尘肺病患者血清PDGF和PⅢNP含量的测定

目的 探讨血小板源性生长因子(PDGF)和Ⅲ型前胶原氨基末端肽(PⅢNP)在尘肺病发生、发展中的意义.方法 采用双抗体夹心法,测定77例尘肺病患者(包括32例矽肺、45例煤工尘肺)和77例健康对照者血清PDGF和PⅢNP的表达水平.结果 尘肺病患者血清PDGF和PⅢNP含量分别为(36.31±3.31)ng/ml、(12.59±2.24)ng/ml,对照组则分别为(23.99±2.14)ng/ml、(9.33±2.63)ng/ml,差异均有统计学意义(P＜0.05);矽肺患者血清PDGF和PⅢNP含量均高于煤工尘肺患者,差异有统计学意义(P＜0.05);尘肺血清PDGF和PⅢNP呈线性关系且含量随着期别的增加而降低,差异有统计学意义(P＜0.05).结论 尘肺病患者血清PDGF和PⅢNP含量可能与尘肺病的发生、发展有关,能否作为尘肺病血清生物标志物有待进一步探讨.     

煤工尘肺患者血清铜蓝蛋白活性与微量元素Cu、Zn相关性的探讨

目的和方法 为探讨煤工尘肺的发病机理,用火焰原子吸收法对48名煤工尘肺患者及40名健康对照者血清微量元素Cu、Zn进行了测定,同时用对苯对苯二胺盐酸盐法测定了血清铜蓝蛋白活性,并对两者进行相关分析。结果 煤工尘肺患者血清铜蓝蛋白活性、血清Cu、Cu/Zn明显高于对照组（P＜0．01）,而血清Zn则明显低于对照组（P＜0．05）。随着煤工尘肺病程的不同,测试指标均有明显改变（P＜0．05）。结论 长期接触煤尘可使血清含铜酶活性改变,且该酶活性改变与体内某些微量元素密切相关。     

煤工尘肺患者血中一氧化氮自由基含量的改变

目的　探讨一氧化氮等自由基与煤工尘肺发生发展的关系。方法　系统测定 16 3例不同期别煤工尘肺患者(0 →Ⅰ→Ⅱ→Ⅲ )及 40例健康对照者血清一氧化氮 (NO)、过氧化脂质 (LPO)、总巯基 (T SH)含量及超氧化物歧化酶同功酶 (SODs)活性。结果　与对照组相比 ,各期别煤工尘肺机体血清NO含量、LPO水平均显著升高 ,而总巯基含量则显著下降 ,血清总SOD活性亦呈代偿性增加 ,且表现为MnSOD活性的显著增加。结论　煤工尘肺发生过程中体内一氧化氮及氧自由基反应呈病理性加剧 ,氧化 /抗氧化状态严重失衡。     

煤工尘肺患者血清白细胞介素6及其可溶性受体的含量及临床意义

目的　探讨血清白细胞介素6(IL-6)和可溶性IL-6受体(sIL-6R)水平与煤工尘肺的关系及临床意义。方法　采用ELISA法检测56例煤工尘肺患者及126名有相同接尘史但未患尘肺的煤矿工人(对照组)血清IL-6及sIL-6R的水平。结果　尘肺患者血清IL-6平均水平为(14.0±13.1)pg/ml,高于对照组［(7.2±8.2)pg/ml］,差异有显著性(P<0.01)。多元线性回归分析表明,尘肺患者血清IL-6水平与尘肺期别呈正相关(r=0.451,P<0.01);尘肺患者血清sIL-6R水平与对照组的差异无显著性(P>0.05)。结论　IL-6可能参与了尘肺的发病过程,测定尘肺患者血清IL-6可能对病情监测有一定参考价值。     

煤工尘肺患者血清铜、锌和血、尿硒含量变化的观察

对４６例煤工尘肺患者血清铜、锌及血、尿硒含量进行了测定。煤工尘肺患者的血清铜含量增高，血清锌含量及锌／铜比值减低。Ⅲ期患者血硒含量有明显降低，尿硒排出增高。煤工尘肺患者，特别是晚期患者适当补充锌和硒有助于提高机体防御机能，增强抵抗力，延缓肺纤维化的发展。     

煤工尘肺患者血清白细胞介素6及其可溶性受体含量的变化

目的探讨煤工尘肺患者血清白细胞介素6(IL -6)和可溶性IL-6受体(sIL-6R)水平的变化.方法用酶联免疫吸附试验法(ELISA法)检测148例不同期别煤工尘肺患者[无尘肺(0 )→Ⅰ→Ⅱ]及40例健康对照者血清的IL-6及sIL-6R水平.结果对照组、无尘肺(0 )组、Ⅰ期尘肺组及Ⅱ期尘肺组人群血清IL-6平均水平分别为:(7.1±6.8)、(7.9±6.8)、(12.6±11.7 )、(24.6±21.5)ng/L,统计学处理差异有显著性(P<0.05).但煤工尘肺患者血清sIL-6R水平与对照组的差异无显著性意义(P>0.05).结论 IL-6 介入了煤工尘肺的发生和发展过程,血清IL-6检测可能对煤工尘肺的早期诊断、疗效判断及病情监测有一定参考价值.     

