移动式水处理在血液净化中的应用与展望

介绍了移动式水处理设备的结构、应用及发展前景，回顾了国内外水处理设备的发展现状，以及移动式水处理设备在临床的应用现状，分析了移动式水处理设备的优点及存在的问题。移动式水处理设备为解决临床急诊和床旁血液净化治疗提供了有力保障．具有广阔的发展前景。     

急诊早期血液净化抢救急性重度中毒78例临床分析

目的 探讨急诊早期血液净化治疗急性药物、毒物重度中毒的方法及应用时机.方法 回顾性分析2010年6月至2012年6月收治的78例急性药物、毒物重度中毒患者的临床资料,包括Glasgow评分、住院天数、机械通气使用率、痊愈率、病死率及血液净化治疗的不良反应等.结果 患者初诊时Glasgow评分为（5.5±2.0）分,使用血液净化的时间为初诊后（2.1±0.7）h,使用血液净化次数（2.6±0.7）次,其中单用血液透析8例,单用血液灌流治疗52例,使用血液透析联合血液灌流治疗10例,使用床边长时间肾脏替代治疗8例.痊愈出院65例（83.3％,65/78）,自动出院10例（12.8％,10/78）,死亡3例（3.8％,3/78）.住院天数（5.4±2.5）d.结论 早期、积极、充分应用血液净化治疗、抢救重度中毒,可提高抢救成功率,疗效确切.     

持续床边血液净化治疗急性重型胰腺炎临床疗效分析

[目的]探讨持续床边血液净化治疗急性重型胰腺炎的临床疗效。[方法]选择某院2009年11月～2011年8月期间收治的急性重型胰腺炎患者72例,根据区组随机化分组方法将患者分为研究组和对照组,每组36例。对照组患者采用常规基础治疗,研究组患者在对照组基础上进行持续床边血液净化治疗。[结果]与对照组相比,研究组患者的平均动脉压明显增高,而心率则明显降低,PCT、SCr、CRP、TB、ALT、AMS、APS等血清生化指标均显著改善,腹痛消失时间、腹胀缓解时间、住院时间均明显缩短,且并发症发生率明显降低,而临床治愈率则显著提高,差别均具有统计学意义(P﹤0.05)。[结论持续床边血液净化能够有效的提高患者的抢救率,减少并发症的发生,对于提高急性重型胰腺炎患者的治愈效果具有重要的作用。     

利用自制反渗水供应装置实现床边血液净化治疗的技术及临床应用

随着血液净化技术的不断发展，床边血液净化治疗已广泛应用于急性重症肾功能衰竭和多脏器功能障碍的就地抢救。目前虽有专用的床边血液净化机，但价格昂贵，而应用简易方法床边治疗则危险性大，且不便操作。我们针对国内大部分医院均已开展血液透析的现实，自行设计了反渗水供应装置进行床边血液净化治疗，取得了良好的效果，现将该技术介绍如下。１基本原理及组成反渗水供应装置的组成及基本原理如图１所示，分别由密闭反渗水箱、供液循环系统、血透机对接装置及监测系统组成。（１）采用进口PVC材料制成内部容积为１６０L的密闭水箱，储…     

舒适护理在ICU床边血液净化患者护理中的应用效果评价

目的:探讨ICU床边血液净化患者运用舒适护理的临床效果。方法:选择我院2014年2月—2015年2月期间收治的ICU床边血液净化患者76例为研究对象,随机分为两组,其中对照组行常规护理,而观察组则运用舒适护理,对比两组护理效果。结果:与对照组比较,观察组的SAS和SDS评分均较低,组间对比差异明显(P0.05);同时,两组护理满意度比较有显著差异(P0.05)。结论:临床上将舒适护理运用在ICU床边血液净化患者中,能够改善患者不良情绪,提高护理满意度。     

杀鼠剂中毒30例临床分析

目的探讨杀鼠剂中毒的临床治疗。方法对我院收治杀鼠剂中毒30例患者使用特效解毒剂及血液净化治疗的有效性进行分析总结。结果治愈27例，占90％，死亡3例，占10％，于入院半小时内死亡，未来得及使用特效解毒剂及血液净化治疗。结论杀鼠剂中毒使用特效解毒剂疗效确切，血液净化治疗采用血液灌流疗效满意。     

血液灌流中深静脉置管的临床护理优势比较

急性中毒是急诊的常见疾病,临床治疗方法有限.血液灌流目前应用广泛,是利用体外循环灌流器中吸附剂的吸附作用,清除体内的外源性或内源性物质、药物,以达到血液净化目的的一种血液净化技术与方法[1].     

急诊血液净化288例次临床分析

血液净化可有效地清除体内过多的代谢产物,纠正水、电解质紊乱,清除毒物,维护机体内环境的稳定和细胞生理功能。急诊血液净化对抢救患者的生命有着重要的作用。本文收集288例次急诊血液净化的原因、并发症、净化时机及预后进行分析与讨论。1临床资料1.1一般资料186例患者共进行了288例次急诊血液净化抢救,其中男性100例,女性86例,平均年龄(52.3±17.5)岁。1.2净化方法288次血液净化中,碳酸盐透析(Bi-HD)239次,连续性血液透析(CAVHD)12次,血液灌流(HP)11次,血液透析串联血液灌流(HD+HP)26次。临床血路建立采用股静脉穿刺、股静脉置管、…     

现代医疗器械在控制和治疗SARS中的应用

介绍了现代医疗器械在控制和治疗SARS中的应用，根据防治SARS的医学流程，从传染源的监控筛选、住院患者的治疗和抢救等方面分别阐述了医用非接触式红外测温仪、移动式床边X射线机、床边血气分析装置、乎吸机和心电监护仪的具体应用。     

急诊血液净化治疗对重度有机磷中毒患者的临床效果分析

目的分析研究急诊血液净化治疗对重度有机磷中毒患者的临床效果。方法对2010年02月~2017年02月我院救治的88例重度有机磷中毒患者进行研究,将其按照双盲法进行随机分组,分为对照组和观察组,各44例。给予对照组患者常规治疗,观察组患者给予常规治疗的基础上行血液净化治疗,对比两组患者的临床疗效。结果观察组患者抢救成功率为97.73%(43/44),对照组为81.82%(36/44),组间比较差异显著(χ~2=6.06,P﹤0.05);观察组患者阿托品用量、ChE恢复时间、自主呼吸恢复时间、意识恢复时间和住院时间等均显著低于对照组(P﹤0.05),观察组患者术后肝肾损伤以及呼吸衰竭等并发症发生率均显著低于对照组(P﹤0.05)。结论急诊重度有机磷中毒患者采用血液净化治疗可以有效的提高临床疗效,缩短各项功能恢复时间,安全性更高,值得临床推广。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.