目的 分析广州市区2014—2016年无偿献血血液报废情况,探讨降低血液报废措施,减少血液报废。方法 收集并统计广州市区2014—2016年血液报废情况,分别统计报废血液比例。结果 2014—2016年报废血液产品共170 576 U,报废率为5.99%;非检验原因报废率(3.11%)高于检验原因报废率(2.88%),检验原因报废率呈逐年下降趋势,其中ALT及HBsAg报废率较高,非检验原因报废率呈逐年上升,其中乳糜血报废率较高。结论 进一步加强献血宣传和征询工作,以及做好团队献血的快速筛查工作,提高工作人员的操作水平,均有利于进一步降低血液报废率。

Objective To analysis blood products and disposal situation in Guangzhou from 2014-2016 to provide measures for reduce the scrap rate. Methods Collecting and statistical analysis of blood products scrap rate from 2014-2016 in Guangzhou respectively. Results A total of 170 576U blood products were scrapped in 2014-2016 and the scrap rate was 5.99%, in which non-detection scrap rate (3.11%) was higher than detection scrap rate (2.88%). Non-detection scrap rate was decreasing these years, among which ALT and HBsAg had a large proportion, while detection scrap rate was increasing, in which chylaemia scrap rate was the most highest. Conclusion We need to strengthen and publicize blood donation, as well as do well rapid screening of team blood donation and improve the operating level of staff.

目的 调查广州市市级(三级)妇幼医院与广州市农村地区区级(二级)妇幼医院护士离职意愿与工作满意度情况。方法 以广州市某三级甲等妇幼医院和4所(花都、南沙、从化、增城)地区二级妇幼医院的3 026名护士为研究对象。应用护士工作满意度量表(MMSS)及离职意愿量表(TIQ)进行问卷调查,并比较分析不同级别妇幼医院护士的离职意愿和工作满意度的差异。结果 相比二级妇幼医院,三级妇幼医院护士的平均年龄较大、学历、职称和奖金均较高、有编制人数所占比例较大,差异有统计学意义(P<0.05)。二、三级妇幼医院护士离职意愿平均得分依次为(2.38±0.682)分、(2.87±0.570)分,工作满意度平均得分依次为(3.34±0.702)分、(3.00±0.482)分。差异均有统计学意义(P<0.05)。结论 相比二级妇幼医院,三级妇幼医院护士离职意愿更强,工作满意度更低,护理管理者可采取有效措施提高护士工作满意度。

Objectives To investigate the current status of nurses' turnover intention and job satisfaction in secondary and tertiary women and children's hospitals in Guangzhou. Methods 3 026 nurses were enrolled in this study, which were from a tertiary hospital in Guangzhou urban area and another 4 secondary hospitals located in rural districts, namely Huadu, Nansha, Conghua, Zengcheng. Systematic sampling was adopted. The Mueller/McCloskey Nurse Job Satisfaction Scale (MMSS) and Turnover IntentionQuestionaire(TIQ)were applied to carry out this investigation. Differences of nurses' turnover intention and job satisfaction between different levels' hospitals were compared and analyzed. Results Compared with those in the secondary hospitals, nurses in the tertiary maternity hospital were at higher average age, had better academic backgrounds with higher professional titles, more bonus and more positions of establishment. The differences all were statistically significant (P<0.05). The average scores of turnover intention for nurses from the secondary and tertiary hospitals were2.38±0.682 and 2.87 ±0.570 respectively. All the differences were statistically significant (P<0.05). Conclusion Compared with those in the secondary maternal and child health hospitals, nurses in the tertiary hospitals were more willing to leave and had lower job satisfaction. Nurse's managers may take effective measurses to increase nurse's satisfaction.

