有限空间作业的危害特点

<正>有限空间作业通常是指在污水池、排水管道、集水井、地窖、化粪池、发酵池及槽罐、管道、反应塔等内部进行的作业。在这些环境中,作业场地狭小、通风不畅、照明不良、人员进出困难且与外界联系不便,因此存在一定的危险性。由于有限空间体积较小,处于半封闭状     

打通人体“堰塞湖”

人体泌尿系统就像一个复杂循环工程中的“排水管道系统”，许多人体毒素和代谢物质经由这条“管道”过滤分解排出体外。因而，也被人们形象地比作“排毒滤水终端”。然而，经过长期运转的“管道”，也会因为器官病变而产生“锈蚀”或堵塞，例如前列腺肥大以及膀胱结石。     

青光眼是不可逆的致盲性眼疾

青光眼是一种由于病理性眼压升高致使视力、视野、视神经等一系列视功能受损的致盲性眼病。对健康人来说,眼睛的房水系统像一个水龙头总是打开的洗涤槽,眼睛的引流管道就像与水槽连接的排水管道。如果洗涤槽正常工作,从龙头出来的水顺利迅速地从洗涤槽排出,就如眼睛的房水系统工作正常,房水生成量正好     

从一个案例看机电一体化设备的维修特点

机电一体化设备一般由机械主体、传感器及检测、计算机及信息处理、执行器四个部分组成。我院供应室使用的日本樱花MU-5030D清洗机属于机电一体化设备。其机械本体为机箱（包括箱体、电动门、旋转臂、载物架、电热器、超声换能器、蒸汽加热管等），还有进水、排水管道，进空气、排空气管道，进汽、排汽管道，电动门机构，压缩空气源及气动门密封机构，洗涤剂管道，等等。     

迎风流泪 与情绪无关的泪水

<正>经常听到很多人在抱怨"迎风流泪",尤其是在冬季更为严重。一开始许多人都是不治不管,直到越来越严重或者是发生了炎症才来看医生。泪道阻塞惹的祸人的泪液来自眼的外上方的泪腺,润湿眼睛表面后汇集于内眼角,经由泪道而流入鼻腔。正常情况下,泪液的排出和分泌处于一种动态平衡。泪道犹如房屋的排水管道,当过多的泪液无法从泪道排出时,就会有泪液集聚于眼睛表面,产生溢泪。在秋冬季节,冷空气刺激使眼睛的泪液     

急性液化石油气刺激反应23例分析

某石油化工公司液化石油气输送管线距附近居民居住区约500m。1999年5月1日在此周围安装排放污水管道及修建排水井,造成该公司石油气输送管线破损,液化气延排水管道逆行至附近平房居民家中。1999年6月初,有居民出现头晕、头痛、呕吐等症状,先后23名居民被送人我院观察治疗。经劳动卫生监测部门在居民家中检测,结果显示,室内空气中含有石油液化气成分。现将住院治疗的23例报告如下。     

军团菌的流行病学及检测技术研究进展

军团菌是一种常见的革兰氏阴性致病菌,广泛存在于天然淡水和人工水环境中,可导致非典型肺炎。世界多个国家和地区均有军团菌病（LD）的报道,培养分离获得军团菌菌株是确定军团菌感染的金标准。人感染军团菌主要是通过吸入被军团菌污染的气溶胶和污染水导致。目前检测方法多采用聚合酶链式反应（PCR技术）辅以尿抗原检测来确定是否感染军团菌。随着我国经济的快速发展,各种排水管道、空调、加湿器等大量使用,为军团菌的滋生创造了良好环境,增大了LD的发病率。加强饮水系统和室内空调系统的卫生管理,对有效地控制军团菌的传播途径十分必要。本文就军团菌病的流行病学、检测技术和预防控制等方面的进展作一综述。     

