城市生活垃圾处理厂卫生学评价

城市生活垃圾处理是城市发展及文明的表现 ,也是近几年来城市发展面临的一项十分迫切的环境卫生问题。目前我国垃圾处理的方法主要有卫生填埋、堆肥以及焚烧等 ,我市采用“快速高温堆肥二次发酵”工艺 ,对城市生活垃圾 1 0 0吨、粪便 1 5吨进行无害化处理 ,使处理后的生活垃圾得到综合利用。1 调查内容生产环境调查　审查厂房建筑设计、工艺流程、有毒有害因素发生源及防护措施 ;生产车间设备及工人操作位噪声、粉尘、有害气体测定。蚊蝇密度及灭蝇调查　①蚊蝇密度调查 :投产前后均与 5～ 1 0月份每旬观察一次 ,蝇密度在厂区设置捕蝇点 4…     

苯巴比妥治疗新生儿缺氧缺血性脑病30例疗效分析

目的:评价苯巴比妥治疗新生儿缺氧缺血性脑病(HIE)的疗效。方法:60例HIE随机分为2组:治疗组在综合治疗的基础上于住院第1d给苯巴比妥15～20mg/kg·d,分2次静脉推注,第2d起给5mg/kg·d,总疗程5～8d;对照组只给综合治疗。观察两组的治疗效果。结果:治疗组总有效率93.3％,对照组总有效率76.6％,治疗组明显优于对照组(P<0.05)。治疗组平均治疗显效时间x±s=5.2±1.14d,对照组平均治疗显效时间x±s=8.4±1.17d,两组比较治疗组明显优于对照组。结论:苯巴比妥对HIE具有良好的近期治疗效果,可常规应用。     

丙氧鸟苷应用时机与分离GVHD和GVL效应关系

①目的研究丙氧鸟苷(GCV)应用时机与胸苷激酶-丙氧鸟苷(TK/GCV)系统分离移植物抗宿主病(GVHD)和移植物抗白血病(GVL)效应的关系。②方法自亲代雄性供鼠骨髓分离CD34+细胞,同时取脾脏T细胞转染TK基因。将52只雌性F1受鼠随机分为6组,移植前2d每只接种EL9611红白血病细胞1×105个。第1组接种后观察白血病自然病程。第2~6组移植前5h给予9.0Gy致死量照射,每只受鼠自尾静脉注入1×105个CD34+细胞和1×107个TK+T细胞。第2组不予GCV,观察急性GVHD发生情况;第3~6组分别于移植后1、5、9和13d给予GCV50mg.kg-1.d-1,腹腔注射,连用7d。行病理学检查确定死因,并检测受鼠外周血细胞Y染色体。③结果第1组小鼠均死于白血病,生存时间为(15.6±0.8)d;第2组小鼠均死于急性GVHD,生存时间为(16.7±1.1)d。第3~6组小鼠生存时间分别为(25.1±2.4)、(30.8±2.9)、(42.2±3.8)和(17.5±1.8)d。第2组和第1组生存时间差别无显著性(F=4.22,q=2.52,P>0.05)。第3、4组生存时间均长于第2组(q=3.68、4.41,P<0.05)。第5组小鼠生存时间长于第3、4、6组,差异均有显著意义(q=3.33~3.85,P<0.05)。存活时间>40d的小鼠脾脏未见白血病细胞浸润。第2~6组小鼠染色体核型分析显示Y染色体阳性率为100%。④结论GCV分离GVHD和GVL效应的效果与其应用时机相关,移植后9d应用效果最好,迟后应用小鼠均死于急性GVHD。     

酒精中毒对豚鼠免疫功能影响的实验研究

选用健康豚鼠24只,随机分成两组,每组12只。实验组每天用50％酒精生理盐水溶液按1ml/100g体重剂量灌胃一次,灌后动物出现昏睡现象2～3h;对照组用同剂量生理盐水灌胃,共20天。结果:①白细胞计数(×10~9/L):实验组5.250±0.872,对照组10.850±1.445,P<0.001;②白细胞吞噬率(％):实验组41.4±3.14,对照组69.5±4.32,P<0.01;     

