以被服洗涤配供服务为突破口积极参与医院后勤社会化改革

国务院《关于城镇医药卫生体制改革指导意见》中指出:"实行医院后勤服务社会化,凡社会能有效提供的后勤保障,都应逐步交给社会去办."根据这一文件精神,我公司以医院被服洗涤配供服务为突破口,探索了一条卫生产业企业积极参与医院后勤社会化改革的新路子,不但取得了明显的社会效益,经济效益也逐年提高.截止目前为止,我公司下属汇生洗涤配供服务有限公司已为市区范围内20余家医院提供了被服洗涤服务,并已开始为其中的6家综合性医院提供床上被服用品的配供服务.     

Assessment of Genotoxic Damage in Lymphocytes of Hospital Workers Exposed to Ionizing Radiation in Argentina

The authors aimed to assess genotoxic damage in the lymphocytes of workers chronically exposed to ionizing radiation. The studied population included 15 exposed donors of the radiology unit of a public hospital in La Plata, Argentina. The control group included 15 nonexposed employers from administrative areas that the authors matched by age, sex, and smoking habits. The mean frequency of cytogenetic damage was higher in the exposed group than in the unexposed group for aneuploidy and structural chromosome aberrations. They observed the highest difference when achromatic lesions (or gaps) were considered. The comet assay showed that the frequency of cells with low damage was higher in the exposed group than in the unexposed group. A mean length analysis showed significant differences between exposed and nonexposed people. The results can be considered to be consistent evidence of occupational radiation exposure, and the results indicate that the workers must be advised to avoid or minimize their exposure.     

Styrene Toxicity: An Ecotoxicological Assessment

Although other aromatic compounds (e.g., benzene, toluene, polycyclic aromatic hydrocarbons (PAH), etc.) have been thoroughly studied over the years, styrene has been given little attention probably due to its lower rate of industrial use. In addition, it is less toxic than benzene and PAH, proven carcinogens. However, it is classified as a mutagen and thus potentially carcinogenic. Its main use is in the production of the polymer polystyrene and in the production of plastics, rubber, resins, and insulators. Entry into the environment is mainly through industrial and municipal discharges. In this review, the toxicological effects of styrene on humans, animals, and plants are discussed. Its mode of entry and methods of monitoring its presence are examined. Although its effects on humans and aquatic life have been studied, the data on short- or long-term exposures to plants, birds, and land animals are insufficient to be conclusive. Since exposure to workers can result in memory loss, difficulties in concentration and learning, brain and liver damage, and cancer, development of accurate methods to monitor its exposure is essential. In addition, the review outlines the present state of styrene in the environment and suggests ways to deal with its presence. It might appear that the quantities are not sufficient to harm humans, but more data are necessary to evaluate its effect, especially on workers who are regularly exposed to it.     

提高洗衣房服务质量满意度

目的 提高洗衣房服务质量满意度.方法 QC小组活动.结果 洗衣房服务质量满意度由活动前的39.5％提高到活动后的76％.结论 通过QC小组活动,提升了洗衣房工作人员素质,提高了洗衣房服务质量满意度.     

Ecotoxicological Hazard Assessment of Two Polymers of Distinctively Different Molecular Weights

Assessment of ecological risks during manufacturing, use, transport, and disposal are becoming increasingly important as planning tools during development of new products. The objective of this study was to establish the potential ecotoxicological hazard associated with two polycarboxylate polymers in water, sludge, sediment, and soil. The concentrations of both polymers were quantified using ¹⁴C-radiolabeled synthesis and liquid scintillation counting (LSC). The program included water column acute and chronic exposures with Ceriodaphnia dubia, Pimephales promelas, and Selenastrum capricornutum, sediment exposures with Chironomus riparius, and soil exposures with Eisenia foetida. Sludge treated with either polymer, from a semicontinuous activated sludge unit, was used to evaluate the effect on growth of five plants. The hazard assessment program for both polymers indicated a very low order of toxicity as defined by the U.S. EPA and OECD. Very small fractions of each polymer may not be removed by waste treatment and could accumulate in sediments, but should not pose a significant risk because of their low toxicity to benthic organisms. Terrestrial testing demonstrated that soil needs to be saturated with these chemicals to produce adverse effects. Bioaccumulation potential for both polymers was extremely low. Use of these polymers does not appear to pose a significant risk to the environment, based on their low inherent toxicity. Received: 27 January 1997/Accepted: 9 September 1997     

intI1 Type Mobile Genetic Elements Co-selected Antibiotic-Resistant Genes in Untreated Hospital Wastewaters

Bulletin of Environmental Contamination and Toxicology - Dissemination of antibiotic-resistant genes (ARGs) from hospital wastewaters (HWWs) is facilitated by the horizontal gene transfer (HGT) and...     

