医疗单位消毒效果及医疗用品监测结果

我们从1999～2001年连续3年对江津市各级医疗单位进行了消毒效果及1次性使用医疗用品的监督监测。1对象与方法1 1监测对象:全市市直属医院15家,乡(镇)卫生院316家,村卫生所397家,个体诊所674家。1 2监测方法及项目:根据GB15980—1995《一次性使用医疗用品卫生标准》、GB15982—1995《医院消毒卫生标准》对1次性医疗用品、医护人员手、物体表面、使用中消毒剂、无菌器械保存液、灭菌器械、环境空气7类样品进行无菌试验和需厌氧菌检测,其中1项有菌生长,均为不合格。2结果2 1将四级医疗机构3年的检测合格率进行比较见表1。四级医疗单位检测合…     

钼的生理功能与检测

钼是人体必需的微量元素之一,钼作为3种钼金属酶的辅基而发挥其生理功能。钼与心血管病密切相关,钼具有抗癌作用。本文叙述了钼的理化性质及检测方法,并列举了部分样品的钼实际测定值。     

胸部肿瘤斜野照射治疗首次摆位射野参数不符的探讨

目的：对胸部肿瘤斜野照射治疗首次摆位射野参数不符进行探讨,通过患者体表标记和升床标记提高摆位精度。方法：选择加速器治疗的40例胸部肿瘤斜野照射的患者首次摆位核对升床,照射野与模拟定位时的数据进行对比。结果：通过对患者首次摆位与模拟定位射野参数核准时升床高度误差为3～8mm;按医嘱升床及射野参数摆位,射野边界误差为3～9mm。结论：通过模拟定位射野参数摆位与体表标记不符的现象,寻找摆位误差的原因。     

离子色谱法同时测定腊肉中的食盐和亚硝酸盐

目的：建立用离子色谱法同时测定腊肉中食盐和亚硝酸盐的方法。方法：样品经前处理后，选用IonpacAS14分离柱，4．5mmol／LNa2CO3／0．5mmol／LNaHCO3作淋洗液，抑制电导检测器进行测定。结果：方法的最低检出限为食盐（以NaCl计）：0．010g／kg；亚硝酸盐（以NaNO2计）：0．005g／kg；相关系数均大于0．999。结论：方法简单可靠，样品经前处理后，7min内可完成两种物质的测定。     

利用射野照相验证片对胸部肿瘤放疗摆位误差的分析

目的利用射野照相和Photoshop软件对胸部肿瘤适形放射治疗进行位置验证,分析摆位误差,为临床靶区（CTV）外扩计划靶区（PTV）提供参考依据。方法 30例胸部肿瘤患者,每位患者在首次及每周一治疗摆位前拍摄正、侧位射野照相各一张,与数字重建图像进行骨性匹配,测量射野中心点在X、Y、Z方向的位移值。结果通过对150张次射野片对比、分析,摆位误差X为（2.22±2.21）mm,Y为（3.69±2.47）mm,Z为（3.38±2.24）mm;获取CTV外扩的边界：X为5.99 mm,Y为9.11mm,Z为8.33 mm。结论通过对摆位误差数据的分析,为胸部肿瘤的适形放疗提供CTV外扩值,提高放射治疗的准确性。     