MTX肌肉注射辅以口服中药治疗异位妊娠临床观察

目的 研究 MTX肌肉注射辅以口服中药 (治疗组 )治疗异位妊娠的临床效果。方法 采用比较的方法,对照组共两组：单纯 MTX肌注组 29例; 0. 4 mg/kg,每日肌注 1次, 5日一个疗程,间隔 5日后进行第 2疗程共进行两个疗程。单纯口服中药组 27例,每日只口服一剂中药。治疗组 30例;单纯 MTX肌注后第 2日开始每日口服一剂中药。结果 对照组中单纯 MTX肌注组,有效例数 24例,所占百分比 82. 76％,治疗后血β-HCG恢复正常时 (d)24. 12± 10. 09,平均住院日 20. 47± 7. 26。单纯口服中药组：有效例数 17例,所占百分比 62. 96％,治疗后血β-HCG恢复正常时 (d)27. 63± 11. 17,平均住院日 35. 12± 8. 83。治疗组：有效例数 26例,所占百分比 86. 67％,治疗后血β-HCG恢复正常时 (d)15. 79± 9. 46平均住院日 13. 01± 4. 03。治疗组与对照组有效 P＜0. 01;治疗后血β-HGC恢复正常时(d)比较P＜0.05,比较P＜0.05;平均住院比较P＜0.01。结论567 肌肉注射辅以口服中药/治疗组2 治疗异位妊娠效果优于对照组。     

BALB／c鼠自身免疫性睾丸炎动物模型的制作

 【目的】探讨BALB／c鼠睾丸炎动物模型的建立方法，观察睾丸炎形成后到生殖功能恢复的时间间隔，以及该动物模型的稳定性。【方法】BALB／c小鼠（10周）背脊皮下注射睾丸混悬液0．1mL，浓度2×10^7／mL，1次/周，共4次。同种睾丸混悬液（组1）、同种睾丸混悬液加完全免疫佐剂（组2）、异种睾丸混悬液（组3）、异种睾丸混悬液加完全免疫佐剂（组4）、空白对照（组5）。【结果】组3建模成功率80％，第5、8、11周按Johusen评分为5．2±1．44、6．2±0．79、8．1±0．87，组1、2、5评分均在9．0以上，组3生精功能明显降低（P〈0．05）。组4小鼠于第2次注射后3～5d，全部死亡。组3第5周生精上皮细胞减少至2～3层，曲细精管管腔中有稀疏的精子，间质出现水肿，淋巴细胞浸润约10％～25％。第5周组3附睾尾精子浓度为（11．0±6．2）×10^6，精子存活率（10．73±8．14）％，精子活动率（7．3±6．1）％，明显低于组1、2、5（P〈0．05），于第11周组3恢复至正常水平。睾丸炎生精障碍持续21～28d。【结论】异种小鼠生殖细胞可诱导建立BALB／c小鼠的EAO模型．模型有一定的持续稳定性，可用于精子发育生物学研究。     

甲巯咪唑不同剂量和方式对Graves甲亢近期疗效对比研究

81例Graves甲亢患者在1次服甲巯咪唑15mg和30mg后4、12和24h的平均过氯酸钾排泌率(分别为64.1±11.6％、69.8±12.2％、58.1±18.0％和52.5±18.4％、60.7±21.3％、55.0±21.7％)在统计学上无显著差异(P>0.05),提示甲巯咪唑15mg和30mg抑制甲状腺内碘有机化的作用强度和持续时间相近。170例经每日单剂量甲巯咪唑15mg(A组),10mg、3次/d(B组),20mg、3次/d(C组)治疗后,血清T_3、T_4浓度恢复正常平均所需时间(分别为5.6±3.0、5.5±l.9和4.8±2.2周)也相似(P>0.05),提示3组同样有效。但在5和10周内恢复正常血清T_3、T_4浓度者,C和B组高于A组。     

