分散固相萃取-气相色谱串联质谱法测定菊花茶中的56种农药残留

目的 建立菊花茶中56种农药残留的分散固相萃取（QuEChERS） - 气相色谱串联三重四级杆质谱（GC - MS/MS）测定方法。方法 样品用乙腈提取,PSA+C18+GCB混合型分散固相萃取剂净化,DB - 5MS色谱柱分离,多反应监测模式（MRM）检测,外标法定量。结果 在0.005～500 mg/L范围内,56种农药的线性相关系数均≥0.995,方法定量限为0.002～0.057 mg/kg,平均回收率为60.0%～118.0%,相对标准偏差（RSD）为0.53%～20.09%。结论 该方法简单快速灵敏,可以实现菊花茶中农药残留的快速高通量检测。     

气相色谱法测定胡萝卜中11种有机磷农药残留

目的通过试验建立气相色谱法测定保鲜胡萝卜中11种有机磷农药残留的检测方法。方法胡萝卜样品经过均质,盐析,乙酸乙酯提取,45℃氮吹至干,乙酸乙酯溶解定容,采用Rtx-1701色谱柱和FPD检测器进行检测,外标法定量,同时进行11种有机磷农药残留的检测。结果样品加标回收率在88.2%～99.7%之间,相对标准偏差小于5.8%,检出低限在0.01～0.05mg/kg之间。结论实验结果表明,该方法简便、快速、准确、分离度好,各项指标均满足进出口保鲜胡萝卜有机磷农药残留的检测要求。     

2016年南方5省150份青辣椒农药残留监测分析

目的 了解我国南方5省市售青辣椒中农药残留情况,为辣椒产业的良性发展和维护消费者食品安全提供科学依据。方法 2016年在海南、广东、广西、福建和云南随机采集市售青辣椒样品150份（每省30份）,按照国家标准GB/T 20769-2008检测啶虫脒等14种农药残留,依据国家标准GB 2763-2016对检测结果进行判定。结果 150份样品中农药残留检出率为58.0%,不合格率为47.3%。啶虫脒具有最高的检出率（30.0%）和不合格率（30.0%）;海南具有最高的农药检出率（96.7%）和不合格率（86.7%）和农药多残留率（40.0%样品含有≥2种农药残留）,样品不合格的原因主要是检出未在我国辣椒上登记使用的农药。结论 我国南方5省150份青辣椒中未登记农药检出率非常高,尤其是啶虫脒和吡虫啉。     

QuEChERS - 超高效液相色谱串联质谱法测定果蔬中33种农药残留

目的 基于QuEChERS技术,采用超高效液相色谱串联质谱（UPLC - MS/MS）建立了水果和蔬菜中杀虫剂、杀菌剂等33种农药残留的检测方法。方法 样品用乙腈提取,经无水硫酸镁、N - 丙基乙二胺（PSA）和石墨化碳黑（GCB）净化,BEH C18色谱柱分离,以正离子多反应监测模式、外标法定量。结果 33种农药在0.5～100 ng/ml范围内具有良好的线性关系,相关系数均大于0.999,定量限和检出限分别为0.5～2.0 μg/kg和0.2～0.6 μg/kg。低、中、高3个加标水平下,33种农药的回收率在79.2%～119.3%之间,相对标准偏差为0.1%～9.7%。应用建立的方法对75份果蔬样品进行检测,检出15种农药,检出率4.0%～14.6%,含量为0.008 52～7.80 mg/kg。结论 本法操作简便、灵敏、准确,适用于果蔬中多种农药残留的快速检测。     

气相色谱法测定蔬菜中7种有机磷农药残留

目的：建立毛细管柱气相色谱法测定蔬菜中有机磷农药残留的分析方法.方法：蔬菜经均质,用乙腈提取,盐析,50℃氮吹,丙酮溶解定容,采用DB-5毛细管柱和火焰光度检测器测定,一次进行7种有机磷农药残留检测.结果：样品加标回收率在94%～106%之间,相对标准偏差在2.7%～5.7%之间,检出限在0.023～0.047 mg/kg之间.结论：实验结果表明,该方法简便、快速、灵敏、准确,各项技术指标满足蔬菜中7种有机磷农药残留检测要求.     

凝胶色谱串联质谱法检测植物性产品中75种农药残留

目的：建立凝胶色谱串联质谱检测水果、蔬菜和谷物中75种农药残留的检测方法.方法：样品经乙腈提取,活性碳及氨基固相萃取小柱净化后,再经过在线GPC进入GC/MS进行检测,使相对检出限有了较大的提高.结果：相对偏差为0.9%～15.7%,回收率在55.8%～130.7%之间,检出限在0.01～0.05 mg/kg之间.结论：该方法能满足植物性食品中多种农药残留的筛选,具有灵敏、快速、重现性好的特点.     

