原发性高血压与血浆同型半胱氨酸及血脂的关系

目的 探讨原发性高血压与血浆同型半胱氨酸(Hcy)水平、血脂及血糖之间的关系.方法 选择原发性高血压患者110例为高血压组,健康者100例为对照组.所有研究对象均空腹取肘静脉血,测定空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)和血浆Hcy水平,测量身高、体重及血压.比较两组FPG、TC、TG及Hcy.结果 高血压组TC、TG及Hcy水平[分别为(5.94±0.39) mmol/L、(1.88±0.36) mmol/L、(16.18±2.47) μmol/L]均明显高于对照组[分别为(5.47±0.29)mmol/L、(1.58±0.21) mmol/L、(10.03±1.73) μmol/L],差异均有统计学意义(P＜0.01),两组FPG比较,差异无统计学意义(P＞0.05).结论 高血压病患者Hcy及血脂水平增高可能参与高血压的发生,是心脑血管疾病的独立危险因子.     

高尿酸血症与原发性高血压关系探讨

目的探讨高尿酸血症与原发性高血压病关系。方法比较高血压组112例患者与正常血压组120例之间的血尿酸水平,分析高尿酸血症与原发性高血压之间的关系。结果高血压病组血尿酸为(471.88±36.47)μmol/L,正常血压组血尿酸为(268±12.36)μmol/L,两者之间差异有统计学意义(P<0.01)。血尿酸水平随着高血压病分级程度及危险度增大而增加(P<0.05)。结论血尿酸水平与高血压病关系密切,高尿酸血症可能是高血压病独立危险因素,是导致心、脑、肾损害的重要因素之一。     

原发性高血压伴高尿酸血症与颈动脉粥样斑块的相关性分析

目的 探讨原发性高血压伴高尿酸血症与颈动脉粥样硬化的关系.方法 128例原发性高血压患者按血尿酸水平分为高尿酸血症组(42例)和尿酸正常组(86例),用高频超声探头检测两组患者有无颈动脉粥样斑块形成,并进行比较.结果 高尿酸血症组中,斑块形成者37例,检出率88.1%(37/42),三酰甘油(TG)(2.18±0.24)mmol/L.尿酸正常组中,斑块形成者25例,检出率29.1%(25/86),TG(1.69±0.14)mmol/L,两组比较差异均有统计学意义(P<0.05).血尿酸水平与粥样斑块厚度存在显著相关性(r=0.824,P<0.01).结论 原发性高血压伴高尿酸血症患者相对于单纯原发性高血压患者更易患颈动脉粥样硬化,高尿酸血症促进了原发性高血压患者患颈动脉粥样硬化的几率.     

非洛地平联合阿托伐他汀治疗老年单纯收缩期高血压的临床效果分析

目的探讨非洛地平联合阿托伐他汀治疗老年单纯收缩期高血压的临床疗效及应用价值。方法回顾性分析2015年12月—2016年12月170例老年单纯收缩期高血压患者的临床资料,根据治疗方法不同分为观察组和对照组,对照组给予非洛地平治疗,观察组给予联合阿托伐他汀治疗,对比两组治疗效果。计量资料比较采用t检验,P0.05为差异有统计学意义。结果观察组治疗后收缩压(134.18±5.41)mm Hg,舒张压(78.94±2.11)mm Hg,脉压差(60.09±1.78)mm Hg;对照组治疗后收缩压(137.74±5.52)mm Hg,舒张压(65.28±1.13)mm Hg,脉压差(71.74±3.87)mm Hg,组间对比差异有统计学意义(P0.05)。观察组治疗后甘油三酯(2.18±0.54)mmol/L,总胆固醇(4.35±0.64)mmol/L,低密度脂蛋白(2.77±0.19)mmol/L;对照组治疗后甘油三酯(3.12±1.01)mmol/L,总胆固醇(5.28±1.05)mmol/L,低密度脂蛋白(3.32±0.68)mmol/L,组间对比差异有统计学意义(P0.05)。结论非洛地平联合阿托伐他汀应用在老年单纯收缩期高血压可以有效改善患者血压,有助于降低脉压差,同时能够辅助降低患者血脂浓度,具有良好的应用价值。     

健康体检人群中高血压与临床指标相关性分析

目的 了解健康人群中高血压与临床指标的关系,以科学有效防控高血压。方法 采用回顾性研究,选择2018年1月—2020年1月甘肃省肃北县某医院进行健康体检的患者作为研究对象,随机选择61例符合高血压组纳入标准的高血压患者作为观察组;随机抽取同期的61例符合非高血压组纳入标准的患者作为对照组,比较两组间各项临床指标的差异。结果 观察组总蛋白(65.56±4.10 )g/L、直接胆红素(4.33±2.82) mmol/L、肌酐(85.34±46.55)umol/L、胆固醇(4.84±1.06)mmol/L,均高于对照组水平:(63.52±5.42) g/L、(3.39±1.44)mmol/L、(71.42±17.37)umol/L、(4.71±0.87)mmol/L,差异有统计学意义(P>0.05) 。两组的胆固醇、直接胆红素和高血压具有相关性,其中胆固醇与高血压呈正相关,OR值和95%CI 分别为17.972和(2.209～146.204);直接胆红素与高血压呈负相关,相应OR值和95%CI 分别为0.735和(0.559～0.967)。结论 血清中的胆固醇和直接胆红素水平与高血压具有相关性,对高血压有很好的预警提示作用。     

