Postoperative water and electrolyte changes in skeletal muscle: a clinical study with three different intravenous infusions

Twenty-seven patients admitted for cholecystectomy were matched for age and sex in three groups for different perioperative fluid therapies over a period of 3 days. Group I was given an acetated half-isotone "balanced" saline solution with the addition of 2.5% glucose, Group II an acetated Ringer solution and Group III an isotonic glucose solution. Percutaneous muscle biopsies were performed before and on the third day after surgery for the determination of water content and the concentration of sodium, potassium, magnesium and chloride in skeletal muscle. The cumulative balance of sodium and potassium was measured daily during the study. In all three groups a significant increase in the total muscle water content was demonstrated. The concentration of sodium and chloride in skeletal muscle increased significantly in Groups II and III, whereas the concentration of potassium decreased in all groups. The cumulative sodium balance was positive in Groups I and II; the potassium balance was negative in all groups. In conclusion, the patients given the balanced saline solution showed the least change in water content and electrolyte concentrations in skeletal muscle.     

Chemical and statistical considerations in the determination of partition coefficients of weakly ionizable drugs and poisons

Equations have been developed that relate the concentration (or a parameter directly proportional to concentration, such as optical absorbance) of a weakly ionizable solute in a water-immiscible phase, in equilibrium with an aqueous phase, to the pH of the aqueous phase, the partition coefficient of the unionized solute and the phase volume ratio. These relationships have been used in the design of experimental methods for determining partition coefficients, which require measurement of solute concentration in only one phase. Data obtained in this way permit ready recognition of deviations from assumptions made in the development of the model; these assumptions include insolubility of the ionized solute in the water-immiscible phase and lack of interaction between buffer components and solute. Conditions for optimal liquid—liquid extraction of weakly ionizable solutes are more easily recognized. With these techniques, the negative logarithm of the acid dissociation constant (pK′_a) and the logarithm of the octanol—water partition coefficient (log P) have been measured for warfarin (pK′_a = 5.15 ± 0.04; log P = 2.82 ± 0.06), strychnine (pK′_a = 8.29 ± 0.02; log P = 2.23 ± 0.04), phenol (pK′_a = 9.88 ± 0.02; log P = 1.75 ± 0.05), procaine (pK′_a = 8.11 ± 0.04; log P = 1.10 ± 0.08), and ephedrine (pK′_a = 9.92 ± 0.01; log P = 1.65 ± 0.04) at 21°C.     

2014—2021年石家庄市生活饮用水水质变化趋势分析

目的 对石家庄市2014—2021年生活饮用水常规指标进行监测,分析水质及主要监测指标变化趋势。方法 收集整理2014—2021年石家庄市生活饮用水监测资料,分析生活饮用水合格率、主要监测指标合格率、主要监测指标变化趋势。 结果 2014—2021年石家庄市共监测水样10529份,总合格率为77.15%;地表水合格率（99.08 %）高于地下水（75.96 %）、城市水合格率（85.17 %）高于农村水（75.05%）、枯水期合格率（79.79%）高于丰水期（74.51%）,完全处理水合格率（99.10%）高于仅消毒（86.29%）和未处理（70.70%）（P均<0.05）。2014—2021年石家庄市生活饮用水最低合格率为69.49%,最高合格率为82.28%,总合格率呈上升趋势（P<0.05）。主要指标耐热大肠菌群 、菌落总数、总硬度、硝酸盐、硫酸盐的合格率均呈上升趋势（P<0.05）,菌落总数、硝酸盐、氟化物、总硬度、溶解性总固体、硫酸盐、氯化物的含量均呈下降趋势（P<0.05）。结论 石家庄市2014—2021年生活饮用水水质整体呈现优化趋势,微生物指标仍是影响水质的主要因素。     

医疗卫生机构气候韧性和环境可持续评价工具研究进展

目的 气候变化给医疗卫生机构带来诸多不确定性威胁,医疗卫生机构亟需提高自身的气候韧性并采取积极的应对措施,如何系统评价医疗卫生机构应对气候变化的能力成为应对气候变化挑战的工作重点。方法 使用范围综述筛选医疗卫生机构气候韧性和环境可持续评价工具相关文献和最新进展,并对密切相关的文献采用引文检索拓展研究范围。结果 借鉴国际经验已开发出适用于我国的《绿色医院建筑评价标准》,但对于医疗卫生机构气候韧性的指南和要求仍在探索中。国际上已经发展了三套较完整的工具包和指南,并已探索性开展了实地应用,包括加拿大的医疗卫生机构气候变化韧性工具包、美国的可持续和气候韧性医疗卫生机构工具包,以及世界卫生组织的气候韧性和环境可持续性的医疗卫生机构指南。结论 医疗卫生机构气候韧性和环境可持续能力评价工具构建是开展脆弱性评估和干预的基础,应积极借鉴国外相关经验开发适宜我国的评价工具,以增强机构和人员应对气候变化的能力。     