大鼠脊髓进行性压迫性损伤半胱氨酸蛋白水解酶-12表达与细胞凋亡

目的探讨大鼠脊髓进行性压迫损伤细胞凋亡、半胱氨酸蛋白水解酶（caspase-12）表达变化规律及其关系。方法随机选用健康成年Wistar大鼠120只,分为两组：手术组和对照组各60只,每个时间点各10只,按白行设计的方法作脊髓压迫模型;对照组,仅做脊髓显露。分别于术后1、3、7、14、21、28d观察脊髓受压后细胞凋亡及caspase-12的表达变化系。结果在各压迫组神经细胞出现凋亡,凋亡的发生率在1、3、7、14、21、28d分别为12．5％±2．3％、13．0％±3．6％、17．2％±4．3％、29．4％±4．4％、36．1％±6．5％、2．3％±7．9％,并伴随caspase-12的表达增强而增加,14、21、28d组间比较差异有统计学意义（均P〈0．05）。结论caspase-12可能参与了脊髓进行性压迫缺血所致的细胞凋亡。     

粗壮女贞的降压作用

粗壮女贞叶提取物静脉注射0．098、0．140和0．200g／kg可使麻醉大鼠的血压显著下降，峰值下降37．7％、38．6％和50．2％：灌胃给药（ig）1．36g／kgqd×3d，不影响清醒大鼠的血压。清醒自发性高血压大鼠ig1．08和2．16g／kgqd×5d，血压由24．3±0．5和24．3±0．6降至18．1±0．9和16．6±0．7kPa，降压作用显著（P＜0．001，＜0．001）；对清醒二肾-夹型高血压大鼠，ig粗壮女贞0．5g／kgqd×7d，血压由20．3±3．9降至16．2±3．9kPa，血压下降20％。以上结果提示具有降压作用。昆明小鼠急性毒性试验，ig49g／kg10d内动物生长良好，未出现死亡；腹腔注射5个剂量组（每组10只）按简化机率单位法测得LD502．64±0．21g／kg（P＝0．95）。     

2，4- 二氯苯氧乙酸作用的鼠乳对幼鼠蓝斑核中 多巴胺β- 羟化酶表达的影响

目的 观察经腹腔注射除草剂2，4- 二氯苯氧乙酸（简称2，4-D）的鼠乳，对幼鼠蓝斑核中多 巴胺β- 羟化酶（DBH）表达的变化，探讨除草剂对神经系统发育的影响。方法 生后7 d 且经母乳喂养的 幼鼠30 只，分成实验组1（10 只）、实验组2（10 只）及对照组（10 只）。实验组1、2 分别按照每天70 及 100 mg/kg 剂量注射2，4-D 至母鼠腹腔（二甲亚砜0.1 ml 做溶剂）；对照组只进行正常鼠乳喂养。待幼鼠哺 乳至第22 天，分别测量其体重、脑重；取幼鼠的蓝斑核进行DBH 免疫染色。结果 ①至生后22 d，实验组2 的幼鼠体重（35.60±2.84）g 与对照组比较（47.21±2.90）g 降低26.8%（P =0.000）；而脑重分别为（1.16±0.05） 和（1.33±0.04）g，实验组2 降低13.1%（P =0.000）；②实验组1、2 幼鼠蓝斑核DBH 相对光密度值为（0.21±0.03） 和（0.19±0.02），低于对照组（0.88±0.38）（P =0.000）。结论 2，4-D 能够抑制幼鼠体重增加；降低幼鼠蓝 斑核DBH 的表达，进而减少脑内去甲肾上腺素的合成，抑制脑及神经系统发育。     

无锡市污水处理厂污泥堆肥发酵无害化处理的卫生学评价

对无锡市芦村污水处理厂污水综合处理后,污泥堆肥发酵无害化处理进行卫生学评价。观察对蝇类孳笺控制,定期采集处理前后的污泥检测寄生虫卵严竣活情况和烘大肠菌值,经检测:污泥堆肥发酵能有效控制蝇类孳生,处理后的污泥中未检出活寄生虫卵。粪大肠菌值为10-1—10-2,符合卫生学标准。同时作为“花木营养基质”再利用有较高的经济价值。     