高胰岛素血症与低血钾型周期性麻痹的初步探讨

目的探讨高胰岛素血症与低血钾型周期性麻痹(HoPP)的关系。方法对48例低血钾型周期性麻痹患者行口服糖耐量实验(OGTT)并测定血糖、胰岛素及血钾,计算胰岛素抵抗指数(IRI)并与正常对照组进行比较。结果低血钾周期性麻痹组OGTT各个时点胰岛素水平[0min(14.11±5.53)mmol/L,30min(121.22±79.96)mmol/L,60min(136.95±68.07)mmol/L,120min(119.13±68.26)mmol/L,180min(52.49±48.53)mmol/L]高于正常对照组[0min(6.78±3.26)mmol/L,30min(60.08±20.53)mmol/L,60min(64.89±24.27)mmol/L,120min(50.77±24.34)mmol/L,180min(19.71±18.82)mmol/L],差别有统计学意义(P0.05);IRI(0.97±0.53)高于正常对照组(0.09±0.59),差别有统计学意义(P0.05)。结论低血钾型周期性麻痹患者存在高胰岛素血症,预防和治疗高胰岛素血症有可能成为预防和治疗低血钾周期性麻痹的一项新的治疗途径。     

妊娠期高血压疾病与正常妊娠不同孕周血脂变化的探讨

目的探讨妊娠期高血压疾病妇女和正常妊娠妇女在中孕及晚孕期间血脂指标的关系。方法选取87例妊娠期高血压疾病妇女和127例正常妊娠妇女,分析两组妇女孕中期和孕晚期血总胆固醇(CHOL)、甘油三酯(TG)的变化。结果与正常妊娠组比较,孕中期妊娠期高血压疾病组CHOL无明显变化,两组差异无统计学意义(P0.05);而孕晚期时妊娠期高血压疾病组CHOL为(6.40±1.41)mmol/L明显高于正常妊娠组的(6.00±1.19)mmol/L,两组差异有统计学意义(P0.05)。妊娠期高血压疾病组孕中期和孕晚期时TG为(2.38±0.94)和(3.47±1.46)mmol/L显著高于正常妊娠组的(1.77±0.84)和(2.17±0.99)mmol/L,差异均有统计学意义(P0.01)。结论妊娠期高血压疾病妇女孕晚期血脂明显升高,孕中期时TG变化较CHOL明显,推测对于TG的监测有利于早期预测妊娠期高血压疾病的发生。     

高血压患者脉压及脉压指数对早期肾损害的指示作用研究

目的 探讨高血压患者脉压(PP)及脉压指数(PPI)对早期肾损害的指示作用.方法 纳入80例经诊断证实为高血压合并肾损害的老年患者作为A组,同时选取60例仅诊断为高血压的老年患者作为B组,再随机抽取30例健康体检老年人作为C组.所有受试者均进行PP、PPI检测,并对A组患者早期肾损害指标进行检测.结果 A组中PP≥60 mm Hg(1 mm Hg=0.133 kPa)及PPI≥0.5的患者分别占70.0％(56/80)、75.0％(60/80),明显多于B组的41.7％(25/60)、43.3％(26/60)和C组的26.7％(8/30)、23.3％(7/30),差异有统计学意义(P＜0.05).A组中PP≥60mm Hg患者的β2微球蛋白(β2-MG)、尿微量白蛋白(MAU)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)及半胱氨酸蛋白酶抑制剂C(Cys-C)分别为(13.23±3.22)mg/L、(56.6±13.2)mg/24 h、(1.9±1.2)mmol/L、(2.6±1.2)mmol/L、(2.01±0.80)m/L,与PP＜60 mm Hg患者的(12.03±2.32)mg/L、(42.7±12.3)mg/24 h、(2.2±1.3)mmol/L、(2.9±1.3)mmol/L、(1.21±0.90)mg/L比较差异有统计学意义(P＜0.05),而血尿酸(SUA)、血肌酐(SCr与PP＜60 mmHg患者比较差异无统计学意义(P＞0.05);PPI≥0.5患者β 2-MG、SCr、MAU、LDL及Cys-C分别为(10.53±2.43)mg/L、(97±22)μmol/L、(52.5±12.4)mg/24 h、(2.2±1.2)mmol/L、(1.91±0.90)mg/L,与PPI＜0.5患者的(14.00±2.15)mg/L、(82±16)μmol/L、(40.7±11.3)mg/24 h、(2.7±1.3)mmol/L、(1.23±1.10)mg/L比较差异有统计学意义(P＜0.05),而SUA、HDL与PPI＜0.5患者比较差异无统计学意义(P＞0.05).结论 高血压合并肾损害患者中PP≥60 mm Hg及PPI≥0.5的患者明显多于单纯高血压患者和健康体检者;PP及PPI可以作为高血压患者早期肾损害的预测指标,对该类患者需要密切关注其PP及PPI的变化.     

