检测腹水脱落细胞端粒酶活性对良恶性腹水鉴别诊断的意义

目的探讨检测腹水脱落细胞端粒酶活性对良恶性腹水鉴别诊断的价值。方法收集各种类型腹水脱落细胞,用聚合酶链反应端粒重复扩增(PCR-TRAP)银染法检测端粒酶活性,并与细胞学检查及腹水肿瘤标志物检查结果进行对比分析。结果脱落细胞端粒酶活性检测对恶性腹水诊断的灵敏度为77.33%,显著高于脱落细胞学检查(37.33%)及肿瘤标志物检查(58.67%),特异度和细胞学检查差异无统计学意义。结论腹水中脱落细胞端粒酶活性检测可作为临床良恶性腹水鉴别诊断依据之一。     

152例腹膜活检在良恶性腹水鉴别中的临床实用性分析

目的评价比较同步进行的腹膜活检、腹水肿瘤标志物测定、腹水脱落细胞学检查在良恶性腹水鉴别诊断中的临床实用价值。方法152例腹水原因待查患者,经B超检查均有不同程度不同部位的腹膜增厚,在超声穿刺探头引导下于增厚的腹膜处进行活检,组织石蜡包埋,HE染色后作病理学诊断。腹水肿瘤标志物AFP、CEA、CA199、CA125检测方法为电化学发光法,腹水肿瘤的细胞学检查采用腹水离心后沉渣包埋免疫组化染色。结果腹膜活检检出阳性率为96.1%（146/152）,明显高于腹水脱落细胞学检查的阳性率17.12%（25/146）,差异有统计学意义（P〈0.01）,腹水肿瘤标志物AFP、CEA值在恶性腹水中有明显升高,但敏感性仅为36.6%（30/82）和46.43%（38/82）,特异性分别为76.56（49/64）和54.69（35/64）,敏感性和特异性均较差,CA199和CA125的值在良恶性腹水中差异无统计学意义,特异性和准确性均不高,故认为腹水肿瘤标志物临床应用价值有限。结论腹膜穿刺活检是一种优于腹水脱落细胞学检查和肿瘤标志物的最有临床价值的检查手段,对于原因不明伴有腹膜增厚的腹水的诊断,腹膜穿刺活检应作为首选的诊断性检查方法。     

几种肿瘤标志物检测在良恶性腹水鉴别诊断中的应用价值

腹水是一种常见病、多发病．病因复杂，良恶性腹水的鉴别诊断在临床上具有极其重要的意义。长期以来，人们致力于寻找一种能够尽早（发生在转移之前）检出恶性肿瘤的指标，其中包括对肿瘤标志物的研究。笔者自2002年4月-2007年9月测定了我院104例良恶性肿瘤住院患者的血清和腹水中的AFP（甲胎蛋白）、CEA（癌胚抗原）、CA125（癌抗原）和CA19—9（肿瘤标志物）水平，并进行了分析，探讨其对肿瘤诊断与良恶性腹水的鉴别诊断价值，现报告如下。     

多项指标联合检测在腹水鉴别诊断中的应用价值

目的:探讨多项指标联合检测在腹水鉴别诊断中的应用价值.方法:我院于2009年8月～2010年8月比较分析了单独检测腹水CA242、CEA、CA19-9、CA-125和多项肿瘤标志物及生化指标联合检测对良、恶性腹水的诊断及鉴别诊断意义.结果:两项联合检测在特异性为100%前提下,联合检测CA242、CEA为最佳;三项联合检测以CA242+CEA+CA19-9特异性最高.结论:检测腹水肿瘤标志物对良、恶性腹水的鉴别诊断有重要意义,多项联合检测可提高诊断的敏感性;虽不能确定诊断,但较单项诊断的诊断率高,可为临床进一步检查、治疗提供依据、指导方向.     

