基本公共卫生服务健康教育知识讲义11

基本公共卫生服务健康教育知识讲义11 基本公共卫生服务健康教育知识讲义 金银滩卫生院 健 康 教 育 知 识 讲 座 第十一期 2012年10 月 关于举办“布鲁氏菌病”健康知识讲座 活动的公告 时间:2012-10-31 举办单位:金银滩镇中心卫生院 布鲁氏菌病(以下简称布病，俗称“懒汉病”、“蔫吧病”)是一种由布鲁氏菌侵入机体引起的严重危害人民身心健康和畜牧业发展的人畜共患传染病，是《中华人民共和国传染病防治法》规定的乙类传染病。我院将举行专题义诊活动，具体如下: 讲座主题:布鲁氏菌病 讲座时间:10月31日上午9:30 讲座地点:金银滩中心卫生院会议室 讲座内容:布鲁氏菌病相关知识宣传、科普资料发放、测量血压 备注:如遇下雨，讲座时间另作调整，以实际 通知 关于发布提成方案的通知关于xx通知关于成立公司筹建组的通知关于红头文件的使用公开通知关于计发全勤奖的通知 为准。 院办 2012年10月22日 concentration. Such as: 0.1015 mol/L,0.09827 mol/L and so on. The calibration standard solution concentration, is called determines, it actually is a titration process. In other words, you want acid titration with NaOH, you must first determine the exact concentration of NaOH by titration. General calibration NaOH using potassium hydrogen phthalate. Question: the exact concentrations of potassium hydrogen di-potassium acid then how come is it? it calibrated to do? said it does not need calibration. Can weigh the preparation of standard solutions. Such as potassium hydrogen di-potassium acid substance we call benchmarking. 1. benchmark benchmark: the ability to direct the preparation of calibration standard solutions or substances. Baseline must satisfy the following conditions: sufficient purity. Purity of more than 99.9%. Composition consistent with the chemical formula. With crystal water, the content should be consistent with the chemical formula. Stable. That cannot be decomposed in weighing or save time, compounding or moisture absorption. Large molar mass. Molar mass, required amount of weighing, weighing the relative error is smaller. Benchmarks are commonly used: pure metal, such as: Ag, Cu, Fe, Zn and so on; pure compounds such as K2Cr2O7,Na2CO3,Na2C2O4,ZnO, and so on. 2. preparation of standard solutions: direct method: on the analytical balance accurate weighing a certain amount of base material, dissolved in a volumetric flask and diluted to the desired size, then calculate the exact concentration of the solution, such as: K2Cr2O2 preparation of standard solutions. Direct method only applies to the base material.is very clear, otherwise it will result in an error. Preparation of 0.1mol • L-1 solution of Na2S2O3 required in scale 25G solid reagents, such as weighing on reagent in analytical balance, it is not necessary. Preparation and storage solutions can be guided by the following principles: 1. regular and substantial solutions, start preparing about 10 times times the stock solution concentration, when taking stock solution diluted 10 times. 2. easy solution of erosion or corrosion of glass to serve in glass bottles, such as fluoride salts (like NaF, NH4F, NH4HF2), caustic soda, and should be kept in polyethylene plastic bottle. 3. volatile, decomposition of the reagents and solutions, such as I2, KMnO4, H2O2, AgNO3, H2C2O4, and Na2S2O3, TiCl3, ammonia water, Br2, CCl4, CHCl3, solutions such as acetone, ethyl ether, ethanol and ...A Large-capacity measuring cups and measuring cylinders measuring small size, this reduces accuracy. Measuring liquids, graduated cylinder should be smooth and stay for more than 15 seconds after treating the surface calm, make the sight line and the graduated cylinder (Cup) of fluid meniscus at the lowest level, high or low readings will not cause major errors (see Figure 1). In General, the graduated cylinder designed glass of high precision. 2. pipette and pipette pipette and pipette is an accurate measure the precision of a certain volume of liquid instruments. Pipette is the capacity of the pot-bellied tubes, only a tick-tick-free, so the tick is the requirement under fixed temperature volume General volumes 1mL, 2mL, 5mL, 10mL, 20mL, 25mL, 50mL, 100mL and other specifications. Pipette is a linear indexing graduated pipette, 金银滩中心卫生院健康教育活动 记录 混凝土 养护记录下载土方回填监理旁站记录免费下载集备记录下载集备记录下载集备记录下载 表 活动时间:2012年10月31日 活动地点:金银滩卫生院会议室 活动形式:现场讲座、宣传、咨询 主办单位:金银滩中心卫生院 接受健康教育人员类别:村医、保健员 参与人数:22 宣传品发放种类及数量:预防布鲁氏菌病基本知识、布鲁氏菌病科普读本22本、宣传布鲁氏菌病纪念品22份等。 活动主题:布鲁氏菌病防治 活动内容: 1发放宣传品; 2发放纪念品; 3宣传布鲁氏菌病防治知识; 4讲解布鲁氏菌病的诊断、治疗; 5现场咨询、互动。 活动总结评价: 1宣传开始前先由工作人员发放宣传品和纪念品; 2讲解《预防布鲁氏菌病基本知识》的相关内容; 3讲解布鲁氏菌病的诊断及治疗; 4宣传结束后，进行现场咨询、互动、交流。 通过以上的活动，使大部分参与者基本掌握布鲁氏菌病的预防、诊断和治疗。 存档材料请附后 ?书面材料 ?图片材料 ?印刷材料 ?影音材料 ?居民签到表 ?其他材料 填表人:(签字) 负责人:(签字) 填表时间: 年 月 日 金银滩中心卫生院“布鲁氏菌病”健康知 识讲座活动总结 2012年10月31日在金银滩中心卫生院会议室举办布鲁氏菌病讲座。为了认真开展此次活动，我院按照上级文件精神要求，精心组织、认真实施，于2012年8月26日召开了全院动员会议，会议上强调了此次讲座活动的重要性和宣传意义，并对卫生院及各村卫生所对此次活动进行了安排和部署，同时强调把布鲁氏菌病防治知识的宣传和普及作为科普知识宣传及健康教育的重要内容，不断提高全镇广大农民群众的布鲁氏菌病防治知识知晓率。 此次宣传活动的开展卫生院制定了切实、可行、有效地宣传活动 计划 项目进度计划表范例计划下载计划下载计划下载课程教学计划下载 ，有步骤、有重点地开展形式多样，内容丰富的宣传活动。