选择离子监测气质联用法测定农产品中的49种农药残留

目的采用双层填料固相萃取柱净化样品,建立气质联用同时测定农产品中49种农药残留的方法。方法干性样品经丙酮提取、新鲜样品经乙腈提取,Carb/NH2固相萃取柱净化,气相色谱质谱选择离子模式测定。结果 49种农药平均回收率为60.1%~117.9%,RSD范围为5%~19.7%,检出限为0.002μg/g~0.45μg/g,定量限为0.004μg/g~0.14μg/g。结论该方法选择性强,准确度好,精密度高,且样品前处理步骤简单,可应用于同时检测农产品中的49种农药残留。     

气相色谱法测定铁皮石斛类保健食品中10种有机磷农药残留

目的建立气相色谱测定铁皮石斛类保健食品中10种有机磷农药残留的分析方法,为保健食品质量控制提供依据。方法样品经乙腈振荡,匀浆提取后,无水硫酸镁和氯化钠盐析,PSA、C18和无水硫酸镁净化与除水,离心后取上清液,加入分析保护剂(10 mg/mlγ-古洛糖酸内酯溶液),采用DB-1701石英毛细管柱(30 m×0.25 mm,0.25μm)分离,火焰光度检测器(FPD)测定。根据保留时间定性,外标峰面积法定量。结果 10种有机磷农药分离良好,峰面积与浓度呈良好的线性相关性(r0.999),线性范围为0.02μg/ml~0.10μg/ml,检出限为0.02 mg/kg~0.03 mg/kg,加标回收率为89.3%~111.0%,相对标准偏差(RSD)为4.7%~7.1%。结论本方法检测有机磷农药残留具有操作简单、快捷、结果准确性高的特点,具有较高的实用性,适用于铁皮石斛类保健食品中10种有机磷农药的同时检测。     

气相色谱法同时检测生活饮用水中的27种有机磷农药残留

目的:建立气相色谱法同时测定饮用水中的27种有机磷农药残留。方法:水中的有机磷农药经液-液萃取浓缩后,用CP-Sil 24 CB毛细管柱分离、脉冲火焰光度检测器(PFPD)进行检测。结果:27种有机磷农药在0.20~10.0μg/ml范围内有较好的线性,相关系数均大于0.99,检出限为0.03~0.31μg/L,水样的加标回收率为70.5%~103.0%,RSD为3.5%~9.7%。结论:所建立的分析方法简便、快速、准确,可同时测定饮用水中的27种有机磷农药残留。     

GC法测定8种拟除虫菊酯类农药残留的含量

目的:建立气相色谱法测定蔬菜、水果中拟除虫菊酯类农药残留含量的方法。方法:采用气相色谱-电子捕获检测器对8种拟除虫菊酯类农药残留量进行检测。结果:各组分在HP-5毛细管色谱柱(30 m×320μm×0.25μm)分离良好;在0.04μg/ml～8.0μg/ml范围内具有良好的线性关系;其回收率在67%～126%。结论:该方法准确可靠,可用于蔬菜水果中拟除虫菊酯农药残留的检测。     

QuEChERS-气相色谱法同时测定果蔬中12种有机氯和拟除虫菊酯类农药残留

目的建立Qu ECh ERS-气相色谱法同时测定果蔬中12种有机氯及拟除虫菊酯类农药残留的方法。方法样品经1%冰乙酸-乙腈均质提取,N-丙基乙二胺(PSA)、ODSC18粉和石墨化碳黑(GCB)粉混合净化后,采用DB-5毛细管柱进行分离,μECD检测器检测,气相色谱法测定,外标法定量。结果 12种农药的浓度为0.025μg/ml~2.5μg/ml时,线性关系良好,相关系数(r)≥0.992。在0.05 mg/kg、0.25 mg/kg、0.50 mg/kg 3种添加水平下,方法的平均回收率为80.21%~113.20%,相对标准偏差(RSD)为3.21%~12.67%(n=6),检出限(LOD)为0.000 2 mg/kg~0.001 0 mg/kg。结论本方法操作简便、定量准确、快速,可满足果蔬中12种有机氯及拟除虫菊酯类农药残留的检测需求。     

