某三级甲等医院模拟肺细菌污染现况调查

目的：调查某三级甲等医院各科模拟肺细菌污染状况并进行分析,以减少院内感染率。方法将9个科室的14个模拟肺分别进行内口及外口采样,进行细菌培养鉴定。同时调查各科模拟肺管理、存放环境、使用频率、呼吸机管道消毒方法及呼吸机使用过程中是否存在脱机时连接模拟肺等情况。结果调查样本中有6个模拟肺内口、2个模拟肺外口检测出致病菌,以铜绿假单胞菌、金黄色葡萄球菌、少动鞘氨醇单胞菌、念珠地丝菌等为主。各科均未建立规范的模拟肺管理及消毒制度,导致模拟肺存放不规范。结论模拟肺细菌污染率高,消毒及管理不规范,临床管理者应采取针对性措施,以减少患者院内感染的发生。     

计算机辅助构建气管软骨环并行气管前壁缺损修复实验研究

目的探讨利用人工材料在计算机辅助下体外构建气管软骨环进行颈段气管缺损修复的可行性。方法用β-磷酸三钙(β-TCP)材料制造出气管环。12只成年杂种犬,雌犬4只,雄犬8只,犬龄约2岁,体质量11~13kg。随机均分为2组。行气管前壁3~5环全层缺损造模(缺损2cm×5cm),在气管切除部位形成一直径约2cm、长约5cm的皮管。实验组利用计算机辅助构建气管软骨环阴模,以β-TCP材料制作的内径约2cm的2个C形气管软骨环支架置于人工皮管外侧,外侧以肌肉覆盖,逐层缝合关闭术腔。对照组以相同方法行气管前壁全层缺损造模,并形成与实验组相同的人工皮管,但皮管外面不置β-TCP构建的软骨环支架。动物饲养至8周时处死取材,行大体解剖、纤维喉镜、CT及常规组织学检查。结果术后所有动物伤口局部未见明显感染征象。对照组1只皮下严重气肿,当日死亡;大体解剖可见修复部分气管前壁塌陷,管腔狭小;其余动物均存活至8周,术后1周出现气喘,术后2周出现进食呕吐及颈部活动受限;纤维喉镜检查,修复部位气管前壁已出现塌陷,有明显的反常呼吸运动。实验组动物均成活良好,未见上述症状。纤维喉镜检查:重建气道通畅。CT检查:植入物位置良好。组织学检查,支架材料已与周围组织融合为一体,组织已长入支架材料的孔隙中。结论实验应用计算机辅助技术,使修复支架制作达到个体化,β-TCP材料具有良好的生物相容性,且应用计算机辅助技术依个体需要快速塑型,能较好地修复气管缺损。     

Design and Evaluation of a New Resin-Filled GFRP Pipe Connection System for Butt Splicing of FRP Bars

Fiber-reinforced polymer (FRP) bars are one of the promising alternatives for steel bars used in concrete structures under corrosion or non-magnetic environments due to the unique physical properties of FRP materials. When compared with steel bars, FRP bars are difficult to be spliced in field application due to their anisotropy and low shear and compressive strengths. In view of this, the paper presents a new non-metallic connection system (i.e., resin-filled glass fiber-reinforced polymer (GFRP) pipe connection system) for the butt splicing of FRP bars. With the proposed connection system and a simplified trilinear interfacial bond-slip model, a set of design formulas were derived based on the requirement that the proposed connection system should provide a load transfer capacity beyond the tensile capacity of the spliced FRP bars (i.e., to fulfill the high tensile strength of FRP materials). Besides, considering the fabrication error-induced load transfer capacity reduction of the connection system in field application, a correction factor was introduced in the paper to compensate for the reduced load transfer capacity by increasing the FRP bar anchorage length. At last, to estimate the effectiveness of the proposed connection system and the derived design formulas, nine specimens were fabricated with a kind of commercially available basalt fiber-reinforced polymer (BFRP) bars and the designed connection system and tested under unidirectional tension to study their tensile performance. With the comparison between the tested and theoretical results, the effectiveness of the proposed connection system and the derived design formulas are verified.     

A Non-Geodesic Trajectory Design Method and Its Post-Processing for Robotic Filament Winding of Composite Tee Pipes

With the advantages of high specific strength and well corrosion resistance, polymer-matrix composite tee pipes are widely used in aerospace and civilian fields. The robotic filament winding technology is suitable for forming complex shape parts. This paper aims to provide a novel non-geodesic trajectory design method to get a continuous trajectory for tee pipe winding. Furthermore, post-processing methods are proposed for realizing the full coverage of tee pipes by robotic filament winding. The CAD/CAM software is then designed to simulate the winding process and realize the cover of the whole tee pipe. Finally, experiments of winding a tee pipe with a desktop winding machine and a six-axis winding robot are carried out. The results show that the tee pipe is fully covered, verifying the accuracy of the design method and post-processing methods.     

