浅谈医疗综合楼设计中的节能措施

在医院建设中，医疗综合楼建设量越来越多，其特点是人员流动性强、功能分区多，能耗高。因此从建设前期规划和方案设计时就应该注重节能设计，其后各个设备专业都从节能方面出发，进行施工图设计，以达到较好的节能效果。本文分析了医疗综合楼的特点和能耗特点，从建筑设计、空调通风、电气、水等各系统中分析系统节能设计的措施，并对节能效果进行了分析。     

电气设计在山东省中医院门诊病房综合楼的应用

山东省中医院门诊病房综合楼是山东省中医院精心打造的一个绿色医疗建筑项目,在设计阶段就定位于绿色医疗建筑。依据《绿色建筑评价标准》的要求,从建筑场地、环境噪声、照明功率、产品选型等方面阐述了绿色建筑电气设计在山东省中医院门诊病房综合楼的应用。     

现场

新疆维吾尔自治区人民医院门诊病房综合楼封顶 西北五省区卫生系统最大的单体医疗建筑项目——新疆维吾尔自治区人民医院门诊病房综合楼10月20日封顶，预计2014年底投入使用。     

千佛山医院门诊医技综合楼设计和施工中的体会

为了适应日益发展的医疗需求,解决住院紧张的现状,改善就医条件,很多医院将门诊、医技功能相结合,建设门诊医技综合楼。文章从工程设计特色、工程施工管理和技术创新、工程取得的成果等方面出发,具体阐述了山东省千佛山医院门诊医技综合楼设计和施工中的体会,为建设门诊医技综合楼的医院提供了全面有效的建设经验。     

合理的医疗流程是人性化医院建筑的首要表现

医疗建筑设计的人性化是专业工程设计人员不断追求的目标,也是医院建设发展的最终归宿。各种人工智能系统和医用机器人的开发利用,提高了医疗质量和人民健康水平,但同时使用者（患者、访客、工作人员）对就医环境、工作环境也提出了新的、更高的要求,使“以人为本”之人性化设计成为医疗建筑设计的热门话题。本文通过对兰州大学第二医院医疗综合楼医疗流程的分析,探讨“人性化”在医疗建筑中的内涵,以提高医院服务的品质。     

医院气动物流传输系统的应用

医院的时空资源有限,人流、物流的矛盾十分突出。气动物流传输系统以其造价低、速度快、噪音小、运输距离长、清洁方便、使用频率高、占用空间小等特点,成为目前最受欢迎的医院物流传输方式。本院于2007年10月在门诊楼、医疗综合楼和医疗辅助楼安装了SUMETZBERGER（舒密）AC-110型气动管道传送系统。设置了1个中心站、2个传输区、     

儿科危急值自动化报告系统的临床应用

目的 分析儿科危急值自动化报告系统的应用效果.方法 建立危急值报告系统,对人工报告流程与自动化报告流程进行接收时间、医疗干预时间比较.结果 危急值自动化报告流程的接收时间(Z=-11.33)与医疗干预时间(Z=-10.22)均明显缩短(P＜0.01).结论 儿科危急值自动化报告系统保证了危急值处理的及时性,简化了报告流程,提高了工作效率及患者就医质量.     

医用直线加速器机房的防护应用研究

我院在市区广盈街东侧建造医疗综合楼,WDVVE6/100医用电子直线加速器及WD-HDR18近距离遥控后装治疗机适合安排在医疗综合楼的地下室。 利用直线加速器及后装机治疗肿瘤,是当前医学领域的一种极为有效的手段。但这两种机器在运行时。会释放出γ射     

医疗电子设备接地系统设计探讨

医疗电子设备接地系统的设计问题,一直备受关注。文章结合济南市历下区人民医院综合楼医疗电子设备接地系统的设计,阐述了医疗电子设备接地、等电位联结形式的选择及做法,并对在设备安装和使用过程中容易出现的问题进行了分析。     

室内空间采用宁静设计概念——天津北辰医院设计特色

天津北辰医院是一所社区医院,新建的医疗综合楼约60000m2,500张床位,紧邻京津高速,集医疗、教育和研发为一体.     

The Varieties of Dignity

As a part of a research project on Dignity and Older Europeans (Fifth Framework (Quality of Life) Programme3) I explore in this paper a set of notions of human dignity. The general concept of dignity is introduced and characterized as a position on a value scale and it is further specified through its relations to the notions of right, respect and self-respect. I present four kinds of dignity and spell out their differences: the dignity of merit, the dignity of moral or existential stature, the dignity of identity and the universal human dignity (Menschenwürde). Menschenwürde pertains to all human beings to the same extent and cannot be lost as long as the persons exist. The dignity of merit depends on social rank and position. There are many species of this kind of dignity and it is very unevenly distributed among human beings. The dignity of merit exists in degrees and it can come and go. The dignity of moral stature is the result of the moral deeds of the subject; likewise it can be reduced or lost through his or her immoral deeds. This kind of dignity is tied to the idea of a dignified character and of dignity as a virtue. The dignity of moral stature is a dignity of degree and it is also unevenly distributed. The dignity of identity is tied to the integrity of the subject's body and mind, and in many instances, although not always, also dependent on the subject's self-image. This dignity can come and go as a result of the deeds of fellow human beings and also as a result of changes in the subject's body and mind.     

