血液灌流治疗药物急性中毒的护理体会

目的探讨血液灌流在急性药物中毒治疗中的效果及其护理方法。方法将急性中毒患者随机分为内科保守治疗组和血液灌流组,血液灌流组在家属签字同意后尽早进行血液灌流,同时给予相应的内科常规救治和护理措施;内科保守治疗组进行内科常规救治和护理。结果血液灌流治疗组患者的意识清醒时间、平均住院时间、有机磷中毒患者胆碱酯酶恢复时间均显著低于常规治疗组。结论血液灌流治疗是抢救急性药物中毒患者的一种安全、有效的治疗措施,治疗过程中应加强病情观察和护理,以提高临床疗效。     

血液透析+血液滤过+血液灌流治疗急性鱼胆中毒18例疗效观察

目的本研究主要就急性鱼胆中毒采用血液透析+血液滤过+血液灌流治疗的临床疗效展开分析讨论。方法选择该院10年12月1日—13年3月1日收治的18例急性鱼胆中毒患者为研究对象,患者入院后均采用血液透析+血液滤过+血液灌流方式治疗。结果所有患者中,治愈17例,1例中途退出而死亡,治愈率为94.44%。结论血液透析+血液滤过+血液灌流联合治疗急性鱼胆中毒有较好效果,值得临床推广应用。     

血液灌流与血液透析灌流治疗重度有机磷农药中毒的比较

血液净化技术已在抢救重度急性有机磷农药中毒（acute organophosphate poisoning,AOPP）中得到广泛应用,临床上常使用单纯血液灌流（HP）或血液透析串联血液灌流（HDP）方法治疗.2种方法在治疗效果、血液动力学等方面是否存在差异尚未见报道.我们比较分析了77例AOPP患者分别进行HP和HDP后,临床效果及血压的改变,现报告如下.     

血液透析串联血液灌流治疗尿毒症脑病临床分析

目的探讨血液灌流(HP)联合血液透析治疗尿毒症脑病的临床效果。方法在综合内科治疗的基础上,对22例尿毒症脑病患者及进行治疗,采用血液灌流联合血液透析治疗19例,单纯血液透析3例,观察患者临床症状及体征等变化情况。结果经血液透析串联血液灌流治疗后,19例中临床症状缓解16例,占84%。结论血液灌流联合血液透析是治疗尿毒症脑病有较好疗效,优于单纯血液透析治疗尿毒症脑病。     

血液灌流联合血液透析治疗尿毒症皮肤瘙痒11例观察与护理

目的观察血液灌流（HP）联合血液透析（HD）治疗尿毒症皮肤瘙痒的临床疗效。方法灌流器串联于透析器前端，联合治疗2h结束灌流，取下灌流器再继续透析2h，每周一次，连续1个月后每两周一次。结果11例患者4例患者皮肤瘙痒完全缓解，6例明显减轻，1例未见明显效果。结论血液透析联合血液灌流治疗尿毒症皮肤瘙痒效果满意。     

JaFron DX-10全自动血液净化机透析联合JF-800A血液灌流机治疗尿毒症的临床效果观察

目的：观察JaFron DX-10全自动血液净化机透析联合JF-800A血液灌流机在尿毒症患者治疗过程中的临床应用效果。方法：将2020年8月～2022年8月在本院接受治疗的尿毒症患者42例作为实验对象，运用电脑随机分组法将患者分为观察组与对照组，每组各有患者21例，观察组患者运用JaFron DX-10全自动血液净化机透析联合JF-800A血液灌流机治疗，对照组单纯应用JaFron DX-10全自动血液净化机透析治疗。结果：观察组患者治疗效果、治疗后血清毒素指标、微炎症指标水平均显著差别于对照组患者，P<0.05；治疗前两组患者血清毒素指标、微炎症指标水平无明显差异，P>0.05。结论：JaFron DX-10全自动血液净化机透析联合JF-800A血液灌流机在尿毒症患者中的应用获得了较为显著的临床效果。     

血液灌流治疗毒鼠强中毒的疗效观察

目的通过对58例中、重度毒鼠强中毒病例的治疗,评价血液灌流在治疗毒鼠强中毒的应用价值。方法列58例中、重度中毒患者于血液灌流前后及清醒、抽搐停止时的血毒浓度进行测定,血液灌流的间隔时间为24h。结果血毒浓度与临床症状：血毒浓度越高,其临床症状越明显;血液灌流疗效：血液灌流能有效地降低血毒浓度,迅速改善临床症状,对于毒鼠强中毒的疗效显著,一般经2～4次灌流后即可达疗效目的。结论血液灌流是治疗毒鼠强中毒最有效的治疗方法。     