2012年北京市丰台区公共场所集中空调通风系统卫生状况调查

目的调查分析2012年北京市丰台区公共场所集中空调通风系统卫生状况,探讨其影响因素并为卫生管理提供技术支持。方法依据《公共场所集中空调通风系统卫生规范》,检测集中空调送风中细菌总数、真菌、β-溶血性链球菌及PM10,风管内表面细菌总数、真菌总数、积尘量,冷却（凝）水中嗜肺军团菌。结果丰台区集中空调通风系统送风中细菌总数、真菌总数、β-溶血性链球菌、PM10合格率分别为61.42%、88.89%、100.00%、90.91%,风管内表面积尘量、细菌总数、真菌总数合格率分别为100.00%、100.00%、99.20%,冷却（凝）水中嗜肺军团菌合格率为98.20%,血清分型以LP1型为主。集中空调送风中细菌总数存在着明显的季节性差异（χ^2=12.338,P〈0.01）,而送风中真菌、PM10未见明显的季节性差异（χ^2=3.155,P〉0.05;χ^2=6.976,P〉0.05）。不同类型集中空调送风中细菌总数、真菌未见明显差异（χ^2=5.782,P〉0.05;χ^2=2.653,P〉0.05）。结论细菌总数、真菌总数、PM10是丰台区集中空调送风卫生质量的主要影响因素,应加强集中空调管理,定期清洗消毒,并主动开展卫生委托监测。     

信息化预警管理在泌尿外科术后双J管留置患者中的应用研究

目的 探讨信息化预警管理系统在留置双J管患者中的应用效果,进一步规范双J管管理,减少导管滞留所致的相关并发症。方法 我科与相关人员联合开发了可嵌入医院HIS信息系统的“双J管信息预警系统”。以2019年7月至2020年6月系统应用前收治的泌尿外科术后留置双J管的患者作为对照组,以2020年7月至2021年10月系统应用后收治的患者作为观察组,每组随机抽取200例。比较两组患者双J管相关信息登记耗时、登记遗漏率、双J管按时处置率及导管相关并发症发生率。结果 观察组双J管相关信息登记耗时为（7.15±1.49）s,少于对照组的（55.55±8.94）s,组间比较差异有统计学意义（P<0.01）。观察组患者信息登记遗漏率低于对照组（1.50%vs 13.00%）,且双J管按时处置率高于对照组（97.00%vs 52.50%）,导管相关并发症发生率低于对照组（49.50%vs 76.50%）,差异均有统计学意义（P<0.01）。结论 双J管信息化预警系统能够快速、便捷、准确地进行患者信息登记,有利于缩短登记耗时、提高患者双J管按时处置率、降低登记遗漏率和导管相关并发症发生率,进而确...     

管式反应器—喷雾流化干燥制粉状磷酸一铵新工艺

简述规模为20万t/a管式反应器—喷雾流化干燥制粉状磷酸一铵新工艺的特点、工艺流程与主要设备,以及主要工艺控制指标,为国内粉状磷酸一铵的生产开辟了一条新的途径。     

试验给水管网不同给水管材腐蚀的电镜分析及细菌API鉴定

目的研究不同给水管材的腐蚀、结垢及饮用水与生物膜中的菌种情况。方法以实验室模拟给水管网为研究对象,应用环境扫描电镜对目前给水管网中使用较为普遍的镀锌管、PPR管(无规共聚聚丙烯管)和ABS(苯乙烯管)管的腐蚀、结垢情况及结垢层元素组成进行了分析;应用生物梅里埃API(Analytic products NC)细菌鉴定系统10S和20E对饮用水及生物膜中常见的菌种进行了鉴定,并分析了菌种致病性。结果镀锌管的腐蚀、结垢情况最为严重,PPR和ABS管内壁存在薄结垢层。API10S试剂条鉴定实验给水管网水样的10株菌中有7株为条件致病菌;API20E试剂条鉴定水样及生物膜样品的21株菌中5株为致病菌,11株为条件致病菌,其余5株对人体尚无致病报道。结论饮用水管网微生物学水质较差,水及生物膜样品中大多数细菌都为条件致病菌,存在一定的微生物风险。在给水管材方面应加快城市旧管网改造步伐,推广应用新型管材。     

制药企业GMP改造中有关操作平台的设计问题

根据在对制药企业GMP改造中的实践，建议洁净区操作平台采用经抛光的304矩形钢管制作，既可达到GMP的要求且经济合理，并列表选出常用规格的承载数据供读者选用。