传染病医院医务人员职业暴露原因及防护对策

目的：分析传染病医院医务人员发生职业暴露的原因并制定相应的防护对策。方法通过调查和整理本院2009年1月至2013年10月上报院感科的《医务人员职业暴露报告卡》资料,对医务人员发生血液传播性疾病职业暴露的相关因素进行分析,提出针对性的防护措施。结果本研究共发生血液传播性疾病职业暴露13人,其中针刺伤11人（84.6%）、皮肤暴露1人（7.7%）、黏膜暴露1人（7.7%）。暴露人员护士为主（84.6%）,其次是医技人员（15.4%）。暴露源9人为艾滋病,2人为丙型肝炎,1人为乙型肝炎;9人进行了药物干预,其中6人为艾滋病预防性用药。13人全程跟踪随访,职业暴露无一人感染。结论医务人员发生职业暴露具有一定的危险性,而在传染病医院发生职业暴露,更易感染血源性传染病,故预防尤为重要。加强医务人员职业暴露防护知识的培训,规范操作行为,纠正个体操作手法缺陷,及时更新有效的防护用品、设施,可预防职业暴露的危险。     

The protective effect of SCR15-18 on cerebral ischemia-reperfusion injury

Abstract

<title/>

Objectives: Soluble complement receptor type 1 (sCR1), a potent inhibitor of complement activation, has been shown to protect brain cells against cerebral ischemic/reperfusion (CI/R) injury due to its decay-accelerating activity for C3/C5 convertase and co-factor activity for C3b/C4b degradation. However, the effect of short consensus repeats (SCRs) 15-18, one of active domains of sCR1 with high C3b/C4b degradability, has not been demonstrated. Here, we investigated the protective effect of recombinant SCR_15-18 protein in middle cerebral artery occlusion (MCAO)-induced focal CI/R injury.

Methods: Recombinant SCR_15-18 protein was successfully expressed in Escherichia coli and refolded to its optimal bioactivity. Seventy-five Sprague-Dawley rats were randomly assigned into three groups: sham-operated group, CI/R group, and SCR_15-18+CI/R group pretreated with 20 mg/kg SCR_15-18 protein. After 2 hours of MCAO and subsequent 24 hours of reperfusion, rats were evaluated for neurological deficits and cerebral infarction. Polymorphonuclear leukocyte accumulation, C3b deposition, and morphological changes in cerebral tissue were also estimated.

Results: SCR_15-18 pretreatment induced a 20% reduction of infarct size and an improvement of neurological function with 22·2% decrease of neurological deficit scores. Inhibition of cerebral neutrophils infiltration by SCR_15-18 was indicated from the reduction of myeloperoxidase activity in SCR_15-18+CI/R rats. Decreased C3b deposition and improved morphological changes were also found in cerebral tissue of SCR_15-18-treated rats.

Discussion: Our studies suggest a definitive moderately protective effect of SCR_15-18 against CI/R damage and provide preclinical experimental evidence supporting the possibility of using it as a small anti-complement therapeutic agent for CI/R injury therapy.     

维生素C和维生素E对小鼠化学性肝损伤的预防性保护作用

目的:探讨维生素C(VC)和维生素E(VE)对CCl_4引起化学性肝损伤的预防性保护作用.方法:昆明种小鼠60只随机分5组,设正常对照组、病理模型组、VC保护组、VE保护组、VC VE保护组,饲养10 d,除正常对照组外,其余各组ip 1.5 mL/L CCl_4致小鼠化学性肝损伤,测定小鼠血清中ALT,AST及肝细胞中MDA,GSH,SOD,HE染色光镜下观察肝细胞形态变化.结果:VC和VE保护组能显著降低血清中ALT和AST(2277.12±1187.90,2163.76±1412.11 nkat/L vs 4527.07±1019.37 nkat/L,P<0.01)以及肝细胞中脂质过氧化物MDA的含量(4.37±0.49,3.26±0.71μmol/g vs 9.25±2.74μmol/g,P<0.01).镜下观查肝损伤明显减轻,体外抗氧化实验能显著性的抑制脂质过化物MDA生成,联合应用有协同效应.结论:VC和VE对化学性肝损伤有预防性保护作用.     

当归补血汤对辐射损伤小鼠的防护作用及机制

目的 观察当归补血汤对⁶⁰C₀-γ射线辐照小鼠的防护作用。方法 将实验小鼠随机分为5组(正常对照组、模型组、当归补血汤低、中、高剂量组),采用⁶⁰C₀-γ放射源照射除正常对照组外的各组小鼠,建立辐射损伤模型,测定各组小鼠外周血中性粒细胞数(NEUT)、骨髓有核细胞数(BMC)、血清超氧化物歧化酶(SOD)活性及血清丙二醛(MDA)含量。结果 辐射损伤小鼠的NEUT、BMC及SOD活性均明显降低(P<0.01),MDA含量增高(P<0.01)。当归补血汤可升高辐射损伤后小鼠NEUT、BMC及SOD活性,降低MDA含量,且当归补血汤高剂量组对辐射损伤小鼠的保护作用更好(P<0.01)。结论 当归补血汤对辐射小鼠的电离损伤有保护作用,且与剂量相关。     