血液灌流对百草枯中毒治疗的影响研究

目的分析百草枯中毒采用连续性静脉-静脉血液滤过联合血液灌流治疗后的临床疗效。方法选取医院2017年6月-2018年8月收治的60例百草枯中毒患者为研究对象,随机分为观察组和对照组,各30例,对比患者临床疗效和治疗前后相关指标变化。结果观察组进行连续性静脉-静脉血液滤过联合血液灌流治疗总有效率高于对照组,且观察组治疗后的相关指标对比好于对照组,P <0.05。结论连续性静脉-静脉血液滤过联合血液灌流治疗,可以提升百草枯患者中毒治疗效果,对于患者临床治疗工作实施质量控制具有重要保障,且在患者临床治疗控制中,可以为患者治疗效果及治疗后的相关指标控制提供帮助。     

血液透析、血液灌流治疗急性百草枯中毒的比较研究

目的探讨血液透析、血液灌流治疗急性百草枯中毒的临床效果。方法选取急性百草枯中毒患者92例,随机分为三组,其中A组41例,给予单纯血液透析+常规治疗;B组20例,给予单纯血液灌流+常规治疗;C组31例,给予血液透析联合血液灌流+常规治疗。结果采取血液透析联合血液灌流进行治疗的患者有效率明显高于单纯采用血液透析或血液灌流进行治疗的患者;经联合治疗而最终死亡的患者存活时间明显长于单纯采用血液透析或血液灌流进行治疗的患者,其间比较差异明显,差异有统计学意义(P﹤0.05)。结论对急性百草枯中毒患者及时采取血液透析联合血液灌注治疗可以有效提高治疗效果。     

血液灌流治疗急性中毒126例临床疗效

目的探讨血液灌流治疗急性中毒的临床疗效。方法126例急性中毒在综合治疗的同时,尽早采用血液灌流,严密监测血液灌流过程,积极预防并发症,配合内科常规治疗,通过观察清醒时间、住院时间及受损的肝肾功能恢复所需时间来判断血液灌流的疗效。结果血液灌注对降低死亡率,减轻肝、肾、心、脑等器官损害,缩短昏迷时间,阿托品总用量减少及减少住院时间有明显疗效。结论血液灌流是治疗急性中毒有效方法之一,值得临床推广。     

Hypersensitivity pneumonitis due to metal working fluids: Sporadic or under reported?

BACKGROUND: Occupational exposure to metal working fluids (MWF) is common with over 1.2 million workers in the United States involved in machine finishing, machine tooling, and other metalworking operations. MWF is a known cause of hypersensitivity pneumonitis (HP). Recent reports of outbreaks of hypersensitivity HP secondary to exposure to MWF are reported. DESIGN: Cases were identified through the Occupational Disease surveillance system in the State of Michigan and from referrals for evaluation to the Division of Occupational and Environmental Medicine at Michigan State University (MSU). Each patient underwent a clinical examination including an occupational history, lung function studies, radiographic imaging, and in some cases lung biopsies. Following the diagnosis of definite HP, an industrial hygiene investigation was carried out, which included a plant walk-through, and review of the "Injury and Illness" log. Air monitoring and microbial sampling results were reviewed. RESULTS: As part of Michigan's mandatory surveillance system for occupational illnesses, seven cases of suspected HP were identified in 2003-2004 from three facilities manufacturing automobile parts in Michigan. Each plant used semi-synthetic MWFs, and conducted a MWF management program including biocide additions. Two facilities had recently changed the MWF before the cases arose. Growth of mycobacteria was found in these two MWFs. Breathing zone samples for particulates of two employees in plant A (two cases) ranged from 0.48 to 0.56 mg/m3. In plant B (four cases), two employees' sampling results ranged from 0.10 to 0.14 mg/m3. No air sampling data were available from plant C. CONCLUSION: Hypersensitivity pneumonitis due to exposure to MWFs is under-recognized by health care providers, and current surveillance systems are inadequate to provide a true estimate of its occurrence. HP arose from environments with exposures well below the Occupational Safety and Health Administration (OSHA) permissible exposure limit (PEL) for MWF, and in one case from exposures well below the National Institute of Occupational Safety and Health (NIOSH) recommended exposure limit (REL). The sporadic nature of reports of HP in relationship to MWF probably represents a combination of workplace changes that cause the disease and inadequate recognition and reporting of the disease when it does occur. Physician awareness of HP secondary to MWF and an effective medical surveillance program are necessary to better understanding the epidemiology and prevention of this disease.     

