Abstract:

ObjectiveTo understand clinical characteristics, pathogenic distribution and antimicrobial resistance of bloodstream infection(BSI) in patients with hematological diseases, so as to provide evidence for rational application of antimicrobial agents.MethodsClinical data of hematological patients with BSI from January 2012 to December 2016 were retrospectively analyzed, including infection site, species of pathogens, resistance to commonly used antimicrobial agents and so on.ResultsA total of 308 patients were with BSI, 337 strains of pathogens were isolated from blood culture, 119 (35.3%) of which were grampositive bacteria, mainly coagulasenegative staphylococcus and Enterococcus; 215 strains(63.8%) were gramnegative bacteria, mainly Escherichia coli(E. coli), Klebsiella pneumoniae(K. pneumoniae), and Pseudomonas aeruginosa(P. aeruginosa); 3(0.9%) were fungi, all were Candida tropicalis. The proportion of gramnegative bacteria isolated from patients with BSI increased gradually, up to 71.6%. Resistance rates of E. coli and K. pneumoniae to cefoperazone/sulbactam, piperacillin/tazobactam, and carbapenems were all<20%. Resistance rates of P. aeruginosa to amikacin, ciprofloxacin, cefoperazone/sulbactam, piperacillin/tazobactam, and carbapenems were all<20%. Susceptibility rates of major grampositive bacteria to vancomycin, teicoplanin, and linezolid were close to or up to 100%, vancomycinresistant Enterococcus (VRE) was not found. Susceptibility rate of Candida tropicalis to amphotericin B was 100%. The detection rates of extendedspectrum βlactamases in E. coli and K. pneumoniae were 55.6% and 41.2% respectively. Five strains of methicillinresistant Staphylococcus aureus were detected among 8 strains of Staphylococcus aureus, and 86.7% of 60 strains of coagulasenegative staphylococcus were methicillinresistant staphylococcus.ConclusionThere are many kinds of pathogens causing BSI in hospitalized patients with hematological diseases, proportion of gramnegative bacteria has increasing tendency, detection rate of multidrugresistant organisms is high, antimicrobial agents should be selected rationally based on the distribution and drug resistance of pathogens in different regions.

Abstract:

ObjectiveTo analyze the species and antimicrobial resistance of pathogens from blood culture of hospitalized patients in a tertiary firstclass hospital, and provide reference for clinical rational antimicrobial use. MethodsData of pathogens isolated from blood culture of patients in a hospital between January 2015 and November 2017 were collected, distribution, antimicrobial resistance characteristics, and positive alarming time were studied retrospectively. ResultsA total of 7 153 blood culture specimens were obtained, 655 strains of pathogens were isolated. 370 strains (56.49%) were gramnegative bacilli, 262 (40.00%) were grampositive cocci, and 23(3.51%) were fungi. The top 5 pathogens were Escherichia coli, coagulase negative staphylococcus (Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus hominis), Klebsiella pneumoniae, Staphylococcus aureus, and Pseudomonas aeruginosa. The average positive alarming time of blood culture from early to late were Enterobacteriaceae(15.50 h), Staphylococcus spp. (18.00 h), nonfermentative bacteria (20.30 h), Enterococcus spp. (22.50 h), Streptococcus spp. (24.15 h), and fungi (38.35 h). Department of hematologyoncology（24.89%） had the highest isolation rate of pathogens from blood culture. Grampositive cocci was found not to be resistant to linezolid, teicoplanin, and vancomycin; imipenem and meropenem had good antimicrobial activity against Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii (resistance rates were all<5%); resistance rates of Acinetobacter baumannii to piperacillin, ceftazidine, cefepime, gentamicin, and compound sulfamethoxazole were all >65%. ConclusionAntimicrobial resistance of hospitalized patients with bloodstream infection in this hospital is serious and distribution in various clinical departments is different. Clinicians should standardize the use of antimicrobial agents according to antimicrobial susceptibility testing results of positive pathogens from blood culture.

