宫颈癌变中叶酸缺乏与脆性组氨酸三联体基因表达异常的相互作用

目的 探讨叶酸缺乏与脆性组氨酸三联体(FHIT)基因异常表达在宫颈癌发生发展中的相互作用。方法 选取经病理学确诊的宫颈炎症(CI)患者80例、低度宫颈上皮内瘤样变(CINⅠ)患者55例、高度宫颈上皮内瘤样变(CINⅡ/Ⅲ)患者55例以及宫颈鳞状细胞癌(SCC)患者64例作为研究对象。采用微生物法测定其血清叶酸水平、甲基化特异性PCR检测FHIT基因CpG岛甲基化状况。Western blot法检测宫颈组织中FHIT蛋白的表达水平。同时采用体外细胞试验方法, 对宫颈癌细胞CaSki(HPV16阳性)进行叶酸干预, 检测不同叶酸浓度下的相关指标的变化。利用SPSS 17.0软件进行相关资料的χ²检验、Kruskal-Wallis检验、Spearman秩相关分析, 应用相加模型进行交互作用评价。结果 随着宫颈病变的加重, 血清叶酸含量逐渐降低(H=59.08, P<0.001), FHIT基因CpG岛甲基化率逐渐升高(趋势检验χ²=28.34, P<0.001), FHIT蛋白表达量逐渐降低(H=50.93, P<0.001)。血清叶酸含量与FHIT蛋白表达量呈正相关(r=0.213, P=0.001), 在CINⅠ、CINⅡ/Ⅲ、SCC组中两者均呈现正相加交互作用。细胞试验显示, 随着叶酸浓度增加, 宫颈癌细胞的增殖抑制率(r=0.98, P<0.001)和凋亡率(r=0.99, P<0.001)逐渐增高, FHIT基因CpG岛甲基化程度逐渐减弱, FHIT蛋白的表达量逐渐升高(r=0.97, P<0.001)。结论 叶酸缺乏和FHIT蛋白异常低表达均可增加宫颈癌和癌前病变的发生风险, 两者在宫颈癌变中存在正相加交互作用。     

脆性组氨酸三联体、甲基-CpG-结合蛋白2异常表达与宫颈癌变的关系及交互作用

目的 探讨脆性组氨酸三联体（FHIT）与甲基-CpG-结合蛋白2（MeCP2）异常表达在宫颈癌变中的交互作用。方法 选择经病理学确诊的宫颈鳞状细胞癌（SCC）患者73例,宫颈上皮内瘤样变（CIN）患者113例（CINⅠ45例;CINⅡ/Ⅲ68例）和宫颈正常（NC）妇女60人作为研究对象,分别采用荧光定量PCR和Western blot检测宫颈组织中FHIT及MeCP2 mRNA和蛋白的表达量,甲基化特异性PCR（MSP）检测FHIT基因CpG岛甲基化状态。利用SPSS 20.0软件进行相关资料的Kruskal-Wallis H检验、χ²检验、χ²趋势检验和Spearman秩相关分析,应用广义多因子降维模型（GMDR）评价交互作用。结果 随着宫颈癌变的进展,FHIT基因CpG岛甲基化率（χ²=18.64,P<0.001,趋势检验χ²=18.08,P<0.001）逐渐升高,FHIT mRNA（H=27.32,P<0.001;趋势检验χ²=12.65,P<0.001）与蛋白（H=47.10,P<0.001;趋势检验χ²=29.79,P<0.001）表达量逐渐降低,且FHIT基因CpG岛甲基化率与FHIT蛋白表达量呈负相关（r=-0.226,P<0.001）。MeCP2 mRNA（H=26.19,P<0.001;趋势检验χ²=11.81,P=0.001）与蛋白（H=69.02,P<0.001;趋势检验χ²=47.44,P<0.001）表达量均逐渐升高。MeCP2蛋白表达量与FHIT mRNA Ct比值呈正相关（r=0.254,P<0.001）,与FHIT蛋白表达量呈负相关（r=-0.213,P=0.001）。GMDR交互作用分析表明,在CINⅡ/Ⅲ组,MeCP2蛋白高表达、FHIT基因CpG岛甲基化及mRNA和蛋白低表达存在交互作用;在SCC组,MeCP2 mRNA和蛋白高表达、FHIT基因CpG岛甲基化及mRNA和蛋白低表达存在交互作用。结论 MeCP2 mRNA和蛋白高表达、FHIT基因CpG岛甲基化及mRNA和蛋白低表达,均可增加宫颈癌变的风险,且在宫颈癌变中具有协同作用。     