改进的QuEChERS-凝胶渗透色谱-气相色谱/质谱法[JP]测定保健食品中53种农药残留

目的 建立保健食品中53种农药残留的QuEChERS-凝胶渗透色谱-气相色谱/质谱检测方法。方法 样品经QuEChERS提取、凝胶渗透色谱柱净化后,DB-5MS (25m×0.25mm,0.25μm）色谱柱分离,质谱检测器检测,外标法定量。结果 在0.02mg/kg添加水平样品的平均回收率除甲胺磷等8种农药在55.7%～77.2%范围内,其余为78.0%～115.2%;相对标准偏差除氧化乐果和甲基毒死蜱大于10%外,其余均小于10 %;在0.05mg/kg添加水平样品的平均回收率除甲胺磷等6种农药在57.7%～77.3%范围内,其余均在78.4%～113.5%范围内;相对标准偏差除氧化乐果外,其余农药均小于10%。速灭威等6种农药的检出限为0.0240～0.0901mg/kg,其余为0.0012～0.0200mg/kg。结论 该方法消耗试剂少,分析成本低,操作简便快速,适合保健食品中53种农药残留的检测。     

气相色谱法快速测定蔬菜、水果中多种有机磷农药残留

目的：建立气相色谱法快速测定蔬菜、水果中多种有机磷农药残留的检测方法。方法：样品用乙酸乙酯提取,经无水硫酸钠脱水后浓缩,进气相色谱分析,外标法定量。结果：该方法12种有机磷农药的线性范围为0.5～10μg/ml,相关系数0.9990以上,平均回收率为80.5%～116.4%,相对标准偏差（RSD）〈15%,检出限为0.002～0.01 mg/kg。结论：该法简便、快速、定量准确、精密度高,适用于蔬菜、水果中多种有机磷农药残留量的检测。     

2013～2018年贵州省市售茶叶农药残留状况分析

目的：了解贵州省市售茶叶中农药残留状况。方法：采集2013～2018年贵州省市售410份茶叶样品检测48种农药含量，依据GB 2763-2016《食品安全国家标准食品中农药最大残留限量》和GB 2763.1-2018《食品安全国家标准食品中百草枯等43种农药最大残留限量》进行判定。结果：410份茶叶样品中，联苯菊酯检出频次最高，检出率为42.6%,数值范围0.063～6.440 mg/kg,均值为0.467 mg/kg。检测出氰戊菊酯、三氯杀螨醇、水胺硫磷、灭线磷和联苯菊酯5种农药超标，超标率分别为2.0%、1.7%、1.6%、1.1%和0.6%。结论：贵州省市售茶叶中农药残留水平不高，个别样品存在农药超标情况，建议加强茶叶监督和管理，完善茶叶相关标准体系。     

毛细管气相色谱法测定韭菜中拟除虫菊酯类农药多残留

目的：测定韭菜中5种拟除虫菊酯类农药残留。方法：应用柱层析净化技术和毛细管气相色谱法,并采取程序升温模式和不分流进样方式在μ-ECD检测器上同时测定韭菜样品中5种拟除虫菊酯类农药多残留组分。结果：5种拟除虫菊酯类农药分离效果较好,其线性范围较宽,并在此浓度范围内与峰面积呈良好的线性关系;同时方法的最小检测限低于1.00μg/L（0.214-0.904μg/L）,相对标准偏差均小于10%（2.48%-8.05%）,其加标回收率在86.26%-102.64%之间。结论：本研究建立的方法简便、快速、经济,具有良好的灵敏度、精密度和准确度,可以满足韭菜样品中拟除虫菊酯类农药多残留检测要求,同时对其他蔬菜中拟除虫菊酯类农药多残留分析具有一定的参考价值。     

长春新碱过量引起严重毒副反应1例的护理体会

报道1例霍奇金淋巴瘤患者因误用长春新碱（VCR）10mg一次性静脉推注后治疗护理情况。其出现间断性神志恍惚、眼睑闭合不全、言语不清、口腔黏膜糜烂、全身疼痛、麻痹性肠梗阻、尿潴留、手足麻木等症状,经积极解救,禁食,持续胃肠减压、胃管内注入麻油、开塞露、生理盐水灌肠,合理应用肠外营养,注重疼痛、心理护理,做好口腔、肛周护理,预防感染加重,患者病情得到控制好转出院。     

