高效液相色谱法同时测定尿液中溴敌隆和溴鼠灵的方法研究

目的:建立反相高效液相色谱法同时快速检测尿液中的溴敌隆、溴鼠灵的分析方法。方法:尿样经乙酸乙酯提取过滤后直接进样,以甲醇-1%甲酸(90:10,V/V)为流动相,流速1.0 ml/min,经ODS-C18色谱柱(150 mm×4.6 mmi.d,5.0μm)40℃分离,在波长265 nm处检测。结果:分离测定过程在10 min之内完成,保留时间分别为溴敌隆3.770 min、溴鼠灵8.110 min。溴敌隆、溴鼠灵线性范围均为0.02～50.0μg/ml,最低检出量为0.16 ng。低、中、高3个浓度水平的样品加标平均回收率为86.0%～109.0%,保留时间与峰面积的日内和日间相对标准偏差分别<1%和<5%。结论:本方法简便、快速、稳定、准确,实用性强,满足中毒应急检测及临床治疗的需要。     

血清奥氮平气相色谱法测定

目的 建立血清中奥氮平定性定量的气相色谱法测定,为临床中毒急救和监测奥氮平疗效提供诊疗依据.方法 取0.5 ml血清加1.0 mol/L氧氧化钠10μl混合,加乙酸乙酯2.0 ml充分震荡萃取,静置5 min,4000 r/min离心10 min,取上清液,氮气吹干.50μl乙醇定容,气相色谱法测定,1.0μl进样.结果 血清中奥氮平浓度在1.0～15 μg/ml范围内呈线性,回归方程y=2313.4x-901.6,r=0.9996.最低检出浓度为0.5 μg/ml.方法回收率为86.8％～103.3％;相对标准差(RSD)为3.5％～4.9％.日内、日间RSD分别为3.75％～4.96％和3.18％～4.90％.结论 该方法操作简便、分析快速,结果准确.为把握药物浓度与疗效、快速诊断中毒安眠药物的类型提供了一个很好的检测方法.     

血清中佐匹克隆测定的紫外分光光度法

目的 建立血清中佐匹克隆定性、定量测定的紫外分光光度法,为临床佐匹克隆中毒提供诊疗依据.方法 取0.5 ml血清加二氯甲烷2.0 ml充分震荡萃取,静置5 min,以4000 r/min离心,取二氯甲烷层于另一试管中氮气吹干,加0.1 mol/L盐酸溶液200μl混匀.取50μl于微量比色池中紫外扫描.结果 血清中佐匹克隆最大吸收峰(304±1) nm,浓度在1.0～30μg/ml范围内呈线性关系,回归方程y=0.0353x+0.0059,相关系数为0.9995,方法回收率为85.8％～102.5％;相对标准偏差(RSD)为:2.9％～4.5％.日内、日间RSD分别为2.73％～5.04％和2.97％～4.74％,最低检出浓度:0.5 μg/ml.结论 该方法操作简便、分析快速,结果准确.为临床诊断佐匹克隆中毒提供了简便准确的检测方法.     

血清中氯美扎酮测定的气相色谱法

目的 建立血清中氯美扎酮定性定量的气相色谱测定法,为临床救治氯美扎酮中毒提供诊断依据.方法 取0.5 ml血清加50g/L氢氧化钠50μl混匀,加乙酸乙酯2.0 ml充分震荡萃取,静置5 min,4000 r/min离心,取上清液,氮气吹干.50μl无水乙醇定容,气相色谱法测定,1.0μl进样.结果 血清中氯美扎酮浓度在5.0～100 μg/ml范围内呈线性,最低检出浓度2.0 μg/ml.回归方程y=962.8x+1543.6,相关系数为0.9995,方法回收率为82.5％～101.3％;相对标准偏差(RS)为:3.5％～4.91％.日内、日间RSD分别为3.18％～4.49％和4.16％～4.95％.结论 该方法操作简便、分析快速,结果准确.为临床治疗疑似氯美扎酮中毒患者的药物定性定量检测,提供了一种简便准确的检测方法.     

