To understand the current situation of occupational exposure to blood-borne pathogens in a women's and children's hospital and analyze the causes to provide a scientific basis for improving occupational exposure prevention and control measures. We analyzed occupational exposure to blood-borne pathogens in a third-class women's and children's hospital from 2015 to 2018, considering the workers’ occupational categories and length of service; the sites, types, and causes of exposure; and the pathogens of the source patients. From 2015 to 2018, there were 146 cases of occupational exposure to blood-borne pathogens, mainly from sharp-instrument injuries (81.5%; 119/146). Trainees represented the highest proportion of occupational exposure (30.1%; 44/146), followed by nurses (29.5%; 43/146). Occupational exposure among staff with less than one year of service accounted for 43.2% (63/146) of cases. Fisher's exact test showed that different occupational groups had different types of occupational exposure, and among the occupationally exposed populations, the proportion of sharp injuries is higher than that of blood and body fluid exposure, and the difference is statistically significant (χ2 = 12.937, P = 0.008). Different occupational groups faced exposure to different types of pathogens: medical staff were more likely than workmen to be exposed to hepatitis B, while workmen were more likely than medical staff to be exposed to unknown pathogens; these differences were statistically significant (χ2 = 55.344, P < 0.001). Health records were established for all cases of occupational exposure to blood-borne pathogens, and no staff members contracted a blood-borne disease due to occupational exposure. In order to reduce occupational exposure, regular training in occupational protection for junior medical staff and workers should be strengthened, the monitoring and protection system of occupational exposure to blood-borne pathogens improved, standard prevention measures strengthened, operations standardized, safe injection equipment provided, and comprehensive measures taken.

Aims To expand the evidence base for the clinical use of metformin, we conducted a meta-analysis of randomized controlled trials (RCTs) comparing the efficacy and safety of metformin versus insulin with respect to short-term neonatal outcomes. Methods A comprehensive search of electronic databases (PubMed, Embase, Cochrane Library, and Web of Science) was performed. Two reviewers extracted the data and calculated pooled estimates by use of a random-effects model. In total, 24 studies involving 4355 participants met the eligibility criteria and were included in the quantitative analyses. Results Unlike insulin, metformin lowered neonatal birth weights (mean difference − 122.76 g; 95% confidence interval [CI] − 178.31, − 67.21; p < 0.0001), the risk of macrosomia (risk ratio [RR] 0.68; 95% CI 0.54, 0.86; p = 0.001), the incidence of neonatal intensive care unit admission (RR 0.73; 95% CI 0.61, 0.88; p = 0.0009), and the incidence of neonatal hypoglycemia (RR 0.65; 95% CI 0.52, 0.81; p = 0.0001). Subgroup analysis based on the maximum daily oral dose of metformin indicated that metformin-induced neonatal birth weight loss was independent of the oral dose. Conclusions Our meta-analysis provides further evidence that metformin is a safe oral antihyperglycemic drug and has some benefits over insulin when used for the treatment of gestational diabetes, without an increased risk of short-term neonatal adverse outcomes. Metformin may be particularly useful in women with gestational diabetes at high risk for neonatal hypoglycemia, women who want to limit maternal and fetal weight gain, and women with an inability to afford or use insulin safely.

