连台手术空气污染的预防与控制

目的了解在无层流设备的手术室进行连台手术时空气污染状况,探讨手术室空气消毒的措施,降低手术病人刀口感染率。方法采用平板沉降法,对处于相对静止洁净状态下和连台手术间隙空气消毒前后的手术间进行空气采样。结果手术间在相对静止洁净状态下空气细菌总平均含量为(120.45±35.21)cfu/m3(WHO规定标准为≤200 cfu/m3),连台手术间隙空气消毒前检测结果为(520.63±151.19)cfu/m3,采用多功能动态杀菌机对连台手术间隙空气进行30 m in消毒后监测结果为(172.34±45.37)cfu/m3。经t检验:(1)连台手术空气消毒前与空气处于相对静止洁净状态下比较,差异有统计学意义(P<0.01);(2)连台手术间隙空气消毒前、后监测结果比较,差异有统计学意义(P<0.01);(3)连台手术间隙空气消毒后与空气处于相对静止洁净状态下比较,差异无统计学意义(P>0.05)。结论无层流设备的手术室连续进行2台手术间隙空气污染严重,采用多功能动态杀菌机进行空气消毒可提高手术间洁净度。     

某地下人防工程夏季环境卫生情况调查与评价

目的调查长期密闭人防工程在人员进驻后微小气候、空气中总悬浮颗粒物 (TSP)浓度与细菌总数的变化 ,为改善工程内环境质量提供科学依据。方法测定某地下人防工程在人员进驻前后 2个房间内的气温、相对湿度、气压、空气中TSP浓度及细菌总数。结果无人进驻时 ,工程内的气温为 2 2 .3℃ ,相对湿度为 72 .5 % ,风速为 0m·s- 1,空气中TSP浓度 1号房间为 1.4 9mg·m- 3,2号房间为 0 .31mg·m- 3,细菌总数为 90 0cfu·m- 3。人员进驻一定时间后 ,气温 1号房间由 (2 2 .3± 0 .9)℃升为 (2 3.4± 0 .4 )℃ ,2号房间由 (2 2 .8± 0 .6 )℃升为 (2 3.9± 0 .3)℃ ;相对湿度 1号房间由通风换气后的 (6 6 .6± 2 .2 ) %升为 (74 .3± 2 .6 ) % ,2号房间由 (6 6 .3± 2 .7) %升为 (75 .5± 4 .9) % ;风速 1号房间为 (0 .12± 0 .0 4 )m·s- 1,2号房间为 (0 .11± 0 .0 5 )m·s- 1;空气中TSP浓度 1号房间为 (0 .34± 0 .19)mg·m- 3,2号房间为 (0 .6 3± 0 .2 0 )mg·m- 3;空气中的细菌总数 1号房间为 (1114± 6 2 9)cfu·m- 3,2号房间为 (14 0 3± 76 8)cfu·m- 3。结论某地下人防工程内无人进驻时的气温较低 ,人员进驻以后气温有所升高 ,相对湿度较高 ,风速接近于零 ,未达标准 ,空气中TSP浓度严重超标 ,细菌总数较     

空气动态消毒对手术室空气质量的影响

手术室不但要求器械达到灭菌,工作人员操作严格无菌,更重要的是手术室环境的消毒一定要达到标准,而手术室空气环境的洁净度是引起手术切口感染的重要因素之一,若空气消毒效果不好将影响手术切口延期愈合和手术治疗效果。为了解手术过程中微生物动态变化对医院感染的影响,本院手术室于2010年1月～2012年12月开展手术室空气动态和静态消毒效果监测,为做好医院感染控制工作提供依据,现报道如下。     

上海市区6～11岁儿童营养不良状况Z分法分析

【目的】　分析上海市区小学生营养不良流行现状。　【方法】　①收集上海市 12个区 3 1所小学 2 5 981名学生 (男 13 2 2 0 ,女 12 761) 1999年 5月测得的身高、体重及出生年月资料。②采用标准差单位法即Z分法作营养状况评估 ,凡身高和体重测量值的Z分值在 < 2和≥ 3之间为中度 ,凡 < 3为重度。　【结果】　① 6～ 11岁男女童HAZ分均值和标准差分别为 0 .0 3± 1.16、0 .0 3± 1.15 ,WAZ分均值和标准差分别为 0 .2 6± 1.2 3和 0 .2 1± 1.2 4,WHZ分均值和标准差分别为 0 .2 2± 1.2 3和 0 .2 0± 1.2 8。②男女童中、重度生长迟缓分别共有 474例 (3 .8% )和 44 4例 (3 .5 % ) ,两者性别差异无明显性 (χ2 =0 .3 4,n’ =1,P =0 .5 6) ;男童中、重度体重低下率为 0 .2 % ,明显低于女童 0 .4% (χ2 =12 .73 ,n’=1,P =3 .6× 10 4) ;男女童中、重度消瘦分别有 61例 (0 .5 % )和 85例 (0 .7% ) ,有明显性别差异 (χ2 =4.48,n’ =1,P =0 .0 3 4)。③男女童中生长迟缓合并体重低下者分别有 15例和 3 3例 ;体重低下合并消瘦者分别有 2例和 13例 ;3种营养不良同时存在者分别有 2例和 6例。　【结论】　上海市区 6～ 11岁男女童按Z分法评估 ,显示急性慢性中、重度营养不良流行程度较低。     

