目的 本研究通过调查中国华南地区一间大型医疗机构(综合医院)中护士日间过度嗜睡的发生率及相关影响因素。方法 纳入了1 102名在职护士要求他们在一段规定的时间内完成一份自我报告问卷,其中包括人口学资料采集、生活习惯(BMI、小睡习惯、打鼾等)、失眠、抑郁、焦虑、MEQ分型、倒班、工作兴趣等与工作及睡眠相关的特征。了解EDS在被试人群中的发生率及其影响因素。结果 共有1 048名护士有效的完成了问卷(应答率为95.1%)。其中169名(16.1%)护士存在日间过度嗜睡(EDS)。抑郁症状(校正后的OR值= 2.24,95%的可信区间 1.51～3.31)、焦虑症状(1.65; 1.02～2.67)、失眠(2.29; 1.56～3.36)、倒班工作(1.98; 1.03～3.83)和对工作的低兴趣(1.74; 1.01～2.99)是EDS发生的独立危险因素。结论 日间过度嗜睡(EDS)在华南地区的综合医疗机构中的青年护士群体中普遍存在。EDS的发生可能与抑郁症状、焦虑症状、失眠、倒班工作和对工作的低兴趣存在相关。

Objective To investigate the prevalence and correlates of excessive daytime sleepiness EDS in a population of hospital nurses in South China. Methods A total of 1 102 nurses working in a large medical center were invited to participate in this cross-sectional study (females 96.9%,mean age 29.6 years). They all completed a self-reported questionnaire consisting of items on demographic variables,lifestyle factors,insomnia,anxiety,depression,and both work-related and sleep related characteristics. Results A total of 1 048 nurses gave a valid response (response rate 95.1%). Among them,169 (16.1%) reported EDS as defined as an Epworth Sleepiness Scale≥14. Depression (adjusted odds ratio=2.24,95% confidence interval 1.51～3.31),anxiety (1.65; 1.02 ～2.67),insomnia (2.29; 1.56～3.36),rotating shift work (1.98; 1.03～3.83) and low interest in work (1.74; 1.01～2.99) were all independent risk factors of the occurrence of EDS. Conclusion EDS were common among this relatively young and healthy nurse population in south China. There were clear associations with EDS and depression,anxiety,insomnia,rotating shift work and low work-related interest.

目的 了解血脂异常在青少年人群中的分布及影响因素。方法 以江门市棠下中学1 449名学生为研究对象,对其进行问卷调查、InBody人体成分仪检测和实验室检查。结果 血脂异常总检出率是8.3%,高胆固醇(TC)、高甘油三脂(TG)、高低密度脂蛋白胆固醇(LDL-C)和低高密度脂蛋白胆固醇(HDL-C)血症的检出率分别为8.3%、7.8%、10.6%和7.2%,女生血脂异常检出率(26.4%)高于男生(19.8%)(P<0.001);多因素分析显示性别(参照男性,OR=1.39,95%CI=1.08~1.80)和体脂百分比(参照正常组,超重、肥胖和重度肥胖组OR和95%CI分别OR = 1.62 / 2.89 / 4.45,95% CI = 1.13~2.32 / 1.85~4.51 / 2.48~7.96)与血脂异常间存在统计学关联(P<0.05)。结论 性别、体脂百分比是青少年血脂异常的影响因素。相对于青少年男生,青少年女生检出血脂异常的比例更高,体脂百分比高的青少年血脂异常的风险更高。

Objective To study the distribution and influencing factors of dyslipidemia among teenagers. Methods A questionnaire survey,InBody body composition test and laboratory examination were conducted on 1 449 students from the Tangxia Middle School in Jiangmen city as study objects. Results The total detection rate of dyslipidemia was 8.3% and the detection rates of high total cholesterol (TC),triglyceride (TG),high low-density-lipoprotein cholesterol (LDL-C) and low high-density-lipoprotein cholesterol (HDL-C) were 8.3%,7.8%,10.6% and 7.2%,respectively. The detection rate of dyslipidemia among teenage girls (26.4%) was higher than that among teenage boys (19.8%) (P<0.001). Multivariate analysis indicated that gender (with reference to male,OR=1.39,95%CI=1.08-1.80) and body fat percentage (with reference to normal group,for overweight,obesity and severe obesity groups,OR=1.62,2.89,4.45 and 95%CI=1.13-2.32,1.85-4.51,2.48-7.96,respectively) were statistically related to dyslipidemia (P<0.05). Conclusion Gender and body fat percentage are the influencing factors of dyslipidemia among teenagers. Compared with teenage boys,the teenage girls have a higher detection percentage of dyslipidemia. Teenagers with higher percentage of body fat show a higher risk of dyslipidemia.

