工作场所空气中甲基丙烯腈热解吸气相色谱测定方法的研究

目的:建立工作场所空气中甲基丙烯腈的热解吸气相色谱测定方法。方法:活性碳管吸附空气中甲基丙烯腈,热解吸后气相色谱(FID)测定。结果:样品中甲基丙烯腈的浓度在0.1~2.00μg/mL(以采集7.5L空气样品计,相当于空气中甲基丙烯腈的浓度在1.3~26.7mg/m3)时,线性关系良好,y=1592.2x+1236.3,r=0.9991(n=6);方法精密度试验,相对标准偏差在3.9%~5.7%之间;平均解吸效率95.1%;100mg活性碳管,穿透容量(BTV)>3.8mg;100mg活性碳采样,吸附60μg甲基丙烯腈,密闭放置1周,损失率<10%。结论:本方法适用于工作场所空气中甲基丙烯腈的浓度测定。     

汽油使用工作场所空气中MTBE的检测方法

目的:建立一种适用于汽油作业场所空气中甲基叔丁基醚的检测方法。方法:用活性碳管采样,二硫化碳解吸,HP-1(100 m×0.25 mm×0.5μm)的毛细管柱分离甲基叔丁基醚后检测。结果:方法的线性范围为0～3 000μg/ml,其相关系数r=0.9999;MTBE的检出限为3μg/ml。每100 mg活性碳的穿透容量大于7.2 mg,MTBE在活性碳管里贮存稳定,解吸效率均在95%以上,采样效率大于99.5%。结论:此方法的指标达到了工作场所空气中毒物检测方法的研究规范要求,适用于汽油使用工作场所空气中甲基叔丁基醚的的检测。     

工作场所空气中甲基丙烯酸正丁酯溶剂解吸气相色谱测定方法的研究

目的:报道了作业场所空气中甲基丙烯酸正丁酯的气相色谱测定方法。方法:空气样品用浸渍活性炭管采集,二硫化碳解吸、FFAP极性填充柱分离,氢火焰离子化检测器(FID)检测。结果:在本法的测定条件下,甲基丙烯酸正丁酯在2μg/ml～500μg/ml浓度范围内有良好的线性响应,相关系数r=0.9999,本法检出限为0.4μg/ml,最低检出浓度为0.1 mg/m3(采样体积3.0 L),采样效率达99.89%以上,穿透容量(BTV)18.8 mg,样品解吸效率为94.30%～97.58%,甲基丙烯酸正丁酯在活性碳管中最少可稳定15 d。结论:本方法可满足工作场所空气中甲基丙烯酸正丁酯浓度的监测。     

空气中亚硝酸盐和硝酸盐的离子色谱测定方法的研究

目的:建立空气中亚硝酸盐和硝酸盐的离子色谱测定方法。方法:本文采用超细玻璃纤维滤纸采集空气中亚硝酸盐和硝酸盐,用蒸馏水洗脱过滤后,经色谱柱分离,电导检测器检测,保留时间定性,峰高或峰面积定量。结果:空气中亚硝酸盐和硝酸盐的线性范围分别为0.5~30.0μg/m l和0.5~30.0μg/m l;相关系数分别为0.9997和0.9992;方法的最低检出限分别为0.5μg/m l和0.5μg/m l;若采集300 L空气进行测定,则最低检出浓度分别为0.017 mg/m3和0.017 mg/m3;相对标准偏差分别为0.39%~1.03%和0.45%~1.00%;样品洗脱效率分别为100.4%~103.2%和102.3%~106.8%;采样效率分别为94.8%~100.0%和92.7%~94.6%;样品在室温中至少可保存1周。结论:此法灵敏度高,选择性好,干扰少,是同时检测空气中亚硝酸盐和硝酸盐的好方法。     

工作场所空气中叔丁醇的检测方法

目的:建立一种适用于工作场所空气中叔丁醇的检测方法。方法:用活性碳管吸附采集空气中的叔丁醇,用5%异丙醇的二硫化碳解吸,Innowax-213(30 m×0.32 mm×0.5μm)的毛细管柱分离叔丁醇后检测。结果:方法的线性范围为0~3100μg/ml,其相关系数r=0.9999;叔丁醇的检出限为3.1μg/ml。每100 mg活性碳的穿透容量为7.4 mg;在空气中叔丁醇含量在该穿透容量范围内,采样效率大于95.0%。叔丁醇在活性碳管里贮存稳定,在7 d内稳定效果好,解吸效率均在90%以上。结论:此方法的指标达到了工作场所空气中毒物检测方法的研究规范要求,适用于工作场所空气中叔丁醇的检测。     

