新型冠状病毒肺炎疫情中医护人员个人防护装备的选择与使用

个人防护设备(personal protective equipment,PPE)是控制院内感染的必要装备,可有效降低医护人员职业暴露的风险。 目前,新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)疫情引起国际高度关注,国内已确诊7万多例患者,死亡人数超过 2 700 人。此外,医护人员的感染超过 3 000 多例,这给医护人员(尤其是为COVID-19患者提供近距离诊疗和护理的医务人员),带来了新的风险和挑战。 本文从PPE的应用标准,正确穿、脱方法及预防防护后暴露的注意事项进行汇总和讨论。     

基于磁驱动技术的空肠营养管的设计

目的:为解决目前床旁鼻肠管快速置入成功率低这一临床难题,该文提出一种基于磁驱动技术的空肠营养管的设计。方法:分析了现有空肠营养管置管过程中的动力因素,结合磁驱动技术原理,提出了通过体外旋转磁场带动体内感应磁体螺旋式前进的设计方案,以期缩短空肠营养管的飘管时间。结果:该设计包括磁性空肠营养管和体外磁力驱动装置两部分。其中磁性空肠营养管由管体和感应磁头两部分构成,感应磁头包括磁体内核和硅胶外壳。磁力驱动装置由多极磁体和手持式微型电机组成。操作时通过体外磁力驱动装置发出大旋转磁场带动空肠营养管的感应磁头做轴向旋转运动,可加速空肠营养管在肠道内的移动,达到缩短飘管时间的目的。结论:该设计基于磁驱动技术原理,设计巧妙,符合磁力学原理,操作简单,具有临床应用潜力。     

腔隙性脑梗死伴脑白质病变患者血清miR-146a和NSE水平与MoCA评分的关系研究

摘要 目的：研究腔隙性脑梗死（LI）伴脑白质病变（WML）患者血清miR-146a和神经元特异性烯纯化酶（NSE）水平与蒙特利尔认知评估量表（MoCA）评分的关系。方法：纳入我院从2017年3月～2019年3月收治的LI伴WML患者108例进行研究,记作LI伴WML组。另取同期收治的单纯WML患者与单纯LI患者各100例,分别记作WML组与LI组,再取同期于我院进行体检的健康人员100例作为对照组。比较四组人员的血清miR-146a和NSE水平、MoCA评分,并作相关性分析。结果：LI伴WML组、WML组、LI组血清miR-146a相对表达量均低于对照组,而LI伴WML组血清miR-146a相对表达量又显著低于WML组、LI组（均P＜0.05）;LI伴WML组、WML组、LI组血清NSE水平均显著高于对照组,且LI伴WML组血清NSE水平均显著高于WML组、LI组（均P＜0.05）。LI伴WML组MoCA总分显著低于WML组与LI组,且WML组与LI组MoCA总分显著低于对照组（均P＜0.05）。经Pearson相关性分析可得：LI伴WML组患者血清miR-146a相对表达量与MoCA总分呈正相关关系（P＜0.05）,而血清NSE水平与MoCA总分呈负相关关系（P＜0.05）。结论：LI伴WML患者的血清miR-146a水平存在明显低表达,而NSE水平存在明显高表达,并与MoCA评分相关,两者可能在认知功能损伤的发生、发展过程中起着至关重要的作用。     

Analysis of Alkylphenol ethoxylates (APEOs) from tannery sediments using LC–MS and their environmental risks

Alkyl phenol polyethoxylates (APEOs) are a major group of high production volume chemicals, extensively used as nonionic surfactants in industrial, agricultural and domestic sectors. These surfactants and its respective metabolites are found to be persistent and toxic. Mainly, they act as endocrine disruptors by mimicking the natural hormones. India being a developing country, witnesses pollution due to various industries including tannery. In the present study, sediment samples were collected from the Vellore district of Tamil Nadu, India to investigate the occurrence of APEOs. The sediments were extracted by ultrasonication and analyzed in a liquid chromatography mass spectrometer. Octyl phenol ethoxylates (OPEOs) were not observed in any of the samples. Nonyl phenol ethoxylates (NPEOs) were detected in the range of ND – 36 mg/kg with 85 % detection frequency. The occurrence of NPEOs in sediment indicates its wide usage in tannery and its partitioning behavior in environment. The levels of NPEOs in the study were found to be unsafe according to the sediment guidelines of various studies. Since NPEOs were observed in sediment samples, possibilities of occurrence of their monomers and metabolites cannot be ruled out. Therefore, further studies are warranted for understanding the levels of monomers and metabolites in order to ascertain the environmental risks more appropriately.     

