氰基丙烯酸酯医用胶的改性研究

目的:对氰基丙烯酸酯医用胶进行改性研究,并筛选出最佳改性材料及添加比例.方法:分别用羧基化多壁碳纳米管(MWCNTs-COOH)、多壁碳纳米管(MWCNTs)、丁腈橡胶、环氧树脂、纳米二氧化硅、聚甲基丙烯酸甲酯(PMMA) 6种材料对5%三氯生/氰基丙烯酸酯抗菌胶进行改性,并测试改性后抗菌胶的拉伸剪切强度(tensile shearing strength, TSS)、玻璃化转化温度(Tg)及黏度.结果:添加0.064%MWCNTs-COOH、6%纳米二氧化硅、4%丁腈橡胶以及6.4%环氧树脂都能使抗菌胶有较好的黏接强度改性效果,其拉伸剪切强度分别为(14.71±1.48)、(14.03±1.92)、(14.6±1.78)、(14.05± 1.46)MPa.添加8%纳米二氧化硅的韧性及黏性改性效果最好,抗菌胶的玻璃化转化温度及黏度分别为(1.1±0.24)℃、(15 536.68±28.4)cP(1 cP=1 mPa·s).当纳米二氧化硅的添加比例为8%时,复合物极为黏稠.添加6%纳米二氧化硅后,抗菌胶拉伸剪切强度为(14.03±1.92)MPa,玻璃化转化温度为(3.6±0.68)℃,黏度为(5 278.87±31.68)cP.结论:6%纳米二氧化硅是最佳的改性材料,其改性表现最为均衡.     

上海市抗肿瘤药物采购配备和临床使用情况分析

目的:通过分析上海市抗肿瘤药物的采购配备与临床使用情况,为制定针对性的肿瘤药物规范管理策略提供参考。方法:基于上海市医疗机构药品招标采购数据库和医院临床用药信息分析系统,分析不同等级医疗机构、药品分类、通用名的抗肿瘤药品的采购金额分布情况,以及抗肿瘤药物处方的总数、总金额、单张处方金额、处方药品种类和数量。结果:从采购金额看,三级医院(占81.04%)、细胞毒类药品(占34.62%,尤其是影响核酸合成的药物)、生物反应调节药(占17.98%)、靶向治疗类药物(占11.91%,以单克隆抗体药和酪氨酸激酶抑制药为主)、辅助用药(占28.06%,其中造血生长因子占比最高)、采购金额最高的前十类药物(累计占比48.12%)都是合理用药和费用控制的关键点;从临床使用情况看,三级医院(处方数量占比70.32%,平均处方费用为1 110.46元)、40岁及以上中老年患者(处方数量占比90.20%,40~49岁区间人群的平均处方费用最高,为1 370.00元)、自费患者(平均处方费用为1 603.15元)都是处方使用的重点干预机构或人群,其中恶性淋巴瘤(3 818.31元/张处方)、肺恶性肿瘤(2 997.52元/张处方)、胰腺恶性肿瘤(2 737.62元/张处方)的处方费用较高。结论:基于上海市抗肿瘤药物采购端和使用端的数据分析结果,建议在限定医疗机构抗肿瘤药物和辅助用药品种品规数量、定期开展抗肿瘤药物重点品种使用的监测与评价、落实抗肿瘤药物和辅助用药的处方点评及公示制度等方面进行关键点控制。     

我院抗肿瘤药物使用状况分析

目的:了解我院2006年度抗肿瘤药物的使用情况.方法:采用金额和用药频度排序法对药物的使用情况进行统计分析.结果:抗肿瘤药物用药金额列前3位依次为紫杉醇(13.13%)、参芪扶正注射液(11.40%)、吉西他宾(9.47%);用药频度前3位依次为他莫西芬(26.28%)、格拉司琼(7.86%)、参芪扶正注射液(7.14%).结论:我院抗肿瘤药使用状况比较合理;抗肿瘤植物药和中药类已经成为肿瘤用药的主要趋势,还应加快国产化疗药物及化疗辅助药物的研制,以降低费用,减轻患者负担.     

