红细胞分布宽度及血小板参数在急性心肌梗死诊断中的应用研究

目的观察急性心肌梗死(AMI)患者红细胞分布宽度(RDW)、血小板计数(PLT)、平均血小板体积(MPV)、血小板分布宽度(PDW)的变化,并探讨其数值变化在急性心肌梗死诊断中的应用。方法选取我院2014年1月至2015年8月期间收治的AMI患者50例(AMI组),分别检测入院时的RDW、PLT、MPV、PDW,同时选择50例健康体检者作为对照组,所有标本采用全自动血细胞分析仪进行RDW、PLT、MPV、PDW的检测。结果 AMI组的RDW、MPV、PDW水平均显著高于对照组(P<0.05),多因素Logistic回归分析显示,高RDW、MPV、PDW水平为AMI的独立危险因素。结论 RDW、MPV、PDW水平升高与AMI发病有关,监测红细胞分布宽度及血小板参数的变化有助于对怀疑急性心肌梗死患者的诊断。     

冠心病患者血小板参数的测定分析

目的 探讨血小板参数在冠心病（CHD）患者中的变化及临床意义。方法 对83例CHD患者和83例健康体检者的血小板含量（PLT）、平均血小板体积（MPV）和血小板分布宽度（PDW）进行检测比较。结果 冠心病组的PLT、MPV和PDW分别为（225±78）×109/L、9.85±1.61fl、18.78±0.72%,对照组的PLT、MPV和PDW分别为（219±72）×109 /L、8.53±0.95fl、16.57±0.53%。经统计学处理,冠心病组的MPV和PDW明显增大,与对照组比较差异具有显著性（P0.05）。结论 血小板体积变大和活化过程与冠状动脉血栓形成有关,是冠心病的危险因子。     

肺癌患者化疗后血小板参数的变化研究

目的探讨肺癌患者化疗后血小板参数的变化及其临床意义。方法用Sysmes1800i全自动血液分析仪对正常健康人、肺癌患者化疗期间血液血细胞参数白细胞(WBC)、血小板(PLT)、血小板平均体积(MPV)、血小板分布宽度(PDW)、大血小板比率(PLCR)等参数进行比较。结果患者组血小板分布宽度(PDW)化疗前后有显著变化(P<0.01),提示肺癌患者化疗后PDW减小是其特征性变化;血小板无明显变化(PLT,P>0.05),血小板平均体积减小(MPV),差异有统计学意义(P<0.05);PLCR无明显变化;正常健康组血白细(WBC,n=45,5.27±1.17),患者组白细胞(n=34,3.10±0.64)。结论血小板分布宽度(PDW)是肺癌患者化疗后骨髓抑制敏感指标。     

四项血小板参数在重症肺炎患儿中的检测及意义

目的:探讨四项血小板参数在重症肺炎患儿中的检测及意义。方法:采用日本SysmexSF23000分析仪检测65例重症肺炎患儿和60例正常对照儿童血浆血小板计数(PLT)、平均血小板体积(MPV)、血小板分布宽度(PDW)、血小板压积(PCT)水平。结果:重症肺炎组PLT、MPV、PDW、PCT明显高于对照组(P<0.05),恢复期组PLT、MPV、PDW、PCT明显低于急性期组(P<0.05)。结论:重症肺炎患儿血小板四项参数PLT、MPV、PCT、PDW水平明显升高,并且急性期明显高于恢复期,临床应密切关注血小板参数变化。     

血小板参数与急性脑梗死发病的相关性研究

目的研究急性脑梗死患者发病与血小板参数的改变之间的相关性。方法对68例急性脑梗死患者和68名健康体检者(对照组)的血小板参数进行检测,主要包括PLT(血小板计数)、IPF(未成熟血小板比率)、MPV(血小板平均体积)和PDW(血小板分布宽度),68例急性脑梗死患者按不同的发病时间分为1周组和2周组,每组34例患者,比较两亚组和对照组之间血小板参数存在的差异。结果急性脑梗死患者发病1周组与对照组比较,PLT、IPF值、MPV和PDW均存在明显差异,具有统计学意义(P<0.05)。急性脑梗死患者发病2周组与对照组比较,PDW的比较存在明显差异,具有统计学意义(P<0.05),PLT、IPF值和MPV的比较无明显差异,不具有统计学意义(P>0.05)。结论急性脑梗死患者血小板参数的改变与其病情的变化有着密切的联系,监测急性脑梗死患者血小板参数的变化,有助于急性脑梗死患者的临床治疗和预后的判断。     