BackgroundIn December 2019, the cases of pneumonia of unknown etiology emerged in Wuhan, China, and rapidly spread throughout the country. The disease was later designated by the World Health Organization (WHO) as Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). Few studies have assessed the clinical characteristics of COVID-19 and control strategies used to mitigate disease spread in high-altitude plateau regions of China.Study ObjectiveTo assess the impact of real-world strategies to control COVID-19 spread in remote plateau regions.MethodsA retrospective study was performed to assess the epidemiology of COVID-19 and strategies used to control disease spread in the high-altitude plateau of Sichuan, China from 24 January 2020 to 19 March 2020.ResultsCOVID-19 spread and outbreaks in Sichuan were attributed to mass gatherings. A total of 70 patients and 20 asymptomatic individuals were found in the hypoxic plateau region of Sichuan. Twelve patients were admitted after the onset of symptoms, while 58 patients and 20 asymptomatic individuals were found by active screening. The symptomatic patients included those with uncomplicated illness (16/70, 22.9%), mild pneumonia (44/70, 62.9%), and severe pneumonia (10/70, 14.3%). Most patients in the study area showed relatively mild and atypical symptoms such as low or no fever and dyspnea. The incidence of severe pneumonia, fever, dyspnea, and interstitial abnormalities identified by chest CT were all significantly lower in screened patients than those admitted after symptom onset (P &lt; 0.05). Severe pneumonia was noted in patients with chronic conditions like hypertension, diabetes etc. as compared to less severe pneumonia in healthy subjects (P &lt;0.05). No patients died and all were eventually discharged.ConclusionMass gatherings increased risk of spread of SARS-CoV-2 responsible for COVID-19. Active screening and early management have collectively contributed to reduced incidence of severe pneumonia and satisfactory prognoses of infections with COVID-19 in this hypoxic plateau region.

Background To understand the current situation of occupational exposure to blood-borne pathogens in a women's and children's hospital and analyze the causes to provide a scientific basis for improving occupational exposure prevention and control measures.Methods We analyzed occupational exposure to blood-borne pathogens in a third-class women's and children's hospital from 2015 to 2018, considering the workers’ occupational categories and length of service; the sites, types, and causes of exposure; and the pathogens of the source patients.Results From 2015 to 2018, there were 146 cases of occupational exposure to blood-borne pathogens, mainly from sharp-instrument injuries (82.2%). Trainees represented the highest proportion of occupational exposure (30.1%), followed by nurses (29.5%). Occupational exposure among staff with less than one year of service accounted for 43.2% of cases. Fisher's exact test showed that different occupational groups had different types of occupational exposure, and nurses had the highest proportion of blood and body fluid exposure (P = 0.008). Different occupational groups faced exposure to different types of pathogens: medical staff were more likely than workmen to be exposed to hepatitis B, while workmen were more likely than medical staff to be exposed to unknown pathogens; these differences were statistically significant (P<0.001). Health records were established for all cases of occupational exposure to blood-borne pathogens, and no staff members contracted a blood-borne disease due to occupational exposure.Conclusions In order to reduce occupational exposure, regular training in occupational protection for junior medical staff and workers should be strengthened, the monitoring and protection system of occupational exposure to blood-borne pathogens improved, standard prevention measures strengthened, operations standardized, safe injection equipment provided, and comprehensive measures taken.

Background To understand the current situation of occupational exposure to blood-borne pathogens in a women's and children's hospital and analyze the causes to provide a scientific basis for improving occupational exposure prevention and control measures.Methods We analyzed occupational exposure to blood-borne pathogens in a third-class women's and children's hospital from 2015 to 2018, considering the workers’ occupational categories and length of service; the sites, types, and causes of exposure; and the pathogens of the source patients.Results From 2015 to 2018, there were 146 cases of occupational exposure to blood-borne pathogens, mainly from sharp-instrument injuries (82.2%). Trainees represented the highest proportion of occupational exposure (30.1%), followed by nurses (29.5%). Occupational exposure among staff with less than one year of service accounted for 43.2% of cases. Fisher's exact test showed that different occupational groups had different types of occupational exposure, and nurses had the highest proportion of blood and body fluid exposure (P = 0.008). Different occupational groups faced exposure to different types of pathogens: medical staff were more likely than workmen to be exposed to hepatitis B, while workmen were more likely than medical staff to be exposed to unknown pathogens; these differences were statistically significant (P<0.001). Health records were established for all cases of occupational exposure to blood-borne pathogens, and no staff members contracted a blood-borne disease due to occupational exposure.Conclusions In order to reduce occupational exposure, regular training in occupational protection for junior medical staff and workers should be strengthened, the monitoring and protection system of occupational exposure to blood-borne pathogens improved, standard prevention measures strengthened, operations standardized, safe injection equipment provided, and comprehensive measures taken.