An Assessment of Three Harpacticoid Copepod Species for Use in Ecotoxicological Testing

The relatively short life cycles of harpacticoid copepods makes them appropriate animals for use in tests that rapidly assess the acute, sublethal, or chronic effects of sediment contaminants. In this study, four harpacticoid copepod species (Nitocra spinipes, Tisbe tenuimana, Robertgurneya hopkinsi, and Halectinosoma sp.) were isolated from clean marine sediments, and procedures for laboratory culturing were developed. Halectinosoma sp. was abandoned due to handling difficulties. For the remaining species, the influence of food type and quantity on life-cycle progression was assessed. A mixed diet, comprising two species of algae (Tetraselmis sp. and Isochrysis sp.) and fish food (Sera Micron) was found to maintain healthy cultures and was fed during laboratory tests. Water-only exposure to dissolved copper (Cu) showed that the times (range) required to cause 50% lethality (LT₅₀) were 24 (22–27) h at 50 μg Cu/l for T. tenuimana; 114 (100–131) and 36 (32–40) h for 200 and 400 μg Cu/l, respectively, for N. spinipes; and 119 (71–201) and 25 (18–33) h for 200 and 400 μg Cu/l, respectively, for R. hopkinsi. 96-h LC₅₀ (concentration causing 50% lethality) were also determined for adult N. spinipes exposed to cadmium, copper, zinc, ammonia, and phenol. A ranking system was generated based on the ease handling and culturing, rate of maturity, food selectivity and sensitivity to Cu. From this ranking, N. spinipes was determined to be the most suitable species for use in developing sediment-toxicity tests. The measurement of total reproductive output of N. spinipes during 10-day exposure to whole sediment was found to provide a useful end point for assessing the effects of sediment contamination.     

医院文化的评价

为了探索医院文化评价的指标与方法、了解医院文化的现状,作者选择了上海市某区2所二级甲等医院进行了医院文化的职工问卷调查.调查结果显示,职工问卷调查能用于评价医院文化现状,但也存在一定的局限性;医院文化具有差异性与共性,目前医院已形成了较好的医院价值观;最后,作者提出了医院文化管理中应重视的几个方面.     

Ecotoxicological Assessment of Persistent Organic and Heavy Metal Contamination in Hong Kong Coastal Sediment

The effects of sublethal treatments (20% and 60% of LC₅₀/24 h) with plant-derived molluscicides on the reproduction of the giant African snail Achatina fulica were studied. Azadirachta indica oil, Cedrus deodara oil, Allium sativum bulb powder, and Nerium indicum bark powder singly and binary combinations on reproduction and survival of A. fulica were investigated. Repeated treatment occurred on day 0, day 15, and day 30. These plant-derived molluscicides significantly reduced fecundity, egg viability, and survival of A. fulica within 15 days. Discontinuation of the treatments after day 30 did not lead to a recovery trend in the next 30 days. Day 0 sublethal treatment of all the molluscicides caused a maximum reduction in protein, amino acid, DNA, RNA, and phospholipid levels and simultaneous increase in lipid peroxidation in the ovotestis of treated A. fulica. It is believed that sublethal exposure of these molluscicides on snail reproduction is a complex process, involving more than one factor in reducing the reproductive capacity of A. fulica. Received: 12 March 2000/Accepted: 31 May 2000     

Primary DNA Damage But Not Mutagenicity Correlates with Ciprofloxacin Concentrations in German Hospital Wastewaters

Recently, we showed for the wastewater of a large Swiss university hospital that primary DNA damage, assessed by a bacterial SOS repair assay (umuC test), could be largely assigned to a specific class of antibiotics, the fluoroquinolones (FQs) (Hartmann et al.[1998] Environ Toxicol Chem 17:377–382). In an attempt to confirm the significance of FQs for the bacterial DNA damaging effects in native hospital wastewaters, 25 samples from five German clinics were screened in this study by the umuC test. The results were compared to HPLC-derived concentrations of ciprofloxacin, an important member of the FQs. Ten samples (40%) were umuC-positive and ciprofloxacin concentrations ranged from 0.7 to 124.5 μg/L (n = 24). Primary DNA damage, as indicated by the umuC test, correlated strongly with ciprofloxacin concentrations in a logistic, dose-dependent manner (r² = 0.896), almost irrespective of the use of S9 metabolic activation. The lowest observed effect concentration (LOEC) for ciprofloxacin was 5.2 μg/L (+S9) and 5.9 μg/L (−S9). Similar to our previous findings, these results indicate that positive umuC results in hospital wastewater are strongly dependent on the presence of fluoroquinolone antibiotics. In a second part of the study, previously generated Ames and V79 chromosomal aberration data of the same samples (Gartiser and Brinker [1995] in Umweltbundesamt Texte 74/95) were compared with the newly generated results. Neither the mutagenic effects detected by the Ames assay (8%, n = 25) nor the positive V79 results (46% n = 13) seemed to be caused by ciprofloxacin. Therefore, the Ames and V79 results suggest the presence of additional mutagens that are yet to be identified. Received: 8 March 1998/Accepted: 27 August 1998     