目的 探究高龄患者植入静脉输液港并发感染相关影响因素分析。方法 随机抽取我院2015年5月—2018年8月期间收入高龄患者总计72例,对并发感染患者数量进行统计,采取Logistic回归方程进行计算,分析高龄患者植入静脉输液港并发感染相关因素。结果 共计纳入植入静脉输液港并发感染患者总计72例,其中并发感染患者为23例,占比31.94%,对比两组一般资料,发现两组患者在穿刺部位、疾病种类、使用时间及频率、是否有糖尿病史、体质量上存在差异,数据对比差异有统计学意义(P＜0.05),将上述有差异资料带入Logistic回归方程计算,发现穿刺部位、疾病种类、使用时间及频率、是否有糖尿病史、体质量均为导致高龄患者植入静脉输液港并发感染影响因素。结论 对高龄患者而言,植入静脉输液港并发感染各项因素中,包括穿刺部位、疾病种类、使用时间及频率、是否有糖尿病史、体质量,患者需加强关注,可控制输液港相关感染。

Objective To explore the influencing factors of infection in elderly patients with intravenous infusion port. Methods 72 elderly patients from May 2015 to August 2018 were randomly selected in our hospital. After counting the number of patients with complicated infection,the relative factors of infection in elderly patients were analyzed by using the Logistic regression equation. Results A total of 72 patients were included in the intravenous infusion port with concurrent infection,of which 23 were accompanied with infection,accounting for 31.94%.By comparing the general data,two groups in puncture sites,types of diseases,application times and frequencies,histories of diabetes and body masses had statistically difference(P<0.05). It was found all the above factors were the concomitant factors leading to the implantation of intravenous infusion port in elderly patients by putting the difference data into the Logistic regression equation. Conclusion To control infusion port related infection,the elderly patients should focus more on the infection factors of the implantation in intravenous infusion port which included puncture sites,types of diseases,application times and frequencies,histories of diabetes and body masses.

目的 分析石河子地区2型糖尿病(T2DM)合并消化道恶性肿瘤患者的临床特征,探讨T2DM合并消化道恶性肿瘤的影响因素。方法 ①纳入我院2015年至今消化道恶性肿瘤患者为研究对象。根据OGTT结果或既往有无T2DM病史分为三组:健康对照组(A组),消化道恶性肿瘤组(B组),T2DM合并消化道恶性肿瘤组(C组)。②全自动生化分析仪测定血清中糖脂代谢指标,化学发光法测定血清甲胎蛋白(AFP)等肿瘤标志物,分析其临床特征,进行组间比较,并探讨其影响因素。采用SPSS 22.0软件处理数据,并进行方差分析;影响因素采用Logistic回归分析;假设检验水准α＝0.05,双侧检验P<0.05差异有统计学意义。结果 ①基线资料比较显示:A组310例(男女比138/172),年龄(52.96±10.98)岁;B组513例(男女比343/170),胃癌患者居多(26.90%),年龄(62.26±12.34)岁;C组134例(男女比80/54),肝癌患者较多(26.12%),年龄(66.78±10.47)岁;与A组相比,B组与C组男性患者较多,年龄较大。②组间基线资料比较显示:三组的性别、年龄存在统计学差异(P<0.001)。③协方差分析消除影响因素后:与A组相比,B组及C组的TG、 TC、HDL-c降低(P<0.001);FPG、AFP、CEA、CA12-5、CA15-3、CA19-9、CA72-4升高(P<0.01)。④Logistic回归分析后结果显示:FPG为消化道恶性肿瘤发生的独立危险因素(OR=1.204);年龄是消化道恶性肿瘤及T2DM合并消化道恶性肿瘤发生的危险因素(OR=1.072,1.105),HDL-c为消化道恶性肿瘤及T2DM合并消化道恶性肿瘤发生的保护因素(OR=0.200,0.111);结论 老年男性T2DM患者易发生消化道恶性肿瘤。因此,对于高龄男性T2DM患者,尤其是HDL-c降低的情况下,应进行相关筛查,以早期防治消化道恶性肿瘤的发生发展。