我国中老年人群骨关节炎罹患现状及其关联因素分析

目的 了解我国中老年人群罹患骨关节炎现状及其关联因素。方法 采用2015年和2018年中国健康养老追踪调查（CHARLS）数据,纳入中老年人群（≥45岁）作为研究对象,运用χ2检验和多因素logistic回归分析中老年人群骨关节炎的关联因素。结果 纳入7 050名中老年人,骨关节炎患病率为33.69％。多因素logistic回归结果表明,从个体社会人口学特征看,年龄≥60岁（OR = 2.254,95%CI:1.985～2.558）、女性（OR = 1.353,95%CI:1.200～1.527）是骨关节炎的危险因素;从慢性病患病情况看,患有高血压（OR = 1.228,95%CI:1.072～1.408）、心脏病（OR = 1.607,95%CI:1.361～1.897）、中风（OR = 2.303,95%CI:1.604～3.306）、肾脏疾病（OR = 2.147,95%CI:1.744～2.644）、胃部疾病或消化系统疾病（OR = 2.810,95%CI:2.487～3.175）是骨关节炎的危险因素;从居住环境看,居住在城市地区（OR = 0.637,95%CI:0.541～0.750）、住房有电梯（OR = 0.879,95%CI:0.785～0.985）、坐式厕所（OR = 0.669,95%CI:0.580～0.770）是骨关节炎的保护因素。结论 我国中老年人群骨关节炎患病状况不容乐观,其关联因素是多方面的,应从个体层面到环境层面重视对骨关节炎的防控。     

重庆市某三甲医院消毒供应中心纯化水细菌污染情况和消毒效果调查

目的了解重庆市某三甲医院消毒供应中心(CSSD)纯化水处理系统的细菌水平、消毒方法及效果。方法运用无菌技术采集重庆市某三甲医院CSSD不同时期的纯化水进行细菌培养,根据细菌培养、余氯、硬度检测结果对纯化水处理系统采取一系列措施以改善水质,并对各项措施的实施效果进行评价。结果该院CSSD纯化水存在细菌总数超标的情况,分别经过调整加盐量、更换水处理机耗材、安装含氯消毒剂加药装置并在水处理机制水时将5%84消毒液持续低流量泵入纯化水储水罐后,细菌总数明显降低,纯化水水质达标。结论该院纯化水存在细菌污染现象,医院应加强管理,CSSD需按时维护水处理设备,定期监测水质。     

Associations of park features with park use and park-based physical activity in an urban environment in Asia: A cross-sectional study

Park use is associated with health, yet our understanding of park features related to their use is limited. Singapore's parks were audited for 30 micro-features, then geospatial analysis characterized micro-features scores for parks nearest to participants' homes. Adults (3,435) reported their park use and park-based physical activity. Using linear regression models, we found living near a park with higher micro-features scores was associated with more time in parks and park-based physical activity. Specific micro-features were associated with more park time (wildlife areas, water features, forested areas, unpaved trails (2–2.6 h/month, p < 0.05)) and with physical activity in parks (water features, forested areas, large playground, open green spaces (1.8–2.2 h/month, p < 0.05)). These findings could inform parks planning to support population-health.     

Optimal Household Water Access Fosters the Attainment of Minimum Dietary Diversity among Children Aged 6–23 Months in Malawi

Along with sanitation and hygiene, water is a well-known driver of child undernutrition. However, a more direct role of household (HH) water access in shaping dietary diversity remains unexplored. We assessed the association between HH water access and achievement of minimum dietary diversity (MDD) among young children. We utilized nationally-representative cross-sectional data from the 2015/16 Malawi Demographic and Health Survey, which included 4727 mother–child dyads, respectively, (26.8 ± 6.8 years, range 15–49 years) and (13.9 ± 4.9 months, range 6–23 months). HH water access was categorized as (1) basic or no access, (2) intermediate, or (3) optimal. MDD was defined as feeding a child, during the previous day, at least four of the food groups defined by the World Health Organization. Only 27.7% of the children achieved MDD standards; most of the children who achieved MDD were from HHs with optimal water access (58.4%, p < 0.001). However, only 5.9% of the mother–child dyads were from HHs with optimal water access. After adjusting for covariates, children from HHs with optimal water access had higher odds of achieving MDD than those from HHs with basic or no water access (aOR = 1.74, CI = 1.24–2.46). Our results highlight the need to incorporate water-based strategies into national nutritional policies to increase dietary diversity among Malawian infants and young children.     

