QuEChERS法提取液相色谱柱后衍生荧光法测定蔬菜和水果中21种N-甲基氨基甲酸酯类农药及其代谢产物残留

目的：建立测定蔬菜和水果中常见的21种N-甲基氨基甲酸酯类农药及其代谢产物残留的液相色谱柱后衍生荧光检测方法。方法：10 g样品用10 ml乙腈快速提取、无水氯化钠和无水硫酸镁盐析后，经Carb/PSA双层SPE柱固相萃取净化，液相色谱柱后衍生荧光法检测。结果：21种N-甲基氨基甲酸酯类农药及其代谢产物的加标回收率在62%-95%，相对标准偏差在2.7%-9.2%之间，检出限在0.002-0.005 mg/kg。结论：本法灵敏、准确，适合于蔬菜和水果中N-甲基氨基甲酸酯类农药及其代谢产物多残留分析。     

柱后衍生-高效液相色谱-荧光检测法测定土壤中氨基甲酸酯农药

目的建立柱后衍生一高效液相色谱一荧光检测法测定土壤中7种氨基甲酸酯类农药残留的方法。方法土壤样品经初筛后用乙腈一氯化钠萃取,用丙酮及二氯甲烷(1:1)混合溶剂作淋洗剂,经过Florisil SPE柱纯化,淋出液经氮吹蒸近干后用甲醇溶解,所得溶液用柱后衍生-高效液相色谱-荧光检测法进行定性及定量分析。结果此方法的检出限在0.001 mg/kkg-0.01 mgkg之间,回收率和相对标准偏差(RSD)范围分别为88.80%-101.10%和1.30%-6.10%。结论所建立的方法符合方法学要求并可应用于土壤环境监测工作。     

高效液相色谱-串联质谱法测定植物源性食品中4种噻唑类杀菌剂

目的:建立一种应用高效液相色谱-串联质谱(HPLC-MS/MS)同时测定植物源性食品中4种噻唑类杀菌剂的新检测方法。方法:采用乙腈提取试样中的噻唑类杀菌剂残留,提取液经浓缩,Sep-pack Vac复合固相萃取小柱净化,用HPLC-MS/MS进行定量分析。结果:4种噻唑类杀菌剂得到良好分离,方法的线性范围为20μg/L～100μg/L,检出限均为10μg/kg,回收率为64%～115%,相对标准偏差(RSD)为2.8%～12.5%。结论:实验结果表明,该方法简便、快速、灵敏、准确,各项技术指标满足检测植物源性食品中4种噻唑类杀菌剂的监测需求。     

饮用水中12种有机磷及氨基甲酸酯类农药残留量的气相色谱-质谱测定法

目的建立饮用水中12种有机磷及氨基甲酸酯类农药残留量的气相色谱-质谱测定法。方法以二氯甲烷-石油醚(体积比为4∶1)为萃取剂进行萃取,采用气相色谱-质谱法同时测定了饮用水中12种有机磷和氨基甲酸酯类农药的含量。结果在0.01～1.0μg/ml内,12种农药的回归方程线性关系良好,相关系数均>0.997,平均回收率为76.0%～111.0%,RSD为5.20%～9.20%,以3倍信噪比计算检出限,敌敌畏、异丙威、灭害威、抗蚜威、马拉硫磷、禾草丹、倍硫磷、对硫磷、溴硫磷、除草通、灭螨蜢、三硫磷的检出限分别为0.009、0.003、0.008、0.001、0.003、0.003、0.0025、0.009、0.005、0.010、0.010、0.006μg/ml。结论该方法简便、快捷,结果准确,灵敏度高,适用于饮用水中12种有机磷和氨基甲酸酯类农药残留量的同时检测。     