Abstract:

ObjectiveTo establish a stable and high reproducibility rat model of deep seconddegree scald and wound infection for the study of repair and treatment of scald and wound infection.Methods40 SD rats were randomly divided into 5 groups, selfmade scald instrument (steam temperature 94℃) was used to produce scald on rats’ skin for 4, 6, 8, 10, and 12 seconds (identical wound at two sides of the spine of each rat), histological changes on wound was observed 24 hours after injury, the best duration for forming deep seconddegree scald was analyzed. Another 30 SD rats were randomly divided into 3 groups, with 10 rats in each group, deep seconddegree scald was formed with the best injury time, 0.3 mL liquid containing 1×107 CFU/mL, 1×108 CFU/ml, and 1×109 CFU/mL Pseudomonas aeruginosa (P. aeruginosa) was respectively inoculated to the wound on one side, while the wound on the other side were inoculated with the same volume of normal saline as control, general condition of rats wound was observed 24 hours after inoculation, HE staining was used to stain the wound and observe inflammatory reaction, the number of bacteria under schar was detected after 1, 2, 4, 7, and 14 days of inoculation, wound healing time was recorded.Results(1) Histopathological findings showed that scald for 8 seconds was the best time for forming deep seconddegree wound. (2) Inoculation of 1×108 CFU/mL and 1×109 CFU/mL bacteria to rat deep seconddegree scald had obvious inflammatory cell infiltration, inflammatory infiltration under the scab of the latter was more obvious. The subeschar bacterial count was 1×105 CFU/g within 14 days after inoculation of 1×109 CFU/mL bacteria to scald wound, and bacteria count showed a rising trend over time. Wound healing time of rats was significantly longer than that of the saline control group(［21.4±2.4］d vs ［18.4±1.7］ d, t=2.72，P＜0.05）.ConclusionTemperature at 94℃ and scald time for 8 seconds is the optimal time for forming deep seconddegree scald; inoculation with P. aeruginosa at a concentration of 1×109 CFU/mL to scald wound can establish a deep seconddegree scald and infection model in SD rats with uniform depth, high reproducibility and good stability.

Abstract:

ObjectiveTo design a concealed investigation scheme to control bias based on direct observation method, evaluate actual hand hygiene(HH) compliance among health care workers(HCWs).MethodsHH compliance among HCWs in 8 general hospitals in Beijing was performed concealed investigation in June 2016, data of HH compliance and correctness were obtained and conducted statistical analysis as well as direct standardization, then compared with HH surveillance data obtained by direct observation method in 2015.ResultsIn 2016, HCWs’ HH compliance rate and correct rate were 58.04% and 88.68% respectively. After direct standardization, ICU had the highest HH compliance rate (81.29%), emergency department had the highest HH correct rate (93.29%), neurology department had the lowest compliance rate and correct rate of HH (42.97% and 82.35% respectively); nurses had the highest compliance rate and correct rate of HH (69.02% and 92.84% respectively), cleaners had the lowest compliance rate and correct rate of HH (37.25% and 71.59% respectively); compliance rate of HH after contacting patients was the highest (71.79%) but correct rate was the lowest (88.76%), compliance rate of HH before cleaning/aseptic procedure was the lowest (43.08%) but the correct rate was the highest (93.50%). HH compliance rate of HCWs investigated by concealed method was lower than that by direct observation(P<0.05), and the extent of discrepancy in correctness was different.ConclusionHH compliance is different in the distribution of departments, personnel, and indication, it is necessary to strengthen intervention in key aspects of HH. There is a certain bias in results of direct observation on HH compliance, HH investigation methods need to be improved.

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ObjectiveTo establish a biological model of systemic infection in immunosuppressed BALB/c mice by intraperitoneal injection of Candida albicans(C. albicans), and provide animal model for studying the pathogenesis of C. albicans infection and pharmacodynamics of antifungal agents.MethodsC. albicans infection model of immunosuppressed BALB/c mice (intraperitoneally injected with cyclophosphamide 200 mg/kg·d for consecutive 2 days) was established through intraperitoneal injection of 0.25 mL virulenceenhanced strain of C. albicans (concentration: 1×107 CFU/mL）. Vein blood of mice tail was taken for detecting white blood cell count and neutrophil count, mice tissue were collected for microscopic fungal examination, culture, pathological examination, and (1, 3)βDglucan detection.ResultsThere were significant differences in white blood cell count, neutrophil count, and average body weight between immunosuppressive group and control group on the 4th day after treatment（all P＜0.05）. The survival rate of C. albicans infection group and control group were 30.00% and 100.00% respectively, difference between two groups was statistically significant (P<0.05). Dissection of mice which died on day 2-14 and survival mice on day 14 after injection of C. albicans found that there were multiple abscess in lung, liver, and kidney tissue, especially kidney infection; a large number of fungal mycelia could be seen by direct microscopic examination of mice tissue, C. albicans was found through tissue culture, histopathology examination showed a large number of mycelia, inflammatory cells and tissue necrosis. The levels of (1,3)βDglucan in lung and kidney tissue of C. albicans infection group were both significantly higher than those of control group (both P<0.05).ConclusionAnimal model of systemic C. albicans infection in immunosuppressed BALB/c mice can be successfully established by this method.