目的 探讨广州地区老年人维生素D水平及其与骨密度、甲状旁腺激素的相关性。方法 收集2016年6月—12月在广州市第一人民医院老年病科就诊的患者。检测25-羟维生素D、甲状旁腺激素、Ⅰ型前胶原氨基端前肽、β-Ⅰ型胶原C端肽、腰椎和髋部骨密度。将患者分为维生素D缺乏组(≤20 ng/mL)、维生素D不足组(20～30 ng/mL)、维生素D充足组(≥30 ng/mL)。结果 ①426例研究对象的平均年龄是(79.77±7.69)岁,25羟维生素D平均值是(20.38±8.20)ng/mL。维生素D缺乏、不足、充足者比例分别是53%(226/426)、34.3%(146/426)、12.7%(54/426)。②25羟维生素D水平随年龄增加而降低。25羟维生素D与股骨颈和全髋骨密度呈正相关(r=0.18,P＜0.001),与甲状旁腺激素呈负相关(r=-2.05,P＜0.001)。结论 广州地区老年人维生素D不足及缺乏十分普遍。维生素D与股骨颈、髋部骨密度呈正相关,与甲状旁腺激素呈负相关。

Objective To investigate the vitamin D level of elder people in Guangzhou and the relationship in vitamin D, bone mineral density and parathyroid hormone. Methods To screening elderly patients in the geriatric department of Guangzhou First peoples Hospital from June to December 2016.Serum 25-hydroxy vitamin D,parathyroid hormone,procollagen typeⅠN-terminal propeptide,β-crosslaps of C-telopeptide of typeⅠcollagen,bone mineral density were measured.Three groups were divided according to the serum 25(OH)D level,including deficiency group(≤20 ng/mL),insufficiency group(20-30 ng/mL) and sufficiency group(≥30 ng/mL). Results The mean age of the 426 subjects was 79.77±7.69 years old. The average level of 25(OH)D was 20.38±8.20 ng/mL. The proportion of vitamin D deficiency, insufficient and sufficient persons were 53% (226/426), 34.3% (146/426), and 12.7% (54/426). The level of 25 hydroxy vitamin D was decreased with age.Correlation analysis showed that 25 hydroxy vitamin D level was positive correlated with the femoral neck and total hip bone density(r=0.18,P＜0.001),was negatively correlated with parathyroid hormone(r=-2.05,P＜0.001). Conclusion Vitamin D deficiency or insufficiency is highly prevalent in elderly men in Guangzhou.25 hydroxy vitamin D level was positive correlated with the femoral neck and total hip bone density, negatively correlated with parathyroid hormone.

目的 分析2014年482例广州登革热患者的X线胸片特点,探讨X线胸片对登革热患者的临床诊断价值。方法 选取广州市第一人民医院2014年收治的482例登革热患者作为研究对象,观察分析其X线胸片检查结果的特征。结果 登革热患者X线胸片影像学特点以非特异性的肺纹理增多增粗和斑片渗出灶为主要表现,另有胸膜增厚、胸腔积液和间质性改变。结论 X线胸片检查可以经济、便捷地了解登革热患者的肺部改变,为临床诊断和治疗提供帮助。

Objective To analyze the characteristics of chest X-ray in 482 cases of dengue fever in Guangzhou 2014, and to discuss the diagnostic value of chest X-ray in dengue fever patients. Methods 482 patients of dengue fever patients admitted in Guangzhou First People's Hospital were selected as the research object. The characteristics of the chest X-ray were observed and analyzed. Results The characteristics of chest X-ray images included lung markings thickening increased, exudation, and might lead to pleural thickening, effusion and interstitial change. Conclusion Chest X-ray was a convenient examination for dengue fever patients which had an important diagnostic and therapeutic value.

目的 分析广州市番禺区户籍和流动人口肺结核病发现延误情况,为研究结核病防治基本公共卫生服务均等化策略提供参考依据。方法 根据中国疾病预防信息系统登记的数据,对2013—2016年番禺区登记的肺结核病人进行统计。采用卡方检验的方法,对比分析户籍和流动肺结核病人发现延误的差异。结果 结核病发现延误中,男性患者户籍与流动患者延误天数比较差异有统计学意义(χ²=19.067,P<0.01),户籍患者延误天数30 d以上的比例高于流动患者。户籍与流动患者的医生延误天数比较差异有统计学意义,流动患者的医生延误比例高于户籍患者(χ²=18.001,P<0.01)。结论 广州市番禺区肺结核发现延误主要由户籍病人患者延误和流动病人医生延误所构成,需采取综合性干预措施,减少结核病患者的发现延误,从而进一步体现结核病防治基本公共卫生服务均等化。

