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ObjectiveTo investigate the inhibitory effect and mechanism of soybeanderived BowmanBirk inhibitor (BBI) on LPSinduced expression of inflammatory cytokines in intestinal epithelial cells.MethodsCytotoxicity effect of LPS and BBI on intestinal epithelial cells was analyzed by MTT assay. Intestinal epithelial cells were pretreated with BBI, followed by LPS stimulation, expression of inflammatory cytokines（TNFα, IL1β, IL8, and MCP1） was detected by quantitative realtime polymerase chain reaction; the activation of NFκB was measured by pNFκBluc system and Western Blot.ResultsThe maximum concentration of LPS（10 000 ng/mL） and  BBI（1 000 μg/mL）had no cytotoxicity effect on intestinal epithelial cells. LPS could potently upregulate the expression of inflammatory cytokines（TNFα, IL1β, IL8, and MCP1）, the upregulation was positively correlated to the concentration of LPS; LPSinduced expression of inflammatory cytokines in intestinal epithelial cells could achieve the highest level, then decreased over time. The upregulation of LPS on inflammatory cytokines in intestinal epithelial cells had dosetime effect; when intestinal epithelial cells were pretreated by BBI for 6 hours, the inhibitory effect of BBI on LPSinduced expression of inflammatory cytokines in intestinal epithelial cells was most obvious, and had dosetime effect.ConclusionBBI can potently inhibit LPSinduced expression of  inflammatory cytokines through inhibiting NFκB in intestinal epithelial cells.

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ObjectiveTo investigate the distribution and antimicrobial resistance of pathogens causing bacterial peritonitis, provide laboratorial guidance for rational use of antimicrobial agents. Methods Pathogenic strains isolated from peritoneal fluid specimen of patients with peritonitis in the Affiliated Hospital of Xuzhou Medical University in 2011-2015 were collected, performed bacterial identification and antimicrobial susceptibility testing, distribution of pathogens and antimicrobial resistance were analyzed. ResultsA total of 491 strains were collected, including 291（59.26%）strains of gramnegative bacilli, 196（39.92%）of grampositive cocci, and 4 (0.82%) of fungi. The top 5 pathogens were Escherichia coli(30.14%), coagulase negative staphylococcus(12.22%), Staphylococcus aureus (10.39%), Klebsiella pneumoniae (8.55%) , and Enterococcus  faecium(6.52%). Antimicrobial resistance rates of Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa to imipenem were 4.90%, 31.04%, 77.28% and 26.27% respectively. Methicillinresistant Staphylococcus aureus(MRSA) and methicillinresistant coagulase negative staphylococcus(MRNCS) accounted for 56.02% and 70.02% respectively. ConclusionThe main pathogens causing bacterial peritonitis are gramnegative bacilli, Escherichia coli ranks first; resistance of pathogens is serious, standard use of antimicrobial agents should be strengthened to reduce the emergence of drugresistant strains.

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ObjectiveTo evaluate clinical significance of direct antiglobulin testing(DAT) in anemia in patients with severe chronic hepatitis B(CHB).MethodsRed blood cell(RBC)related parameters detection and DAT were performed among 30 healthy persons, 30 CHB patients, and 50 severe CHB patients, clinical factors related to positive DAT were analyzed.ResultsRBC count, hemoglobin (Hb) concentration, and hematocrit（HCT）level in severe CHB patients were all lower than CHB patients and healthy group（P＜0.05）， RBC distribution width(RDW) in severe CHB patients were all higher than CHB patients and healthy group（P＜0.05）；the positive rate of DAT in patients with severe CHB, CHB, and healthy group were 62.82%, 13.33% and 0 respectively. RBC count, Hb concentration, and HCT level in severe CHB patients with positive DAT were all lower than severe CHB patients with negative DAT （all P＜0.05）, while RDW was higher than the latter (P=0.001); after RBC was separated through capillary, positive intensity of DAT of aged RBCs was higher than young RBCs in severe CHB patients （P<0.001）；among severe CHB patients, DATpositive and negative patients differed in gender, age, alanine aminotransferase, total bilirubin， complement C3,Creactive protein， and complication of diabetes(all P≤0.05).ConclusionAnemia in severe CHB patients may be related to immune hemolysis of aged RBCs induced by antibody adsorption.