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ObjectiveTo investigate drug resistance of HIV1 infected people who failed in antiviral therapy in Jiangsu Province from 2010 to 2014, and provide reference for clinical antiviral therapy.MethodsBased on the network of drug resistance detection laboratories, detection results of HIV1 genotype resistance in Jiangsu Province from 2010 to 2014 were collected, drug resistance, drug resistance gene loci and virus gene subtypes in different years were statistically analyzed.ResultsFrom 2010 to 2014, 74, 113, 197, 278, and 346 specimens were included, rates of specimens with resistance detection results were 68.92%, 48.67%, 51.27%, 52.52%, and 57.80% respectively. The main HIV1resistant drugs were similar in each year, nucleoside drugs were mainly lamivudine(3TC), abacavir(ABC), didanosine(DDI), and emtricitabine(FTC), nonnucleoside drugs were mainly efavirenz(EFV) and nevirapine(NVP). Drug resistance of HIV1 to protease drugs was quite different, resistance rate of currently used lopinavir/ritonavir(LPV/r) was less than 1%. The major drug resistance loci of HIV1 in four years were 184, 181, 190, and 103 respectively, 184 mutation mainly caused 3TC and FTC resistance, while 181, 190, and 103 mutation were associated with EFV and NVP resistance. HIV1 gene subtype was mainly CRF01_AE, which showed an upward trend.ConclusionThere is an increasing trend of resistance rate of HIV1 genotype in HIVinfected patients who failed in antiviral therapy in Jiangsu Province, drug resistance detection for patients receiving antiviral therapy should be strengthened, so as to adjust antiviral treatment scheme in time.

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ObjectiveTo evaluate the value of serum procalcitonin (PCT) in diagnosing intracranial infection in adults.MethodsLiteratures about serum PCT for diagnosing intracranial infection in adults were retrieved from English database (PubMed, The Cochrane Library）and Chinese database (China National Knowledge Infrastructure［CNKI］, Wanfang Database, and VIP Database) from establishment of database to June 2017. According to inclusion and exclusion criteria, QUADAS2 risk assessment tool provided by RevMan 5.3 statistical software was used to evaluate the quality of included literatures, MetaDisc 1.4 software was used for Meta analysis, Stata 13.0 software was used to judge the publication bias and draw Deeks diagram.ResultsA total of 9 articles and 1 446 patients were included in the study. Total sensitivity was 0.86 (95% CI: 0.82-0.89), specificity 0.91 (95% CI: 0.89-0.92), positive likelihood ratio 6.50 (95% CI: 4.15-10.18), negative likelihood ratio 0.15 (95% CI: 0.07-0.33), diagnostic odds ratio 44.66 (95% CI: 16.26-122.66), SROC AUC 0.9357, and Q* index 0.8720. Heterogeneity test showed there was heterogeneity among studies. Subgroup analysis showed that SROC AUC (0.9692) and Q* value (0.9185) were the highest when PCT positive threshold was 0.1-0.5 ng/mL.ConclusionSerum PCT has high diagnostic value for intracranial infection in adults, and can be used for differentiating diagnosis of intracranial infection.

