匀浆膳联合酸奶在危重症病人中的临床应用

目的: 探讨危重症病人应用匀浆膳联合酸奶行EN治疗的方法和效果. 方法: 将400例急诊手术、复苏抢救后的危重症病人随机分为两组.研究组给予匀浆膳联合酸奶治疗;对照组给予匀浆膳治疗.伤后48 h开始每天分别给予鼻饲额定热量的两种肠内营养治疗,不足部分辅以PN补充.根据有关监测指标、血常规、血气分析和肝肾功能检查,进行APACHE-Ⅱ评分,比较各营养指标、胃肠功能障碍指标以及预后. 结果: 研究组各营养指标均高于对照组,胃肠道并发症发生率低于对照组,预后优于对照组. 结论: 危重症病人给予匀浆膳联合酸奶行EN治疗,可有效地改善病人的营养状况,减少胃肠道并发症,提高生存率,有利于病人的康复.     

商品与自制匀浆膳对卧床病人营养及生化状况影响的比较

目的:比较商品匀浆膳与传统自制匀浆膳对长期卧床病人营养状况及生化检测指标的影响.方法:选择住院病人39例,采用人群自身对照研究方法,对每一位病人分别进行传统自制匀浆及商品匀浆管饲喂养,时间均为6个月.每月对其进行一次人体测量,收集三头肌皮皱厚度(TSF)和上臂围(MAC)结果.每月检测两次血清总蛋白(TP)、血清清蛋白(ALB)、三酰甘油(TG)、血胆固醇(TC)和血肌酐(Cr)、血尿素氮(BUN)、血清总胆红素(STB)、直接胆红素(CB)、血钙(Ca)、血磷(P)、血钠(Na)、血钾(K)等.取各种指标结果的平均值,比较两种不同匀浆膳组各项指标的差异.结果:39例病人在观察期内服用自制或商品匀浆膳均未出现腹胀、腹泻、腹痛、恶心、呕吐等胃肠道反应.除血Na商品匀浆膳组低于自制匀浆膳组(P＜0.05)外,其余各项指标两组间差异均无显著性意义(P＞0.05).结论:配比合理的匀浆膳是老年卧床病人肠内营养支持的一种比较理想的制剂,自制与商品匀浆膳均具有独自的特点和优势,应同时存在,配合使用.     

一日三餐如何搭配更健康

合理的膳食搭配能够提升人们的身体素质和抵抗力,有效帮助人们预防疾病.一日三餐,如何搭配更加健康?现从选购食材、营养搭配、烹饪方式等方面为您支招. 食材安全、新鲜、应季最重要 我们接触食物的第一步,通常都是在超市、商场、菜市场购买食材.因物流发达和保鲜技术发展,现在我们能买到全国乃至世界各地的多种食材.但食材的品质参差不齐,选购关键是安全、新鲜,选择当地应季的更好.     

别把菜叶随意丢弃

正夏秋之交,蔬菜大量上市,各种蔬菜所含营养成分不同,吃菜时要合理搭配,才能获得较全面的营养。但我们在平时做菜时,一些菜叶及根茎经常被扔掉,殊不知,这些被扔掉的部分可是营养宝库呢!蔬菜的叶子是植物合成营养成分的工厂,也是营养精华。阅读《中国食物成分表》第2版、《中国居民膳食指南》等参考文献,结合自己多年     

匀浆膳在鼻饲中的应用及护理

匀浆膳是一种热量充足、营养齐全的平衡膳食。常用于各种原因不能从口进食的患者。现将我院自1997年以来的48例管饲膳食应用情况如下。1 临床资料 本组48例,为脑血管疾病,其中15例昏迷,采用鼻饲胃管,平均使用天数为56天。营养液配方:属于完全营养标准配方,各种营养素含量:蛋白质69 g,脂肪55 g,碳水化合物350 g,热量2 100 Kcal,主要食物是经炒熟的面或米粉,大豆水泡后制成豆汁状,猪肉粉,奶粉,鸡蛋,蔬菜,葡萄糖,香油等。适用于长时间、完全营养支持,是鼻饲病人的首选配方。2 护理2.1 每次注入匀浆膳前,检查胃管是否在胃中,首先注入少量温开水,再注入膳食,最后用温开水冲管。2.2 保持注射器、餐具清洁,膳食应鲜配制,配制时必须无菌操     