目的 分析广州市离退休干部的体检结果,为疾病的预防和治疗提供依据。方法 以2015年在我院进行体检的离退休干部为对象,对其中有相同体检内容的3 841位的结果进行分析,探讨该人群中阳性体征检出率最高的前15种疾病,以及这些疾病在不同性别人群中的差异,并与2014年检出结果进行对比。结果 总体人群前15种阳性体征检出率疾病中,大部分疾病的检出率在不同性别人群有统计学差异。老年性白内障(总人群检出率67.56%)、高血压病(46.6%)、结节性甲状腺肿(44.18%)位居前三位;与2014年的检测结果相比,老年性白内障、高尿酸血症、胆囊结石这三种疾病的检出率有所下降,而结节性甲状腺肿、痔疮、慢性咽炎、高脂血症、胆囊炎这五种疾病的检出率有所上升(差异均有统计学意义,P<0.05)。结论 离退休人员性别差异罹患各种疾病的几率不同,男性更易罹患老年性白内障、高尿酸血症、牙周炎、牙龈炎、脂肪肝、糖尿病、胆囊炎。女性更易罹患结节性甲状腺肿、痔疮、慢性咽炎、高脂血症。定期健康体检后的进一步健康管理还相当薄弱,健康干预日益迫切需要。

Objective We analyzed the physical examination results of retired cadres,to acquaint the health status of the targeted population and provide the basis for the disease prevention and treatment. Methods Among the retired cadres who conducted healthy examination in the successive two years of 2014 and 2015, we selected 3841 cases of which examination items were the same in these two years. Based on their healthy examination results, we investigated the diseases of which detected rates of positive sign ranked in top 15, including the different appearances between different genders, and made comparisons with that of year 2014. Results Out of the top 15 diseases, senile cataract, hypertension and nodular goiter ranked in top 3. Compared with that of year 2014, a decrease of the detection rate could be seen in three diseases namely senile cataract, hyperuricemia and cholecystolithiasis, but an increase in five diseases namely nodular goiter, hemorrhoids, chronic pharyngitis, hyperlipidemia and cholecystitis. Conclusion Regular examination is an important way to acquaint the health status of retired cadres, and find pathogenesis risk factors timely. The healthy management however is still weak after physical examination.Thus it can be seen that healthy intervention has become increasingly urgent.

目的 了解广州市社区医务人员对颈动脉狭窄防治知识的认知程度、认知途径及对相关健康教育的需求情况。方法 对37家社区卫生服务中心194名广州市社区医务人员进行问卷调查,分析调查结果。结果 社区医务人员中52.58%能够指出颈动脉狭窄与脑卒中的关系,但对症状性颈动脉狭窄定义、颈动脉狭窄的外科治疗方法知晓率偏低(14.95%、18.56%),97.94%能够指出颈部彩超是颈动脉狭窄最常用的筛查方法,但对彩超结果判读、干预方法指导等方面内容掌握率偏低。对颈动脉狭窄知识来源目前最主要的是用药指南和药品说明书(33.89%)认为最有效获得颈动脉狭窄知识的途径是专题继续教育培训班(26.12%)。结论 社区医务人员已经形成了脑卒中和颈动脉狭窄的基本观念,但是不能达到足够的“深度”,通过开展多种形式继续教育,增进社区医务人员对颈动脉狭窄认知的广度和深度,引导和拓宽获得知识的途径将是必要和有效的。

Objective To understand the knowledge and needs of carotid stenosis prevention among community health workers in Guangzhou. Methods A Kirkpatrick model-based questionnaire survey was conducted among 194 health workers in community health service center in Guangzhou. Results 52.58% of the community medical staff could point out the relationship between carotid stenosis and stroke, but few of them could accurately point out the definition and surgical treatment of symptomatic carotid stenosis(14.95%,18.56%). 97.94% of them could pointed out that the most commonly used screening methods for cervical carotid stenosis, but most of them didn't know how to interpret the inspection result of color doppler ultrasound. Medication guide were the main knowledge source of carotid stenosis(33.89%) and post-graduate training was the most promising approach(26.12%). Conclusion Community health workers have formed the basic concept of stroke and carotid stenosis, but it was limited in extent. It is necessary to carry out various forms of continuing education to improve the level of awareness of community health workers on carotid artery stenosis.

