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ObjectiveTo evaluate the current situation of human resource allocation in district and county centers for disease control and prevention （CDCs） in Kashgar ， identify existing problems and influencing factors， and to provide scientific evidence for optimizing the human resource allocation. MethodsA survey was conducted among all CDCs in Kashgar in February 2022. The questionnaire included the institutional and individual questions. ResultsThe overall staff size approved for the CDCs in Kashgar was 604， with a staffing rate of 76.17%， among which the staffing rates in 5 county CDCs were less than 60%. Currently， there were a total of 524 approved staff members in all CDCs， resulting in a vacancy rate of 13.25%. In the district CDC， 85 staff members were on duty， while the median of staff on duty was 34 in each county CDC. The staff in the district CDC was ageing， of which those aged over 45 accounted for 67.06%. The staff in the county CDCs was generally young， of which those aged less than 35 accounted for 54.22%. Moreover， the proportion of staff with bachelor’s degree or above in the district and county CDCs was 31.76% and 24.95%， respectively. The proportion of staff without professional title was 32.94% and 48.03%， respectively. In contrast， the proportion of those with middle and senior professional title was 57.89% and 22.02%， respectively. In addition， in recent 3 years， 24 staff members resigned in the CDCs， all of whom had professional titles. ConclusionHuman resources are insufficient in CDCs in Kashgar. Furthermore， staff structure is unreasonable， with a serious loss of human resources. In particular， the district CDC needs to optimize the allocation of human resources.
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Objective:To explore the application effect of medical waste management system based on B/S architecture in medical waste disposal.Methods:Select a third-class hospital in Yantai for continuous quality improvement of medical waste disposal, and verify the feasibility of the medical waste management system through key indicators such as medical waste related theoretical knowledge, medical waste disposal efficiency, and medical waste disposal management process standardization rate. Through monitoring indicators and result feedback evaluation, it is judged whether the medical waste management system has positive significance for the improvement of medical waste disposal.Results:Taking the adoption of medical waste management system as the node, a five-month comparison before and after was conducted to monitor key indicators such as medical waste disposal efficiency and standardized rate of medical waste disposal management processes. The daily error rate of medical waste classification was reduced from 6.00% to 1.33%, the daily confusion rate of working procedures was reduced from 6.67% to 0.67%, the time delay rate of medical waste disposal was reduced from 7.33% to 2.00%, and the standardized rate of medical waste disposal management processes was increased from 93.33% to 100%. All the data were statistically significant ( P<0.05). Conclusions:Since the operation of the medical waste management system, through the top-down management and control of the administrator and with its unique time retrieval function, the time delay problem of the previous manual management has been greatly improved. The classification management function of medical waste solves the criticism of unclear and chaotic classification of medical waste. The department retrospective function enables the division of responsibilities for medical waste work to be clear, and improves the work efficiency. The construction of medical waste management system based on B/S architecture provided a new information approach for the scientific management of medical waste and a reference for the scientific and effective management of clinical medical waste.
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ObjectiveTo determine the epidemiological characteristics of infectious disease related public health bud-events in Shanghai and assess the effects of bud-event surveillance， so as to provide scientific evidence for improving the surveillance system. MethodsSurveillance data of infectious disease related public health bud-events were collected from 16 districts of Shanghai from 2017 through 2020. Then the data were analyzed and compared with infectious disease related public health emergencies during the same period. ResultsA total of 6 376 infectious disease related public health bud-events were documented in Shanghai in 2017‒2020， which involved 29 792 cases. There were two seasonal peaks， April through June and November through December. Clustered events accounted for 38.85%， mainly caused by chickenpox （14.10%）， hand，foot and mouth disease （11.17%） and norovirus-associated infectious diarrhea （6.54%）. The 36.73% of the bud-events occurred in school settings， which involved 24 718 cases （accounting for 83.00% of all cases）. Median time duration between onset date of the first cases and report date of the events was 4 days， and median duration of the events was 14 days， demonstrating positive correlation. In addition， all the infectious disease related public health emergencies（n=77） from 2017 through 2020 were classified as common events or unclassified. The proportion of infectious disease related public health emergencies in the bud-events during the same period was 1.21%， and that of infectious disease related public health emergencies in the bud-events in school settings was 2.48%. ConclusionTwo peaks of infectious disease related public health bud-events are observed in spring as well as autumn and winter in Shanghai from 2017 through 2020. Schools should be prioritized for control and prevention of infectious diseases. Bud-event surveillance system has been contributable to the prevention and control of public health emergencies， especially in the early detection， reporting and control of clustered events in schools. Bud-event surveillance system should be further improved and assessed comprehensively.