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ObjectiveTo systematically evaluate the efficacy and safety of nucleo(s)tide analogues (NAs) sequential/NAs sequential combined with pegylated interferon (PegIFN) for the treatment of HBeAgpositive chronic hepatitis B（CHB）. MethodsPubMed, Cochrane Library, Embase, and Chinese Medical databases (CNKI, Wanfang and VIP) from database establishment to March 25, 2017 were retrieved, randomized controlled trials of NAs sequential/sequential combined with PegIFN for the treatment of CHB after application of NAs to achieve virologic response were included in study, Meta analysis was performed by RevMan 5.3 software, HBeAg seroconversion rate and HBsAg negative conversion rate at the end of treatment were compared. ResultsNine studies were eventually included, 4 were about NAs sequential PegIFN,5 about NAs sequential combined with PegIFN. At the end of treatment, compared with using NAs monotherapy for antiviral treatment, NAs sequential/sequential combined with PegIFN therapy can improve HBeAg seroconversion rate(31.2％ vs 11.7％；OR, 3.69 ［95％CI, 2.43-5.60］；P＜0.01) and HBsAg negative conversion rate(11.5％ vs 0.5％；OR, 9.31［95％CI, 2.72-31.89］；P＜0.01). According to the results of subgroup analysis, HBeAg seroconversion rate in NAs sequential PegIFN therapy group was higher than control group (25.3％［42/166］ vs 10.0％［17/170］; OR,3.1［95％CI, 1.66-5.79］；P＜0.01)；HBeAg seroconversion rate in NAs sequential combined with PegIFN therapy was higher than control group (36.8％［63/171］ vs 13.5％［23/171］；OR,4.24［95％CI, 2.41-7.46］；P＜0.01). Sequential/sequential combination therapy showed more adverse reaction, most of which can be tolerated or improved after symptomatic treatment. ConclusionFor the treatment of HBeAgpositive CHB, after application of NAs to achieve virologic response, NAs sequential/sequential combined with PegIFN therapy for 48 weeks can significantly increase HBeAg seroconversion rate and HBsAg negative conversion rate.

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ObjectiveTo study the proliferation of CRTH2 (CD4+CD294+Th2) cells promoted by pneumococcal vaccine through antigen presentation of dendritic cells (DCs), so as to provide a new approach for amplification and sorting of Th2 cells. MethodsCDs induced from peripheral blood mononuclear cells were cocultured with T lymphocytes after loading pneumococcal vaccine antigen, mixed lymphocyte reaction (MLR) was detected by cell counting kit8(CCK8), DCs and CRTH2 cells were analyzed by flow cytometry. ResultsPneumococcal vaccine could promote the maturation of DCs, together with TNFa, it was adjuvant for maturation of DCs. Pneumococcal vaccine antigenloaded DCs could increase the rate of subsets of CRTH2 cells on day 5(［0.93±0.10］%) compared with day 1(［0.70±0.02］%), and absolute number also increased (both P<0.05). ConclusionAmplification of CRTH2 cells can be greatly promoted by pneumococcal vaccine antigenloaded DCs, which might be one of the effective way to induce amplification of Th2 cells.