为使此次宣传活动扎实有效开展，我院抽调人力，成立讲座活动督导小组，对各村宣传活动进行检查指导，并对各村的部分布鲁氏菌病患者进行了访视。此次宣传活动卫生院及各村卫生所悬挂宣传横幅11条，设立咨询宣传点11个，出黑板报1版，发放宣传材料300余份、张贴标语等。通过此次活动的开展，进一步提高了全镇农民群众防病治病的意识，使更多的群众了解了布鲁氏菌病的防治知识，进一步提高了我镇农民群众的健康水平 。 concentration. Such as: 0.1015 mol/L,0.09827 mol/L and so on. The calibration standard solution concentration, is called determines, it actually is a titration process. In other words, you want acid titration with NaOH, you must first determine the exact concentration of NaOH by titration. General calibration NaOH using potassium hydrogen phthalate. Question: the exact concentrations of potassium hydrogen di-potassium acid then how come is it? it calibrated to do? said it does not need calibration. Can weigh the preparation of standard solutions. Such as potassium hydrogen di-potassium acid substance we call benchmarking. 1. benchmark benchmark: the ability to direct the preparation of calibration standard solutions or substances. Baseline must satisfy the following conditions: sufficient purity. Purity of more than 99.9%. Composition consistent with the chemical formula. With crystal water, the content should be consistent with the chemical formula. Stable. That cannot be decomposed in weighing or save time, compounding or moisture absorption. Large molar mass. Molar mass, required amount of weighing, weighing the relative error is smaller. Benchmarks are commonly used: pure metal, such as: Ag, Cu, Fe, Zn and so on; pure compounds such as K2Cr2O7,Na2CO3,Na2C2O4,ZnO, and so on. 2. preparation of standard solutions: direct method: on the analytical balance accurate weighing a certain amount of base material, dissolved in a volumetric flask and diluted to the desired size, then calculate the exact concentration of the solution, such as: K2Cr2O2 preparation of standard solutions. Direct method only applies to the base material.is very clear, otherwise it will result in an error. Preparation of 0.1mol • L-1 solution of Na2S2O3 required in scale 25G solid reagents, such as weighing on reagent in analytical balance, it is not necessary. Preparation and storage solutions can be guided by the following principles: 1. regular and substantial solutions, start preparing about 10 times times the stock solution concentration, when taking stock solution diluted 10 times. 2. easy solution of erosion or corrosion of glass to serve in glass bottles, such as fluoride salts (like NaF, NH4F, NH4HF2), caustic soda, and should be kept in polyethylene plastic bottle. 3. volatile, decomposition of the reagents and solutions, such as I2, KMnO4, H2O2, AgNO3, H2C2O4, and Na2S2O3, TiCl3, ammonia water, Br2, CCl4, CHCl3, solutions such as acetone, ethyl ether, ethanol and ...A Large-capacity measuring cups and measuring cylinders measuring small size, this reduces accuracy. Measuring liquids, graduated cylinder should be smooth and stay for more than 15 seconds after treating the surface calm, make the sight line and the graduated cylinder (Cup) of fluid meniscus at the lowest level, high or low readings will not cause major errors (see Figure 1). In General, the graduated cylinder designed glass of high precision. 2. pipette and pipette pipette and pipette is an accurate measure the precision of a certain volume of liquid instruments. Pipette is the capacity of the pot-bellied tubes, only a tick-tick-free, so the tick is the requirement under fixed temperature volume General volumes 1mL, 2mL, 5mL, 10mL, 20mL, 25mL, 50mL, 100mL and other specifications. Pipette is a linear indexing graduated pipette, 同时，也应意识到，布鲁氏菌病防治宣传工作，不是一朝一夕的宣传，而是每一天的宣传。今后我们要继续加强布鲁氏菌病防治知识宣传工作，做到长抓不懈，使布鲁氏菌病防治知识和布鲁氏菌病控制工作的宣传进入千家万户，家喻户晓。 金银滩中心卫生院 2012.10.31 布鲁氏菌病 主讲——张自红 布鲁氏菌病,brucellosis,又称地中海弛张热～马耳他热～波浪热或波状热～是由布鲁氏菌引起的人畜共患性全身传染病～其临床特点为长期发热、多汗、关节痛及肝脾肿大等。 西医学布鲁氏菌病 名: 主要症发热～肝脾肿大～关节痛～英文名brucellosis 状: 多汗 称: 多发群其他名地中海弛张热、马耳所有人 体: 称: 他热 传染性: 有传染性 发病部肝脏～脾胃～淋巴 位: 基本信息 1814年Burnet首先描述地中海弛张热～并与疟疾作了鉴别。1860年Marston对本病作了系统描述～且把伤寒与地中海弛张热区别开。1886年英国军医Bruce在马尔他岛从死于“马尔他热”的士兵脾脏中分离出“布鲁氏菌”～首次明确了该病的病原体。1897年Hughes根据本病的热型特征～建议称“波浪热”。后来～为纪念Bruce～学者们建议将该病取名为“布鲁氏菌病”。1897年Wright与其同事发现病人血清与布鲁氏菌的培养物可发生凝集反应～称为Wright凝集反应～从而建立了迄今仍用的血清学诊断方法。我国古代医籍中对本病虽有描述～但直到1905年Boone于重新对本病作正式报道。 疾病病原 布鲁氏菌为革兰氏阴性短小杆菌～初次分离时多呈球状～球杆状和卵圆形～故有人建议称“布鲁氏菌病菌”。该菌传代培养后渐呈短小杆状～菌体无鞭毛～不形成芽胞～毒力菌株可有菲薄的荚膜。1985年WHO布鲁氏菌病专家季员会把布鲁氏菌属分为6个种19个生物型～即羊种,生物型1，3,～牛种,生物型1，7.9,。猪种,生物型1，5,及绵羊型副睾种～沙林鼠种～犬种,各1个生物型,。我国已分离到15个生物型～即羊种,1，3型,～牛种,1，7.9型,～猪种,1.3型,～绵羊副睾种和犬种各1个型。临床上以羊、牛、猪三种意义最大～羊种致病力最强。多种生物型的产生可能与病原菌为适应不同宿主而发生遗传变异有关。 本菌生长对营养要求较高～目前实验室研究多用牛、羊新鲜胎盘加10%兔血清制作培养基～其效果较好。