再谈Expiration date的翻译问题

目的:国内学界对于Expiration date是译为"失效期"还是译为"有效期"素有质疑和分歧。为此,本文再次探讨了Expiration date的正确译法。方法:采用文献分析法对国际上权威标准和指南中Expiration date的定义和解释进行分析,与我国失效期、有效期等相关概念的定义进行对比分析。结果:根据国际上的定义,在Expiration date当天,药品仍是符合标准的。这与目前我国对药品失效期的定义和解释并不一致,将其翻译为"失效期"是不准确的。另外,Expiration date和有效期在法律上分别属于"期日"和"期间"的概念,将Expiration date简单译为"有效期"也是不准确的。结论:Expiration date是有效期的最后一天,作为辅助期日起到了确定有效期(期间)终点的作用。Expiration date也是用于药品容器标签上的有效期的标注方法,可将其直译为"有效期终止日期"等,也可根据《药品说明书和标签管理规定》中规定的有效期的标注方法将其译为"有效期至"。

Patients’Knowledge, Attitude and Practices on Disposal Methods of Expired and Unused Medicines: Implication for Creation of Drug Take-Back Program

Background: Handling of medicines is a day-to-day activity by patients and many health care providers. However, multiple studies have brought to light inappropriate disposal methods for expired and unused medication (EUM). Improper disposal of expired and unused medicines is hazardous both to humans and the environment. Objective: This sought to measure patients’ knowledge, attitude, and practices on disposal methods of EUM. Methods: A cross-sectional study was carried out among 384 patients at three outpatient pharmacies at the University Teaching Hospitals (UTHs). The structured questionnaire was used to collect data and STAT version 15.1 was used to analyse the data. Results: 384 respondents participated in this study and, at some point, had EUM. In this study, 356 (92.7%) of the participants reported that they had never heard of a drug take-back system. Most of the participants 285 (74.2%) and 239 (62.2%) kept and donated their unused medicine, respectively. Additionally, 244 (63.5%), 212 (55.2%), and 176 (44.8%) of the participants disposed of expired medicines in the bin or garbage, flushed them in toilets or sinks, or burned them, respectively. Occupation was significantly associated with unsafe disposal of unused medicine [P-value = 0.019]. Conclusion and Relevance: Knowledge of safe disposal methods for EUM was good amongst most participants. However, used unsafe disposal methods. The majority of the participants exhibited positive attitude concerning safe disposal methods. This study highlights the need for drug-take-back program creation in Zambia.

Expired drugs as vapor-phase corrosion inhibitors of copper in simulated marine atmospheric environment

Urea,paracetamol and glutamine(based on the expired drugs)were selected as vapor-phase corrosion inhibitors(VCIs)to study their corrosion protection effect on red copper in simulated marine atmospheric environment by using weight loss,electrochemical measurement techniques(specially designed electrochemical testing device for simulating marine atmospheric environments)and surface morphology characterization analysis(SEM/EDS,XRD,RAMAN,XPS).Weight loss results show that the three corrosion inhibitors have good corrosion inhibition effect on red copper,and the corrosion inhibition efficiency in the order of glutamine(83.62%)>urea(68.46%)>paracetamol(61.47%).Surface morphology characterization analysis provides evidence of adsorption of corrosion inhibitors molecules on the red copper surface,thus forming a protective film that blocked the red copper surface from the aggressive chloride ion attack.

Lock-up装置在连续梁桥上的减震性能研究

以某客运专线上大跨连续梁桥为实际工程背景,研究了Lock-up装置对结构纵向抗震性能的影响。根据Lock-up装置在地震作用下具有反复锁止的受力特点,采用非线性时程分析方法,分析了锁止速度对结构减震性能的影响。结果表明:对于大跨连续梁桥,Lock-up装置能够充分发挥活动墩的抗震承载能力,有效地提高桥梁结构整体抗震性能。当锁止速度较小时,Lock-up装置可以采用大刚度连杆模拟,并假定其始终处于完全锁定状态。但当锁止速度较高时,应考虑Lock-up装置反复锁止的实际工作特点,否则应用上述计算方法所得的结果偏于不安全。