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ObjectiveTo compare the efficacy of antibiotic lock technique (ALT) and systemic medication on the treatment of central venous catheterrelated infection(CRI). MethodsCatheters which had been formed bacterial biofilm in vitro were implanted into the central venous of rabbits, and rabbits were randomly divided into two groups, catheter group received the injection of mixture of antibiotics and heparin， systemic group received intramuscular injection of antibiotics and intraductal injection of heparin solution. Medicine was given continuously for 10 days, catheter blood and peripheral venous blood were taken every day before replacing the medicine, bacterial colony counts were detected. All rabbits stopped using antibiotics on day 11, then removed catheters after a 5day observation of catheterization. Before extubation, the catheter blood and peripheral blood were collected to perform bacterial colony counting and antimicrobial susceptibility testing， and removed catheters were performed catheter tip bacterial culture and observation of biofilm. ResultsDuring the medication period, the average bacterial counts of catheter blood in catheter group at different time were all lower than systemic group, difference was statistically significant(all P＜0.05）；from the 4th day, the catheter group gradually appeared positive specimens of peripheral blood culture(a total of 6 cases), and systemic group appeared positive specimens on the second day(a total of 31 cases). During medicine withdrawal period, bacterial counts of catheter blood in two groups on the day of extubation were both higher than those on the day of medicine withdrawal, differences were both statistically significant(both P＜0.05). On the day of medicine withdrawl, 2 cases in catheter group and 8 cases in systemic group were isolated bacteria from peripheral blood; there was no new positive specimens in catheter group on the day of extubation, but there was 1 new positive specimen in systemic group. Catheter tip bacterial count in systemic group was higher than catheter group (［8.02±0.05］ log10CFU/mL vs ［3.12±0.14］log10CFU/mL, t=26.82，P＜0.05）. 33.33% of specimens in catheter group could be observed scattered biofilm, while all specimens of systemtic group were covered by biofilm. Bacterial culture and antimicrobial susceptibility testing of catheter blood and peripheral blood before extubation revealed that diameter of the zone of inhibition in catheter group ranged 19-20 mm, in systemic group ranged 15-16 mm, bacteria from two groups were all sensitive to commonly used antimicrobial agents. ConclusionIn the treatment of central venous CRI, the effect of ALT on local clearance of bacteria is better than that of systemic administration, and it can significantly reduce systemic infection. However, if bacterial biofilm in the catheter is not completely cleared, infection can still relapse after medicine withdrawal. Therefore, accurate dosage and medication time is worthy of further quantitative study.

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ObjectiveTo explore the survival time and its influencing factors of patients in Guizhou Province after they received antiretroviral therapy(ART) for treating human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). MethodsA retrospective cohort analysis was conducted to analyze survival time of AIDS patients who received ART in Guizhou Province in 20052016, life table method was used to calculate the survival probability, Cox proportional hazards regression model was used to analyze the influencing factors of survival time. ResultsA total of 15 921 patients were included in the study, the median age at the beginning of therapy was（42.13±14.40）years old, 58.61% of patients were married/housemate. The length of ART followup was （median［P25-P75］： 15.96［ 6.00-33.00］） months. 9.77% of the followup cases died, 59.29% of the deaths occurred within 12 months of initiation of treatment; survival rates in the first, fifth, and tenth year were 93.00%, 82.00%, and 74.00% respectively. Cox proportional hazards regression model analysis showed that female patients were 0.58 times more likely to die than male patients（95% CI：0.49-0.68）；the risk of death increased with increase of ages; the higher the baseline CD4+T lymphocyte count, the lower the risk of death; the risk of death in patients without symptoms or signs before therapy was 0.70 times than those with symptoms or signs（95% CI：0.60-0.81）. ConclusionThe antiviral therapy of AIDS patients in Guizhou Province is generally well, patients with high risk factors for death should be paid high attention, it is suggested that medical level and service quality should be improved when patients are treated.

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ObjectiveTo evaluate the advantage of homemade negative pressure device combined with nanosilver dressing for promoting the healing of infected incision in rats, and explore its clinical curative effect. MethodsInfected incision model rats were randomly divided into conventional treatment group, and simple pressure suction group, pressure suction combined with silver ion dressing group. The healing time and healing area of rats in each group after treatment were evaluated, immunohistochemical and fluorescent quantitative analysis of inflammatory factors in incisional wound tissue were performed. Three methods were applied to patients with surgical site infection(SSI), granulation coverage time, granulation recovery time, and incision healing time of three groups of patients were compared. ResultsImmunohistochemistry and its IOD value, the relative mRNA expression levels of TNFα, IL2, and IL8 in rat wound tissue treated with pressure suction combined with silver ion dressing were all inferior to conventional treatment group and simple negative pressure suction group, difference was statistically significant (P< 0.05); in clinical application, wound healing time, postoperative Creactive protein level, and pain assessment scores in patients treated with pressure suction combined with silver ion dressing were all superior to conventional treatment group and simple negative pressure suction group, difference were all statistically significant (all P< 0.05). ConclusionCompared with conventional treatment method, pressure suction with silver ions dressing treatment can more effectively control SSI, reduce local inflammation of incision, and promote incision healing.