Investigation of the optimum heel pad stiffness: a modeling study

Due to the controversy regarding the criterion for diagnosing heel pad (HP) pathology based on evaluating the state of the heel pad stiffness (HPS), this paper intended to apply modeling to understand the influence of the HPS on the mechanical responses of the HP at heelstrike during locomotion, in an attempt to investigate the optimum HPS in terms of the health-related mechanical responses. Two different models, a finite element model and a classical mechanical model, were used to simulate the mechanical responses (force loading and deformation) experienced by the HP at heelstrike. Both excessive force loading and deformation are believed to be detrimental to the heel pad. In the simulation, the corresponding force loading, deformation and net effect (the adding of the normalized force loading and deformation) were calculated for each HPS value. Two models found consistent trends that the stiffer the HP, the greater the force loading and the lower the deformation. In contrast, a softer HP experienced a lower force loading and a greater deformation. Both the force loading and deformation were at medium levels and the net effect was minimal at a HPS value between the highest and lowest values used in the simulation. The modeling result suggested that the optimum HPS should be in a state at which both the force loading and deformation were at medium levels and the net effect was minimal, in terms of the health-related mechanical responses. The abnormal level of HPS, either too high or too low, may correlate to respective pathologies.     

Effect of high temperature on feeding behaviour and heat production in group-housed young pigs.

To assess the acclimation of pigs to heat stress, the effects of high (33 degrees C) or thermoneutral (23 degrees C) constant temperatures on feeding behaviour and components of energy balance were studied in group-housed young pigs. Three groups of five pigs were used at each temperature. After 1 week of adaptation, voluntary feed intake (VFI) and heat production (HP) were recorded for thirteen consecutive days. Animals were fed ad libitum. Fasting HP was measured on the last day. Average initial body weights (BW) were 21.4 and 20.9 kg at 23 and 33 degrees C respectively. Feeding behaviour was measured individually and rate of feed intake and characteristics of feeding behaviour were calculated. The O(2) consumption, CO(2) production and physical activity of the group were used to calculate total HP (HP(tot)) and its components, i.e. fasting HP (HP(fas)), HP due to physical activity (HP(act)) and thermic effect of feed (TEF). The BW gain and VFI were reduced by 37 and 30 % respectively at 33 degrees C. The decrease in VFI corresponded to reduced consumption time (-34 %) and size of the meals (-32 %). Feeding behaviour was mostly diurnal (66 % of the VFI), and the rate of feed intake (28 g/min) was not affected by temperature. Daily HP(tot), HP(fas) and TEF, expressed per kg metabolic weight (BW(0.60)), were significantly decreased at 33 degrees C by 22, 18 and 35 % respectively, whereas HP(act) was not affected; TEF expressed per g feed was not affected (2 kJ/g). The decrease in HP(tot) at 33 degrees C was caused by a reduction in TEF and HP(fas) (kJ/d per/kg BW(0.60)), which are both related to reduction in VFI.     

Validity of the Hochberg procedure revisited for clinical trial applications

There is much interest in using the Hochberg procedure (HP) for statistical tests on primary endpoints of confirmatory clinical trials. The procedure is simple to use and enjoys more power than the Bonferroni and the Holm procedures. However, the HP is not assumption free like the other two procedures. It controls the familywise type I error rate when test statistics (used for statistical tests) are independent or if dependent satisfy a conditionally independent formulation. Otherwise, its properties for dependent tests at present are not fully understood. Consequently, its use for confirmatory trials, especially for their primary endpoints, remains worrisome. Confirmatory trials are typically designed with 1–2 primary endpoints. Therefore, a question was raised at the Food and Drug Administration as to whether the HP is a valid test for the simple case of performing treatment‐to‐control comparisons on two primary endpoints when their test statistics are not independent. Confirmatory trials for statistical tests normally use simple test statistics, such as the normal Z, student's t, and chi‐square. The literature does include some work on the HP for dependent cases covering these test statistics, but concerns remain regarding its use for confirmatory trials for which endpoint tests are mostly of the dependent kind. The purpose of this paper is therefore to revisit this procedure and provide sufficient details for better understanding of its performance for dependent cases related to the aforementioned question. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.     