高效液相色谱法紫外检测器串联荧光检测器同时测定血浆中10种抗凝血类杀鼠剂

目的:建立同时测定血浆中10种抗凝血类杀鼠剂的高效液相色谱方法。方法:血浆样品经乙腈超声提取后,采用甲醇 40 mmol/L乙酸铵梯度洗脱,在XBridge C18柱上实现10种杀鼠剂完全分离,紫外检测器串联荧光检测器实现高灵敏检出,外标法定量。结果:加标回收率在73%~112%之间,测定的相对标准偏差在2.4%~8.6%。对于4-羟基香豆素类杀鼠剂,方法检出限在1~2 ng/ml;对于茚满二酮类杀鼠剂检出限为20 ng/ml。结论:本法灵敏度高,操作简单,适合于中毒病人的诊断检测。     

固相萃取-气相色谱质谱联用法测定尿中邻苯二甲酸酯类代谢物

目的建立固相萃取-气相色谱质谱联用法测定尿液中邻苯二甲酸单甲酯、邻苯二甲酸单乙酯、邻苯二甲酸单丁酯、邻苯二甲酸单2-乙基己酯、邻苯二甲酸单苄酯等5种邻苯二甲酸酯类代谢物的方法。方法尿液通过β-葡萄糖苷酶酶解,固相萃取小柱净化,三氟化硼乙醚甲醇溶液衍生,最后通过DB-5毛细管色谱柱(30m×0.25 mm,0.25μm),气相色谱质谱联用法测定。结果该方法在25.0~1000μg/L浓度范围内,5种邻苯二甲酸酯的浓度与峰面积的线性关系良好,相关系数为0.9989~0.9996,方法检出限为10.0~15.0μg/L;在空白样品中添加15.0、200和500μg/L三个浓度水平,平均回收率为80.2%~97.8%,相对标准偏差为4.2%~10.2%(n=6)。采用该方法对81位孕妇的尿液进行了检测,检出率为98.7%。结论固相萃取-气相色谱质谱联用法适用于尿液中5种邻苯二甲酸酯类代谢物的同时检测。     

同时测定大豆中二苯醚类除草剂的多残留

[目的]建立同时测定大豆中苯达松、三氟羧草醚、氟磺胺草醚、苯草醚、甲羧除草醚、精恶唑禾草灵、除草醚、乙羧氟草醚、乙氧氟草醚9种二苯醚类除草剂多残留量的高效液相色谱分析方法。[方法]将样品中的二苯醚类除草剂用乙腈提取、凝胶色谱和Florisil固相萃取小柱净化后,经C8色谱柱分离,采用二极管阵列检测器检测。[结果]对样品的提取、净化及液相色谱的分离条件进行了优化。待测9种二苯醚类除草剂在0.10～10.0mg/L质量浓度范围内呈良好的线性关系,相关系数r=0.9971～0.9998,方法的精密度RSD为1.49%～4.65%,在0.05～0.5mg/kg的添加水平范围内,加标回收率为75.4%～101.9%,方法的检出限(S/N=3)为6.9～36μg/kg。同时对待测除草剂的液相色谱-质谱确证实验进行了研究。[结论]所建立的方法简便、快速,适用于大豆中9种二苯醚类除草剂残留量的同时测定。     

QuEChERS-气相色谱-质谱联用法测定育发类化妆品中的斑蝥素

目的建立QuEChERS-气相色谱-质谱法测定育发类化妆品中斑蝥素的分析方法。方法用丙酮溶解样品,超声、离心后取上清液,加入分散固相萃取吸附剂(PSA粉末、GCB粉末和无水硫酸镁)净化,冷冻离心后取上清液浓缩,供气相色谱-质谱分析。结果斑蝥素在浓度0.1~2.5μg/mL范围线性良好(r2=0.999 5),在0.1~2.5μg/g添加水平回收率为86.0%~92.8%,相对标准偏差(RSD)为5.2%~7.3%;检出限(LOD)为0.02μg/g,定量限(LOQ)为0.08μg/g。结论该方法能有效去除育发类化妆品中的复杂基质,灵敏度高,定性、定量准确,可满足测定基质复杂的育发类化妆品中斑蝥素检测的需要。     