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ObjectiveTo investigate the changes in distribution and antimicrobial resistance of pathogens causing bloodstream infection in a hospital in 2012-2015. MethodsPathogenic bacteria isolated from blood culture in a hospital microbiology laboratory between January 2012 and December 2015 were collected and divided into 2012-2013 group and 2014-2015 group, distribution characteristics, constitute, and antimicrobial susceptibility of two groups were compared. ResultsGramnegative bacteria were the main pathogens isolated during two periods, accounting for 54.96% and 54.66% respectively, there was no significant differences in pathogen distribution between two groups (P>0.05). Grampositive cocci had a high sensitivity to vancomycin and linezolid, resistant rates were both 0; resistance rates of coagulase negative staphylococci to oxacillin were all >80%, resistance to penicillin was also >90%; Enterobacteriaceae was highly sensitive to imipenem and meropenem, but resistance strains had appeared; Acinetobacter baumannii was sensitive to minocycline during two periods, resistance rates were 35.90% and 34.55% respectively, resistance rates to other antimicrobial agents were also high (>75%). ConclusionThe isolation rate of drugresistant pathogenic strains causing bloodstream infection is high, monitoring on bacterial resistance is helpful for guiding rational use of antimicrobial agents in clinic. 

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ObjectiveTo study the changing trend of prevalence rates of healthcareassociated infection (HAI) and antimicrobial use in hospitalized patients in medical institutions of Hubei Province, and provide a scientific basis for improving HAI management.MethodsThe crosssectional survey results of HAI in Hubei Province in 2010, 2012, and 2014 were analyzed. ResultsThe prevalence rates of HAI in 2010, 2012, and 2014 were 3.48%（1 526/43 909）, 3.03%（1 919/63 320）, and 2.86%（2 174/76 145）respectively, which showed a downward trend, difference was statistically significant（χ2=36.44，P<0.01）. Antimicrobial usage rate decreased from 54.29% (23 838/43 909) in 2010 to 41.02% (31 238/76 145) in 2014, difference was statistically significant(χ2=2 194.09, P<0.01). Among patients receiving therapeutic use of antimicrobial agents, the specimen detection rate increased from 30.49% (4 297/14 091) in 2010 to 52.13% (10 556/20 248) in 2014 (χ2=1 593.98, P<0.01). ConclusionThe prevalence rate of HAI showed a downward trend in Hubei Province, crosssectional survey on antimicrobial use showed a gradual decrease.

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ObjectiveTo understand healthcareassociated infection(HAI) in group burn/trauma patients, and explore its risk factors.MethodsHAI occurred among 25 hospitalized patients with group burn/trauma during a bus deflagration event on May 12, 2014 were monitored and analyzed.ResultsOf 25 burn/trauma patients, 7 developed 10 times of HAI, incidence and case incidence of HAI were 28.00% and 40.00% respectively; the main infection sites were wound and lower respiratory tract, accounting for 60.00% and 30.00% respectively. 30 strains of pathogens were isolated from 7 patients with HAI, including  16 strains (53.34%) of gramnegative bacteria, 13 strains（43.33%） of grampositive bacteria, and 1 fungus (3.33% ). Risk factors for HAI were large burned area, high degree of inhalation injury, arteriovenous catheterization, urinary tract catheterization, tracheotomy, use of ventilator, and surgery.ConclusionIncidence of HAI is high in the group burn/trauma patients, corresponding intervention measures should be formulated according to the risk factors, so as to reduce the occurrence of HAI.

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ObjectiveTo investigate the distribution characteristics of methicillinresistant Staphylococcus aureus (MRSA) in a children’s hospital, and provide basis for the prevention and control of MRSA infection in children. MethodsChildren who admitted to a children’s hospital from 2011 to 2015 were analyzed retrospectively, clinical data of children, isolation of pathogens, types of specimens, and healthcareassociated infection(HAI) status were analyzed. ResultsFrom 2011 to 2015, a total of 911 children isolated Staphylococcus aureus (SA, 1 108 positive specimens), 494 of whom isolated MRSA (599 positive specimens), 54.23% of children isolated MRSA（isolation rate of specimens was 54.06%）；there was no significant difference in the isolation rate of MRSA between children of different genders（P＞0.05）；isolation rate of MRSA in different age groups was statistically significant（P＜0.05）. Isolation rates of MRSA from blood, puncture fluid, secretion, and pus were 68.97%, 66.00%, 55.81%, and 54.47% respectively. Isolation rate of SA and MRSA increased from 0.61% and 21.74% in 2011 to 1.40% and 75.59% in 2015 respectively, difference were both significant(both P<0.05). Incidence of SA and MRSA increased from 0.198% in 2011 to 2.697% and 2.119% in 2015 respectively, both showed an upward trend year by year(both P<0.05). ConclusionIsolation rate of MRSA and incidence of HAI in this children’s hospital increased year by year, it is necessary to intensify management, use antimicrobial agents scientifically and rationally, timely perform disinfection and isolation, so as to curb the emergence and spread of MRSA in hospital settings. 

