加强手术室管理,控制医院感染

目的加强手术室医院感染的控制与管理,降低医院感染的发生率。方法针对手术室的工作特点,制定并落实各项有效的消毒隔离措施和感染监测制度,严格执行无菌操作规程,创造合格的手术环境。结果制定有效的手术室消毒隔离制度和感染监测制度,并通过医护人员的积极配合,创造合格的手术室环境,使无菌手术切口感染率下降至0.25%,特殊手术无医院感染发生。结论加强手术室医院感染的管理,可有效地防止医院感染的发生,降低无菌手术切口感染率。     

New PCR ribotypes of Clostridium difficile detected in children in Brazil

A total of 35 Brazilian isolates of Clostridium difficile from faecal stools and four isolates from hospital environments were analyzed by PCR ribotyping. A whole cell protein profile (as an alternative for serogrouping), in vitro toxin production and susceptibility to vancomycin, metronidazole and clindamycin were also investigated. All strains were typeable by both phenotypic and genotypic methods, and a total of 13 different PCR ribotypes were identified, of which seven (132, 133, 134, 135, 136, 142 and 143) were considered new types and accounted for 78.5% of all samples evaluated (including hospital environments). A non-toxigenic C. difficile PCR ribotype 133 was detected in all children groups examined (inpatients, outpatients and healthy children), whilst toxigenic PCR ribotypes 015, 131, 134 and 135 were associated mostly with symptomatic children. Serogroups G and D were disseminated both in patients from the community and from the pediatric hospital, with group G prevalent among outpatient children. All strains were susceptible to vancomycin and metronidazole but high levels of resistance to clindamycin were found, especially among serogroups G and D. Co-existence of different ribotypes and serogroups in the same individual was observed. The new seven ribotypes found in this investigation may represent strains characteristic of this region of Brazil.     

云县罗扎河下游落叶季雨林的群落生态学研究

对罗扎河下游鲜为人知的落叶季雨林进行了群落生态学研究,结果表明:罗扎河下游落叶季雨林群落高度在15~20m之间;群落乔木层以厚皮树(Lannea coromandelica)、一担柴(Colonafloribunda)、粗糠柴(Mallotus philippensis)、毛果扁担杆(Grewia eriocarpa)、灰毛浆果楝(Cipadessa cinerascens)等树种为优势种;灌草层以刚莠竹(Microstegiumciliatum)盖度最大,其余如飞机草(Eupatoriumodoratum)、藿香蓟(Agera-tumconyzoides)、蹄盖蕨(Athyriumsp.)等种的盖度也比较大;群落中乔木和附生、藤本植物种类较少,而灌木和草本植物种类较多;多数乔木层植株胸径在5~10cm之间,大径级乔木比较少,即使群落中的优势种也主要是通过较多数量的中小径级个体体现出来。多样性指数计算表明,本落叶季雨林的生物多样性指数虽然比典型热带山地雨林为低,但大致相当于季风常绿阔叶林。     

滇东南马关古林箐热带雨林望天树群落的研究

云南东南部马关县古林箐的望天树群落以龙脑香科植物望天树为乔木层优势种,无患子科植物番龙眼为亚优势种,外貌以常绿大、中高位芽植物组成为特征,林内板根和茎花现象普遍,层间木质藤本和维管附生植物丰富,属于一种热带季节性雨林群落类型。在植物区系组成上,该群落以樟科、番荔枝科、楝科、大戟科、桑科、无患子科、橄榄科、柿树科等为主要组成科,在重要值统计上,以大戟科、无患子科、柿树科、龙脑香科、番荔枝科、樟科、楝科、橄榄科、桑科等为较优势的科,与东南亚热带雨林很接近,故为东南亚热带雨林的北缘类型。     

古浪县北部荒漠植被主要植物种的生态位特征

利用Shannon-Wiener生态位宽度公式和Pianka生态位重叠公式,计测分析了甘肃省古浪县北部荒漠植被主要植物种在不同植被演替阶段的生态位宽度和生态位重叠。结果表明:在流动沙地上花棒的生态位宽度最大,其次是沙蒿;在半固定沙地上白刺的生态位宽度最大;在固定沙地上,不论是封育植被还是未封育植被中均是花棒的生态位最宽。同一植物种的生态位随着植被演替阶段的变化而发生变化,这种变化反映了不同演替阶段下的植被恢复效果。优势种的生态位重叠大,生态位宽的物种对重叠值也大,相同物种对在不同演替阶段的生态位重叠不一致。有些物种生态位宽度窄,但重叠值大,是由荒漠植被区物种分布存在生境斑块现象造成的。     

危重病房耐碳青霉烯酶鲍曼不动杆菌同源性研究

目的探讨杭州市第一医院危重病房耐碳青霉烯酶鲍曼不动杆菌之间的同源性,进行分子流行病学调查,旨在为制定预防和控制其院内感染的措施提供依据。方法收集该院危重病房2005年1月至12月分离到的34株亚胺培南耐药鲍曼不动杆菌。采用全自动微生物分析系统VITEK-AMS60对34株耐碳青霉烯酶鲍曼不动杆菌进行鉴定及药敏;用琼脂稀释法和E-test法测定14种抗菌药物的最低抑菌浓度(MIC),脉冲场凝胶电泳(PF-GE)分析其耐药株的同源性,对碳青霉烯类基因OXA-23型、OXA-24型、IMP型、VIM型基因进行PCR扩增及序列分析。结果PFGE发现34株鲍曼不动杆菌菌株为同一耐药克隆株,在危重病房呈爆发流行。所有对亚胺培南耐药鲍曼不动杆菌明确产OXA-23型碳青霉烯酶,未检出OXA-24、IMP、VIM基因型。34株菌株质粒提取未成功。结论该院同一个耐药克隆株在危重病房不同患者身上流行,可能与行气管插管、呼吸机、氧气湿化瓶、护士手操作有关。     