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ObjectiveTo understand current situation and development trend of dental unit waterlines (DUWLs) management at home and abroad.MethodsLiteratures related to DUWLs were retrieved from PubMed, China National Knowledge Infrastructure (CNKI), WanFang Data, VIP Database, and China Biology Medicine (CBM), retrieval time was from the establishment of database to December 2017, bibliometrics was used to analyze the data.ResultsA total of 270 articles were included, there were 109 Chinese literatures and 161 English literatures; literatures were from 18 countries, the top 5 countries for publication were China (n=110), Britain (n=60), the United States (n=48), Poland (n=14), and India (n=10), accounting for 89.63% of the total literatures. The top three provinces for publication in China were Jiangsu Province (n=22), Guangdong Province (n=17), and Tianjin City (n=12), accounting for 46.79% of the total Chinese literatures. Seven highfrequency words have been obtained, hotspot of research was contamination and control of DUWLs. The first author published 1-13 articles, the core authors published at least 3 articles of this study, 18 core authors published 81 articles, accounting for 30.00% of the total number of articles.ConclusionDomestic research presents rising trend on the whole, but the extent of study still needs to be enlarged. Domestic research is relatively concentrated, but the core research has not yet been formed; hotspot of global study is explicit, but there is no unified management plan.

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ObjectiveTo understand status and influencing factors of occupational stress of health care workers(HCWs) in Qingyang City of Gansu Province, so as to provide scientific basis for alleviating occupational stress and improving occupational health of HCWs.MethodsMaslach burnout inventorygeneral survey (MBIGS) and convenient sampling method were adopted to conduct survey on HCWs in city, county, and township levels of hospitals in seven counties and one district of Qingyang City, SPSS 19.0 statistical software was used to analyze the data.ResultsA total of 18 medical institutions were surveyed, and 494 valid questionnaires were collected. Among 494 HCWs, 443 (89.68%) had occupational burnout, 245(49.60%) had moderate or above occupational burnout, at a relatively serious level. The mean scores of three dimensions were: emotional exhaustion （12.65±8.13）, cynicism （6.86±6.09）, and low sense of achievement（22.48±9.03）. The score in emotional exhaustion of HCWs with years of service≤5 years was lower than that of 5-10 years group, difference were both significant (P<0.05); and score in cynicism of HCWs with years of service≤5 years was lower than that of 5-10 and 10-15 years, difference were both significant (both P<0.05). The scores in low sense of achievement of HCWs with master degree or higher were lower than those of undergraduate, junior college or lower, difference was significant (P<0.05). The scores in low sense of achievement of HCWs with high professional title were higher than those of associate, middle, and primary groups, difference was significant (P<0.05). There was no significant difference in the scores of emotional exhaustion, cynicism, and low sense of achievement among HCWs of different gender, occupation, and marital status (all P>0.05). ConclusionOccupational stress of HCWs in Qingyang City of Gansu Province is serious, management department can take targeted intervention measures to alleviate occupational stress of HCWs with long length of service year, high educational level, and low professional title, protect occupational health of HCWs, and improve level of medical service.

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ObjectiveTo establish a risk prediction scoring model for catheterassociated urinary tract infection (CAUTI) in elderly patients, provide evidence for screening highrisk population, and effectively prevent and control urinary tract infection in elderly patients.MethodsA retrospective study was conducted to collect medical data of elderly patients with indwelling urinary catheters during hospitalization between January 1, 2015 and November 30, 2017 (data from 2015 to 2016 was as modeling group, in 2017 as validation group), logistic regression model was constructed to analyze risk factors, according to OR value, the corresponding point of each risk factor was scored, an infection risk scoring model was established, receiver operating characteristic (ROC) curve was used to evaluate prediction effect of model. According to the established infection risk scoring model, patients in validation group were scored, ROC curve was used to evaluate the predictive effect of the model.ResultsLogistic regression analysis showed that age (≥80 years), renal dysfunction, combined use of antimicrobial agents, days of special antimicrobial use (≥15 days), length of postoperative hospital stay (≥15 days), duration of indewlling catheter (≥7 days) were independent risk factors for CAUTI in elderly patients, the corresponding points in the risk scoring model were 3, 3, 3, 5, 7, and 9 respectively. Score>15 points was highrisk group, the area under the curve(AUC) of scoring model was 0.91 (95% CI: 0.90-0.93, P<0.05), sensitivity and specificity were 84.8% and  85.3% respectively. ROC curve was drawn according to the risk score of validation group, AUC was 0.92 (95% CI: 0.88-0.95, P<0.05), sensitivity and specificity were 84.7% and 86.6% respectively. ConclusionThe established risk scoring model has good discriminatory validity for both modeling group and validation group, and can be used in the identification of susceptible highrisk population for CAUTI in elderly patients, so as to achieve early prevention and control.