Lock-up装置的作用机理与分析模型

为探讨Lock-up装置的分析模型,介绍了其构造、阐述了其作用机理,给出了Lock-up装置阻尼力的力学模型并提出了相应的数值模拟方法。基于某铁路桥梁,建立全桥有限空间模型,采用文中提出的模拟方法进行了Lock-up装置的减震性能分析,通过与常用的刚性连杆或主从约束模拟方法的比较,明确了刚性连杆模拟方法的适用条件。结果表明,Lock-up装置的地震作用过程比较复杂,当Lock-up装置能够激发出极大的阻尼力时,文中的模拟方法与常用的刚性连杆或主从约束模拟方法结果非常接近,通常情况按刚性连杆或主从约束模拟方法得到的结果偏大。

粘滞阻尼器和Lock-up装置在连续梁桥抗震中应用

近年来,我国逐渐在一些桥梁结构中使用了可提高结构抗震性能的减隔震装置,如隔震支座、阻尼器(地震响应校正装置)等。对应用较广的粘滞阻尼器和Lock-up装置的工作机理进行了介绍,对其在连续梁桥抗震中的应用进行了研究,通过实际桥例探讨了两种装置对连续梁桥抗震性能改进的有效性,并对其实用的局限性也进行了分析。研究的结果可供桥梁工程设计人员和科研人员参考。

Reasons for Reverse Flow of Expired Foods and Discussions on Solutions

In recent years,food safety accidents resulted from reverse flow of expired foods is of frequent occurrence. Therefore,finding out reasons for reverse flow of expired foods and taking effective measures to avoid reverse flow of expired foods are greatly significant to safeguard China's food safety. From analysis on current recovery processing situations and related regulations of expired foods in China,it is found that reverse flow of expired food is mainly resulted from no law to comply with,no regulation to follow in recovery processing of expired foods,enterprises lacking good faith,and imperfect accountability system and supervision system. In view of these factors,it comes up with following recommendations:( 1) Improving legal regulations on processing of expired foods;( 2) Making clear responsibility investigation of supervision and law enforcing departments;( 3) Setting up " Four in One" supervision mode integrating enterprise self-discipline,market supervision,social monitoring,and information platform;( 4) Improving the supervision system for recovery processing of expired foods.

Expiratory Upper Airway Obstruction Caused by the Soft Palate during Bag-Mask Ventilation

Introduction: Expiratory upper airway obstruction during bag-mask ventilation is not well characterized. Methods: An audit was done to assess expiratory obstruction in 90 adult surgical patients undergoing bag-mask ventilation during the induction of general anaesthesia. Results: Clinicians experienced difficulty delivering gas to the lungs when the head was neutral in 52 of 90 patients (58%;inspiratory obstruction) but this problem was corrected by head tilt and chin lift in all but 2 patients. Clinicians experienced difficulty recovering gas from the lungs when the mouth was held closed under the mask in 30 of the remaining 88 patients (34%;expiratory obstruction). This problem persisted despite head tilt and chin lift in all but one patient but was uniformly corrected by opening the mouth. Inspection of the soft palate revealed that it was lying on the posterior pharyngeal wall in 27 of 30 patients with expiratory obstruction and that the retropalatal space was patent in 55 of 58 patients without expiratory obstruction (χ2, P < 0.001). The clinical predictors of expiratory upper airway obstruction included advanced age, large tongue, and large uvula. Conclusion: Expiratory airway obstruction should be suspected in all cases of difficult mask ventilation that cannot be corrected by head tilt and chin lift. Simply allowing the mouth to open between positive pressure breaths will permit gas to exit the lungs.

Lock-up装置对大跨连续刚构桥地震响应分析

为研究Lock-up装置对大跨连续刚构桥的地震响应,先介绍了Lock-up装置的基本情况、发展历史、构造及作用机理;接着,以某连续刚构桥为例进行不同情况下的地震响应有限元模拟,在其过渡墩处设置不同的约束,以大跨连续刚构桥墩底及桩顶弯矩和位移为参数进行比较分析。本文计算结果表明,对于大跨连续刚构桥来说,Lock-up装置可以使过渡墩与主墩很好地协同受力,降低地震对主墩的不利影响,得出在地震作用下Lock-up装置对大跨度连续刚构桥非常有效的结论。

Respiratory Changes in the Superior Vena Cava Area on Inspiratory and Expiratory Chest CT: Comparison between Patients with COPD and with Bronchial Asthma