石灰水对埃及伊蚊不同发育阶段影响研究

目的通过石灰水对埃及伊蚊生活史幼期不同阶段生长发育影响的实验室研究,评价生石灰对防治埃及伊蚊的干预效果,为生石灰用于埃及伊蚊的防治提供实验数据。方法将一定数量的埃及伊蚊依据不同发育阶段(卵、Ⅰ~Ⅳ龄期蚊幼、蛹)分别饲养于石灰水中,观察蚊幼活动情况,记录不同时期相应孵化时间、孵化率和死亡率,同时将实验室过夜自来水(实验室脱氯水)饲养蚊虫作对照,分析比较不同饲养环境、不同发育阶段埃及伊蚊发育的变化差异。结果对照组埃及伊蚊卵的平均孵化时间为1.75 d,而试验组(1.3 g/L石灰水饲养)埃及伊蚊卵的平均孵化时间为3.84 d,是对照组的2.19倍,孵化时间的差异具有统计学意义(t=36.02,P<0.05)。试验组埃及伊蚊卵孵化率为59.3%,对照组为89.3%,两组之间孵化率的差异具有统计学意义(χ^(2)=35.38,P<0.05)。Ⅰ~Ⅳ龄试验组蚊幼死亡率分别为44.0%、92.0%、97.3%、98.7%,显著高于对照组蚊幼死亡率,两组之间死亡率的差异具有统计学意义(χ^(2)值为65.79~276.53,P<0.05)。试验组蛹的死亡率为98.7%,显著高于对照组的死亡率,两组之间死亡率的差异具有统计学意义(χ^(2)=280.35,P<0.05)。对照组埃及伊蚊卵、蚊幼和蛹的死亡率分别为10.7%、2.3%和2.0%,三组之间死亡率的差异具有统计学意义(χ^(2)=25.09,P<0.05)。对照组埃及伊蚊卵的死亡率明显高于蚊幼和蛹。试验组埃及伊蚊卵、蚊幼和蛹的死亡率分别为40.7%、83.0%和98.7%,三组之间死亡率差异具有统计学意义(χ^(2)=170.88,P<0.05)。结论石灰水对埃及伊蚊不同发育阶段均具有明显抑制作用,对蛹的杀灭作用最大,其次是蚊幼和卵。随着埃及伊蚊幼虫年龄的增长,石灰水对其抑制效果逐渐增强。但生石灰对埃及伊蚊成蚊的防治效果有待进一步的现场验证。     

滤膜法与涂抹法检测血液透析相关用水微生物的效果

目的 探讨滤膜法和涂抹法检测血液透析相关用水微生物的效果,为选择合适的检测方法提供依据。方法 回顾性收集某三级甲等综合性医院2018年1-12月同时采用滤膜法和涂抹法检测血液透析相关用水微生物的结果,对比分析滤膜法和涂抹法检测细菌检出率、单位菌落数、超干预值检出率和微生物合格率。结果 共收集274份血液透析相关用水微生物检测结果,其中透析液131份,反渗水39份,B浓缩液（下简称B液）14份,置换液34份,其他透析用水56份。滤膜法细菌检出率均高于涂抹法,其中透析液、反渗水、置换液、其他透析用水标本使用两种方法的细菌检出率比较,差异有统计学意义（均P<0.05）。透析液、B液、其他透析用水标本单位菌落数滤膜法数值上低于涂抹法,但仅其他透析用水标本使用两种方法检测结果单位菌落数差异有统计学意义（t=-3.011,P=0.004）。超干预值检出率其他透析用水滤膜法低于涂抹法,差异有统计学意义（χ²=6.596,P=0.010）。置换液、反渗水标本微生物合格率滤膜法数值上低于涂抹法,但仅置换液标本微生物合格率差异有统计学意义（χ²=18.987,P<0.001）。结论 滤膜法检出细菌的能力高于涂抹法,但其在血液透析相关用水微生物检测中存在一定局限性,除用于置换液比较适合外,应用在其余血液透析相关用水微生物的检测效果并不优于涂抹法。