护士抗肿瘤药物职业暴露干预效果评价

目的评价综合医院护士抗肿瘤药物职业防护干预效果。方法于2011年3月对某三级甲等综合医院护士进行问卷调查,内容包括一般资料、抗肿瘤药物的职业防护认知情况、工作中防护措施和防护管理情况等。实施职业防护教育培训和行政干预措施,6个月后再次调查,对两次调查结果进行统计学分析。结果护士抗肿瘤药物职业暴露经干预后,相关防护知识知晓率有非常明显或明显提高(P0.01,P0.05);配制抗肿瘤药物时防护措施实施率、职业暴露后紧急处理措施率明显提高(P0.01)。结论职业防护教育和行政干预是短时间内提高护士抗肿瘤药物的职业防护认知能力及防护措施实施率行之有效的措施。     

不同溶剂及稀释度对聚氨脂清漆中苯提取效率的影响

[目的]考察不同溶剂及稀释度对聚氨脂清漆中苯的提取效率。[方法]用二硫化碳、正己烷、乙酸乙酯、四氢肤喃和甲醇为稀释溶剂,对清漆试样分别按(1+2、1+4、1+6、1+8、1+10)稀释,加入10μg/m L苯标准后用气相色谱法氢火焰离子化检测器(FID),以聚乙二醇硝基苯改性(FFAP)型毛细管色谱柱分离、测定。[结果]苯的检出限为0.008 4μg/m L,定量限为0.028μg/m L,苯在二硫化碳介质中能达到很好的基线分离,不同稀释度的二硫化碳介质中苯的回收率范围为80.9%~96.1%,相对标准偏差(RSD)为1.15%~9.52%,适宜的稀释度应>(1+8),试样的总标准差均<自身浓度的5%;准确度的置信限为0.96。[结论]稀释度过小可导致试样回收率和重复性降低,在最佳条件下试样中苯有良好的精密度和足够的准确度。     

围手术期预防使用抗菌药物合理性探讨

目的 探讨甲状腺、乳腺、疝气修补术3种清洁手术围手术期预防使用抗菌药物的合理性,并制定相应的具体实施细则.方法 调查2008年3月104例3种清洁手术出院病历中预防使用抗菌药物的基本情况,成立合理用药评价小组对调查结果进行合理性探讨,并制定预防使用抗菌药物的实施细则.结果 104例病例中抗菌药物预防使用率为100.00%,平均使用抗菌药物时间6 d;药物利用频度居前10位的抗菌药物中青霉素类2种,头孢菌素类7种,氨基糖苷类1种;不合理使用抗菌药物主要表现形式为无指征用药(75.00%)、溶媒选择不当(54.81%)、用药时机不当(49.04%)、用药疗程长(44.23%)、更换药物频繁或无依据(37.50%)、用法用量不正确(29.81%)等;医院合理用药评价小组制定的实施细则内容具体,科学性和操作性较强.结论 3种清洁手术围手术期预防使用抗菌药物不合理现象较严重,制定的实施细则有助于规范预防使用抗菌药物的管理.     

多频听觉稳态诱发反应在婴幼儿听力测试中的应用

目的:利用多频听觉稳态诱发反应(ASSR)对婴幼儿听力进行测试,评价ASSR在婴幼儿听力测试中的价值。方法:对41例(82耳)婴幼儿行ABR和ASSR测试,分别记录测试结果,对比分析2种方法的敏感性(χ2检验)。结果:20耳(24.4%)未引出ABR,2耳(2.4%)全频未引出ASSR,前者明显高于后者(P<0.01)。结论:ASSR在频率特性、刺激强度以及客观性上优于ABR。     

中山市某三甲医院单抗类抗肿瘤药应用分析

目的通过分析单抗类抗肿瘤药使用情况,了解其使用现状、短期疗效及不良反应,为临床合理用药提供参考。方法收集2013年上半年中山市某三甲医院使用单抗类抗肿瘤药物的病例310例,摘录患者基本资料、用药情况及治疗期间出现的不良反应,对其使用情况进行分析,并结合住院时长分析短期疗效。结果单抗类抗肿瘤药物收费数量、金额占抗肿瘤药物收费总数量、总金额的0.12%和13.67%左右。241例(78%)单次疗程住院时长在14天以内,没有出现严重不良反应。298例(96%)顺利完成化疗疗程。结论单抗类抗肿瘤药物临床疗效良好,不良反应多为轻中度化疗反应,经处理后能恢复,但由于价格昂贵,限制了临床的应用。     