The health promotion implications of the knowledge and attitude of employees in relation to health and safety leaflets

Selected aspects of the efficacy of printed leaflets produced by a government health and safety agency and widely distributed by the enforcement bodies and other organisations to promote workplace health and safety are examined. It is based on a study of 30 small or medium-sized enterprises and examines the views of 120 employers and employees regarding the availability, attractiveness, relevance and usefulness of the leaflets and estimates the reader comprehension and readability of the selected leaflets. The results indicate that the selected leaflets are considered acceptable and comprehensible by the majority of respondents. As these are typical of the leaflets available in the health and safety field this is a positive outcome. The discussion focuses around the ability of the leaflets to engage and to inform and suggestions are made to encourage a wider debate on the criteria which contribute to these two aspects of leaflet use. It is contended that leaflets will continue to be important in the attempts of those involved in workplace health and safety to facilitate learning and to contribute to the overall process of behaviour change. This study raises a number of key issues regarding the future design and use of such leaflets.     

氟硒镉致大鼠睾丸脂质过氧化及微量元素变化

目的 探讨氟硒镉对大鼠睾丸脂质过氧化及微量元素变化的影响。方法 将氟硒镉经饮水染毒大鼠，10周后检测睾丸中脂质过氧化物（LPO）和谷胱甘肽过氧化物酶（GSH—Px）及镉硒锌铁的含量。结果 与对照组比较，氟、镉组LPO含量明显增高，GSH—Px显著降低，硒组没有明显改变。任意二联及三联时LPO含量较氟硒镉单独组明显降低，GSH—Px明显增高。各实验组硒无明显变化，氟组的镉硒锌铁也无明显改变，镉组的镉、铁显著增高，硒组、氟硒组的锌、铁显著增高，镉硒、氟镉以及氯硒镉组的镉、铁里明显升高。结论 氟、镉可引起大鼠睾丸脂质过氧化作用增强。抗氧化酶活性降低，硒的影响甚微。当三者任意二联时可降低脂质过氧化作用，三联时作用更强。硒可降低镉在睾丸中的蓄积，同时提高硒、锌水平，氟硒镉均可引起睾丸中铁水平升高，并有协同作用。     

2015—2016年自贡市中小学生近视流行现况与教室环境卫生关联性分析

目的了解2015—2016年自贡市中小学生近视的流行现况及教室环境卫生状况,为近视的预防及后期进行影响因素研究提供线索。方法利用2015-2016年自贡市中小学生常见病和教学与生活环境卫生监测工作终期数据,分析7～18岁中小学生近视检出情况,利用2×2列联表的关联性分析探索教室环境监测评价综合结果与学生近视之间关系。结果2015-2016年中小学生近视检出率分别为44.9%、53.4%,重度近视占近视的比例分别为62.8%、69.4%;2016年近视检出增长率为18.7%,其中重度近视检出增长率最大。城区中小学生近视检出率高于乡村,女生近视检出率高于男生,城乡学生近视检出率均随着学习阶段递增而增加,差异均有统计学意义(均P＜0.05);教室环境监测评价综合得分低的学校学生近视检出率高(P＜0.05,Ф＞0)。结论自贡市中小学生近视检出情况较严重,不容乐观,应加强中小学近视筛查并采取干预措施;中小学教室环境卫生监测项目达标低,可能是导致学生近视高检出率的原因之一,应完善相关教学设施的建设。     

低硒、低碘模型大鼠F_2代生殖功能评价

目的探讨硒、碘缺乏模型动物对F2代雌性、雄性生殖功能的影响。方法采用自制人工合成饲料,利用SD大鼠建立低硒、低碘及硒碘联合缺乏动物模型,确定动物模型建立成功后,利用该模型进行大鼠的三代繁殖试验及模型稳定性监测。观察F2代模型大鼠精子形态、血清睾酮、睾丸和附睾组织病理及透射电镜超微结构的改变;检测F2代模型孕鼠生育指标、胎仔骨骼及内脏发育指标,探讨硒、碘缺乏对F2代模型动物雌性、雄性生殖功能的影响。结果经各项指标检测,三代繁殖试验中动物模型稳定性良好。通过对雄性F2代模型动物大鼠的精子形态学指标、血清睾酮含量的检测及睾丸、附睾组织病理形态学、超微结构透射电镜观察,低硒、低碘及硒碘联合缺乏均可引起雄性F2代模型动物的生殖功能损伤。通过对雌性F2代模型动物妊娠鼠体重、胚胎发育及其F3代胎仔骨骼、内脏发育的检测,低硒、低碘及硒碘联合缺乏均可引起雌性F2代模型动物生殖功能损伤。结论低硒、低碘及硒碘联合缺乏均可引起F2代模型动物生殖功能损伤。     