许昌市市区垃圾容器垃圾残留物蝇蛆（蛹）侵害情况调查及其防治措施

目的了解现代城市中各类垃圾容器中垃圾残留物的蝇蛆（蛹）侵害情况,探索控制蝇蛆（蛹）的有效措施。方法采取目测法,观察各类垃圾容器中蝇蛆（蛹）存活情况及数量,统计阳性侵害桶数及阳性只数。结果经调查,公共场所垃圾容器阳性侵害率为7．25％,平均阳性个数为1．97只／个;单位、社区垃圾容器,阳性侵害率为13．75％,平均阳性个数为2．24只／个;市场垃圾容器阳性侵害数为25．63％,平均阳性个数为2．61只/个;垃圾中转站的垃圾中转箱阳性侵害率为20．00％,平均阳性个数为4．19只／个。结论公共场所垃圾容器中蝇蛆（蛹）侵害牢低,平均阳性个数低。定期清理垃圾容器内的垃圾残留物,设置密闭垃圾容器,清理垃圾箱槽底部积存的污物污水,加大对蝇密度较高的区域的消杀力度,可以明显减轻现代城市中各类垃圾容器中垃圾残留物的蝇蛆（蛹）侵害。     

HOW SAFE IS YOUR HOSPITAL - DOCTOR?

The use of disposable syringes, needles and other ‘disposable’ items has gained wide popularity in hospital practice. The supposed advantages are ensuring sterility and preventing the spread of infection from patient to patient. However are these aims really being met? In the present state of awareness and disposal procedures being followed we are not achieving aims and it may even be more prudent to go back to the glass syringes with proper autoclaving facilities. Alternatively there is the need to improve the disposal facilities in hospitals for the disposable articles.KEY WORDS: Disposable equipment, Syringes, Infection controlUse of needles and syringes has revolutionized the medical practice. It is amazing that syringe was used for the first time by Alexander Fleming in 1910 to administer Salvarasan nicknamed ‘606’ for the treatment of syphilis. We have come a long way since. Today we cannot imagine a modern hospital without syringes and needles. Every medical practitioner frequently uses needles and syringes either for drug administration or to obtain a specimen of blood, fluid or tissue for diagnostic tests.In not so distant past, glass syringes were the norm - the user being responsible for its proper sterilization and maintenance. Some practitioners still use them, though, these are now near extinct species. The plastic age, with the advent of plastic syringes, shifted the onus of sterilization from the user to the manufacturer. Doctors were more than happy to cast off the responsibility of sterilizing the syringes and needles and grabbed the plastic syringes. The genie of “disposable” articles was thus unbottled. The catalog of so called disposables now includes syringes, needles, catheters, cannulae, gloves, intravenous drip sets, blood taking sets, the tiles and tubes used in labs, specimen collection containers, and others. These “disposable” plastic articles have some distinct advantages :

• a)These are easy to store, nonbreakable, have long shelf life and are ready to use. It is common practice among doctors and nurses to carry such ready-to-use articles in their pockets.
• b)The needles accompanying these syringes are very sharp, easy to use and the jab is less painful to the patient. The reusable conventional all - metal hypodermic needles get blunted due to repeated use, and the jabs are distinctly painful.
• c)The cumbersome process of washing and sterilizing the glass syringes is eliminated.
• d)The plastic ware are the “in” thing, are extensively used in Western world, therefore, appear fashionable and glamorous to both, the patients and the medics.

These are some of the obvious reasons why plastic ware have become not only acceptable but almost a necessity in modern medical practice. The manufacturers promote and propagate their use with obvious eyes on the profit margins.But it all appears too good to be true and benign. Every leisure, every perk is counterbalanced by undeclared responsibility. Often we forget or disregard, sometimes unknowingly but mostly consciously, these coexisting additional responsibilities and the restraints.The privilege of use of plasticware thrusts upon us some such responsibilities. These are :

• a)Proper and safe disposal.
• b)Destruction of the “disposable” to prevent recycling.