Objective To analyze the clinical characteristics of patients with type 2 diabetes mellitus (T2DM)complicated with gastrointestinal malignancy in Shihezi area, and investigate the influencing factors of T2DM complicated with gastrointestinal malignancy. Methods ①Patients with malignant tumors of the digestive tract in our hospital from 2015 to the present have been included in the study. They were divided into three groups based on OGTT results or previous history of T2DM: healthy control group (group A), gastrointestinal malignant tumor group (group B), and T2DM combined gastrointestinal malignant tumor group (group C). ②Automatic biochemical analyzer measured serum glucose and lipid metabolism indicators, chemiluminescence method was used to measure serum alpha-fetoprotein (AFP)and other tumor markers, to analyze its clinical characteristics, make a comparaison between groups, and explore its influencing factors. The data was processed with SPSS 22.0 software and analysis of variance was performed; the influencing factors were analyzed by logistic reg-ression; hypothesis test level = 0.05, and the two-sided test P <0.05 was statistically significant. Results ①Comparison of baseline data showed that 310 cases (male/female 138/172)in group A were (52.96±10.98)years old. In group B, 513 patients (male/female 343/170)were diagnosed with gastric cancer (26.90%), aged (62.26±12.34)years. There were 134 cases in group C (male/female 80/54), with more liver cancer patients (26.12%), and the age was (66.78±10.47)years. Compared with group A, group B and group C had more male patients and were older. ②Comparison of baseline data among groups showed there were statistical differences in gender and age among the three groups (P<0.001). ③After covariance analysis eliminated influencing factors: compared with group A, TG, TC and HDL-c were decreased in group B and group C (P<0.001). FPG, AFP, CEA, CA12-5, CA15-3, CA19-9, and CA72-4 increased (P<0.01). ④Logistic regression analysis results: FPG was an independent risk factor for gastrointestinal malignancy (OR=1.204). Age wss a risk factor for gastrointestinal malignancy and T2DM complicated with gastrointestinal malignancy (OR=1.072, 1.105), HDL-c was the protective factor (OR=0.200, 0.111). Conclusion Elderly male T2DM patients are prone to gastrointestinal malignancies. Therefore, for elderly men with T2DM, especially when HDL-c is reduced, relevant screening should be performed to prevent and control the occurrence and development of gastrointestinal malignant tumors in the early stage.

目的 了解医务人员临床工作中血源性职业暴露的情况、暴露后的心理健康状况及其影响因素,采取干预措施,保障医务人员身心健康。方法 对医院2013年1月—2017年12月上报的79例血源性职业暴露者,在1个月内进行现状调查,同时采用自填式问卷症状自评量表(SCL-90)对调查对象进行调查,对其暴露后的心理影响程度进行评估。结果 医务人员在发生血源性职业暴露后其中躯体化因子、人际关系敏感因子、抑郁因子、焦虑因子在职业暴露前后的比较及与未发生职业暴露的医务人员相比较,均有不同程度的提高,差异均有统计学意义(P<0.001)。单因素分析显示影响血源性职业暴露后医务人员的心理健康状况的因素有年龄、职业、工龄、既往发生职业暴露史和患者患传染病种类(P<0.05)。其中年龄在21~25岁年龄的医务人员的得分较高,职业为医生和陪护工人的得分较高,工龄在1~5年的得分较高,既往发生过职业暴露的医务人员得分较高,患者患传染病类型为梅毒及暴露源不明的得分较高。结论 医务人员在发生血源性职业暴露后,其心理健康状态可受到较大影响;工龄、既往发生职业暴露史和患者患传染病种类是医务人员发生血源性职业暴露后心理状况健康的独立影响因素。医院管理者在重视预防及减少职业暴露的同时,更应关注血源性职业暴露后的心理变化,及时提供心理支持和医疗帮助。

目的 探讨孕妇学校改革创新后,孕妇对孕妇学校授课的效果和满意度及影响因素分析。方法 2016年8月—2017年6月,通过师资授课比赛、课后孕妇满意度、对相关知识知晓率排名相结合方式竞争产生孕妇学校授课师资队伍,随机选取部分听课孕妇作为调查对象。结果 授课后,孕妇对相关知识的知晓得分提高约20分(P＜0.05),孕妇对核心知识点知晓率提高明显(P＜0.05),孕妇对课程讲授效果各方面满意度均在94%以上。对课程不满意的维度主要有授课PPT制作、教学计划、授课形式等,不满意比例分别为19.1%、18.0%和16.3%。对课程不满意组孕妇较满意组孕妇年龄偏大(P＜0.05),其余孕妇基本特征差异无统计学意义。结论 孕妇学校师资改革成效明显,行之有效,值得推广。