hnRNP K在宫颈上皮内瘤样变中的作用及其与HPV16交互效应

目的 探讨hnRNP K与HPV16感染在宫颈上皮内瘤样变（CIN）中的作用及其交互效应。方法 选取2014年6月至2015年6月在山西省介休市建立的社区队列中经病理学确诊的正常宫颈（NC）女性67例和CIN患者137例（CINⅠ患者69例、CINⅡ/Ⅲ患者68例）为研究对象。采用结构式问卷收集研究对象人口学资料及宫颈病变相关因素的基础上，采集宫颈脱落细胞和宫颈活检或手术组织，应用分子导流杂交法检测HPV16感染状况，并采用Western blot技术检测宫颈组织中hnRNP K蛋白表达水平。采用SPSS 23.0软件对资料进行整理分析，研究对象的人口学特征、相关因素、hnRNP K蛋白和HPV16感染在NC组、CINⅠ和CINⅡ/Ⅲ组的差异通过χ²检验、趋势χ²检验、Kruskal-Wallis H检验进行比较；hnRNP K蛋白表达量的组间两两多重比较采用Bonferroni法；采用非条件logistic回归模型计算hnRNP K蛋白、HPV16感染与CIN的关联强度OR值及其95% CI，采用相加交互模型及交互效应指标评价hnRNP K蛋白和HPV16感染两因素在CIN中的交互效应。结果 CINⅡ/Ⅲ组HPV16感染率（41.2%）高于NC（10.4%）、CINⅠ（14.5%），差异有统计学意义（P<0.001），且随着CIN程度加重，HPV16的感染率呈上升趋势（趋势χ²=18.512）。hnRNP K蛋白表达量在NC组、CINⅠ组和CINⅡ/Ⅲ组间差异有统计学意义（H=48.138，P<0.001），且随着CIN程度加重呈上升趋势（趋势χ²=21.765，P<0.001）。交互效应分析显示，hnRNP K蛋白高表达与HPV16感染在CINⅡ/Ⅲ组存在正相加交互作用（API=0.639，95% CI：0.083~1.196），在CINⅠ组尚未发现存在类似交互作用。结论 hnRNP K蛋白高表达、HPV16感染均可能增加CIN的发生风险，且在高度CIN发生中存在正相加交互作用。     

hnRNP E1与HPV16早期基因E2和E6在宫颈癌变中的作用及交互效应

目的 探讨核不均一核糖核蛋白（hnRNP）E1与HPV16早期基因E2和E6在宫颈癌变进展中的作用及相互关系。方法 从在山西省介休市建立的自然人群宫颈病变队列中,选取2014年6-9月经病理学确诊的正常宫颈（NC）女性56例,低度宫颈上皮内瘤变（CIN Ⅰ）病例58例和高度宫颈上皮内瘤变（CIN Ⅱ/Ⅲ）病例50例,以及同期在山西省肿瘤医院确诊的40例宫颈鳞状细胞癌（SCC）病例作为研究对象。采用结构式问卷收集研究对象的宫颈病变相关资料的同时,采集宫颈组织活检标本和宫颈脱落细胞。采用导流杂交法检测HPV感染状况,采用Western Blot检测hnRNP E1以及HPV16 E2和E6蛋白表达水平。采用SPSS 22.0软件进行Kruskal-Wallis H检验、χ²检验、趋势χ²检验和logistic回归分析,采用广义多因子降维法（GMDR）评价交互作用。结果 HPV16感染率在CINⅠ（15.52%,9/58）、CINⅡ/Ⅲ（40.00%,20/50）和SCC组（67.50%,27/40）均高于NC组（8.93%,5/56）,并随着宫颈病变程度的加重呈现升高趋势（趋势检验χ²=43.613,P<0.001）。hnRNP E1表达量在不同宫颈病变组间差异有统计学意义（H=9.98,P=0.019）,且随宫颈病变程度的加重呈现降低趋势（趋势检验χ²=9.495,P=0.002）。HPV16 E2（H=16.20,P=0.001）和E6（H=15.44,P=0.001）表达水平在不同宫颈病变组间差异均有统计学意义。采用GMDR分析显示,hnRNP E1低表达、HPV16 E2低表达与HPV16 E6高表达在CIN Ⅱ/Ⅲ和SCC组中存在交互作用（P<0.05）,而在CIN Ⅰ组未发现存在交互效应（P>0.05）。结论 hnRNP E1低表达和HPV16早期基因的异常表达可能会增加宫颈病变的发病风险,并在宫颈癌变中存在交互作用。     