福建省建筑材料天然放射性水平调查分析

[目的 ]分析福建省建材中天然放射性水平 ,并探讨建材辐射水平与人体的外照射有效剂量关系。 [方法 ]采集全省建材 2 6类2 75个样品 ,按规定方法分析测定样品中天然放射性核素含量。 [结果 ] 1建材原料中各种核素均值 2 2 6 Ra为 (79.0± 87.3) Bq· kg- 1 ,2 32 Th为 (40 .2± 38.3) Bq· kg- 1 ,4 0 K为 (383.2± 371 .6) Bq· kg- 1 ,Ra当量浓度均值为 (1 61 .4± 1 32 .8) Bq· kg- 1 ,空气吸收剂量率均值为(1 7.9± 1 3.7)· 1 0 - 8Gyh- 1 ,建材原料对人体的外照射有效剂量均值为 (52 0 .6± 41 9.7)μSv/ a。 2成品建材中 2 2 6 Ra含量为 (69.1± 37.7)Bq· kg- 1 ,2 32 Th为 (96.6± 66.7) Bq· kg- 1 ,4 0 K为 (459.3± 41 7.8) Bq· kg- 1 ,Ra当量浓度为 (2 1 3.7± 1 0 9.5) Bq· kg- 1 ,空气吸收剂量率为 (2 3.4± 1 0 .9)· 1 0 - 8Gyh- 1 ,成品建材对人体的外照射有效剂量为 (683.9± 350 .8)μSv/ a。 3装璜材料中 2 2 6 Ra含量为 (63.0± 2 8.1 )Bq· kg- 1 ,2 32 Th为 (44.9± 46.0 ) Bq· kg- 1 ,4 0 K为 (479.9± 355.2 ) Bq· kg- 1 ,Ra当量浓度为 (51 4 .6± 359.3) Bq· kg- 1 ,空气吸收剂量率为 (2 0 .5± 1 5.2 )· 1 0 - 8Gyh- 1 ,装璜材料对人体的外照射有效剂量为 (51 4 .6     

DX—01B型臭氧消毒机对空气微生物消毒效果观察

臭氧消毒是医院常用空气消毒方式之一 ,但其受臭氧浓度、相对温度和湿度等诸多因素的影响。为观察其杀菌效果 ,我们采用ＤＸ - 0 1Ｂ型臭氧消毒机对室内空气进行了消毒试验 ,结果报告如下。1　内容与方法　选择某部卫生所治疗室为试验现场 ,房间容积 54ｍ3。将房间门窗用胶带密封 ,用ＤＸ- 0 1Ｂ型臭氧消毒机 (洛阳高新泰润电子有限责任公司生产 )对房间消毒。臭氧发生量 10 0 0ｍｇ·ｈ 1。试验期间空气温度 (Ｔ) ( 16± 0 .5)℃ ,相对湿度 (ＲＨ)30 %～ 4 0 %。消毒前后分别用ＦＡ -Ｉ型 6级撞击式空气微生物采样器 (辽阳应用技术研究所产…     

2种消毒方法对手术室空气消毒效果的比较观察

室内空气消毒有多种方法 ,如紫外线、臭氧、化学熏蒸或喷洒等 ,但是均不能在有人存在的情况下使用。如何保持医院内高危易感科室特别是手术过程中手术室的空气持续消毒与洁净是一个十分重要的课题 ,我们选用上海某品牌ＭＫＪ160 0型医用空气消毒洁净器对手术室内空气动态消毒效果进行了检测 ,现将结果报告如下。1　方法1 1　实验现场及设备　选择彭州市人民医院 90ｍ3 大小的一手术室、二手术室 2间 ;一手术室内安置ＭＫＪ160 0型消毒洁净器 1台 ;二手术室采用原有的紫外线灯管消毒 (辐射强度均大于 10 0ｃｍ2 )。1 2　采样及布点　依据《消…     

脊柱手术过程中空气细菌含量的动态分析

目的 研究骨科脊柱手术过程中空气细菌含量动态变化.方法 采用沉降法监测脊柱手术过程中空气细菌含量,即在手术前、切皮时、缝合时、手术结束时的细菌含量.结果 脊柱手术过程中细菌含量具有两个明显的峰值,分别是手术开始时和手术结束后.结论 医院手术室在手术过程中空气细菌总数的变化出现了两个明显的高峰,人员的活动是影响手术室手术过程中空气细菌总数变化的主要因素.     