Abstract:ObjectiveTo establish a risk assessment system for healthcareassociated infection(HAI) in intensive care unit(ICU) based on risk matrix, and clarify the focus of HAI management.MethodsThe risk database was established through literature review, risk assessment scale and score were defined on the basis of expert consultation method. On the basis of risk matrix analysis, the risk assessment system was constructed through risk order, risk matrix, and risk band.Results25 risk factors for infection in ICU were included in this risk assessment. Health care workers (R=18.06), degree of diseases (R=15.33), invasive procedure (R=15.33), and object surface (R=14.69) were high level of risk; health care workers (P=4.17), invasive procedure (P=4.00), and object surface (P=3.83) were high probability of the occurrence of risk; transmission through devices (C=4.83), three catheters (C=4.67), and transmission through contact (C=4.50) were high severity of the occurrence of risk. Among 25 risks, there were 12 risks in the high risk band (LR=20), 10 in the middle risk band (LR=16), and 3 in the low risk band (LR=4).ConclusionThe high risk of HAI in ICU is that the standard preventive measures are not implemented properly by health care workers, patient’s condition is complex, invasive procedure, and disinfection of environmental object surface is not qualified.

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ObjectiveTo investigate risk factors for peripherally inserted central catheter (PICC)related fungal infection in patients with hematological malignancies.Methods528 patients with hematological malignancies and received PICC in a hospital from July 2010 to July 2015 were selected, through retrospective study and according to whether PICCrelated fungal infection occurred, patients were divided into bloodstream infection(BSI) group, puncture site infection group, and noninfection group, risk factors for PICCrelated fungal infection was performed logistic regression analysis.ResultsAmong 528 hematological malignancies patients with PICC, 48 (9.09%) had fungal infection, 32 cases (66.67%) were with catheterrelated fungal BSI (CRFBSI), 6(12.50%) were with puncture site infection, and 10(20.83%) were with both CRFBSI and puncture site infection; 48 strains of fungi were isolated, mainly Candida parapsilosis (21 strains, 43.75%). Multivariate logistic regression analysis showed that neutrophil count≤0.5×109/L, length of hospital stay>10 days, antimicrobial use, and chemotherapy use>3 times were independent risk factors for bloodstream fungal infection in PICC patients; chemotherapy use>3 times and  delayed catheter maintenance cycle were independent risk factors for infection at puncture site.ConclusionPICCrelated fungal infection results from multiple risk factors, comprehensive and dynamic assessment of risk factors should be paid attention, effective intervention measures needs to be taken.

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ObjectiveTo analyze direct economic loss due to healthcareassociated infection(HAI) in patients with hematological diseases.MethodsA 1∶1 matched casecontrol study was conducted to investigate medical expense and length of hospital stay of patients, patients with HAI were subdivided into three groups: single site infection group, multisite infection group, and multidrugresistant organism(MDRO) infection group, direct economic loss due to HAI in each group was analyzed.ResultsThe average medical expense of patients in case group (patients with HAI) was 69 844.70 Yuan, while that in control group was 35 077.13 Yuan, the average medical expense of patients increased by 34 767.57 Yuan due to HAI, the increased medical expenses were mainly fees for medicine, laboratory examination, and blood transfusion. The average medical expense of patients with different infection were significantly different (P<0.05), medical expense of patients in MDRO group and multisite infection group were both higher than patients in singlesite infection group, loss in MDRO infection group was the highest (average medical expense was 121 949.02 Yuan). Direct economic loss varied with different diseases, the top three diseases with direct economic loss were Bunkitt’s lymphoma, acute promyelocytic leukemia, and acute myeloid leukemia, direct economic losses were 151 960.09, 100 419.29, and 74 298.47 Yuan respectively. The median of average length of hospital stay in case group was 30 days, which was longer than 17 days in control group (P<0.05), there was no significant difference in the average length of hospital stay between patients with different types of infection (P=0.620). Compared with control group, the average length of hospital stay of HAI patients with different hematological diseases prolonged by 4-30 days.ConclusionHAI can increase medical expense and length of hospital stay of patients with hematological diseases, direct economic loss varies with different types of infection and diseases, management of MDRO and special disease should be strengthened, effective measures should be taken to prevent and control HAI.

