介人放射学防护装置的设计与防护效果

[目的 ]通过设计和制造防护装置 ,对介入用X线机采取防护措施 ,达到对介入医师有效防护的目的。 [方法 ]根据介入用X线机的具体情况 ,对手术现场X射线辐射区域进行分析 ,设计制造出有效的防护装置 ,并检测各种介入手术防护前后的辐射剂量 ,观察其屏蔽效率。 [结果 ]设计制造的“十”字形纵横屏蔽装置 ,对介入手术者身体主要部位的照射剂量由 10 0 ,3 0 0 μGy/h分别降至 0 .3 ,2 μGy/h ,屏蔽效率为 76.9%～ 99.9%。[结论 ]该装置设计合理 ,适用性强 ,防护效果好 ,适于推广使用     

胸腹部介入治疗中照射剂量调查分析

由于介入放射学应用的增多以及必须暴露在X线下工作,操作时间长等特点,其剂量和安全防护问题已被人们所重视.为此,我们于1995年,对我市4家医院7名介入手术操作人员的受照剂量及二尖瓣球囊扩张术时X射线剂量场的分布情况进行了调查,结果报告如下:1 测试方法1.1 治疗手术为二尖瓣球囊扩张和肝动脉灌注.使用的X线机有日本—850mA、西门子—50型、菲利普—1000mA、上海—500mA4种.治疗投照条件为70～125kV、0.2～3mA,照射野5cm×5cm～20cm×20cm,焦台距90～120cm,曝光时间15～49分钟,曝光量405～2 940mA·s.球管位置在诊视床上方.     

直接冠脉支架植入治疗急性心肌梗死的有效性和安全性观察

目的:观察直接冠脉支架植入治疗急性心肌梗死的有效性和安全性。方法:回顾性分析2016年6月~2018年6月在本院心内科诊断为急性心肌梗死的患者110例,术前常规药物准备,行冠状动脉造影,判断梗死相关动脉,根据冠脉病变特点对照组行球囊预扩张后支架植入,观察组行直接支架植入。比较两组患者的手术时间、造影剂使用剂量、照射剂量和X线照射时间,并比较两组患者的不良反应发生情况。结果:观察组患者的手术时间为(41.4±7.8)min,造影剂使用剂量(114.9±39.2)mL,照射剂量(0.9±0.3)mGy,X线照射时间(8.6±1.1)min;对照组患者的手术时间为(55.2±7.3)min,造影剂使用剂量(137.1±58.7)mL,照射剂量(1.5±0.4)mGy,X线照射时间(11.8±1.2)min。组间各项比较,P<0.05,差异有统计学意义。观察组与对照组患者的不良反应发生率,P>0.05,差异无统计学意义。结论:对急性心肌梗死患者直接冠脉支架植入安全性好,且能在更短时间内完成手术,X线照射时间短,造影剂使用剂量和照射剂量小,疗效确切。     

单X射线管和双X射线管介入设备的介入职业人员手部皮肤受照剂量比较研究

目的建立介入职业人员手部皮肤受照剂量的测量方法,对常规单X射线管和较新的双X射线管介入设备下介入职业人员手部受照剂量进行比较研究,为介入职业人员手部剂量监控和放射防护的改进提供科学依据。方法选用热释光剂量计(TLD),并进行皮肤个人剂量当量H_p(0.07)刻度。选择2台单X射线管和3台双X射线管介入设备,测量4种介入手术类型的231人次介入职业人员手部皮肤剂量。对单X射线管和双X射线管介入设备下测得的介入职业人员手部剂量统计比较。结果经手部皮肤个人剂量当量H_p(0.07)刻度,TLD线性拟合度较好(R~2=0.99996)。单X射线管和双X射线管介入设备的介入职业人员手部皮肤受照剂量均表现为治疗类手术高于造影类手术,手部受照剂量和曝光时间正相关。以神经系统血管造影术为例,同类手术中,双X射线管介入设备较单X射线管介入设备曝光时间短(U=-4.307,P0.05),但介入职业人员手部皮肤受照剂量高。结论双X射线管介入设备与单X射线管介入设备相比,提高了手术效率,但也增加了介入职业人员的受照剂量。应加强介入职业人员的辐射防护意识和措施,保证职业人员的健康。     

