早期输血治疗婴儿维生素K缺乏性颅内出血14例临床分析与随访

对１９９４年至１９９７年收治的婴儿维生素Ｋ缺乏性颅内出血症，在常规治疗基础上早期输注新鲜血治疗１４例和对照组常规治疗１６例进行对比观察并随访６月￣３年。其结果：治疗组６例（４２．９％）正常而无后遗症，４例（２８．６％）轻度智力低下，３例（２１．４％）有严重后遗症，１例（７．１％）死亡；而对照组４例（２５％）正常，２例（１２．５％）轻度智力低下，６例（３７．５％）有严重后遗症，４例（２５％）死亡。显     

广西吸毒成瘾者丙型肝炎病毒的感染及其分子生物学研究

选择２８３名静脉吸毒者（ＩＶＤＡｓ）和１２１名献血员（ＢＤｓ）进行Ａｎｔｉ－ＨＣＶ、ＨＣＶ血清基因型、ＨＣＶ基因型和ＨＣＶｃＤＮＡ序列的检测。结果表明，ＩＶＤＡｓ和ＢＤｓ的Ａｎｔｉ－ＨＣＶ检出率分别为９１．１７％和０．８３％；ＩＶＤＡｓ的ＨＣＶ血清基因型为１型８１．８５％（２２１／２７０），２型１．４８％（４／２７０），ｌ＋２型０．３７％（１／２７０），不能定为１和／或２型１６．３０％（４４／２７０）；ＨＣＶ基因型为１ａ型：２８．６％（３４／１１９）；ｌｂ型：３８．７％（４６／１１９）；２ａ型１０．９％（１３／ｌ１９）；２ｂ型１４．３％（１７／ｌ１９）；３ａ型２６．９％（３２／１１９）；３ｂ型４０．３％（４８／１１９）；６ａ型８．４％（１０／１１９）；６ｂ型２６．７％（３１／１１９）；其中１４．３％的病例有４～５种不同基因亚型的混合感染现象。     

医院感染患者血粘附分子的变化意义

目的研究粘附分子在医院感染患者发病过程中的变化意义。方法用流式细胞术测定６４例医院感染患者血粘附分子ＣＤ４４, ＣＤ５４,ＣＤ６２Ｐ的变化,并与２０例正常人比较。结果医院感染患者血粘附分子ＣＤ４４（ ２１．２％９．１％）,ＣＤ５４（５．４％±２．７％）,ＣＤ６２Ｐ（１８．９％±７．６％）较正常人（８．６％ ±４．４％,２．０％ ±０．９３％,６．３％±３．５％）明显升高（Ｐ＜０．０１）;轻症医院感染患者上述指标（１５．２％ ±５．９％,４．０％±２．１％,１３．８％ ±５．６％）较重症医院感染患者（２７．２％± ８．１％,７．２％± ３．８％,２６．３％± ５．２％）显著降低（Ｐ＜０．０５）,但仍高于正常人（Ｐ＜０．０５）。结论粘附分子升高在医院感染的发病机制中起重要作用,对判断或监测病情有一定意义。     

复合蛋白锌治疗HBsAg、HBeAg、抗-HBc三阳患儿疗效观察

选择ＨＢｓＡｇ、ＨＢｅＡｇ、抗－ＨＢｃ三项血清学指标阳性患儿３５例（其中肝功正常２７例，ＡＬＴ单项增高８例）作为复合蛋白锌治疗观察对象，疗程３～６个月。结果３５例中ＨＢｓＡｇ转阴３例（８．５７％），ＨＢｅＡｇ转阴１２例（３４．２８％），抗－ＨＢｅ转阴２例（５．７１％），抗－ＨＢｃ转阴３例（８．５７％）。其中６例做了血清锌检查，其值在６．４～１２．４之间，处于较低水平。复合蛋白锌初步观察对ＨＢｅＡｇ转阴有一定作用，显示通过微量元素的调整对ＨＢＶ的复制可能有一定抑制作用。     

部队士兵人体成分的测定与分析

应用生物电阻抗（ＢＩＡ）法测定了３１４名部队士兵的人体成分，年龄２０．３±１．５岁，身高１７１．２±５．７ｃｍ，体重６１．８±６．９ｋｇ，体质指数（ＢＭＩ）２１．１±２．１，瘦体重（Ｌ）５５．２±５．８ｋｇ，Ｌ占体重８９．６±７．１％，脂肪重（Ｆ）６．６±４．９ｋｇ，占体重１０．４±７．１％；ＢＩＡ、理想体重和ＢＭＩ三种方法对肥胖的检出率分别为８．３％，３６．２％和６．７％，ＢＩＡ法与理想体重法有非常显著差异，ＢＩＡ法与ＢＭＩ法差异不明显，但两者一致性较差；年龄、体重、生物电阻抗、ＢＭＩ、Ｆ与Ｆ％相关非常显著。结果提示：（１）部队士兵随年龄的增高，Ｆ有增多趋势；（２）受试人群营养状况良好，锻炼强度适宜；（３）理想体重法与ＢＭＩ法判断肥胖，不适用于全训部队士兵     

