焦炉工外周血P21、P53蛋白的检测

目的　了解接触煤焦油沥青的焦炉工外周血中P2 1、P5 3蛋白表达水平及其在肺癌高危人群筛检中的意义。方法　采用P2 1、P5 3免疫组化染色试剂盒 ,对 5 6名焦炉工和 40名对照者的外周血进行检测。结果　 5 6例焦炉工中有 13例P2 1蛋白阳性 ,12例P5 3蛋白表达阳性。阳性率分别为 2 3 2 %和 2 1 4% ;40名对照者外周血中各有 2例P2 1、P5 3蛋白阳性 ,阳性率为 5 0 % ,两组间差异有统计学意义 (P <0 .0 5 )。对焦炉工按是否吸烟与工龄进行分组比较 ,未发现P2 1、P5 3组间差异。结论　煤焦油沥青可使接触者外周血中P2 1、P5 3蛋白表达水平升高。     

焦炉工外周血淋巴细胞热应激蛋白70水平与DNA损伤的关系

目的探讨焦炉工外周血淋巴细胞热应激蛋白70(HSP70)水平与DNA损伤的关系。方法应用Westernblot法测定淋巴细胞HSP700水平,用微核分析和慧星试验(CometAssay)测定DNA损伤程度。结果焦炉工组淋巴细胞HSHSP70水平(1960±536)高于对照组(1712±442),差异有显著性(P<0．05);焦炉工组微核率(5162／106±2205／106)和DNA损伤积分(67000／106±64934／106)也都明显高于对照组(2362／106±1241／106、28936/106±30874／106),差异有显著性(P<0．05)。焦炉工人组中淋巴细胞HSP70水平与微核率和DNA损伤积分均呈明显的负相关,且差异有显著性(r值分别为-0．461、-0．663,均P<0．01)。结论焦炉工外周血淋巴细胞HSP70水平的增高可能与保护DNA免受致癌物损伤有关。     

焦炉工多环芳烃接触与尿1-羟基芘及血清肿瘤坏死因子-α的关系

目的 探讨焦炉工外接触等级与尿中1-羟基芘物质的量浓度的关系,同时研究血清肿瘤坏死因子-α(TNF-α)水平能否作为焦炉工多环芳烃(PAH)的接触评价指标以及TNF-α与1-羟基芘物质的量浓度的关系.方法 以某焦化厂86名生产工人和35名对照者为研究对象,采集血清和班后尿,并收集个人信息,检测血清中TNF-α水平,用高效液相色谱法测定尿中1-羟基芘.结果 焦炉工尿1-羟基芘物质的量浓度(4.78±2.09)μmol/mol Cr显著高于对照组[(2.12±1.81)μmol/mol Cr,P＜0.001],并呈炉顶＞炉侧＞炉底＞对照组的趋势.与外接触呈显著相关性(r=0.727,P＜0.001);在同样外接触条件下,吸烟量显著影响尿中1-羟基芘的水平(P＜0.05);焦炉工血清中TNF-α水平(30.1±2.0)μg/L明显高于对照人群[(17.7±1.8)μg/L,P＜0.001];焦炉工尿1-羟基芘水平与血清中TNF-α呈弱相关(r=0.316,P＜0.001).结论 焦炉工尿中1-羟基芘水平与外接触等级存在良好的剂量-效应关系,可反映PAH接触个体的内剂量水平;焦炉工人血清TNF-α有可能作为PAH接触评价的参数.     

谷胱甘肽S-转移酶M1基因型与石棉作业工人血液脂质过氧化水平的关系

目的　探讨谷胱甘肽S 转移酶M1(GSTM1)基因型与接触石棉的工人血液发生脂质过氧化的关系。方法　选择 94名石棉作业工人及 5 1名对照工人作为研究对象 ,通过问卷调查收集每个研究对象的一般情况、职业史等。同时测定血浆丙二醛 (MDA)的含量 ,分析淋巴细胞DNA中GSTM1的基因型。结果　石棉作业工人血浆MDA含量为 (0 .2 83± 0 .0 5 4)nmol/L ,明显高于对照组工人 [(0 .16 3± 0 .0 5 3)nmol/L],差异有显著性 (P <0 .0 1) ,但MDA含量与工龄和累积石棉接触剂量之间的相关关系不明显 ;对照组工人携带GSTM1- /-者血浆中的MDA含量 [(0 .190± 0 .0 34 )nmol/L]明显高于携带GSTM1+/+者[(0 .138± 0 .0 5 5 )nmo/L],差异有显著性 (P <0 .0 1) ,而石棉作业工人组虽也有类似趋势 ,但无统计学差异 (P >0 .0 5 ) ;对于石棉作业工人来说 ,在工龄相同或累积石棉接触剂量相同时 ,携带GSTM1- /-者的血浆MDA含量均高于携带GSTM1+/+者 ,但差异均无显著性 (P >0 .0 5 )。结论　接触石棉和GSTM1- /-基因型均与作业工人机体内脂质过氧化有关 ,但石棉的作用可能大于GSTM1基因型的作用。     