目的 了解广州综合医院内分泌科门诊就诊者中抑郁焦虑障碍的患病率。方法 对广州市第一人民医院的内分泌科门诊就诊的患者进行横断面调查。采用医院焦虑抑郁量表(HADS)对105名入选的患者进行筛查,精神科医生对HADS≥8 分的患者进行国际神经精神科简式访谈问卷( MINI ) 的诊断性评估。结果 MINI诊断的抑郁障碍、焦虑障碍、抑郁和焦虑共病的患病率分别为3.80%、0.95%和2.86%。结论 抑郁和焦虑障碍是综合医院内分泌科门诊就诊者中的常见问题,但识别率和治疗率均不高。

Objective To investigate the prevalence rates of depressive and anxiety disorders of the endocrinology outpatients in a general hospital of Guangzhou. Methods A cross-sectional survey was conducted in the endocrinology outpatient department of Guangzhou First People's Hospital. A total of 105 outpatients were screened with hospital anxiety and depression scale(HADS). The patients with the HADS score of 8 and over were investigated and diagnosed by psychiatrists with the mini-international neuropsychiatric interview(MINI). Results The prevalence rates of MINI-diagnosed depressive disorder, anxiety disorder, and depressive-anxiety co-morbid disorders were 3.80%, 0.95% and 2.86%, respectively. Conclusion Depression and anxiety disorders are common problems in the endocrinology outpatient department of general hospitals,but few outpatients were well-diagnosed and treated.

目的 了解2014年广州地区儿童专科医院的病原菌分布及耐药情况与全国细菌耐药监测网(CARSS)公布数据的异同点,并提出相关用药建议,为儿童临床合理应用抗生素提供科学依据。方法 将2014年本中心儿童院区检测的儿童细菌耐药数据与同期国家卫生计生委合理用药专家委员颁布的CARSS数据进行比较。结果 儿童医院与CARSS数据比较,革兰阳性菌比例较高(49.8% vs 28.5%),革兰阴性菌比例较低(50.2% vs 71.5%);肺炎链球菌、化脓性链球菌及流感嗜血杆菌检出率较高;耐药率明显升高的是肺炎链球菌对青霉素耐药率(33.2% vs 4.3％),耐药率明显降低的是鲍曼不动杆菌对碳青霉烯类耐药率(10.3% vs 57.0％),大肠埃希菌对喹诺酮类耐药率(27.6% vs 54.3％)。结论 广州地区儿童病原菌分布及耐药情况与CARSS数据比较有一定差异,特别是儿童主要致病菌肺炎链球菌对青霉素耐药的形势严峻,经验性抗感染治疗时需考虑本地及儿童的病原菌特殊性。

目的 了解长期低剂量辐射费放射工作人员健康状况的影响。方法 采用现况调查,按照国家卫生部发布健康监测标准对放射工作人员健康状况进行调查分析。结果 放射工作人员白细胞、血小板计数低于对照组,染色体畸形率、微核率高于对照组,差异有统计学意义(P<0.05)。随着工龄的增长,微核率呈上升趋势。结论 加强放射工作人员防护意识,缩短放射接触时间,加大设备保护力度,促进放射工作人员的健康。

Objective To study the health status of radiological workers who explore to long-term low-dose radiation.Methods A cross-sectional study had been investigated according to the National Ministry of Health monitoring standards of radiological workers. Results The white blood cell and platelet counts of radiological worker were less than the control group. There was a significant difference with the rate of chromosome abnormalities and the rate of micronucleus in the radiological workers(P<0.05). With the growth of length of service time, the micronucleus rate rose up. Conclusion We need to strengthen awareness of radiation protection, shorten the time of radiation exposure, increase equipment support level to protect the health of radiological workers.