护理学生临床实习前锐器伤预防的认知情况调查研究

Objective: To investigate the cognition of sharp injury prevention among nursing students before the clinical practice in order to provide a basis for corresponding measures and active measures. Methods: In July 2014, a total of 232 nursing students in 3 A grade Hospital of Guangzhou, from 30 colleges and universities of 8 provinces, were tested by self-made questionnaire in regard to sharp injury prevention knowledge. Results: The awareness rate of occupational exposure, occupational exposure prevention, Guideline for prevention and control for occupational exposure to bloodborne pathogen by National Health and Family Planning Commission 2009 was 28.94% and 13.71%, 1.01%; and the highest score of sharp instrument injury prevention knowledge was 22 points, the lowest score was 4 points, with an average of 15.92 ± 2.59 points. Sharp injury knowledge gained from school education accounts for 87.31%, but the students who have not received relevant education accounts for 3.05%. Conclusion: The overall situation of occupational exposures cognition is not optimistic, the master of sharp instrument injury prevention knowledge is not complete; and related curriculum in part of the schools is unreasonable, or receives poor effect. Some schools need to adjust the curriculum, strengthen the prevention knowledge of sharp injuries, occupational exposure to bloodborne pathogen. Hospitals need to strengthen pre-job training of nursing students and strengthen the clinical teaching work. Schools and hospitals need to jointly explore teaching mode for nursing students, so as to promote the students to master the sharp instrument injury prevention knowledge, the implementation of relevant measures of protection, and ensure the safety of students and patients. 目的  对护理学生临床实习前锐器伤预防的认知情况进行了解，以便为采取积极有效的应对措施提供依据。方法  采用自行编制问卷对2014年7月广州市某三甲医院来自全国8省30所高等院校的232名护理实习学生的一般资料和锐器伤认知情况进行调查并分析。结果  职业暴露、职业暴露后预防、国家卫计委2009《血源性病原体职业接触防护导则》知晓率为28.94%、13.71%、1.01%；锐器伤预防知识最高得分22分，最低得分4分，均数为（15.92±2.59）分。锐器伤知识来源于学校教育为87.31%，而未接受过相关教育者为3.05%。结论  研究对象对职业暴露认知总体情况不容乐观；锐器伤预防知识掌握不全；部分学校相关课程设置不合理或教育效果欠佳。部分学校需调整课程设置，加强锐器伤预防、血源性病原体职业接触防护等相关知识的教育，医院需强化护理实习生岗前培训，加强临床带教工作，学校与医院需探讨共同教导护理实习学生模式，从而促进学生掌握锐器伤预防相关知识，落实相关防护措施，保障患者和学生的安全

Performance of Different Combination Models of High-Risk HPV Genotyping in Triaging Chinese Women With Atypical Squamous Cells of Undetermined Significance

Objective: The purpose of this study was to evaluate the effect of different combination models of high-risk human papilloma viruses (HPV) genotyping in triaging Chinese women with atypical squamous cells of undetermined significance (ASCUS).Methods: We established a screening cohort of 3,997 Chinese women who underwent cervical cytology and HPV genotyping test. Women with ASCUS cytology underwent punch biopsy under colposcopy/endocervical curettage. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of different combination models of HR-HPV genotyping calculated that cervical intraepithelial neoplasia 2 or higher (CIN2+) on histology were endpoints.Results: Of the full sample, 393 women had ASCUS. Among ASCUS women with a CIN2 lesion, the prevalence for HPV were 40.0% (type 16), 10.0% (type 18), 0.0% (type 33), 30.0% (type 52), 40.0% (type 58), and 30.0% (other nine types). For ASCUS women with a CIN3 lesion, the prevalence for HPV were 68.4% (type 16), 15.8% (type 18), 10.5% (type 33), 31.6% (type 52), 15.8% (type 58), and 36.8% (other nine types). Combination model including HPV16/18/33/52/58 for predicting CIN2+ lesion in women with ASCUS had relatively higher sensitivity [93.1% (78.0, 98.1)], specificity [75.8% (71.2, 79.9)], PPV [23.5% (16.7, 32.0)], and NPV [99.3% (97.4, 99.8)] than other combination models. Moreover, the referral rate of HPV16/18/33/52/58 (29.3%) was lower than HR-HPV (36.1%).Conclusions: The study demonstrates that specific HR-HPV types HPV16/18/33/52/58 may be an effective strategy in ASCUS triage. This improves the subsequent selection of ASCUS patients