脉动真空灭菌器B-D试验阳性结果的分析与验证

B—D试验是检验脉动真空压力蒸汽灭菌器能否安全使用的主要方法，但其过程中影响因素多，其阳性检测结果并不都是因灭菌器故障而致。通过对B—D试验的阳性检测结果进行较系统的验证，分析其阳性检测结果产生的原因，避免因误判而影响灭菌器的正常使用。     

反复腹痛患儿幽门螺杆菌感染的影响因素分析

目的:探讨反复性腹痛患儿幽门螺杆菌(HP)感染相关因素,为预防幽门螺杆菌感染提供依据。方法:选择反复慢性腹痛患儿196例,利用13C-尿素呼气试验及HP粪便抗原检测确定反复腹痛儿童Hp感染情况,此两种检测均阳性者作为病例组,阴性者作为对照组;采用统一编制的调查表收集被调查者的相关资料。结果:196例反复腹痛患儿中感染HP 85例(病例组),感染阳性率为43.4%。单因素分析两组在年龄、病程、居住地的分布差异无统计学意义(P>0.05),而男女性别构成差异有统计学意义(P<0.05);是否与家人同睡、母亲文化程度、其他照顾者是否有胃病史均与HP感染有关(P<0.05)。经多因素非条件Logistic回归分析,控制混杂因素后结果仍显示性别、是否与家人同睡、其他照顾者胃病史有无3个因素与感染有关,即性别为女性、独睡、被除父母外无胃病史的其他照顾者照看的儿童HP感染的危险性降低。结论:此次调查显示反复腹痛儿童HP感染与性别、是否与家人同睡和其他照顾者胃病史有关联。     

幽门螺杆菌感染相关因素的研究进展

幽门螺杆菌（HP）是革兰阴性微需氧的螺旋样杆菌，主要通过口-口途径在人-人之间感染传播。HP的发现加深了人类对慢性感染、炎症和癌症之间关系的认识。其特定的螺旋形体型、鞭毛及动力、尿素酶和黏附素活性，以及细胞毒素基因A（cagA）、空泡细胞毒素基因A（vacA）等是影响HP感染研究较多的相关致病因素。HP感染在胃癌的发生、发展中可能具有重要作用，但尚未确切证实HP感染是导致胃癌的主因。文章概述了HP感染相关致病因素的研究进展。     

Health-promoting organization and organizational effectiveness of health promotion in hospitals: a national cross-sectional survey in Taiwan

To assess the organizational health-promotion (HP) status and its effect on the organizational effectiveness of HP in a national cross-sectional survey of all hospitals above the local community hospital level in Taiwan's hospitals, questionnaires were sent to 474 hospitals, of which 162 (34.18%) hospitals returned them and were rendered valid. The results of the organizational HP status reveal that the standardized overall score achieved is 76.26, suggesting that there is considerable room for improvement. The results of correlation analysis partially support the proposition of this study, suggesting that the higher the organizational HP status, the better the self-evaluated overall organizational and administrative effectiveness of its HP. When hierarchical multiple regression was performed, support for ownership (private hospitals), hospital accreditation grades (academic medical centers) and overall score of the Organizational Health of Hospital Assessment Scale were significant predicators of self-evaluated overall organizational effectiveness (F = 11.097, p < 0.01, R(2) = 0.369). Moreover, drafted annually, HP policies and plans and the number of staff HP training activities were found to partially mediate the relation between the organizational HP status, hospital characteristics and self-evaluated overall organizational effectiveness. The results contribute to clarify the conception of health-promoting hospital organizations and to identify a number of dimensions of health-promoting organizations related to the organizational effectiveness of HP in hospitals, which could allow hospitals to establish a healthier organization and more effective HP programs. This study also supplies the research field with important data and insights that can be used in future research.     

Lead effects on protamine-DNA binding

BACKGROUND: Lead impairs male fertility and may affect offspring of exposed males, but the mechanisms for this impairment are not completely clear. Protamine P1 and P2 families pack and protect mammalian sperm DNA. Human HP2 is a zinc-protein and may have an important role in fertility. As lead has affinity for zinc-containing proteins, we evaluated its ability in vitro to bind to HP2 and its effects on HP2-DNA binding. Methods and Results UV/VIS spectroscopic data indicated that HP2 binds both Pb(2+) and Zn(2+)(as chloride salts). They also provided evidence that thiol groups mainly participate for Zn(2+)-binding; however, HP2 has additional binding sites for Pb(2+). The mobility shift assay showed that lead interaction with HP2 caused a dose-dependent decrease on HP2 binding to DNA, suggesting that lead may alter chromatin stability. CONCLUSIONS: These in vitro results demonstrate that lead can interact with HP2 altering the DNA-protamine binding. This chemical interaction of lead with protamines may result in chromatin alterations, which in turn may lead to male fertility problems and eventually to DNA damage.