2008年重庆市燃煤型氟中毒病区环境氟调查分析

Objective To find out the distribution pattern of environmental fluoride in the coal-burning endemic fluorosis areas to provide scientific evidence for establishing prevention and remedial measures in Chongqing. Methods According to historical data in Chongqing In 2008, 4 endemic villages(Lingyun and Lizi Villages of Wushan County, and Taiping and Daqing Villages of Pengshui County) and 2 non-endemic villages (ShuangLou and XianLong Villages of Yongchuan County) were investigated. Dental fluorosis of children in 8 to 12 year old and residents over 16 years of age for clinical skeletal fluorosis were examined in four endemic villages. Five households from each of 6 villages were taken, where 500 g of coal, mixed clay with coal, mixed coal of soil, coal cinder, soil were sampled; 15 people were taken in each village, each household gathering 500 g of corn, rice, potatoes, vegetables, grain and vegetable, 100 g of dried pepper and 250 ml of drinking water were sampled from 15 families of each village. Household drinking water samples were collected 1, each 250 ml. For those having tea-drinking habit, each household was collected 50 g of tea and 600 ml of drinking tea, the amount of fluoride were determined. Indoor and outdoor air was collected and measured in 5 households in each village. Results The detected rate of dental fluorosis of children in endemic areas was 74.65% (736/986). The detected rate of skeletal fluorosis of adult was 7.20%(736/986). The average fluoride content of coal, mixed clay with coal, mixed coal of soil, cinder coal, soil in the endemic villages was (310.56±209.46), (360.51±224.96), (293.62±65.15), (186.59±133.66), (497.54±294.70)mg/kg. The average fluoride content in non-endemic villages was (48.68±10.62), (275.66±62.69), (152.20±34.43), (209.14±188.66),269.98±58.21)mg/kg. The fluoride content level of endemic villages was significantly higher than that of non-endemic villages(t=7.67,31.54,5.82, 5.82, all P<0.05). The average fluoride content of drinking water, corn, pepper, flee, potato and vegetable in the endemic villages was (0.30±0.14)mg/L, (1.83±2.67), (23.50±91.80), (0.77±0.25), (0.44±0.11), (0.48±0.18)mg/kg, The average fluoride content in non-endemic village was (0.18±0.06)mg/L, (2.21±0.46), (2.82±2.51), (1.31±0.21), (0.64±0.41), (1.10±0.77)mg/kg. The fluoride content in drinking water and pepper in the endemic villages was significantly higher than that of the non-endemic villages(t=7.79, 2.33, all P<0.05). The fluoride content of rice, potato and vegetable in the non-endemic villages was significantly higher than that of the endemic villages(t=39.29,4.69,4.01, all P<0.05). There was no significant difference of fluoride content of tea and drinking tea between endemic villages[(99.41±55.83)mg/kg, (1.59±0.91)mg/L] and non-endemic villages[(79.95±43.78)mg/kg, (1.80±1.16)mg/L, t=1.01, 0.27, all P>0.05]. The amount of drinking tea in the endemic village[(1.45±0.68)L/d] was higher than that in non-endemic village[(1.00±0.47)L/d, t=4.27, P<0.05]. The average fluoride content of indoor air in the endemic village[(12.77±8.08)μg/m3] was higher than that in non-endemic village [(1.16±1.08)μg/m3, t=9.49, P<0.01]. There was no significant difference of fluoride content of outdoor air between endemic village and non-endemic village[(1.10±1.57), (0.39±0.31)μg/m3, t=2.01, P>0.05)]. Conclusions The fluoride source of coal-burning endemic fluorosis areas are coal and mixed coal of soil in Chongqing. Fluoride enters into human bodies mainly via respiratory, not from food. Although fluoride is rich in pepper, people don't eat it, so reducing the fluoride content in indoor air is the principle measure. Drinking tea may be was one factor of endemic fluorosis, which needs to be further studied.     

重庆市燃煤型氟中毒病区煤氟调查分析

[目的]掌握重庆市燃煤型氧中毒病区煤氟含量及其与病情的变化关系,为分析氟中毒的主要氟源提供科学依据.[方法]以病情较重的彭水县的大青村、太平村和巫山县的凌云村、栗子村为调查点,永川区的双楼村、现龙村为对照点,调查8～12岁儿童氟斑牙患病率,16岁以上人群氟骨症患病情况;检测病区和非病区的煤、拌煤土、拌煤、煤渣、饮用水、土壤、空气中的氟含量,调查病区和非病区居民生活,估算出通过不同途径进入人体的氟的含量.[结果]病区儿童的氟斑牙检出率以及16岁以上人群氟骨症检出率均高于非病区的水平,病区与非病区居民经消化道进入人体的氟含量相差不大,经水体进入人体的氟虽有差别,但未超过国家标准,但病区空气氟含量超过国家标准,经呼吸系统进入人体的氟的总量病区是非病区的7.57倍.[结论]重庆市燃煤型氧中毒氟源是煤,主要的摄氟途径为呼吸系统.     

