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ObjectiveTo evaluate the value of recombinant culture filter protein10early secretory antigenic target 6 （rCFP10ESAT6） protein from Mycobacterium tuberculosis (M. tuberculosis) on the serodiagnosis of tuberculosis (TB), and to develop more effective diagnostic reagents for tuberculosis. MethodsThe rCFP10ESAT6 protein was expressed and purified by metal chelation chromatography. Sera of 192 healthy persons and 210 TB patients were detected the antibodies against M. tuberculosis rCFP10ESAT6 antigens by ELISA. ResultsThe rCFP10ESAT6 protein existed in inclusion bodies of Escherichia coli, and amounted to 25% of total bacterial protein, its molecular weight was estimated about 28 kD. Of sera from 210 TB patients, the sensitivity of antibody detection using rCFP10ESAT6 protein was 30.10% (31/103) and 28.97％ (31/107) in 103 bacteriumpositive patients and 107 bacteriumnegative patients, overall sensitivity was 29.52% (62/210);of 192 healthy subjects, the sensitivity of antibody detection using rCFP10ESAT6 protein was 2.11% (2/95) in 95 PPDnegative persons and 6.19% (6/97) in 97 PPDpositive persons, respectively, overall specificity was 95.83% (184/192).ConclusionThe recombinant CFP10ESAT6 might be used as one of multiple antigens in the serodiagnosis of tuberculosis.

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ObjectiveTo study the latent tuberculosis infection (LTBI) in the new recruits with enzymelinked immunospot assay (ELISPOT), and evaluate the value of ELISPOT on the detection of LTBI .MethodsA total of 366 new recruits were intradermally injected with purified protein derivative (PPD) ,and detected with ELISPOT assay with recombinant CFP10/ESAT6 fusion protein (rCFP10/ESAT6) as a stimulus. New recruits who were ELISPOT and PPDnegative were vaccinated by intradermal injection with Bacillus CalmetteGuerin (BCG) vaccine, they were detected by PPD skin test and ELISPOT assay again 10 months later.ResultsAmong 366 new recruits , the positive rate of PPD skin test and ELISPOT assay was 44.81% and 31.69%, respectively. Of 202 PPDnegative and 164 PPDpositive new recruits, 53 (26.24%) and 63 (38.41%) were ELISPOT positive, respectively， overall consistency between two tests was 57.92% (212/366), the difference was statistically significant(χ2=14.34，P<0.001). Among new recruits with BCG vaccination , PPD and ELISPOTpositive rate was 58.53% (127/217) and 29.03% (63/217) respectively, spot forming cell (SFC) were 32.44±26.52; Among new recruits without BCG vaccination , PPD and ELISPOTpositive rate was 24.83% (37/149) and 35.57% (53/149) respectively, SFC were 41.81±30.48. 78.18% of 110 new recruits vaccinated by BCG vaccine 10 months later were PPDpositive, but all of they were ELISPOTnegative. ConclusionELISPOT technique has high specificity and sensitivity for screening TB infection.

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ObjectiveTo analyze the prevalence and risk factors of tuberculosis (TB) infection and TB disease among health care workers (HCWs), and to provide evidence for intensifying control of TB.MethodsA systematic review was applied to analyze the literatures about TB infection control status in healthcare facilities from 1995 to 2010．ResultsThe prevalence of TB infection among Chinese HCWs was 60.4%-62.8%, which was much higher than that of general population;the prevalence of TB disease was also higher than that of general population, the highest prevalence was 6.7/1 000 population/year. A higher risk of acquiring TB disease was associated with many factors, including certain work locations, healthcare facility design, working environment, and personal protective measures.ConclusionTB is a significant occupational problem among HCWs,available evidence reinforces the need to design and implement effective and affordable TB infection control programs in healthcare facilities in China.