溶剂解吸-气相色谱法测定工作场所空气中的α-氯乙酰苯

目的:建立溶剂解吸-气相色谱法测定工作场所空气中α-氯乙酰苯的检测技术。方法:对工作场所空气中α-氯乙酰苯用活性炭管采集,用5%丙酮苯溶液解吸,经SE-30柱分离,电子捕获检测器检测。结果:本方法测定工作场所空气中的α-氯乙酰苯,线性范围为0.0~2.0μg/ml,检出限为1.0×10-5μg(进样1μl液体),最低检出浓度为0.01 mg/m3(采集2 L空气)。α-氯乙酰苯在0.025~0.6μg/ml浓度范围内,其相对标准偏差范围为2.9%~9.6%。结论:本方法快速、准确、灵敏度高、操作简便,仪器配置要求低,适用于工作场所空气中α-氯乙酰苯浓度的日常监测。     

工作场所空气中四溴化碳吸收液采样气相色谱测定方法的研究

目的:建立工作场所空气中四溴化碳吸收液采样气相色谱测定方法。方法:选用无水乙醇作吸收液采集空气中四溴化碳,以毛细管气相色谱(ECD)测定。结果:空气中四溴化碳浓度在0~20 mg/m3(以采集3 L空气样品计,相当于10 ml无水乙醇吸收液采样管中四溴化碳溶液浓度0~6μg/ml)时,线性关系良好(r=0.9997,n=3),回归方程Y=35520.3X-2966.5;方法的检出限为0.086μg/ml(进样1μl,3倍噪声所相当的量);最低检出浓度为0.29 mg/m3(以采集3.0 L空气样品计);相对标准偏差在0.4%~4.0%之间;采样效率92.7%;四溴化碳乙醇溶液封闭严密,4℃冰箱保存6 d稳定。结论:本方法适用于工作场所空气中四溴化碳的浓度测定。     

溶剂萃取气相色谱法测定空气中二甲基甲酰胺和二甲基乙酰胺

用水采集作业场所空气中二甲基甲酰胺(DMF)和二甲基乙酰胺(DMA),经三氯甲烷萃取后进样,大口径FFAP毛细管柱分离,氢焰离子化检测器检测。DMF和DMA的检测范围分别为3~200μg/m l,2~200μg/m l,相对标准偏差为0.76%~4.9%。     

工作场所空气中甲基丙烯腈溶剂解吸气相色谱测定方法的研究

目的建立工作场所空气中甲基丙烯腈的溶剂解吸气相色谱测定方法。方法活性碳管吸附空气中甲基丙烯腈,用2% (v/v)丙酮二硫化碳解吸后毛细管气相色谱(FID)测定。结果空气中甲基丙烯腈的浓度在0 ~133mg/m3(以采集1 5L空气样品计,相当于甲基丙烯腈标准溶液浓度在0 ~200μg/ml)时,回归方程Y= 393 71X+920 9,r=0 9996,最低检出限0 9μg/ml,平均解吸效率93 5%,穿透容量(BTV) >546μg;采样效率≥94%,样品在室温下可保存5d。结论本方法适用于工作场所空气中甲基丙烯腈的浓度测定。     

工作场所空气中羰基镍的石墨炉原子吸收测定法

目的:建立工作场所空气中羰基镍的石墨炉原子吸收的检测方法。方法:活性碳管吸附工作场所空气中的羰基镍,稀硝酸解吸液解吸,石墨炉原子吸收法测定。结果:标准曲线回归方程为Y=0.00279X+0.00041;相关系数r=0.9995;检出限为1.62μg/L;高、中、低3个浓度6次测定的平均相对标准偏差小于5%;平均解吸效率大于90%;室温下采样后活性碳管可放置14 d。结论:该方法适用于工作场所空气中羰基镍的浓度测定。     