叶酸与p16蛋白在宫颈癌变中的作用及其相互效应

目的 探讨叶酸与p16蛋白在宫颈癌变中的作用及其相互效应。方法 选取经病理学确诊的80例正常宫颈（NC）妇女、55例低度宫颈上皮内瘤样变（CINⅠ）患者、55例高度宫颈上皮内瘤样变（CINⅡ/Ⅲ）患者、64例宫颈鳞状细胞癌（SCC）患者为研究对象。分别采用微生物法和Western-blot方法检测其血清叶酸水平和p16蛋白的表达量。同时采用体外细胞实验研究方法,对HPV阴性的宫颈癌细胞C33A和HPV16阳性的宫颈癌细胞Caski进行不同浓度叶酸干预,检测两种宫颈癌细胞的增殖和凋亡情况,以及p16蛋白的表达。结果 NC组、CINⅠ组、CINⅡ/Ⅲ组和SCC组血清叶酸含量分别为（5.96±3.93） ng/ml、（5.08±3.43） ng/ml、（3.92±2.59） ng/ml、（3.18±2.71） ng/ml,p16蛋白表达水平分别为0.80±0.32、1.33±0.52、1.91±0.77、2.09±0.72;随着宫颈病变的进展,血清叶酸含量逐渐降低（趋势检验 χ²=32.71,P<0.001）,p16蛋白表达量逐渐升高（趋势检验 χ²=56.06,P<0.001）。在CINⅠ、CINⅡ/Ⅲ、SCC组中血清叶酸缺乏与p16蛋白高表达均存在正相加交互作用。体外实验结果显示,随着叶酸浓度的增加,宫颈癌细胞的增殖抑制率（C33A：r=0.928,P=0.003;Caski：r=0.962,P=0.001）和凋亡率（C33A：r=0.984,P<0.001;Caski：r=0.986,P<0.001）均上升,p16蛋白表达量逐渐降低（C33A：r=-0.817,P=0.025;Caski：r=-0.871,P=0.011）,且p16蛋白表达量与宫颈癌细胞的增殖抑制率（C33A：r=-0.935,P=0.002;Caski：r=-0.963,P=0.001）和凋亡率（C33A：r=-0.844,P=0.017;Caski：r=-0.898,P=0.006）均呈负相关关系。结论 血清叶酸缺乏与p16蛋白高表达均可增加宫颈癌和癌前病变的发病风险,两者在宫颈癌和癌前病变中存在正相加交互作用。补充叶酸可逆转p16蛋白的异常表达,有效抑制宫颈癌细胞的增殖,促进凋亡。     

叶酸与HPV16 E6/E7 mRNA表达在宫颈癌变中的交互作用

目的 探讨叶酸与人乳头瘤病毒16型(HPV16)E6/E7 mRNA表达在宫颈癌变中的交互作用。方法 选取经病理学确诊的宫颈鳞状细胞癌(SCC)患者64例、低度宫颈上皮内瘤样变(CIN1)患者55例、高度宫颈上皮内瘤样变(CIN2+)患者55例和正常宫颈(NC)者80例作为研究对象。采用微生物法测定血清叶酸和红细胞叶酸水平,应用real-time PCR法检测HPV16 E6/E7 mRNA表达水平。利用SPSS 16.0软件进行相关资料的χ²检验、方差分析、Welch检验、Kruskal-Wallis H检验、有序logistic回归和Spearman秩相关分析,应用相加模型进行交互作用分析。结果 随着宫颈癌变的进展,血清叶酸和红细胞叶酸水平均呈逐渐降低趋势(χ²=32.71,P<0.001; χ²=16.32,P<0.001),且血清叶酸和红细胞叶酸含量呈正相关(r=0.41,P<0.001);HPV16 E6/E7 mRNA表达水平随着宫颈癌变的进展呈逐渐升高趋势(χ²=30.11,P<0.001; χ²=38.99,P<0.001);红细胞叶酸含量与HPV16 E6/E7 mRNA表达量呈负相关(E6:r=-0.14,P=0.009;E7:r=-0.21,P=0.001),红细胞叶酸缺乏与HPV16 E6/E7mRNA高表达在CIN1、CIN2+和SCC组均存在正相加交互作用。结论 叶酸缺乏和HPV16 E6/E7 mRNA高表达均可增加宫颈癌及癌前病变发生的风险,两者在宫颈癌变进展中存在协同作用。     

