异无统计学意义（P＞0.05）。Hp对甲硝唑、克拉霉素、左氧氟沙星、利福平、阿莫西林、四环素、呋喃唑酮、庆大霉素耐药率依次为88.66%（219/247）、38.46%（95/247）、38.06%（94/247）、4.05%（10/247）、1.21%（3/247）、0.40%（1/247）、0.40%（1/247）、0（0/247）。双重耐药率为38.46%（95/247），其中Hp对克拉霉素+甲硝唑组合耐药率最高（18.62%，46/247），对甲硝唑+左氧氟沙星耐药率居其次（17.00%，42/247）。多重耐药率为19.84%（49/247）。不同年龄、性别患者双重耐药率、多重耐药率比较差异均无统计学意义（P＞0.05）。结论  深圳地区分离的Hp菌株对甲硝唑、克拉霉素、左氧氟沙星耐药率相对更高，且双重耐药、多重耐药情况严重。

        Objective  To investigate the antibiotic resistance of Helicobacter pylori（Hp）to eight commonly  used antibiotics in outpatients of general hospitals in Shenzhen．Methods  Gastric mucosal samples were collected from 313 patients who tested positive for the  ¹³C breath test，and Hp strains were isolated and cultured．Antibiotic susceptibility testing was performed on the isolated Hp strains．Results  Of the 313 patients，247 Hp strains were isolated，with a culture-positive rate of 78.91%．There was no significant difference in culture-positive rates between different genders and age groups（P＞0.05）．The resistance rates to metronidazole，clarithromycin，levofloxacin，rifampicin，amoxicillin，tetracycline，furazolidone，and gentamicin were 88.66%（219/247），38.46%（95/247），38.06%（94/247），4.05%（10/247），1.21%（3/247），0.40%（1/247），0.40%（1/247），0（0/247），respectively．The dual resistance rate was 38.46%（95/247），with the highest combination  resistance observed in clarithromycin + metronidazole（18.62%，46/247），followed by metronidazole + levofloxacin（17.00%，42/247）．The multi-drug resistance rate was 19.84%（49/247）．There were no significant differences in dual resistance rates（P＞0.05）or multiple resistance rates（P＞0.05）between different age groups and genders．Conclusions  The Hp strains isolated in Shenzhen exhibited relatively higher resistance rates to metronidazole，clarithromycin，and levofloxacin，with substantial dual and multi-drug resistance．

更好地保障医务人员的职业安全与健康是备受关注的议题。文章介绍了华南理工大学附属第二医院（广州市第一人民医院）基于国际医院评审认证标准促进医院职业安全与健康管理体系建设完善的经验做法, 为国内三甲医院的职业安全与健康管理体系建设提供参考。

How to better protect the occupational safety and health of medical personnel is a topic of great concern．This article introduces the empirical approach of Guangzhou First People’s Hospital, the Second Affiliated Hospital of South China University of Technology to establish and improve hospital occupational safety and health management system based on international hospital accreditation standard．It provides a reference for the construction of occupational safety and health management system in domestic 3A-grade hospital．

目的 分析医院职业暴露工作人员特征、发生职业暴露环节、类型及处理方式,为医院制订干预措施提供理论基础。方法 回顾性分析玉溪市人民医院2018—2023年共301例发生职业暴露工作人员资料, 包括职业暴露时间、性别、年龄、科室、岗位类型、在院工作时间、职位、职业暴露发生环节、职业暴露类型、暴露源、职业暴露后是否需要用药等处置信息。结果 301例职业暴露工作人员平均年龄为（28.81±10.92）岁, 女性占比84.7%（255例）; 57.8%（174例）职业暴露发生在检查/穿刺/注射/采血/置管/治疗/手术等操作中, 38.9%（117例）发生在医疗废物处置环节;87.7%（264例）的暴露类型为针刺伤;45.5%（137例）接触暴露源为有血源性传播疾病的患者。发生职业暴露工作人员中, 不同岗位职业暴露者的暴露类型、职位、科室、是否需要药物干预及接触暴露源情况比较差异有统计学意义（P<0.05）。结论 应加强医务工作者职业暴露相关知识及应急处置培训, 对不同工龄、岗位医务工作者制定针对性培训方案, 加强医疗废物处置流程及临床操作技能规范等知识培训,预防医务工作者职业暴露的发生。

