鞍山市铁东区公共场所使用化妆品存在的主要卫生问题及对策

目的了解鞍山市铁东区公共场所使用化妆品卫生问题,保障使用者身体健康。方法对2013年度鞍山市铁东区卫生防疫站辖区内监管的公共场所随机抽检化妆品,对公共场所使用化妆品单位数及比例,化妆品标签标识卫生问题等进行描述。结果住宿业化妆品使用情况为56%,其他三种场所100%使用。化妆品标签标识检查住宿业合格率最低,仅为50%。国产特殊用途化妆品持有效证件率仅为65%,普通的仅为62%。标签标识问题突出,进货渠道复杂。化妆品抽检合格率低。结论公共场所的化妆品卫生质量令人担忧。     

鞍山市铁东区公共场所卫生基层问题及解决建议

笔者作为基层卫生监督工作人员经过十多年的公共场所卫生监督工作,通过对鞍山市铁东区公共场所卫生监督情况进行分析。发现当前存在许多公共场所卫生监督执法困难和难题,主要表现为卫生监督队伍薄弱,新兴公共场所剧增,公共场所执法依据不确定性（无法可依）等问题。笔者提出相应的解决建议,应转变卫生监督观念,提高监督管理质量。     

连花清瘟制剂治疗社区获得性肺炎疗效及安全性的系统评价和Meta分析

目的 探究连花清瘟制剂治疗社区获得性肺炎的疗效和安全性。方法 系统检索PubMed、Embase、Cochrane Collaboration、中国知网、维普、万方医学网数据库中所有口服连花清瘟制剂治疗社区获得性肺炎的临床随机对照试验,时间为从建库至2023年2月,制订纳排标准并对检索结果进行筛选,采用风险评估工具（ROB）量表对最终纳入研究的方法学质量进行评价,使用R软件进行数据合并及Meta分析。结果 共纳入30篇文献,包含2 800例患者,在使用抗生素等常规治疗的基础上联合使用连花清瘟,结果显示加用连花清瘟可以提高治愈率［相对危险度（RR）=1.32,95%置信区间（95%CI）［1.23,1.42］,P<0.000 1］并缩短退热时间［均数差（MD）=-1.45,95%CI［-1.93,-0.97］,P<0.000 1］,以患者群体将退热时间分为普通人群及特殊人群亚组,结果均显示加用连花清瘟可以缩短退热时间（普通人群MD=-1.51,95%CI［-2.07,-0.94］,P<0.000 1,特殊人群MD=-1.22,95%CI［-2.16,-0.29］,P=0.010 6）,且不会增加不良反应发生率（RR=0.85,95%CI［0.62,1.15］,P<0.000 1）。使用剪补法补充9篇阴性结果虚拟文献后,加用连花清瘟仍然可以提高CAP的治愈率（RR=1.20,95%CI［1.13,1.29］,P<0.000 1）,结果稳定。结论 CAP治疗中使用抗生素的基础上加用连花清瘟可以提高治愈率并缩短退热时间。     

The role of brain magnetic resonance imaging on the timing of antiepileptic drugs withdrawal following mesial temporal lobe epilepsy surgery

Objectives:To assess the influence of magnetic resonance imaging (MRI) brain findings on the timing of antiepileptic drugs (AEDs) withdrawal following anterior temporal lobectomy (ATL) in patients with mesial temporal lobe epilepsy (MTLE).Methods:We conducted a retrospective chart review at King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia from Jan, 2004 – Dec, 2017 of patients with MTLE who underwent ATL and included patients who had a minimum of 2 years of follow-up. We evaluated the association between the time required to start tapering and discontinuing AEDs after ATL in patients with Engel class I outcomes and their preoperative brain MRI.Results:We studied 64 patients who underwent ATL. The majority of patients (63%) had hippocampal sclerosis (HS) on histopathology. Following ATL, the mean time to start tapering AEDs was 10 months and AEDs were discontinued at a mean of 48 months. Abnormal brain MRI was observed in 53 (83%) patients, with findings suggestive of mesial temporal sclerosis (MTS) accounting for 75% of these abnormalities. The presence of any MRI abnormality was associated with a 10-month earlier tapering of AEDs (p<0.01), and an 18-month earlier complete withdrawal of AEDs (p<0.01). The odds of being seizure-free within the first year were higher if MTS was present in the brain MRI (adjusted OR=16). Similarly, this was associated with seizure freedom after the first year (adjusted OR=14.8, p<0.01). The presence of unilateral temporal IEDs on preoperative EEG were also associated with earlier tapering and discontinuation of AEDs as well as a seizure-free state after ATL surgery (OR=8.5 and 4.2, for the first and second year respectively, p<0.01).Conclusion:Patients with abnormal MRI findings and unilateral IEDs had earlier tapering of AEDs with an overall shorter AED discontinuation plan. Moreover, the presence of MTS on MRI, along with unilateral IEDs, were predictors of seizure freedom following ATL.