血清中敌敌畏检测的气相色谱法

目的 建立血清中敌敌畏浓度检测的气相色谱法,为临床诊断和监测提供定量依据.方法 取0.5 ml血清加乙酸乙酯2.0 ml充分震荡萃取,静置5 min,4000 r/min离心,取上清液,氮气吹干,50μl乙醇定容,取1.0μl进样玻璃填充柱,用氮磷检测器检测和气相色谱法分析.结果 血清中敌敌畏浓度在5.0～50.0 μg/ml范围内呈线性关系,回归方程y=804.13x-691.8,r=0.9992.最低检出浓度为2.0μg/ml,回收率为86.8％～94.5％,相对标准偏差(RSD)为4.6％～5.5％.日内、日间RSD分别为4.52％～5.21％和3.56％～5.52％.结论 该方法操作简便、分析快速,结果准确,适于临床的快速诊断敌敌畏中毒和量化评估治疗效果.     

血清中佐匹克隆测定的气相色谱法

目的 建立血清中佐匹克隆定性定量测定的气相色谱法,为临床佐匹克隆中毒诊断提供依据.方法 取0.5 ml血清加混合有机溶剂(二氯甲烷+异丙醇=95+5 )2.0 ml充分振荡萃取,静置5min,4000 r/min离心,取上清液,氮气吹干.50μl乙腈定容,气相色谱法测定,1.0μl进样.结果 血清中佐匹克隆浓度在0.10～10.0 μg/ml范围内呈线性,回归方程y=0.0012x-0.4972,相关系数为0.9995,方法回收率为85.8％～102.3％;相对标准偏差(RSD)为3.1％～4.8％.日内、日间RSD分别为1.96％～4.66％和2.06％～4.90％,最低检出浓度为0.05 μg/ml.结论 气相色谱法可用于疑似佐匹克隆中毒患者的定性定量检测.     

血清中布洛芬检测的气相色谱法

目的 建立血清中布洛芬定性定量的气相色谱法测定,为临床监测血清布洛芬浓度和观察疗效提供依据.方法 取0.5 ml血清加5％氢氧化钠混合,加乙酸乙酯2.0 ml充分震荡萃取,静置5min,4000 r/min离心10 min,取上清液,氮气吹干.50μl乙醇定容,1.0μl进样,气相色谱法测定.结果 血清中布洛芬浓度在20～300 μg/ml范围内呈线性,回归方程y=284.8x+426.6,相关系数为0.9995,方法回收率为85.2％～102.3％;相对标准偏差(RSD)为3.1％～4.8％.日内、日间RSD分别为3.14％～4.92％和3.39％～4.10％,最低检出浓度为10.0 μg/ml.结论 该方法操作简便、分析快速,结果准确.可为临床监测布洛芬药物中毒的疗效观察提供适宜的检测方法.     

血浆醋氯芬酸测定方法的改进

目的为提高血浆醋氯芬酸的分离效果,对高效液相色谱(HPLC)测定方法进行改进.方法血浆中醋氯芬酸经盐酸酸化后用乙醚萃取浓缩,以Hypersil-C18(4.6mm× 250mm,10μm)为色谱柱;以甲醇:水:冰醋酸(70:30:0.5,V/V为流动相,流速为1.5ml/min;检测波长为276 nm.结果醋氯芬酸浓度在0.1～100μg/ml范围内线性关系良好(r=0.996 1);最低检出限为0.1 μg/ml;平均回收率为(101.17±1.17)%,日内、日间精密度分别为(6.04±2.45)%和(5.01±1.39)%.结论改进后的方法简便、准确可靠、灵敏,适用于人血浆醋氯芬酸浓度的测定和药代动力学研究.     

