目的 探讨广州市区小学生的性格发展状况,为了解和促进广州市儿童的性格和身心健康发展提供科学依据和建议。方法 采取横断面调查研究,通过整群随机抽样的方法抽取广州市区两所小学三年级学生共405名,采用儿童艾森克个性问卷(Junior Eysenck Personality Questionnaire, JEPQ)量表进行问卷调查,采用两独立样本t检验比较性别、年龄组、不同地区间的JEPQ各维度得分,采用卡方检验比较不同地区间JEPQ各维度的高分比例。 结果 广州市区小学生JEPQ的内外向(extroversion and introversion, E)、神经质(neuroticism, N)、精神质(psychoticism, P)、掩饰性(lie, L)维度标准分T分分别为50±11、50±16、42±18、50±10。其中,20.6%的儿童情绪不稳定(N维度T分>61.5);22.3%和32.7%的儿童分别为内向(E维度T分<43.3)和外向(E维度T分>56.7)倾向;6.3%的儿童性格孤僻或有攻击性(P维度T分>61.5)。与重庆、滁州、和西安地区相比,广州地区男女生的E维度得分较高(除西安女生,P<0.05)。结论 广州市区的两成小学生有焦虑、紧张的倾向,与其他城市相比更为外向。建议打造学校-社区-家庭“三位一体”的支持网络,为儿童的身心健康发育保驾护航。

Objective To explore the personality status of urban primary school students in Guangzhou, to provide evidence and suggestions for personality traits, as well as physical and psychological health improvement of children in Guangzhou city.Methods This is a cross-sectional study. Cluster sampling was applied to the survey of personality traits in 405 grade-3 pupils from two primary schools of Guangzhou, using Junior Eysenck Personality Questionnaire (JEPQ). Independent t test was used to compare scores of all the dimensions in JEPQ between genders, age groups, and districts. Chi-square was used to compare proportion of high score in each dimension between districts. Results The standard T points of JEPQ in the dimensions of extroversion & introversion (E), neuroticism (N), psychoticism (P), lie (L) of Guangzhou city pupils were 50±11, 50±16, 42±18 and 50±10, respectively. Among them, 20.6% of subjects were emotionally unstable (T score＞61.5 in N dimension). 22.3% and 32.7% of children were introverted (T score＜43.3 in E dimension) and extroverted (T score＞56.7 in E dimension) respectively, and 6.3% of children were unsocial or aggressive (T score＞61.5 in P dimension). Compared with Chongqing, Chuzhou and Xi-an cities, the scores of E dimension were higher in both boys and girls of Guangzhou city (except for Xi-an girls, P<0.05). Conclusion Around twenty percent of Guangzhou city primary students tend to be anxious and nervous. Compared with the other cities, pupils in Guangzhou city are more extroverted. We suggested a three-in-one support network of school-community-family should be built to facilitate the children's physical and mental health development.

