从甲乳外科的运营分析到医院精细化管理的思考

通过对医改新形势下三级综合医院甲乳外科的运营分析,进行医院精细化管理的探讨。调研某三甲医院甲乳外科的运营情况,包括工作量、运行效率、损益情况等,分析其运营状况。结果显示,甲乳外科门诊、住院和超声检查患者较多,医师工作负荷重,通过计算该科室需要增加2名文员;损益分析发现甲乳外科属于“金牛科室”,且科室床位使用率较高,应适当扩大规模,新增10张床位。对医院各科室进行详细的运营分析,可为医院管理者提供决策依据,并逐步实现医院的精细化管理。     

中美饮食文化对奶业发展的影响度比较

饮食观念的转变,为奶业大发展提供了广阔的市场空间。特别是美国的饮食文化对促进美国奶业的发展起到了至关重要的作用。通过引导饮食文化的转变,促进中国奶制品的消费,进而找出影响中国奶业发展的又一重要因素,已成为加快我国奶业发展的重要课题。     

DNS分光光度法测定牛奶中总糖含量的研究

建立了3,5-二硝基水杨酸分光光度法(DNS分光光度法)测定牛奶中总糖含量的方法,并与国标法(直接滴定法)进行比较.结果显示,DNS分光光度法测定结果的准确度与直接滴定法无明显差异.该法操作简单,试剂消耗体积少,稳定性较高,平均回收率为96%~103%.     

“三鹿奶粉事件”中生鲜乳收购站的产品责任分析

将初级农产品作为产品责任法中的"产品",其生产者认定为产品责任承担主体,加大对消费者的保护力度,是世界产品责任立法的发展趋势.我国应将生鲜乳等初级农产品纳入产品责任的"产品"范围之内,让缺陷初级农产品生产者对受损害的消费者直接承担产品责任,以有效遏制和防范产品质量安全事件的频发.在 "三鹿奶粉事件"中,缺陷生鲜乳的生产者--收购站应承担产品责任.在产品责任构成要件方面,应该适当降低消费者对因果关系的证明标准.     

Risk Assessment of Human Listeriosis from Semisoft Cheeses Made from Raw Sheep's Milk in Lazio and Tuscany (Italy)

Semisoft cheese made from raw sheep's milk is traditionally and economically important in southern Europe. However, raw milk cheese is also a known vehicle of human listeriosis and contamination of sheep cheese with Listeria monocytogenes has been reported. In the present study, we have developed and applied a quantitative risk assessment model, based on available evidence and challenge testing, to estimate risk of invasive listeriosis due to consumption of an artisanal sheep cheese made with raw milk collected from a single flock in central Italy. In the model, contamination of milk may originate from the farm environment or from mastitic animals, with potential growth of the pathogen in bulk milk and during cheese ripening. Based on the 48‐day challenge test of a local semisoft raw sheep's milk cheese we found limited growth only during the initial phase of ripening (24 hours) and no growth or limited decline during the following ripening period. In our simulation, in the baseline scenario, 2.2% of cheese servings are estimated to have at least 1 colony forming unit (CFU) per gram. Of these, 15.1% would be above the current E.U. limit of 100 CFU/g (5.2% would exceed 1,000 CFU/g). Risk of invasive listeriosis per random serving is estimated in the 10^?12 range (mean) for healthy adults, and in the 10^?10 range (mean) for vulnerable populations. When small flocks (10–36 animals) are combined with the presence of a sheep with undetected subclinical mastitis, risk of listeriosis increases and such flocks may represent a public health risk.     

Pure Gold for Broken Bodies: Discursive Techniques Constructing Milk Banking and Peer Milk Sharing in U.S. News

Technological advances provide increased ability to transfer human tissues—blood, organs, milk—from one body to another. This article analyzes mechanisms of reality construction in U.S. news to construct shared human breast milk. Articles used typifications and human interest stories to convey participants as victims, lay heroes, and villains. Milk banking was portrayed as institutionally integrated through associations, expert testimonies, and formalized procedures, making banked milk “pure gold.” Peer sharing was portrayed as institutionally opposed through institutional warnings, expert testimonies, informal procedures, and hypothetical atrocities, making peer milk “fool's gold.” Findings suggest that “biovalue” of human milk is interconnected with institutional processing.     

Determination of a Tolerable Daily Intake of DDT for Consumers of DDT Contaminated Fish from the Lower Yakima River, Washington*

DDT, DDE, and DDD have been detected at elevated concentrations in sediments and fish of the Yakima River, its tributaries and drainages. An assessment was conducted to evaluate the public health significance of eating fish from the river. This was accomplished by establishing a daily intake level of DDT for the population of greatest concern, and comparing this level to a tolerable daily intake. The most sensitive and highly exposed group was determined to be breastfeeding infants. Infant daily intakes of DDT, based on estimated mother's DDT-breast milk levels, were compared to a recommended tolerable daily intake. Results indicate that mothers who frequently consume Yakima River bottom-feeding fish could have breast milk DDT concentrations sufficiently high to expose their infants to levels above the tolerable daily intake.     

微波消化-分光光度法测定牛奶中钙含量

建立了微波消化-分光光度法测定牛奶中钙含量的方法,研究了缓冲溶液种类、物质的量浓度、pH值、邻甲酚酞和三乙醇胺用量、显色时间等对测定结果的影响,对测定条件进行了优化.在pH=11.0的氨性缓冲溶液中,钙与邻甲酚酞迅速形成紫色络合物.该法用于测定市售牛奶样品得到较满意的结果,Ca2＋质量浓度在0.02～2.50μg/mL范围具有良好的线性关系（R2=0.999 9）,回收率在84%～108%之间.     

培美曲塞联合顺铂治疗晚期乳腺癌36例疗效分析

目的 探讨培美曲塞联合顺铂治疗晚期乳腺癌36例临床疗效.方法 研究对象为2010年6月至2012年6月本院收治的36例晚期乳腺癌患者.静脉滴注培美曲塞二钠500mg/m2,d1;顺铂25mg/m2,d1～d3.21天为1个周期.每个患者至少治疗2个疗程后评价疗效和不良反应.结果 36例患者,CR 0例,PR 7例（19.4％）,SD 17例（47.2％）,PD12例（33.3％）,总有效率为19.4％ （7/36）,临床获益率为66.7％ （24/36）.主要不良反应为骨髓抑制,20例表现为白细胞减少（Ⅰ～Ⅱ级）,占55.6％.其他不良反应还包括疲乏21例,占58.3％;皮疹17例,占47.2％例;恶心、呕吐15例,占41.7％.结论 培美曲塞联合顺铂方案治疗蒽环类和紫杉类化疗失败的转移性乳腺癌有较好的疗效,患者耐受性好,值得临床进一步研究.