血液中甲硝唑测定的紫外分光光度法

目的 探讨建立血液中甲硝唑定性定量检测的紫外分光光度法.方法 患者血清经2.0ml乙酸乙酯振荡萃取,静置5 min,10 000 r/min离心,取乙酸乙酯层,氮气吹干,加0.2 ml 0.1 mol/LHCl混匀取50μl紫外分光光度法测定.结果 血清中甲硝唑浓度在2.0～30.0μg/ml范围内呈线性关系,回归方程y=25.3587x+0.0076,相关系数r=0.9996,回收率为95.5％～102.6％,相对标准偏差(RSD)为3.8％～4.9％.日内、日间RSD分别为3.4％～4.8％和2.9％～4.8％,最低检出限为0.5 μg/ml.结论 该方法操作简便、分析快速,结果准确.为临床诊断治疗甲硝唑中毒提供了一种简便准确的检测方法.     

QuEChERS净化—液相色谱串联质谱法测定血浆中8种抗凝血灭鼠剂

摘要:目的 建立QuEChERS净化,同位素稀释液相色谱串联质谱法（LC-MS/MS）测定血浆中大隆、溴敌隆、杀鼠醚、杀鼠灵、氯杀鼠灵、敌鼠、氯敌鼠、杀鼠酮抗凝血灭鼠剂的检测方法。方法 血浆样品经QuEChERS方法前处理,以杀鼠灵-D5作为同位素内标,采用BDS HYPERSIL C18(4.6 mm i.d×100 mm, 2.4 μm)分离,以甲醇-乙酸铵缓冲液梯度洗脱,流速为0.50 ml/min。采用电喷雾电离(ESI)负离子质谱在多反应监测(MRM)模式下检测。结果 8种抗凝血灭鼠剂在0.20 μg /L～25.0 μg /L(或者0.50 μg/L～25.0 μg/L)范围内有良好的线性关系(r＞0.999),检测限为0.044～0.19 μg /L,平均加标回收率为70.4%～101.5%（n=7）,相对标准偏差1.7%～8.9%（n=7）。结论 该方法快速、简单,灵敏度高,可应用于中毒病人血样中8种抗凝血灭鼠剂的同时检测。     

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.     

Psychopathological features of a patient population of targets of workplace bullying

BACKGROUND: A strong association between workplace bullying and subsequent anxiety and depression, indicated by empirical research, suggests that bullying is an aetiological factor for mental health problems. AIMS: To evaluate levels of stress and anxiety-depression disorder developed by targets of workplace bullying together with outcome at 12 months and to characterize this population in terms of psychopathology and sociodemographic features. METHODS: Forty-eight patients (36 women and 12 men) meeting Leymann Inventory of Psychological Terror criteria for bullying were included in a prospective study. Evaluations were performed at first consultation and at 12 months using a standard clinical interview, a visual analogue scale of stress, the Hospital Anxiety and Depression (HAD) scale, the Beech scale of stress in the workplace and a projective test (Picture-Frustration Study). RESULTS: At first consultation, 81% of patients showed high levels of perceived stress at work and 83 and 52% presented with anxiety or depression, respectively. At 12 months, only 19% of working patients expressed a feeling of stress at work. There was a significant change in symptoms of anxiety while there was no change in symptoms of depression. Stress at work and depression influenced significatively capacity to go back to work. At 12-month assessments, workers showed a significantly better score on the HAD scale than non-workers. Over half the targets presented a neuroticism-related predominant personality trait. CONCLUSION: Workplace bullying can have severe mental health repercussions, triggering serious and persistent underlying disorders.     