饮用水中F-、Cl-、NO3-N、SO42-的离子色谱测定法

目的建立用离子色谱测定饮用水中F^-、Cl^-、NO3-N、SO4^2的方法。方法用DIONEX DX-600型离子色谱仪，IonpacAS14分离柱，以3．5mmol/L Na2CO3／1．0mmol／L NaHCO3作淋洗液，对饮用水中F^-、Cl^-、NO3-N、SO4^2进行测定，水样勿需特殊前处理，只需用0．45μm滤膜过滤即可。结果方法最低检出限为F^-0.01mg/L、Cl^-0.03mg/L、NO3-N0.03mg/L、SO4^2 0.05mg/L；平均回收率为F^-97.5％、Cl^-98.1％、NO3-N92.2％、SO4^2 101.8％。相关系数均大于0．999。结论方法灵敏度高，回收率好，简便快捷，10min内即可完成4种离子的测定。     

2008年重庆市燃煤型氟中毒病区环境氟调查分析

目的 了解重庆市燃煤型氟中毒病区环境氟分布特征,为制订科学防治措施提供科学依据.方法 2008年,根据重庆市的历史资料,以巫山县凌云村、栗子村和彭水县太平村、大青村4个病区村和永川区的双楼村、现龙村2个非病区村为调查村.对4个病区村所有8～12岁儿童进行氟斑牙检查,对16岁以上人群进行临床氟骨症检查.6个调查村每村抽取5户居民,每户采集1份家中所用煤、拌煤土、混土煤、煤渣、土壤,每份500 g;每村抽取15户居民,每户采集玉米、大米、土豆、蔬菜,粮食和蔬菜样品各1份,每份500 g,干辣椒样品1份,每份100 g;每户采集1份饮用水水样,每份250 ml;有饮茶习惯的居民村,每村采集茶叶15户以上,每户采集50 g茶叶和600 ml茶水测定含氟量;每村抽取5户居民,测旺火时的室内、外空气含氟量.结果 病区村儿童氟斑牙检出率为74.65%(736/986),成人氟骨症检出率为7.20%(75/1592);病区村煤、拌煤土、混土煤、煤渣、土壤含氟量分别为(310.56±209.46)、(360.51±224.96)、(293.62±65.15)、(186.59±133.66)、(497.54±294.70)mg/kg;非病区村分别为(48.68±10.62)、(275.66±62.69)、(152.20±34.43)、(209±14±188.66)、(269.98±58.21)mg/kg,病区村均显著高于非病区村(t=7.67、31.54、5.82、5.82,P均<0.05);病区村饮用水、玉米、辣椒、大米、土豆、蔬菜含氟量分别为(0.30±0.14)、(1.83±2.67)、(23.50±91.80)、(0.77±0.25)、(0.44±0.11)、(0.48±0.18)mg/kg,非病区村分别为(0.18±0.06)、(2.21±0.46)、(2.82±2.51)、(1.31±0.21)、(0.64±0.41)、(1.10±0.77)mg/kg;饮用水、辣椒含氟量病区村显著高于非病区村(t=7.79、2.33,P均<0.05);大米、土豆、蔬菜含氟量非病区村显著高于病区村(t=39.29、4.69、4.01,P均<0.05);病区村茶叶、茶叶水含氟量[(99.41±55.83)、(1.59±0.91)mg/L]与非病区村[(79.95±43.78)、(1.80±1.16)mg/L]比较,差异无统计学意义(t=1.01、0.27,P均>0.05);但病区人均饮茶水量[(1.45±0.68)L/d]显著高于非病区村[(1.00±0.47)L/d,t=4.27,P<0.05].病区村室内空气氟[(12.77±8.08)μg/m3]显著高于非病区村[(1.16±1.08)μg/m3,t=9.49,P<0.01],病区村室外空气氟[(1.10±1.57)μg/m3]与非病区村[(0.39±0.31)μg/m3]比较,差异无统计学意义(t=2.01,P>0.05).结论 重庆市氟中毒病区的氟源为煤和拌煤土,氟进入人体的途径主要为呼吸道,从食物摄入量很少,干辣椒含氟量虽高,但居民不食用;防治措施应以控制室内空气氟为主.饮茶可能为氟中毒的因素之一,须在深入研究基础上采取相应措施.     

激光定位灯在放射治疗中的摆位功能

在放射治疗技术摆位操作中,利用激光定位灯对治疗的准确性起到质量控制的作用.通过对电子线源皮距垂直照射,X线源皮距定角、垂直照射,X线等中心照射摆位过程中对激光定位灯的应用,能简捷、快速的提高摆位的准确性.