三氯乙烯对豚鼠皮肤致敏作用与肝肾功能的损害

目的 探讨三氯乙烯(TCE)对豚鼠皮肤致敏作用及肝肾功能的损害.方法 采用豚鼠最大值试验(GPMT),将动物分成阴性对照组、阳性对照组和TCE实验组,每组6只豚鼠,分别皮内注射橄榄油、2,4-二硝基氯苯(DNCB)和TCE.实验结束后观察动物皮肤改变,应用自动生化分析仪检测致敏动物血清中丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、白蛋白、球蛋白、乳酸脱氧酶(LDH)、肌苷、尿酸等指标.结果阳性对照组和TCE实验组动物出现明显皮肤红斑、水肿,阳性对照组动物致敏率为100%,TCE实验组动物致敏率为83.3%.阳性对照组动物血清中ALT、AST活力升高,TCE实验组动物血清中ALT、AST、LDH活力明显高于阴性对照组,差异有统计学意义(P＜0.05或P＜0.01).结论 TCE可诱导豚鼠产生明显的皮肤致敏作用,属强致敏物,并可引起实验动物肝功能指标的改变.     

三氯乙烯致豚鼠皮肤变态反应和血清免疫球蛋白水平改变

目的:探讨三氯乙烯(TCE)对豚鼠皮肤变态反应和血清免疫球蛋白水平的改变。方法:采用豚鼠最大值试验GPMT,动物分成阴性对照组、阳性对照组和TCE实验组,每组6只豚鼠,分别皮内注射橄榄油、2,4-二硝基氯苯(DNCB)和TCE。实验结束后观察动物皮肤改变,应用自动生化分析仪检测致敏动物血清免疫球蛋白水平。结果:阳性对照组和TCE实验组动物出现明显皮肤损害,阳性对照组动物致敏率为100%,TCE实验组致敏率为83.3%。TCE致敏豚鼠血清总IgG含量明显高于阴性对照组(P0.05)。结论:三氯乙烯属于强致敏物,可诱导豚鼠产生皮肤变态反应,引起血清免疫球蛋白改变。     

三氯乙烯致敏豚鼠及IL-10表达的研究

目的研究细胞因子白细胞介素-10(IL-10)在三氯乙烯(TCE)致敏豚鼠表皮中的表达,探讨TCE药疹样皮炎发病机制。方法将白色雌性豚鼠随机分成空白对照组、溶剂对照组、TCE实验组、2,4—二硝基氯苯(DNCB)阳性对照组,根据豚鼠最大反应试验(guinea pig maximization test,GPMT)方法处理豚鼠,在终末激发后进行皮肤反应评分,皮肤反应评分≥1判断为致敏,依据致敏结果以及取材时间的不同将TCE实验组分为致敏组24 h、72 h和未致敏组24 h、72 h,DNCB阳性对照组24 h和72 h。无菌条件下取皮制成蜡块,采用Elivison二步法免疫组织化学法检测各组表皮中IL-10的表达情况。结果 TCE实验组致敏率为62.1%;TCE致敏24 h组和72 h组的IL-10水平高于溶剂对照组,且差异有统计学意义(P0.05);同时TCE致敏24 h组与TCE未致敏24 h组比较、TCE致敏72 h组与TCE未致敏72 h组比较,差异也有统计学意义(P0.05);TCE致敏24 h组与DNCB 24 h组比较,差异有统计学意义(P0.05)。结论 TCE对豚鼠皮肤具有致敏作用,IL-10在TCE药疹样皮炎发生过程中具有重要意义。     