抽拉式介入手术性腺防护装置的研制与应用

目的：根据医院介入手术临床应用需求,研制一种抽拉式介入手术性腺防护装置。方法：通过对环绕式双层结构的可弯曲式放射防护材料收纳器和三段式放射防护材料等进行技术设计,实现患者盆部性腺的环绕式防护。结果：该装置设计简单、结构合理,可在不透X射线的防护状态和透X射线的可视状态之间方便地进行切换,并符合介入手术的无菌要求。结论：抽拉式介入手术性腺防护装置在保证临床介入手术效果的同时,解决了患者性腺防护的难题,具有良好的临床应用价值。     

婴幼儿枕秃发生的相关因素分析及临床意义

目的 :探讨小儿枕秃发生因素及临床意义。方法 :采用问卷式调查 4 87例 ,进行血清骨碱性磷酸酶、血清钙、左腕、左膝 X线摄片、骨密度检查 ,进行综合分析。结果 :发生枕秃 2 0 5例 ( 4 2 .1% ) ,其发生因素有 :1年龄以 3～月龄发生率最高 ,随月龄增加而减少。 2使用过硬枕头 ,如书、谷枕。 3睡眠姿势以仰卧者易发生。 4头面部湿疹者易发生。 5头部多汗、夜惊等。所有病例进行血清骨碱性磷酸酶测定、枕秃组与对照组各 4 0例进行血清钙测定分析无明显差异 ( P>0 .0 5 )。结论 :枕秃为小儿的生理现象 ,与钙、维生素 D的摄入量关系不明显     

综合性放射防护措施在介入治疗防护中的应用价值分析

目的探讨综合性放射防护措施在介入治疗防护中的应用价值。方法选择某医院40例进行介入手术操作的医务人员作为研究对象,对其在介入操作中进行综合性放射防护,监测其X射线辐射剂量。结果铅防护服防护效率为76.27%,床下铅橡胶帘防护效率为84.86%,铅玻璃防护屏防护效率为86.24%,三种放射防护器材前后X线辐射剂量有显著差异,P0.05。距离球管2米处X线衰减量为60.15%,3米处为85.42%;2米和1米、3米和2米之间的辐射剂量差异均有统计学意义,P0.05。结论对介入手术治疗的医务人员采取综合性防护措施能够减少X射线辐射,可降低伤害。     

X线机高压测量仪测量结果分析

目的本文使用自行研制的X线机高压测量仪,对两台X线机进行测量,同时使用非介入式X线多参数测量仪进行测量,比较两者的测量结果,判定研制设备的测量误差。方法 选择两台X线发生装置作为被测件用来测量数据,设定常用曝光参数,用研制的X线机高压测量仪和非介入式X线多参数测量仪分别测量两台X线机高压数据,计算测量误差。结果研制的X线机高压测量仪能够获得X线机高压发生器输出高压的平均值、上升时间、下降时间、曝光时间及纹波系数,高压值测量误差小于非介入式X线多参数测量仪。结论自行研制的X线机高压测量仪的测量误差能够满足测量的需要。     

手术室床旁X线摄影辅助架的设计

目的 :研制一种用于手术室床旁的X线摄影辅助架。方法 :该装置由暗合固定板、托槽、拐臂、卡块、调节钮、凹槽和定位槽组成,其中托槽材质为胶木,其余都选用不锈钢材质。使用时经过卡块的凹槽将装置固定于手术床旁轨道上,固定板和托槽可放置并固定胶片暗盒(或成像板),可根据投照部位需要任意调节固定板和托槽的高度及角度。结果:该摄影辅助架可根据需要任意旋转和调节各种角度,升降及伸缩自如,可满足术中各类床旁辅助X线摄影检查。结论:该装置操作简单、快捷、灵活、方便、省时,解决了长期困扰手术室X线摄影时的暗盒(或成像板)固定和旋转问题,并且可减轻对医护人员和其他人群的辐射。     

某医院2009～2010年介入工作人员个人剂量监测与分析

目的 为了解武汉地区介入诊疗中工作人员受照剂量水平,保障介入放射诊疗中工作人员健康与安全.方法 采用热释光剂量计对某医院介入放射诊疗工作人员进行剂量测量,并以铅围裙内外剂量结果作为有无防护进行比较.结果 该医院介入放射诊疗工作人员未被屏蔽部分接受的剂量非常高,年剂量达到17.82mSv;采用合理防护部位受照剂量相对较小,年剂量为3.426mSv.结论 工作人员应注意介入手术中合理使用防护用品,以降低受照剂量.     

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 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.     

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.     

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.     

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.     

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.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.