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ObjectiveTo evaluate the significance of change in T help cell 17(Th17) and regulatory T cell （Treg） in HIVinfected patients. Methods106 HIVinfected patients and 30 healthy volunteers were selected. Flow cytometry was used to detect the CD4+ T ,Th17 and Treg cells in peripheral blood. HIV RNA levels in serum were tested by RTPCR.ResultsCD4+ T cells were 13-702/uL, 19 patients were ≤200/uL (group A), 32 were 201-350/uL（ group B）, 26 were 351-500/uL（group C）, 29 were >500/uL（group D）; All were significantly lower than （798-1 130/uL） in healthy control group（P<0.05）. The percentage of Th17 cells in CD4+ T cells were (0.73±0.21)%,(1.52±0.33)%, (2.92±0.46)% , and (3.74±0.58）% in group A, B ,C and D, respectively, which were all lower than (4.90±1.43)％ of control group（P<0.05）; The percentage of Treg cells in CD4+ T cells were (9.78±2.15)%, (7.23±1.72)%, (5.69±1.67)% , and (4.62±0.97)% in group A, B,C and D,respectively, group A, B and C were higher than (4.43±0.97)％ of control group（P<0.05）, but group D had no significant difference compared with control group（P>0.05）. HIV RNA levels were (0-5.36)×107copies/mL in HIVinfected patients, the average levels of HIV RNA were (5.36±1.21)×106copies/mL ; HIV RNA levels in group A,B,C and D were（6.24±1.36）×107copies/mL，（4.36±1.02) ×106 copies/mL，（5.78±1.67）×104copies/mL，and （3.54±1.25) ×103copies/mL ,respectively，there was significant difference between each group(P<0.05), HIV RNA levels were negatively correlated with CD4 +T cells count. ConclusionHIV infection can result in the decrease of Th17 and CD4+T cells， imbalance of Th17/Treg cells， and negative correlation with HIV RNA levels.

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ObjectiveTo study the express and clinical significance of serum interleukin18 （IL18）, vascular endothelial growth factor （VEGF） and transforming growth factor β1 (TGFβ1) in HBV/HCV/HIV coinfection patients .MethodsSerum IL18, VEGF and TGFβ1 levels in patients with HBV/HCV/HIV coinfection or simple HBV or HCV infection were detected with ELISA method，and liver function biochemical indicators of alanine transaminase(ALT), aspartate aminotransferase(AST),gamma glutamyl transferase（GGT） levels were simultaneously detected , correlation between these indicators and IL18,VEGF, TGFβ1 was analyzed ; 30 healthy people were randomly selected as control group ,statistical analysis was made.ResultsSerum IL18, VEGF, and TGFβ1 values in patients with HBV/HCV/HIV coinfection were not associated with gender (P>0.05), which were significantly higher than that of simple HBV or HCV infection and normal control group (P<0.01)，and was the highest in patients with HBV+HCV+HIV coinfection (IL18,VEGF,TGFβ1 levels were ［312.44±45.24］pg/L，［326.43±51.24］pg/mL and ［283.51±49.27］μg/L， respectively) ，followed by HCV+ HIV coinfection，which were （［224.32±34.37］pg/L，［257.72±47.72］pg/mL and ［204.11±43.28］μg/L， respectively), HBV+ HIV coinfection were （［129.44±27.62］pg/L，［147.67±41.22］pg/mL and ［120.47±30.23］μg/L respectively). In patients with HBV/HCV/HIV coinfection ,serum IL18,VEGF, and TGFβ1 levels were positively correlated with ALT,AST, and GGT (r value was 0.667, 0.652, 0.672； 0.643, 0.618. 0.623; 0.712, 0.673 and 0.705， respectively).ConclusionDetection of serum IL18,VEGF,and TGFβ1 levels are important to evaluate the status of patients with HBV/HCV/HIV coinfection .