老年人体检，别忘做血管超声

人的血管好比家中的排水管道。天长日久，水管一会生锈，水中的杂质．污垢沉积到一定程度，就会造成管道堵塞。人的血管也是如此，在各种不良因素的长期作用下，原本光滑的管壁上会生出很多硬化斑块。当斑块形成并突起于管腔时，血管腔就会变窄。当斑块发生破裂、形成血栓后，就会导致脏器缺血，梗死。同时，部分斑块还可能会脱落，导致远处血管的栓塞，如脑栓塞、肺栓塞等。中老年人是动脉硬化的高发人群，定期做血管超声有助于早期发现血管病变。     

灭菌器故障停机检修的应急对策

2011年消毒供应室使用中的3台山东新华医疗出品的双扉平移门脉动真空灭菌器,出现进水排水管道、输气管道等故障及再生水系统需要更新等问题.决定对灭菌器进行停机检修,为慎重起见,这次检修视为大修,按照卫生部新规范标准执行各种监测,合格后方可启用. 1 启动应急预案 向院领导汇报,成立调度小组,由院办、医务科、设备科、护理部、感染科、供应室护士长组成,由供应室护士长担任总调度员,负责全局;利用3～4 d时间,安排在手术量相对较少的周五～日;确定厂方技术员、工程师等;利用院内网向全院简要告知,取得理解和配合.     

坑道水库建材对消毒剂的影响及对策

本文根据消毒剂稳定性及杀菌效果 ,从坑道水库储水长年低温的实际情况出发 ,选用二氯异氰尿酸钠作为储水消毒剂 ,进行了坑道储水的消毒研究〔1,2〕,发现坑道水库建材对消毒剂有效氯的影响。现报告如下。内容与方法　 (1)水库结构 :3个坑道水库 ,均采用普通水泥为材料 ,呈整体打筑结构。库底有铁制排水管道和泄水管道 ,从库口到库底有铁制固定扶梯 ,均已严重锈蚀 ,储水量为二位数吨级 ,储存时间在 10年以上。 (2 )有效氯检测方法 :采用中国预防医学科学院环境卫生监测所检测盒检测。 (3)硬化水泥对有效氯的影响 :将有效期内 42 5及 5 2 5标号…     

口腔综合治疗台安装前期须解决的问题

口腔综合治疗台需要连接进水、出水、压缩空气、负压抽吸和电源,治疗单元边柜上还有洗涤的进水、出水,电话线,数字图像信号和病人叫号等各种管道和线路,在新建和改造口腔门诊时这些问题需要综合考虑和合理布置。本文整理、总结和归纳了口腔综合治疗台安装前期需考虑的安装问题和相应的技术要求。     

The Israeli Study of Surgical Infections (ISSI): II. Initial comparisons among hospitals with special focus on hernia operations

In a study of 5,571 patients from the general surgery departments of 11 Israeli hospitals, the crude overall wound infection rates showed interhospital heterogeneity. The rates ranged from 6.3% to 12.4% (P(chi 2) = 0.039). Controlling for the different distributions of procedures performed in the various institutions did not reduce this variability. None of the hospitals had either consistently high or consistently low infection rates. A hospital could have low rates for one procedure and high rates for another. Therefore, the decision was made to proceed with procedure-specific analyses. This article details results of the analysis of 1,487 hernia operations. Four variables (old age, infection at another site, incarceration, and introduction of drains) accounted for almost all the differences in infection rates among the institutions. Of the four, presence of drains had the strongest association with infection (P derived from the logistic model less than 0.001). The risk was consistent in all hospitals and was unconfounded by other measurable factors. In contrast, the pattern of using drains seemed arbitrary and inconsistent, ranging from 9% of patients in one hospital to 41% in another. These findings were used as a basis for discussion with the surgical teams and for the initiation of a randomized clinical trial on the use of drains in hernia operations.     

Use of two teflon stents in malignant non-hilar biliary atresia

Insertion of biliary stents in cases of malignant biliary obstruction is a widely accepted method to resolve jaundice. The authors applied two 10 French biliary teflon stents to prolong the drain patency in 32 patients with distal malignant obstruction, thought to be inoperable at the time of intervention. Among the followed, inoperable 23 cases 14 patients died for the time of evaluation. The median survival was 150 days, the median drain patency was 99 days. Cholangitis was the cause of death in three patients. Repeated endoscopic interventions were: transient nasobiliary drainage without drain replacement in two patients and four changes of stents in three patients. In the 13 patients, surviving and wearing their drains at least for 100 days the patency of the double drains was 157 days. These results obtained in the long-time survivors support the comparability of the patency of double teflon stent to that of metalstents. In majority of cases the two teflon drains remained patent until the deaths of patients.     

