目的 接触苯及苯系化合物作业人员血常规检查结果的分析。方法 收集2022年1月—2022年12月726名接触苯系物作业人员健康监护资料,均行血常规检测,并对其进行分析。结果 男性苯及苯系物接触作业人员的红细胞计数（RBC）（t=16.253）、血红蛋白（Hb）（t=25.345）、淋巴细胞绝对值（t=4.420）高于女性,血小板计数（PLT）（t=-5.523）低于女性,差异有统计学意义（P<0.001）;30~39岁和≥50岁作业人员、40~49岁和≥50岁作业人员的Hb比较差异有统计学意义（F=6.581,P=0.001）,<30岁和≥50岁作业人员、30~39岁和≥50岁作业人员、40~49岁和≥50岁作业人员的PLT比较差异有统计学意义（F=7.082,P=0.001）。结论 苯及苯系化合物的接触对劳动者血常规的结果有一定的影响,其中女性、高龄更为明显,应加强相应的职业健康防护措施,应改善作业环境,完善防护设备,防止职业疾病的发生。

Objective Analysis of blood routine test results for workers exposed to benzene and its derivatives．Methods Collect health monitoring data from 726 workers exposed to benzene derivatives from January 2022 to December 2022,all of whom underwent blood routine tests and were analyzed．Results The absolute values of RBC（t=16.253）,Hb（t=25.345）,and lymphocytes（t=4.420）in male workers exposed to benzene and its derivatives were higher than those in females,while PLT（t=-5.523）was lower than that in females,with statistical significance（P<0.001）;There was a significant difference in Hb between workers aged 30-39 and≥50,and between workers aged 40-49 and≥50（F=6.581,P=0.006,P<0.001）．There was a significant difference in PLT between workers aged 30-39 and≥50,between workers aged 30-39 and≥50,and between workers aged 40-49 and≥50（F=7.082,P=0.005,P=0.001,P<0.001）．Conclusions The exposure to benzene and its derivatives has a certain impact on the blood routine results of workers,with females and elderly being more prominent．Corresponding occupational health protection measures should be strengthened,the working environment should be improved,protective equipment should be perfected,and occupational diseases should be prevented．

目的 分析不同年龄、不同季节河源市源城区呼吸道感染的病原学情况,指导临床用药。方法 回顾性研究2020年3月—2022年2月2 468例呼吸道感染的住院患儿,取咽部分泌物送广州达安临床检验中心进行呼吸道核酸六项检测并分析结果。包括：肺炎链球菌（Sp）、呼吸道合胞病毒（RSV）、卡他莫拉菌（MC）、流感嗜血杆菌（Hi）、肺炎支原体（LP）、腺病毒（ADV）。结果 （1）2 468例患儿的标本中阳性率52.8%,其中RSV最高,其他依次为Sp、Hi、MC、MP、ADV。而混合感染仅次于RSV。（2）婴儿组和幼儿组以RSV感染为主,在学龄前组和学龄组儿童中,以Sp感染为主,各病原体的混合感染组合很多,一种细菌合并一种病毒多见。（3）秋冬季是河源市源城区呼吸道感染的高发季节,RSV是秋冬季呼吸道感染最主要的病原体。结论 秋冬季节为河源市源城区呼吸道感染的高发季节,RSV为该季节的主要病原体。RSV也是婴幼儿组感染的主要致病菌,随着年龄增大,细菌感染导致的呼吸道疾病逐渐占优势。混合感染在各年龄组中均占比较高,值得临床诊疗的重视。