Purpose: In patients with obstructive lung diseases, alteration of intrathoracic pressure is closely related to hyperinflation and leads to hemodynamic impairments. Both intrathoracic pressure and hemodynamics are affected by the respiratory phase. In fact, a previous study showed that respiratory phasic variations in the superior vena cava (SVC) area significantly correlated with the extent of emphysema. Chronic obstructive pulmonary disease (COPD) and bronchial asthma manifest different pathophysiological changes in hyperinflation and hemodynamics. The current study was conducted to evaluate differences in respiratory variations in the cross-sectional area of the SVC between patients with COPD and with asthma. Materials and Methods: We measured the SVC area and calculated the ratio of the SVC area on inspiratory and expiratory scans (i/e-SVC ratio) in 66 patients with COPD and 16 patients with asthma. The cor-relations of the i/e-SVC ratios with airflow limitation, pulmonary small vessels less than 5 mm2 (%cross-sectional area [%CSA] < 5), and respiratory changes in lung volume (i/e-LV) obtained by inspiratory and expiratory computed tomography (CT) images were evaluated. Results: There was no significant difference in i/e-SVC ratio between COPD and asthma groups. In COPD patients, the i/e-SVC ratio significantly correlated with the %CSA ﹣0.433, P = 0.003), i/e-LV ratio (ρ = ﹣0.371, P = 0.011), and percent of predicted forced expiratory volume in 1 second (FEV1% predicted) (ρ = ﹣0.474, P = 0.001), whereas in asthma patients, there were no significant correlations between the i/e-SVC ratio and those functional parameters. Conclusion: There would be differences in the relationship between intrathoracic pressure and cardiopulmonary hemodynamics between COPD and asthma patients.

Effects of Denture Removal on Expiratory Upper Airway Patency during Mask Ventilation in Complete Denture Wearers under General Anesthesia

Background: Some anesthetized patients present with expiratory airway obstruction (EAO) during mask ventilation (MV). EAO may occur more frequently among edentulous patients for whom a firmer grip of the mask and the mandible is needed to avoid gas leakage. We compared EAO grades before and after denture removal and identified predictors of EAO during MV in edentulous patients. Methods: One hundred and eight denture-wearing edentulous patients were anesthetized, their mouths were wrapped with film, their nasal masks and mandibles were held with two hands, and their lungs were ventilated in a pressure-controlled mode. Their dentures were subsequently removed, mouths were re-wrapped, and nasal MV was reapplied. EAO was graded based on capnography waveforms as follows: Grade I, normal waveform (no obstruction);II, loss of the alveolar plateau of the waveform (partial obstruction);and III, no waveform (total obstruction). EAO grades were compared before and after denture removal. Predictive demographic variables for occurrence of total EAO were identified using a multivariate analysis. Results: The proportions of Grades I, II, and III were 43.5%, 26.9%, and 29.6% when dentures were worn and 35.2%, 15.7%, and 49.1%, respectively, when dentures were removed. A significant difference was observed in EAO grades before and after denture removal (P = 0.000034). Age ≥ 75 years (adjusted odds ratio 3.41;95% confidence interval 1.31 - 8.87;P = 0.012) and body mass index ≥ 25 kg/m2 (adjusted odds ratio 2.61;95% confidence interval 1.07 - 6.40;P = 0.036) were independently associated with an increased incidence of total EAO in patients with their dentures removed. Conclusion: Denture removal impaired expiratory upper airway patency in edentulous patients, particularly in older or obese patients, during MV.

Assessment of Knowledge, Attitude and Practices towards the Disposal of Unused and Expired Medications among Students of Private Medical Universities in Lusaka, Zambia