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ObjectiveTo study the relationship between hepatitis B virus (HBV) mutation at nucleotides 1653T and liver cancer. MethodsOne hundred and nineteen serum samples of HBVinfected patients were collected (All were positive HBV DNA) , 24 ,35, 29, and 31samples were from asymptomatic carriers（ASC）, patients with chronic hepatitis B (CHB), liver cirrhosis (LC) ,and hepatocellular carcinoma (HCC),respectively. Partial fragments of HBV pre C and C gene were amplified by seminested polymerase chain reaction . The PCR products were subjected to direct sequencing and the mutation at 1653T was determined by sequence analysis. HBV genotypes were detected by restriction fragment length polymorphism based on S gene PCR products. ResultsAll samples from 24 ASC were not found mutation at nucleotides 1653T ; 1(2.86%) sample from 35 CHB and 5(17.24%) from 29 LC were found mutation at 1653T; The detection rate of 1653T mutation was not significantly different between CHB and LC（χ2=2.36, P＞0.05）；14(45.16%) samples were found mutation at 1653T in HCC，the mutation at 1653T in HCC was significantly higher than that of LC(χ2=5.40,P<0.05). Of 119 serum samples of HBV, 2 of 51 genotype B and 18 of 58 genotype C were detected mutation at nucleotides 1653T , the other 10 samples couldn’t be determined genotype .The difference in mutation at 1653T between genotype C and B was significant (χ2=11.57, P<0.01).ConclusionHBV 1653T mutation is correlated with HCC, and is more prone to occur in genotype C infection; 1653T mutation can be as predictive risk factors for hepatocarcinogenesis.

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ObjectiveTo investigate clinical efficacy and safety of entecavir for chronic hepatitis B (CHB) patients. MethodsSixtytwo CHB patients were randomly divided into treatment group and control group, treatment group (30 cases) were given entecavir 0.5mg/d, control group (32 cases) were given lamivudine 100mg / d, serum alanine transaminase (ALT) normalization rate, rates of HBV DNA value below the detection limit ,HBeAg seroconversion rate, and adverse effect rate were observed at week 4,12,24 and 48 of treatment.ResultsAt week 4,12,24 and 48 of treatment, rate of serum HBV DNA value below the detection limit was 63.33%, 76.67%, 86.67%, and 93.33% in treatment group and 37.50%, 50.00%, 56.25% , and 65.63% in control group, respectively, the difference was statistically significant (P<0.05 or P<0.01); there was no statistical difference in ALT normalization rate, HBeAg negative seroconversion rate, and the adverse effect rate between two groups (both P>0.05).ConclusionEntecavir can rapidly reduce the serum HBV DNA value of patients with CHB, effectively inhibit hepatitis B virus replication, and with good safety.

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ObjectiveTo explore the treatment strategy for entecavirrefractory chronic hepatitis B (CHB) patients.MethodsOne entecavirrefractory CHB patient was switched to combination treatment of lamivudine with adefovir dipivoxil, and levels of HBV DNA and serum alanine transaminase (ALT) were followed up.ResultsAfter one year combined treatment , patient’s serum HBV DNA level dropped to 1.19×103IU/mL from the initial top of 2.02×108IU/mL and ALT level was recovered to normal range (≤40 U/L). ConclusionThe combination use of lamivudine with adefovir dipivoxil is effective for this entecavirrefractory CHB patient , but whether the treatment can be popularized needs to be further investigated.

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ObjectiveTo investigate drug resistance and antimicrobial combination against 38 strains of methicillinresistant Staphylococcu aureus (MRSA) isolated from intensive care unit (ICU) patients, so as to select rational antimicrobial agents to treat MRSA infection.MethodsThe isolates were identified by VITEK2 automatic bacterial identification system and Staphylococcus aureus latex coagulation method, MRSA were detected with Staphylococcus aureus latex coagulation method. Drug susceptibility tests were performed with microbroth dilution method based on Clinical and Laboratory Standards Institute (CLSI) Standard .ResultsThirtyeight MRSA stains were sensitive to linezolid (LZD), vancomycin (VAN), and teicoplanin (TEC)； the resistant rate to levofloxacin (LVX) and rifampicin (RIF) was 100.00% and 78.95% respectively. The fractional inhibitional concentration (FIC)<1 of RIF combining with LZD,VAN and TEC was 13.16%-31.58%; The FIC<1 of LVX combining with LZD,VAN and TEC was 2.63%-36.84%， the difference between antimicrobial combination had statistical significance （P<0.01）. ConclusionRational choice of antimicrobial agents to treat MRSA infection in ICU patients should be according to antimicrobial agents and patients’ state.