老年病人长期应用成品匀浆膳的营养评价

目的：观察长期管喂成品匀浆膳对高龄病人营养支持的效果。方法：应用自制的成品匀浆膳行营养，观察营养支持前及支持后4，8和12个月病人营养指标的变化。结果：营养支持12个月后血清白蛋白（Ab)，磷（P）和外周血淋巴细胞计数等有显著增高。血糖自4个月起减低，与支持前比较差异显著。结论：成品匀浆膳长期应用有助于维持老年病人自身的营养状态。     

黄芪匀浆膳对重型颅脑损伤患者免疫功能和营养代谢的影响

目的研究黄芪匀浆膳对重型颅脑损伤患者免疫功能及营养代谢的影响。方法将75例患者依不同营养措施综合考虑各非处理因素分为黄芪匀浆膳组、匀浆膳组和肠内营养多聚合剂组,每组25例。黄芪匀浆膳组尽早(48～72小时)给予改良匀浆膳加黄芪水煎液(相当于生药60g)治疗,匀浆膳组仅给予改良匀浆膳治疗,肠内营养多聚合剂组给予肠内营养多聚合剂治疗,早期肠内营养不足部分由肠外营养补充,共20天。各组肠内营养支持前后均采血测定IgA、IgG、IgM,T细胞亚群(CD4、CD8、CD4/CD8),同时监测空腹血糖、白蛋白、转铁蛋白、血红蛋白、氮平衡等营养代谢指标。结果黄芪匀浆膳组营养支持后IgG、CD4(%)、CD4/CD8升高,与匀浆膳组和肠内营养多聚合剂组比较,差异具有显著性(P<0.01);黄芪匀浆膳组和匀浆膳组营养支持后空腹血糖降低,与肠内营养多聚合剂组比较,差异具有显著性(P<0.01,P<0.05),黄芪匀浆膳组与匀浆膳组比较,差异亦有显著性(P<0.05);黄芪匀浆膳组营养支持后,负氮平衡转为正氮平衡,转铁蛋白与白蛋白升高,与匀浆膳组和肠内营养多聚合剂组比较,差异具有显著性(P<0.05,P<0.01)。结论黄芪匀浆膳可显著改善重型颅脑损伤患者免疫功能、血糖及蛋白质营养代谢。     

为提高全民身体素质 《中国居民膳食指南》修订出台

1997年4月25日,中国营养学会召开新闻通报会,公布了新修订的《中国居民膳食指南》。 膳食指南是营养工作者根据营养学原理,提出的一组以食物为基础的建议性陈述,以指导人们合理选择与搭配食物,平衡膳食、合理营养,以期减少与膳食有关疾病,促进健     

中风患者的合理膳食与指导

本文分析了中风患者营养失衡的原因,探讨了如何评估中风患者营养失衡及其影响因素,提出了一般病人膳食原则和危重病人膳食原则。建议中风患者合理膳食,注重营养素的合理搭配及利用,及时为中风患者提供合理的膳食指导,能有效降低相关并发症的发生率。     

回生淀粉匀浆膳对2型糖尿病管饲病人血糖的影响

目的:探讨回生米饭作匀浆膳主食对2型糖尿病管饲病人餐后血糖应答的影响。方法:采用人群自身对照研究方法,将22例病情和血糖基本稳定的2型糖尿病管饲病人随机分为两组,即普通米饭匀浆膳组和回生米饭匀浆膳组。普通米饭匀浆膳组病人试验前3 d给予普通米饭匀浆膳,后3 d给予回生米饭匀浆膳;回生米饭匀浆膳组则食用顺序相反。每组各11例。普通米饭匀浆膳用新鲜蒸米饭作主食,回生米饭匀浆膳用冷藏蒸米饭作主食,其他食物成分相同,两种匀浆膳总热量相等。于试验第3天和第6天观察病人空腹和餐后30、60、120和180 min血糖和胰岛素的变化,持续观察病人的胃肠道反应。结果:与普通米饭匀浆膳比较,管饲回生米饭匀浆膳后,病人餐后60和120 min血糖值均显著降低(P<0.01),餐后30 min胰岛素水平显著降低(P<0.05);餐后血糖应答曲线和胰岛素释放曲线均低于管饲普通米饭匀浆膳后,且波动平稳。试验期间未发生消化道不良反应。结论:回生淀粉匀浆膳作主食具有吸收缓慢而持久的特点,可维持餐后血糖稳定,病人耐受性良好。     

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.