包头市温室作业人员肺通气功能研究

目的　了解温室作业对接触者肺通气功能的影响。方法　对 12 0名温室作业人员和 115名对照人员进行肺通气功能测定。结果　①肺功能通气指标FEV1 0 (96 6± 40 2 /10 3 4± 43 9)、FEV1 0 % (97 1± 2 1 1/10 3 1± 2 3 3 )、MMF(92 0± 42 3 /10 8 3± 42 6)、MVV(61 2± 18 2 /68 7± 2 2 4)、V50 (78 9± 3 3 6/90 0± 3 4 2 )和V2 5(90 4± 43 0 /110 0± 48 9)比较 ,接触组低于对照组 ,并且差异均具有显著性 (P <0 0 5 )。②两组中吸烟者肺通气功能结果比较 ,接触组FEV1 0(91 3± 44 0 /98 0± 44 7)、FEV1 0 % (94 9± 2 3 8/10 4 5± 2 2 9)、MVV(5 7 7± 16 3 /66 8± 2 2 5 )、和V2 5(88 4± 41 2 /10 6 7±46 4)低于对照组 ,差异具有显著性 (P <0 0 5 )。剔除吸烟因素后 ,接触组肺通气功能指标FVC、MMF、MVV、V50 和V2 5比较 ,低于对照组 ,并且差异均具有显著性。③随着从事温室作业时间的延长 ,MMF、MVV、V50 、V2 5呈现下降的趋势 ,差异具有显著性 (P <0 0 5 )。④随着年龄的增加 ,温室作业人员V2 5、MMF呈现下降的趋势 ,差异具有显著性 (P <0 0 5 )。结论　从事温室作业可对接触者的肺通气功能产生损害、吸烟与温室作业对接触者的肺通气功能可能产生协同作用 ,并且     

亚甲基四氢叶酸还原酶基因单体型与焦炉作业工人染色体损伤易感性的关系

目的探讨亚甲基四氢叶酸还原酶(MTHFR)基因多态性与焦炉作业工人染色体损伤易感性的关系。方法选取140名焦炉工和66名医护人员作为研究对象,采用胞质分裂阻滞微核实验评价个体染色体损伤水平,测定尿中1-羟基芘浓度反映多环芳烃暴露内剂量,聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法分析MTHFR基因两个单核苷酸多态性(SNP)位点(C677T、A1298C),利用PHASE2·1软件经Bayesian法计算单体型。校正年龄、性别和尿1-羟基芘水平,用协方差分析比较MTHFR不同基因型或单体型之间外周血淋巴细胞微核率的差异。结果研究对象中MTHFRC677T和A1298C两个变异等位基因频率分别为0·56和0·16,其分布均符合Hardy-Weinberg平衡。本研究中MTHFR基因这两个SNPs存在连锁不平衡关系(D’=0·99),研究对象中有四种单体型677T-1298A、677C-1298A、677C-1298C和677T-1298C,其频率分别为0·555、0·279、0·163和0·003。在焦炉工组,非677C-1298A/677C-1298A单体型对的微核率高于677C-1298A/677C-1298A,差异有显著性(1·00±0·67vs0·60±0·41,P=0·04),其中677T-1298A/677T-1298A单体型对微核率高于677C-1298A/677C-1298A,差异有显著性(1·08±0·71vs0·60±0·41,P=0·04)。在焦炉工组和对照组中,未发现上述两个SNPs与微核率之间显著关联。结论MTHFR基因单体型可能是影响焦炉工染色体损伤的遗传易感性因素之一。     

对苯二甲酸和乙二醇及联苯-联苯醚对职业人群肝肾损伤的研究

目的　研究对苯二甲酸 (TPA)、乙二醇 (EG)、联苯 -联苯醚 (DOW )对职业人群肝肾损伤的影响 ,寻找作业工人健康监护的早期指标。方法　采用职业流行病学的方法 ,在对某化纤公司进行劳动卫生学调查的基础上 ,分析TPA、EG、DOW接触工人肝肾功能的变化。结果　TPA +EG +DOW接触组男工的血清γ 谷氨酰转肽酶 (GGT)活力和总胆汁酸 (TBA)的含量分别为 (35 .45±16 .0 9)U/L、(10 .2 9± 6 .76 ) μmol/L ,女工的血清丙氨酸转氨酶 (ALT)活力和TBA含量分别为(30 .6 8± 8.5 8)U/L、(9.5 3± 6 .6 3) μmol/L ,均不同程度地高于对照组、TPA接触组和DOW接触组 ,且差异有显著性 (P <0 .0 5、P <0 .0 1) ;TPA +EG +DOW接触组尿N 乙酰 β D 氨基葡萄糖苷酶 (NAG)活力和 β2 微球蛋白 (β2 MG)含量与对照组、TPA接触组和DOW接触组相比 ,差异有显著性 (P <0 .0 5、P<0 .0 1) ,男工为 (5 .6 8± 4.0 1)U/mmolCr与 (2 3.49± 13.44 )mg/molCr;女工为 (6 .6 8± 4.6 8)U/mmolCr与 (2 2 .80± 13.0 0 )mg/molCr。经多元回归分析 ,控制了性别、吸烟、饮酒等混杂因素 ,接触不同的毒物与作业工人肝肾损伤的关系有显著性 (P <0 .0 0 1)。结论　TPA、EG、DOW对职业人群的肝肾损伤存在联合作用 ,建议血清ALT、GGT、TBA、尿NAG和     