多药耐药相关蛋白及谷胱甘肽-S-转移酶π与人肺癌多药耐药细胞系SPC-A1/TAX耐药性关系研究

目的研究多药耐药相关蛋白(MRP)、谷胱甘肽-S-转移酶π(GST-π)与人肺腺癌多药耐药细胞系SPC-A1/TAX多药耐药性之间的关系。方法采用S-P免疫组化法检测细胞MRP、GST-π的表达;采用MTS法分别检测并比较SPC-A1、SPC-A1/TAX细胞对6种不同化疗药物的敏感性。结果耐药组MRP、GST-π表达均为阳性,亲本组MRP、GST-π表达均为阴性,耐药组与亲本组间差异有统计学意义(P<0.05,P<0.01);SPC-A1/TAX较SPC-A1除对原诱导药物TAX具有耐受性外,对其他5种抗肿瘤药物也表现出不同程度的耐药性。结论MRP、GST-π在SPC-A1/TAX细胞系中表达与该人肺腺癌多药耐药细胞系的MDR具有相关性,是其MDR产生的可能机制。     

甘草甜素对脓毒症小鼠急性肺损伤保护作用的实验研究

目的探讨高迁移率族蛋白B1(HMGB1)抑制剂甘草甜素(Glycyrrhizin)对脓毒症小鼠急性肺损伤的保护作用及其可能机制。方法选择雄性Ba1b/C小鼠80只,将其随机分为假手术组、模型组、溶剂组、药物组每组各20只,采用盲肠结扎穿孔术制作小鼠脓毒症模型,造模成功后30min腹腔给予甘草甜素,术后6h麻醉处死、取标本;测定每组10只小鼠左肺叶组织的肺水含量,肺组织中白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)和白细胞介素1β(IL-1β)的表达量,采用免疫印迹法法检测每组8只小鼠右肺组织中HMGB1和TLR4表达量。结果假手术组、模型组、溶剂组、药物组小鼠的肺水含量分别为(69.3±0.01)%、(78.9±0.11)%、(8.1±0.15)%、(72.3±0.09)%,与假手术组相比,模型组和溶剂组小鼠的肺水含量显著增加(P<0.05),药物组与溶剂组相比,甘草甜素可以显著降低肺组织中的肺水含量,差异有统计学意义(P<0.05);同时药物组小鼠肺组织中HMGB1、TLR4、IL-6、TNF-α和IL-1β的表达量显著降低,差异有统计学意义(P<0.05)。结论甘草甜素对脓毒症小鼠急性肺损伤有治疗作用,有可能应用于临床上脓毒症患者的治疗。     

Transport of a Solvent Mixture Across Two Glove Materials When Applied in a Paint Matrix

The transport of mixed paint solvents through natural rubber latex (4 mil) and nitrile rubber (5 mil) gloves was evaluated after spray application of the paint formulation directly on the glove surface. Glove materials and thicknesses were those selected by the majority of spray painters in the local automobile repair industry. A flat panel containing glove specimens mounted in multiple permeation cells permitted evaporation of solvents from the applied paint and incorporated a solid sorbent receiving medium for measuring glove membrane transport. The panel was sprayed in a paint booth to simulate use conditions. Charcoal cloth under the glove adsorbed transported solvents, which were quantified by gas chromatography. For each solvent component, results were expressed as mass transported through the glove relative to the mass applied, per unit area, during 30 min after spray application. The paint formulation contained ketones, acetates, and aromatics. Natural rubber latex allowed 6-10 times the transport of solvents relative to nitrile rubber for all eight solvent components: methyl ethyl ketone, toluene, styrene, ethyl benzene, xylene isomers, and 2-heptanone. m-Xylene showed the largest difference in transport between the two glove materials. This solvent also had the highest transport for each material. The results indicate that nitrile rubber gloves offer somewhat greater chemical resistance to all eight solvents studied compared with natural rubber latex gloves, regardless of the chemical properties of the individual solvent components. However, it must be emphasized that neither of the glove materials, in the thicknesses used in this study, provide adequate protection when exposed by direct spray painting. Simulation of realistic spray conditions may offer a source of useful information on the performance of chemical protective gloves because it accounts for solvent evaporation and the effect of paint polymerization after application on glove transport.     