固相萃取-高效液相色谱测定水中5种磺酰脲类除草剂

[目的]本文建立了同时测定水中5种磺酰脲类除草剂的固相萃取-高效液相色谱分析方法.[方法]水样中5种除草剂(甲磺隆、氯磺隆、苄嘧磺隆、苯磺隆、吡嘧磺隆)的残留经C18固相萃取小柱萃取,采用高效液相色谱法,用C18色谱柱分离,以乙腈:0.001mol/L盐酸(55:45,v/v)为流动相,等度洗脱,紫外检测器在波长为230nm处测定.[结果]对样品前处理和色谱分离条件进行了优化,5种除草剂的质量浓度在0.05～2.00mg/L范围内其浓度与峰面积呈良好的线性关系(r=0.998～0.9999).自来水与河水样品的加标平均回收率为73.0%～99.4%,相对标准偏差(RSD)为1.45%～4.15%;对于100.0ml水样,本方法的检出限为0.30～0.70μg/L.[结论]本法简便、快速、准确、灵敏度高,能满足环境水样中5种磺酰脲类除草剂残留分析要求.     

气相色谱串联质谱法检测饮用水中酰胺类除草剂残留

目的建立固相萃取—气相色谱串联质谱法检测饮用水中毒草胺、二甲吩草胺、乙草胺、甲草胺、杀草丹、异丙甲草胺、丁草胺和丙草胺8种酰胺类除草剂的方法。方法水样经过活化后的C_(18)固相萃取柱,用乙腈-甲苯(3∶1,V/V)混合溶液洗脱,利用DB-5 MS石英毛细管柱分离,气相色谱串联质谱仪在多反应监测模式(MRM)下定性定量分析。结果 8种酰胺类除草剂在(1.0～200)μg/L范围内线性关系良好,相关系数在0.999以上,方法检出限在(0.14～0.32) ng/L之间。在3个加标浓度水平(0.005、0.025和0.1μg/L)下,回收率为75.8%～106.6%,相对标准偏差(RSD)为1.3%～6.2%。将建立的方法应用于实际样品的检测,水样中可检出目标物。结论该方法简单快速,灵敏度和准确度高,能满足生活饮用水中常见酰胺类除草剂的检测。     

长春新碱过量引起严重毒副反应1例的护理体会

报道1例霍奇金淋巴瘤患者因误用长春新碱（VCR）10mg一次性静脉推注后治疗护理情况。其出现间断性神志恍惚、眼睑闭合不全、言语不清、口腔黏膜糜烂、全身疼痛、麻痹性肠梗阻、尿潴留、手足麻木等症状,经积极解救,禁食,持续胃肠减压、胃管内注入麻油、开塞露、生理盐水灌肠,合理应用肠外营养,注重疼痛、心理护理,做好口腔、肛周护理,预防感染加重,患者病情得到控制好转出院。     

Correlates of stages of change of smoking among inhabitants of deprived neighbourhoods

BACKGROUND: This study examines the prevalence and correlates of stages of change of smoking, in terms of psychosocial, structural and sociodemographic factors, among inhabitants of deprived neighbourhoods. METHODS: Cross-sectional data were obtained from a survey on health related behaviour. Subjects were 2009 current and former smokers, aged 20-46, living in deprived neighbourhoods in Rotterdam, the second largest city in the Netherlands. Three groups of smokers were formed according to the stages of change-definitions of the Transtheoretical Model: smokers not planning to quit (precontemplators), smokers planning to quit (contemplators/preparators) and former smokers (actors/maintainers). Smokers planning to quit and smokers not planning to quit were compared regarding psychosocial factors (attitude, social norm, self-efficacy), structural factors (neighbourhood problems, material deprivation, financial problems, employment status) and sociodemographic factors (age, gender, marital status, cultural background, educational level). Former smokers were compared with smokers planning to quit regarding structural and sociodemographic factors. Logistic regression was used to assess correlates of stages of change. RESULTS: Smokers planning to quit (prevalence = 19%) reported a more positive attitude, stronger social norms and higher self-efficacy expectations in quitting smoking than smokers not planning to quit (prevalence = 57%). Smokers planning to quit less often were Dutch-born, more often had attended higher vocational schooling or university and more often reported experiencing two or more neighbourhood problems compared to smokers not planning to quit. Former smokers (prevalence = 24%) were older, more often Dutch-born, married, employed and higher educated, compared to smokers planning to quit. Furthermore, former smokers less often reported material deprivation and financial problems than smokers planning to quit. CONCLUSION: Among people living in deprived neighbourhoods, different factors correlate with different stages of change of smoking. Implications for health promotion are discussed.     

