Normal and homogeneous red blood cell populations over a wide range of hyper-iso-hypotonic media

The volumes of human erythrocytes after rapid and gradual swelling in hypotonic NaCl media were measured using a Coulter Counter Z_B at temperatures of +4°C and +20°C together with potassium leakage, the degree of hemolysis and the ‘returning volume’, i. e., the volume in an isotonic solution to which the cells will return from that in a hypotonic solution. The methodological and systematic errors in the volume measurements were corrected by taking into account the shape dependence of the Coulter Counter and the change in cell population during hemolysis, whereafter the measured cell volume values and the comparison between them become more reliable. The curves for cell volume as an inverse function of osmotic pressure appeared to be non-linear. The slopes were small at first but shoed a rapid increase as the cells approached their maximal volume. The critical hemolytic volume was approx.8% higher at +20°C after both rapid and gradual swelling than at +4°C and approx.4% higher after a gradual swelling as compared with a rapid swelling both at +4°C and +20°C.A decrease in temperature resulted in an increase in the critical osmotic pressure both in rapid and gradual hemolysis, but did not greatly affect the amount of prelytic K⁺ leakage. The critical osmotic pressure was smaller in gradual hemolysis than in rapid hemolysis and the prelytic K⁺ leakage was doubled at both +4°C and +20°C.The shifts in osmotic fragility as a function of temperature may be due to differences in the visco-elastic properties of the cell membrane, but the shifts in osmotic fragility as a function of swelling rate may be connected with differences in potassium leakage and membrane stretch.     

不同秸秆还田量对旱地全膜双垄沟播土壤水分及玉米生长的影响

在通渭半干旱区通过试验研究了不同秸秆还田量对全膜双垄沟播玉米生长形状、土壤水分状况及产量的影响。试验设计了3个还田量梯度,即玉米秸秆按6 000 kg·hm^-2（低量还田处理）、9 000 kg·hm^-2（中量还田处理）、12 000 kg·hm^-2（高量还田处理）整秆还田,不还田处理作为对照。结果表明,在生育前期时,0～200 cm土壤水分呈现出还田量越高土壤含水量越高的趋势,在出苗期最为明显,高、中、低还田量处理较对照土壤含水量分别高出6.07%、1.24%、0.31%,而在抽雄期后,则表现为低量还田处理>中量还田处理>不还田处理>高量还田处理,叶面积大小表现为高量还田处理>中量还田处理>低量还田处理>不还田处理。耗水量表现为低量还田处理<中量还田处理<不还田处理<高量还田处理。产量及水分利用效率以6 000 kg·hm^-2还田量处理最高,适宜在半干旱旱作区进行推广。     

综合医院手术部洁净空调系统设计思路探讨

结合工程实例,对手术室洁净空调系统设计中系统划分、设备选择、气流组织、系统控制和节能措施等方面进行深入探讨。介绍了笔者在手术室空调系统设计中的主要思路：高级别手术室（Ⅰ、Ⅱ级）空调系统独立设置;手术室空调系统采用二次回风来代替再热过程,实现节能;手术部的新风系统集中设置;洁净手术室室内送风口集中布置在手术台上方,使手术台及其周边区位于洁净气流形成的主流区内。     

医院药房面临的退药问题不容忽视

目的：介绍目前有关医院药房退药的政策和实际情况,并就规范这一问题提出合理化建议。方法：根据退药产生的实际原因区别对待,妥善处理。结果和结论：在保证用药安全的前提下,充分考虑人性化的服务理念。新时代的药剂师应承担更大的责任。     

Interviews and assessments of returning non-compliant periodontal maintenance patients

BACKGROUND: Periodontal therapy without a maintenance programme has been shown to be of doubtful value. Most studies show a low-level of compliance with periodontal maintenance therapy. Many suggestions as to the reasons for this have been put forward, but it has been difficult to confirm these, as the patients are not available to be interviewed. AIM: To identify, interview and assess returning non-compliant periodontal maintenance patients. METHOD: All patients who had undergone periodontal therapy between 1986 and 2004 but not complied with the maintenance therapy were interviewed and assessed when they later returned to the specialist office for treatment. RESULTS: Sixty-one patients with an average age of 56.4 years (SD 11,1) were studied. There were 18 males and 43 females. The patients were compliant for 3.4 years (SD 3.2) before leaving and returning after 5.5 years (SD 3.3) of non-compliance. Average tooth loss while non-compliant was 1.6 teeth (SD 2.8). The interviews revealed that 37 patients attended their own dentist's office exclusively for maintenance therapy, eight patients gave health reasons and seven patients lack of motivation or failure to cooperate. Thirty-six patients were re-referred by their own dentist, 13 changed dentist and were referred by this dentist, while 12 patients contacted the specialist office directly. Fifty-three patients claimed to have been fully compliant with their own dentist while non-compliant with the specialist office. CONCLUSION: The main reason for non-compliance was that the patients did attend their own dentist exclusively for maintenance therapy. Tooth loss and periodontal deterioration was more marked in this group than patients who in addition attended the specialist office for maintenance therapy.     