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ObjectiveTo evaluate the effect of three methods on detecting cleaning efficacy of suction luminal devices in pediatric department, and find out a proper detection method for such devices. MethodsRandom number table method was adopted to take samples of suction lumen devices after cleaned in central sterile supply department in JanuaryApril 2016, visual observation with the aid of magnifying glass, jieli strip detection method, and ATP bioluminescence assay were adopted to detect cleaning efficacy of outer surface, screwed connection, and inner wall of lumen devices, the qualified rates of cleaning detected by three methods were compared.  ResultsThe qualified rates of suction lumen devices after cleaned detected by visual observation with the aid of magnifying glass, jieli strip detection method, and ATP bioluminescence assay were 99.00%, 91.00%, and 71.50% respectively，qualified rates of cleaning detected by three methods were statistically significant（χ2 =71.545，P＜0.001）, pairwise comparison showed a significant difference (both P＜0.0167）； qualified rates of cleaning of the outer surface of lumen detected with three methods were all 100.00%； qualified rates of cleaning of screwed connection were 100.00%, 98.00%, and 97.00% respectively（χ2=5.695，P＞0.05）；qualified rates of cleaning of inner wall were 99.00%, 92.00%, and 72.00% respectively（χ2=72.634，P＜0.01）, pairwise comparison were all significantly different（all P＜0.01）. ConclusionThe cleaning quality of the outer surface and screwed connection of pediatric suction lumen devices can be assessed by visual observation with the aid of magnifying glass, cleaning quality of the inner wall of lumen can be detected by ATP bioluminescence method, when condition is limited，Jieli strip method can be used for routine detection, supplemented by ATP bioluminescence detection on a regular basis.

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ObjectiveTo analyze the medical environmental distribution characteristics of carbapenemresistant Klebsiella pneumoniae (CRKP).MethodsOn April 25 and August 29, 2016, random sampling was performed before cleaning and disinfecting the surrounding of patients who isolated CRKP in a hospital, sampling were mainly object surfaces and medical devices. Distribution characteristics of CRKP were analyzed. ResultsThe number of environmental sampling in surgical intensive care unit(SICU), respiratory ICU(RICU), and emergency ICU(EICU) were 90, 41， and 56 respectively. CRKP was not found in SICU and RICU specimens; 6 strains of CRKP were isolated in EICU, the isolation rate was 10.71%. In April 2016, 103 specimens were taken, and 6 strains of CRKP were isolated, isolation rate was 5.83%, which was higher than in August of 2016(P<0.05). There were no significant differences in isolation rates of CRKP among different specimens and different responsible persons (all P>0.05). ConclusionKey departments, such as EICU, should be intensified cleaning and disinfection, so as to reduce the spread of CRKP in the medical environment.