幼儿头发中微量元素含量与儿童多动症关系研究

对 360 4名 1～ 7岁儿童头发中微量元素与儿童多动症 (MBD)的关系进行研究。结果表明 ,正常儿童头发中 Zn(81 .95± 1 8.45× 1 0 -6)含量明显高于多动症儿童头发中 Zn(79.1 7±1 9.31× 1 0 -6,P<0 .0 5)含量。多动症儿童头发中 Mn(1 .90± 0 .96× 1 0 -6)、Pb(1 3.60± 7.1 6×1 0 -6)含量非常显著地高于正常儿童头发中 Mn(1 .79± 0 .84× 1 0 -6,P<0 .0 0 1 )、Pb(1 2 .65±7.61× 1 0 -6,P<0 .0 0 1 )含量。正常女性儿童头发中 Zn(81 .2 5± 1 8.45× 1 0 -6)含量明显高于女性多动症儿童头发中 Zn(78.48± 1 8.76× 1 0 -6,P<0 .0 5)。正常男性儿童头发中 Zn(82 .61±1 8.1 7× 1 0 -6)含量明显高于男性多动症儿童头发中 Zn(79.92± 1 9.52× 1 0 -6,P<0 .0 5)。男性多动症儿童头发中 Fe(30 .69± 5.1 5× 1 0 -6)、Mn(1 .95± 1 .0 0× 1 0 -6)、Pb(1 4.1 0± 7.45×1 0 -6)含量明显高于正常男性儿童头中 Fe(2 9.96± 5.2 2× 1 0 -6,P<0 .0 1 )、Mn(1 .82± 0 .91×1 0 -6,P<0 .0 1 )、Pb(1 3.49± 7.88× 1 0 -6,P<0 .0 5)含量。女性儿童多动症发病率占总人数的6%左右 ,男性儿童多动症发病率占总人数的 1 4%左右     

免疫接种乙型肝炎病毒外膜小S蛋白产生的细胞免疫反应

目的　研究BALB/c(H 2 d)小鼠免疫接种乙型肝炎病毒 (HBV)外膜小S蛋白 (HBVsmallSenvelopeprotein,S HBsAg)产生的细胞免疫反应。方法　BALB/c(H 2 d)小鼠腹腔接种 0～ 5 μg的S HBsAg ;4周后分离脾淋巴细胞 ,体外分别用特异性多肽、S HBsAg刺激 ,分别用51Cr释放实验3 H掺入实验检测细胞毒T淋巴细胞 (cy totoxicTlymphocyte,CTL)及辅助T淋巴细胞 (helperTlymphocyte,HTL)增殖实验。结果　CTL反应的靶细胞自然释放率 ,自然释放 /最大释放 ,平均数±标准差为 (2 8 76± 13 4 5 ) % ;分别接种 0 ,0 6 5 ,1 2 5 ,2 5 ,5 μgS HB sAg的BALB/c(H 2 d)小鼠脾淋巴细胞CTL特异性释放率 (平均数±标准差 )分别为 (31 2 1± 9 2 3) % ,(4 2 36±19 32 ) % ,(91 2 1± 2 2 97) % ,(6 9 2 5± 2 4 l3) % ,(5 1 4 9± 2 1 6 6 ) % ,均高于作为对照的 0组小鼠脾淋巴细胞CTL释放率 ,差异有统计学意义 (P <0 0 5 ) ;HTL增殖实验 ,用S HBsAg刺激的 0 6 5～ 5 μg实验组BALB/c(H 2 d)小鼠脾淋巴细胞cpm值 (平均数±标准差 )分别为 3830 2 4± 14 96 12 ,2 736 19±12 38 0 6 ,4 10 0 37±172 3 74 ,12 4 6 18± 10 88 88,均高于未用S HBsAg刺激的对照组BALB/c(H 2 d)小鼠脾淋巴细胞cpm值 ,差异有统计学意义 (P     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.