Objective To improve the knowledge of kartagener syndrome and the understanding of primary ciliary dyskinesia ( PCD) . Methods Three cases of Kartagener syndrome were reported and analyzed on clinical manifestations, symptoms, imaging appearances of chest, and family history. Meanwhile the related literatures were reviewed. Results The three patients deserved special recognition because of recurrent upper and lower respiratory tract infection. Of them, the third case showed mainly the symptoms of nasosinusitis at an early age, and the distinct pulmonary symptoms appeared in his adulthood. Further examination showed that the triad of chronic sinusitis, bronchiectasis, and situs inversus is present in all cases. The parents of the two cases were consanguineous marriaged. Examination of the bronchial mucosal biopsy specimen of the first case under transmission electron microscopy showed cilia with the absence of inner dynein arms. The three cases got improvement after treatment of anti-infection and expectorant. Conclusion For patients with recurring infection in the upper and lower respiratory tract from infancy, the possibility of PCD should be considered no matter whether a situs inversus exists.
目的 全面介紹先天性囊性腺瘤樣畸形(CCAM)其可能的病因，臨床、病理特點及診斷手段，循證探討針對CCAM的治療方法及預后。 方法 對我院2011年11月收治的1例罕見的CCAM患者的臨床資料進行分析，并對相關文獻進行復習。 結果 患者數次誤診后最終診斷為CCAM，予手術治療后痊愈，隨訪1年無復發。 結論 CCAM是一種少見的、非遺傳性的、錯構瘤樣的肺發育異常，為一種良性的肺部畸形，其特點是局部肺終末呼吸性細支氣管過度生長。CCAM多通過產前影像學檢查、活組織檢查或術后病檢診斷。手術為治愈該病的最根本、最重要措施。
目的 提高對外源性過敏性肺泡炎的認識。 方法 回顧分析2011年10月報道1例外源性過敏性肺泡炎（過敏性肺炎）患者的診斷及治療經過，總結其臨床特征、診療要點及預后評價。 結果 患者數次誤診后最終診斷為外源性過敏性肺泡炎，予脫離變應原及激素治療后痊愈，隨訪半年無復發。結論 該病臨床表現無特異性，需結合患者病史、臨床癥狀、血清學檢查、影像學表現，甚至肺泡灌洗液及肺活檢綜合判斷；脫離變應原為該病治療的最根本、最重要措施；對于病情嚴重患者，短期全身性使用糖皮質激素可縮短病程或改善癥狀。
Objective To investigate and analyze the difficulties of nosocomial infection management in different-level medical institutions in Shanghai, and to provide scientific basis for improving the level of nosocomial infection management. Methods A questionnaire was designed to include 10 difficulties in nosocomial infection management such as professional title promotion, salary, and personnel allocation. In October 2023, the Shanghai Nosocomial Infection Quality Control Center, in collaboration with the Shanghai Hospital Association, conducted a questionnaire survey among the heads of nosocomial infection management departments in medical institutions in Shanghai. The scores of difficulties were analyzed by stratification according to hospital level, allocation and changes of full-time personnel. Results A total of 548 questionnaires were distributed, and 530 valid questionnaires were retrieved, with a recovery rate of 96.72%. There were 55 public tertiary, 93 public secondary, 169 public primary and 213 social medical institutions. The rates of full-time personnel allocation meeting standards were 76.36% (42/55), 72.04% (67/93), 31.95% (54/169), and 21.60% (46/213), respectively. There was a statistically significant difference in the rates of full-time personnel allocation meeting standards among different levels of medical institutions (χ2=105.149, P<0.001). There was no statistical difference in the total scores of nosocomial infection management difficulties among different-level medical institutions (F=1.657, P=0.176). There were statistically significant differences in the scores of difficulties in professional title promotion, cumbersome daily norms and requirements, insufficient allocation of full-time personnel, and high personnel turnover (P<0.05). Conclusions The main difficulties in nosocomial management of medical institutions at all levels in Shanghai include the difficulty in career promotion, cumbersome daily norms and requirements, insufficient allocation of full-time personnel and lack of experience. In the future, medical institutions should strengthen the allocation of full-time personnel and enhance their capabilities, provide smooth promotion channels, to promote the high-quality development of nosocomial infection management ultimately.
Objective To investigate the current status of occupational environment support, occupational satisfaction, and job competence of hospital infection prevention and control personnel, and to explore the mediating effect of occupational satisfaction on the relationship between occupational environment support and job competence, in order to provide reference and guidance for effectively improving the job competence of hospital infection prevention and control personnel. Methods A survey questionnaire was distributed to various levels and types of medical institutions in Shanghai through the platform of the Shanghai Hospital Infection Quality Control Center. The questionnaire included the Occupational Environment Support Scale, Occupational Satisfaction Scale, and Job Competency Assessment Scale. The mediating effect of occupational satisfaction on the relationship between occupational environment support and job competency of hospital infection prevention and control personnel was analyzed. Results A total of 1027 hospital infection prevention and control personnel from 728 medical institutions participated in this survey, with 989 valid questionnaires and an effective response rate of 96.3%. There were statistically significant differences in the job competency scores of hospital infection prevention and control personnel based on gender, years of experience in infection control work, professional background, highest education level, professional title, job nature, type of medical institution, and annual income (P<0.05). The total score of job competence for hospital infection prevention and control personnel was 301.0 (267.5, 326.0), the total score of occupational environment support was 21.44±3.66, and the total score of occupational satisfaction was 19.25±2.78. The occupational environment support of hospital infection prevention and control personnel was positively correlated with occupational satisfaction and job competence (r=0.373, 0.339; P<0.001), and occupational satisfaction was positively correlated with occupational environment support (r=0.547, P<0.001). The mediating effect of job satisfaction on the occupational environment support and job competence was 0.085, accounting for 22.8% of the total effect. Conclusion Occupational satisfaction partially mediates the relationship between occupational environment support and job competence, and the mediating effect is significant.