Objective To analyze the etiology of respiratory tract infection in Yuancheng District of Heyuan City ,which was in different ages and seasons,and to provide guidance of clinical drug usage．Methods Cases of 2 468 hospitalized children with respiratory tract infection from March 2020 to February 2022 were analyzed．The secretion from pharynx was collected and sent to Guangzhou Da’an Clinical Examination Center for six respiratory nucleic acid tests and then the results were analyzed,including Streptococcus pneumoniae（Sp）,respiratory syncytial virus（RSV）,Moraxella catarrhalis（MC）,Haemophilus influenzae（Hi）,Mycoplasma pneumonia（MP）,adenovirus（ADV）．Results The positive rate of 2 468 hospitalized children with respiratory tract infection was 52.8%,of which the highest was RSV,followed by Sp,Hi,MC,MP,ADV．Meanwhile the mixed infection rate was second to RSV．RSV infection was the main infection in infant group and early-aged children group,while in preschool group and school-aged group,Sp infection was the main infection．There were many mixed infection of pathogen,and one bacteria combined with one virus was more common．Respiratory tract infection had high incidence in autumn and winter in Yuancheng District of Heyuan City,RSV was the major pathogen．Conclusions Autumn and winter were the seasons with high respiratory tract infection incidence in Yuancheng District of Heyuan City,and RSV was the main pathogen in these two seasons．RSV was also the main pathogen of infant group infection．But with the increase of children’s age,bacterial infection became the main reason of respiratory tract diseases．Mixed infection accounts for a high proportion in all age groups,which should be valued in clinical diagnosis and treatment．

目的 使用金标免疫层析法检测儿童腹泻粪便标本,将其轮状病毒的结果进行分析汇总。方法 选取本院2020年1月—2021年1月收治的86例儿童腹泻者,根据金标免疫层析法的检测方式,将检测结果为阳性者的轮状病毒粪便标本进行回顾性分析。将86例阳性者的轮状病毒粪便标本送往我市疾控中心,采用逆转录-聚合酶链式反应(RT-PCR)进行检测,分析对比检测情况。结果 86例儿童腹泻感染经金标免疫检测为阳性者80例,阳性率为93.02%,同时将86例粪便标本送往本市疾控中心采用RT-PCR检测验证70例阳性,轮状病毒阳性率为81.39%,两种检测方法相比,金标免疫检测结果其准确度更高;80例阳性者中,1岁以下的婴幼儿为31例,占38.75%,较为多见,其次为1岁、2岁的儿童,各占23.75%、25.00%。季节性以秋季和冬季为轮状病毒的高发期,11-12月份36例,占45.00%,1-2月、9-10月18例、16例,占22.50%、20.00%;男女性别比中2组阳性率比较,经统计学分析无明显差异性(χ²=2.500,P＞0.05)。结论 轮状病毒多以5岁以下的婴幼儿为主,秋冬季节较为常见,采取金标免疫层析法的检测方式,来检测儿童的粪便标本,其操作简单,可快速准确地检测出轮状病毒,且该方法具有一定的临床诊断价值,值得推广应用。

目的 分析献血者乙型肝炎病毒(HBV)核酸检测非重复反应性确认及追踪结果。方法 对1 200例于我站无偿献血者的血液样本进行非重复反应性确认,补充乙肝“两对半”检测,并对其部分单项核酸检测反应的患者予以回访结果追踪。结果 1 200份无偿献血血液样本单项核酸检测有反应性者150份(12.50%)。150份单项核酸检测有反应性样本经重新病毒核酸检测后,仍有58例样本有反应性(38.67%)、92例样本为非反应性(61.33%)。其中有18例献血者实际召回抽血,完成两次追踪,第一次追踪60~125天,第二次追踪间隔天数在160~356天,第一次追踪HBV DNA有反应(+)8例,第二次追踪仍存在反应(+);7例HBV DNA有反应者存在抗-HBc阳性(+)。核酸反应检测HBV-DNA阳性值10~17有37.25%,高于核酸反应检测值<10的4.17%(P<0.05)。结论 部分单项核酸检测反应无偿献血者存在一定的输血传播HBV风险,多为HBV隐匿性感染,此时需要重视其输血情况,屏蔽单项核酸反应性献血者。

Objective To analyze the results of nonrepetitive reactivity of HBV nucleic acid detection in blood donors. Methods 1 200 blood samples from our station were confirmed by nonrepetitive reaction, supplemented with the “two to half” test of hepatitis B, and some patients with single nucleic acid detection were followed up. Results One hundred and fifty samples (12.50%) were reactive in single nucleic acid detection in 1 200 blood samples. After the virus nucleic acid detection, 58 samples were reactive (38.67%), 92 were nonreactive (61.33%). 18 donors were actually recalled and drew blood, completed two tracking. The first tracking time was 60-125 days, the second time interval was 160-356 days. In the first tracking 8 cases had HBV DNA reaction (+) , which still had reaction in the second tracking; 7 HBV DNA positive donors had HBC antibody (+).The proportion of HBV-DNA positive with 10-17 value in mucleic acid reaction test(37.25%) was higher than that with value below 10(4.17%,P＜0.05). Conclusion Some donors with single nucleic acid detection reaction have a certain risk of transmission of HBV, most of them had hidden infection of HBV. At this time, we should pay attention to the blood transfusion and avoid the single nucleic acid reactive donors.