但即使在良好培养条件下生长仍较缓慢～在不良环境～如抗生素的影响下～本菌易发生变异。当细菌壁的脂多糖,LPS,受损时细菌落即由S型变为R型。当胞壁的肽聚糖受损时～则细菌失去胞壁或形成胞壁不完整的L型布鲁氏菌。这种表型变异形成的细菌可在机体内长期存在～伺环境条件改善后再恢复原有特性。 concentration. Such as: 0.1015 mol/L,0.09827 mol/L and so on. The calibration standard solution concentration, is called determines, it actually is a titration process. In other words, you want acid titration with NaOH, you must first determine the exact concentration of NaOH by titration. General calibration NaOH using potassium hydrogen phthalate. Question: the exact concentrations of potassium hydrogen di-potassium acid then how come is it? it calibrated to do? said it does not need calibration. Can weigh the preparation of standard solutions. Such as potassium hydrogen di-potassium acid substance we call benchmarking. 1. benchmark benchmark: the ability to direct the preparation of calibration standard solutions or substances. Baseline must satisfy the following conditions: sufficient purity. Purity of more than 99.9%. Composition consistent with the chemical formula. With crystal water, the content should be consistent with the chemical formula. Stable. That cannot be decomposed in weighing or save time, compounding or moisture absorption. Large molar mass. Molar mass, required amount of weighing, weighing the relative error is smaller. Benchmarks are commonly used: pure metal, such as: Ag, Cu, Fe, Zn and so on; pure compounds such as K2Cr2O7,Na2CO3,Na2C2O4,ZnO, and so on. 2. preparation of standard solutions: direct method: on the analytical balance accurate weighing a certain amount of base material, dissolved in a volumetric flask and diluted to the desired size, then calculate the exact concentration of the solution, such as: K2Cr2O2 preparation of standard solutions. Direct method only applies to the base material.is very clear, otherwise it will result in an error. Preparation of 0.1mol • L-1 solution of Na2S2O3 required in scale 25G solid reagents, such as weighing on reagent in analytical balance, it is not necessary. Preparation and storage solutions can be guided by the following principles: 1. regular and substantial solutions, start preparing about 10 times times the stock solution concentration, when taking stock solution diluted 10 times. 2. easy solution of erosion or corrosion of glass to serve in glass bottles, such as fluoride salts (like NaF, NH4F, NH4HF2), caustic soda, and should be kept in polyethylene plastic bottle. 3. volatile, decomposition of the reagents and solutions, such as I2, KMnO4, H2O2, AgNO3, H2C2O4, and Na2S2O3, TiCl3, ammonia water, Br2, CCl4, CHCl3, solutions such as acetone, ethyl ether, ethanol and ...A Large-capacity measuring cups and measuring cylinders measuring small size, this reduces accuracy. Measuring liquids, graduated cylinder should be smooth and stay for more than 15 seconds after treating the surface calm, make the sight line and the graduated cylinder (Cup) of fluid meniscus at the lowest level, high or low readings will not cause major errors (see Figure 1). In General, the graduated cylinder designed glass of high precision. 2. pipette and pipette pipette and pipette is an accurate measure the precision of a certain volume of liquid instruments. Pipette is the capacity of the pot-bellied tubes, only a tick-tick-free, so the tick is the requirement under fixed temperature volume General volumes 1mL, 2mL, 5mL, 10mL, 20mL, 25mL, 50mL, 100mL and other specifications. Pipette is a linear indexing graduated pipette, 本菌有A、M和G三种抗原成份～G为共同抗原～一般牛种菌以A抗原为主。A与M之比为20:1,羊种菌以M为主～M比A为20:1,猪种菌A:M为2:1。制备单价A、M抗原可用其鉴定菌种。布鲁氏菌的抗原与伤寒、副伤寒、沙门菌、霍乱弧菌、变形杆菌OX19等的抗原有某些共同成份。本菌致病力与各型菌新陈代谢过程中的酶系统～如透明质酸酶、尿素酶、过氧化氢酶、琥珀酸脱氢酶及细胞色素氧化酶等有关。细菌死亡或裂解后释放内毒素是致病的重要物质。 布鲁氏菌在自然环境中生活力较强～在病畜的分泌物～排泻物及死畜的脏器中能生存4个月左右～在食品中约生存2个月。加热60?或日光下曝晒10，20分钟可杀死此菌～对常用化学消毒剂较敏感。 编辑本段流行病学 本病流行于世界各地～据调查全世界160个国家中有123个国家有布鲁氏菌病发生。我国多见于内蒙、东北～西北等牧区。解放前在牧区常有流行～在北方农区也有散发。解放后国家成立了专门防治机构～发病率也逐年下降。 传染源 目前已知有60多种家畜、家禽～野生动物是布鲁氏菌的宿主。与人类有关的传染源主要是羊、牛及猪～其次是犬。染菌动物首先在同种动物间传播～造成带菌或发病～随后波及人类。病畜的分泌物、排泄物、流产物及乳类含有大量病菌～如实验性羊布氏菌病流产后每毫升乳含菌量高达3万个以上～带菌时间可达1.5，2年～所以是人类最危险的传染源。各型布鲁氏菌在各种动物间有转移现象～即羊种菌可能转移到牛、猪～或相反。羊、牛、猪是重要的经济动物～家畜与畜产品与人类接触密切～从而增加了人类感染的机会。 患者也可以从粪、尿、乳向外排菌～但人传人的实例很少见到。 传播途径 ?经皮肤粘膜接触传染 直接接触病畜或其排泄物～阴道分泌物～娩出物,或在饲养、挤奶、剪毛～屠宰以及加工皮、毛、肉等过程中没有注意防护。可经皮肤微伤或眼结膜受染,也可间接接触病畜污染的环境及物品而受染,?经消化道传染 食用被病菌污染的食品、水或食生乳以及未熟的肉、内脏而受染,?经呼吸道传染 病菌污染环境后形成气溶胶～可发生呼吸道感染。这三种途径在流行区可两种或三种途径同时发生,?其它如苍蝇携带～蜱叮咬也可传播本病。但重要性不大。 易感人群 人类普遍易感 ～病后可获得一定免疫力～不同种布鲁氏菌间有交叉免疫～再次感染发者有2，7%～疫区居民可因隐性染病而获免疫。 流行特征 本病一年四季均可发病～但以家畜流产季节为多。发病率牧区高于农区～农区高于城市。流行区在发病高峰季节,春末夏初,可呈点状暴发流行。患病与职业有密切关系～兽医、畜牧者、屠宰工人、皮毛工等明显高于一般人群。