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ObjectiveTo realize the real status of medical waste management in some regions of China , so as to provide reference for rational management. MethodsSixtyfour hospitals in 8 cities were as study subjects , questionnaire, indepth interview and field visit were adopted.ResultsNo hospital had the independent department in charging of medical waste, 47 hospitals (73.44%) were charged by a certain department and 17 (26.56%) by multisectors. The most complete system was the transfer registration system (97.92%, 47/48) and the least complete systems were training (20.83%,10/48) and inspection system (18.75%,9/48). 45 hospitals (70.31%) had complete training content, and general hospitals were more complete than specialized hospitals; 29 hospitals (45.31%) had full protective equipments；64 hospitals (100.00%) collected medical waste with yellow bags; 49 hospitals (76.56%) provided all necessary transferring equipment and facilities ; 60 hospitals (93.75%) had temporary stations; 51 hospitals (79.69%) use the centralized disposal method.ConclusionHospitals need to set up a special department for medical waste management, internal system and external supervision should be unified, training and occupational protection should be improved, and the process of medical waste management should be standardized .

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ObjectiveTo find the epidemiological characteristics of measles in Taizhou City from 2004-2008, so as to provide basis for scientific prevention and control measures. MethodsDescriptive epidemiological method was adopted to describe measles prevalence.ResultsFrom 2004 to 2008, the incidence of measles were 426, 1 734, 189, 667, 2 121 cases, respectively, annual reported incidence was 8.27/100,000, 33.65/100,000, 3.67/100,000, 13.14/100,000 and 41.16/100,000, respectively, there was no death case reported ; The number of measles in floating population were 208, 484, 75, 278 and 607 cases, respectively. In 2005, “special strengthening immunity activity to eliminate measles” was carried out, measles incidence in 2006 was the lowest (3.67/100,000). Incidence peaks were between March and May each year. In 2008, the cases concentrated on population below the age of 2 years old and 10-40 years old; 84.82% (1 799/2 121) of population were without history of measles vaccination or with unknown immunization history.ConclusionThe carrying out of strengthened immunity activity can control the incidence of measles obviously; routine immunization in population under the age of 2 and 10-40 years old should continue to strengthen.

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ObjectiveTo investigate the violation and bacterial carriage state of cockroaches in wards of a hospital (1-11 storey),and provide scientific basis for carring out comprehensive measures to eliminate the pollution of cockroaches to medical environment.MethodsThe visual and paper sticky capture method were applied to investigate the harmful invasion of cockroaches . Cockroaches were stickily captured from each floor, and were randomly divided into 11 groups, each had 5, they were sent to the laboratory for bacterial isolation and culture, serological and biochemical testing with routine methods. Results228 houses in wards of a hospital building were investigated, the traces of cockroaches by visual method in 171 houses were found, the positive rate was 75.00%. There were 191 pieces of sticky cloth for sticking cockroaches, and the positive papers were 80 pieces, 243 cockroaches were captured, violation rate of cockroaches was 41.88%, density of cockroaches were 1.27 per paper. Opportunistic pathogens were detected on the surface and the bodies of 11 groups of cockroaches,among which the main pathogens were Proteus spp.(14 strains), Klebsiella pneumoniae(11), Escherichia coli(7), Enterobacter agglomerates(8), Pseudomonas aeruginosa(5), Acinetobacter baumannii(3).ConclusionCockroach is one of the factors contributing to hospital environmental surface pollution; regular killing of cockroaches and timely monitoring the environmental hygiene are important measures to prevent nosocomial infection.