目的 本文通过对越秀区2016—2020年学生肺结核流行特征和筛查情况分析,为学校制定针对性防控措施提供参考依据,最大限度地做好学校结核病防控工作。方法 在“国家结核病管理信息系统”专网中,导出2016—2020年常住在越秀区的学生肺结核患者的病案信息到EXCLE表,进行逻辑核对和补漏;将患者每次所做的密切接触者筛查资料统一并录入到一个EXCLE汇总表,将信息表转换成FoxPro 6.0数据库进行统计,分析本地居住学生肺结核登记发病率、新发与复发构成比,人群分布特征、发现方式、就诊和确诊延误、耐药情况、密切接触者筛查情况。结果 共登记学生肺结核191例,登记发病率为3.25/10万,不同年份登记发病率未见统计学差异(χ²=7.84. P=0.097 3),但学生患者占比从2016年的2.52%上升到2020年的7.74%,上升了3.07倍。学生患者均为新发,男女性别比为1.27:1,以15～24岁年龄段的高中生和大学生构成为主,分别占45.55%和39.79%,两者合计85.34%。发现方式主要以转诊、追踪到位和因症到结防机构直接就诊为主,分别为44.50%、25.13%、23.56%,其中转诊比例最高,占了44.50％;各年的发现方式构成比差异未见统计学意义(χ²=12.057,P=0.441 1)。共登记涂阳患者45例,就诊延误10例,延误率22.22%,确诊延误2例,延误率4.44%;共登记涂阴患者146例,就诊延误29例,延误率19.86%,确诊延误3例,延误率2.05%。共登记培养阳性(涂阳培阳45例,涂阴培阳6例),对一线抗结核药物(HRZES)全敏感42例,全敏感率82.35%;单耐药9例,耐药率17.65%,其中单耐药率最高的为异烟肼和链霉素,不同年份的全敏感率未见统计学差异(χ²=3.81 P=0.432)。需开展筛查的学生肺结核患者178例,已开展筛查的患者169例,筛查率94.94%。需筛查的密切接触者7954例,实际接受筛查(开展了PPD或胸片筛查1项或以上)者7 898例,筛查率99.30%,发现活动性肺结核13例,检出率0.16%。密切接触者筛查方式:胸片筛查6 317人,发现胸片异常42人,异常率0.66%;PPD筛查7 897人,强阳性493人,强阳性率6.24%;症状筛查7 897人,自诉有症状64人,症状阳性率0.81%。结论 2016—2020年,广州市越秀区学生肺结核疫情较轻,患者以高中和大学生首次发病为主,男女差别不大,但就诊延误和确诊延误仍较普遍。其次,对学生患者及其密切接触者的筛查工作做得较好,及时发现了较多现症患者及近期感染者。因此,继续加强高中以上学校的结核病防治知识宣传工作和做好应筛必筛工作,是今后学校疫情控制的侧重点。

目的 探讨广州地区老年住院患者营养状态与日常生活能力(ADL)的相关性。方法 选取2018年7月—2019年6月在广州市第一人民医院住院年龄≥60岁的老年人共275例,收集其一般资料信息,各项临床营养指标(BMI、血清白蛋白、血红蛋白、总胆固醇、甘油三酯)、并运用营养风险筛查2002(NRS2002)评估营养风险、采用Barthel指数评定量表评估日常生活能力;分析老年住院患者营养状态与ADL之间的相关性。结果 在本组研究中,根据NRS2002评分(营养风险:NRS2002≥3;无营养风险NRS2002＜3),营养风险发生率58.9%(162/275);无营养风险发生率41.1%(113/275)。老年住院患者的NRS2002评分与ADL评分呈负相关关系(r=-0.393,P＜0.05);ADL评分与BMI、血清白蛋白、总胆固醇、血红蛋白水平呈正相关关系(P＜0.05)。结论 广州地区老年住院患者NRS2002为日常生活能力的影响因素,通过降低NRS2002评分来减少营养风险可改善老年人的日常生活能力;老年人的营养风险发生率高,应当尽早进行营养干预。

Objective To investigate relationship between nutritional status and activities of daily living(ADL) in elderly inpatients in Guangzhou. Methods Total of 275 people older than 60 were included in this study from Guangzhou First People's Hospital from July 2018 to June 2019. Their nutritional markers(including BMI, plasma albumin, hemoglobin, total cholesterol, triglyceride),the activities of daily living(ADL) were evaluated with Barthel index and the nutrition risk screening 2002(NRS2002)used to assess the nutritional risk status were collected to analyze the relationship between nutrition and ADL. Results In these subjects, based on the NRS2002 scores(nutritional risk that the NRS2002 scores were equal or greater than 3, and the non-nutritional risk that the NRS2002 scores were less than 3),58.9%(162/275) patients were having nutritional risk and 41.1%(113/275) were having non-nutritional risk. In elderly inpatients,NSR2002 were negatively associated with ADL(r=-0.393,P＜0.05). ADL was positively associated with BMI, plasma albumin and hemoglobin level(P<0.05). Conclusion In the old, the NRS2002 is an influencing marker of activities of daily living in Guangzhou. Reducing the nutritional risk by lowering the NRS2002 scores can improve ADL in the elderly. The incidence of nutritional risk is highly prevalent in elderly and early nutritional treatment will be needed.