发病年龄以青壮年为主～男多于女。牧区存在自然疫源地～但疫区流行强度受布鲁氏菌种、型及气候～人们的生活水平与对牧畜、牧场管理情况的影响。 编辑本段发病机理 病菌自皮肤或粘膜侵入人体～随淋巴液达淋巴结～被吞噬细胞吞噬。如吞噬细胞未能将菌杀灭～则细菌在胞内生长繁殖～形成局部原发病灶。此阶段有人称为淋巴源性迁徙阶段～相当于潜伏期。细菌在吞噬细胞内大量繁殖导致吞噬细胞破裂～随之大量细菌进入淋巴液和血循环形成菌血症。在血液里细菌又被血流中的吞噬细胞吞噬～并随血流带至全身～在肝、脾、淋巴结、骨髓等处的单核—吞噬细胞系统内繁殖～形成多发性病灶。当病灶内释放出来的细菌～超过了吞噬细胞的吞噬能力时～则在细胞外血流中生长、繁殖～临床呈现明显的败 血症。在机体各因素的作用下～有些遭破坏死亡～释放出内毒素及菌体其它成份～造成临床上不仅有菌血症、败血症～而且还有毒血症的表现。内毒素在致病理损伤～临床症状方面目前认为起着重要作用。机体免疫功能正常～通过细胞免疫及体液免疫清除病菌而获痊愈。如果免疫功能不健全。或感染的菌量大、毒力强～则部分细菌逃脱免疫～又可被吞噬细胞吞噬带入各组织器官形成新感染灶～有人称为多发性病灶阶段。经一定时期后～感染灶的细菌生长繁殖再次入血～导致疾病复发。组织病理损伤广泛。临床表现也就多样化。如此反复成为慢性感染。 未经治疗的患者血清抗体最先是IgM升高～随后是IgG升高～IgA在其后呈低水平上升～持续约一年后下降。此后每当病情反复加重时～IgG又可迅速回升。动物实验用牛种布鲁氏菌免疫家兔～提取IgM～IggG～分别作杀菌试验～证明IgM～IgG有较强的杀菌活性。用强毒羊种菌感染豚鼠后～提纯IgG～IgM能起保护作用。但也有人认为血清抗体与保护免疫不相关～仅可作为疾病活动的标志。如Hodgkin’s病～淋巴瘤的患者布鲁氏菌病发病率高,布鲁氏菌抗原皮试在敏感患者呈典型超敏反应。说明细胞免疫在抗布鲁氏菌感染上起着重要作用。本病的慢性期检测发现有循环免疫复合物增加～还可出现自身抗体～表明慢性期体液免疫也参与了病理损伤。有人报道慢性期IgG型循环免疫复合物升高占患者的53.13%～IgM型循环免疫复合物升高占患者28.13%～故认为一半以上的患者组织损伤可能为循环免疫复合物所致。研究还发现1/3的患者下丘脑—垂体—肾上腺系统功能减退～致机体失去了免疫稳定作用～也可能是疾病慢性化的原因之一。 机体的各组织器官～网状内皮系统因细菌、细菌代谢产物及内毒素不断进入血流～反复刺激使敏感性增高～发生变态反应性改变。近期的研究表明～?～?～?～?型变态反应在布鲁氏菌病的发病机理中可能都起一定作用。疾病的早期人体的巨噬细胞～T细胞及体液免疫功能正常～它们联合作用将细菌清除而痊愈。如果不能将细菌彻底消灭～则细菌、代谢产物及内毒素反复在局部或进入血流刺激机体～致使T淋巴细胞致敏～当致敏淋巴细胞再次受抗原作用时～释放各种淋巴因子～如淋巴结通透因子、趋化因子、巨噬细胞移动抑制因子、巨噬细胞活性因子等。致以单核细胞浸润为特征的变态反应性炎症～形成肉芽肿、纤维组织增生等慢性病变。 病理变化 本病病理变化广泛～受损组织不仅为肝、脾、骨髓、淋巴结～而且还累及骨、关节、血管、神经、内分泌及生殖系统,不仅间质细胞～而且还损伤器官的实质细胞。其中以单核-吞噬细胞系统的病变最为显著。病灶的主要病理变化:?渗出变性坏死改变 主要见于肝、脾、淋巴结、心、肾等处～以浆液性炎性渗出～夹杂少许细胞坏死,?增生性改变 淋巴、单核-吞噬细胞增生～疾病早期尤著。常呈弥漫性～稍后常伴纤维细胞增殖,?肉芽肿形成 病灶里可见由上皮样细胞、巨噬细胞及淋巴细胞～浆细胞组成的肉芽肿。肉芽肿进一步发生纤维化～最后造成组织器官硬化。三种病理改变可循急性期向慢性期依次交替发生和发展。如肝脏～急性期内可见浆液性炎症～同时伴实质细胞变性、坏死,随后转变为增殖性炎症～在肝小叶内形成类上皮样肉芽肿～进而纤维组织增生～出现混合型或萎缩型肝硬化。 临床表现 本病临床表现复杂多变、症状各异～轻重不一～呈多器官病变或局限某一 局部。根据1977年九月我国北方防治地方病领导小组办公室颁发的“人布鲁氏菌病的诊断和治疗效果判定试行标准”～临床上分型为:多性期,慢性活动型,慢性期相对稳定型。国外按鲁德涅夫,рудHEB,分期法分为:急性期～指患病3个月以内,亚急性期～3个月到1年,慢性期～1年以上。 concentration. Such as: 0.1015 mol/L,0.09827 mol/L and so on. The calibration standard solution concentration, is called determines, it actually is a titration process. In other words, you want acid titration with NaOH, you must first determine the exact concentration of NaOH by titration. General calibration NaOH using potassium hydrogen phthalate. Question: the exact concentrations of potassium hydrogen di-potassium acid then how come is it? it calibrated to do? said it does not need calibration. Can weigh the preparation of standard solutions. Such as potassium hydrogen di-potassium acid substance we call benchmarking. 1. benchmark benchmark: the ability to direct the preparation of calibration standard solutions or substances. Baseline must satisfy the following conditions: sufficient purity. Purity of more than 99.9%. Composition consistent with the chemical formula. With crystal water, the content should be consistent with the chemical formula. Stable. That cannot be decomposed in weighing or save time, compounding or moisture absorption. Large molar mass. Molar mass, required amount of weighing, weighing the relative error is smaller. Benchmarks are commonly used: pure metal, such as: Ag, Cu, Fe, Zn and so on; pure compounds such as K2Cr2O7,Na2CO3,Na2C2O4,ZnO, and so on. 2. preparation of standard solutions: direct method: on the analytical balance accurate weighing a certain amount of base material, dissolved in a volumetric flask and diluted to the desired size, then calculate the exact concentration of the solution, such as: K2Cr2O2 preparation of standard solutions. Direct method only applies to the base material.is very clear, otherwise it will result in an error. Preparation of 0.1mol • L-1 solution of Na2S2O3 required in scale 25G solid reagents, such as weighing on reagent in analytical balance, it is not necessary. Preparation and storage solutions can be guided by the following principles: 1. regular and substantial solutions, start preparing about 10 times times the stock solution concentration, when taking stock solution diluted 10 times. 2. easy solution of erosion or corrosion of glass to serve in glass bottles, such as fluoride salts (like NaF, NH4F, NH4HF2), caustic soda, and should be kept in polyethylene plastic bottle. 3. volatile, decomposition of the reagents and solutions, such as I2, KMnO4, H2O2, AgNO3, H2C2O4, and Na2S2O3, TiCl3, ammonia water, Br2, CCl4, CHCl3, solutions such as acetone, ethyl ether, ethanol and ...A Large-capacity measuring cups and measuring cylinders measuring small size, this reduces accuracy. Measuring liquids, graduated cylinder should be smooth and stay for more than 15 seconds after treating the surface calm, make the sight line and the graduated cylinder (Cup) of fluid meniscus at the lowest level, high or low readings will not cause major errors (see Figure 1). In General, the graduated cylinder designed glass of high precision. 