低血糖生成指数膳食对妊娠期高血糖患者糖代谢情况的影响

目的 研究低血糖生成指数(LoGI)膳食对妊娠期高血糖患者血糖控制的作用.方法 选取妊娠期高血糖患者364例,经口服葡萄糖耐量试验(OGTT)确诊为妊娠期糖尿病(GDM)或妊娠期糖耐量受损(GIGT),将所有患者按照完全随机化分组的原则分为对照组180例(给予正常膳食)和观察组184例(给予LoGI膳食),观察6周,所有患者采用自我血糖监测(SMBG)法记录治疗6周内糖代谢情况,6周后再行75 g OGTT,测量两组患者血糖水平并比较.结果 治疗0周时,两组75 g OGTT空腹血糖和2h血糖比较差异无统计学意义(P＞0.05).治疗6周时,75 g OGTT空腹血糖对照组为(6.7±0.6) mmol/L,观察组为(5.7±0.5)mmol/L,两组比较差异有统计学意义(P＜0.05);2h血糖对照组为(9.3±0.7) mmol/L,观察组为(8.1±0.9) mmol/L,两组比较差异有统计学意义(P＜0.05).观察组治疗2、4、6周时空腹血糖和餐后血糖显著低于对照组[空腹血糖:(5.5±0.6)mmol/L比(6.5±0.8) mmol/L、(5.3±0.7)mmol/L比(6.3±0.6) mmol/L、(5.2±0.6) mmol/L比(6.7±0.8)mmol/L;餐后血糖:(8.0±0.7)mmol/L比(8.9±0.9) mmol/L、(7.7±0.9) mmol/L比(9.1±0.7) mmol/L、(7.8±0.8)mmol/L比(8.9±0.9) mmol/L],差异有统计学意义(P＜0.05).治疗6周后观察组115例GDM患者中42例(36.5％)转为GIGT,50例(43.5％)转为糖耐量正常(NGT),对照组133例GDM患者中69例(51.9％)转为GIGT,12例(9.0％)转为NGT.观察期间两组患者体重增长值比较差异无统计学意义(P＞0.05).结论 LoGI膳食能有效调节妊娠期高血糖患者的血糖水平,可在临床推广应用.     

肝炎肝硬化患者肝功能检验结果的临床价值分析

目的分析肝炎肝硬化患者肝功能检验结果的临床价值。方法选择2014年1月—2015年2月收治的肝炎肝硬化患者37例作为研究组;选取同期健康体检者40例作为参照组。根据研究组患者肝功能分为A级7例,B级14例,C级16例。比较研究组和参照组及不同肝功能分级患者TBA、CHO、ALB、CHE水平。计量资料采用t检验及方差分析,两两比较采用LSD-t检验,P0.05为差异有统计学意义。结果研究组TBA、CHO、ALB、CHE分别为(48.55±30.45)μmol/L、(2.26±0.13)mmol/L、(30.22±3.14)g/L、(2 313.40±150.61)U/L,参照组分别为(5.11±2.13)μmol/L、(5.23±0.32)mmol/L、(47.12±4.22)g/L、(8 709.37±340.55)U/L,两组比较差异均有统计学意义(均P0.05)。肝功能A级患者TBA、CHO、ALB、CHE分别为(37.51±6.53)μmol/L、(3.23±1.12)mmol/L、(41.02±3.15)g/L、(3 141.37±1 032.55)U/L,B级分别为(41.35±20.43)μmol/L、(2.46±1.05)mmol/L、(32.12±2.54)g/L、(1 823.34±473.24)U/L,C级分别为(81.25±50.24)μmol/L、(2.11±0.13)mmol/L、(20.41±3.04)g/L、(1 343.23±231.21)U/L,三组比较差异均有统计学意义(均P0.05)。结论肝功能检验在肝炎肝硬化患者临床诊断中具有较高应用价值,值得推广使用。     

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 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.     

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.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

The risk of heat exhaustion at a deep underground metalliferous mine in relation to surface temperatures

The risk of heat exhaustion at a deep underground metalliferous mine was assessed in relation to thermal conditions prevailing on the surface. For each day of a 1-year prospective case series of heat exhaustion, surface 24-h mean wet and dry bulb temperatures were recorded. From this data, 24-h mean wet bulb globe temperatures were derived using certain assumptions. The three surface temperature variables were significantly higher on those days on which heat exhaustion occurred, compared to those days on which it did not occur (P < 0.001). The relative risk of heat exhaustion on days when the 24-h mean wet bulb globe temperature was in the range 26.0-28.0 degrees C was 4.82 (95% confidence interval 2.12-10.96). Surface temperature data could be used at this mine to warn miners about the risk of heat exhaustion.