综合利用城市固体废弃物促进循环经济发展

发展循环经济要求对日益增多的城市固体废弃物进行总量控制与循环利用.根据我国国情,借鉴国外经验,从加强政府引导扶持、完善相关法律法规、促进企业采取有效措施、改变民众消费观念、鼓励民间资本参与5个方面进行探讨.     

空调生存环境对豚鼠红细胞膜脂质变化的影响

目的通过动物实验,研究空调环境对机体红细胞膜脂质成分的影响,为进一步研究空调环境对红细胞变形性的影响提供实验依据。方法采用豚鼠作为实验动物。实验分两组,每组12只。对照组:豚鼠在通风房间中自由饮水和进食,喂养15 天。实验组:豚鼠在温度为22℃空调房间内饲养15天。15天后,用心脏穿刺法采集豚鼠血液5ml,肝素抗凝,分离红细胞制备红细胞膜悬液。用UV265紫外分光光度计测定红细胞膜胆固醇及磷脂的含量。结果空调环境下豚鼠红细胞膜中胆固醇含量比正常对照组显著增高(P<0．01),而磷脂含量比对照组显著降低(P<0．01)且胆固醇／磷脂也有显著差异(P<0．01)。结论空调环境能改变红细胞膜的脂质成分,从而影响红细胞变形性。     

Séances par téléphone dans le contexte du Covid-19 : le cadre et ses limites

To deal with the Covid 19 pandemic, health protection measures require changes to our clinical practices. Faced up with the unprecedented nature of this situation, the liberal psychotherapist is led to rethink some aspects of the framework of his practice in order to preserve the thread of the transferential relationship. The authors develop a clinical reflection on the clinical setting in a pandemic period by exploring in particular the dynamics of telephone sessions. For telephone interviews, the question of the sound envelope is central, in particular regarding the psychic function of silence. We choose to illustrate our point with short vignettes than by relying on long-term clinical cases, more likely to represent the variety of new clinical situations encountered and the questions that accompany them. This article introduces his point by recounting the plague epidemic in ancient Greece to show the impact of the environment on humans and its collective fantasy implications. Being faced up with death, contamination, the invisible enemy brings out a palpable concern. It is indeed quite remarkable that these same reactions and concerns in front of death caused by the pandemic match whith what is related by Thucydides who survived the plague, which affected Athens during the Peloponnesian War. In another context, Winnicott highlights the place and importance of the therapeutic environment. It is both a question of adjusting the framework according to the context while maintaining certain intangible aspects representing the permanence of the link and its framework. A framework cannot exist without being kept, which is equivalent to thinking of the framework above all as an internal framework, questioning the clinician about what he values and what he makes sense in his practice. In the current context, these questions arise from the perspective of a certain flexibility, depending on the human context (child, adolescent, consultations, etc.) or external context (crisis linked to a virus, etc.) showing that it is more than never question of exercising on a case-by-case basis, taking into account changes in the environment. The initial observation during this period of confinement concerns the fact that some patients contact a therapist for the first time by telephone and wish to initiate psychotherapy (during this period) when they explain that such an initiative was not possible. despite the difficulties already encountered in the past. But there is also the opposite case: patients who have no intention of continuing the work already started during this time. Thus, faced up with the injunction of confinement, they show themselves in the psychic impossibility of following the treatment by other means such as, for example, telephone sessions. In this perspective, the silence on the phone takes on a different tone; silence reveals itself to be a source of greater anxiety than in presence: the presence of bodies, of its movements perceptible as imperceptible, of a gesture that carries or accompanies the senses, breathing, the visual context of the office and of its “decor”, represent as many essential elements in the usual capacity of the frame; in the absence of these basic sensory elements, silence can be experienced as a void, or even a gap in the bond, opening Pandora's box of paranoid fantasies acting unconsciously. If silence is representative of the whole framework, it promotes in this context the partialization of the clinician's body reduced to one ear and not to a whole body. Here, it is the change of framework that mobilizes the difference, established by Mr. Klein, between the partial and total object; this circumstance neo-framework could therefore call for regressive movements, undoing the silence of its symbolic function when the bodies are present.     