Choice of measures of vaccination and estimates of risk of pediatric pertussis

BackgroundVaccination uptake at the individual level can be assessed in a variety of ways, including traditional measures of being up-to-date (UTD), measures of UTD that consider dose timing, like age-appropriate vaccination, and risk reduction from individual doses. This analysis compared methods of operationalizing vaccination uptake and corresponding risk of pertussis infection.MethodsCity-wide case-control study of children in Philadelphia aged 3 months through 6 years, between 2001 and 2013. Multiple logistic regression was used to isolate the independent effects of each measure of vaccination uptake and the corresponding relative odds of pertussis.ResultsBeing UTD on vaccinations was associated with a 52% reduction in risk of pertussis (OR 0.48, 95% CI: 0.34, 0.69). Evaluation of delayed receipt of vaccine versus on-time UTD yielded similar results. There was a decrease in risk of pertussis for each additional dose received with the greatest reduction in pertussis infection observed from the first (OR 0.48, 95% CI: 0.28, 0.83) and second dose (OR 0.17, 95% CI: 0.08, 0.34). Additional doses conferred minimal additional protection in this age group.ConclusionExamining vaccination status by individual doses may offer improved predictive capacity for identifying children at risk for pertussis infection compared to the traditional UTD measure.     

上海市某医院骨科平均住院日影响因素分析

对上海市某医院2003年-2007年骨科出院病人的住院日描述性分析．2003年-2007年骨科的床位利用指数与平均住院日相关性分析．2003年-2007年骨科床位与医护比例分析．2007年骨科前10大病种平均住院目影响因素分别进行单因素相关性分析和多因素逐步回归分析（STATA软件）。通过对骨科10大病种住院日影响因素分析,术前等待天数、手术类型、是否输血分别对10个、9个和8个病种的住院目有影响。输血因素和手术类型是医院不可控、由病人的病情决定的,术前等待天数是管理因素,是最值得医院重视的影响因素。     

两种不同肌瘤剔除术治疗子宫肌瘤的临床疗效比较

目的:比较腹腔镜子宫肌瘤剔除术与腹式子宫肌瘤剔除术的临床疗效。方法:回顾分析63例腹腔镜子宫肌瘤剔除术与61例腹式子宫肌瘤剔除术的临床资料,比较2种手术方式的手术时间、术中出血量、肛门排气时间、使用抗生素时间、术后感染率、体温恢复正常时间、住院时间等情况。结果:两组患者接受子宫肌瘤剔除术顺利完成,腹腔镜组手术时间长于开腹组(P0.05),腹腔镜组术中出血量及剔除肌瘤个数均少于开腹组(P0.05),术后腹腔镜组体温恢复正常时间、肛门排气时间、抗生素使用及住院时间均短于开腹组,两组患者最多随访6个月,腹腔镜组平均康复时间较开腹组短(P0.05),两组随访B超均未发现明显肌瘤结节。结论:腹腔镜子宫肌瘤剔除术损伤小,恢复快,住院时间短,是值得推广的微创手术。     

尘肺病患者145例死因调查

目的分析汉中市尘肺病的发生、发展和死亡原因，以提高尘肺病患者的生存质量。方法对145例尘肺病患者的死因进行回顾性分析，计算其平均发病年龄、死亡年龄及患尘肺病后的存活年限。结果矽肺的平均发病年龄和死亡年龄均早于煤工尘肺和石棉肺，尘肺病的主要死因为患肺部疾患，患尘肺病后的平均存活年限为12a。结论加强职业健康体检工作，对尘肺病人做到早发现早治疗和预防并发症的发生。     

