OBJECTIVE To analyze the epidemiological characteristics of hospital-associated infections(HAIs)in a large scale three-A hospital and assess the occurrence and development trends of HAIs before and after COVID-19 epidemic and during different stages of prevention and control strategies so as to provide scientific bases for HAIs management.METHODS The surveillance data were collected from the patients who were hospitalized in a large scale three-A hospital by nosocomial infection real-time surveillance system from Jan.2018 to Dec.2023.The prevalence trend,infection sites and distribution of pathogens were analyzed.The study period was divided into the pre-epidemic stage and the epidemic stage,the epidemic stage was divided into the strict infection prevention and control phase and the loose infection prevention and control phase.The epidemiological characteristics of HAIs were observed and compared.RESULTS From 2018 to 2023,the prevalence rate of HAIs was decreased from 3.39％to 2.21％,and there was significant difference in the prevalence rate of the infections among the years(x2=105.00,P＜0.001).During the six years,the prevalence rate of HAIs was highest in the internal medicine wards of critical care medicine department(54.91％),and the gram-negative bacteria(56.61％)were dominant among the pathogens.Lower respiratory tract(41.85％),bloodstream(20.93％)and urinary tract(20.50％)ranked the top 3 infection sites;the lower respiratory tract infection ranked the first place before the COVID-19 epidemic and the different stages of epidemic.The overall prevalence rate of HAIs was 3.26％during the epidemic period,remarkably lower than 3.91％before the COVID-19 epidemic(P＜0.001);the overall prevalence rate of HAIs was 2.21％in the loose prevention and control phase of 2023,remarkably lower than 3.78％in the strict prevention and control phase(P＜0.001).CONCLUSIONS The prevalence of HAIs generally shows a downward trend during the six years.The lower respiratory tract is the major infection site,and the gram-negative bacteria are dominant among the pathogens,especially Klebsiella pneumoniae.The prevention and control strategies for the COVID-19 epidemic may facilitate the reduction of incidence of HAIs,and the prevalence rate is remarkably reduced even in the loose prevention and control phase.It is necessary for the hospital to take targeted prevention and control measures based on the departments,carry out rigid surveillance of the major infection sites and patho-gens,and conduct multidisciplinary coordinated prevention and control so as to control the HAIs.

OBJECTIVE To analyze the epidemiological characteristics of hospital-associated infections(HAIs)in a large scale three-A hospital and assess the occurrence and development trends of HAIs before and after COVID-19 epidemic and during different stages of prevention and control strategies so as to provide scientific bases for HAIs management.METHODS The surveillance data were collected from the patients who were hospitalized in a large scale three-A hospital by nosocomial infection real-time surveillance system from Jan.2018 to Dec.2023.The prevalence trend,infection sites and distribution of pathogens were analyzed.The study period was divided into the pre-epidemic stage and the epidemic stage,the epidemic stage was divided into the strict infection prevention and control phase and the loose infection prevention and control phase.The epidemiological characteristics of HAIs were observed and compared.RESULTS From 2018 to 2023,the prevalence rate of HAIs was decreased from 3.39％to 2.21％,and there was significant difference in the prevalence rate of the infections among the years(x2=105.00,P＜0.001).During the six years,the prevalence rate of HAIs was highest in the internal medicine wards of critical care medicine department(54.91％),and the gram-negative bacteria(56.61％)were dominant among the pathogens.Lower respiratory tract(41.85％),bloodstream(20.93％)and urinary tract(20.50％)ranked the top 3 infection sites;the lower respiratory tract infection ranked the first place before the COVID-19 epidemic and the different stages of epidemic.The overall prevalence rate of HAIs was 3.26％during the epidemic period,remarkably lower than 3.91％before the COVID-19 epidemic(P＜0.001);the overall prevalence rate of HAIs was 2.21％in the loose prevention and control phase of 2023,remarkably lower than 3.78％in the strict prevention and control phase(P＜0.001).CONCLUSIONS The prevalence of HAIs generally shows a downward trend during the six years.The lower respiratory tract is the major infection site,and the gram-negative bacteria are dominant among the pathogens,especially Klebsiella pneumoniae.The prevention and control strategies for the COVID-19 epidemic may facilitate the reduction of incidence of HAIs,and the prevalence rate is remarkably reduced even in the loose prevention and control phase.It is necessary for the hospital to take targeted prevention and control measures based on the departments,carry out rigid surveillance of the major infection sites and patho-gens,and conduct multidisciplinary coordinated prevention and control so as to control the HAIs.

Objective To explore preoperative psychological experience in patients with the tibia and fibula fracture that treated with 3D printing individualized external fixation, and provide theoretical basis for the medical treatment and care. Methods From December 2013 to November 2015, sevenpatentstreated with 3D printing individualized external fixation in Xi′an Honghui Hospital, Xi′an Jiaotong University Health Science Center were selected as the interview object. This qualitative study was completed by phenomenon research methods, and combined with a variety of forms of interview.Colaizzi content analysis method was used to analyze the contents of collected data, and sort and refine the theme. Results Four effective subjects were extracted about preoperative psychological experience in patients with the tibia and fibula fracture treated with 3D printing individualized external fixation, in turn were uncertainty effect of surgery; high expectations, but the lack of knowledge about 3D printing, economic burden of disease; longing for family support system. Conclusions Medical staff should pay attention to preoperative psychological feelings in patients with the tibia and fibula fracture treated with 3D printing individualized external fixation, deal with a targeted psychological nursing and coping style, provide an effective nursing intervention and health education. further more optimize the 3D external fixation cost,and incorporate the 3D external fixation into the social medical insurance category.

Objective To observe the clinical effect of Jiawei Zuojin Pills combined with western medicine on reflux esophagitis with liver-stomach disharmony syndrome. Methods Totally 90 cases were divided into observation group (45 cases) and control group (45 cases). The control group was given rabeprazole sodium enteric-coated capsule and domperidone tablets, and the observation group was given Jiawei Zuojin Pills additionally for four weeks. The clinical effect, TCM syndrome score and endoscopic improvement were observed. Results The total effective rate of observation group was 95.5%(43/45), control group was 93.3%(42/45), with no significant difference between the two groups (P>0.05). The excellent rate of observation group was 77.8% (35/45), control group was 57.8% (26/45), with significant difference (P<0.05). TCM syndrome score was improved in both groups (P<0.001), and the degree of improvement in the observation group was better than control group (P<0.05). The total effective rate rate under endoscopic of observation group and control group was 96.5% (43/45) and 77.8% (35/45) respectively, with significant difference (P<0.05). Conclusion Jiawei Zuojin Pills combined with western medicine has obvious efficacy in treating reflux esophagitis with liver-stomach disharmony syndrome.