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   分析贝伐珠单抗与化疗对晚期结直肠癌患者4种错配修复蛋白（MSH2、MLHI、MSH6、PMS2）水平影响。方法   选择2022年1月—2024年1月江苏省宿迁市中医院肿瘤科102例晚期结直肠癌患者，按抽签法分成两组，即化疗组及联合组，各51例。化疗组应用FOLFOX（亚叶酸钙+奥沙利铂+氟尿嘧啶）方案进行化疗，联合组采取贝伐珠单抗联合FOLFOX方案治疗。对比其肿瘤控制效果、免疫功能及MSH2、MLHI、MSH6和PMS2水平变化，并对比组间不良反应发生率。结果   联合组客观缓解率、疾病控制率高于化疗组（P＜0.05）；治疗后联合组患者CD4⁺ 、CD3⁺ 、CD8⁺ 、和CD4⁺ /CD8⁺数值高于化疗组，且两组治疗后均低于治疗前（P＜0.05）；治疗后两组患者MSH2、MLHI、MSH6和PMS2缺失率对比无统计学意义（P＞0.05），但其阳性、阴性表达情况对比差异有统计学意义，联合组MSH2、MLHI、MSH6和PMS2阳性率低于化疗组（P＜0.05）；两组不良反应发生率对比差异无统计学意义（P＞0.05）。结论   对晚期结直肠癌在化疗基础上增加贝伐珠单抗抗肿瘤效果显著，改善其免疫功能，虽无法改善患者错配修复蛋白缺损，但可辅助降低其阳性率，且不影响安全性。

       Objective  To analyze the effects of bevacizumab and chemotherapy on the levels of four mismatch  repair proteins（MSH2，MLHI，MSH6，PMS2）in patients with advanced colorectal cancer．Methods  A total of 102 patients with advanced colorectal cancer from the Oncology Department of Suqian Traditional Chinese Medicine Hospital in  Jiangsu Province from January 2022 to January 2024 were selected，and were divided into two groups according to the drawing method，namely the chemotherapy group and the combination group，with 51 patients in each group．The chemotherapy group received FOLFOX（calcium folinate+oxaliplatin+fluorouracil）regimen for chemotherapy，while the combination group received bevacizumab combined with FOLFOX regimen for treatment．Tumor control effect，immune function，and changes in MSH2，MLHI，MSH6，and PMS2 levels，and its incidence of adverse reactions were compared．Results  The objective remission rate and disease control rate of the combined group were higher than those of the chemotherapy group（P＜0.05）．After treatment，the CD4⁺ ，CD3⁺ ，CD8⁺ and CD4⁺ /CD8⁺ values in the combination group were higher than those in the chemotherapy group，and those after treatment were lower than those before treatment in both groups（P＜0.05）．After treatment，there were no significant differences in the deletion  rates of MSH2，MLHI，MSH6，and PMS2 between the two groups of patients（P＞0.05），but there was a significant difference in their positive and negative expression．The positive rates of MSH2，MLHI，MSH6，and PMS2 in the combination group were lower than those in the chemotherapy group（P＜0.05）．There was no significant difference in the incidence of adverse  reactions between the two groups（P＞0.05）．Conclusions  Adding bevacizumab on the basis of chemotherapy has a significant anti-tumor effect on advanced colorectal cancer，improving its immune function．Although it cannot improve the mismatch  repair protein defect in patients，it can assist in reducing its positivity rate and has high safety．