Correlates of stages of change of smoking among inhabitants of deprived neighbourhoods

BACKGROUND: This study examines the prevalence and correlates of stages of change of smoking, in terms of psychosocial, structural and sociodemographic factors, among inhabitants of deprived neighbourhoods. METHODS: Cross-sectional data were obtained from a survey on health related behaviour. Subjects were 2009 current and former smokers, aged 20-46, living in deprived neighbourhoods in Rotterdam, the second largest city in the Netherlands. Three groups of smokers were formed according to the stages of change-definitions of the Transtheoretical Model: smokers not planning to quit (precontemplators), smokers planning to quit (contemplators/preparators) and former smokers (actors/maintainers). Smokers planning to quit and smokers not planning to quit were compared regarding psychosocial factors (attitude, social norm, self-efficacy), structural factors (neighbourhood problems, material deprivation, financial problems, employment status) and sociodemographic factors (age, gender, marital status, cultural background, educational level). Former smokers were compared with smokers planning to quit regarding structural and sociodemographic factors. Logistic regression was used to assess correlates of stages of change. RESULTS: Smokers planning to quit (prevalence = 19%) reported a more positive attitude, stronger social norms and higher self-efficacy expectations in quitting smoking than smokers not planning to quit (prevalence = 57%). Smokers planning to quit less often were Dutch-born, more often had attended higher vocational schooling or university and more often reported experiencing two or more neighbourhood problems compared to smokers not planning to quit. Former smokers (prevalence = 24%) were older, more often Dutch-born, married, employed and higher educated, compared to smokers planning to quit. Furthermore, former smokers less often reported material deprivation and financial problems than smokers planning to quit. CONCLUSION: Among people living in deprived neighbourhoods, different factors correlate with different stages of change of smoking. Implications for health promotion are discussed.     

Choice of measures of vaccination and estimates of risk of pediatric pertussis

BackgroundVaccination uptake at the individual level can be assessed in a variety of ways, including traditional measures of being up-to-date (UTD), measures of UTD that consider dose timing, like age-appropriate vaccination, and risk reduction from individual doses. This analysis compared methods of operationalizing vaccination uptake and corresponding risk of pertussis infection.MethodsCity-wide case-control study of children in Philadelphia aged 3 months through 6 years, between 2001 and 2013. Multiple logistic regression was used to isolate the independent effects of each measure of vaccination uptake and the corresponding relative odds of pertussis.ResultsBeing UTD on vaccinations was associated with a 52% reduction in risk of pertussis (OR 0.48, 95% CI: 0.34, 0.69). Evaluation of delayed receipt of vaccine versus on-time UTD yielded similar results. There was a decrease in risk of pertussis for each additional dose received with the greatest reduction in pertussis infection observed from the first (OR 0.48, 95% CI: 0.28, 0.83) and second dose (OR 0.17, 95% CI: 0.08, 0.34). Additional doses conferred minimal additional protection in this age group.ConclusionExamining vaccination status by individual doses may offer improved predictive capacity for identifying children at risk for pertussis infection compared to the traditional UTD measure.     

上海市某医院骨科平均住院日影响因素分析

对上海市某医院2003年-2007年骨科出院病人的住院日描述性分析．2003年-2007年骨科的床位利用指数与平均住院日相关性分析．2003年-2007年骨科床位与医护比例分析．2007年骨科前10大病种平均住院目影响因素分别进行单因素相关性分析和多因素逐步回归分析（STATA软件）。通过对骨科10大病种住院日影响因素分析,术前等待天数、手术类型、是否输血分别对10个、9个和8个病种的住院目有影响。输血因素和手术类型是医院不可控、由病人的病情决定的,术前等待天数是管理因素,是最值得医院重视的影响因素。     

两种不同肌瘤剔除术治疗子宫肌瘤的临床疗效比较

目的:比较腹腔镜子宫肌瘤剔除术与腹式子宫肌瘤剔除术的临床疗效。方法:回顾分析63例腹腔镜子宫肌瘤剔除术与61例腹式子宫肌瘤剔除术的临床资料,比较2种手术方式的手术时间、术中出血量、肛门排气时间、使用抗生素时间、术后感染率、体温恢复正常时间、住院时间等情况。结果:两组患者接受子宫肌瘤剔除术顺利完成,腹腔镜组手术时间长于开腹组(P0.05),腹腔镜组术中出血量及剔除肌瘤个数均少于开腹组(P0.05),术后腹腔镜组体温恢复正常时间、肛门排气时间、抗生素使用及住院时间均短于开腹组,两组患者最多随访6个月,腹腔镜组平均康复时间较开腹组短(P0.05),两组随访B超均未发现明显肌瘤结节。结论:腹腔镜子宫肌瘤剔除术损伤小,恢复快,住院时间短,是值得推广的微创手术。     