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ObjectiveTo understand the history and current situation of digestive endoscope cleaning and disinfection in domestic medical institutions. MethodsQuestionnaire survey was used to investigate and analyze the history and current situation of digestive endoscope cleaning and disinfection in medical institutions in some provinces and cities in China. ResultsA total of 278 medical institutions in 11 provinces and cities of China participated in the investigation, 78, 175, and 278 institutions filled out complete information in 1986, 2005, and 2015 respectively. The personnels participated in cleaning consisted of doctors, nurses and workers, the combination of nurses and workers increased from 2.56% in 1986 to 23.74% in 2015. In 1986, 100% of medical institutions used storage water for digestive endoscope cleaning; in 2005 and 2015, all used running water for cleaning, besides, 30.29% of medical institutions used filtered water or purified water for cleaning, in 2015, 50.72% of medical institutions used filtered water, 17.63% used purified water for cleaning. In 1986, no cleaning enzyme were used, in 2015, 98.92% of medical institutions used enzyme for cleaning; in 1986, irrigation of digestive endoscopy channel was performed with simple rinsing（94.87%）, in 2015, enhanced irrigation (34.53%) and automatic irrigation (53.24%) were the main rinsing modes. In 2005 and before, >90% of digestive endoscope cleaning and disinfection were not recorded or manually recorded, in 2015, 36.33% of institutions used information traceability system. ConclusionThe staffing of digestive endoscope cleaning in domestic medical institutions, quality of cleaning water, selection of high efficiency disinfectant, monitoring and recording of digestive endoscope cleaning and disinfection in domestic medical institutions were greatly improved compared with 1986 and 2005, cleaning and disinfection gradually standardized, disinfection and sterilization methods of digestive endoscope tend to be diversified.

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ObjectiveTo understand effect of application of disposable shoe covers on the culture result of airborne bacteria in intensive care unit (ICU). MethodsAccording to Hygienic standards for disinfection in hospitals（GB 15982-2012）and Technical standards for disinfection in medical institutions（WS/T 367-2012），the colony forming units of bacteria in ICU air were detected for 15 consecutive days when disposable shoe covers were used and unused, bacterial culture results were analyzed. ResultsThe number of patients, number of visitors, temperature, and humidity in ICU when disposable shoe covers were used and unused were not significantly different (all P>0.05). The total number of bacterial colonies in ICU air when using disposable shoe covers was (median ± interquartile range: ［1.20±2.20］ CFU/15 min.·Φ9 cm. plate), which was significantly higher than air when disposable shoe covers were not used(median ± interquartile range: ［0.60±1.10］ CFU/15 min.·Φ9 cm. plate), difference was statistically significant（P<0.05）.The qualified rate of bacterial culture result of air when disposable shoe covers were not used was higher than that when disposable shoe covers were used （96.67% vs 86.67%, P<0.05）. ConclusionThe use of disposable shoe covers can not improve ICU air quality.

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ObjectiveTo explore the role of infection control nurses in healthcareassociated infection(HAI) management, and provide basis for HAI management. MethodsThrough setting up infection control nurses in clinical departments of the whole hospital, clarifying their responsibilities and duties, training, and supervising them, the effect of infection control nurses on HAI management was observed. ResultsA total of 67 infection control nurses were set up in the clinical departments of the whole hospital, HAI management knowledge among health care workers (HCWs) in 26 departments improved significantly, scores of HAI management knowledge among HCWs in April and December was compared, difference was statistically significant (Z=-2.193，unilateral P=0.014）. Hand hygiene compliance rate of HCWs improved from 83.35%（1 817/2 180）in April to 89.53% (2 002/2 236) in December, difference was statistically significant（χ2=36.13，P＜0.01）. A total of 56 670 hospitalized patients were monitored from April to December 2015, the total length of hospital stay was 411 164 days, utilization rate of three catheters was 27.18%, three catheterrelated infection rate was 0.74‰. The median scores of supervision on HAI management in clinical departments improved from 95.30 in May to 97.70 in September（P＜0.05）. ConclusionSetting up infection control nurses is of great significance to strengthen the HAI management organization and promote the quality of HAI management.

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目的了解我国一般人群通过血液传播感染丙型肝炎病毒（HCV）的风险。方法通过文献检索，对1996—2016年国内发生的HCV感染暴发事件进行回顾性分析。结果共检索到因血液透析发生HCV感染暴发事件10起，涉及血液透析患者689例，其中258例感染HCV，感染风险为37.45%；不安全注射导致HCV感染暴发事件3起，涉及人群基数不祥，其中447例感染HCV；输血或单采血浆导致HCV感染暴发事件4起，共涉及191例，其中156例感染HCV，感染风险为81.68%。结论我国一般人群通过血液传播感染HCV的风险极高。