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ObjectiveTo survey bacterial antimicrobial resistance status and evaluate the general indexes which can  evaluate the level, trend, degree and rate of antimicrobial resistance. MethodsAntimicrobial sensitivity test results  of 1 523 strains of pathogens isolated from 2 884 patients with nosocomial infection  in a hospital from 2002 through 2009 were analyzed, and change in common bacterial resistance  to antimicrobial agents was described with  antimicrobial resistant rate of stages, rate difference, ratio and sum of the rate difference . ResultsThe increase of antimicrobial resistant rate was the fastest in  Escherichia coli to piperacillin/tazobactam , Pseudomonas aeruginosa to ceftazidime and piperacillin, Klebsiella pneumoniae to amoxicillin/clavulanic acid, and Enterobacter cloacae to ciprofloxacin, the difference  value was 8.43,6.87,  6.80 ,31.36 and 5.65,  respectively; increase of total antimicrobial resistant rate of  Klebsiella pneumoniae exceeded Escherichia coli, sum of the rate difference was 136.53 and 115.65 respectively; and decrease of  total antimicrobial resistant rate of Enterobacter cloacae exceeded Pseudomonas aeruginosa,  sum of the rate difference was -125.16 and -6.15 respectively; total antimicrobial resistant rate of Staphylococcus aureus showed  a trend of  increase, and Staphylococcus epidermidis showed  a trend of decrease, sum of the rate difference was 50.30 and -157.01, respectively.ConclusionFour indexes including antimicrobial resistant rate of stages, rate difference, ratio and sum of the rate difference can evaluate the antimicrobial resistance from many aspects , which  has important guidance for the  study of antimicrobial resistance and antimicrobial application in clinic.

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ObjectiveTo evaluate the point prevalence rate and trends of nosocomial infection (NI) in a hospital , so as to provide the basis for targeted prevention of NI.MethodsAccording to the criteria set up by the Ministry of Health, point prevalence rates of NI in patients who were hospitalized on the appointed day were investigated by the combination of bedside examination and medical records checking.Results942 and 929 patients were surveyed on June 18 ,2009 and June 30,2010 respectively, the actual investigated rate was 100.00%; The point prevalence rate of NI was 4.14% (39 cases) and 4.52%（42 cases）respectively, and the point prevalence rate of casetimes was 5.10%（48 cases） and 5.17%（48 cases）respectively；  The high infected sites were lower respiratory tract （56.25% vs 58.34%） and urinary tract（16.66% vs 20.83%）; The main risk factors of NI were male patients, patients aged ＜2  or ＞ 60 years of age , urinary catheter , blood vessel catheter, use of ventilator; The usage rate of antimicrobial agents was  54.67% and 52.31% respectively, sample detection rate was 42.30% and 43.30% respectively.ConclusionTargeted surveillance and management of key departments and key sites should be strengthened; the monitoring and management of antimicrobial agents should be stressed,  antimicrobial usage rates should be reduced,  detection rate of samples should be improved, and antimicrobial agents should be used correctly and  rationally.

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ObjectiveTo realize the isolation status of fastidious bacteria causing respiratory tract infection and antimicrobial susceptibility of fastidious bacteria to cefditoren pivoxil as well as the other 9 antimicrobial agents, so as to provide reference for clinical treatment.Methods Fastidious bacteria isolated from sputum of patients with respiratory tract infection during the year of 2005, 2007, 2008, and JanuaryJune in 2010 were collected. Antimicrobial susceptibility of fastidious bacteria were tested with KirbyBauer method recommended by Clinical and Laboratory Standards Institute (CLSI). ResultsA total of 462 isolates were isolated from 438 patients, βlactamaseproducing rate was as follows: Haemophilus influenzae (HI) 23.62% (30/127), Haemophilus parainfluenzae (HP) 2.51%(5/199), Moraxella catarrhalis (MC) 41.58% (42/101), penicillinresistant Streptococcus pneumoniae (SP) isolates was not found. The susceptibility rate (SR) of HI, HP, MC, and SP to cefditoren pivoxil was 96.30%, 94.36%, 100.00%, and 100.00%, respectively;The SR of HI and HP to cefotaxime, cefuroxime, cefaclor and cefazolin was 83.59%-93.33%, SR to amoxicillin/clavulanic acid was 91.67% and 88.21% respectively; SR of MC and SP to amoxicillin / clavulanic acid was 100.00%; SR of HI to clarithromycin was 87.96%,SR of HP, SP and MC to clarithromycin was 34.29%-59.00%; SR of 4 kinds of fastidious bacteria to tetracycline was 22.86%-63.00%; The resistant rate of HI,HP and MC to trimethoprim/sulfamethoxazole was 54.63%-3.33%.ConclusionCefditoren pivoxil has strong activity against fastidious bacteria causing respiratory tract infection; in order to reduce the emergence of drugresistant strain, clinicians should choose antimicrobial agents according to antimicrobial susceptibility test results.