2. pipette and pipette pipette and pipette is an accurate measure the precision of a certain volume of liquid instruments. Pipette is the capacity of the pot-bellied tubes, only a tick-tick-free, so the tick is the requirement under fixed temperature volume General volumes 1mL, 2mL, 5mL, 10mL, 20mL, 25mL, 50mL, 100mL and other specifications. Pipette is a linear indexing graduated pipette, 潜伏期 为7，60天～平均两周。少数患者可长达数月或1年以上。 急性期 80%起病缓慢～常出现前驱症状～其表现颇似重感冒。全身不适～疲乏无力～食纳减少～头痛肌痛、烦躁或抑郁等。持续3，5天。10，27%患者急骤起病～以寒战高热～多汗～游走性关节痛为主要表现。 发热 76.8%以上有发热.典型病例热型呈波浪状～初起体温逐日升高～达高峰后缓慢下降～热程约2，3周～间歇数日至2周～发热再起～反复数次。但据729例热型分析～目前呈典型波状热仅占15.78%～低热占42.11%～不规则热占15.36%～间歇热为12.76%～其它尚有弛张热、稽留热型等。热前多伴寒战畏寒。高热患者意识清晰～部分还可以下床活动～而热退后反感症状恶化～抑郁寡欢～软弱无力。 多汗 为本病的突出症状之一～每于夜间或凌晨退热时大汗淋漓。也有患者发热不高或处于发热间歇期仍多汗。汗味酸臭。盛汗后多数感软弱无力～甚至可因大汗虚脱。 关节痛 76.09%以上有关节痛～与发热并行。疼痛呈锥刺样或钝痛～痛剧者似风湿～辗转呻吟。但关节疼痛程度与病理改变并不平行。病变主要累及大关节～如髋、肩、膝等～单个或多个～非对称性～局部红肿。也可表现为滑膜炎～腱鞘炎、关节周围炎。少数表现为化脓性关节炎。急性期患者疼痛多呈游走性～慢性期病变已定局～疼痛固定某些关节。肌肉也痛～尤其下肢肌及殿肌～重者呈痉挛性痛。 泌尿生殖系病症 因睾丸炎及附睾炎引起睾丸肿瘤是男性患者常见症状之一～多为单侧。个别病例可有鞘膜积液、肾盂肾炎。女性患者可有卵巢炎、子宫内膜炎及乳房肿痛。但人类引起流产者少。 其它 坐骨神经、腰神经、肋间神经、三叉神经等均可因神经根受累而疼痛。脑膜、脑脊膜受累可发生剧烈头痛和脑膜刺激症。其次还可出现肝脾肿大～淋巴结肿大以及皮疹。部分患者还可出现顽固性咳嗽～咳白色泡沫痰、鼻衄、便血等。 慢性期 由急性期发展而来～也可缺乏急性病史由无症状感染者或轻症者逐渐变为慢性。慢性期症状多不明显～也有典型～呈多样表现。 慢性期活动型者 具有急性期的表现～也可长期低热或无热～疲乏无力～头痛～反应迟钝～精神抑郁～神经痛～关节痛～一般局限某一部位～但重者关节强直～变形。一部分患者自述症状很多～缺乏体征～类似神经官能症,另一部分患者表现多器官和系统损害～如骨骼肌肉持续不定的钝痛～反反复复～迁延不愈～晚期有的发展成为关节强直～肌肉挛缩～畸形～瘫痪。神经系统表现为神经炎、神经根炎～脑脊髓膜炎。泌尿生殖系统～可有睾丸炎、附睾炎、卵巢炎、子宫内膜炎等。心血管系统可有支气管炎或支气管肺炎。另外尚有肝脾肿大～淋巴结肿大,视网膜血栓性静脉炎～视神经炎,乳突炎及听神经损伤等。 慢性期相对稳定型者～症状、体征较固定～功能障碍仅因气候变化～劳累过度才加重。但久病后体力衰竭、营养不良、贫血。 牛种型病例易表现为慢性～羊种型和猪种型病例病情较重～并发症较多。近年来本病有逐渐轻化的趋势～可能与预防接种及抗生素的普遍应用有关。 患病后复发率6，10%～常在3个月以内发生。可能是细菌为细胞内寄生～不易为抗生素杀灭或者与疗程不够有关。 编辑本段诊断依据 流行病学资料 是否有流行地区居留史与病畜接触史～进食未严格消毒的乳制品及未煮熟的畜肉史。 临床表现 反复发作的发热～伴有多汗、游走性关节痛。查体发现肝脾及淋巴结肿大。如有睾丸肿大疼痛～神经痛～则基本可确诊。 实验室检查 1(血象 白细胞半数正常或轻度减少～淋巴细胞相对或绝对增多～分类可达60%以上。血沉在各期均增速。久病者有轻或中度贫血。 2(细菌学检查 患者血液、骨髓、乳汁、子宫分泌物均可做细菌培养。因牛种菌初分离困难。要求严格的环境～故各种标本最好采集两份～一份用含肝浸液的肉汤做培基～在CO2孵箱中培养,另一份放一般环境中孵育～培养时间不得短于2周。急性期阳性率高～慢性期低。骨髓标本较血液标本阳性率高。有人建议慢性布鲁氏菌病患者的血液接种到鸡胚卵黄中可获较高阳性率。 3(免疫学检查 ,1,血清凝集试验,Wright试验, 试管法较灵敏。患者多在第二周出现阳性反应～1:100以上有诊断价值。病程中效价递增4倍及以上意义更大。正常人可有低滴度的凝集素,某些传染病的假阳性率可达30%以上～如兔热病该凝集效价升高,注射霍乱疫苗的人90%可呈假阳性,接种布鲁氏菌活菌苗者～凝集效价也增高。诊断时要注意分析。另外由于抗体IgA、IgG、IgM量的比例不同～如IgA含量高则可出现患者血清低稀释度为阴性～高稀释度反为阳性的所谓前带现象。因此做该实验时应增大患者血清稀释范围。 ,2,补体结合试验补体结合抗体主要为IgG～出现较迟～持续较久～一般1:16以上即为阳性。对慢性患者有较高特异性。 ,3,抗人球蛋白试验,Coombs’tist, 用于测定血清中的不完全抗体。不全抗体可阻断完全抗体与抗原的凝集反应～使凝集试验呈假阴性。Coombs试验是使不完全抗体与不可见抗原结合的复合物通过抗人球蛋白血清结合成块～直接可见。故凝集试验阴性者可作此检查。1:160以上为阳性。 ,4,酶联免疫吸附试验,ELISA, 1:320为阳性。此法比凝集法敏感100倍～特异性也好。目前又发展有Dat-ELISA、生物素一新合素ELISA法检测～特异性更好。 ,5,皮肤试验为细胞介导的迟发型变态反应～一般发生在起病20天以后。其方法是以布鲁氏菌抗原作皮内试验～阴性有助于除外布鲁氏菌感染。阳性仅反映过去曾有过感染。接种疫苗也可呈阳性～所以对无症状的阳性者可视为本病病人。 ,6,其它实验检查 琼脂扩散～对流电泳、被动血凝试验～放射免疫及免疫荧光抗体试验等均可应用。 特殊检查 并发骨关节损害者可行X线检查,有心脏损害可做心电图,有肝损伤做肝功能检查。对于肿大的淋巴结必要时可做淋巴结活检～镜下看有无特异的肉芽肿。有脑膜或脑病变者可作脑液检查及脑电图。脑脊液变化类似结核性脑膜炎者～应当注意。 鉴别诊断 主要与伤寒、副伤寒、风湿热～肺结核～疟疾等相鉴别。鉴别时注意体会本病特征性表现～如发热伴出汗、关节痛、神经痛、全身软弱 ,游走性关节痛,高热但神志精神尚可～很少有谵妄。再结合流行病学和实验室检查可以做出正确诊断。 编辑本段诊断要点 全身性布鲁氏菌病:白细胞总数不升高～但淋巴细胞比例升高。特殊的血清凝集素反应～效价1:100为可疑～1:300者以上即可诊断。有时血培养阳性。接触性布鲁氏菌病:患者以布鲁氏菌抗原作皮试为强阳性～但既往有接触史的人～皮试也可出现阳性。补体综合试验具有较高的特异性～在病程第3周出现阳性。[1] 疾病治疗 治疗原则 concentration. Such as: 0.1015 mol/L,0.09827 mol/L and so on. The calibration standard solution concentration, is called determines, it actually is a titration process. In other words, you want acid titration with NaOH, you must first determine the exact concentration of NaOH by titration. General calibration NaOH using potassium hydrogen phthalate. Question: the exact concentrations of potassium hydrogen di-potassium acid then how come is it? it calibrated to do? said it does not need calibration. Can weigh the preparation of standard solutions. Such as potassium hydrogen di-potassium acid substance we call benchmarking. 