长春新碱过量引起严重毒副反应1例的护理体会

报道1例霍奇金淋巴瘤患者因误用长春新碱（VCR）10mg一次性静脉推注后治疗护理情况。其出现间断性神志恍惚、眼睑闭合不全、言语不清、口腔黏膜糜烂、全身疼痛、麻痹性肠梗阻、尿潴留、手足麻木等症状,经积极解救,禁食,持续胃肠减压、胃管内注入麻油、开塞露、生理盐水灌肠,合理应用肠外营养,注重疼痛、心理护理,做好口腔、肛周护理,预防感染加重,患者病情得到控制好转出院。     

Choice of measures of vaccination and estimates of risk of pediatric pertussis

BackgroundVaccination uptake at the individual level can be assessed in a variety of ways, including traditional measures of being up-to-date (UTD), measures of UTD that consider dose timing, like age-appropriate vaccination, and risk reduction from individual doses. This analysis compared methods of operationalizing vaccination uptake and corresponding risk of pertussis infection.MethodsCity-wide case-control study of children in Philadelphia aged 3 months through 6 years, between 2001 and 2013. Multiple logistic regression was used to isolate the independent effects of each measure of vaccination uptake and the corresponding relative odds of pertussis.ResultsBeing UTD on vaccinations was associated with a 52% reduction in risk of pertussis (OR 0.48, 95% CI: 0.34, 0.69). Evaluation of delayed receipt of vaccine versus on-time UTD yielded similar results. There was a decrease in risk of pertussis for each additional dose received with the greatest reduction in pertussis infection observed from the first (OR 0.48, 95% CI: 0.28, 0.83) and second dose (OR 0.17, 95% CI: 0.08, 0.34). Additional doses conferred minimal additional protection in this age group.ConclusionExamining vaccination status by individual doses may offer improved predictive capacity for identifying children at risk for pertussis infection compared to the traditional UTD measure.     

上海市某医院骨科平均住院日影响因素分析

对上海市某医院2003年-2007年骨科出院病人的住院日描述性分析．2003年-2007年骨科的床位利用指数与平均住院日相关性分析．2003年-2007年骨科床位与医护比例分析．2007年骨科前10大病种平均住院目影响因素分别进行单因素相关性分析和多因素逐步回归分析（STATA软件）。通过对骨科10大病种住院日影响因素分析,术前等待天数、手术类型、是否输血分别对10个、9个和8个病种的住院目有影响。输血因素和手术类型是医院不可控、由病人的病情决定的,术前等待天数是管理因素,是最值得医院重视的影响因素。     

Correlates of stages of change of smoking among inhabitants of deprived neighbourhoods

BACKGROUND: This study examines the prevalence and correlates of stages of change of smoking, in terms of psychosocial, structural and sociodemographic factors, among inhabitants of deprived neighbourhoods. METHODS: Cross-sectional data were obtained from a survey on health related behaviour. Subjects were 2009 current and former smokers, aged 20-46, living in deprived neighbourhoods in Rotterdam, the second largest city in the Netherlands. Three groups of smokers were formed according to the stages of change-definitions of the Transtheoretical Model: smokers not planning to quit (precontemplators), smokers planning to quit (contemplators/preparators) and former smokers (actors/maintainers). Smokers planning to quit and smokers not planning to quit were compared regarding psychosocial factors (attitude, social norm, self-efficacy), structural factors (neighbourhood problems, material deprivation, financial problems, employment status) and sociodemographic factors (age, gender, marital status, cultural background, educational level). Former smokers were compared with smokers planning to quit regarding structural and sociodemographic factors. Logistic regression was used to assess correlates of stages of change. RESULTS: Smokers planning to quit (prevalence = 19%) reported a more positive attitude, stronger social norms and higher self-efficacy expectations in quitting smoking than smokers not planning to quit (prevalence = 57%). Smokers planning to quit less often were Dutch-born, more often had attended higher vocational schooling or university and more often reported experiencing two or more neighbourhood problems compared to smokers not planning to quit. Former smokers (prevalence = 24%) were older, more often Dutch-born, married, employed and higher educated, compared to smokers planning to quit. Furthermore, former smokers less often reported material deprivation and financial problems than smokers planning to quit. CONCLUSION: Among people living in deprived neighbourhoods, different factors correlate with different stages of change of smoking. Implications for health promotion are discussed.     