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Objective:To observe the natural course of patients with simple traumatic intraparenchymal contusions and hematomas (TIPHs), and analyze the risk factors for TIPHs progression.Methods:Using a prospective observational study, 69 patients with TIPHs in Affiliated Xiaolan Hospital, Southern Medical University from July 2018 to January 2020 were selected. The gender, age, cause of injury, compound injury status, combined injury and Glasgow coma score (GCS) were recorded. The plasma levels of prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fbg), international normalized ratio (INR), D-dimer, platelet, hemoglobin at admission were detected. The occurrence of hypoxemia and high intracranial pressure were observed. The time of the first CT examination, volume of the first CT hematoma, time of the control CT examination, volume of the control CT hematoma, and lesion morphology, multifocality, subarachnoid hemorrhage (SAH), edema zone and cortical distance showed in the first CT examination were recorded. The risk factors of progression in patients with TIPHs were analyzed.Results:Among 69 patients with TIPHs, TIPHs progression was in 28 cases (progression group), and the progression rate was 40.58%; TIPHs progression was not in 41 cases (non-progression group). There were no statistical differences in gender composition, age, PT, APTT, INR, hemoglobin, cause of injury, compound injury, incidence of hypoxemia, incidence of high intracranial pressure, incidence of SAH, incidence of edema zone, incidence of irregular lesions, time of the first CT examination, time of the control CT examination and volume of the first CT hematoma between 2 groups ( P>0.05). The GCS, cortical distance and Fbg in progression group were significantly lower than those in non-progression group, the TT, platelet, multifocality rate and volume of the control CT hematoma were significantly higher than those in non-progression group, and there were statistical differences ( P<0.01 or <0.05). Multivariate Logistic regression analysis result showed that cortical distance <1 cm, Fbg<2 g/L and multifocality were independent risk factors affecting the progression in patients with TIPHs ( OR = 6.723, 5.515 and 4.827; P<0.05). The model had a sensitivity of 71.43% (20/28), a specificity of 92.68% (38/41), and an accuracy of 84.06% (58/69) in judging the progression of TIPHs. Conclusions:Based on the risk factors for the progression of TIPHs, predicting these patients in advance can provide necessary intervention measures for high-risk patients, which will help to reduce the rate of progression and improve the prognosis of patients.
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<p><b>OBJECTIVE</b>To establish an emergency response capability assessment indexes for disease control and prevention institutions.</p><p><b>METHODS</b>Health emergency response capability assessment indexes of Shanghai Centers for Disease Control and Prevention(CDCs) was drafted based upon documentary analysis, expert consultation and focus group discussion according to duties and features of emergency work of CDCs. The assessment indexes were determined by applying Delphi method (18 experts), and the weights of indexes were determined using analytic hierarchy process and proportional distribution method. And then the established index system was used to assess the emergency response capability of CDCs in Shanghai.</p><p><b>RESULTS</b>Two rounds of expert consultations were conducted. Kendall's coefficient of concordance was 0.420 and 0.495 at the first and second round of expert consultations respectively. After two rounds of consultations, the expert authority score was above 0.7. There were 7 primary indexes, 24 secondary indexes and 84 third-level indexes. The seven primary indexes included emergency management system, emergency response team, surveillance and early-warning ability, emergency response capacity, emergent supply capability, communication and cooperation, scientific research and exchange, with systematic weights of 0.2123, 0.1754, 0.1334, 0.1916, 0.1281, 0.0962 and 0.0630,respectively. According to the investigation, Shanghai Municipal Center for Disease Control and Prevention ranked first in the total score of emergency response capability evaluation.</p><p><b>CONCLUSIONS</b>The indexes identified in this study have good reliability and feasibility, and can be used in assessment of emergency response capability in disease prevention and control institutions.</p>
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China , Delphi Technique , Emergency Medical Services , Primary Prevention , Reproducibility of ResultsABSTRACT
Hepatitis B virus infection is the major cause of chronic hepatitis B(CHB),liver cirrhosis(LC),and hepatocellular carcinoma(HCC).Over 47 000 people die of LC and HCC caused by HBV infection in the world each year.This article introduces the related variations of hepatitis B virus and the correlation with clinical treatment and prognosis.