目的 分析高龄呼吸道感染患者病原菌检测结果及耐药性情况,总结高龄呼吸道感染患者抗菌药物的合理用药经验。方法 对我院2018年1月—2020年12月收治的784例高龄呼吸道感染患者痰液标本进行病原菌培养及药敏试验,统计分析检测结果。结果 701株病原菌中,革兰阴性(G-)菌、革兰阳性(G+)菌和真菌分别检出497株、136株和68株,分别占70.90%、19.40%和9.70%。G-菌以肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌和奇异变形杆菌为主,分别占21.97%(154株)、18.97%(133株)、14.98%(105株)和7.13%(50株),G+菌以金黄色葡萄球菌为主,占11.27%(79株)。G-菌耐药性前五位依次为氨苄西林、哌拉西林、复方磺胺甲噁唑、头孢唑啉和头孢他啶,耐药率依次为95.96%、85.11%、79.88%、77.06%和52.92%。G+菌耐药性前五位依次为青霉素、氨苄西林、红霉素、环丙沙星和复方磺胺甲噁唑,耐药率依次为95.59%、89.71%、84.56%、80.15%和75.00%。结论 高龄呼吸道感染患者病原菌构成以肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌、奇异变形杆菌和金黄色葡萄球菌为主,G-菌对氨苄西林、哌拉西林、复方磺胺甲噁唑、头孢唑啉和头孢他啶耐药最强,G+菌对青霉素、氨苄西林、红霉素、环丙沙星和复方磺胺甲噁唑最强,且呈多重耐药特征,加强临床耐药性监测有助于指导合理用药。

Objective To analyze the test results and drug resistance of pathogenic bacteria in elderly patients with respiratory tract infections, and summarize the rational use of antibiotics in elderly patients with respiratory tract infections. Methods The sputum samples of 784 elderly patients with respiratory tract infections admitted to our hospital from January 2018 to December 2020 were collected for pathogen culture and drug sensitivity test, and the test results were statistically analyzed. Results Among 701 strains of pathogenic bacteria, 497 strains were Gram-negative (G-) bacteria (70.90%), 136 strains were Gram-positive (G+) bacteria (19.40%) and 68 strains were fungi (9.70%). G-bacteria were mainly Klebsiellapneumoniae, Pseudomonas aeruginosa, Escherichia coli and Proteus mirabilis, accounting for 21.97% (154 strains), 18.97% (133 strains), 14.98% (105 strains) and 7.13% (50 strains). G+bacteria were mainly Staphylococcus aureus, accounting for 11.27% (79 strains). The top five antibiotics which G-bacteria resisted were ampicillin, piperacillin, compound sulfamethoxazole, cefazolin and ceftazidime.The resistance rates were 95.96%, 85.11%, 79.88%, 77.06% and 52.92%,respectively. The top five antibiotics which G+bacteria resisted were penicillin, ampicillin, erythromycin, ciprofloxacin and compound sulfamethoxazole, and the drug resistance rates were 95.59%, 89.71%, 84.56%, 80.15% and 75.00%, respectively. Conclusions The pathogenic bacteria in elderly patients with respiratory tract infections were mainly Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, Proteus mirabilis and Staphylococcus aureus. G-bacteria resisted ampicillin, piperacillin,compound sulfamethoxazole, cefazolin and ceftazidime the most. G+bacteria were most resistant to penicillin, ampicillin, erythromycin, ciprofloxacin and compound sulfamethoxazole, and were characterized by multi-drug resistance.Enhancing bacterial resistance monitoring helps guiding the rational use of drugs.