Behavioural evaluation of workers exposed to mixtures of organic solvents.

Reports from Scandinavia have suggested behavioural impairment among long term workers exposed to solvents below regulatory standards. A cross sectional study of behavioural performance was conducted among printers and spray painters exposed to mixtures of organic solvents to replicate the Scandinavian studies and to examine dose-response relationships. Eligible subjects consisted of 640 hourly workers from four midwestern United States companies. Of these, 269 responded to requests to participate and 240 were selected for study based on restrictions for age, sex, education, and other potentially confounding variables. The subjects tested had been employed on average for six years. Each subject completed an occupational history, underwent a medical examination, and completed a battery of behavioural tests. These included the Fitts law psychomotor task, the Stroop colour-word test, the Sternberg short term memory scanning test, the short term memory span test, and the continuous recognition memory test. Solvent exposure for each subject was defined as an exposed or non-exposed category based on a plant industrial hygiene walk-through and the concentration of solvents based on an analysis of full shift personal air samples by gas chromatography. The first definition was used to maintain consistency with Scandinavian studies, but the second was considered to be more accurate. The average full shift solvent concentration was 302 ppm for the printing plant workers and 6-13 ppm for the workers at other plants. Isopropanol and hexane were the major components, compared with toluene in Scandinavian studies. Performance on behavioural tests was analysed using multiple linear regression with solvent concentration as an independent variable. Other relevant demographic variables were also considered for inclusion. No significant (p greater than 0.05) relation between solvent concentration and impairment on any of the 10 behavioural variables was observed after controlling for confounding variables. Exposed/non-exposed comparisons showed a significantly poorer digit span among those exposed, but this has not been generally reported in the Scandinavian studies. The medical examination showed no abnormalities of clinical significance. The inability to replicate the findings of the Scandinavian studies could have been due to the shortness of the duration of workers' exposure, the type of solvents in the mixtures, use of different behavioural tests, or to selection factors.     

Behavioural evaluation of workers exposed to mixtures of organic solvents

Reports from Scandinavia have suggested behavioural impairment among long term workers exposed to solvents below regulatory standards. A cross sectional study of behavioural performance was conducted among printers and spray painters exposed to mixtures of organic solvents to replicate the Scandinavian studies and to examine dose-response relationships. Eligible subjects consisted of 640 hourly workers from four midwestern United States companies. Of these, 269 responded to requests to participate and 240 were selected for study based on restrictions for age, sex, education, and other potentially confounding variables. The subjects tested had been employed on average for six years. Each subject completed an occupational history, underwent a medical examination, and completed a battery of behavioural tests. These included the Fitts law psychomotor task, the Stroop colour-word test, the Sternberg short term memory scanning test, the short term memory span test, and the continuous recognition memory test. Solvent exposure for each subject was defined as an exposed or non-exposed category based on a plant industrial hygiene walk-through and the concentration of solvents based on an analysis of full shift personal air samples by gas chromatography. The first definition was used to maintain consistency with Scandinavian studies, but the second was considered to be more accurate. The average full shift solvent concentration was 302 ppm for the printing plant workers and 6-13 ppm for the workers at other plants. Isopropanol and hexane were the major components, compared with toluene in Scandinavian studies. Performance on behavioural tests was analysed using multiple linear regression with solvent concentration as an independent variable. Other relevant demographic variables were also considered for inclusion. No significant (p greater than 0.05) relation between solvent concentration and impairment on any of the 10 behavioural variables was observed after controlling for confounding variables. Exposed/non-exposed comparisons showed a significantly poorer digit span among those exposed, but this has not been generally reported in the Scandinavian studies. The medical examination showed no abnormalities of clinical significance. The inability to replicate the findings of the Scandinavian studies could have been due to the shortness of the duration of workers' exposure, the type of solvents in the mixtures, use of different behavioural tests, or to selection factors.     