目的 结合临床现状分析影响护士护患沟通能力的相关因素,并根据影响因素制定相关应对方案。方法 采用《护士临床沟通能力量表》对广州市某三甲医院的941名护士进行调查。结果 护士沟通能力得分为(4.19±0.43)(评分范围为1～5分),其中情感支持能力维度得分最低(4.05±0.37),护士性别、婚姻状况、职称、职务和培训次数不同,其护患沟通能力得分有差异(P<0.05))。结论 护士的情感支持能力有待提高,性别、婚姻状况、职称、职务和接受培训的次数是护患沟通能力的影响因素,管理者应根据护士特征应加强对护士的培训,以提高其护患沟通能力。

Objective Combined with the clinical situation, this paper analyzes the relevant factors that affect the nurse-patient communication ability, and makes relevant countermeasures according to the influencing factors. Methods 941 nurses in a tertiary hospital in Guangzhou were surveyed using the Nurse Clinical Communication Competence Scale. Results The communication competence score of nurses in the hospital was (4.19±0.43) (the score was ranged from 1 to 5), among which nursing staffs' emotional support competence were scored in lowest (4.05±0.37). There was statistically significant in communication competence between nurses with different gender, marital status, job title, position and training times. (P<0.05). Conclusion The emotional support competence of nurses needs to be improved. The gender, marital status, professional title, position and number of trainings are the influencing factors of nurse-patient communication ability. Nursing managers could improve nurses' communication competence by increasing the training of nurses according to their charateristics.

目的 探讨广州市第一人民医院2008—2019年所有就诊的肿瘤患者的具体情况,研究各类肿瘤的发病趋势和危害程度,为制定预防措施和工作重点提供依据。方法 根据广州市恶性肿瘤病例登记报告系统数据,对2008—2019年在广州市第一人民医院就诊的23 778例肿瘤病例从基本情况、肿瘤部位和随访情况等几方面进行回顾性统计分析。结果 2008—2019年位列前三位的肿瘤分别是结直肠癌、肺癌和肝癌,甲状腺癌占比呈明显上升趋势。30岁以下年龄组肿瘤种类以白血病为主,30～60岁年龄组肿瘤种类以结直肠癌为主,60岁以上年龄组肿瘤种类以肺癌为主。甲状腺癌的预后最好,胰腺癌的预后最差。纯手术组疗效最佳。结论 在广州地区合理优化资源进行重点肿瘤的筛查,才可以有限降低罹患肿瘤的风险,提高肿瘤患者生命质量。

Objective The aims of study were to explore the situation of all patients with cancer in Guangzhou First People's Hospital from 2008 to 2019, to find the incidence trends and hazards of different types of tumors, and to provide evidence for developing preventive measures. Methods According to the data of the Guangzhou tumor case report system, a retrospective statistical analysis was performed on the basic situation, tumor location and follow-up of 23 778 tumor cases in Guangzhou First People's Hospital from 2008 to 2019. Results The top three tumors in 2008—2019 were colorectal cancer, lung cancer and liver cancer. The tumor types under 30 years old were leukemia, the tumor types in the 30-60 age group were colorectal cancer, and the tumor types above 60 years old were mainly lung cancer. The prognosis for patients with thyroid cancer was the best, and the prognosis for patients with pancreatic cancer was the worst. The effect of the operation group was the best. Conclusion Rational optimization of resources for screening key tumors could reduce tumor incidence and improve the quality of life of cancer cases in Guangzhou area.

目的 了解广州市海珠区肺结核患者登记情况及流行特征,为进一步做好海珠区肺结核防治提供依据。方法 收集2008—2017年海珠区结核病信息管理系统中按现住址登记的肺结核患者资料,采用描述性流行病学方法和相关统计方法对肺结核患者登记资料进行分析。结果 2008—2017年海珠区共报告登记肺结核患者 14 384 例,年报告发病率由2008年的105.3/10万下降到2017年的73.1/10万,呈下降趋势(χ²=164.973,P<0.001);男女发病相对比为2:1;各个年龄组均有发病,其中25～34岁年龄组发病人数最多,占总发病数的21.61%;职业分布方面,家务及待业人群最多,占总发病率34.48%,其次分别是其他(不固定职业),占17.29%,退休人群,占15.12%,学校学生占比5.52%。地区分布方面,各街道年平均发病率相差较大,最高为131.23/10万,最低的为66.40/10万,差异有统计学意义(χ² =164.973,P<0.001)。结论 广州市海珠区肺结核疫情呈逐年下降趋势,但部分街道肺结核发病率仍达100/10万以上。男性人群、25~34岁年龄组和低收入人群(家务及待业、不固定职业、退休人群)是防控的主要人群,学生肺结核发病人数多,要加强学校结核病防控和筛查工作。