Prospects for incorporation of epigenetic biomarkers in human health and environmental risk assessment of chemicals

Epigenetic mechanisms have gained relevance in human health and environmental studies, due to their pivotal role in disease, gene × environment interactions and adaptation to environmental change and/or contamination. Epigenetic mechanisms are highly responsive to external stimuli and a wide range of chemicals has been shown to determine specific epigenetic patterns in several organisms. Furthermore, the mitotic/meiotic inheritance of such epigenetic marks as well as the resulting changes in gene expression and cell/organismal phenotypes has now been demonstrated. Therefore, epigenetic signatures are interesting candidates for linking environmental exposures to disease as well as informing on past exposures to stressors. Accordingly, epigenetic biomarkers could be useful tools in both prospective and retrospective risk assessment but epigenetic endpoints are currently not yet incorporated into risk assessments. Achieving a better understanding on this apparent impasse, as well as identifying routes to promote the application of epigenetic biomarkers within environmental risk assessment frameworks are the objectives of this review. We first compile evidence from human health studies supporting the use of epigenetic exposure‐associated changes as reliable biomarkers of exposure. Then, specifically focusing on environmental science, we examine the potential and challenges of developing epigenetic biomarkers for environmental fields, and discuss useful organisms and appropriate sequencing techniques to foster their development in this context. Finally, we discuss the practical incorporation of epigenetic biomarkers in the environmental risk assessment of chemicals, highlighting critical data gaps and making key recommendations for future research within a regulatory context.     

Review of impact categories and environmental indicators for life cycle assessment of geotechnical systems

Life cycle assessment (LCA) has only had limited application in the geotechnical engineering discipline, though it has been widely applied to civil engineering systems such as pavements and roadways. A review of previous geotechnical LCAs showed that most studies have tracked a small set of impact categories, such as energy and global warming potential. Accordingly, currently reported environmental indicators may not effectively or fully capture important environmental impacts and tradeoffs associated with geotechnical systems, including those associated with land and soil resources. This research reviewed previous studies, methods, and models for assessment of land use and soil‐related impacts to understand their applicability to geotechnical LCA. The results of this review show that critical gaps remain in current knowledge and practice. In particular, further development or refinement of environmental indicators, impact categories, and cause–effect pathways is needed as they pertain to geotechnical applications—specifically those related to soil quality, soil functions, and the ecosystem services soils provide. In addition, many existing methods emerge from research on land use and land use change related to other disciplines (e.g., agriculture). For applicability to geotechnical projects, the resolution of many of these methods and resulting indicators need to be downscaled from the landscape/macro scale to the project scale. In the near term, practitioners of geotechnical LCA should begin tracking changes to soil properties and report impacts to land and soil resources qualitatively.     

Life cycle assessment of emerging technologies at the lab scale: The case of nanowire‐based solar cells

Nanomaterials are expected to play an important role in the development of sustainable products. The use of nanomaterials in solar cells has the potential to increase their conversion efficiency. In this study, we performed a life cycle assessment (LCA) for an emerging nanowire‐based solar technology. Two lab‐scale manufacturing routes for the production of nanowire‐based solar cells have been compared—the direct growth of GaInP nanowires on silicon substrate and the growth of InP nanowires on native substrate, peel off, and transfer to silicon substrate. The analysis revealed critical raw materials and processes of the current lab‐scale manufacturing routes such as the use of trifluoromethane (CHF₃), gold, and an InP wafer and a stamp, which are used and discarded. The environmental performance of the two production routes under different scenarios has been assessed. The scenarios include the use of an alternative process to reduce the gold requirements—electroplating instead of metallization, recovery of gold, and reuse of the InP wafer and the stamp. A number of suggestions, based on the LCA results—including minimization of the use of gold and further exploration for upscaling of the electroplating process, the increase in the lifetimes of the wafer and the stamp, and the use of fluorine‐free etching materials—have been communicated to the researchers in order to improve the environmental performance of the technology. Finally, the usefulness and limitations of lab‐scale LCA as a tool to guide the sustainable development of emerging technologies are discussed.     

Using anticipatory life cycle assessment to enable future sustainable construction

The built environment is the largest single emitter of CO₂ and an important consumer of energy. Much research has gone into the improved efficiency of building operation and construction products. Life Cycle Assessment (LCA) is commonly used to assess existing buildings or building products. Classic LCA, however, is not suited for evaluating the environmental performance of developing technologies. A new approach, anticipatory LCA (a‐LCA), promises various advantages and can be used as a design constraint during the product development stage. It helps overcome four challenges: (i) data availability, (ii) stakeholder inclusion, (iii) risk assessment, and (iv) multi‐criteria problems. This article's contribution to the line of research is twofold: first, it adapts the a‐LCA approach for construction‐specific purposes in theoretical terms for the four challenges. Second, it applies the method to an innovative prefabricated modular envelope system, the CleanTechBlock (CTB), focusing on challenge (i). Thirty‐six CTB designs are tested and compared to conventional walls. Inclusion of technology foresight is achieved through structured scenario analysis. Moreover, challenge (iv) is tackled through the analysis of different environmental impact categories, transport‐related impacts, and thickness of the wall assemblies of the CTB. The case study results show that optimized material choice and product design is needed to reach the lowest environmental impact. Methodological findings highlight the importance of context‐specific solutions and the need for benchmarking new products.