新生儿窒息后血清S-100B蛋白的变化及临床意义

[目的]探讨新生儿窒息后血清S-100B蛋白含量的变化及其临床意义.[方法]采用酶联免疫吸附试验双抗体夹心法检测40例足月窒息新生儿(轻度窒息24例,重度窒息16例)出生后d 1、d 3的血清S-100B蛋白含量,并与20例正常足月新生儿进行对照.[结果]窒息新生儿血清S-100B蛋白水平显著高于正常对照组,窒息程度越重,血清S-100B蛋白水平越高(F=11.72,P＜0.01).窒息后脑损伤程度越重,d 1血清S-100B蛋白水平越高(F=25.97,P＜0.01),中、重度HIE患儿生后d 3血清S-100B蛋白水平与无脑损害及轻度HIE患儿相比仍然较高(F=84.06,P＜0.01).[结论]新生儿窒息后血清S-100B蛋白含量的变化有助于缺氧缺血性脑损伤严重程度的判断.     

血清S-100B蛋白在新生儿缺血缺氧性脑病诊断和预后判断中的价值评价

目的通过检测新生儿HIE患儿中血清S-100B蛋白的变化,探讨其在HIE诊断和预后判断中的作用。方法选择足月窒息新生儿307例为观察对象,其中46例发生HIE为HIE组,有43例留取到24h血清标本,选择同期正常足月新生儿43例为对照组,有21例留取到24h血清标本,采用双抗体夹心ELISA方法检测S-100B蛋白浓度。HIE组与正常组观察对象于生后6个月后进行DST发育检测。结果①正常组与HIE组24h血清S100B蛋白浓度分别为(1.07±0.32)μg/L与(3.83±2.32)μg/L,组间比较t=7.631,P<0.05;②轻度HIE组与中重度HIE组24h血清S100B蛋白浓度分别为(2.84±1.06)μg/L与(6.11±2.83)μg/L,与正常组3组之间比较F=48.2242,P<0.01;③正常组与HIE组6个月DST测试结果具有显著差异u=3.1024,P<0.05;正常组、轻度HIE组与中重度HIE组3组之间的DST测试结果具有显著差异χ2=17.34,P<0.05。④DST正常组24h血清S100B蛋白浓度(1.89±0.98)μg/L与可疑/异常组(4.6±1.47)μg/L比较,t'=8.096,P<0.001。结论①24h血清S-100B蛋白浓度作为生化指标,可提示新生儿HIE的发生,并能反映其严重程度。②S-100B对新生儿HIE预后可能有预测作用。     

IGF-1、S-100B蛋白在新生儿窒息和缺氧缺血性脑病诊断中的价值

目的:探讨血清胰岛素样生长因子I(IGF-1)、S-100B蛋白在诊断新生儿窒息和缺氧缺血性脑病(HIE)中的意义。方法:采用放射免疫法、酶联免疫法分别检测40例窒息患儿、37例缺氧缺血性脑病(HIE)患儿和30例正常新生儿血清中IGF-1、S-100B蛋白的浓度。结果:①窒息组、HIE组IGF-1水平均较对照组明显降低,差异有统计学意义(P<0.01);②窒息组、HIE组S-100B蛋白水平较对照组均明显增高,差异有统计学意义(P<0.01)。结论:监测IGF-1水平有助于推测HIE的发生,血清S-100B蛋白水平的早期检测可作为窒息缺氧后脑细胞损伤程度的定量指标,为HIE的早期诊断、早期干预治疗提供了可靠的生化指标。     

新生儿脑病S-100蛋白监测与预后的研究进展

目的:通过监测新生儿缺氧缺血性脑病(HIE)患儿血清中S-100蛋白含量的动态变化,建立对HIE患儿的早期科学诊断及预后评估技术指标。并探讨S-100蛋白浓度变化与病情的严重程度及转归之间的关系。方法:采用酶联免疫吸附试验、双抗体夹心法检测,对120例HIE有症状组患儿(HIE轻度症状组40例,HIE中度症状组40例,HIE重度症状组40例)和40例新生儿窒息组患儿与40例对照组健康新生儿血清S-100蛋白含量进行检测,并进行动态观察。结果:①HIE有症状组不同时期血清S-100蛋白含量均显著高于对照组(P<0.01);②新生儿窒息组不同时期的血清S-100蛋白含量也明显高于对照组(P<0.01);③HIE有症状组血清S-100蛋白含量明显高于新生儿窒息组(P<0.05)。结论:HIE有症状组患儿病情越重,其血清S-100蛋白含量则越高,提示血清S-100蛋白可作为判断HIE病情程度的客观依据和早期诊断以及预后评估HIE的主要指标。     

脐血乳酸/肌酐比值在新生儿缺氧缺血性脑病早期诊断中的应用

目的探讨脐血血清乳酸/肌酐比值与新生儿缺氧缺血性脑病(HIE)的关系.方法选择有窒息史的新生儿60例,正常足月儿30例,用生化法测定脐血乳酸/肌酐比值,结合HIE分度,探讨其相关性.结果脐血乳酸/肌酐比值HIE组明显高于正常组和单纯窒息组(P＜0.05).结论脐血测定血清乳酸/肌酐比值对早期诊断HIE及预后判断有临床意义.     