Objective To understand the registration situation and epidemic characteristics of tuberculosis patients in Haizhu district of guangzhou, and to provide a basis for further prevention and treatment of tuberculosis in Haizhu district. Methods The data of tuberculosis patients registered at present address in the TB information management system of Haizhu district from 2008 to 2017 were collected, and the registration data of tuberculosis patients were analyzed using descriptive epidemiological methods and relevant statistical methods. Results From 2008 to 2017, 14 384 cases of tuberculosis patients were reported in Haizhu district. The annual reported incidence rate decreased from 105.3/100,000 in 2008 to 73.1/100,000 in 2017, showing a down ward trend (χ² = 164.973, P<0.001). The relative incidence of male and female was 2:1; all age groups had morbidity, of which 25~34 years old group had the largest number of cases, accounting for 21.61% of the total number of cases; in occupational distribution, household chores and unemployed were the most, accounting for 34.48 %, followed by other (non-fixed occupations), accounting for 17.29%, retired people, accounting for 15.12%, and school students accounting for 5.52%. In terms of regional distribution, the average annual incidence rate of each street varied greatly, with the highest being 131.23/100,000 and the lowest being 66.40/100,000. The difference is statistically significant(χ²=164.973,P<0.001). Conclusion The incidence of tuberculosis in Haizhu district of Guangzhou has been decreasing year by year, but the incidence of tuberculosis in some streets is still more than 100/100,000. Male population, 25~34 years old group and low-income population (domestic and underemployed, irregular occupation, retired population) are the main population for prevention and control. Students have a large number of cases of tuberculosis, so we need to strengthen prevention, control and screening of tuberculosis in schools.

目的 探讨职业性噪声暴露对广州市黄埔区某企业噪声作业工人听力损失状况的影响。方法 观察2016年8月—2018年8月,广州市黄埔区某企业噪声作业工人年度职业健康体检1 600例为调查对象,对该群体的纯音听阈测试检查结果进行分析。结果 随工龄不同听力损失发生率相比,差异有统计学意义(P<0.05),还会随着工龄的增长而增加听力损失几率;佩戴听力防护用品工人听力损失发生率低于不佩戴听力防护用品的工人,差异有统计学意义(P<0.05)。结论 噪声作业工人工龄时间越长听力损失发生率越高,防护听力用品的使用可有效降低听力损伤发生率,故在噪声作业时,企业应做好听力损伤防护措施,保障工人身心健康。

目的 分析抽检血液成分关键指标结果并采用趋势分析方法进行评估。方法 收集整理2015—2017年每月1次的8种血液成分质量控制的检测数据,选择关键指标并制作折线图,联合行动限和警戒限进行趋势分析。结果 未能100%达到GB 18469—2012《全血及成分血质量要求》的项目包括悬浮红细胞容量及Hct、单采血小板及浓缩血小板血小板含量、新鲜冰冻血浆及冷沉淀VIII因子含量。新鲜冰冻血浆及冷沉淀的VIII因子含量项目分别出现10次和5次偏离数据;单采血小板及浓缩血小板的血小板含量项目分别出现3次和4次偏离数据。结论 根据血液成分的关键指标结果进行趋势分析发现问题,主动寻找原因并及时采取相应措施,是确保血液质量的一种有效手段。

Objective To analyze and evaluate the results of key indexes of the blood component by trend analysis. Methods Collected and arranged the data of eight kinds of blood component quality control,which was did once month in 2015-2017.Selected the key indexes and made the line charts.Allied with the action limits and warning limits for trend analysis. Results The key indexes could not 100% meet the “Quality requirements for whole blood and component blood”,including capacity and Hct of suspended red blood cell,platelet content of apheresis platelets and platelets concentrate,factor VIII content of fresh frozen plasma and cryoprecipitate.The factor VIII of fresh frozen plasma and cryoprecipitate showed ten and five deviation data, respectively, the platelet content of apheresis platelet and platelets concentrate showed three and four deviations, respectively. Conclusion It's an effective way to ensure blood quality by trend analysis based on the results of key indexes of blood components, and actively find the cause and take corresponding measures in time.