The ideal way of disposal and destruction of these plastic ware involves following steps :

• a)All these articles after use must be dipped in suitable disinfectant solution for few hours to reduce the load of pathogens.
• b)These must then be shredded or incinerated to destroy the item completely to prevent recycling.

The ideal is defined as conjectural, therefore, unachievable - rightly so. Specially in our circumstances, safe disposal is almost unheard-of. Neither the paramedics are educated and motivated adequately nor are the wherewithal for such safe disposal available.Let us peep in one of the busy wards of our hospitals and see what really transpires. For the sake of simplicity let us take the case of syringes and needles. On an average, every patient in these wards needs two jabs a day - either to take the specimen or to administer a drug. It means about 100 jabs in a 50 bedded ward - and that many syringes and needles per day, which the ward never ever gets. But our staff is not deterred by such obstacles, the resident doctors and nurses have to be perpetually on syringe hunt - begging, borrowing AND (not or) lifting them from wherever they can - including consultants'' lockers or colleagues'' pockets. But there is never enough for everyone due to the prohibitive cost and enormous number of these syringes required.Ingenuity comes in handy in such circumstances. Following are some of the commonly resorted ways. Each patient is allotted a syringe - to be used repeatedly for few days before discarding. Or the patients are “pooled” around a syringe and needle, same needle and syringe being used on a group of them. Sometimes syringes are considered “superfluous” while collecting blood samples - or in dire circumstances the “flush” technique is followed. It is simple - just flush the used syringe with saline - and hopefully out go all those “bad” bugs, the syringe is ready for the next in line. Just pray that it is not you!! That much for the principles of asepsis and sterilisation. Some patients - the elite educated ones come with their own syringes and needles as a respite - though not often.After the poor syringe and needle have done their tour of duty through the ward or Out Patient Department (OPD), they go to their resting place - not an antiseptic container but usually a cardboard “khokha”. Such a “khokha” gallantly displays its scars and the blood of the victims on its walls. The “khokha” is also the resort of used bandages, dressings, gauze pieces, cotton swabs, used gloves, broken glass pieces of phials, empty vials and waste papers. The venerable Class IV employee, with his bare hands scoops up the contents for their onward journey to - incinerator? Well you missed it again. It is the garbage dump near the incinerator. It is obvious because the road to incinerator is paved with bramble, broken glass bottles, sharply cut tins etc and in any case - who remembers seeing any embers or smoke in the incinerator? The garbage dump is much easily approachable and magnanimous. In some places these used syringes and needles are returned to the medical store - the all encompassing accounting procedure must be followed before issuing the fresh indent! Despite this small detour, what ever the route may be, the ultimate destination is the garbage dump.We all believe in rebirth. From the soil unto soil - and from the soil again. In come our rag pickers. They too have their own specializations and hierarchy - some go only for papers, others for polythenes while the ones in higher echelons go only for hard plastic moulded wares - the syringes, the catheters and the like. These are value added items and fetch better returns than other items. But it is hard work - rummaging through these heaps braving the sun and competing the stray dogs, one manages a bagful of these goodies in a day. So what if in the course of such treasure hunt one gets few jabs from unsheathed needles or cuts due to sharp glass pieces? A severe cut is usually dressed with gauze and bandage readily available in the same dump! All that talk about HIV, hepatitis viruses and other germs getting through these pricks and cuts is only figment of someone''s imagination. The thought of contracting these diseases is a luxury the rag picker can ill afford. The effort is worth it, as a bagful of syringes and needles fetch handsome Rs 5–10 per kilo - enough for a meal to pull him through the night.A number of companies dealing with disposable plastic wares have sprung up in last few years. These are very kind in accepting all these syringes and needles from poor rag pickers. They contribute to the ever increasing industrial “production” by repacking and marketing these items. Since their inputs are minimal, they successfully bag most of the contracts on the basis of lowest quotation. And there comes the old syringe wrapped in stylish labels - “DISPOSABLE HYPODERMIC SYRINGE, STERILE, NONTOXIC, PYROGEN FREE” “Destroy after single use” is normally in the tiniest print and not readable. After all, how many of us can recount the birth and lives our souls have gone through? Why bother about a lowly syringe and needle?     