多环芳烃与p16、FHIT基因CpG岛甲基化在宫颈上皮内瘤变中的交互效应

目的 探讨多环芳烃与p16、FHIT基因CpG岛甲基化在宫颈上皮内瘤变（CIN）中的作用及其交互效应。方法 利用2014年6-12月建立的山西省阳曲县宫颈病变研究队列。包括经病理学确诊的CIN患者169例（CINⅠ86例,CINⅡ/Ⅲ 83例）和正常宫颈（NC）妇女91例。全部研究对象采用高效液相色谱法检测尿液中的1-羟基芘（1-OHP）浓度,甲基化特异性PCR法检测抑癌基因p16、FHIT CpG岛甲基化状态。应用SPSS 20.0软件进行相关资料的Kruskal-Wallis H检验、χ²检验、趋势χ²检验,应用logistic回归模型计算因素与宫颈疾病之间关联强度的OR值及其95%CI,应用广义多因子降维模型（GMDR）评价交互作用。结果 随着CIN程度加重,1-OHP水平逐渐上升（H=50.743,P<0.001）,1-OHP高暴露率逐渐升高（趋势检验χ²=20.146,P<0.001）。CINⅠ、CINⅡ/Ⅲ组p16、FHIT CpG岛甲基化率均高于NC组;随着CIN程度的加重,p16基因CpG岛甲基化率（趋势检验χ²=9.75,P=0.002）、FHIT基因CpG岛甲基化率（趋势检验χ²=10.39,P=0.001）均逐渐升高。GMDR交互作用分析显示,在CINⅠ和CINⅡ/Ⅲ组,1-OHP高暴露与p16、FHIT基因CpG岛甲基化呈交互作用。结论 1-OHP高暴露和p16、FHIT CpG岛甲基化均可增加CIN的风险,且在病变中具有协同作用。     

多环芳烃与高危型人乳头瘤病毒感染在宫颈上皮内瘤变中的作用及其交互效应

目的 探讨多环芳烃（PAHs）与高危型人乳头瘤病毒（HR-HPV）感染在宫颈上皮内瘤变发生发展过程中的作用及其交互效应。方法 从建立的自然人群队列中选取2014年6－12月经病理学确诊的正常宫颈（NC）妇女208例,低度宫颈上皮内瘤变（CIN Ⅰ）患者154例,高度宫颈上皮内瘤变（CIN Ⅱ/Ⅲ）患者124例为研究对象。采用高效液相色谱法检测其尿中1-羟基芘（1-OHP）的浓度（反映PAHs内暴露情况）,应用导流杂交技术检测HPV感染状态及感染类型。利用SPSS 22.0软件进行资料的χ²检验、χ²趋势检验、Kruskal-Wallis H检验、Nemenyi秩和检验、Spearman秩相关分析,采用相加模型评价两因素间交互作用。结果 NC、CIN Ⅰ、CIN Ⅱ/Ⅲ组HR-HPV感染率分别为27.9%、37.0%、58.9%,尿1-OHP浓度（μmol/molCr）分别为0.07±0.09、0.11±0.10、0.17±0.15。随着宫颈病变程度的加重,HR-HPV感染率（趋势检验χ²=29.89,P<0.001）和PAHs高暴露率（趋势检验χ²=27.94,P<0.001）均逐渐升高。HR-HPV感染与尿中1-OHP浓度呈正相关（r=0.680,P<0.001）。CIN Ⅱ/Ⅲ组中HR-HPV感染与PAHs高暴露存在正相加交互作用,而在CIN Ⅰ组中未发现存在类似交互作用。结论 HR-HPV感染和PAHs高暴露均可增加宫颈上皮内瘤变的患病风险,两者在高度宫颈上皮内瘤变发生发展中存在协同作用。     