重症监护中心患者感染病原菌及耐药谱分析

目的探讨某院重症监护中心(ICU)患者感染病原菌种类、对常用抗菌药物耐药谱等,为临床和医院感染科管理提供第一手资料。方法采用K-B法对28种常用抗菌药物进行耐药率测定、纸片扩散初筛和确证试验检测ESBLs、并进行MRSA、MRCNS和VRE测定。结果在201份阳性标本中共培养出264株菌,其中G-杆菌192株,占72.7%,主要为PAE、ABA、KPN、ECO和SMA;G 菌43株,占16.3%,主要为EC、SAU和CNS;真菌29株,占11.0%,主要为白色念珠菌;病原菌抗药性强,G-杆菌对IPM、AZT、CAZ、FEP、CFS、AMK、CIP不同程度敏感,G 菌对VAN、SXT、RIF、NIF不同程度敏感;KPN、ECO的ESBLs为64.7%和64.3%、MRSA80.0%、MRCNS 66.7%、VRE 22.2%。结论ICU患者感染病原菌以G-杆菌为主,提示临床医生提高标本送检率,控制抗菌药物滥用,降低细菌耐药性,提高治愈率。     

低氧对子宫内膜异位症影响的研究进展

子宫内膜异位症（EMs）是育龄期女性最常见的妇科疾病之一,是具有恶性行为的良性疾病,可发生于全身各个部位。导致EMs的危险因素众多,主要包括内分泌、遗传、环境和免疫因素。目前EMs的病因仍然未知,近年来有研究表明缺氧是EMs发生的驱动力,缺氧可以通过3个方面影响EMs的发生和发展,一是缺氧过度激活环氧合酶2/前列腺素E₂（COX-2/PGE₂）而上调类固醇激素生成酶,因此促进雌激素生成,同时缺氧降低雌激素受体α（ERα）与ERβ的比值和孕激素受体（PR）,改变类固醇激素的作用效率;二是缺氧激活血管内皮生长因子（VEGF）、血管生成素（Ang）等血管生成因子促进异位病灶快速形成血管,为异位病灶生长提供氧气及营养物质;三是缺氧干扰EMs细胞的正常自噬过程,促进其发生侵袭、转移。综述缺氧参与EMs的发病机制以及相关治疗,以期为临床诊断、治疗提供新视角。     

Arsenic speciation transported through the placenta from mother mice to their newborn pups

The primary goal of the present study was to confirm the arsenic species that can be transferred from the mother to the bodies of newborn pups through the placenta and the speciated arsenic distribution in the liver and brain of newborn mice after gestational maternal exposure to inorganic arsenic (iAs). Mother mice were exposed to iAsIII and iAsV in drinking water during gestation. The livers and brains of the mother mice and their newborn pups were taken. Contents of iAs, monomethylarsonic acid (MMA), dimethylarsinic acid (DMA), and trimethylarsenic (TMA) compound were detected using the HG-AAS method. Contents of iAs, MMA, and DMA in the liver of mother mice increased with the concentration of arsenite or arsenate in their drinking water. However, only DMA increased with the concentration of arsenate or arsenite in the drinking water in the brain of mother mice. On the other hand, contents of both iAs and DMA in the liver and brain of newborn mice increased with the concentration of arsenate or arsenite administered to their mother orally. Contents of arsenic species in the liver and brain of both mother mice and their newborn pups were significantly lower in the 10 ppm iAsV group than in the 10 ppm iAsIII group. Ratios of iAs or DMA levels between the brain and the liver of newborn mice were larger than 1, whereas those in mother mice were much smaller than 1. iAs taken from drinking water was distributed and metabolized mainly in the liver of mother mice. iAsIII in low levels may be taken up and metabolized easily in the liver compared to iAsV. Both iAs and DMA are transferred from the mother through the placenta and cross the immature blood-brain barrier (BBB) easily. Compared to that in the liver of newborn mice, DMA as an organic metabolite is prevalent in brain, a lipidic organ, if the BBB is not matured enough to prevent it from entering the brain.     

Major chemical incidents: bridging the occupational--public health gap

Increasing awareness and concern about possible long-term health effects of exposure to chemicals after major chemical incidents has opened up a new area of public health activity. However, progress is hampered by a lack of low level exposures in potentially highly susceptible subgroups of the populations, and by a lack of expertise in public health. The challenge is to extend the toxicological and epidemiological experience developed in the occupational setting to the community level. To better define the problem population surveillance of acute chemical hazards, first set up in Wales, has been extended throughout the UK, and is also being piloted internationally. Further work is needed to address specific problems of the epidemiological follow-up of populations exposed, the assessment of the psychological consequences at the community level, and risk perception and communication. Organisational arrangements for the public health management of incidents and their sequelae must move beyond short-term funding and market competition and must incorporate the expertise of the occupational disciplines.     

青少年痛经与子宫内膜异位症的关系

子宫内膜异位症(endometriosis,EMs)是女性常见的妇科疾病,痛经、慢性盆腔痛及不孕是其主要临床表现.EMs的发病机制尚不清楚,但EMs相关暴露因素和发生、发展可贯穿女性一生,对女性生命健康造成严重的负面影响.痛经是青少年女性最常见的月经症状,EMs是青少年继发性痛经最常见的原因.青少年痛经与EMs的诊断密...