1. benchmark benchmark: the ability to direct the preparation of calibration standard solutions or substances. Baseline must satisfy the following conditions: sufficient purity. Purity of more than 99.9%. Composition consistent with the chemical formula. With crystal water, the content should be consistent with the chemical formula. Stable. That cannot be decomposed in weighing or save time, compounding or moisture absorption. Large molar mass. Molar mass, required amount of weighing, weighing the relative error is smaller. Benchmarks are commonly used: pure metal, such as: Ag, Cu, Fe, Zn and so on; pure compounds such as K2Cr2O7,Na2CO3,Na2C2O4,ZnO, and so on. 2. preparation of standard solutions: direct method: on the analytical balance accurate weighing a certain amount of base material, dissolved in a volumetric flask and diluted to the desired size, then calculate the exact concentration of the solution, such as: K2Cr2O2 preparation of standard solutions. Direct method only applies to the base material.is very clear, otherwise it will result in an error. Preparation of 0.1mol • L-1 solution of Na2S2O3 required in scale 25G solid reagents, such as weighing on reagent in analytical balance, it is not necessary. Preparation and storage solutions can be guided by the following principles: 1. regular and substantial solutions, start preparing about 10 times times the stock solution concentration, when taking stock solution diluted 10 times. 2. easy solution of erosion or corrosion of glass to serve in glass bottles, such as fluoride salts (like NaF, NH4F, NH4HF2), caustic soda, and should be kept in polyethylene plastic bottle. 3. volatile, decomposition of the reagents and solutions, such as I2, KMnO4, H2O2, AgNO3, H2C2O4, and Na2S2O3, TiCl3, ammonia water, Br2, CCl4, CHCl3, solutions such as acetone, ethyl ether, ethanol and ...A Large-capacity measuring cups and measuring cylinders measuring small size, this reduces accuracy. Measuring liquids, graduated cylinder should be smooth and stay for more than 15 seconds after treating the surface calm, make the sight line and the graduated cylinder (Cup) of fluid meniscus at the lowest level, high or low readings will not cause major errors (see Figure 1). In General, the graduated cylinder designed glass of high precision. 2. pipette and pipette pipette and pipette is an accurate measure the precision of a certain volume of liquid instruments. Pipette is the capacity of the pot-bellied tubes, only a tick-tick-free, so the tick is the requirement under fixed temperature volume General volumes 1mL, 2mL, 5mL, 10mL, 20mL, 25mL, 50mL, 100mL and other specifications. Pipette is a linear indexing graduated pipette, ?早治疗。诊断一经确立～立即给予治疗～以防疾病向慢性发展,?联合用药～剂量足～疗程够。一般联合两种抗菌药～连用2，3个疗程,?中医结合。中医包括蒙医、藏医和汉医,?综合治疗。以药为主～佐以支持疗法～以提高患者抵抗力,增强战胜疾病的信心。 基础治疗和对症治疗 ?休息。急性期发热患者应卧床休息～除上厕所外～一般不宜下床活动,间歇期可在室内活动～也不宜过多。?饮食。应增加营养～给高热量、多维生素、易消化的食物～并给足够水分及电解质。?出汗要及时擦干～避免风吹。每日温水擦浴并更换衣裤一次。?高热者可用物理方法降温～持续不退者也可用退热剂,中毒症状重、睾丸肿痛者可用皮质激素,关节痛严重者可用5，10%硫酸镁湿敷,头痛失眠者用阿斯匹林、苯巴比妥等。?医护人员应安慰病人～做好患者思想工作～以树立信心。 抗菌治疗 急性期要以抗菌治疗为主。常用抗生素有链霉素、四环素族药物、磺胺类及TMP～另外氯霉素、利福平、氨苄青霉素也可试用。通常采用:链霉素加四环素族药物或氯霉素。链霉素1，2g/日～分两次肌注,四环素族类的四环素2g/日～分四次服,强力霉素较四环素强～仅需0.1，0.2g/日,氯霉素2g/日～分次服。第二为TMP加磺胺类药或加四环素族药。如复方新诺明,每片含TMP80mg～SMZ400mg,～4，6片/日～分两次服。为了减少复发～上述 方案 气瓶 现场处置方案 .pdf气瓶 现场处置方案 .doc见习基地管理方案.doc关于群访事件的化解方案建筑工地扬尘治理专项方案下载 的疗程均需3，6周～且可交替使用上述方案2，3个疗程。疗程间间歇5，7天。利福平为脂溶性～可透过细胞壁～抗菌谱较广～值得试用。 菌苗疗法 适用于慢性期患者～治疗机理是使敏感性增高的机体脱敏～减轻变态反应的发生。方法有静脉、肌肉、皮下及皮内注射～视患者身体情况～接受程度而守。每次注射剂量依次为40万、60万、80万、200万、350万、1050万、2550万、6050万菌体～每天、隔日或间隔3，5日注射一次。以7，10次有效注射量为一疗程。菌苗疗法可引起剧烈全身反应～如发冷、发热、原有症状加重～部分患者出现休克、呼吸困难。故肝肾功能不全者～有心血管疾病、肺结核者以及孕妇忌用。菌苗疗法也宜与抗菌药物同时应用。 水解素和溶菌素疗法 水解素和溶菌素系由弱毒布鲁氏菌经水解及溶菌后制成～其作用与菌苗相似～疗效各说不一。 中医中药疗法 没有任何证据表明～中医药或针灸对该病有任何疗效。 其它疗法 肾上腺皮质激素对中毒症状重者～伴有睾丸炎者～伴顽固性关节痛者可应用。免疫增强剂及免疫调节剂～如左旋米唑、转移因子等对调节机体免疫力可能有益。物理疗法对症治疗也可应用。 慢性期的并发症治疗可随症使用抗生素及对症措施。 编辑本段疾病预后及后遗症 一般预后良好～大部分患者即使不经治疗亦有自愈倾向。未经抗生素治疗这一般1~3月内可康复～但易复发～部分病程可达一年以上～及时治疗病程可大为缩短。慢性期可有局限性病灶后遗症～如关节和脊柱强直、肌腱挛缩变硬等[2]。 编辑本段疾病预防 在我国推广以“检疫、免疫、捕杀病畜”的综合性防治措施～同时针对疾病流行的三个环节采取相应措施～已使人间发病率由1980年的0.07/10万下降到1989年的0.03/10万。 管理传染源 对牧场、乳厂和屠宰场的牲畜定期卫生检查。检出的病畜～及时 隔离治疗～必要时宰杀之。病畜的流产物及死畜必需深埋。对其污染的环境用20%漂白粉或10%石灰乳消毒。病畜乳及其制品必需煮沸消毒。皮毛消毒后还应放臵三个月以上～方准其运出疫区。 病、健畜分群分区放牧～病畜用过的牧场需经三个月自然净化后才能供健康畜使用。 切断传播途径 加强对畜产品的卫生监督～禁食病畜肉及乳品。防止病畜或患者的排泄物污染水源。对与牲畜或畜产品接触密切者～要进行宣传教育～做好个人防护。 保护易感人群及健康家畜 除注意防护外～重要措施是进行菌苗免疫。 对接触羊、牛、猪、犬等牲畜的饲养员～挤奶员、兽医、屠宰人员、皮毛加工员及炊事员等～均应进行预防接种。人用19—BA菌苗及104M菌苗～以后者效果稍好。但免疫期均为一年～需每年接种一次～而多次接种又可使人出现高度皮肤过敏甚至病理改变。另外～接种后产生的抗体与自然产生的抗体无法鉴别～给诊断带来困难～因此近年主张不要广泛使用。新近从牛型布鲁氏菌体中提取PI～进行了人群接种～表明免疫原性强～反应较轻～并有利于感染与免疫之鉴别。将来可能代替104M活菌苗～用于人群接种。 对健康畜行预防注射～菌苗有牛型19号菌苗及猪型2号菌苗。预防注射对孕畜可引起流产～故应在配种前进行。近年牧区试验的猪型2号苗饮水免疫、羊5号菌苗气雾免疫及对羔羊和犊牛口服,100菌,免疫等都取得了很好效果～各地可因地制宜地采取。 流行期措施 当出现布病暴发流行时应尽快采取紧急措施。主要包括以下几点: 1(组建临时领导机构～包括当地人兽医的医疗行政管理人员及有关专业人员。尽快与上级有关行政和业务部门取得联系～并报告。迅速利用现有的通讯宣传设施等进行宣传教育。 2(对现患及时诊断和治疗～并对周围人群进行检疫。 3(对传染源进行调查和管理。一般采用专访及座谈～并对牲畜进行检疫。确定外传性,即疫畜来自外地,及内源性,本地疫畜,。查出的传染源及时处理,隔离和淘汰,～对各类传播因子～如流产胎儿,牛、羊、猪等,～污染乳肉等应做消毒处理或深埋、焚烧等。对传染源曾栖息之处应予以消毒处理。 4(预防接种～对疫区内高危人群,包括职业人群及非职业人群,予以104M苗免疫,对健康畜或畜群进行预防接种:牛应以S19免疫～羊应以S2苗免疫～因对猪无合适疫苗应注意观察。[3] 编辑本段中医辨治 急性期湿热毒邪外犯肌表～内侵脏腑～以邪实为主～治疗以清热化湿解毒为主,慢性期正虚邪恋～治疗以益气养血、活血通络为主～佐以清除余邪。 