Anterior temporal lobectomy (ATL) is the standard treatment for medically refractory mesial temporal lobe epilepsy (MTLE), achieving seizure remission in approximately 70% of patients. ^1-3 However, the feasibility and timing of antiepileptic drug (AEDs) withdrawal after ATL are debatable. ⁴ The need for AEDs withdrawal stems from the adverse effects following long-term use, ^5,6 difficulties in maintaining compliance, and their high cost. ^7,8 Moreover, AEDs withdrawal following successful ATL is generally considered safe. ⁴ There are no evidence-based guidelines for managing AEDs withdrawal after resective epilepsy surgery. ^9,10 Moreover, few prospective and retrospective studies have assessed postoperative AEDs management exclusively in patients with MTLE. ^4,11-13 Hence, the timing of AEDs withdrawal after temporal lobectomy is controversial. ^12,14,15 The difficulties faced are how to taper AEDs, how soon it is safe to taper, which clinical profiles favor tapering, and what is the optimal time to start the tapering process. Predicting successful AEDs withdrawal following ATL has been examined in a few studies; however, the results were inconsistent. ^9,12,16-18 In one study, brain magnetic resonance imaging (MRI) findings were associated with seizure outcomes following ATL with successful AEDs discontinuation. ¹² The MRI can detect brain abnormalities, predict postoperative seizure, and AEDs freedom ² Despite this, data are lacking regarding the role of MRI in determining the time to start tapering AEDs postoperatively, as well as the time until AEDs discontinuation in those who do not require postoperative AEDs treatment. These data are essential for establishing guidelines that could assist clinicians with AED management following ATL.We aimed to assess the role of brain MRI in planning the tapering of AEDs and determining when to discontinue AEDs in patients with MTLE following ATL. We also evaluated seizure outcomes in patients with a minimum of 2 years of postoperative follow-up.     

不同程度铅中毒大鼠模型的制备

目的：建立不同程度大鼠铅中毒模型。方法：Wistar大鼠分别自由饮用不同浓度的醋酸铅1、3、6个月,以原子吸收法测定全血和脑匀浆液的铅水平。结果：实验组全血和脑匀浆中的铅水平均明显高于对照组（P〈0．01）,且二者的铅水平随染铅时问的延长、浓度的增加均明显升高（P〈0．05）。结论：以不同时间、不同浓度染铅均成功地建立了大鼠铅中毒模型。     

Enhancement of Ceramics Based Red-Clay by Bulk and Nano Metal Oxides for Photon Shielding Features

We prepared red clays by introducing different percentages of PbO, Bi₂O₃, and CdO. In order to understand how the introduction of these oxides into red clay influences its attenuation ability, the mass attenuation coefficient of the clays was experimentally measured in a lab using an HPGe detector. The theoretical shielding capability of the material present was obtained using XCOM to verify the accuracy of the experimental results. We found that the experimental and theoretical values agree to a very high degree of precision. The effective atomic number (Z_eff) of pure red clay, and red clay with the three metal oxides was determined. The pure red clay had the lowest Z_eff of the tested samples, which means that introducing any of these three oxides into the clay will greatly enhance its Z_eff, and consequently its attenuation capability. Additionally, the Z_eff for red clay with 10 wt% CdO is lower than the Z_eff of red clay with 10 wt% Bi₂O₃ and PbO. We also prepared red clay using 10 wt% CdO nanoparticles and compared its attenuation ability with the red clay prepared with 10 wt% PbO, Bi₂O₃, and CdO microparticles. We found that the MAC of the red clay with 10 wt% nano-CdO was higher than the MAC of the clay with microparticle samples. Accordingly, nanoparticles could be a useful way to enhance the shielding ability of current radiation shielding materials.