扁桃体非霍奇金淋巴瘤的临床病理及分型的研究

目的探讨扁桃体非霍奇金淋巴瘤的临床表现、病理组织形态、免疫表型的特点及分型。方法收集1998年1月~2004年9月36例扁桃体非霍奇金淋巴瘤活检病例的临床资料、复查HE切片及免疫组织化学标记。结果病变部位:左侧扁桃体17例,右侧扁桃体14例,双侧扁桃体5例。其中以弥漫性大B细胞淋巴瘤最多见(17/36),滤泡性淋巴瘤次之(9/36),结外边缘区B细胞淋巴瘤(2/36)、外周T细胞淋巴瘤(6/36)、鼻外NK/T细胞淋巴瘤(2/36)较少。结论扁桃体非霍奇金淋巴瘤与其他结外淋巴瘤相同,是组织形态、免疫表型、生物学行为均不同的多种类型淋巴瘤。     

结外鼻型NK／T细胞淋巴瘤的临床及病理学特征分析

目的总结结外鼻型NK／T细胞淋巴瘤的临床病理组织学特征。方法回顾性分析21例结外鼻型NK／T细胞淋巴瘤的临床表现、病理组织学特点,采用免疫组化SP法检测结外鼻型NK／T细胞淋巴瘤免疫表型、病毒EBV等表达情况。结果镜下21例均有不同程度的毛细血管增生,18例可见明确的肿瘤细胞以血管为中心呈破坏性浸润,表现为肿瘤细胞在血管内膜下及管壁内浸润,多种炎症细胞混合浸润,1例可见鳞状上皮假瘤样增生,21例的肿瘤细胞均为T细胞分化抗原CD45RO（＋）,NK细胞相关抗原CD56（＋）,T细胞颗粒相关抗原TIA．1（＋）,EBV（＋）。结论结外鼻型NK／T细胞淋巴瘤有特征性临床、病理学改变,根据典型的临床表现、病理形态学改变、免疫表型特点及EBV原位杂交阳性可作出准确诊断。     

扁桃体恶性淋巴瘤的临床分析

目的探讨扁桃体恶性淋巴瘤的临床特点、诊断及治疗.方法回顾分析1995年元月～2002年12月收治的21例扁桃体恶性淋巴瘤的临床资料.结果扁桃体恶性淋巴瘤占同期恶性淋巴瘤的5.4%,占同期结外淋巴瘤的10.3%,61.9%的患者表现为咽痛,52.4%的患者表现为咽部异物感,21例患者均为非霍奇金淋巴瘤,78.6%的患者为B细胞淋巴瘤,7例接受规则放化疗的患者6例生存期均已超过3年.结论扁桃体恶性淋巴瘤是比较常见的结外淋巴瘤,临床表现缺乏特异性,误诊率高,扁桃体恶性淋巴瘤主要为非霍奇金淋巴瘤,多数来源于B细胞,患者对放化疗敏感.     

形态学联合流式细胞术对淋巴瘤骨髓浸润的应用

目的探讨形态学检查联合流式细胞术(FCM)对淋巴瘤骨髓浸润的临床应用。方法对77例淋巴瘤患者的骨髓标本行FCM免疫表型、涂片及活检,观察骨髓受累率,并初步评价其临床价值。结果 11例霍奇金淋巴瘤(HL)切片法仅发现1例骨髓受累;66例非霍奇金淋巴瘤(NHL)中,FCM检出41例,涂片法检出8例,切片法检出19例。FCM发现的41例中,18例为早期浸润(瘤细胞5%);20例为小细胞淋巴瘤(SLL);2例为浆细胞性淋巴瘤,2例为滤泡性淋巴瘤,1例同时表达T、B细胞抗原。结论形态学联合FCM检查提高了骨髓受累的检出率,免疫表型对早期浸润和SLL有重要诊断价值。     

67例面中线非霍奇金淋巴瘤临床病理及其EBV感染关系

目的 探讨面中线非霍奇金淋巴瘤(Non-Hodgkin’s lymphma，NHL)的临床病理特点及其与EBV感染的关系。方法 应用免疫组化SP法检测多种抗体标记T淋巴细胞(CD45RO、CD56、TIA-1)和B淋巴细胞(CD20、CD45RA)，同时进行EBV原位杂交检测。结果 (1)67例病例中，男女之比为2．7：1，平均年龄43岁，发病部位多位于鼻腔；(2)按照WHO新分类法，67例中B细胞淋巴瘤有31例(47．4％)，NK／T细胞淋巴瘤有30例(46．2％)，外周T(非特殊类)细胞淋巴瘤有6例(9．1％)；(3)67例中有27例EBER1／2检测表达阳性(40．3％)，其中25例为NK／T细胞淋巴瘤，2例为外周T(非特殊类)细胞淋巴瘤，31例B细胞淋巴瘤均表达阴性。结论 面中线NHL以NK／T细胞淋巴瘤多发，EBV感染与淋巴瘤组织类型有关，与部位无关。     