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ObjectiveTo understand the distribution and antimicrobial resistance of pathogens from patients with breast abscess during lactation, so as to guide clinicians to make rational treatment.MethodsPathogens and antimicrobial susceptibility testing result of pathogens isolated from breast abscess of lactation patients in a specialty hospital from January 2015 to December 2016 were retrospectively analyzed.ResultsA total of 142 specimens from breast abscess were collected, 98 of which were isolated 99 strains of pathogens, there were 94 strains (94/99, 94.95%) of Staphylococcus aureus（S. aureus）, 43 (43/94, 45.74%) strains of methicillinresistant S. aureus (MRSA), 2 Klebsiella pneumoniae, 1 S. epidermidis, 1 Enterococcus faecalis, and 1 Proteus penneri. Resistance rate of S. aureus to penicillin was up to 90.43%, resistance rates to erythromycin, clindamycin, and tetracycline were 55.32%, 39.36%, and 27.66% respectively, to ciprofloxacin, mupirocin, compound sulfamethoxazole, and amikacin were relatively low, none strains were found to be resistant to vancomycin, fusidic acid, teicoplanin, quinupristin/dalfopristin, and linezolid; resistance rates of 43 strains of MRSA to erythromycin, clindamycin, and tetracycline were 83.72%, 72.09%, and 44.19% respectively.ConclusionThe main pathogens causing breast abscess during lactation are S. aureus, and its’ resistance rates to penicillin, erythromycin, clindamycin, and tetracycline are relatively high, these antimicrobial agents should not be empirically selected for the treatment of breast abscess. MRSA should be paid attention, antimicrobial agents should be chosen according to antimicrobial susceptibility testing result, patients who suspended breastfeeding needs to be guided to remove breast milk.

Abstract:

蜡样芽孢杆菌是革兰阳性需氧芽孢杆菌，广泛分布于自然环境并可长期存在于医院环境中［12］。蜡样芽孢杆菌可引起不同程度的感染，如食物中毒、局部感染、菌血症等。尽管血标本中芽孢杆菌的分离经常考虑为污染，但蜡样芽孢杆菌对于血液病患者往往为血流感染的病原菌，甚至可伴发严重的并发症，即颅内感染，病死率高达42%［34］。我国恶性血液病伴中性粒细胞缺乏患者中由该菌引起的菌血症并伴发神经系统症状的病例并不常见，目前尚无报道。本文对某院一例恶性血液病患者在粒细胞缺乏期合并蜡样芽孢杆菌菌血症病例进行总结，分析如下。

Abstract:

真菌感染是因一种或多种真菌侵袭导致的疾病，占医院感染的29.94%［12］。然而，随着侵入性操作、器官移植、广谱抗菌药物和化学治疗药物应用的不断增加，真菌感染率逐年上升［3］。目前，报道的真菌感染致病菌有假丝酵母菌、曲霉菌、毛霉菌和隐球菌等菌种［45］，其中以假丝酵母菌最常见［67］。然而，临床上仍有少部分真菌感染由于临床病例收集不集中且报道较少，导致诊断较为复杂，甚至因治疗不及时使患者病情恶化，因此，全面掌握相关病原菌信息是解决治疗问题的关键。

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医用手套的使用是手卫生和职业防护的一部分，正确的使用对提高手卫生依从性和减少医务人员职业伤害有促进作用。2009年世界卫生组织（WHO）发布的《世界卫生组织医疗机构手卫生指南》［1］中对手套的使用规定为：（1）戴手套不能代替手卫生（洗手、手消毒）；（2）当可能接触血液或其他有潜在传染性的物质、黏膜和非完整皮肤时，应戴手套；（3）护理患者后要摘手套，护理一例以上患者时不要戴同一副手套；（4）从同一患者身体的污染部位移到其他部位前要更换或摘除手套，接触污染部位后接触周围环境要更换或摘除手套；（5）避免重复使用手套，如果重复使用，应执行合适的再生方法确保手套的完整性和清除微生物。手套常见的材质有天然乳胶、丁腈（合成橡胶）、聚乙烯（PE）、聚氯乙烯（PVC）；表面型式分为麻面、光面、有粉表面、无粉表面；根据功能分为灭菌手套和非灭菌手套（清洁手套）。因此，本文就手套应用中存在的问题以及如何正确选择和使用手套作以综述。