Background: The disposal of unused and expired medications has been a concern in many countries in that, the pharmaceutical waste enters the ecosystem and eventually causes a negative impact on human health and environment. Aim: To assess the knowledge, attitude and disposal practices of unused and expired medicines by students in the private medical universities in Lusaka of Zambia. Method: A cross-sectional survey was conducted over a period of 8 weeks among 391 respondents from three private universities in Lusaka. Respondents were polled using semi structured questions that focused on their knowledge, attitudes, and disposal practices for unused and expired drugs. In order to analyze data, the statistical package for social sciences (SPSS) version 20 was utilized. Results: The mean age of the participants was 23 years (SD: ±3). Out of the 391 participants, 320 (81.8%) knew about medicine waste and 391 (100.0%) responded that unsafe disposal of unused and expired medicine poses a threat to human health and can harm the environment. The drug-take-back system was unknown to a vast percentage of the respondent 371 (94.9%). The majority 274 (70.1%) of respondents had unused medicine stored at home, with antibiotics 215 (56.0%) and analgesia 111 (28.4%) being the most prevalent types of drugs kept in the households. The most commonly used disposal practice for unused 126 (32.2%) and expired medicines 274 (70.1%) was throwing them in household garbage. Only 27 (6.9%) and 30 (7.7%) reported returning unused and expired medicines to the nearest pharmacy respectively. The majority of respondents believed the risk stemmed from the presence of an undesired drug in the home, the potential for harm to children, a lack of proper information on safe disposal practices, and the necessity for a take-back program. Conclusions: The majority of the study participants used unsafe methods to dispose of unused and expired medicine. However, most of the participants acknowledged that unsafe disposal of unused and expired medicines is a public health problem and proposed the need to introduce drug take-back programs in the communities.

Lock-up装置在连续梁桥中应用的优化研究

以某5跨连续梁桥为工程背景,对Lock-up装置的工作性能和机理进行了分析。采用非线性时程分析方法,对地震中Lock-up装置锁止速度和Lock-up装置的位置对桥梁减震的影响进行了分析,得到了Lock-up的最优锁止速度和该桥的最优减震方案。结果表明:对于多跨连续梁桥,Lock-up装置可以很好地提高桥梁的整体抗震性能;从经济和减震效果看并不是越多的Lock-up装置越好。

新《公司法》中的股东出资义务

新《公司法》以强化股东出资义务为导向,对公司出资制度进行了修改,新增了董事会核查和催缴、股东失权制度以及加速到期制度。这些新增制度在实践中如何适用,需进一步研究和探索。股东违反出资义务需要承担补足和赔偿责任,其他股东和董事也可能承担相应责任。

我国农村订单定向医学生履约期满后续约意愿分析

目的 系统评价我国农村订单定向医学生履约期满后续约意愿。方法 系统检索有关订单定向医学生履约期满后基层服务意愿的研究,由2名研究人员独立筛选文献、提取所需信息,并对纳入研究进行偏倚风险质量评价,采用Stata 17.0软件进行Meta分析。结果 共纳入29篇文献,包括12 928名研究对象,其中2 732名订单定向医学生有续约意向。结果显示,我国订单定向医学生履约期满后意愿续约率为17.5%(95%CI:12.6%~22.3%)。结论 我国订单定向医学生履约期满后意愿续约率较低,有必要采取有针对性的措施,促进订单定向医学生续约意愿的提高。

基于效期管理软件的药品养护模式的构建和评价

目的 探索创新药品效期管理模式,并对该模式在药品效期养护中的应用进行评价。方法 通过开发药品效期管理软件,效期盘点定人定位,采用信息化与人工相结合的模式进行药品效期管理,收集2020年7月至2021年12月医院信息系统记录的过期药品报损率、效期盘点记录的近效药品数以及药师工作效率和满意度,对该效期管理模式进行评估。结果 基于药品效期管理软件的药品养护模式下,药品效期导致的药品报损减少,排查出的近效药品数逐月降低,药师工作时间缩短,满意度提高至100%。结论 基于药品效期管理软件的药品养护模式,可以有效降低传统人工效期记录模式中存在的漏查事件,减少药品不良事件发生,节约医疗资源,保障临床药品质量,提高药师工作效率和满意度,具有临床应用价值。