白血病病人化疗后实施保护性隔离预防感染的效果评价

目的评价白血病病人在化疗后即开始保护性隔离预防感染护理的效果。方法对照组在骨髓抑制期开始实施常规预防感染措施,实验组在化疗后实施严格的保护性隔离,观察2组病人感染的发生率。结果对照组无感染率35.48%,实验组无感染率63.44%。结论在化疗后实施严格的保护性隔离有助于降低感染发生率,使病人顺利度过骨髓抑制期。     

日本血吸虫中国大陆株23 kDa膜蛋白核酸疫苗对猪免疫保护作用的研究

目的 研究日本血吸虫中国大陆株23kDa膜蛋白（SjC23）DNA疫苗诱导猪的保护性免疫作用。方法 构建并大量制备pcDNA3．1－SjC23质粒DNA和pcDNA3．1－p34，pcDNA3．1－p40（小鼠IL－12的2个亚单位）的DNA疫苗。30头2．5月龄的上海松江本地猪（阉猪）发为A、B、C3组，每组10头。A组（SjC23组）于每头猪两侧臂部肌肉注射500μgpcDNA3．1－SjC23质粒DNA，B组（Sj23＋IL－12组），于每头猪肌肉注射500μgpcDNA3．1－SjC23DNA及500μgpcDNA3．1－p35和500μgpcDNA3．1－p40的混合质粒DNA；C组（对照组）每头猪肉注射500μgpcDNA3．1质粒DNA。共免疫3次，每次间3周。末次免疫后30d，每猪经背部皮肤攻击感染日本血吸虫尾蚴600条。攻击后45d剖杀，经胸主动脉灌中，并从门静脉收集计算成虫。从肝脏的同一部位切下小块肝组织，置5％KOH内消化后，计算每克肝组织虫卵数（EPG），比较各组间减虫率、减雌率和减卵率。在免疫前，末次免疫后和攻击后从猪耳静脉采血，分离血清，用ELISA检测抗SjC23抗体。结果 SjC23组与SjC23＋IL－2组与质粒对照组相比，分别获得29．2％和58．6％的减虫率、50．8％和58．8％的减雌率以及48．2％和56．4％的减卵率。抗体检测SjC23组和SjC23＋IL－12组均有约50％的实验猪可检测到明显的抗SjC23抗体。结论 SjC23DNA疫苗可诱导猪产生较好好的保护保护作用，具有较大的发展潜力。     

粒细胞集落刺激因子对四氯化碳所致小鼠慢性肝损伤的预防作用

肝硬化目前尚缺乏满意治疗方法,阻断肝硬化的进展,将有助于延长患者生命.我们用重组人粒细胞集落刺激因子(rhG-CSF),研究粒细胞集落刺激因子对CCl4所致小鼠慢性肝损伤的预防作用.     

汞泄漏处置包的制作与应用

为及时有效处置汞剂泄漏,防止环境污染,保护患者及医护人员健康,按照处理汞剂泄漏的操作流程,将处置汞剂泄漏需要使用的药物及防护用品等组装成汞泄露处置包,处置临床发生的汞剂泄露事件.经临床使用,泄露汞剂均得到了及时、规范、有效的处理.     

Gonad shielding in paediatric pelvic radiography: Effectiveness and practice

The use of Gonad Shields (GS) has been advocated during pelvic radiography since the 1950's, particularly in children where the risks from radiation are higher. Previous literature reports that GS are often omitted and rarely used correctly.ObjectivesPresentation of findings concerning use of GS in the context of previous data in the literature, and recommend any appropriate actions.MethodA retrospective analysis of images from an existing DICOM Digital Teaching Library (DTL) was conducted. Images of the pelvis from paediatric patients were reviewed and scored on whether a GS was present and (if present) whether the shield was considered to adequately protect the gonads.Results130 images were reviewed. 70 male and 60 female. The gonads were deemed to be protected by a shield in 22 images (17%), inadequately protected when a shield was used in 44 images (34%) with the remaining 64 images (49%) having no shield at all. A lack of adequate protection for the gonads was found, with females more likely to be inadequately protected than males (χ² = 19.009, df = 1, p < 0.001). These findings become more clinically significant when reports of ovaries lying outside of the pelvic basin (in paediatric patients) are considered.ConclusionsThe current practice of gonad shielding is neither effective nor beneficial for female paediatric patients, incorrect shield placement can often require repeat exposures. This finding is commensurate with previous literature. Therefore, gonad shielding is no longer an appropriate optimization tool for female paediatric patients during conventional radiography of the pelvis, and should be abandoned.     

富巯基食物对摄砷小白鼠保护效应

目的是探讨巯基对砷中毒的保护作用。应用分别加豌豆、绿豆和水解毛发增加饲料巯基方法 ,观察了给小白鼠饲含砷 80 mg/ kg饲料时的巯基保护效应。结果表明 ,巯基保护组动物体重和脏器重量高于单纯摄砷组 ,同时注意到器官巯基水平和毛、肝、肌肉砷含量介于对照和单纯摄砷组之间。结论是食物中巯基能减弱砷毒性 ,其机理可能涉及到砷毒性高的形态转为毒性较低形态 ,因为在保护组砷水平仍高于对照组。