江门市儿童手足口病危险因素病例对照研究

目的了解江门市手足口病（HFMD）发病的危险因素,为制定有效的防控措施提供科学依据。方法2011年7-8月,选择常住江门且临床诊断为手足口病的非重症患儿62例和未患过手足口病的儿童126名,采用病例对照研究方法,利用自制问卷,调查分析手足口病的影响因素。结果单因素分析结果显示,大门口10m范围内可见垃圾、大门口视野可见苍蝇、卫生间使用情况、最近两周邻居／玩伴患病以及发病前两周医疗机构暴露情况可能是手足VI病发病的危险因素;母亲文化程度可能是发病的保护性因素。多因素分析结果显示,手足口病发病影响因素为发病前两周医疗机构暴露（0R_=24．982,P〈0．05）、大门口10m范围内可见垃圾（OR=5．246,P=0．002）、大门口视野可见苍蝇（OR=I．565,P=0．004）和卫生间使用情况（OR=2．373,P=0．006）。结论在江门市预防HFMD重点应加强健康宣教以改善不良卫生环境,同时应采取隔离病例等有效措施减少交叉感染。     

品管圈理念在手术室处理医疗垃圾中的应用效果分析

目的 探讨品管圈理念在手术室处理医疗垃圾中的应用效果,为临床合理选择医疗垃圾处理方法提供参考。 方法 采用前瞻性研究方法,选择2014年7月—2015年7月普通外科手术室的8名护士作为调查对象,普通外科手术室从2015年1月成立手术室品管圈,圈名为“医疗垃圾环保圈”,由主管护师2名,护师3名,护士3名组成;观察与记录品管圈活动对策实施前后手术室医疗垃圾管理存在的问题,同时对圈员们解决问题能力、团队凝聚力、沟通协调能力进行调查与分析。 结果 品管圈活动实施前医疗垃圾管理中存在的缺陷与问题有60处,其中生活垃圾与医疗垃圾混放22次,占比36.7%;锐器处理不当8次,占比13.3%;医疗垃圾袋封口不严4次,占比6.7%;医疗垃圾在手术室存储时间过长16次,占比26.7%;医疗垃圾袋渗漏10次,占比16.7%;2015年1~7月品管圈实施后只有10处相关医疗垃圾管理处理的问题,发生情况明显少于品管圈实施前(P＜0.05)。品管圈实施后圈员的解决问题能力、团队凝聚力和沟通协调能力评分都明显高于实施前,差异有统计学意义(P＜0.05)。 结论 品管圈理念在手术室处理医疗垃圾中的应用能提高圈员的综合素质能力,减少医疗垃圾处理缺陷的发生,从而提高医院管理质量。      

顺德区农村集中式供水卫生现状调查

目的调查顺德区农村集中式供水水厂的卫生现况、制水工艺流程和卫生管理情况,水源水和出厂水水质状况。方法制定的“农村集中式供水单位基本情况调查表”,现场调查各水厂的卫生现状,出厂水水质按《生活饮用水标准检验规范)(2001)检验评价。结果供水厂取得卫生许可证百分比仅是70．8％,提示我们的卫生工作必须向村一级基层单位深入渗透。各水质的硬件设施较好,长期投加水处理剂的厂家达到80％以上,但投加有卫生许可批件的消毒剂的水厂仅6家,占25．0％。结论顺德区水源水质量不理想,以化学污染为最严重,出厂水的水质合格率高,这是充分肯定了顺德区水厂的水处理过程完全、必须设备的拥有率和自动化程度高是保证出厂水质的前提。     