气相色谱法同时检测茶叶中12种农药残留

目的:建立同时检测茶叶中12种有机磷和有机氯农药残留的气相色谱法。方法:用丙酮和石油醚混合溶剂浸提,石墨化碳柱固相萃取。采用电子捕获检测器、程序升温、OV-1701(30 m×0.25 mm×0.25μm)毛细管柱气相色谱法检测。结果:12种农药的回收率为79.0%～102.1%,相对标准偏差RSD为1.87%～3.34%;检出限为0.008 mg/kg～0.051 mg/kg;12种农药线性范围为0.1 mg/L～15.0 mg/L,相关系数r≥0.9923。结论:该方法简便、灵敏、准确,适用于分析茶叶中的12种有机磷和有机氯农药残留含量。     

固相萃取-气相色谱-质谱仪联用同时测定蔬菜中多种有机磷和硫丹类农药残留

目的建立快速测定蔬菜中有机磷和硫丹类农药残留的固相萃取-气相色谱-质谱仪联用检测方法。方法采用乙腈提取,Carb/NH2固相萃取柱净化,DB-17MS石英毛细管色谱柱,以GC-MS选择离子监测模式检测蔬菜中12种有机磷和3种硫丹类。结果 15种农药组分线性范围在0.2~1.0μg/ml之间,标准曲线线性系数r0.99,检出限在0.01~0.08 mg/kg,定量下限0.05~0.26 mg/kg之间,样品高、低两个浓度加标回收率在76%~117%之间,相对标准偏差(RSD)在1.27%~6.53%之间。结论方法准确度高、灵敏度好、重现性好、快速,适用于蔬菜中有机磷和硫丹类农药残留测定。     

同位素内标-气相色谱串联质谱法测定果蔬中41种有机氯和拟除虫菊酯农药残留

目的建立同位素内标-气相色谱串联质谱测定果蔬中41种有机氯和拟除虫菊酯农药残留的方法。方法样品用Qu ECh ERS法提取后,引入分析保护剂,气相色谱串联质谱法测定。结果 41种有机氯和拟除虫菊酯农药残留在0.10~4.0μg/ml范围内线性相关系数在0.992~0.999之间,方法定量限在0.002 mg/kg~0.023 mg/kg,加标回收率为69.1%~115.1%,相对标准偏差为2.6%~9.7%。结论本法操作简便、结果准确、灵敏度高,可满足果蔬中41种有机氯和拟除虫菊酯农药残留的检测要求。     

气相色谱法测定土壤中有机磷农药残留

目的:应用气相色谱法测定土壤中敌敌畏等8种有机磷农药残留。方法:先用乙腈-NaCl盐析法萃取土壤中残留的农药,而后将溶剂置换为丙酮,处理好的样液用气相色谱法进行定性和定量分析。结果:此方法最低检出限可达到0.008 mg/kg或更低,回收率范围为87.0%~105.0%,RSD为3.3%~7.2%。结论:所建立的方法符合我国农药残留检测相关标准的要求。     

气相色谱法测定中药材中拟除虫菊酯类农药残留量

目的:建立毛细管气相色谱同时测定中药材中氯氰菊酯、氰戊菊酯、溴氰菊酯、甲氰菊酯和三氟氯氰菊酯的残留量的方法。方法:采用OV-1701弹性石英毛细管柱(30 m×0.53 mm×0.32μm)分离和电子捕获检测器检测。结果:在0.05~2.5μg/ml的线性范围内,相关系数(r)分别为0.9995、0.9924、0.9992、0.9988和0.9976。低、中、高3个添加水平的回收率分别为71.4%~99.6%、72.1%~101.9%、75.2%~98.2%,相对标准偏差(RSD)为1.4%~9.8%,检出限为0.05~0.1 mg/kg。结论:方法简便快速,适合中药中痕量拟除虫菊酯类农药残留的同时测定。     

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。