湿热内蕴型 相当于急性期～菌毒血症及病灶损害轻浅阶段。 症状:畏寒发热～午后热甚～身痛～脘痞～舌苔腻～脉濡数。治法:利湿化浊～清热解毒。方药:甘露消毒丹加减。藿香10克～佩兰10克～蔻仁10克～滑石15克～菖蒲10克～黄芩12克～连翘15克～木通6克～茯苓15克。水煎服～一日一剂～早晚分二次口服。 湿热伤营型 此时菌毒血症及脏器病损均较严重。 症状:烦热多汗～关节疼痛～肝脾、睾丸肿痛～舌苔黄～脉细数。治法:清热解毒～滋阴养血。方药:清营汤合三仁汤加减。丹参15克～生地15克～玄参10克～麦冬15克～黄连6克～连翘10克～郁金12克～杏仁10克～薏苡仁15克～滑石15克～芦根15克。水煎服～一日一剂～早晚分二次口服。 concentration. Such as: 0.1015 mol/L,0.09827 mol/L and so on. The calibration standard solution concentration, is called determines, it actually is a titration process. In other words, you want acid titration with NaOH, you must first determine the exact concentration of NaOH by titration. General calibration NaOH using potassium hydrogen phthalate. Question: the exact concentrations of potassium hydrogen di-potassium acid then how come is it? it calibrated to do? said it does not need calibration. Can weigh the preparation of standard solutions. Such as potassium hydrogen di-potassium acid substance we call benchmarking. 1. benchmark benchmark: the ability to direct the preparation of calibration standard solutions or substances. Baseline must satisfy the following conditions: sufficient purity. Purity of more than 99.9%. Composition consistent with the chemical formula. With crystal water, the content should be consistent with the chemical formula. Stable. That cannot be decomposed in weighing or save time, compounding or moisture absorption. Large molar mass. Molar mass, required amount of weighing, weighing the relative error is smaller. Benchmarks are commonly used: pure metal, such as: Ag, Cu, Fe, Zn and so on; pure compounds such as K2Cr2O7,Na2CO3,Na2C2O4,ZnO, and so on. 2. preparation of standard solutions: direct method: on the analytical balance accurate weighing a certain amount of base material, dissolved in a volumetric flask and diluted to the desired size, then calculate the exact concentration of the solution, such as: K2Cr2O2 preparation of standard solutions. Direct method only applies to the base material.is very clear, otherwise it will result in an error. Preparation of 0.1mol • L-1 solution of Na2S2O3 required in scale 25G solid reagents, such as weighing on reagent in analytical balance, it is not necessary. Preparation and storage solutions can be guided by the following principles: 1. regular and substantial solutions, start preparing about 10 times times the stock solution concentration, when taking stock solution diluted 10 times. 2. easy solution of erosion or corrosion of glass to serve in glass bottles, such as fluoride salts (like NaF, NH4F, NH4HF2), caustic soda, and should be kept in polyethylene plastic bottle. 3. volatile, decomposition of the reagents and solutions, such as I2, KMnO4, H2O2, AgNO3, H2C2O4, and Na2S2O3, TiCl3, ammonia water, Br2, CCl4, CHCl3, solutions such as acetone, ethyl ether, ethanol and ...A Large-capacity measuring cups and measuring cylinders measuring small size, this reduces accuracy. Measuring liquids, graduated cylinder should be smooth and stay for more than 15 seconds after treating the surface calm, make the sight line and the graduated cylinder (Cup) of fluid meniscus at the lowest level, high or low readings will not cause major errors (see Figure 1). In General, the graduated cylinder designed glass of high precision. 2. pipette and pipette pipette and pipette is an accurate measure the precision of a certain volume of liquid instruments. Pipette is the capacity of the pot-bellied tubes, only a tick-tick-free, so the tick is the requirement under fixed temperature volume General volumes 1mL, 2mL, 5mL, 10mL, 20mL, 25mL, 50mL, 100mL and other specifications. Pipette is a linear indexing graduated pipette, 正虚邪恋型 相当于慢性期～已无菌毒血症～以神经功能失调为主。 症状:烦热失眠、乏力～腰腿疼痛～身体虚弱～或已有关节变形及活动受限～舌有瘀点～脉沉细。治法:益气养血化瘀～清除余邪。方药:独活寄生汤加减。党参12克～当归10克～熟地15克～白芍15克～赤芍10克～川芎10克～丹参30克～茯神12克～桑寄生15克～秦艽15克～独活10克～黄柏10克～鸡内金6克。水煎服～一日一剂～早晚分二次口服。 针灸疗法 1毫针疗法:取穴:大椎GV14～足三里ST36～合谷LI4～风门BL12。邪在卫分加曲池LI11～内关PC6～太冲LR3,邪在气分加三阴交SP6～气海CV6～中脘CV12,肘关节疼痛加曲池LI11～手三里LI10～尺泽LU5,指关节疼痛加外关TE5～八邪EX?/FONT>VE9,髋关节疼痛加秩边BL54～环跳GB30,膝关节疼痛加膝眼EX朙E4～阳陵泉GB30等,并发睾丸炎～加三阴交SP6～行间LR2～侠溪GB43等。毫针刺～均用泻法～留针15分钟。 2电针疗法: 取穴:大椎GV14～足三里ST36～合谷LI4～风门BL12。用毫针刺入得气后～接通电针仪～行中强刺激～通电15-20分钟。每日1次。穴位注射疗法:取穴:足三里ST36～曲池LI11。用黄连素奴夫卡因注射液每穴注入3毫升～均双侧取穴。每日选用1穴～4个穴轮换～8天为1疗程～间隔3-5天再进行第2疗程。 单方验方 穿山龙2毫升,含生药1克,～每日肌肉注射1次～15次1疗程。 雄黄30克～研为细末～大蒜60瓣捣成泥状～作成60丸～每日3次～每次1丸～连服20天为1疗程。 预防: 注意防治牲畜间的布鲁氏菌病～人群气雾免疫～提高人体免疫力。加强畜产品卫生监督～对从事牲畜、兽医、畜产品加工人员～做好个人防护～并采取M?/FONT>104冻干活菌苗皮肤划痕接种免疫。 感染事件 2011年3月至5月间～东北农业大学的27名学生和1名教师相继被确诊感染了布鲁氏菌病。经查～28名师生均是因为在实验中使用了未出具检疫合格证明的山羊而染病。 