心脏骤停患者呼气末二氧化碳分压与自主循环恢复关系的研究

目的探讨心脏骤停(CA)患者呼气末二氧化碳分压(P_(ET)CO_(2))与自主循环恢复(ROSC)的关系研究。方法回顾性选取2018年5月~2023年5月就诊于北京大学第三医院秦皇岛医院急诊科及重症医学科成人CA患者107例的数据。分析CA患者P_(ET)CO_(2)水平与ROSC的关系。结果107例CA患者经心肺复苏术(CPR)抢救治疗后,73例患者自主循环恢复设为ROSC组,34例患者复苏失败设为无ROSC组。ROSC组在10、20和30 min时P_(ET)CO_(2)均高于无ROSC组,差异有统计学意义(t=29.457、56.934、51.801,P<0.05)。107例CA患者中共有67例患者存活(存活组),40例患者死亡(死亡组)。两组0 min时P_(ET)CO_(2)差异无统计学意义(t=0.504,P=0.615);存活组在10、20和30 min时P_(ET)CO_(2)均高于死亡组,差异有统计学意义(t=16.955、14.757、17.071,P<0.05);P_(ET)CO_(2)、CA对ROSC造成影响时,标准化路径系数分别为0.182、0.187、0.353,路径呈现出的0.05水平的显著性(Z=2.283、2.340、5.798,P<0.05)。结论CA患者P_(ET)CO_(2)水平与ROSC的关系为正向影响关系,可以监测并预估患者CPR质量。

基于过期葡萄糖酸亚铁和废锂箔制备高性能LiFePO_(4)/C正极的研究

近几年,锂离子电池的市场需求剧增,导致原材料价格暴涨。为此,分别将过期葡萄糖酸亚铁和废锂箔与H_(3)PO_(4)反应生成Fe_(3)(PO_(4))2/葡萄糖酸钠磷酸酯和Li_(3)PO_(4)粉末,然后采用磷酸铁工艺制备LiFePO_(4)/C纳米颗粒,并研究其储锂性能。研究结果表明,LiFePO_(4)/C正极在1.0C循环300圈后的可逆容量和容量保持率分别高达129.3mAh/g和97.0%,与商业LiFePO_(4)正极材料性能相当,这可能归功于纳米颗粒及碳层之间的协同效应。该研究降低了LiFePO_(4)的制备成本和环境排放。

吸气后屏气和缩唇呼气的脑功能活动特征研究

目的:通过检测不同呼吸运动模式的大脑皮质激活状态,探究随意呼吸动作的大脑调控机制。方法:招募健康男性7例和健康女性16例。设置2种运动任务:吸气-屏气(呼气肌等长收缩)、吸气-缩唇呼气(呼气肌等张收缩)。受试者执行任务时检测功能性近红外光谱(functional near-infrared spectroscopy,fNIRS),比较2种任务下脑氧合血红蛋白浓度(HbO2)浓度信号的时间变化和空间分布差异。结果:在吸气-屏气任务时,双侧初级运动皮质(BA4)、双侧运动前区/辅助运动区(BA6)、双侧背外侧前额叶皮质(BA46)、双侧额极区和眶额区(BA10、BA11)、双侧初级视觉皮质(BA17)、右侧初级躯体感觉皮质(BA1、BA2、BA3)、右侧额下回前部(BA47)以及左侧视觉联合皮质(BA18)显著激活。在缩唇呼气任务时,脑皮质显著激活区在双侧额极区(BA10)和眶额区(BA11)。2种任务比较发现,屏气较缩唇呼气在右侧运动前区/辅助运动区(BA6)激活更强。结论:随意吸气后实施屏气或缩唇呼气动作特征性地表现为前额叶占主导的感觉运动皮质活动。呼气肌的等长收缩和等张收缩存在中枢控制差异。

几种常见滴定液长期稳定性考察

通过长期考察乙二胺四醋酸二钠滴定液、亚硝酸钠滴定液、盐酸滴定液、硫代硫酸钠滴定液、氢氧化钠滴定液、硝酸银滴定液、硫酸滴定液、高氯酸滴定液的稳定性,为其有效期制定提供参考。每3个月考察滴定液的液性状是否改变和计算滴定液浓度差异相对平均偏差(RSD)是否大于0.1%来判定其有效期,每个滴定液考察3个批次。结果3~6个月内比较稳定的有乙二胺四醋酸二钠滴定液(0.05 mol/L)、亚硝酸钠滴定液(0.1 mol/L)、盐酸滴定液(0.1 mol/L)、硫代硫酸钠滴定液(0.1 mol/L)、氢氧化钠滴定液(0.1 mol/L)、硝酸银滴定液(0.1 mol/L),因此有效期建议定为3个月;硫酸滴定液(0.05 mol/L)、高氯酸滴定液在0~3个月内浓度差异比较大,建议有效期定在3个月内。