957例煤工尘肺死亡病例回顾性调查分析

[目的]研究尘肺病患者的死亡规律,为尘肺防治提供科学依据。[方法]对1964-1999年间某煤矿企业957例煤工尘肺死亡病例进行回顾性调查分析。[结果]①1995-1999年间死亡的尘肺病人数是1964-1969年的14.1倍, 近期该企业尘肺患者仍处于死亡高峰期。②死因构成中列前4位的是尘肺、肺结核、慢性肺心病、肺癌,构成比分别为21.9%、20.3%、19.5%、8.9%;不同期别尘肺死亡病例中,死亡原因的构成比顺序有所不同。随着时间的推移尘肺死因构成顺序发生了变化,肿瘤、脑血管意外的构成比由20世纪60年代的6.6%、3.3%上升到90年代后期的13.3%、11.8%。③尘肺病人寿命呈明显延长趋势,由1969年的48.3岁延长至1999年的71.4岁,平均每5年延长约4岁。④尘肺死亡病例中肺结核合并率为25.8%,不同期别间有显著性差异(P<0.01),随尘肺期别升高肺结核合并率上升,Ⅲ期尘肺死亡病例中60.5%合并有肺结核。尘肺合并结核患者的病程平均为(7.6±5.7)年,显著短于单纯尘肺患者的平均病程(11.7±6.9) 年(P<0.01);尘肺合并结核患者平均死亡年龄为(58.9±9.7)岁,显著小于单纯尘肺患者(65.1±9.4)年(P<0.01)。⑤尘肺死亡病例的发病潜伏期为31.5年。[结论]尘肺患者寿命显著延长,但尘肺及其并发症仍严重威胁尘肺患者的生命, 防治并发症是提高尘肺患者生命质量的关键。     

矽肺和煤工尘肺患者脂质过氧化状态的比较研究

已有学者分别对矽肺和煤工尘肺患者的脂质过氧化状态进行了研究[1,2 ] ,但未见两种尘肺的比较研究。为探讨矽肺和煤工尘肺患者脂质过氧化的差异 ,我们对矽肺和煤工尘肺患者及其对照组的血清丙二醛 (ＭＤＡ)含量、超氧化物歧化酶(ＳＯＤ)和谷胱甘肽过氧化物酶 (ＧＳＨ Ｐｘ)活力进行了比较。一、对象与方法1.对象 :矽肺组为男性患者 10 0例 ;煤工尘肺组为男性患者 47例 (均系职业病诊断组集体诊断的病例 ,受检前全部患者再次复查胸片 ,诊断确切 ) ,其中Ⅰ期矽肺组 5 8例 ,Ⅱ Ⅲ期矽肺组 42例 ;Ⅰ期煤工尘肺组 2 5例 ,Ⅱ Ⅲ期煤工尘肺组2 2…     

尘肺患者血清中铜蓝蛋白和免疫球蛋白含量的分析

目的研究尘肺患者血清中铜蓝蛋白(CP)及免疫球蛋白含量的变化,为尘肺病的诊断、分期以及防治工作提供依据。方法采用免疫透射比浊法对2009—2010年广东省职业病防制院住院部103例不同期别的尘肺病人以及未接触过粉尘作业的30名门诊体检人员进行血清中铜蓝蛋白和免疫球蛋白有关指标的测定。检测结果用两两比较的t检验进行统计学分析。结果与对照组相比,尘肺患者血清中CP含量与免疫球蛋白,尤其是IgG和IgA的含量升高,差异均有统计学意义(P<0.05);与Ⅰ期尘肺患者相比,Ⅱ、Ⅲ期尘肺患者CP、IgG、IgA和IgM含量呈递增趋势,经统计学分析,差异有统计学意义(P<0.05)。结论尘肺患者血清中CP含量的升高与免疫球蛋白,尤其是IgG和IgA的含量升高对尘肺患者临床诊断、分期、预后以及尘肺病发病机制的探讨有一定的意义。     

血清SOD、MDA水平与煤工尘肺相关性的研究

目的通过研究煤矿工人血清SOD与MDA水平 ,探讨其与煤工尘肺发病和病情变化的关系。方法采用黄嘌呤氧化酶法和TBA法分别检测72名煤工尘肺患者和110名未患尘肺的接尘工人的血清SOD与MDA水平。结果尘肺组血清SOD平均水平 (105.6±24.2unit/ml)明显高于对照组 (84.9±33.1unit/ml) ,差异有显著性意义 (P<0.05) ;尘肺患者血清SOD水平随着尘肺期别的晋级而相应地升高 ,多元线性回归分析表明,尘肺患者的尘肺期别与血清SOD水平呈正相关(r=0.50,P<0.01) ;尘肺患者血清MDA平均水平与对照组的差异无显著性(P>0.05)。结论SOD与尘肺的发生发展过程有关 ,SOD水平的变化可能预示着尘肺病情的发展变化。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.