对肝外胆管梗阻时“软藤征”的再认识

本文回顾性分析了48例“软藤征”的病因,其中恶性疾病28例(占58.3％),良性疾病20例(占41.7％)。据本文资料,作者认为“软藤征”是肝管分叉部及肝外胆管急性完全(或接近完全)性梗阻时肝内胆管扩张的特征性X线表现,并非恶性梗阻特有,良性梗阻亦常见。作者指出,只要肝内胆管无或仅有轻度炎症,胆管具有良好的弹性和扩张性,不论良、恶性病变都可出现“软藤征”。那种认为当梗阻病变未显示时,仅根据“软藤征”即可作出恶性梗阻诊断的观点很值得商榷。作者认为,“软藤征”的定性及病因诊断主要应根据PTC或ERCP,或二者联合显示梗阻局部病变的形态学特征来确定。     

食管平滑肌瘤诊断的新征象

本文报告2例食管平滑肌瘤,经食管钡透检查,发现两种新的征象,我们称之为“粘膜折叠征”和“粘膜外凸征”。经食管镜检查与术中观察分析可印证:这两种征象的出现是食管粘膜深陷于肿瘤表面的凹陷处,或深陷于两个肿瘤挤压在一起的间隙中而形成的,而食管壁以外的任何肿瘤压迫食管壁都不可能出现的征象。出现上述两种征象,可以作为食管平滑肌瘤与纵隔肿瘤鉴别诊断的依据,也可以作为多发性食管平滑肌瘤挤压在一起的征象。     

Study of preclinical changes in workers exposed to inorganic mercury in chloralkali plants

Summary The aim of the present work was to clarify the question of preclinical changes of Hg intoxication (micromercurialism) in man. The study to detect these disorders was performed on 39 chloralkali plant workers who had been exposed to mercury for more than 7 years. The ambient air, urine and blood values of the last few years were determined in extensive measurements by various methods and related to one another. The average ambient air concentrations were clearly below the currently applicable threshold limit value (German MAK) of 0.1 mg/m³. For the purpose of clarifying the mentioned question of preclinical changes of intoxication, the exposed persons were subjected to psychomotor-function examinations and compared with a group of nonexposed persons. The blood pressure and pulse frequency values of both groups were also determined and compared with one another. No significant differences between the two groups of persons examined were detectable.Presented at the 18th Congress of the Deutsche Gesellschaft für Arbeitsmedizin in Frankfurt, 24th May 1978     

Diagnosing protan heterozygosity using the Medmont C‐100 colour vision test

Background : A surprisingly high 15 per cent of women in Caucasian societies are carriers of the genes for abnormal colour vision but there is no clinical method to identify them. It has long been known that heterozygotes for the protan colour vision deficiencies can demonstrate a reduced luminous sensitivity to red light. This is known as Schmidt's sign, which is thought to arise from mosaicism (Lyonisation). The Medmont C‐100 colour vision test measures relative spectral sensitivity using flicker photometry to differentiate protans and deutans. It should be able to diagnose Schmidt's sign. Method : We tested six known protan heterozygotes (four whose sons have a protan colour vision deficiency and two whose fathers are protan) with the Medmont C‐100 test. Results : All six heterozygotes made average settings of ‐1.75 or more negative at the Medmont C‐100 test, settings which are at or beyond the boundary of the distribution of settings made by observers with normal colour vision. There have been two previous cases reported in the literature of protan heterozygotes, who made protan settings on the Medmont C‐100 or its predecessor test, the OSCAR. We also tested six daughters of the known heterozygotes, 50 per cent of whom are likely to be heterozygotes. Four of the six (66 per cent) made protan settings on the Medmont C‐100. The other two made normal 0.0 settings. Conclusion : We conclude that the Medmont C‐100 can be used clinically to diagnose carriers of protan colour vision deficiency.     

