目的 分析非结核分枝杆菌(non-tuberculous mycobacteria,NTM)肺病误诊原因.方法 回顾分析误诊为肺结核的NTM肺病2例临床资料.结果 2例均因咳嗽咳痰就诊,2次痰涂片抗酸杆菌均阳性,胸部CT检查均有肺尖部胸膜下薄壁空洞,肺部散在斑片影伴支气管扩张,初步诊断为肺结核,抗结核治疗均无效,外院行痰细菌培养均提示胞内分枝杆菌生长,明确诊断为NTM肺病.按药物敏感试验结果予抗NTM治疗,患者症状逐步消失,肺部病变逐步吸收好转,复查痰细菌培养3次均阴性,1例疗程1年半,1例疗程2年,随访至今病情稳定无复发.结论 NTM肺病临床表现与肺结核病相似,但发病率低,临床少见,易误漏诊,临床医生应提高警惕,及时行NTM检测是确诊的关键.

Objective To study the clinical features of EEG in glioma patients with secondary epilepsy. Methods The clinical data and 24 h Electroencephalogram (24 h EEG) of 51 glioma patients with the first clinical symptom of epilepsy during April 2010 and June 2014 in our hospital were retrospectively analyzed. Results Cranial CT and ( or) MRI examina-tion revealed the lesions in the 51 cases, of which 12 cases were located in the frontal lobe, 26 cases located in the temporal lobe (10 cases in the new temporal lobe cortex, 7 cases in prior to the medial temporal lobe, 5 cases in the medial temporal lobe and the temporal-pillow after border area, 4 cases inside and outside the temporal lobe) , 9 cases located in the parietal lobe, 4 cases located in the occipital lobe. 24 h EEG revealed that 13 cases were normal, and 38 cases were abnormal, of which 23 were mild, 11 were moderate and 4 were serious. Postoperative pathological examination revealed that 19 cases were astrocytoma ( WHO Ⅱ) , 14 cases were oligoastrocytoma ( WHO Ⅱ) , 9 cases ( WHOⅠ) were ganglion glial cell tumor, 7 cases were oligodendroglioma (WHO Ⅱ), 2 cases were ependymoma (WHO Ⅱ). The follow-up (mean 7. 4 months)re-vealed that 33 cases had no obvious seizures after operation, while 18 cases still had seizures. Conclusion The change of EEG and imaging can help early diagnosis and positioning of intracerebral gliomas. Surgery is an important approach to treat gliomas epilepsy.

在医院感染管理和预防控制环节中,医院的行政人员是一个容易被忽视的群体,医院的行政部门也是医院感染管理的薄弱环节,我科于2007年8月～2008年1月连续半年对我院的行政后勤部门的办公室空气细菌总数进行监测,现将结果和管理举措报告如下.

消毒供应科工作环境及工作性质的特殊性决定工作人员经常接触各科污染制品,并经常使用各种物理、化学方法进行消毒灭菌,而其中涉及的大多数因素均对人体有害.其职业安全因素越来越引起人们的关注,如不清楚这些危害因素或缺乏自我防护知识,极易导致与工作相关的疾病,因此加强消毒供应科人员的自身防护,可有效预防医院感染的发生.

目的近年来由于学生好奇误食引发的植物中毒事故不断发生,尤其是学前班的学生,分辨能力低,成为发生植物中毒的危险人群。2007年5月10日,河北省行唐县龙洲镇西街小学学前班的8名同学误食滴水观音,中毒8人。结果经护肝、营养心肌、止血、促排泄等对症治疗,现已全部痊愈出院。结论学校及家长应加大对学生普及卫生安全知识的力度,严防"病从口入"关。

2006年10月对我院普通临床科室部分医护工作站医护人员使用中的26台微机键盘进行了消毒前、消毒后的微生物监测. 1 材料与方法 1.1 采样、监测方法采样时用浸有无菌生理盐水的无菌洗脱液的棉拭子一只,在微机键盘上往返涂擦3次,并随之转动棉拭子,剪去手接触部分,将棉拭子投入装有10ml无菌生理盐水的试管内,将采样管用力振打80次,震荡洗下微生物,用无菌吸管吸取1.0毫升待检样品,接种于灭菌平皿,再加入已熔化的45℃-48℃的营养琼脂15-18ml,边倾注边摇匀,待琼脂凝固置37℃温箱培养48h,记数菌落数,并分离致病菌.

医务人员在医疗护理工作中,许多工作都是由手完成,因此医护人员手上的微生物数量要比其他人群多.手的微生物污染是造成医院感染的最直接的传播途径,由于医务人员的手传播细菌而造成医院感染约占30%[1].