血清和尿S-100B蛋白对新生儿缺氧缺血性脑病预后的评估价值

目的 调查缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)新生儿生后不同时间点血清和尿S-100B蛋白的变化,探讨其判断病情及其预后的临床价值。 方法 采用双抗体夹心酶联免疫吸附法(ELISA)检测48例HIE新生儿和25例正常对照儿生后1、3 d和7 d血清和尿S-100B 蛋白,并对HIE患儿在1岁时做了随访观察。 结果 HIE组生后1、3 d和7 d血清和尿S-100B蛋白均较正常对照组明显增高(P<0.05或<0.01),其增高程度与病情一致,即S-100B蛋白越高,病情越重;预后异常组生后1 d和3 d血S-100B和生后3 d和7 d尿S-100B蛋白明显高于预后正常组(P<0.05或<0.01)。以血S-100B>5 μg/L和尿S-100B>3 μg/L作为判断HIE不良预后的界值,生后1 d和3 d血S-100B>5 μg/L判断预后的准确性分别为88.1%和77.3%;生后3 d和7 d尿S-100B>3 μg/L判断预后的准确性分别为 90.5%和85.7%。血和尿S-100B蛋白对判断HIE预后差异无统计学意义。 结论 HIE新生儿生后血清和尿S-100B蛋白升高与病情及预后密切相关,S-100B蛋白对判断新生儿HIE预后具有重要的临床价值。     

局部亚低温对脑出血病人血清S-100B蛋白的影响

目的探讨局部亚低温治疗对脑出血病人血清S-100B蛋白的影响。方法将24例脑出血患者按1∶1配对分为亚低温组(12例)和对照组(12例),应用ELISA法检测24例脑出血病人(亚低温组12例,对照组12例)血清S-100B蛋白含量,同时检测11例正常人血清S-100B蛋白含量。结果脑出血病人血清S-100B蛋白含量明显高于正常人(P<0.05);局部亚低温治疗后脑出血病人亚低温组与对照组之间血清S-100B蛋白有显著性差异(P<0.05)。结论①急性脑出血病人血清S-100B蛋白水平较正常人高,因此S-100B蛋白可作为脑出血病情观察指标之一。②局部亚低温治疗能间接降低脑出血病人血清S-100B蛋白水平,从而发挥其脑保护作用。     

外源性神经生长因子治疗中重度新生儿缺氧缺血性脑病的疗效及其对NSE和S-100B蛋白的影响

目的探讨外源性神经生长因子(nerve growth factor,NGF)治疗中重度新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)的临床疗效及其对血清NSE和S-100B蛋白的影响。方法将58例中重度HIE新生儿随机分为两组,在基础治疗上,常规对照组加用脑蛋白水解物(脑活素),而NGF治疗组尽早(生后24 h内)应用鼠NGF。观察两组患儿治疗后的NBNA评分和随访1年后智能发育商(DQ)及血清NSE和S-100B蛋白的变化。另取12例正常新生儿作为治疗前正常对照。结果 NGF治疗组的NBNA评分及DQ正常率均明显高于常规对照组(p<0.05),治疗前两组HIE患儿血清NSE及S-100B水平均显著高于正常对照组(p<0.01),治疗3 d及7 d后NGF治疗组血清NSE及S-100B明显低于常规对照组(p<0.05)。结论外源性神经生长因子治疗新生儿HIE,可以减少NSE及S-100B的释放,发挥神经保护作用。     

心脏型脂肪酸结合蛋白对缺氧缺血性脑病新生儿心肌损害的诊断价值

[目的]观察新生儿缺氧缺血性脑病（hypoxie—ischemic encephalopathy，HIE）血清心脏型脂肪酸结合蛋白（hFABP）及肌酸磷酸激酶同功酶（CK-MB）水平变化，探讨检测h-FABP的价值。【方法】对59例新生儿HIE发病24～48h和治疗10～14d后血清h-FABP和CK—MB值进行两次检测。并与30例无窒息新生儿对照组比较。【结果】发病48h内与对照组比较，新生儿HIE血清h-FABP及CK-MB值显著上升（P〈0．01）。治疗后，HIE患儿血清h-FABP和CK—MB值均下降，与治疗前比较差异均有显著性（P〈0．01）。HIE患儿血清hFABP检出率为44．1％，CK—MB检出率为23.7％，两者差异有显著性（χ^2=5．446，P〈0．05）。血清h-FABP和CK—MB识别HIE患儿发生意外的敏感性分别为100％和76．5％，阴性预测值为100％和91．1％。【结论】h—FABP定量测定可作为判断新生儿HIE病情轻重、评价学出意外的一项客观指标．且比CK—MB具有更高的敏感性。     

颅脑损伤患儿血清S-100B蛋白、神经元特异性烯醇化酶的变化

[目的]探讨颅脑损伤患儿血清S-100B蛋白、神经元特异性烯醇化酶(NSE)的变化及其临床意义。[方法]分别用ELISA法和放免法检测40例颅脑损伤患儿血清S-100B蛋白与NSE水平。[结果]重度颅脑损伤患儿血清S-100B、NSE浓度显著高于轻度颅脑损伤患儿(P﹤0.01),两组患儿血清S-100B、NSE浓度均高于正常对照组(P﹤0.01)。[结论]血清S-100B蛋白、NSE水平是判断不同脑损伤有价值的神经生化标记物。     

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.