医务人员手耐甲氧西林葡萄球菌携带调查及药敏分析

目的调查医务人员手耐甲氧西林葡萄球菌(MRS)的携带及药敏情况。 方法随机抽取某院168名医务人员，分别采集其按六步洗手法洗手前后的手部皮肤拭子标本（共336份）进行MRS分离培养和药敏试验。结果医务人员手MRS携带率在洗手前高达66.67%，而洗手后仍有41.07%，但两者比较，差异有显著性（χ2=22.14，P<0.01）。所携带的MRS均为耐甲氧西林凝固酶阴性葡萄球菌（MRCNS），未检出耐甲氧西林金黄色葡萄球菌（MRSA）。检出的MRCNS除对万古霉素敏感、对呋喃妥因耐药率较低外，对 β 内酰胺类抗生素的青霉素、氨苄西林、阿莫西林/克拉维酸、头孢噻吩、头孢噻肟表现出高度耐药，耐药率为70.37%~100.00%；对环丙沙星、红霉素、四环素、克林霉素、复方磺胺甲口恶唑的耐药率达42.33%~80.42%；其耐药率显著高于对甲氧西林敏感的葡萄球菌，并表现出多重耐药。结论医务人员手MRS的高携带率应引起广大医务工作者的高度重视。采用六步洗手法洗手有助于减少MRS携带，减少医源性MRS的蔓延和流行。     

Synergistic effects and physiological responses of selected bacterial isolates from animal feed to four natural antimicrobials and two antibiotics

In this study, 20 samples from three different sources of animal feed were investigated and six bacterial isolates were identified. The susceptibility of four natural antimicrobials, namely, eugenol, cinnamaldehyde, thymol, and carvacrol, against six of these isolates was determined. Carvacrol and eugenol showed better inhibitory effects with larger zones of inhibition. The minimal inhibitory concentration for a range of antibiotics on the susceptibility of two isolates (namely, Sphingomonas paucimobilis and Klebsiella oxytoca) was investigated using the VITEK? 2 microbiological identification system. Both isolates showed a variety of resistance to 18 antibiotics. The minimal inhibitory concentration and fractional inhibitory concentration index of those two isolates for ampicillin and nitrofurantoin in combination with four phenolic compounds was determined. Synergistic interactions were found for most antimicrobial/antibiotic combinations; thymol and carvacrol were very effective (fractional inhibitory concentration ≤0.5) in combination with all antibiotics tested against S. paucimobilis and K. oxytoca, respectively. Ultra performance liquid chromatography techniques were used to investigate the physiological effects of the four natural antimicrobials against those two isolates. Two identical peaks were found to be systematically different between cinnamaldehyde-treated and -untreated cells. The identity of the peaks is unknown and further investigation is needed.     

Inhalation and dermal exposure to eight antineoplastic drugs in an industrial laundry facility

Objectives The aims of the study were to quantify levels of dermal and inhalation exposure to antineoplastic drugs in an industrial laundry service in the Netherlands and to test the removal efficiency of the washing procedure for removal of antineoplastic drugs. Methods During four workdays dermal and inhalation exposure to eight frequently used antineoplastic drugs (cyclophosphamide, ifosfamide, methotrexate, 5-fluorouracil, etoposide, cytarabine, gemcitabine and chlorambucil) were measured for all job titles involved in handling unwashed laundry. To test the removal efficiency of the washing procedure, 10 × 10 cm sections were excised before and after the washing procedure. These sections were taken from 15 bed sheets that were collected in hospitals of patients who were treated with one of the selected antineoplastic drugs. Results During none of the four measurement days, detectable levels of any of the eight antineoplastic drugs (cyclophosphamide, ifosfamide, methotrexate, 5-fluorouracil, etoposide, cytarabine, gemcitabine, or chlorambucil) were found on workers’ skin of hands or in any of the air samples. Only four out of the 15 bed sheets from patients that were treated with antineoplastic drugs appeared to be contaminated with detectable levels of antineoplastic drugs before the washing procedure (range 13.0-3,060 ng/100 cm²). After the pre-washing and after the complete washing procedure, no detectable levels of any of the eight antineoplastic drugs were found anymore in the selected bed sheets. Conclusions The implementation of guidelines for working with antineoplastic drugs seems to be successful in reducing exposure to antineoplastic drugs of workers in this laundry facility to an acceptable, non-detectable level and to remove antineoplastic drug contamination from bed linen.     