目的 分析2016—2018年度广州市单采血小板报废的主要原因,并探讨如何降低单采血小板报废率。方法 统计2016—2018年度广州市单采血小板的采集量、报废数量和报废率等相关数据,分析报废原因,提出相应改进措施。结果 2016—2018年广州血液中心单采血小板总报废率为1.13%,三年的报废率逐年下降。报废的最主要原因为血液感染因子筛查不合格或ALT异常,占总报废率64.44%;其次分别为血量不足(占比14.4%)、采血耗材/血袋/热合口漏(占比11.01%)等。结论 我中心单采血小板报废率虽逐年下降,但仍需加强献血前宣传,动员更多的健康适龄公民参加无偿献血,同时重视采前血液感染因子的筛查工作、采血前及采血过程的护理干预、设备维护保养和产品处理能力的培训,进一步有效降低血液报废率。

Objective To analyze the main causes of apheresis platelets discarding in Guangzhou from 2016 to 2018, and discuss how to reduce the discarding rate. Methods Collected the data of apheresis platelets collection, the discarding number and the discarding rate in Guangzhou from 2016 to 2018,to analysis the reasons of apheresis platelets discarding and introducing improvement measures. Results From 2016 to 2018, the total discarding rate of apheresis platelets collected from Guangzhou Blood Center was 1.13%. In the three years,the discarding rate declined year by year.The main reasons for apheresis platelets discarding were the result of blood infection factor test or ALT was not qualified, accounting for 64.44% of the total scrapping rate. Then followed by insufficient blood volume (14.4%) and Blood consumables/blood bags/heat closure leakage (11.01%). Conclusion Although the rate of apheresis platelet discarding in Guangzhou Blood Center is decreasing year by year, we still need to enhance blood donation propaganda, mobilize more healthy citizens to participate in blood donation, and pay attention to the screening of blood infection factors before blood collection, nursing blood donor before and during blood collection, and training of ability in equipment maintenance and product handling, so as to further effectively reduce the rate of blood discarding.

目的 应用FRAX^®工具评估广州社区中老年人发生骨质疏松性骨折的风险。方法 回顾性研究1 140例广州社区中老年人的临床资料,应用FRAX^®工具计算未来10年发生主要骨质疏松性骨折及髋部骨折的风险,分析不同危险因素与骨折风险的关系。结果 广州社区中老年人群10年内发生主要骨质疏松性骨折概率为(4.2±3.6)%,髋部骨折概率为(1.3±2.4)%。主要骨质疏松性骨折风险及髋部骨折风险、OSTA值均随着年龄增长而增加。多因素回归分析结果显示: 年龄、性别、既往骨折、继发性骨质疏松、股骨颈T值、跌倒对主要部位骨折及髋部骨折风险具有独立性预测意义。结论 FRAX^®工具可用于评估广州社区中老年人骨质疏松性骨折风险,建议在社区中老年人健康体检时应用FRAX^®工具进行骨折风险评估。

Objective To predict the osteoporotic fracture risk in senile people in Guangzhou communities by FRAX,the fracture risk assessment tool published by WHO. Methods Clinical data of 1140 cases were collected for the retrospective analysis. The FRAX tool was uesed to calculate the 10-year probability of a major osteoporotic and hip fracture.The relationship between different risk factors and the fracture risk predicted by FRAX was analyzed. Results The 10-year probability of major osteoporotic fractures was (4.2±3.6)%, and the 10-year probability of hip fractures was (1.3±2.4)%.The 10-year probability of the major osteoporotic and hip fracture increased with age.Multivariate regression analysis showed that age,gender,previous fracture,secondary osteoporosis,T-score of femoral neck BMD and fall were independent predictors of the 10-year probability of major osteoporotic fracture and hip fracture. Conclusion The FRAX tool may be effectively applied to assess the fracture risk of senile population in Guangzhou communities.We recommedated that FRAX-tool should be included in routine health check-up.