Objective To explore the effect of pregnant women's school after reform and innovation. Methods FromAugust 2016 to June 2017, teachers of pregnant women's school were produced by teaching competition and pregnant women's satisfaction and degree of knowledge. Survey objects were randomly selected. Results After teaching, knowledge degree of pregnant women improved about 20 points (P<0.05). The awareness rate of pregnant women on core knowledge points increased (P<0.05). Satisfaction degree of pregnant women on the course was over 94%. The main dimensions of dissatisfaction with the course included PPT production, teaching plan and teaching form. The proportions of dissatisfaction were 19.1%, 18.0% and 16.3% respectively. Unsatisfied women ages were older than satisfied women (P<0.05). Conclusion Reform and innovation is effective, and it is worth promoting.

目的 探讨鼻咽癌(NPC)放疗致鼻窦炎发生的临床特征、影响因素。方法 回顾性分析2014年1月—2017年6月期间,我院收治的228例NPC患者临床资料,根据患者是否进行放疗,将患者分为非放疗组(106例)和放疗组(122例)。对比分析两组鼻咽癌致鼻窦炎的临床特点,以单因素和多因素Logistic分析鼻咽癌患者放疗后发生鼻窦炎的影响因素。结果 放疗组患者鼻窦炎发生率为81.97%,高于非放疗组患者鼻窦炎发生率54.72%,差异有统计学意义(P＜0.05)。放疗组鼻窦炎累及部位发生率从高到低,依次为后组筛窦、蝶窦、前组筛窦、窦口鼻道复合体、额窦以及上颌窦。放疗组患者鼻窦炎后组筛窦、蝶窦累及率高于非放疗组患者,差异具有统计学意义(P＜0.05)。单因素分析结果显示,放疗后鼻窦炎的发生,与患者年龄是否＞50岁,病程是否＞2年,是否存在鼻腔侵犯,肿瘤分期,是否使用滴鼻剂及是否进行鼻咽冲洗有关,差异有统计学意义(P＜0.05)。多因素Logistic回归分析结果显示,患者病程＞2年,存在鼻腔侵犯以及T3+T4期肿瘤是NPC放疗后鼻窦炎发生的独立危险因素;使用滴鼻剂和鼻咽冲洗是NPC放疗后鼻窦炎发生的保护因素。结论 NPC放疗后具有较高的鼻窦炎发生率,并且主要累及后组筛窦和蝶窦,对于病程＞2年、存在鼻腔侵犯以及T3+T4期肿瘤的患者,应积极采取措施预防鼻窦炎的发生,使用滴鼻剂和鼻咽冲洗是预防NPC放疗后鼻窦炎发生的有效措施。

Objective To investigate the clinical features and influencing factors of nasosinusitis caused by nasopharyngeal carcinoma (NPC) radiotherapy. Methods The clinical data of 228 NPC patients admitted to our hospital from January 2014 to June 2017 were retrospectively analyzed. According to whether the patients were treated with radiotherapy, the patients were divided into non-radiotherapy group (106 cases) and radiotherapy group (122 cases). The clinical characteristics of nasosinusitis were analyzed and compared. Univariate and multivariate logistic analysis was used to analyze the influencing factors of nasosinusitis after radiotherapy in patients with nasopharyngeal carcinoma. Results The incidence of sinusitis was 81.97% in the radiotherapy group, which was higher than that in the non-radiotherapy group (54.72%). The difference was statistical significance (P<0.05). The incidence of sinusitis involvement in the radiotherapy group was in the order of ethmoid sinus, sphenoid sinus, anterior ethmoid sinus, sinus ostium and nasal tract sinus complex, frontal sinus, and maxillary sinus. The incidences of ethmoid sinus and sphenoid sinus in the post-nasal sinusitis group were higher than that in the non-radiotherapy group (P<0.05). Univariate analysis showed that the occurrence of sinusitis after radiotherapy was related to whether the patient's age was > 50 years, whether the disease duration was >2 years, whether there was nasal invasion, tumor staging, whether nasal drops were used, and whether nasopharyngeal irrigation was performed. Multivariate logistic regression analysis showed that patients with a disease course of >2 years had nasal invasion and T3+T4 tumors were independent risk factors for sinusitis after NPC radiotherapy; use of nasal drops and nasopharyngeal washing were protective factors. Conclusion There is a higher incidence of sinusitis after radiotherapy of NPC, and mainly affects the ethmoid sinus and sphenoid sinus in the posterior group. Patients with a disease course of >2 years, with nasal invasion, and T3+T4 tumors should actively take measures to prevent the occurrence of sinusitis. The use of nose drops and nasopharyngeal washing is an effective measure to prevent the occurrence of sinusitis after NPC radiotherapy.