Ecotoxicological profile of xylenes. Working Party on Ecotoxicological Profiles of Chemicals

The xylenes (o, m, p), which are produced in large amounts and widely used, must be considered as environmental contaminants, as they have been identified in the atmosphere of many countries. Their acute and chronic toxicity in mammals is moderate. Mutagenic and teratogenic properties can be excluded. Carcinogenic potential has been at present inadequately studied. In man some disturbances are evident at the concentration of 45 ppm. Hepatic metabolism is a valid process of detoxification and its high rate limits the risk of accumulation of the xylenes in adipose tissue. Ecotoxicological data refer almost exclusively to water. No long-term tests have been made. However, the high volatility, elevated elimination, and the low factor of accumulation suggest the impact on aquatic environment should be limited. Xylenes are easily biodegraded by many microorganisms. Photoxydation is one of the main degradation processes, responsible for the disappearance of the xylenes from the atmosphere.     

医院文化评价

为研究医院职工问卷调查方法在评价医院文化中的可靠性,作者在上海市闵行区某医院内,进行职工医院文化评价的2次问卷调查。根据调查结果,认为问卷调查在医院文化评价中具有较好的可靠性和可行性;虽然医院文化评价非常重要,本次研究确定的评价指标体系具有一定的科学性,但对医院文化评价方法仍需完善。     

Ecotoxicological evaluation of cork-boiling wastewaters

Toxicity tests with Vibrio fischeri, Daphnia magna, and Lemna minor were used to evaluate acute and chronic toxicity of cork-boiling wastewaters and correlation analysis was performed with physicochemical parameters. Acute toxicity values (EC₅₀) ranged from 2.3% to 24.2% in the Microtox test and from 4.4% to 29.5% in the Daphnia test. According to these values, 78% of the samples were classified as acutely toxic to the most sensitive species (V. fischeri). Significant correlation was obtained between EC₅₀ and chemical oxygen demand, biochemical oxygen demand after 5 days, total organic carbon, tannin and lignin and total solids. No significant correlation was found between the two acute tests. The D. magna chronic test showed significant differences between all tested concentrations and the control, with an EC₅₀ of 0.32%. An EC₅₀ value of 26.0% was calculated for L. minor. For the analysis of cork-boiling wastewater toxicity and routine biomonitoring, the use of the Microtox test is suggested, to afford greater environmental protection.     

转轨时期医院经营管理效益量化评价方法研究

效益评价是医院经营管理中的一项重要工作。医院经营管理的效益分为社会效益和经济效益。两个效益的人为脱节和社会效益指标的虚化,形成了效益评价的难点。本文采取层次分析法,将医院的社会效益、经济效益与医院的投入、消耗和产出的１９个指标有机结合起来,使两个效益在有机统一的前提下指标量化,这样既增强了两个效益评价工作的可操作性,也增强了效益评价结果对医院经济工作指导的操作性。     

苯酚的遗传毒性研究

通过小鼠骨髓染色体畸变和小鼠精子畸形试验，对苯酚的遗传毒性进行了观察．结果在５０、１００、２００ｍｇ／ｋｇ体重３个剂量组中，染色体畸变率和畸变细胞百分率显著高于阴性对照组，且有统计学意义．在相同剂量范围内与阴性对照组相比，小鼠精子畸形百分率未有显著性差异。结合国外有关报道，可以认为苯酚是一种具有遗传毒性的诱变剂。长期职业接触可能会对作业工人产生远期危害．     

医院后勤绩效指标建立与考核实践

随着医院后勤改革的不断深入,精细化管理的要求不断提高,后勤管理者的一项很重要的职能就是代表医院对各类服务机构进行考核。通过考核提高服务质量,节约支出。但由于历史、社会以及后勤自身的原因,医院后勤人力资源管理相对滞后,缺乏有效的监督和考核。作为医院后勤管理者,应该很清醒地认识到,后勤服务绩效如何,直接影响到医院临床一线工作的顺利进行及医疗质量。因此,如何提升服务部门的服务质量、如何挖掘资源潜力、如何加强考核力度、如何提高考核效率、如何调动一切积极因素为医务工作服务,必将成为整个后勤管理部门的重中之重!建立起有效的绩效考核机制势在必行。只有对医院后勤各科室及各社会机构进行绩效评估,从管理的角度抓问题关键,才能解决问题,从根本上提高后勤服务的整体质量。设计一套行之有效的绩效评估指标也将成为该项工作的起点和基础。