2010年某镇中心幼儿园手足口病的回顾性调查分析

目的总结2010年桃园镇中心幼儿园手足口病流行的教训,做好全市集居儿童的防控工作。方法对桃园镇中心幼儿园2010年手足口病发病情况进行回顾性调查,对相关人员进行现场访谈。结果 2010年桃园镇中心幼儿园手足口病罹患率为5.18%,高于村办园罹患率(χ2=68.33,P<0.05),高于散居儿童罹患率(χ2=12.91,P<0.05)。罹患率无性别差异(χ2=0.17,P>0.05)。小小班罹患率最高为22.22%,随年龄增长罹患率下降(χ2=79.82,P<0.05)。发病高峰为5月份,占60%。全园先后发生3次聚集性发病。临床症状典型,无并发症,无重症病例。结论中心幼儿园对手足口病认识不足、应急处理不果断、防控措施不到位。建议开展持久的有针对性的健康教育活动、严格执行托幼机构卫生保健制度、建立健全多方协作防控机制。     

某县民办幼儿园食品卫生现状的分析

目的了解宽甸县民办幼儿园食品卫生现状,为制定监管对策提供依据。方法编制调查表对县内全部民办幼儿园62所进行现场卫生学调查,对餐(饮)具进行消毒效果考核。结果民办幼儿园食品卫生许可办证率为67.74%,食品从业人员健康培训合格证持有率为69.57%。从业人员个人卫生及卫生知识合格率分别为57.60%和60.33%。加工设施合格率为62.90%,台帐建立及原料索证不合格,餐(饮)具消毒合格率为52.43%。结论民办幼儿园卫生状况总体不佳,存在食品安全隐患,大型幼儿园好于中型,中型好于小型,应全面加强民办幼儿园监管力度。分别情况,以帮扶改造为切入点,促进提高达标,取缔违法经营。     

某幼儿园一起经气溶胶传播的诺如病毒聚集性疫情调查

目的通过调查某幼儿园一起诺如病毒感染聚集性疫情,分析疫情发生的原因,探讨如何在托幼机构有效开展诺如病毒等传染病的防控。方法制定病例定义并开展病例搜索,通过病例个案调查和现场流行病学调查,分析流行特征和危险因素,采集病例、食堂工作人员、饮用水和食堂留样食品标本等进行实验室检测。结果疫情发生时间为2018年4月25日8:00～4月27日13:30,病例集中在一个班,发病14例,班级罹患率37.84%(14/37),男女生发病率分别为33.33%(6/18)、42.11%(8/19),男女生发病率差异无统计学意义(P=0.737)。该幼儿园无外食,供水、供餐均为随机分配。首发病例在教室呕吐后,生活老师未按照"消毒-清理-消毒"的规范流程进行消毒处理,处置呕吐物时未转移班上儿童。采集6例现症病例肛拭子、呕吐物标本,RT-PCR检测均为诺如病毒GⅡ核酸阳性,采集4例食堂员工肛拭子标本、饮用水和食堂留样食品所有检测结果均为阴性。结论该疫情为一起诺如病毒感染引起的胃肠炎聚集性疫情,生活老师清扫呕吐物的过程中处理不当,且未进行人员疏散,密闭环境中形成携带病毒的气溶胶,造成局部范围的共同暴露感染,并通过气溶胶-人-人接触模式进一步传播是主要原因。建议托幼机构加强传染病防病意识,加强对老师的卫生培训、指导,严格执行传染病报告和管理制度,提高消毒等工作的规范性,以预防和控制诺如病毒胃肠炎等疾病在托幼机构中的发生,保证儿童的健康。     

细节管理在消毒供应护理管理中的应用及实施效果

目的探讨细节管理在消毒供应护理管理中的应用及实施效果。方法采用组织教育学习、建立质量控制小组、完善安全管理制度、规范洗消流程、加强自我防护等细节管理措施,调查应用细节管理前与细节管理后的医务人员对消毒供应工作的满意度并统计护理人员职业损害的发生率情况。结果将细节管理应用到消毒供应护理管理的工作中后,医务人员对消毒供应工作的满意率由77.5%提高到了90.0%,差异具有统计学意义(P<0.05),而护理人员职业损害的发生率也由实施细节管理前的20%降至细节管理后的5%,差异具有统计学意义(P<0.05)。结论细节管理在消毒供应护理管理中的应用能够提高消毒供应的工作质量,降低职业损害的发生。     

甘露消毒丹加味治疗危重型手足口病患儿60例疗效观察

目的观察甘露消毒丹加味治疗危重型手足口病患儿的临床疗效。方法将120例危重型手足口病患儿随机分为治疗组和对照组,每组60例。2组均予常规治疗,治疗组在常规治疗的基础上联合甘露消毒丹加减煎剂口服。结果治疗组总有效率为93.3%,对照组为75.0%,2组比较差异有统计意义(P0.05);治疗组发热、皮疹、口腔疱疹消退时间,精神、食欲好转时间明显短于对照组,差异均有统计意义(P0.05)。结论甘露消毒丹加味治疗危重型手足口病有一定的临床疗效。     

手足口病聚集性和暴发疫情处置工作规范(2012版)