四川省某镇井水污染状况调查

[目的]了解四川省某镇井水污染状况,包括污染物种类、含量及其与污染源间距离的关系。[方法]采用整群抽样方法,抽取95份井水水样,测定挥发酚、氯化物等6项指标。分别在造纸厂排污沟不同距离处采集沟水,同时采集离排污沟不同距离处3口井的井水作为样本,检测水中挥发酚、氯化物等指标水平及分析其与污染源距离间的相关性。[结果]95口井中有8口井的井水挥发酚浓度（0．007～0．010mg／L）超过我国生活饮用水标准0．002mg／L,占8．42％;其中1口井的井水中汞含量为0．04mg／L,超过国家饮井水标准,其余指标均合格。挥发酚与污染源间距离存在相关性,随距离的增加,挥发酚浓度下降,离排污沟100m以外的井水挥发酚浓度〈0．002mg／L,其他指标-9排污沟距离无相关性。[结论]该镇部分井水受到挥发酚污染,建议饮水井必须打在离排污沟100m以外,距排污沟100m以内的井水不可作为饮用水使用。     

Outbreak of waterborne hepatitis E in Hyderabad, India, 2005

A large outbreak of hepatitis E occurred in 2005 in Hyderabad, Andhra Pradesh, India. A total of 1611 cases were reported between 1 March and 31 December 2005 (attack rate 40/100,000). The epidemic curve suggested a continuing common source outbreak. Cases were centred around open sewage drains that crossed the old city. The attack rate was significantly higher in neighbourhood blocks supplied by water supply lines that crossed open drains (203/100,000) than in blocks supplied by non-crossing water pipes with a linear trend (38/100 000, P<0.00001). Crossing water pipelines were repaired and the attack rates declined.     

Molecular epidemiology of Pseudomonas aeruginosa in an intensive care unit.

Genotyping was used to analyse Pseudomonas aeruginosa isolates from sink drains and 15 intubated patients as part of a 3-month prospective study of strain transmission in a medical-surgical intensive care unit. Ninety percent of all washbasin drains were persistently contaminated with several P. aeruginosa genotypes. In 60% (9/15) of the patients, P. aeruginosa colonization or infection was hospital-acquired: P. aeruginosa strains isolated from these patients were present in hospital sinks or in other patients before their admission. Since all patients were immobile, personnel were the probable route of transmission of P. aeruginosa in the hospital. The mechanism of strain transmission from sinks to hands during hand washing was investigated in a children''s hospital. When P. aeruginosa was present at densities of > 10(5)/c.f.u. per ml in sink drains, hand washing resulted in hand contamination with P. aeruginosa via aerosol generation in the majority of experiments or P. aeruginosa was detected using an air sampler above the washing basin. High P. aeruginosa cfu were present at 4.30 h in the eight sinks (5.4 x 10(5)-7.0 x 10(10) c.f.u./ml), whereas at 13.00 h P. aeruginosa c.f.u. were significantly lower (3.1 x 10(2)-8.0 x 10(5) c.f.u./ml). These data reveal that the danger of bacterial contamination of hands during hand washing is highest in the morning. The identified transmission routes demand more effective hygienic measures in hospital settings particularly concerning personnel hands and sink drains.     