职业接触铅工人血细胞参数变化的调查

目的　对 5 98名工人的血铅及血细胞参数进行测定 ,以了解职业铅接触对工人造血系统的影响以及血细胞参数的变化。方法　据血铅测定水平将 5 98名职业接触铅工人分为 2组 :铅接触组 (血铅小于 2 .4 1μmol/ /L) 32 5名和铅吸收组 (血铅大于或等于 2 .4 1μmol/L) 2 73名。血铅测定采用石墨炉原子吸收法 ;血细胞参数的测定采用全自动血细胞分析仪进行测定。结果　铅吸收组的血红蛋白 (Hb) [男 :(12 9.3± 12 .3)g/L ,女 :(112 .2± 9.4 )g/L]、红细胞压积 (HCT) [男 :(0 .338± 0 .0 30 )L/L ,女 :(0 .30 2± 0 .0 2 8)L/L]明显低于正常组和铅接触组 ,差异均有显著性 (P <0 .0 5 ,P <0 .0 1) ;并且随血铅水平增高 ,Hb和HCT水平降低 ,血铅与Hb和HCT有弱的负相关关系。铅吸收组的红细胞平均分布宽度 (RDW) (男 :16 .6 8%± 0 .80 % ,女 :16 .98%± 0 .98% )明显高于正常组和铅接触组 ,铅接触组的RDW(男 :14 .77%± 0 .83% ,女 :14 .92 %± 1.13% )也明显高于正常组 ,差异均有显著性 (P <0 .0 5 ,P <0 .0 1) ;血铅与RDW有弱的正相关关系。结论　用Hb、HCT和RDW 3个指标可以反映铅作业工人是否贫血和贫血程度。     

焦炉工血清SOD活性IL-2、TNF-α表达水平

目的 探讨焦炉逸散物对焦炉工外周血血清中超氧化物歧化酶(SOD)活性、白细胞介素-2(IL-2)及肿瘤坏死因子-α(TNF-α)表达水平的影响.方法 随机选取焦炉作业工人60名(20名炉顶工、20名炉侧工和20名炉底工)作为暴露组,随机选取20名不接触有害物质的大学生作为对照组.用黄嘌呤氧化酶法对血清SOC活力进行测定;用双抗体夹心酶联免疫吸附法(ELISA)对IL-2和TNF-α的表达水平进行测定.结果 炉顶工SOD活力、IL-α水平、TNF-α水平分别为(10.50±5.34)U/mL、(59.188±47.7)pg/mL、(59.188±47.7)pg/mL;与对照组比较,焦炉工血清SOD活性明显增高(P＜0.05),IL-2和TNF-α表达水平明显降低(P＜0.05).结论 接触焦炉逸散物可以导致接触者SOD活性增高,IL-2和TNF-α表达水平降低.     

修饰蓖麻毒素减轻其对小鼠肝毒性的研究

目的　探讨化学修饰后的蓖麻毒素 (RT)对小鼠肝脏毒性及其抗癌作用的变化。方法　测定RT及其修饰物N [3 (2 吡啶二硫基 )丙酰基 ]蓖麻毒素 (RT PDP)染毒小鼠血清谷胱甘肽转硫酶 (GST)活力、肝组织谷胱甘肽 (GSH)含量 ,电镜下观察染毒小鼠肝脏的病理改变。结果　随着RT及RT PDP染毒剂量的增加 ,小鼠血清GST活力随之增加 ,且RT组小鼠血清GST活力高于RT PDP组。当染毒剂量均为 12 .5、15 .0 μg/kg时 ,RT组小鼠血清GST活力 [(93.6 5± 12 .30 )、(15 3.71±2 6 .6 4 )IU/L]明显高于RT PDP组 [(6 2 .97± 11.2 2 )、(78.2 0± 15 .71)IU/L],差异有显著性 (P <0 .0 5 ) ;RT和RT PDP各剂量染毒组小鼠肝组织GSH含量均随染毒剂量增加而下降 ,当染毒剂量为 2 .5、5 .0、7.5、10 .0、15 .0 μg/kg时 ,RT组小鼠肝组织匀浆中GSH含量分别为 (3.5 3± 0 .95 )、(2 .12± 0 .5 4 )、(1.82±0 .71)、(1.5 2± 0 .34)、(0 .81± 0 .36 ) μmol/L ,RT PDP组小鼠肝组织匀浆中GSH含量分别为 (6 .34±1.4 3)、(4.14± 1.82 )、(3.5 4± 0 .6 4 )、(2 .73± 1.82 )、(1.82± 0 .6 2 ) μmol/L ,RT PDP组仍明显高于RT组 ,差异均有显著性 (P <0 .0 1) ;电镜观察显示 ,RT对小鼠肝细胞的损伤大于RT PDP。结论　化学修饰蓖麻毒素可     

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.     

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.     

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.