咽部及鼻部非霍奇金淋巴瘤EBV感染与分型的相关性研究

目的探讨咽部及鼻部非霍奇金淋巴瘤(NHL)EB病毒(EBV)感染与分型的相关性,为NHL的临床诊治提供参考。方法选取2015年3月-2016年3月诊治127例咽部及鼻部NHL患者NHL病变组织标本,进行免疫组化染色SP法及EBVR-1的原位杂交检测,分析结果。结果 86例为NK/T细胞淋巴瘤、31例为B细胞淋巴瘤、10例为T细胞淋巴瘤,构成比分别为67.72%、24.41%、7.87%,鼻腔及咽部NHL患者以NK/T细胞淋巴瘤为主,分别占81.58%、66.67%,扁桃体NHL患者以B细胞淋巴瘤为主,占62.50%,以上各病变部位的以NK/T细胞淋巴瘤与B细胞淋巴瘤分型之间比较差异均有统计学意义(P<0.05);NK/T细胞淋巴瘤患者85例EBVR-1阳性,B细胞淋巴瘤患者14例EBVR-1阳性,T细胞淋巴瘤患者7例EBVR-1阳性,阳性率分别为98.84%、45.16%、70.00%,不同淋巴瘤分型的EBVR-1阳性率比较差异有统计学意义(P<0.05)。结论咽部和鼻部NHL分型以NK/T细胞淋巴瘤多见,但扁桃体部位则以B细胞淋巴瘤多见,EBV感染在NK/T细胞淋巴瘤发生及发展中可能起到极为重要作用。     

乙型肝炎病毒感染对B细胞性非霍奇金淋巴瘤预后的影响

目的探讨乙型肝炎病毒感染对B细胞性非霍奇金淋巴瘤预后的影响。方法应用ELISA法测定B细胞性非霍奇金淋巴瘤患者确诊时的乙型肝炎病毒抗原抗体两对半。结果28例B细胞性非霍奇金淋巴瘤患者中,伴乙型肝炎病毒感染者12例（占43％）,表面抗原阳性者4例（占14％）;伴乙型肝炎病毒感染的B细胞性非霍奇金淋巴瘤患者的化疗后完全缓解率低于无乙型肝炎病毒感染的B细胞性非霍奇金淋巴瘤患者。结论携带乙型肝炎病毒的B细胞非霍奇金淋巴瘤患者化疗后肝功能损害的发生率高,且与乙型肝炎病毒阴性组对比,患者预后不佳。     

鼻腔NK/T细胞淋巴瘤25例病理分析

鼻腔NK/T细胞淋巴瘤是一种少见、类型特殊的结外非霍奇金淋巴瘤,临床及病理诊断有时非常困难,极易造成误诊.本文收集鼻腔NK/T细胞淋巴瘤25例,进行总结分析,旨在提高临床及病理的诊断水平,减少误诊.     

鼻型NK／T细胞淋巴瘤

鼻型NK／T细胞淋巴瘤是一种来源于NK／T细胞，以面部中线部位的组织破坏为特征，并与EB病毒密切相关的一类淋巴瘤。新近WHO对淋巴组织肿瘤分类，认为本病是非霍奇金淋巴瘤（NHL）的一个独立病种。     

22例恶性淋巴瘤临床病理分析

目的 :根据WHO(2008版)造血和淋巴肿瘤分类标准,对22例淋巴瘤临床特征、临床病理特征进行分析探讨,以提高对淋巴瘤的临床病理特征及分类的认识.方法 :收集沭阳仁慈医院2010年1月-2015年12月病理诊断为恶性淋巴瘤22例患者,复习其临床资料,观察HE切片病理组织学形态与细胞学形态,并对淋巴瘤的类型、免疫组化标记结果 进行分析与探讨,按WHO(2008版)淋巴组织肿瘤分类标准,进行病理诊断与分类分型.结果:(1)22例淋巴瘤中,非霍奇金淋巴瘤(NHL)21例(95.4%),霍奇金淋巴瘤1例(4.6%).NHL21例中B细胞淋巴瘤15例(71.4%),T和HK细胞淋巴瘤6例(28.5%).B细胞性淋巴瘤15例中,弥漫性大B细胞淋巴瘤(DLBL)11例(73.3%),套细胞淋巴瘤2例(13.3%),滤泡性淋巴瘤1例(6.6%),小B细胞性淋巴瘤1例(6.6%);T细胞和NK细胞淋巴瘤6例,其中NK/T细胞性淋巴瘤4例(66.6%),其中鼻型NK/T细胞淋巴瘤3例,鼻外型NK/T细胞淋巴瘤1例,周围T细胞淋巴瘤非特异性1例,间变性大细胞淋巴瘤ALK-1例.(2)22例HL和NHL中,男性18例,女性4例,男女比例为4.5:1,发病年龄35-81岁,平均年龄60岁,病位以颈部淋巴结多见.结论 :22例淋巴瘤中,NHL发病远多于HL,NHL中以DLBCL多见;发病多见于中老年人,男性患者多见,以颈部淋巴结为多见起病部位.     

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.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.