细胞外信号调节激酶1/2表达与HPV16感染及其交互效应在子宫颈癌变中的作用

目的 探讨细胞外信号调节激酶（p-ERK）1/2表达与HPV16感染在子宫颈癌变中的作用及其交互效应。方法 选取2013年9月至2014年3月在山西省肿瘤医院、山西省妇幼保健院、山西省晋煤集团总医院经组织病理学确诊的正常子宫颈（NC）女性34例、低度子宫颈上皮内瘤变（CINⅠ）患者26例、高度子宫颈上皮内瘤变（CINⅡ/Ⅲ）患者57例和子宫颈鳞状细胞癌（SCC）患者59例为研究对象。采用调查问卷收集研究对象的人口学特征和子宫颈癌相关因素等资料,并采集子宫颈组织标本。采用PCR法检测HPV16感染状况,应用免疫组化法检测子宫颈组织中磷酸化ERK1/2（p-ERK1/2）蛋白的表达情况。同时使用ERK抑制剂U0126对子宫颈癌细胞Siha（HPV16阳性）和C33A（HPV阴性）进行抑制,比较抑制前后细胞的增殖、凋亡情况。结果 随着子宫颈癌变的进展,HPV16感染率（趋势χ²=17.99,P<0.001）和p-ERK1/2的表达率（趋势χ²=10.58,P=0.001）均逐渐升高,HPV16感染与p-ERK1/2蛋白表达在CINⅠ、CINⅡ/Ⅲ、SCC组中均存在正相加交互作用。细胞实验结果显示,ERK抑制后,Siha和C33A细胞均表现为增殖能力降低（Siha：t=6.863,P<0.001;C33A：t=7.092,P<0.001）、凋亡率增高（Siha：t=-5.201,P=0.006;C33A：t=-4.335,P=0.005）。ERK抑制后HPV16阳性Siha细胞较HPV阴性C33A细胞增殖指数高（t=7.066,P<0.001）、凋亡率低（t=-2.431,P=0.057）。结论 p-ERK1/2高表达和HPV16感染均可增加子宫颈癌变风险,两者在子宫颈癌变中存在正相加交互作用。在子宫颈癌细胞增殖凋亡过程中,ERK1/2的活化可能对HPV16感染细胞的作用更为显著。     

阴道微环境改变与HPV16感染在宫颈上皮内瘤变中的作用及其交互效应

目的 探讨阴道微环境改变和HPV16感染在宫颈上皮内瘤变中的作用及其交互效应。方法 研究对象来源于课题组前期在山西省建立的宫颈病变研究队列,包括623例正常宫颈（NC）妇女、303例低度宫颈上皮内瘤变（CINⅠ）患者和93例高度宫颈上皮内瘤变（CINⅡ/Ⅲ）患者。在收集其人口学特征和宫颈上皮内瘤变相关因素资料的同时,采用导流杂交技术检测HPV16感染状况,应用需氧菌性阴道炎/细菌性阴道病联合检测试剂盒检测阴道分泌物中的H₂O₂、β-葡萄糖醛酸苷酶、凝固酶、唾液酸酐酶和白细胞酯酶,以及阴道pH值和清洁度。应用SPSS 22.0软件进行数据的录入和资料分析。结果 随着宫颈病变的进展,HPV16感染率（趋势性χ²=55.45,P<0.001）、H₂O₂ （趋势性χ²=26.19,P<0.001）、pH值（趋势性χ²=5.06,P=0.024）、阴道清洁度（趋势性χ²=19.55,P<0.001）、β-葡萄糖醛酸苷酶（趋势性χ²=17.52,P<0.001）、唾液酸酐酶（趋势性χ²=14.90,P<0.001）的异常率均逐渐升高,而凝固酶和白细胞酯酶异常率未见相应趋势。广义多因子降维模型交互作用分析显示,在CINⅠ组,HPV16感染与H₂O₂、β-葡萄糖醛酸苷酶、凝固酶、唾液酸酐酶异常呈交互作用,在CINⅡ/Ⅲ组,HPV16感染与阴道清洁度、H₂O₂、β-葡萄糖醛酸苷酶、唾液酸酐酶异常呈交互作用。结论 阴道微环境改变和HPV16感染均可增加宫颈病变的发病风险,且在宫颈上皮内瘤变中具有交互作用。     

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 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.     

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.     

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.     

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.     

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.