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目的探讨重症监护室耐甲氧西林金黄色葡萄球菌(MRSA)感染高危人群、高危因素的预防与控制措施,降低MRSA感染率。方法早期筛查MRSA携带者、感染者并早期干预。结果及时发现了MRSA感染者和携带者，经不断改进干预措施，未发生因MRSA感染而导致的医院感染流行或暴发事件。结论加强MRSA早期筛查及干预，能做到早发现、早诊断、早隔离、早治疗，有效防止或终止MRSA导致的医院感染暴发流行。

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目的了解某综合医院住院患者医院感染及社区感染现患率。方法由医院感染管理专职人员与临床监控医生组成调查组，对2010年6月8日0∶00—24∶00该院所有住院患者进行医院感染和社区感染现患率调查。结果应调查住院患者678例，实际调查676例，实查率99.71%。发现医院感染19例，23例次，医院感染现患率为2.81%，例次现患率为3.40%；社区感染180例，感染率为26.63%。医院感染率最高的科室为重症监护室（22.22%）；感染部位以下呼吸道居首位，占39.13%；病原体以大肠埃希菌居首位，占24.00%。社区感染率最高的科室为儿科（90.91%）；感染部位以下呼吸道居首位，占55.49%；病原体以铜绿假单胞菌居首位，占21.43%。抗菌药物使用率为39.20%，使用率最高的科室为重症监护室；治疗性使用抗菌药物前病原学送检率为82.45%。结论现患率调查结果提示应加强重点科室医院感染的预防，尤其是下呼吸道感染；提高病原学送检率，进一步规范抗菌药物的使用。

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目的了解某三级甲等医院口腔外科患者围手术期抗菌药物使用情况，评价其用药合理性。方法在排除医院和社区感染病例的基础上，采用单纯随机抽样方法抽取该院2009年4月—2010年4月口腔外科手术患者478例，调查其以预防为目的的抗菌药物使用情况。结果所调查的478例口腔外科患者围手术期抗菌药物预防性应用率高达100.00%（478/478），其中用药时机不符合要求者占1.88%(9/478)，用药时间≥3 d者占88.70%（424/478），抗菌药物选用级别高者占83.26%（398/478），抗菌药物选用种类不恰当者占26.78%（128/478）。结论除用药时机选择较合理外，该院口腔外科围手术期抗菌药物应用存在用药时间长、用药级别高等诸多不规范，需加强管理，以确保合理用药。

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目的了解新上岗医务人员对医院感染知识的需求情况。方法采用自行设计的问卷调查表对47名新上岗医务人员进行调查。结果新上岗医务人员希望获取的医院感染知识内容依次为：职业防护知识(95.74%)、医院感染诊断（89.36%）、隔离预防技术（74.47%）、消毒灭菌知识（70.21%）、重点部位感染预防控制（63.83%）、医院感染流行病学知识（53.19%）、合理使用抗菌药物（51.06%）、手卫生知识（36.17%）、医疗废物管理（36.17%）、医院感染相关法律法规（34.04%）。最希望采取的教育方式是医院的多方式方法培训教育，需求率87.23%。结论新上岗医务人员对医院感染知识普遍渴求，并希望接受多种形式的培训。