目的 通过皮肤点刺筛查慢性荨麻疹的变应原,为临床治疗提供依据。方法 采用“阿罗格”点刺液对2 974例临床确诊慢性荨麻疹患者行皮肤点刺试验进行29种变应原的检测,并设阳性(0.1%组胺)及阴性(生理盐水)对照,记录阳性反应的变应原和反应强度。结果 2 974名受试者中,呈阳性反应人数有1 052人,阳性率为35.37%;阳性反应结果中,受试者对蟑螂、粉尘螨、屋尘螨最为敏感,阳性率分别为78.80%、78.04%和73.76%;不同性别、月份、年龄组的阳性反应种数与反应强度无统计学上的差异:不同变应原的反应强度秩和检验(χ²=9 741.284,P<0.001)差异有统计学意义,受试者对蟑螂、粉尘螨、屋尘螨、杂草、虾和霉菌Ⅰ等的过敏强度较大。结论 皮肤点刺作为慢性荨麻疹筛查变应原的方法之一,能筛选出阳性反应强度最大的前几个变应原,临床能为患者进行行为干预规避过敏原或进一步脱敏治疗提供参考依据。

目的 评价血清异常凝血酶原(PIVKA-Ⅱ)检测在原发性肝癌中的诊断价值。方法 收集在我院收治的住院病人及健康体检人群血清标本共968份,其中原发性肝癌组202例,慢性乙型肝炎组385例,肝硬化组62例,脂肪肝组117例,其它消化系统疾病组93例,健康对照组109例。化学发光法分别检测标本中AFP和PIVKA-Ⅱ水平。分别以健康对照组和慢性肝病组为对照,计算AFP和PIVKA-Ⅱ单独检测和联合检测对原发性肝癌的诊断性能(敏感度、特异度、Kappa值以及ROC曲线等)。结果 原发性肝癌组血清AFP和PIVKA-Ⅱ水平均高于其他各组(P<0.05)。AFP和PIVKA-Ⅱ单独检测和联合检测诊断原发性肝癌的敏感度分别为64.36%、95.05%、97.52%;以健康组为对照,AFP和PIVKA-Ⅱ单独检测和联合检测对原发性肝癌的诊断特异度分别为97.25%、98.17%、96.33%, Kappa值分别0.910、0.917、0.937,ROC曲线下面积分别为0.908、0.987、0.992;以慢性肝病组为对照,AFP和PIVKA-Ⅱ单独检测和联合检测对原发性肝癌的诊断特异度分别为80.67%、92.38%、76.95%, Kappa值分别0.654、0.831、0.621,ROC曲线下面积分别为0.801、0.976、0.963。结论 血清PIVKA-Ⅱ在原发性肝癌的中诊断价值优于AFP,其与AFP的联合检测可提高原发性肝癌的诊断敏感度。

目的 分析KRAS基因突变在左半结肠、右半结肠癌分布几率的差异性。方法 回顾性分析我院病理科分子实验室2015年到2017年间接收的537例结肠癌手术标本,用ARMS-PCR法进行了KRAS基因的检测,并对左右半结肠腺癌KRAS基因突变比例进行χ²检验,P＜0.05为差异有统计学意义。结果 537例中有187(34.82%)例为右半结肠腺癌,左半结肠腺癌有350(65.18%)例。KRAS基因突变检测阳性例数为240例,阳性率为44.69%;右半结肠腺癌KRAS基因突变阳性数为114例,阳性率为60.96%;左半结肠癌KRAS基因突变阳性数为126例,阳性率为36.00%。双侧结肠腺癌KRAS基因突变差异有统计学意义。结论 右半结肠癌的患病例数低于左半结肠癌,右半结肠癌KRAS基因突变阳性率较左半结肠癌高,本研究为区分左右半结肠癌的分子靶向治疗提供了数据支持。

Objective To analyze the differences distribution of KRAS gene mutations in the left hemi colon cancer and right hemi colon cancer. Methods Retrospectively to analyse the 537 colorectal cancer patients who were received by our molecular laboratory of pathology from 2015 to 2017, ARMS-PCR method was used to detect the KRAS gene. The ratio of KRAS gene mutation in left and right hemi colon cancer was tested by χ² test, P<0.05 was considered statistically significant. Results There were 187(34.82%) patients with right hemi colon cancer; and there were 350 (65.18%)patients with left half hemi colon cancer. The KRAS positive patients were 240 cases, which were 44.69% in total. The positive patients with right hemi colon cancer were 114 cases which had a higher rate of 60.96%, the left hemi colon cancer patients were 126 cases with a lower rate of 36.00%. Conclusion The number of right hemi colon cancer was lower than the number of left hemi colon cancer. And the KRAS gene mutation in right hemi colon cancer had more positive than left hemi colon cancer. This study provides a number aid for treating right and left colon cancer in the subsequent molecular targeted drug therapy.