尘肺病患者145例死因调查

目的分析汉中市尘肺病的发生、发展和死亡原因，以提高尘肺病患者的生存质量。方法对145例尘肺病患者的死因进行回顾性分析，计算其平均发病年龄、死亡年龄及患尘肺病后的存活年限。结果矽肺的平均发病年龄和死亡年龄均早于煤工尘肺和石棉肺，尘肺病的主要死因为患肺部疾患，患尘肺病后的平均存活年限为12a。结论加强职业健康体检工作，对尘肺病人做到早发现早治疗和预防并发症的发生。     

性发育异常发病机制的研究进展

正常的性腺分化可分为3个过程：原始性腺形成、性别决定和卵巢/睾丸发育。在任一环节中,基因表达或调控发生异常均有可能导致性发育异常疾病的发生。性发育异常是指染色体、性腺和解剖性别不典型。随着分子生物学技术的发展,不断地发现新的基因或信号通路参与性腺分化和发育,如SRY、SF1、WT1、Sox9等基因与睾丸发育密切相关,Wnt/Rspo1/B连环蛋白通路、Dax1、Foxl2等基因在卵巢分化中发挥着重要作用,一些非编码RNA和转化生长因子也有重要的调节功能,且睾丸和卵巢发育均为主动过程,即使在出生后因某些基因的改变两者间也可出现横向分化。这些为揭示性分化异常的发病机制提供了可能。     

One-year stability of the Measure of Processes of Care

BACKGROUND: The Measure of Processes of Care (MPOC) is a 56-item self-administered measure designed to examine what parents of a child with a chronic health problem think of the services they and their child receive, and to measure the extent to which these services are family-centred. Reliability and validity of the MPOC were established in prior studies. The aim of the present study was to assess the 1-year stability of the MPOC to justify its use as an evaluative tool. METHODS: Nine paediatric rehabilitation centres in the Netherlands participated in this short longitudinal survey study. Subjects were 205 parents (response rate 74.8%) of children aged 1-18 years who received care in one of the participating paediatric rehabilitation centres. All subjects filled out two MPOCs with a 1-year interval. RESULTS: All correlations between the scale scores of the MPOC at the first and second administration were relatively high and significant (range: 0.443-0.609, all P < 0.001), demonstrating high inter-individual stability. However, all mean scale scores, except for Providing General Information, significantly reduced after 1 year. CONCLUSIONS: The MPOC has a moderate 1-year stability. However, because of its tendency to score lower when repeated after 1 year, its use as an evaluative follow-up instrument to assess the effectiveness of a programme intervention is restricted.     

儿童皮质发育畸形的MRI诊断

目的探讨儿童皮质发育畸形(MCD)的MRI表现特点,为MCD的早期诊断提供依据。 方法选择2010年1月至2012年12月在四川省医学科学院·四川省人民医院放射科经MRI检查确诊为MCD的44例患儿为研究对象。回顾性分析及总结其MRI影像学特征。本研究遵循的程序符合四川省医学科学院·四川省人民医院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象及其监护人知情同意,并与监护人签署临床研究知情同意书。 结果本组44例经MRI确诊为MCD患儿中,巨脑回-无脑回为17例,多小脑回为14例,灰质异位为9例,脑裂畸形为4例。MCD的MRI特点中,巨脑回表现为脑回增宽、皮质增厚及白质变薄;无脑回表现为正常脑沟、脑回消失,皮质增厚及白质变薄;多小脑回表现为脑回增多、细小;灰质异位表现为皮质下及侧脑室周围深部白质区结节状、团块状或带状病灶,信号与灰质信号相同;脑裂畸形表现为从侧脑室到脑表面贯穿大脑半球的裂隙,表面覆盖灰质。 结论MRI是诊断儿童MCD的可靠影像学方法。     

西林瓶装注射用水的装量检查分析

为了检查西林瓶装注射用水的实际分装量是否符合2005年版《药典》三部要求,按照2005年版《药典》三部中“生物制品分装和冻干规程”,分装规格为0．8ml的西林瓶装注射用水10000瓶,随机在分装过程的前、中、后阶段共抽取100瓶,轧盖、目检。分别用1ml标定注射器及1ml普通无菌注射器抽取每瓶注射用水的实际体积,以t检验法对实际抽取量与标示量的差值进行统计学分析,结果显示其与2005年版《药典》三部要求分装附加量为0．1ml相比有显著性差异（P〈0．001）。