高同型半胱氨酸血症患者血小板参数检测的临床意义

目的观察高同型半胱氨酸血症(HHcy)患者血小板参数的变化,并对其临床价值做初步评价。方法检测65例HHcy患者,50例健康体检者(正常对照组)的血小板计数(PLT)、平均血小板体积(MPV)、血小板压积(PCT)、血小板分布宽度(PDW)及大血小板比率(P-LCR)水平,分析Hcy与PLT、MPV、PCT、PDW及P-LCR的相关性。结果HHcy患者PLT、MPV、PDW及P-LCR水平与对照比较,均明显增高,差异均具有统计学意义(P0.05),PCT水平与对照组比较,差异无统计学意义(P0.05)。HHcy患者血清Hcy水平与MPV、PDW及P-LCR呈明显正相关(P0.05)。结论 HHcy患者血小板参数变化明显,提示Hcy可以通过增加血小板活性,在血栓性疾病发生、发展中起重要的作用。     

血小板参数对川崎病诊断的临床意义

目的探讨小儿川崎病发病第1周、第2~3周血小板参数的变化和临床意义。方法对78例川崎病患儿(病例组)及78例同期体检健康儿童(对照组)取静脉全血用ADVIA2120全自动血液细胞分析仪测定血小板数(PLT)、血小板压积(PCT)、血小板平均体积(MPV)、血小板体积分布宽度(PDW)。对疾病组和对照组血小板参数分别进行比较,并对血小板各参数进行相关性分析。结果川崎病患儿发病第1周PLT、PCT明显高于对照组(P0.05),PDW低于对照组(P0.05),MPV与对照组比较差异无统计学意义;川崎病患儿发病第2~3周PLT、PCT明显高于对照组(P0.05),MPV、PDW均低于对照组(P0.05);川崎病发病第2~3周PLT、PCT高于川崎病发病第1周,川崎病发病第2~3周MPV、PDW低于川崎病发病第1周。川崎病患儿PLT与MPV、PDW呈负相关(r=-0.391;r=-0.362);PLT与PCT呈正相关(r=0.969);PCT与PDW呈负相关(r=-0.356);MPV与PCT、PDW无相关性(r=-0.207;r=0.226)。结论血小板参数变化对川崎病诊断有非常重要意义,并可作为判断患儿病情及指导临床治疗用药的指标。     

血小板参数的变化在急性脑梗死患者中的临床意义

目的 检测外周血血小板参数的变化在急性脑梗死(CI)患者诊疗中应用价值.方法 应用全自动血细胞分析仪,对82例急性脑梗死患者及50例健康体检者(对照组)进行血小板参数[主要指血小板计数(PLT)、未成熟血小板比率(IPF)、血小板平均体积(MPV)、血小板分布宽度(PDW)]的检测,82例患者按不同发病时间段分为1～7d及8～14d两个检测组各41例,分别与对照组进行血小板参数的比较.结果 CI发病1～7d组与健康对照组比较,IPF值两组比较差异有显著统计学意义(P＜0.01),PLT、MPV、PDW两组对比差异有统计学意义(P ＜0.05); CI发病8～14d组与健康对照组比较,PDW两组比较差异有统计学意义(P＜0.05),PLT、MPV、IPF两组比较差异无统计学意义(P＞0.05).结论 监测急性脑梗死患者外周血血小板参数不同时间段的变化,有助于临床观察脑梗死患者病情的疗效及预防、预后的判断.     

急性心肌梗死患者血小板相关参数与血清同型半胱氨酸测定的临床意义

目的:观察急性心肌梗死(AMI)患者的血小板相关参数、血清同型半胱氨酸的变化,探讨其检测在急性心肌梗死中的意义。方法:测定对照组与急性心肌梗死组治疗前后的血小板计数(PLT)、平均血小板体积(MPV)、血小板分布宽度(PDW)及血清同型半胱氨酸(Hcy)并对检验结果进行分析。结果:与对照组相比,AMI组治疗前MPV与PDW水平明显升高(P<0.01),Hcy水平升高(P<0.05),PLT水平明显降低(P<0.01),两组差别具有统计学意义,AMI组治疗后PLT水平上升,MPV、PDW、Hcy水平下降,与对照组相比差别无统计学意义。结论:监测血小板参数和Hcy的变化,有助于对急性心肌梗死的治疗和预后。     

脑梗死患者血小板参数检测30例分析

目的:探讨血小板参数血小板计数PLT,血小板压积PCT,平均血小板体积MPV,血小板体积分布宽度PDW在脑梗死疾病中的变化。方法:全自动血液细胞分析仪检测30例脑梗死患者血小板4项参数,并与对照组正常人50例进行比较。结果:脑梗死患者的血小板计数PLT和血小板压积PCT明显减少,存在显著性差异(P<0.05),血小板体积分布宽度PDW、平均血小板体积MPV明显升高,存在显著性差异(P<0.05)。结论:血小板参数检测对脑梗死患者有重要意义。     

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.