C-12多肿瘤标志物检测对良恶性腹水鉴别诊断价值的探讨

目的　探讨鉴别良恶性腹水的新方法。方法　比较两组患者 12 6例血清C -12肿瘤标志物的检测情况。结果恶性腹水组血清CEA、AFP、CA19-9及CA2 42水平较良性腹水组升高 (P <0 0 1) ,其诊断恶性腹水的敏感性分别为 73 6%,76 4%,87 5 %,3 6 1%,特异性分别为 88 9%,81 5 %,79 6%及 98 1%。C -12结果中 3项以上阳性对恶性腹水的敏感性为 62 5 %,特异性达 96 3 %。结论　肿瘤标志物检测有助于良恶性腹水的鉴别诊断 ,C -12可同时检测 12种肿瘤标志物 ,可提高诊断恶性腹水的敏感性和特异性     

良恶性胸腹水脱落细胞鉴别诊断的研究进展

临床鉴别诊断良恶性胸腹水一直是困扰临床医师的难题,对患者脱落的细胞进行鉴别一直是进行恶性胸腹水准确诊断的最好方法,但是当患者腹水出现肿瘤细胞被破坏或肿瘤细胞大量减少的情况后,对患者进行细胞鉴别的难度增大,本研究采取综合标志物检测方法对良恶性胸腹进行鉴别。     

甲状腺结节细针抽吸细胞端粒酶活性的定量检测及其意义

本文探讨细针抽吸细胞(FNAC)端粒酶活性检测对甲状腺良恶性结节的诊断价值。用端粒重复序列扩增法测定28例甲状腺癌、18例甲状腺腺瘤及7例结节性甲状腺肿术前FNAC及术后甲状腺组织端粒酶的活性。结果提示，FNAC标本端粒酶活性测定可作为术前鉴别甲状腺结节良恶性的一种检测方法。     

胸腹水组合分析联合血清肿瘤标志物检测在胸腹水性质鉴别中的价值

目的:探讨胸腹水组合分析、血清肿瘤标志物和血清葡萄糖联合检测对胸腹水良恶性鉴别的临床应用价值。方法:对208例胸腹水患者血清CEA、CA125、CA199,血糖、胸腹水脱落细胞,胸腹水CEA、CA125、CA199,胸腹水LDH、ADA、糖定量检测结果进行分析,比较检测指标的相关性和对胸腹水异常指标检出率的差异。结果:根据临床B超、CT、组织病理等结果将208例患者分为良性胸腹水组152例和恶性胸腹水组56例。脱落细胞学检查见癌细胞42例,检出率为75%;恶性胸腹水组患者ADA和LDH值均高于良性胸腹水组,差异有统计学意义(P0.05), ADA与LDH联合检测阳性率高于单独检测;血糖/胸腹水糖定量1.0对鉴别恶性胸腹水有指导意义;血清中CA199、CA125、CEA的浓度均高于胸腹水中CA199、CA125、CEA的浓度,差异有统计学意义(P0.05)。结论:胸腹水脱落细胞学检查鉴别胸腹水性质的特异性高但灵敏度低,容易造成漏检,胸腹水组合分析结合血清肿瘤标志物以及血糖/胸腹水糖定量能有效提高胸腹水良恶性的鉴别率。     

检测腹水中AFP、CEA、CA125及CA153对恶性腹水的诊断价值

目的 探讨检测腹水甲胎蛋白（AFP）、癌胚抗原（CEA）、糖类抗原125（CA125）及糖类抗原153（CA153）在恶性腹水诊断中的应用。方法采用电化学发光法检测42例恶性腹水患者及46例良性腹水患者血清和腹水AFP、CEA、CA125及CA153的含量,并根据受试者工作特性（ROC）曲线建立最件的临床判断临界值。结果恶性组腹水中4种标志物水平均明显高于良阵组水平（P〈0．001）;恶性组腹水中4种标志物水平均明显高于血清中水平（P〈0．01或P〈0．05）;CEA与CA153联合检测其敏感性和特异性高达97．6％和93．4％。结论检测腹水中AFP、CEA、CA125及CA153对恶件腹水的诊断具有重要的临床意义,其中CEA与CA153联合检测为最佳组合。     

检测可溶性上皮型钙黏附蛋白对良恶性腹水的鉴别诊断价值

目的 探讨检测可溶性上皮型钙黏附蛋白(sE-cad)对良恶性腹水的鉴别诊断价值.方法 检测31例良性疾病患者腹腔液(不伴腹水),82例良性腹水及119例恶性腹水中sE-cad和癌胚抗原(CEA)含量.结果 恶性腹水sE-cad和CEA含量显著高于各良性腹水及腹腔液(P<0.01),sE-cad对恶性腹水诊断的灵敏度、阴性预测值、总准确率分别为89.9%、86.8%、92.5%,显著高于CEA的68.1%、65.8%、76.6%(P值均<0.05).恶性腹水sE-cad显示一定的组织特异度.结论 sE-cad可作为良恶性腹水鉴别诊断的高效肿瘤标志物.     

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.     

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.     

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.