Objective To analyze the characteristics,occupational exposure links, types, and treatment methods of occupational exposure among healthcare staff hospital, providing a theoretical basis for the development of related intervention strategies for hospitals．Methods A retrospective study was conducted to explore 301 cases of occupational exposure among healthcare staff in The People’s Hospital of Yuxi City from 2018 to 2023．Data of 301 cases were collected, including information on gender, age,department,personnel category, length of service in the hospital, job title, and the circumstances of occupational exposures, which covered exposure links, type, source, and post-exposure medication treatment measures．Results Among the 301 healthcare staff experiencing occupational exposure, the average age was（28.81±10.92）years, with 84.7%（255 cases）being female．Occupational exposure most frequently occurred during procedures such as examination, puncture, injection, blood collection, catheterization, treatment, and surgery（57.8%,174 cases）, followed by the disposal of medical waste（38.9%, 117 cases）．The primary type of exposure was needle-stick injury（87.7%）．Contact with patients suffering from blood-borne infectious diseases accounted for 45.5%（137 cases）of the occupational exposure incidents．There were significant differences in exposure types, job positions, departments, sources of exposure, and post-exposure medication treatment measures among healthcare staff of different categories（P<0.05）．Conclusions To prevent the occurrence of occupational exposure among healthcare staff, it is necessary to enhance training on occupational exposure knowledge and emergency management, particularly improving the disposal of medical waste and clinical operational skills．Additionally, it is crucial to have personalized training programs tailored to healthcare staff based on their varying lengths of service and positions．

目的 探讨基于区域专科联盟模式,在联盟医院内建立淋巴水肿专科干预小组的有效策略及其对患者干预效果的影响。方法 对区域医联体内7家联盟医院（包括德阳市人民医院、广汉市人民医院、罗江区人民医院、广汉妇幼保健院、德阳肿瘤医院、中江妇幼保健院、什邡市妇幼保健院）20名医护人员进行淋巴水肿知识及干预技能培训,建立区域性淋巴水肿专科干预小组,制定小组工作职责、实施专科质量控制。选取2024年5—8月淋巴水肿专科干预小组干预模式开展期间作为观察组, 选取2024年1—4月淋巴水肿专科干预小组干预模式开展前作为对照组。对比两组医护人员淋巴水肿相关知识掌握合格率、住院患者淋巴水肿风险筛查率、淋巴水肿高风险患者措施落实率、出院随访患者上肢功能评定评分及患者就医满意度。结果 干预后,护理人员淋巴水肿知识各维度得分[基础知识（17.36±2.54）、诊断与评估（25.66±4.34）、治疗与管理（25.08±4.73）、预防与康复（15.36±2.53）、总分（85.36±8.52）]均高于干预前[基础知识（11.35±2.29）、诊断与评估（17.87±3.18）、治疗与管理（18.28±3.85）、预防与康复（10.39±2.24）、总分（55.35±7.56）]（t=7.859, P<0.001; t=6.475, P<0.001; t=4.986, P<0.001; t=6.578, P<0.001; t=11.782, P<0.001）; 观察组住院患者淋巴水肿风险筛查率高于对照组（80.72% vs 61.24%）, 对比差异有统计学意义（χ²=31.454, P<0.001）; 观察组患者出院时及出院后1月上肢功能评定（DASH）量表评分[（23.36±8.63）（20.16±7.34）分]低于对照组[（25.32±9.16）（22.25±7.67）分], 对比差异有统计学意义（t=2.884, P=0.004; t=3.646, P=0.001）; 观察组患者出院时患者就医满意度评分（83.36±8.63）高于对照组（71.37±10.33）, 对比差异有统计学意义（t=16.460, P<0.001）。结论 基于区域专科联盟体的联盟医院淋巴水肿专科干预小组能够有效地实现三级医院优质干预资源下沉, 在联盟内可实现淋巴水肿防治同质化、专科人才培训基地建设,整体提升区域内淋巴水肿防控效果,提高患者就医满意度。