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目的了解某医院护士职业防护情况，探讨其职业暴露的危险因素，为临床相关知识培训提供依据。方法自行设计调查表，对在临床工作5年内的104名护士进行调查，内容包括护士职业防护行为依从性和对职业防护知识的认知情况。采用等级评分（1分表示完全做不到，2分表示偶尔做得到，3分表示一半时间做得到，4分表示大部分时间做得到，5分表示完全做得到）的方式对护士职业防护行为的依从性进行评定。结果护士职业防护行为依从性得分：规范的操作行为（3.48±0.81）分，处理锐器（2.11±0.92）分，医疗废弃物处理（3.02±0.78）分，而防护用品的使用及手卫生均＜2分；护士对职业防护知识的认知情况：对标准预防的概念及措施、锐器处理知识、洗手及消毒的指征与方法、不良操作行为、医疗废弃物的处理、职业暴露后的紧急处理及报告 6个条目的认知率仅为12.50%～40.38%。结论该院护士对职业防护知识认知不足，自我防护意识较弱，职业防护行为依从性不高，应加强对其职业防护知识教育培训，以保障职业安全。

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目的分析血站采血护士职业暴露的危险因素，并探讨有效的防护措施。方法对血站采血护士职业暴露的原因、方式、危险程度及防护方法进行分析。结果采血时环境拥挤，互相碰撞；长时间工作或一人同时为2名献血者采血；操作中双手回套针头，护针帽脱落，传递过程中被带血针头刺伤及采集小样针头放置不当，易导致采血护士针刺伤。2006年未设置防刺破试管座前，采血护士针刺伤发生率为80%；采用不锈钢试管座后未再发生针刺伤。结论采血护士易受职业暴露危险因素的影响，针刺伤是其职业暴露的主要方式。应加强采血护士的职业防护。

Abstract:

目的了解某基层医院医疗废物管理现状，促进《医疗废物管理条例》在基层医院的贯彻落实。方法调查该院2003—2009年医疗废物管理进展情况。结果该院医疗废物处置经历了从不规范到过渡性处置，到逐渐规范化处置的一系列过程。从混入生活垃圾填埋到自制焚烧炉焚烧，直至达到标准的规范化处置，处置医疗废物的能力逐年加大。结论加强医疗废物规范化处置是贯彻落实《医疗废物管理条例》的必然要求，是预防和控制医院感染、减少职业伤害、保护环境、保障医疗质量和医疗安全的重要措施，是一项需多部门共同参与、共同监管的系统工程。

Abstract:

目的了解基层医疗机构“84”消毒液使用中存在的问题并提出相应对策。方法对8所乡镇卫生院和10所村卫生室的“84”消毒液使用情况进行实地督查，查阅相关原始记录。结果18所基层医疗机构中，5所（27.78%）使用中的“84”消毒液过期；12所（66.67%）未进行有效浓度监测；7所（38.89%）配制浓度不准确；6所（33.33%）卫生院索证不全，10所（55.56%）卫生室无任何证件；“84”消毒液种类繁多，卫生室采购渠道和使用方法不规范。结论集团式一体化监管体系、完善的管理组织、规范的采购渠道、正确的使用方法，是保证基层医疗机构“84”消毒液规范使用的关键。

Abstract:

马尔尼菲青霉菌病是由马尔尼菲青霉菌引起的一种系统性真菌病。过去认为该病少见，但随着艾滋病（获得性免疫缺陷综合征，AIDS）患者人数的增加，其已经成为AIDS流行区患者的常见机会性真菌感染性疾病之一。即使有效的抗真菌治疗，AIDS合并马尔尼菲青霉菌病的病死率仍高达20%［1］。因此，在临床上应该引起足够的重视，尽早发现并及时进行有效的抗真菌治疗，这是降低该病病死率的主要方法。

Abstract:

全球1/3的人口感染结核分枝杆菌(Mycobacterium tuberculosis,MTB)，其中大部分为潜伏感染［1］。研究人员对MTB潜伏感染的关注度日益增高。笔者针对当前研究MTB潜伏感染所使用的各种动物模型进行综述，分析包括小鼠、豚鼠、兔以及非人灵长类的动物模型优势和局限性，以期为研究人员正确选择合适的MTB潜伏感染动物模型以及深入开展潜伏感染的研究提供帮助。