Biological monitoring of workers exposed to inorganic lead in Singapore

Medical surveillance of workers exposed to a lead hazard is a common practice in many countries. In Singapore, legislation on periodic medical examinations for lead exposed workers in factories was introduced in 1985. This paper discusses the results of the laboratory tests in workers exposed to inorganic lead in 1987. The WHO recommended that the health-based limit for lead absorption be 40 micrograms/dL for adult male workers. Taking this level, we could divide the factories into a "higher risk" category and a "lower risk" one, the latter not having a single result of blood lead of 40 micrograms/dL or above. The former category included factories manufacturing PVC and lead storage batteries, with the highest level of 79.6 micrograms/dL found in PVC manufacture. Of the 3 main races in Singapore, the Chinese have the lowest blood lead levels after adjusting for the type of industry, age and duration of exposure to lead. Age was correlated with the duration of lead exposure. The higher blood lead levels in Malays and Indians may have been contributed to by eating habits (eating with hands). The higher prevalence of smoking among Malays may also be contributory. The results in this study, while reassuring that no worker was found with blood lead above 80 micrograms/dL, also indicated that workers in some factories were still exposed to a health risk.     

全血贮存条件对离子交换高效液相色谱法检测HbA1c的影响

目的探讨不同温度、不同时段的贮存条件对全血HbA1c测定结果的影响。方法用离子交换高效液相色谱法检测全血HbA1c。取60例全血新鲜样本,每样本分装成15份,1份作为新鲜样本标准当天检测;5份4℃贮存,分别于3d、1周、2周、3周、4周后取出检测;3份-20℃、3份-40℃、3份-80％贮存,分别于1、3、6个月后取出检测,比较各个贮存条件下结果的平均值。结果4℃样本2周内的结果略高于当日结果2．5％左右,从第3周开始逐渐下降,第4周低于当日结果7．2％。-20℃、-40℃、3和6个月的结果都比当日结果低,且随时间延长有逐渐降低的趋势;除-80％冻存1个月的结果与当日结果差异无统计学意义（P〉0．05）外,其余各组结果与当日结果比较差异均有统计学意义（P〈0．05）。-80℃冻存1、3和6个月的结果都比当日结果略高,且随时间的延长结果略有升高,偏离当日结果的程度要比-20℃、-40℃偏离程度小。结论在相同温度条件下贮存时间越短贮存温度越低HbA1c越接近当日结果;贮存温度对结果的影响要比贮存时间更大。-80℃贮存1个月是本实验显示的最佳贮存条件。     

沼气发酵对病原菌杀灭效果的研究

目的探讨沼气发酵对病原菌的杀灭效果。方法建立中温(37℃)沼气发酵模型,并对4种常见病原体(金黄色葡萄球菌、乙型溶血性链球菌、伤寒沙门氏菌、福氏志贺菌)开展沼气发酵杀菌试验。结果金黄色葡萄球菌、乙型溶血性链球菌均在48小时时检测不出;伤寒沙门氏菌10天时检测不出;福氏志贺菌30天时仍能检出。结论沼气发酵对病原体有一定的杀灭效果,对革兰氏阳性菌的杀灭效果优于革兰氏阴性菌。     

Improving medical stores management through automation and effective communication

Background

Medical stores management in hospitals is a tedious and time consuming chore with limited resources tasked for the purpose and poor penetration of Information Technology. The process of automation is slow paced due to various inherent factors and is being challenged by the increasing inventory loads and escalating budgets for procurement of drugs.

Methods

We carried out an indepth case study at the Medical Stores of a tertiary care health care facility. An iterative six step Quality Improvement (QI) process was implemented based on the Plan–Do–Study–Act (PDSA) cycle. The QI process was modified as per requirement to fit the medical stores management model. The results were evaluated after six months.

Results

After the implementation of QI process, 55 drugs of the medical store inventory which had expired since 2009 onwards were replaced with fresh stock by the suppliers as a result of effective communication through upgraded database management. Various pending audit objections were dropped due to the streamlined documentation and processes. Inventory management improved drastically due to automation, with disposal orders being initiated four months prior to the expiry of drugs and correct demands being generated two months prior to depletion of stocks. The monthly expense summary of drugs was now being done within ten days of the closing month.

Conclusion

Improving communication systems within the hospital with vendor database management and reaching out to clinicians is important. Automation of inventory management requires to be simple and user-friendly, utilizing existing hardware. Physical stores monitoring is indispensable, especially due to the scattered nature of stores. Staff training and standardized documentation protocols are the other keystones for optimal medical store management.