尘肺病患者145例死因调查

目的分析汉中市尘肺病的发生、发展和死亡原因，以提高尘肺病患者的生存质量。方法对145例尘肺病患者的死因进行回顾性分析，计算其平均发病年龄、死亡年龄及患尘肺病后的存活年限。结果矽肺的平均发病年龄和死亡年龄均早于煤工尘肺和石棉肺，尘肺病的主要死因为患肺部疾患，患尘肺病后的平均存活年限为12a。结论加强职业健康体检工作，对尘肺病人做到早发现早治疗和预防并发症的发生。     

西林瓶装注射用水的装量检查分析

为了检查西林瓶装注射用水的实际分装量是否符合2005年版《药典》三部要求,按照2005年版《药典》三部中“生物制品分装和冻干规程”,分装规格为0．8ml的西林瓶装注射用水10000瓶,随机在分装过程的前、中、后阶段共抽取100瓶,轧盖、目检。分别用1ml标定注射器及1ml普通无菌注射器抽取每瓶注射用水的实际体积,以t检验法对实际抽取量与标示量的差值进行统计学分析,结果显示其与2005年版《药典》三部要求分装附加量为0．1ml相比有显著性差异（P〈0．001）。     

两种不同肌瘤剔除术治疗子宫肌瘤的临床疗效比较

目的:比较腹腔镜子宫肌瘤剔除术与腹式子宫肌瘤剔除术的临床疗效。方法:回顾分析63例腹腔镜子宫肌瘤剔除术与61例腹式子宫肌瘤剔除术的临床资料,比较2种手术方式的手术时间、术中出血量、肛门排气时间、使用抗生素时间、术后感染率、体温恢复正常时间、住院时间等情况。结果:两组患者接受子宫肌瘤剔除术顺利完成,腹腔镜组手术时间长于开腹组(P0.05),腹腔镜组术中出血量及剔除肌瘤个数均少于开腹组(P0.05),术后腹腔镜组体温恢复正常时间、肛门排气时间、抗生素使用及住院时间均短于开腹组,两组患者最多随访6个月,腹腔镜组平均康复时间较开腹组短(P0.05),两组随访B超均未发现明显肌瘤结节。结论:腹腔镜子宫肌瘤剔除术损伤小,恢复快,住院时间短,是值得推广的微创手术。     

对《医疗事故处理条例》的几点认识--学习《医疗事故处理条例》的一点体会

国务院颁布的《医疗事故处理条例》（以下简称《条例》）在吸收、总结原《医疗事故处理办法》（以下简称《办法》）实施十几年以来正反两方面经验教训的基础上，对《办法》作了许多重大的修改：《条例》扩大了医疗事故的主体与范围，提出了防范医疗事故的一些重要措施，授权医学会独立担纲医疗事故技术鉴定工作，赋予了患者更多的权利，规定医疗事故民事责任争议可以“私了”，制定了更为规范的医疗事故的赔偿制度等。《条例》作出的这些新规定必将使医疗事故得以更加科学、客观、公正、公平、合理的解决。认真学习、把握《条例》的这些新规定，很好地透视《条例》的立法宗旨与原则，必将极大地提高学习、宣传《条例》的主动性与积极性，更好地推进《条例》的贯彻执行工作。     

The analysis of case-control studies of the efficacy of screening for recurrence of cancer

Occasionally, the efficacy of screening for cancer recurrence has been evaluated by means of case-control studies. However, these studies generally have not been designed and analyzed in a manner that will yield an unbiased result. The commentary shows that by adhering to the principles developed for the analysis of studies of the efficacy of screening for the presence of a given cancer in persons with no history of this disease, a case-control study of screening for recurrence will improve its chances of obtaining valid findings.     

137例地中海贫血出生相关因素分析

目的:揭示地中海贫血患儿出生相关因素,提出干预措施,为进一步制定地贫预防控制总体规划提供决策参考。方法:对近3年137例地贫儿(45例重型β-地贫、29例中间型β-地贫、32例中间型α-地贫和31例巴氏胎儿水肿综合征)出生相关因素进行调查研究。结果:地贫儿出生相关社会心理因素顺位依次为:基因携带者不知情(70.07%)、经济困难(21.17%)、心理因素(5.11%)、其它(3.65%)。基因携带者对自身情况不知情是本组地贫儿主要出生相关因素,与其它出生相关因素有显著差异(P<0.05)。结论:基因携带者自身的认识与重视是预防控制工作的一个重要组成部分,地贫高发区人群携带者(轻型β-地贫、α-地贫特征和静止型携带者)的检出及系统管理是预防控制工作的关键环节,应进一步应用生物、社会及心理的医学模式搞好地贫预防控制工作。