全血中杀鼠迷的高效液相色谱-电喷雾电离质谱联用法测定研究

目的:建立简便、准确、灵敏的测定全血中痕量杀鼠迷的高效液相色谱-电喷雾电离质谱检测方法。方法:全血样品经乙酸乙酯萃取,以甲醇+0.1%乙酸(50+50)为流动相,采用XDBC18柱(150mm×2.1mm×5μm)分离,通过电喷雾电离离子化技术及选择性离子检测(SIM)进行测定,定量分析离子为m/z:293[M+H]+。结果:线性范围为1.00～50.0μg/L,定量检测下限为0.50μg/L,方法回收率在90.8%～102.7%,RSD均小于10%。结论:该法操作简便、快速、灵敏、准确,适用于中毒病人的中毒诊断分析。     

高效液相色谱-电喷雾电离质谱联用法测定水中痕量五氯酚研究

目的建立简便、灵敏、准确的测定水中痕量五氯酚的固相萃取-高效液相色谱-质谱联用的检测方法,并用于生活饮用水、渔塘水中痕量五氯酚的污染监测。方法水样经Oasis HLB小柱富集,以甲醇-甲基叔丁基醚(10+90)洗脱,采用甲醇和2mmol/L醋酸铵溶液为流动相进行梯度淋洗,以ZORBAXEclipseXDB-C18柱( 150mm×2 1mm×5μm)分离,通过选择性离子检测(SIM)及电喷雾电离离子化技术进行测定。结果线性范围为5 0μg/L~500 0μg/L,定量检测下限为5 0ng/L,方法回收率在82 8% ~108 5%,RSD均小于10%。结论该法灵敏度高、操作简便、快速,适用于实际样品的测定。     

蜂蜜中4种氟喹诺酮残留的高效液相色谱-质谱测定

目的:建立蜂蜜中氧氟沙星、恩诺沙星、双氟沙星、沙拉沙星4种氟喹诺酮残留的高效液相色谱-质谱联用检测方法。方法:样品经磷酸盐缓冲液稀释、溶解后,用Waters Oasis MAX小柱进行净化、提取,Cloversil-C18柱(150 mm×4.6 mm×5μm)分离;流速:0.5 ml/min;柱温:30℃;流动相:乙腈/0.05%三氟乙酸(25/75,v/v);通过电喷雾电离离子化在选择离子监测(SIM)模式下测定,氧氟沙星、恩诺沙星、双氟沙星、沙拉沙星定量分析离子m/z:362.0[M+H]+、360.1[M+H]+、400.0[M+H]+和386.0[M+H]+,外标法定量。结果:在0.50~100.0μg/kg范围内4种目标化合物均呈良好的线性关系,平均回收率大于95.3%,RSD均小于3.5%,检出限为0.5μg/kg。结论:本法简便、灵敏、重现性好、特异性强,是蜂蜜中4种氟喹诺酮残留检测的有效方法。     

高效液相色谱-质谱联用法测定饮料中人工合成色素的研究

目的:建立简便、灵敏、准确的测定饮料中日落黄,柠檬黄,胭脂红,苋菜红和亮蓝等5种人工合成色素的高效液相色谱-质谱检测方法。方法:饮料样品经聚酰胺粉吸附后,过滤,酸性水洗水溶性杂质,甲醇-甲酸洗天然色素,再用水洗至中性,用乙醇-氨解吸色素,用水溶解,定容,以甲醇+乙酸铵为流动相,采用梯度淋洗,用ZORBAXSBC18柱(150mm×2.1mm×5μm)分离,通过选择性离子检测(SIM)及电喷雾电离离子化(ESI)进行测定,定量分析离子日落黄m/z:203.0;407.0,柠檬黄m/z:198.0;467.0,胭脂红,苋菜红m/z:268.0,537.0,亮蓝m/z:373.0,747.0。结果:方法平均回收率88.2%,RSD在3.58%～8.25%范围。结论:该法分离效果好,检测灵敏度高,操作简便,适用于饮料中色素的检测,此法也同样适用于其他食品中色素检测。     

HPLC/MS法测定全血中大隆和氟鼠酮的研究

目的:建立全血中同时测定大隆、氟鼠酮的高效液相色谱-质谱联用检测方法。方法:血液样品经乙酸乙酯提取后,采用XDB C18柱(150 mm×2.1 mm×5μm);流速:500μl/m in;柱温:30℃;流动相:甲醇+0.2%乙酸(88+12,v/v);通过电喷雾电离离子化在选择离子监测(SIM)模式下测定,定量分析离子大隆m/:z 523[M-H]-;氟鼠酮m/z:541[M-H]-,外标法定量。结果:在0.005~1.0 mg/L范围内两者均呈良好的线性关系,大隆、氟鼠酮的平均回收率分别为91.9%和87.6%,RSD分别为5.0%和5.1%,定量检出限分别为0.062和0.051 ng。结论:本方法简便、灵敏、重现性好、特异性强,能满足大隆和氟鼠酮中毒病人的诊断要求。     