单细胞电泳试验检测接触丙烯腈男工精子DNA双链断裂

目的　探讨接触丙烯腈对男工精子ＤＮＡ 损伤作用。方法　用单细胞凝胶电泳试验或称慧星试验对９名接触丙烯腈男工和９ 名健康对照者精子ＤＮＡ 链断裂进行了检测。结果　接触组男工精子细胞核平均慧星尾长为（８．８±３．６８）μｍ ,明显长于对照组的（４．５±２．２５）μｍ 。接触组１级、２ 级、３ 级和４ 级慧星百分率分别为５．５％ 、８．７％ 、６．７％ 和９．０％ ,明显高于对照组的４．４％ 、３．３％ 、４．０％ 和４．２％ 。结论　接触丙烯腈引起男工精子ＤＮＡ链断裂,并可能损害男性生殖功能     

甲基汞对大鼠脑突触体谷氨酸摄取的抑制作用

应用高亲和性摄取试验研究了甲基汞在体外对大鼠脑突触体谷氨酸摄取的影响。结果表明,１×１０－９～１×１０－４ｍｏｌ／Ｌ甲基汞可使大鼠大脑皮层、海马、纹状体和小脑突触体３Ｈ－Ｌ－谷氨酸摄取量分别下降０．７％～７４．４％、７．５％～９１．１％、１．４％～７６．６％和４．４％～７７．０％,其中在１×１０－６～１×１０－４ｍｏｌ／Ｌ范围内均有显著性意义（Ｐ＜０．０５）,且均存在明显的剂量—效应关系,其抑制作用的ＩＣ５０分别为７．９、３．６、２．２和４．３×１０－６ｍｏｌ／Ｌ。本研究结果提示甲基汞可明显抑制大鼠脑突触体高亲和谷氨酸摄取功能。     

上海市2005名社区老年人综合健康状况评估研究

对上海市静安区三个有代表性居委的２００５名社区老年人的健康状况进行了行多维在，结果表明，社区老年人中４０．６％有不同程度的健康功能障碍，各种慢性患病率高达７８．７％，其中以高血压病患者率最高，为３２．３％，以下依次为心脏病（２６．８％）消化系统疾病（２６．１％），关节炎及风湿（２５．２％）慢性阻塞性肺病（１４．６％），２１．６％的老年人有轻中度日常活动能力障碍，２．５％有重度及完全障碍；８．４％有     

莱西市新兴商场个体食品批发户卫生状况与管理对策

１９９６年６月３日至９日，作者对莱西市新兴商场个体批发户的卫生状况进行了调查分析，结果提示：（１）个体食品批发者持证率低，卫生许可证，健康证持证率分别仅为１９．４％和１７．３％；（２）一般卫生较差，参加食品卫生培训者占１７．９％，工作服帽穿戴率为０，防蝇设施齐全的仅占７．５％；（３）食品无标签及标识不全，有生产日期及保质期的食品仅占８１．４％和８５．９％，假冒伪劣食品还占相当比重；（４）食品经营者     

ＰＤＣＡ 循环质控在预防前列腺穿刺活检 患者感染中的效果分析

摘要：目的　观察计划、实施、检查、处理（ＰＤＣＡ） 循环质控方法在预防前列腺穿刺活检患者感染中的 运用效果分析。方法　选取２０１６年３月至２０１７年３月福建医科大学附属第二医院前列腺穿刺活检的８０例 患者作为观察组,观察组前列腺穿刺活检患者为该院泌尿外科实施ＰＤＣＡ 管理后的患者,等比抽样选取该 院２０１５年３月至２０１６年３月收治该院未实施ＰＤＣＡ 循环质控的８０例患者作为对照组;对比两组患者术后 护理差错事件、感染情况、住院费用情况。结果　观察组患者感染２例（２．５０％）、菌血症１例（１．２５％）, 低于对照组患者的感染９例（１１．２５％）、菌血症７ 例（８．７５％）,差异有统计学意义（χ ２＝４．７８３、４．７３７, 犘＜０．０５）。观察组患者护理缺陷、护理纠纷、意外事件的发生率分别为１．２５％、１．２５％、１．２５％,低于对 照组患者,差异有统计学意义（χ ２＝４．７３７、５．７６９、５．７６９,犘＜０．０５）。观察组患者平均住院日为（７．８± ０．７）ｄ,短于对照组患者（１８．３±１．４）ｄ;平均护理费为（０．７±０．３） 万元,高于对照组（０．５±０．２） 万 元,治疗费（０．６±０．２）万元,低于对照组（１．１±０．３） 万元,总费用（１．３±０．３） 万元,低于对照组患 者（１．６±０．５）万元,差异有统计学意义（狋＝８．７６７,３．４６２,４．０１５,４．３３２,犘＜０．０５）。观察组护理满意 度为９５．００％,高于对照组护理满意度８３．７５％,差异有统计学意义（χ ２＝６．３５６,犘＜０．０５）。结论　ＰＤ ＣＡ 循环质控有助于降低前列腺穿刺活检患者的感染率,降低患者护理差错事件及住院费用。 关键词：ＰＤＣＡ 循环质控;前列腺穿刺感染;住院费用 中图分类号：Ｒ７３７．２５　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１８）１２ ０９４５ ０４ 犜     

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.     

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.