Intraoperative technique as a factor in the prevention of surgical site infection

Approximately five percent of patients who undergo surgery develop surgical site infections (SSIs) which are associated with an extra seven days as an inpatient and with increased postoperative mortality. The competence and technique of the surgeon is considered important in preventing SSI. We have reviewed the evidence on different aspects of surgical technique and its role in preventing SSI. The most recent guidelines from the National Institute for Health and Clinical Excellence in the UK recommend avoiding diathermy for skin incision even though this reduces incision time and blood loss, both associated with lower infection rates. Studies comparing different closure techniques, i.e. continuous versus interrupted sutures, have not found a statistically significant difference in the SSI rate, but using continuous sutures is quicker. For contaminated wounds, the surgical site should be left open for four days to allow for treatment of local infection before subsequent healing by primary intention. Surgical drains should be placed through separate incisions, closed suction drains are preferable to open drains, and all drains should be removed as soon as possible. There are relatively few large studies on the impact of surgical techniques on SSI rates. Larger multicentre prospective studies are required to define what aspects of surgical technique impact on SSI, to better inform surgical practice and support education programmes for surgical trainees.     

Effect of Subsurface Drains on Runoff Losses of Metolachlor and Trifluralin from Mississippi River Alluvial Soil

Subsurface drains reduced runoff losses of metolachlor and trifluralin from plots on Mississippi River alluvial soil planted with soybean. The drains reduced metolachlor runoff losses by 90% and trifluralin losses by 57%. Concomitantly, runoff volume was reduced 24% and soil erosional losses by 75%. The large reduction of metolachlor losses in runoff was due to a first event from the nondrained plot that was characterized by high chemical concentration, a characteristic that was not duplicated in the corresponding events from the drained plots. Due to low sediment concentrations in runoff and to low water solubility, trifluralin loss in runoff, even from the nondrained treatment, was less than 0.2% of the application. Received: 10 February 1996/Revised: 21 May 1996     

Complications and risks of suction drainage

After the introduction of Redon high-vacuum drainage, a considerable decrease in post-operative haematomas has been noted. But some of the complications could not be prevented by using the Redon system. They were in fact the result of it. The Redon system cannot be classified as a "closed" wound drainage. During bottle replacement, the system must be disconnected. An effective closed system must remain absolutely tight from application to removal of the drain so no possibility exists of contamination infection from the outside. After introduction of a continuously absolutely closed system in a prospective study with 3 different systems the influence after hip joint arthroplasty operations on wound healing was investigated. The wounds were drained with the Redon high-vacuum system or the newly developed, permanently closed drainage system with maximum obtainable low pressure of 80% vacuum and 50% vacuum. Here the maximum obtainable vacuum builds up slowly in relation to the accumulated amount of wound fluids. The loss of low pressure in Redon systems differs between the drains. In the intra-articular drains the mixture of air and blood results in a linear decrease and follows not a hyperbola like in subcutaneous drains. Because of the high suction at the beginning of the Redon drainage necrotic muscle cells adhere to the outside of the drain openings and clogs them up mechanically. The stronger the suction effect on the tissue, the more fatty live cells and small vessels enter the lumen of the drain in the Redon system and 80% vacuum. This mechanisms result in bleeding from the drain canal after removal of the drain and "secondary" haematomas. In the absolutely continuously closed system with maximum obtainable low pressure of 50% vacuum increased suction, lowered bleeding after removal of the drain and best healing results were observed. The 9.8% Cfu occurrence on Redon drains after removal found in the study is within the lower average figures given in literature while the 0.9% figure with both closed systems was never reached before.     

Residues of some organochlorine insecticides from some water bodies,their toxicity to mosquito larvae Culex pipiens pipiens and influence on mitochondrial ATPase of Bolti fish Tilapia niloticus

Residues of organochlorine insecticides were extracted from several water bodies, including irrigation canal, main drain, collector drains, brackish water of Bitter lake, and tap water around Ismailia, Egypt. Hexachloro cyclohexane (HCH) isomers were the most prevailing compounds detected. Highest residue concentration was detected in collector drains. Residues have shown an inductive effect on mitochondrial ATPase extracted from gills, liver and brain of Bolti fish Tilapia niloticus. Ouabrain, the potent Na‐K‐ATPase inhibitor has cancelled out the inductive effect residues inflected on gills and brain ATPase. The toxicity of the different organochlorine extracts to 3 ^rd instar larvae of Culex pipiens pipiens varied according to the source of residue.