高效液相色谱-串联质谱测定鸡肉中氟喹诺酮类药物残留的研究

目的:建立鸡肉中培氟沙星、单诺沙星、双氟沙星、氧氟沙星、诺氟沙星、沙拉沙星、环丙沙星、恩诺沙星和司帕沙星等9种氟喹诺酮类药物残留的高效液相色谱-串联质谱检测方法.方法:样品经磷酸盐缓冲液提取后,用Waters Oasis (R) MAX小柱进行净化、提取,Cloversil-C18柱(150mm×4.6 mm i.d,5μm)分离;柱温:30℃;流动相:甲醇/乙腈/0.2%甲酸(15/15/70,v/v/v);通过电喷雾电离离子化在多离子监测(MRM)模式下测定.结果:各氟喹诺酮在0.05～50.0 μg/kg范围内均呈良好的线性关系,相关系数>0.998,回收率在89.0%～110.0%之间,相对标准偏差(RSD)在2.8%～9.1%之间,检出限均为0.05 μg/ks.结论:所建方法简便、快速、干扰少、特异性强,是鸡肉中9种氟喹喏酮残留检测的理想方法.     

高效液相色谱法测定蔬菜中精喹禾灵残留研究

目的:建立快速、简便、灵敏的蔬菜中精喹禾灵残留的高效液相色谱检测方法。方法:蔬菜样品经甲醇/丙酮/盐酸溶液提取,通过中性氧化铝和弗罗里硅土的混合柱净化,在XDB C8(150 mm×4.6 mmi.d.,5μm)色谱柱上,以甲醇/乙酸-乙酸铵溶液(10 mmol/L,pH 6.2,80/20,v/v)为流动相,流速为0.8 ml/min,柱温为35℃,紫外检测波长为235 nm。结果:蔬菜中精喹禾灵的平均回收率在83.2%-94.2%范围,RSD小于5.5%,线性范围为0.5-50.0 mg/L(r=0.9992)。结论:建立的方法用于蔬菜中精喹禾灵残留的测定,具有操作简便、快速、准确的优点。     

高效液相色谱法测定血浆中米非司酮研究

目的:建立血浆中米非司酮的高效液相色谱测定法。方法:血浆样品中米非司酮以醋酸乙酯提取后,以SB C18(250 mm×4.6 mm×5μm)为分析柱,采用甲醇-乙腈-水(55∶25∶20)为流动相,流速1.0 m l/m in,紫外法检测,检测波长为302 nm,外标法定量。结果:血浆中米非司酮在0.05~5.0μg/m l浓度范围内呈良好的线性,其检出限为0.01μg/m l,平均回收率为98.4%,日内和日间精密度(RSD)分别小于8.5%和13.4%。结论:建立的方法用于血浆中米非司酮的测定,操作简便、灵敏、快速,可用于临床的检测。     

高效液相色谱法测定奶粉中磷脂酰胆碱含量研究

目的:建立应用高效液相色谱-紫外检测器测定奶粉中磷脂酰胆碱(PC)含量的方法。方法:奶粉中PC经乙醚萃取后,采用XDB C18(150 mm×4.6 mm×5μm)色谱柱,以乙腈∶甲醇∶异丙醇=10∶80∶10(v/v/v)为流动相,流速为1.0 m l/m in,柱温为35℃,UV 208 nm检测。结果:奶粉中PC的平均回收率为86.4%,RSD为3.21%(n=6),线性范围为0.050~0.40 mg/m l(r=0.9990)。结论:建立的方法用于奶粉中PC含量的测定,操作简便、快速。     

LC/MS/MS电喷雾正负离子切换同时检测动物组织中的性激素

目的:固相萃取高效液相色谱-串联质谱电喷雾正负离子切换同时测定禽畜组织中已烯雌酚(DES)、甲基睾酮(MET)、丙酸睾酮(TES)的残留量。方法:样品经甲醇提取,Alltech Extract-clean columns C18,200 mg/6 ml小柱净化和富集。通过Waters SunFireTMC183.5μm 100×2.1 mm色谱柱分离,流动相为:甲醇∶水=85∶15(V/V),ES-、ES+切换,MRM方式测定,外标法定量。结果:最低检出限分别为:已烯雌酚0.15μg/kg;甲基睾酮0.15μg/kg、丙酸睾酮0.33μg/kg;回收率在94.5%～105%之间,相对标准偏差3.2%～10.2%。结论:该方法操作简便、快捷,是动物组织激素残留的快速而准确的检测方法。     

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.     

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。     

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。     

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。     

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。     

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。     

244株真菌鉴定结果分析

目的 了解某院2000～2001年各类真菌的检出率。方法 用酵母样真菌同化试验编码鉴定板TH-15进行编码鉴定。结果 真菌分离率为8．85％；244株真菌分为10种，其中以白色念珠菌和热带念珠菌较高，分别占真菌总数的75．41％和11．47％；检出真菌的主要标本是痰和阴道分泌物。结论 及时进行真菌培养，有利于合理使用抗菌药物和控制真菌感染。