目的 了解南昌市某政府机关退休人员的健康状况,为制定有针对性的疾病防治措施提供依据。方法 根据南昌大学医院体检科常规体检项目,于2016—2018年对南昌市某政府机关退休职工进行健康体检,分析体检异常所占比例,采用χ²检验比较两样本率。结果 腹部彩超、甲状腺彩超、血脂、幽门螺杆菌（HP）、心电图、肝肾功能、宫颈刮片与白带（女）、血糖、肿瘤指标等为主要异常指标。2016—2018年的腹部彩超异常率分别高达82.98%、88.64%和82.95%,腹部彩超异常者中前列腺增生、脂肪肝和胆道系统异常所占比例较高。腹部彩超异常比例男性高于女性,甲状腺彩超和肿瘤指标异常比例女性高于男性（P<0.05）。结论 该政府机关退休职工健康体检指标异常所占比例较高,需要建立健康档案数据库进行健康管理,并对体检指标异常者安排定期复检,以实现对疾病的“早发现,早诊断,早治疗”。

Objective To understand the health status of retired people in a government agency in Nanchang city,and to provide evidence for the prevention and treatment of diseases. Methods According to the routine physical examination items of the department of physical examination of Nanchang university hospital,the health examination of retired staffs of a government agency in Nanchang city from 2016 to 2018 was carried out. The proportion of abnormal physical examination was analyzed,and the rate of two samples was compared by χ² test. Results Abdominal ultrasound,thyroid ultrasound,blood lipid,helicobacter pylori （HP）,electrocardiogram,liver and kidney function,cervical scraper and leucorrhea （female）,blood sugar,tumor index were the main abnormal indexes. The abnormal rate of color Doppler ultrasound was as high as 82.98% and 82.95%,respectively. The proportions of benign prostatic hyperplasia,fatty liver and abnormal biliary system were higher in the patients with abnormal abdominal color Doppler ultrasound. The abnormal rate of abdominal color Doppler ultrasound was higher in male than that in female,and the abnormal rate of thyroid ultrasound and tumor index were higher in female than that in male （P< 0.05）. Conclusion The proportions of abnormal health examination indexes of retired staffs in this government agency are relatively high. It is necessary to establish a health record database for health management,and arrange periodic reexamination for those who have abnormal physical examination indexes in order to realize importance of early detection and early diagnosis of diseases,and have early treatment.

目的 了解新生儿先天性心脏病的患病情况,为制定和采取干预措施提供依据。方法 对2015年10月—2016年9月分娩的5 769名新生儿进行心脏彩超检查,根据筛查结果进行统计分析。结果 共筛查出182例新生儿先天性心脏病,患病率3.15%,先天性心脏病新生儿中女婴比例较高,差异边缘显著,早产儿比例较高,差异有统计学意义,产母年龄和正常组分布相近。先天性心脏病类型中室间隔缺损和房间隔缺损的构成比分别排第一位(48.90%)和第二位(38.46%),严重先天性心脏病仅占5.43%。结论 新生儿先心病的发病率较高,采用心脏彩超筛查可尽早发现先心病患儿,同时需做好先心病患儿的随访工作,及时进行干预。

Objective To investigate the prevalence of neonatal congenital heart diseases (CHD) and providing basis for integrating efficient interventions. Methods The color Doppler echocardiography screening were applied to 5 769 newborns from Oct 2015 to Sep 2016, and the data was collected and analyzed. Results 182 cases of neonatal CHD were detected, and the prevalence rate of neonatal CHD was 3.15%. The proportion of girls and premature infants in the newborns with CHD was significantly higher than normal newborns, but the age distribution of their mothers was similar. In the 182 CHD cases, ventricular septal defect(48.90%) and atrial septal defect(38.46%) accounted for the most, while the constituent ratio of severe CHD was only 5.43%. Conclusion The prevalence of neonatal CHD was relatively high, and the color Doppler echocardiography screening could find out neonatal CHD earlier. The follow-up examinations and interventions should be conducted in time.