A test method for the evaluation of protective glove materials used in agricultural pesticide operations.

The ASTM Standard Test Method for Resistance of Protective Clothing Materials to Permeation by Liquids and Gases (F 739-85) and the recommended permeation cell have been modified to permit the testing of protective clothing materials for permeation by the low volatility, low water solubility active ingredients present in many pesticide formulations. The modification makes use of solid collection medium, a thin (0.02-in. thick) sheet of silicone rubber, to collect permeants. Those compounds permeating the protective material can then be desorbed into an appropriate solvent and analyzed using conventional methods and instruments. A series of permeation tests have been conducted using samples of 10 common, commercially available protective glove materials and the modified cell. Permeation of the active ingredient as well as carrier solvent components of several concentrated pesticide formulations containing low volatility, low water solubility active ingredients and aromatic hydrocarbon carrier solvents has been monitored. The relative breakthrough and the total mass of material permeating the glove materials appears to be strongly related to the concentration of the aromatic carrier solvent present in the formulations studied to date. The collection method was found to be less useful for monitoring the permeation of active ingredients, which have reasonably high water solubilities. The results obtained by using this method with samples of protective glove materials challenged by several concentrated pesticide formulations are described. For these formulations containing xylene boiling range aromatic solvents, gloves made of nitrile rubber, butyl rubber, and Silver Shield were most resistant to permeation; natural rubber and polyethylene glove materials were least resistant.     

Synthetic surgical gloves

Surgical gloves are used by healthcare workers primarily to minimize the transmission of bloodborne pathogens and other potential infectants. Gloves made of synthetic materials are getting more attention with the increasing prevalence of allergies to natural rubber latex (NRL) among patients and medical staff. However, synthetic gloves are perceived by some people as providing less protection and being less comfortable than NRL gloves. In this study, we evaluated eight models of synthetic surgical gloves from six manufacturers. We examined their barrier effectiveness (that is, their resistance to viral penetration, resistance to puncture, and strength) durability, and comfort and compared these characteristics to those of NRL gloves. We found that all the gloves offered good barrier protection, but that their level of comfort varied widely. Three gloves were rated Preferred, three were Acceptable, and the remaining two gloves were Not Recommended.     

Application of QuEChERS Method for Simultaneous Determination of Pesticide Residues and PAHs in Fresh Herbs

The aim of this study was to evaluate the application of quick, easy, cheap, effective, rugged and safe method for simultaneous determination of polycyclic aromatic hydrocarbons and pesticide residues in fresh herbs. In the experiment two extraction solvents and standard types of sorbents were used. The extracts were analyzed using GC–SIM–MS. The results suggest that acetonitrile is more suitable extraction solvent giving more purified samples and better recovery values (71.6 %–116.9 %) with RSD lower than 15 % for most of the compounds. In real samples pesticides were identified in the samples of parsley, tarragon and lovage. In few samples the pesticide levels exceeded the MRL established by EU.     

Executive Health: How to Maintain It

Large amounts of volatile solvents were used to extract pecticides from various types of samples using Public Health Service methods. Even though ail evaporations and concentrations were done in a hood, the extraction procedures themselves were conducive to the buildup of solvent concentrations in the laboratory. The concentrations approached but did not reach maximum allowable levels. Before the daily number of samples could be increased a better air exchange system would be needed. It would appear that routine handling of volatile solvents allows a buildup of vapors in a laboratory.