2010年12月间～东北农大动物医学学院相关教师从哈尔滨市香坊区幸福镇纪家村青喜养殖场分3批购入4只山羊作为实验用品～此后共有4名教师、2名实验员、110名学生用这些山羊做了5次实验。今年3月至5月间～东北农大27名学生和1名教师～相继被确诊感染布病。 经学校查实～造成此次事故的原因为:一是购买实验山羊时～相关教师未要求养殖场出具相关检疫合格证明,二是实验前相关教师未对实验山羊进行现场检疫,三是在指导学生实验过程中～相关教师未能严格要求学生遵守操作规程、进行有效防护。学校认定此次事故是一起因相关教师在实验教学中违反有关规定造成的重大教学责任事故。此后～学校及时向学生及家长公布了事故 调查报告 行政管理关于调查报告关于XX公司的财务调查报告关于学校食堂的调查报告关于大米市场调查报告关于水资源调查报告 ～并承诺对事故承担全部法律责任。 事故发生后～东北农大立即对已发生疫情的2个实验室进行了全面消毒～并查封停止使用。此后～学校又按照实验课的开课日期对2010年11月4日至2011年3月31日期间～所有以山羊为实验动物以及在被污染的2个实验室做过实验的181名学生进行了全面排查。经布鲁氏菌血清学检测～均未感染布病。 患病师生于3月14日至5月25日在黑龙江省农垦总局总医院接受治疗。经专家会诊～25名患者达到临床治愈～1名患者好转～2名患者核磁共振检查仍提示关节腔少量积液～医生建议住院观察或门诊 随访。全部患者均未发生睾丸炎、骨质改变、脑膜炎、脊髓炎等布病常见并发症。 事故发生后～东北农大成立了由校长牵头的学校布病防控领导小组及后续处臵工作领导小组～经反复多次与学生及家长协商～提出了善后问题处理的解决方案:一是由学校承担学生本次治疗期间的医疗费及住院伙食补助费。二是经司法医学鉴定～若出现由本次布病引起的伤残～学校按伤残等级赔偿标准予以全额赔偿～鉴定费用由学校承担。三是经权威医院,三级甲等医院专科,诊断～布病复发或由本次布病感染转入慢性期～学校依法支付治疗期间的医疗费等相关费用,如出现并发症～经司法医学鉴定并发症的出现与本次布病感染存在因果关系～学校依法支付治疗期间的医疗费等相关费用,如出现由此次布病引发的不孕不育～学校依法承担法律赔偿责任。四是学生按照医院医嘱定期做针对布病的复查～由学校承担检查费、交通费等相关费用。五是通过给予学生一次性补助3万元～以及免除一年学费6000元、毕业时提供创业基金1万元、给予营养费,康复费,1万元、争取社会捐助5000元等形式～累计给予学生补助6.1万元。六是学生完成学业毕业时～学校将积极帮助推荐工作。 东北农大对事故相关责任人也作出了严肃处理:对2名实验指导教师分别给予了降级、记大过处分～调离教师岗位,对2名实验员及1名实验指导教师分别给予了记大过、记过处分,停发上述5人本年度校内津贴和年终一次性奖金～2年内不得晋升专业技术职务～并分别追偿经济责任1万元至5万元,免去了该校动物医学学院院长和院党总支书记职务。 金银滩中心卫生院 concentration. Such as: 0.1015 mol/L,0.09827 mol/L and so on. The calibration standard solution concentration, is called determines, it actually is a titration process. In other words, you want acid titration with NaOH, you must first determine the exact concentration of NaOH by titration. General calibration NaOH using potassium hydrogen phthalate. Question: the exact concentrations of potassium hydrogen di-potassium acid then how come is it? it calibrated to do? said it does not need calibration. Can weigh the preparation of standard solutions. Such as potassium hydrogen di-potassium acid substance we call benchmarking. 1. benchmark benchmark: the ability to direct the preparation of calibration standard solutions or substances. Baseline must satisfy the following conditions: sufficient purity. Purity of more than 99.9%. Composition consistent with the chemical formula. With crystal water, the content should be consistent with the chemical formula. Stable. That cannot be decomposed in weighing or save time, compounding or moisture absorption. Large molar mass. Molar mass, required amount of weighing, weighing the relative error is smaller. Benchmarks are commonly used: pure metal, such as: Ag, Cu, Fe, Zn and so on; pure compounds such as K2Cr2O7,Na2CO3,Na2C2O4,ZnO, and so on. 2. preparation of standard solutions: direct method: on the analytical balance accurate weighing a certain amount of base material, dissolved in a volumetric flask and diluted to the desired size, then calculate the exact concentration of the solution, such as: K2Cr2O2 preparation of standard solutions. Direct method only applies to the base material.is very clear, otherwise it will result in an error. Preparation of 0.1mol • L-1 solution of Na2S2O3 required in scale 25G solid reagents, such as weighing on reagent in analytical balance, it is not necessary. Preparation and storage solutions can be guided by the following principles: 1. regular and substantial solutions, start preparing about 10 times times the stock solution concentration, when taking stock solution diluted 10 times. 2. easy solution of erosion or corrosion of glass to serve in glass bottles, such as fluoride salts (like NaF, NH4F, NH4HF2), caustic soda, and should be kept in polyethylene plastic bottle. 3. volatile, decomposition of the reagents and solutions, such as I2, KMnO4, H2O2, AgNO3, H2C2O4, and Na2S2O3, TiCl3, ammonia water, Br2, CCl4, CHCl3, solutions such as acetone, ethyl ether, ethanol and ...A Large-capacity measuring cups and measuring cylinders measuring small size, this reduces accuracy. Measuring liquids, graduated cylinder should be smooth and stay for more than 15 seconds after treating the surface calm, make the sight line and the graduated cylinder (Cup) of fluid meniscus at the lowest level, high or low readings will not cause major errors (see Figure 1). In General, the graduated cylinder designed glass of high precision. 2. pipette and pipette pipette and pipette is an accurate measure the precision of a certain volume of liquid instruments. Pipette is the capacity of the pot-bellied tubes, only a tick-tick-free, so the tick is the requirement under fixed temperature volume General volumes 1mL, 2mL, 5mL, 10mL, 20mL, 25mL, 50mL, 100mL and other specifications. Pipette is a linear indexing graduated pipette,