<正>www.moh.gov.cn2012-06-21卫办疾控发〔2012〕80号各省、自治区、直辖市卫生厅局,新疆生产建设兵团卫生局,中国疾病预防控制中心:为进一步规范手足口病防控工作,特别是做好聚集性和暴发疫情的应对处置,保护人民群众特别是儿童的生命安全和身体健康,我部组织制定了《手足口病聚集性和暴发疫情处置工作规范(2012版)》。现印发给你们,请结合实际,认真贯彻执行。     

消毒供应中心物品追溯系统的建立及使用效果分析

目的:探究供应室质量管理追溯系统在消毒供应室中的应用效果。方法:入选2016年11月~2017年4月某院消毒供应室中的手术无菌器械包600件,按照随机的分配原则分成对照组与观察组,各300件。对照组按照院内常规的消毒方式提供消毒供应,观察组执行质量管理追溯系统提供消毒供应,比较两组的无菌器械的消毒与使用中的出错情况及临床对消毒供应的满意度。结果:观察组中无菌器械的消毒与使用中的出错率为2.0%,对照组中无菌器械的消毒与使用中的出错率为11.4%,两组比较差异有统计学意义(P0.05);观察组中临床对消毒供应室的工作满意度为97.6%,对照组的满意度为79.0%,两组比较差异有统计学意义(P0.05)。结论:质量管理追溯系统在消毒供应室的应用效果较好,可保证消毒过程的全程控制,提高工作效率,避免出错。     

细节管理对消毒供应室护理质量提高的作用研究

目的探讨细节管理对消毒供应室护理质量提高的作用研究,为临床护理工作提供参考。方法选取2016年1月～2018年1月于我院消毒供应室工作的护理人员66名为研究对象,按照护理管理模式不同分为对照组和观察组,每组各33例,其中对照组采用常规护理管理,观察组采取细节管理模式定为观察组,比较不同护理管理模式实施后科室医师对其工作满意度、临床护理质量及消毒护理差错率发生情况,并作统计学分析。结果临床科室医师对观察组满意度为99.0%,对照组为94.0%,差异有统计学意义(P 0.05)。观察组护理人员手术配合能力、安全识别能力及风险防范能力上均优于对照组,差异有统计学意义(P 0.05)。观察组护理差错发生率为2.14%,显著低于对照组护理差错发生率5.76%,差异有统计学意义(P 0.05)。结论细节管理模式应用于消毒供应室护理能显著提高其护理质量及护理技能,减少护理差错的发生率,值得临床推广使用。     

2013-2014年庐江县手足口病聚集性疫情流行特征及危险因素分析

目的 了解庐江县2013—2014年手足口病(HFMD)聚集性疫情流行特征及危险因素,为制定手足口病防控措施提供科学依据。方法 通过国家疾病控制管理系统获得2013—2014年庐江县手足口病疫情信息,并选取发生聚集疫情的幼托机构的儿童及看护人作为研究对象进行问卷调查,统计分析庐江县手足口病聚集性疫情的流行特征及其发病危险因素。结果 2013—2014年庐江县手足口病发病率分别为55.37/10万和214.87/10万;共报告手足口病聚集性疫情44起,累计发病例数181例,占同期该病发病总数的6.69%。多因素Logistic回归分析表明,接触手足口患者、看护人手足口病知识缺乏、饭前便后不洗手或很少洗手、有吮咬手指习惯和近一周与儿童公用玩具等5个因素是儿童患手足口病的独立危险因素,其OR值分别是6.518、9.595、10.224、5.642和3.824。结论 庐江县手足口病发病受多种因素影响,加强手足口病监测、及时发现聚集性疫情、培养良好的卫生习惯和积极开展健康教育等措施可以预防和减少手足口病的发生。     

西安市某幼儿园一起手足口病聚集性病例的分析

目的：通过对某幼儿园手足口病暴发疫情调查分析,为有效防控手足口病疫情提供科学依据。方法对西安市碑林区某幼儿园手足口病暴发疫情进行调查,并对结果进行描述性流行病学分析。结果该起疫情历时11 d,涉及手足口病15例,其中1例为重型。疫情主要集中在托2班和小4班,患儿年龄在2～4岁之间,实验室检查显示病原体为肠道病毒71型。结论应加强宣传教育及幼托机构消毒和检查制度,综合预防手足口病的发生。     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Deoxynivalenol in cereals in Russia

A survey of the occurrence of deoxynivalenol (DON) and zearalenone (ZEN) in wheat, rye, barley and maize harvested in 1989-2001 in several regions of Russia has been conducted. A total of 5652 samples of cereals were analysed for DON and ZEN by using TLC and normal-phase HPLC with UV-detector. DON was detected in 69% of 2166 samples from Krasnodar region which is considered to be the major Fusarium endemic region of Russia. The contamination levels ranged from 0.1 till 8.6 ppm, MTEL was exceeded in 37% of these samples. The positive correlation between DON concentration and a percentage of Fusaria-damaged wheat kernels has been shown. DON occurrence and contamination levels were much lower that for wheat. Based on the results of monitoring and the data of average actual consumption of wheat products in Russia, the estimated daily intake of DON per 1 kg of body weight (EDI)was calculated. EDI varied from 0.07 ug in 1990-1991 till 1.40 ug in 1992. Although average EDI were lower than adopted tolerable daily intake (TDI, 3 ug/kg body weight) EDIs for the North-Caucasian region in some cases exceeded TDI.