An international matched cohort study of the contribution of metabolic impairments to subclinical atherosclerosis in United Kingdom and Jamaican African-Caribbeans

Caucasian carriers of the T allele at R46L in the proprotein convertase subtilisin/kexin type 9 (PCSK9) locus have been reported to have 15% lower low-density lipoprotein (LDL) cholesterol (C) levels and 47% lower coronary heart disease (CHD) risk. Our objective was to examine two PCSK9 single nucleotide polymorphisms (SNPs), R46L and E670G, in 5783 elderly participants in Prospective Study of Pravastatin in the Elderly at Risk (PROSPER), of whom 43% had a history of vascular disease at baseline, and who were randomized to pravastatin or placebo with followup. In this population 3.5% were carriers of the T allele at R46L, and these subjects had significantly (p < 0.001) lower levels of LDL C (mean, −10%), no difference in LDL C lowering response to pravastatin, and a non-significant 19% unadjusted and 9% adjusted decreased risk of vascular disease at baseline, with no on trial effect. Moreover, 6.0% were carriers of the G allele at E670G with no significant relationships with baseline LDL C, response to pravastatin, or vascular disease risk being observed. Our data support the concept that the rare allele of the R46L SNP at the PCSK9 locus significantly lowers LDL C, but does not greatly reduce CHD risk in an elderly population with a high prevalence of cardiovascular disease.     

Influence of genes, sex, age and environment on the onset of autoimmune hepatitis

The pathogenesis of autoimmune hepatitis （AIH） is complex. However, it is believed that a susceptible individual, owing to his genetic background, sex and age, can develop the disease following exposure to an environmental trigger. Autoimmune hepatitis does not follow a Mendelian pattern of inheritance; hence no single causative genetic locus has been identified. However, several genes, inside and outside the HLA locus, have been linked to an increased susceptibility to AIH. Epidemiological evidence also suggests that the sex and age of the patient plays a role in AIH pathogenesis as the disease onset occurs mainly in the two first decades of life and a higher disease incidence is observed in females. No environmental trigger has been identified, but several have been proposed, mainly viruses and xenobiotics. This article aims at reviewing the current knowledge on susceptibility factors leading to AIH and putative triggers, emphasizing fundamental mechanisms responsible for the break of liver immunological tolerance.     

云南南部地区三带喙库蚊与伪杂鳞库蚊种群与环境因素关系的地理信息系统分析

三带喙库蚊是云南地区主要乙脑媒介,而伪杂鳞库蚊也被怀疑在云南地区能起到传播乙脑的作用,它们的种群动态与特定地区的环境因素密切相关,也关系到当地乙脑的流行态势。本研究选择云南省南部边境地区孟腊县2个村:龙塘村和东方红村,在2村内设置16个诱蚊采样点,并应用地理信息系统对2村的三带喙库蚊和伪杂鳞库蚊种群与环境因素之间的关系进行分析。研究结果表明,灯点离水稻田最近空间水平距离(DTF)与灯点平方公里缓冲区间水稻田面积(KFA)、样点伪杂鳞库蚊种群优势度呈正相关关系;样点三带喙库蚊的优势度与灯点离河流最近空间水平距离(DTR)存在负相关关系;KFA与样点三带喙库蚊种群密度呈正相关关系。文章还在此基础上对西部开发中环境改变对这两种蚊虫乃至乙脑流行的可能影响进行了进一步探讨。     

对社区居民开展构建和谐医患关系教育的探索

在患方及居民中开展构建和谐医患关系教育,对纠正患者就医心态、净化就医环境具有重要作用。对社区居民进行构建和谐医患关系教育需要社会多部门参与,动员居民积极参加教育活动,运用多种教育形式、针对不同人群,从“知-信-行”三个维度转变群众对待医患关系的态度。     

海上环境下海水浸泡颅脑火器伤治疗的实验研究

目的探讨海上环境对海水浸泡颅脑火器伤治疗的影响,为提高海战救护能力提供参考。方法雄性杂种犬60只,按数字表法随机分为陆地组[码头环境,气温（30±5）℃,相对湿度（86.3±5）%],海上组[在医院船上,海上风力2～5级,海面浪高2～5m,舰船摇摆度8～16°,气温（32±5）℃,相对湿度（92.3±6）%],每组30只。动物被制作成海水浸泡颅脑火器伤模型。30min后用常规方法加β-七叶皂甙钠、盐酸纳洛酮治疗。对两组动物行经颅多普勒超声检测、动脉血气分析、颅内压监测,并对各项指标变化及疗效进行比较。结果治疗后3h两组犬各项检测指标均优于治疗前（P〈0.05）。治疗后陆地组脑血管痉挛好转率、颅内压恢复情况、动物存活率都优于海上组（P〈0.01）。结论海上风浪、风力和湿热环境对海水浸泡颅脑火器伤的救治疗效有明显的影响。针对海上环境的影响因素采取相应的措施,提高医护人员海上的手术技巧和对海上环境的适应能力是提高海上颅脑火器伤救治疗效和降低死亡率的关键。