Objective To explore effective strategies for establishing a lymphoedema specialty nursing team within alliance hospitals based on a regional specialty alliance and assess its impact on patient care outcomes．Methods A regional lymphedema specialty nursing team was established by training 20 healthcare professionals from 7 hospitals（Deyang City People’s Hospital,Guanghan People’s Hospital, Luojiang People’s Hospital, Guanghan Maternal and Child Health Hospital, Deyang Tumor Hospital, Zhongjiang Maternal and Child Health Hospital, and Shifang Maternal and Child Health Hospital）in a regional medical consortium, focusing on lymphedema knowledge and intervention skills．The team’s responsibilities and nursing quality control protocols were standardized．The observation group included data from May to August in 2024（post-intervention period）, while the control group comprised data from January to April in 2024（pre-intervention period）．Comparisons were made between the two groups regarding healthcare professionals’qualification rate in lymphedema knowledge,inpatients’ lymphedema risk screening rate, implementation rate of preventive measures for high-risk patients, upper extremity function assessment scores（using the Disabilities of the Arm,Shoulder and Hand [DASH] scale）at discharge and 1-month post-discharge, and patient satisfaction．Results After the intervention, healthcare professionals’ lymphedema knowledge scores significantly improved across all domains：basic knowledge（17.36±2.54 vs 11.35±2.29）, diagnosis/assessment（25.66±4.34 vs 17.87±3.18）, treatment/management（25.08±4.73 vs 18.28±3.85）,prevention/rehabilitation（15.36±2.53 vs 10.39±2.24）,and total score（85.36±8.52 vs 55.35±7.56）（t=7.859, P<0.001; t=6.475, P<0.001; t=4.986, P<0.001; t=6.578, P<0.001; t=11.782, P<0.001）．The observation group demonstrated a higher lymphedema risk screening rate（80.72% vs 61.24%,χ2=31.454,P<0.001）．DASH scores in the observation group were significantly lower than the control group at discharge（23.36±8.63 vs 25.32±9.16）and 1-month post-discharge（20.16±7.34 vs 22.25±7.67）（t=2.884, P=0.004; t=3.646, P=0.001）．Patient satisfaction scores at discharge were higher in the observation group（83.36±8.63 vs 71.37±10.33, t=16.460, P<0.001）．Conclusions The lymphoedema specialty nursing team in alliance hospitals based on a regional specialty alliance effectively facilitates the high-quality nursing resources homogenization in primary hospitals．Within the alliance, it achieves homogenization of lymphoedema prevention and treatment, establishes a training base for specialty talents, and overall enhances lymphoedema prevention and control within the region, thereby improving patient satisfaction with healthcare．

本文分析了广州市南沙区某公立医院人力资源管理现状,并基于SWOT分析法探索其发展策略。研究发现,该医院的人力资源管理具有成熟的管理体系和一体化管理的实施优势,但也面临财政支持不足和人才及岗位结构不均衡的劣势。政策支持与区域医疗资源扩展为其提供了重要的机遇,但日益增长的行业竞争和人才吸引与保留的难题构成了威胁。医院应优化管理架构,加强顶层设计,改善学科和人才结构,采取一体化与差异化发展策略,以构建高效的人才队伍,提升医院竞争力。本文通过对优势、劣势、机遇和威胁的综合分析,制定了针对性的管理对策,为同类医疗机构提供了参考。

This paper analyzes the current state of human resource management（HRM）in a public hospital in Nansha District,Guangzhou,and explores development strategies based on a SWOT analysis．The study reveals that the hospital’s HRM benefits from a mature management system and the implementation of integrated management．However,it also faces challenges such as insufficient financial support and an imbalance in the structure of personnel and positions．Policy support and the expansion of regional medical resources present significant opportunities,while increasing industry competition and challenges in attracting and retaining talent pose threats．The hospital should optimize its management structure,enhance top-level design,improve the discipline and personnel structure,and adopt integrated and differentiated development strategies to build an efficient talent team and enhance its competitiveness．Through a comprehensive analysis of strengths,weaknesses,opportunities and threats,this paper formulates targeted management strategies,providing valuable references for similar medical institutions．