职业女性母乳喂养持续时间及影响因素

目的了解职业女性母乳喂养持续时间及其影响因素,为构建职业女性母乳喂养支持方案提供参考。方法在郑州市2所三级甲等医院儿童预防保健门诊选取364名产后返岗的职业女性,采用自制的职业女性母乳喂养调查问卷开展调查。采用Kaplan-Meier法和Cox回归模型分析母乳喂养持续时间及其影响因素。结果产后返岗职业女性母乳喂养持续时间均值为11.94个月。Cox回归分析显示,是否坚持纯母乳喂养到6个月、预计母乳喂养时间、返岗后是否继续母乳喂养是母乳喂养持续时间的影响因素(均P0.01)。结论职业女性母乳喂养持续时间与WHO的建议还有一定差距。应进一步提高6个月纯母乳喂养水平,帮助返岗职业女性制定科学合理的母乳喂养规划和目标,采取有效措施改善工作场所母乳喂养支持,为持续母乳喂养创造条件。     

伴随输液法减少尼莫地平静脉泵入时疼痛和回血的探讨

目的探讨减少静脉泵入尼莫地平时的局部疼痛和静脉血反流情况。方法将 4 80例病人分为对照组 12 0例 ,观察组 36 0例。观察组在静脉泵入尼莫地平的同时以一定的速度从同一通道伴随输入 0 .9%氯化钠或 5 %葡萄糖注射液 (下称稀释液 ) ,观察不同伴随输液速度时静脉血反流情况及病人局部静脉疼痛情况 ,并观察额外输液对病人血压的影响。对照组直接用微量泵泵入尼莫地平注射液。结果在静脉泵入尼莫地平的速度一定时 (1mg/h) ,对照组静脉血反流率 95 .8% (115 / 12 0 ) ;观察组稀释液以 7gtt/min的速度维持输液即可完全阻止静脉血反流 ,以 10gtt/min的速度维持输液可以使 99.4 %病人无疼痛感 ,泵入尼莫地平前后血压值与对照组比较 ,差异无显著性意义(P >0 .0 5 )。结论在静脉泵入尼莫地平的同时以一定的速度 (10 gtt/min)从同一通道输入稀释液安全 ,可缓解疼痛 ,阻止静脉血反流。     

Pandemic influenza, reopening schools, and returning to work

In this issue of Emerging Infectious Diseases, Victoria Davey and Robert Glass present a paper (1) in which they consider the question of when to “switch off” community-based interventions designed to reduce the spread of pandemic influenza. These authors attempt to answers questions such as when it would be optimal to reopen schools that have been closed as part of a nonpharmaceutical, communitywide influenza mitigation strategy.     

2013年北京医院门诊药房退药情况分析

目的：总结退药原因,探讨减少退药的方法。方法收集2013年1月～12月门诊药房西药退药处方872例,中药退药处方198例,并分别对数据进行统计分析。结果门诊药房西药退药原因主要有医生操作失误272张（31.2％）,不良反应177张（20.3％）,患者病情变化、住院及死亡109张（12.5％）,患者拒绝用药74张（8.5％）,不合理用药33张（3.8％）等,其中前4项为主要原因,共计632例,占退药总例数的72.5％。中药退药原因主要为不良反应45张（22.7%）,患者拒绝用药45张（22.7%）,医保拒付、患者家中有药37张（18.7%）,医生操作失误26张（13.2%）,患者病情变化、住院及死亡22张（11.1%）,不合理用药23张（11.6%）,其中前4项为主要原因,共计153例,占退药总例数的77.3％。结论医院医生和药师应共同努力,采取建立退药制度、加强医患沟通、合理检查流程等措施,提高医疗服务质量,减少退药情况的发生。