Maternal bodies, breast-feeding, and consumer desire in urban China

Urban Chinese women in the 1990s formulated their infant-feeding decisions in the context of a society undergoing radical transformation as the nation moved from a centrally planned socialist economy to a global, market-oriented one. Narratives of new mothers in Beijing in the 1990s provide insights into the multiple forces that shaped their infant-feeding practices. These personal histories also illustrate the limitations of multilateral breast-feeding programs that emphasize breast-feeding as a natural interaction between mother and infant. The cases I present here demonstrate instead that the material, bodily manifestations of breast-feeding require nursing mothers to continually renegotiate relations with husbands, coworkers, and family. Chinese women's accounts also add insight to theoretical deliberations on gender and the body, for they demonstrate that cultural expectations and the demands of the lactating body must be considered to understand fully the process of women's decisions in a social and not strictly reproductive context. On a larger scale, the data also illustrate how global intervention, in the form of the WHO-UNICEF-sponsored Baby-Friendly Hospital Initiative, promotes breast-feeding as a woman's primary duty at the same time that market forces counter this message as women redefine their individual expectations and social relationships.     

Resultados de un programa de rehabilitación domiciliaria tras hospitalización en pacientes con fractura de cadera

IntroductionHip fracture is one of the most frequent disabling injuries, presenting serious complications during the acute and subacute phase. Rehabilitation at home, after hospital discharge, allows rapid functional recovery. The objective of this study is to evaluate the possible usefulness of a home rehabilitation program in patients with hip fracture integrated in a Hospital at Home Unit.MethodsRetrospective study that consecutively included patients accepted for home rehabilitation treatment between September 9, 2019 and December 31, 2021 in the Hospital at Home Unit of the Hospital Universitario de la Ribera, Alzira, Valencia. Demographic, clinical, functional and quality of care variables were collected.ResultsTwo hundred twenty-four subjects were included. The mean age was 84.6 (SD 7.7) years, with 66% women and 34% men, with 32% of patients diagnosed with dementia in one of its degrees of severity. The mean hospital stay was 8.4 (SD 4.1) days and 6.5 (5.3) days in the Hospital at Home Unit rehabilitation program. 90% of the patients included in the program reached the therapeutic goal outlined during hospital admission.ConclusionsThe home rehabilitation of patients with hip fracture contributes to a functional recovery of the patient in a shorter time. Further studies are necessary to confirm the results obtained.     

秦岭宁陕县森林植被碳储量与碳密度特征

以秦岭南坡中段宁陕县林区2003年二类森林调查资料为基础,采用政府间气候变化委员会(IPCC)推荐使用的森林碳储量估算方法,从森林类型、林种、年龄和林分起源的角度,对该林区森林植被碳储量和碳密度进行估算。结果显示:(1)宁陕县森林植被碳储量为12.31Tg(1Tg=1×1012 g),平均碳密度为66.36Mg/hm2(1Mg=1×106 g),其各乡镇森林植被碳储量和碳密度在空间上的分布不平衡。(2)各森林类型中针叶林总碳储量为0.71Tg,平均碳密度为64.11 Mg/hm2,阔叶林总碳储量为11.61Tg,占宁陕县总碳储量的94.3%,碳密度为67.65Mg/hm2。(3)各林种中防护林碳储量最大(8.13Tg),占宁陕县总碳储量的66%,特种用途林碳密度最大(81.43Mg/hm2)。(4)不同林分起源中,天然林碳储量为12.231Tg,占宁陕县总碳储量的99.3%,人工林碳储量较小。(5)不同年龄森林中未成熟森林(包括幼龄林、中龄林和近熟林)碳储量为12.13Tg,占总碳储量的98.5%,近熟林碳密度最大(80.14Mg/hm2),幼龄林碳密度最小(39.85Mg/hm2)。研究表明,宁陕县森林具有较大的固碳能力和固碳潜力,其森林面积和蓄积是决定森林碳储量大小的重要因子,而森林碳密度的大小与森林类型、年龄组成和林分起源方式密切相关。     

1949-2008年黄土高原沟壑区农业生态经济系统耦合分析——以陕西长武县为例

在分析农业经济系统与农业生态系统相互胁迫、动态演进关系的基础上,采用改进的熵值法确定了位于黄土高原沟壑区的长武县农业生态经济系统评价指标权重,利用耦合度模型分析了1949-2008年长武县农业生态经济系统耦合规律.结果表明:1949-2008年,长武县农业生态经济系统的发展经历了"粗放式传统农业阶段-农业机械化进程阶段-前现代化农业协调发展阶段"3个历史时期,与国家宏观经济政策调控效应基本吻合,系统耦合在"协调发展"和"极限发展"间经历了两起两落的急剧变化过程.1955-1961年、1984-1992年,长武县农业生态经济系统处于极限化耦合态势;1962-1965年、1981-1983年,为纠正前阶段宏观政策后的快速过渡期;1949-1954年、1966-1980年为生态系统与经济系统的低水平协调发展阶段;1993年以后,农业生态经济系统经过螺旋式发展,进入高水平协调发展阶段.目前,长武县农业生态经济系统有突破协调发展水平,并向极限化发展的潜在危险.良好的农业政策和外部环境能够促进农业生态经济系统在协调发展的水平上稳定发展,反之,容易出现系统相悖发展的局面.