目的 为科学合理的测算公立医院人员编制以及编制管理改革提供参考。方法 对各省市公立医院机构编制标准以及相关文献进行系统分析,系统总结编制影响因素以及编制测算方法。结果 公立医院人员编制受多方面因素影响,而现阶段人员编制测算主要以床位数与门诊量为主要考量因素,其他因素为辅。结论 结合我国公立医院人事管理改革方向,在公立医院人员编制管理上,首先需要科学核定医院应配备人员总量,全方位考虑各影响因素,并设定一定的可伸缩区间,使医院可根据实际情况在一定范围内自主选择。

Objective To provide references for public hospital personnel calculation and personnel system reform. Methods The related standards of public hospitals in various provinces and literatures were analyzed systematically to sum up influence factors and calculation methods. Results Public hospital personnel complement is affected by various factors. At this stage that was mainly measured by the number of beds and outpatient service,and supplemented by other factors. Conclusion With the reform of personnel management in public hospitals in our country, in the management of public hospital staff, the first need to scientifically measure the total amount of personnel that hospital should be equipped with considering various factors. And to set an interval, the hospital may make an independent choice according to the actual situation.

目的 了解孕妇妊娠期运动现状及其影响因素,为优化妊娠期运动方案提供依据。方法 采用便利抽样法,使用自编《孕妇妊娠期运动现状及影响因素调查问卷》对广州市某三级甲等妇幼保健院214名孕周＞37周的孕妇进行调查。结果 妊娠期每次运动时长集中在30min~1 h的孕妇占43.0%;91.6%的孕妇选择散步和爬楼梯,仅有8.4%的孕妇接触过孕妇体操和瑜伽等其他运动形式;妊娠合并糖尿病与无合并症孕妇运动量相比,差异无统计学意义(P>0.05);家人朋友为孕妇主要获取妊娠期运动信息来源。认为妊娠期运动不重要、缺乏安全感、家庭及社会支持为妊娠期运动的主要影响因素。结论 孕妇运动量总体处于较低水平,运动形式单一,受认知、心理、生理、社会因素影响;孕妇尤其是患有妊娠合并糖尿病的孕妇对妊娠期运动的重要性和必要性没有给予足够的重视;医护人员对于妊娠期运动的引导作用较弱。

目的 分析不同性别学龄儿童行为问题影响因素,为促进儿童行为健康发展提供指导依据。方法 以儿童保健门诊就诊的学龄儿童200名,男童110例,女童90例,平均年龄为(7±15)a 为调查对象,采用儿童行为量表(CBCL)检测所有调查对象的行为问题。由男/女童父母在专业人员指导下进行问卷调查,对收集的数据使用SPSS 11.0统计软件进行资料分析。结果 本次调查中男、女童年龄差异无统计学意义,男、女童在检出儿童行为问题方面有明显的差异性(P<0.05,P<0.01)具有统计学意义。男童在强迫性、违纪方面明显高于女童,女童在抑郁、社交退缩、体诉方面高于男童。结论 儿童行为问题的发生,受多方面因素影响包括社会环境、家庭环境以及父母的教养方式,应根据男童和女童的不同行为特点,给予有效的干预让孩子的身心发展更趋稳定和健康,从而降低儿童行为问题的发生。

Objective To explore the influence factors of children's behavior problem in school-age children, and to provide the evidence for promoting healthier children's behavior. Methods The objects of our study included 200 school-aged children in health care clinic (110 boys and 90 girls ), the average age is 7(7±15)years, and we used the CBCL questionnaire to assess all the children's behavior problems. The CBCL questionnaire was finished by the parents of the children guided by the specialized investigator. The data was analyzed by the SPSS 11.0 software. Results The score of boys in compulsivity and disobey is significant higher than girls(P<0.05), and the girls have higher score in depression, social flinch and physical demands than boys(P<0.01). There is no significant difference between different genders in the age of the children. Conclusion Behavior problems of children were affected by many kinds of factors including social environment, family environment and parenting styles. We need to conduct appropriate behavior intervention according to the different behavior characteristics between boys and girls, to promote healthier children's behavior and to reduce the behavior problems of children.