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目的了解基层医疗机构医院感染管理现状，为加强医院感染管理提供依据。方法2016年6—7月采用随机抽样方法抽取某地区辖区内县级以下的18所基层医疗机构，采用现场查看与考核的方法进行调查。结果18 所医院中有10所公立医院、6所私立医院、2所合资医院。18所基层医院中仅2所（11.11%）医院提供了培训资料，仅2所（11.11%）医院工作人员知晓无菌物品采购流程，仅1所（占5.56%）医院医疗废物管理较规范。18所医院均无医院感染管理组织，均未开展医院感染监测工作，医院建筑布局不明，均未开展标准预防与手卫生相关工作，消毒隔离技术未开展，均无无菌物品管理相关制度及管理，均无重点部门及重点部位的相关管理制度。结论基层医疗机构医院感染管理存在问题较多，应加强区域医院感染管理质量控制中心建设，建立健全医院感染管理组织，加强医院感染管理，提高医疗质量。

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明串珠菌属（Leuconostoc spp.）是过氧化氢酶阴性、革兰染色阳性球菌属，常见于生产乳奶制品、发酵、酿酒和制糖过程中，在乳品生产技术方面占有非常重要的地位。1984年，Shlaes等［1］首次证实明串珠菌属为条件致病菌，免疫力低下人群属于易感人群，可以引起颅内、腹腔、胸腔及骨髓等部位感染。除上述易感人群外，婴儿同样是感染该菌属的高危人群。目前对明串珠菌属致病的病例报道较少，感染患者一般为存在基础疾病者，本病例报告的为西藏高原地区1例乳酸明串珠菌感染健康婴儿引起脓毒症的病例。

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泌尿系感染是临床上最常见的感染性疾病，超过50%的女性一生中至少经历一次泌尿系感染［1］，尽管泌尿系感染具有自限性，但仍给患者和公共卫生系统带来沉重的经济负担［2］。此外，在相当多女性中，感染在一年内会复发多次。成人女性发病率高于男性［3］；儿童中，女孩的发病率约为7%，男孩约为2%［4］。大多数泌尿系感染的预后较好，但肾脏发生瘢痕增生的风险高达40%［5］。与女性泌尿系感染相似，儿童复发的风险为25%～40%［6］。泌尿系感染最常见的病原微生物是大肠埃希菌，超过80%的非复杂性泌尿系感染与此病原微生物相关［7］。目前，抗菌药物是治疗泌尿系感染最有效的方法［8］，但人类在与泌尿系感染的战斗中从未取得过完全的胜利，由于抗菌药物的滥用，耐药性细菌感染越来越严重［910］，尤其是对于感染后内毒素引起的脓毒血症一直缺乏更有效的治疗方法［11］。尽管细菌已经产生多种机制对内源性抗生素耐药［12］，但并未发现对抗菌肽耐药［13］。抗菌肽是一种具有抗菌活性的小分子多肽，能作用于细胞膜，在膜上形成跨膜离子通道，破坏膜的完整性，造成细胞内容物外漏，从而杀死细胞［14］。除了直接的抗菌活性，抗菌肽也具有选择性免疫激活和调节功能［15］。抗菌肽具有抗菌活性高、抗菌谱广，以及靶菌株不易产生抗性突变等特点而备受瞩目［16］。在本综述中，我们将讨论抗菌肽在泌尿系感染中的作用及其提高固有免疫方法的不同作用机制，同时，探讨维生素D、雌激素、中草药用于预防和治疗泌尿系感染的潜在价值。

Abstract:

手机作为当下人们使用最频繁的工具，在日常生活中发挥着巨大作用。对医院而言，手机越来越多的应用于挂号、就诊、报告反馈甚至包括部分诊疗活动。移动通信方面的创新使得医疗机构通过手机对患者进行更好的疾病管理［1］，如糖尿病和哮喘的实时监测［2］，疫苗接种及旅途中流行病的控制等［3］。但手机在极大提高医务人员工作效率的同时，自身作为一种细菌定植场所存在被病原菌污染的隐患。有微生物学家认为手机因为经常性的接触而生成的热量，为常见于人类皮肤的微生物创建了一个最好的繁殖场所［4］，特别对于手术室、重症监护病房（ICU）、新生儿病房等重点科室，手机引发医院感染、特别是多重耐药菌感染的可能性不能被忽视。本文将医院内医务人员手机的使用情况、手机污染状况和手机的消毒方法等内容综述如下。

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