Storage temperatures of medications on an air medical helicopter

INTRODUCTION: The safety and efficacy of medications stored on air medical helicopters may be adversely affected by extreme temperatures. The purpose of this study was to determine whether temperatures inside an air medical helicopter drug box were within the U.S. Pharmacopeia recommendations for controlled room temperature. This is defined as a temperature between 15 degrees and 30 degrees C (59 degrees and 86 degrees F) with a mean kinetic temperature of less than 25 degrees C (77 degrees F). An additional goal was to determine whether time/temperature indicator labels can reliably monitor mean kinetic temperatures. METHODS: Temperatures were monitored with miniature electronic temperature recorders and color-changing time/temperature indicator labels. RESULTS: The mean kinetic temperatures for the summer and winter periods were 25.1 degrees C (77.2 degrees F) and 12.7 degrees C (54.8 degrees F), respectively. In the summer, the electronic recorders logged temperatures exceeding 25 degrees C (59 degrees F) 37% of the time and more than 30 degrees C (86 degrees F) 6% of the time. In the winter, temperatures less than 15 degrees C (59 degrees F) were recorded 83% of the time. The mean kinetic temperatures obtained from the electronic recorder and the time/temperature indicator labels differed by less than 0.7 degree C (1.3 degrees F). The results show that medications on an air medical helicopter are subject to temperatures out of the recommended range and that time/temperature indicator labels can reliably monitor mean kinetic temperatures.     

上海市部分空调系统微生物污染状况的初步调查

[目的]了解当前上海地区空调系统微生物污染情况，更好地控制空调环境的卫生状况。[方法]采用多阶段随机抽样方法，对上海市不同类型空调系统进行横断面调查。选取上海市闵行、闸北、浦东、静安、黄浦、长宁6个区中央及非中央两种类型的空调系统，对其过滤网、热交换器、空调冷却循环水中的细菌总数、霉菌总数以及军团菌、溶血性链球菌、金黄色葡萄球菌、芽胞杆菌等项目进行检测。[结果]中央空调冷却循环水在6月～9月份军团菌污染阳性率均在50％以上，10月份呈现明显下降趋势；在各种不同类型的公共场所中，地铁站、医院、商场酒店的军团菌阳性率均在55％以上；不同类型空调系统过滤网、热交换器的细菌总数、霉菌总数及军团菌、溶血性链球菌、金黄色葡萄球菌检出率均较低，而芽胞杆菌检出率高。[结论]上海市中央空调冷却水军团菌污染状况严重，而不同类型空调系统过滤网、热交换器的卫生状况相对较好。     

光离子化检测仪进行挥发性有机物测定研究

目的在光离子化TVOC仪上,许多有机物都有浓度响应。采用现场直读仪器方法对空气中挥发性有机物进行测定,建立其方法。方法采用现场读数仪器和气体采样器同时在现场采样和测定,将现场采集的样品进行气相色谱分析,比较两种结果的差异。结果现场光离子化TVOC仪与气相色谱仪的测定结果无显著性差异。结论光离子化检测法适合室内空气中总有机挥发物的测定与国标法无差别。     

工作场所空气中五氧化二磷离子色谱测定方法的研究

目的：建立工作场所空气中五氧化二磷的离子色谱测定方法。方法：本文采用吸收液采集工作场所空气中五氧化二磷，生成磷酸，经色谱柱分离，电导检测器检测，保留时间定性，峰高或峰面积定量。结果：工作场所空气中五氧化二磷的线性范围为0～4．0μg／ml；相关系数为0．9997；检出限为0．5μg／ml；若采集15L空气进行测定，则最低检出浓度为0．33mg／m^3；相对标准偏差为0．71％～3．68％；样品加标回收率为101．9％～105．5％；样品在室温下至少可保存1周。结论：此法灵敏度高，选择性好，干扰少，是检测工作场所空气中五氧化二磷的好方法。     

三种空气消毒方法效果的比较

目的：探讨理想的空气消毒方法及不同消毒方法对空气的消毒效果。方法：以微生物检验科无菌室中自然菌作为观察对象，用平板自然沉降法于消毒前及消毒后不同时段采样检测菌数并作细菌鉴定，用来比较紫外线、过氧乙酸和空气消毒洁净器对细菌室空气自然菌的杀菌效果。结果：三种消毒方法均能使空气细菌明显下降；过氧乙酸和空气洁净器消毒效果显著；空气洁净器能在日常检验工作中持续消毒杀菌；革兰阳性球菌和革兰阴性菌对三种消毒方法均敏感。结论：空气洁净器是较好的空气消毒方法。     

老年机械通气患者气管内导管生物被膜形成状况的研究

目的：探讨老年机械通气患者气管内导管生物被膜的形成状况,明确相关性和危险因素.方法：分析22例老年患者的25个气管导管各留置时间段与细菌培养结果.结果：25个气管导管细菌培养阳性22个,占88%,培养阴性的3个,占12%.结论：细菌密度与气管插管时间密切相关,随着插管时间的延长,细菌计量明显增加.