The rise and fall in incidence of malignant mesothelioma from a British Naval Dockyard, 1979-1999

BACKGROUND: The incidence of malignant mesothelioma in Britain is predicted to rise over the next 15-25 years because of past failure to protect the workforce against inhalation of asbestos. In British Naval dockyards, alternative insulation materials and respiratory protection were introduced from the mid-1960s. Aims This study was carried out to investigate the effects of these control measures on mesothelioma deaths in dockyard workers. METHODS: Cases of mesothelioma of the pleura and peritoneum between 1979 and 1999 in workers from the Devonport Naval Dockyard, south-west England, were sought from coroners' and medico-legal records. RESULTS: Three hundred and one cases were identified, 7% peritoneal. The peak incidence occurred in 1991 with 25 cases per annum (quadratic model fit R(2) = 74.2%, P < 0.001) and we predict that by 2003 the incidence will fall to fewer than five cases per annum. The mean time between first exposure and presentation was 48.5 years [95% confidence interval (CI) = 47.3-49.8], but this was significantly shorter in the more heavily exposed trades, when compared with the less heavily exposed (42 years, 95% CI = 39.0-45.0, versus 49.5 years, 95% CI = 48.2-50.9). Those with higher exposure were also at significantly greater risk of peritoneal disease (P < 0.023, Fisher's exact test). CONCLUSION: The reduction in incidence of mesothelioma is greater than can be accounted for by reduction in numbers of dockyard workers over the last 50 years. Changes in insulation materials and improved industrial hygiene measures introduced into the Devonport Dockyard from the mid-1960s have resulted in an earlier decline in the incidence of malignant mesothelioma than that predicted for the British workforce as a whole.     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

Organophosphate toxicity and occupational exposure

The ubiquitous organophosphates present a continuing health hazard in agriculture, public health eradication programmes and as chemical warfare agents. Despite significant progress in understanding the potential mechanisms of toxicity far beyond the commonly accepted mechanism of cholinesterase inhibition in intentional exposures, the precise health effects following occupational exposures are yet to be completely defined. A much greater understanding exists of the clinical features of organophosphate poisoning. These are characterized by a triphasic response involving an initial acute cholinergic phase, an intermediate syndrome (both associated with high mortality) and a disabling but non-lethal delayed polyneuropathy. The delayed polyneuropathy may occur in the absence of the cholinergic or intermediate phases. However, progress is still required in order to improve the quantification and assessment of occupational exposures and the implementation of appropriate preventive measures. Finally, evidence-based guidelines for appropriate or optimal therapeutic interventions following poisoning are required urgently and collaborative work with colleagues in developing countries, where the occurrence of organophosphate exposures is more frequent, may provide the answers.     

Miliaria rubra of the lower limbs in underground miners

This report documents a case series of miliaria rubra of the lower limbs in miners at a deep underground metalliferous mine in tropical arid Australia. During the summer months of February and March 1999, all cases of miliaria rubra of the lower limbs in underground miners seen at the mine's medical centre were clinically examined and administered a questionnaire. Twenty-five patients were seen, an incidence of 56.4 cases per million man-hours. Miliaria rubra was most often located between the ankle and knee (88% of cases). Twenty-four percent had concurrent folliculitis and 20% had concurrent tinea. Thirty-two percent had a personal history of asthma. Walking through ground-water and splashing of the legs was common. Three to 4 weeks of sedentary duties in air conditioning was generally required to achieve resolution of miliaria rubra. The incidence of miliaria rubra of the lower limbs is 38% of the incidence of heat exhaustion at the same mine. The length of disablement is greater, however. Atopics may be at increased risk of miliaria rubra. Control measures are discussed.     

Planning research

The starting point for any research project should be a question.Once this has been defined and the relevant scientific literaturereviewed, a protocol should be drawn up. This will be used notonly as a guide to the conduct of the study and in the preparationof the final report, but also in seeking any financial supportand approvals that are required for the investigation. A protocolis normally arranged in sections covering the background tothe study, the question(s) that it will address, the methodsthat will be used for the collection and analysis of data, thestatistical power of the investigation (where relevant), anyethical considerations, and the financial input that will beneeded. A pilot study is often helpful where aspects of thestudy method are untried or of uncertainvalidity.