性发育异常发病机制的研究进展

正常的性腺分化可分为3个过程：原始性腺形成、性别决定和卵巢/睾丸发育。在任一环节中,基因表达或调控发生异常均有可能导致性发育异常疾病的发生。性发育异常是指染色体、性腺和解剖性别不典型。随着分子生物学技术的发展,不断地发现新的基因或信号通路参与性腺分化和发育,如SRY、SF1、WT1、Sox9等基因与睾丸发育密切相关,Wnt/Rspo1/B连环蛋白通路、Dax1、Foxl2等基因在卵巢分化中发挥着重要作用,一些非编码RNA和转化生长因子也有重要的调节功能,且睾丸和卵巢发育均为主动过程,即使在出生后因某些基因的改变两者间也可出现横向分化。这些为揭示性分化异常的发病机制提供了可能。     

One-year stability of the Measure of Processes of Care

BACKGROUND: The Measure of Processes of Care (MPOC) is a 56-item self-administered measure designed to examine what parents of a child with a chronic health problem think of the services they and their child receive, and to measure the extent to which these services are family-centred. Reliability and validity of the MPOC were established in prior studies. The aim of the present study was to assess the 1-year stability of the MPOC to justify its use as an evaluative tool. METHODS: Nine paediatric rehabilitation centres in the Netherlands participated in this short longitudinal survey study. Subjects were 205 parents (response rate 74.8%) of children aged 1-18 years who received care in one of the participating paediatric rehabilitation centres. All subjects filled out two MPOCs with a 1-year interval. RESULTS: All correlations between the scale scores of the MPOC at the first and second administration were relatively high and significant (range: 0.443-0.609, all P < 0.001), demonstrating high inter-individual stability. However, all mean scale scores, except for Providing General Information, significantly reduced after 1 year. CONCLUSIONS: The MPOC has a moderate 1-year stability. However, because of its tendency to score lower when repeated after 1 year, its use as an evaluative follow-up instrument to assess the effectiveness of a programme intervention is restricted.     

儿童皮质发育畸形的MRI诊断

目的探讨儿童皮质发育畸形(MCD)的MRI表现特点,为MCD的早期诊断提供依据。 方法选择2010年1月至2012年12月在四川省医学科学院·四川省人民医院放射科经MRI检查确诊为MCD的44例患儿为研究对象。回顾性分析及总结其MRI影像学特征。本研究遵循的程序符合四川省医学科学院·四川省人民医院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象及其监护人知情同意,并与监护人签署临床研究知情同意书。 结果本组44例经MRI确诊为MCD患儿中,巨脑回-无脑回为17例,多小脑回为14例,灰质异位为9例,脑裂畸形为4例。MCD的MRI特点中,巨脑回表现为脑回增宽、皮质增厚及白质变薄;无脑回表现为正常脑沟、脑回消失,皮质增厚及白质变薄;多小脑回表现为脑回增多、细小;灰质异位表现为皮质下及侧脑室周围深部白质区结节状、团块状或带状病灶,信号与灰质信号相同;脑裂畸形表现为从侧脑室到脑表面贯穿大脑半球的裂隙,表面覆盖灰质。 结论MRI是诊断儿童MCD的可靠影像学方法。     

西林瓶装注射用水的装量检查分析

为了检查西林瓶装注射用水的实际分装量是否符合2005年版《药典》三部要求,按照2005年版《药典》三部中“生物制品分装和冻干规程”,分装规格为0．8ml的西林瓶装注射用水10000瓶,随机在分装过程的前、中、后阶段共抽取100瓶,轧盖、目检。分别用1ml标定注射器及1ml普通无菌注射器抽取每瓶注射用水的实际体积,以t检验法对实际抽取量与标示量的差值进行统计学分析,结果显示其与2005年版《药典》三部要求分装附加量为0．1ml相比有显著性差异（P〈0．001）。