三氯乙烯致敏豚鼠皮肤组织中白细胞介素-1、-6和-8表达的研究

目的研究白细胞介素(IL)-1、IL-6和IL-8在三氯乙烯(TCE)致敏豚鼠皮肤组织中的表达情况,探讨TCE药疹样皮炎发病机制。方法将白色雌性豚鼠随机分成空白对照组、溶剂对照组、TCE实验组、2,4-二硝基氯苯(DNCB)阳性对照组,根据豚鼠最大值试验(GPMT)方法处理豚鼠,在终末激发后(依据致敏结果以及取材时点的不同,将TCE实验组以及DNCB阳性对照组分为TCE致敏组24 h、TCE致敏组72 h、TCE未致敏组24 h和TCE未致敏组72 h;DNCB组24 h和DNCB组72 h)进行皮肤反应评分,并采取皮肤组织,制成蜡块,采用Elivison二步法免疫组织化学法检测各组皮肤组织中IL-1、IL-6和IL-8的表达情况。结果根据皮肤反应评分≥1判断为致敏阳性,TCE实验组致敏率为62.1%;TCE致敏组24 h和TCE致敏组72 h的IL-1水平要显著高于溶剂对照组,且差异有统计学意义(P<0.05);同时TCE致敏组24 h与TCE未致敏组24 h比较、TCE致敏组72 h与TCE未致敏组72 h比较差异也有统计学意义(P<0.05),但IL-6和IL-8水平在各个组别和不同时间点之间差异无统计...     

三氯乙烯染毒对豚鼠肝功能与凋亡基因表达的影响

目的探讨使用三氯乙烯(TCE)染毒对豚鼠肝功能和肝细胞凋亡基因(BAX、BAD、Bc1-2)表达的影响。方法将24只豚鼠随机分为3组,采用豚鼠最大值法(GPMT),设立TCE实验组、阴性对照组、阳性对照组,用皮内注射的方式分别注射TCE、橄榄油、2,4-二硝基氯苯(DNCB),实验结束后观察动物皮肤改变,应用自动生化分析仪检测动物肝功能指标,用荧光定量PCR检测肝细胞凋亡基因表达水平。结果 TCE实验组和阳性对照组动物出现明显皮肤损害。TCE实验组动物血清中丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、乳酸脱氢酶(LDH)活力明显高于阴性对照组(P0.05或P0.01)。肝细胞BAX、BAD的mRNA表达水平比阴性对照组显著升高,Bc1-2表达水平下降(P0.05或P0.01)。结论三氯乙烯可诱导豚鼠产生明显的皮肤变态反应,引起实验动物肝功能指标改变和肝细胞凋亡基因表达水平明显改变。     

职业性三氯乙烯药疹样皮炎患者血清肝纤维化指标的研究

目的研究三氯乙烯药疹样皮炎患者肝损害指标透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(C-Ⅳ)、甘胆酸(CG)的水平,探讨三氯乙烯皮炎肝损害后肝纤维化指标的改变,为判断三氯乙烯药疹样皮炎肝损害的预后提供依据.方法对28名三氟乙烯药疹样皮炎及16名对照组进行放射免疫法检测HA、LN、PCⅢ、C-Ⅳ、CG水平,并对中毒组与对照组、皮炎轻重不同组进行对比分析,对血清肝纤维化损害指标与常规肝损害指标进行相关分析.结果肝损害指标HA、PCⅢ、C-Ⅳ、CG等在三氯乙烯药疹样皮炎患者明显增高(P＜0.05),与丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素、胆汁酸等肝损害指标有良好的相关性.严重皮炎组血清肝纤维化指标值低于一般皮炎组,LN在三氟乙烯皮炎病例反而低于对照组.结论 HA、PCⅢ、C-Ⅳ、CG检测可以作为三氯乙烯药疹样皮炎患者肝损害程度的评价指标.三氯乙烯药疹样皮炎患者皮肤病变的严重程度与患者肝损害后肝纤维化指标不平衡.三氯乙烯皮炎患者肝损害可引起多个肝纤维化指标明显升高.     

三氯乙烯致敏豚鼠皮肤组织中TNF-α和IL-1的表达水平

目的研究TNF-α及IL-1在三氯乙烯(TCE)致敏豚鼠皮肤组织中的表达情况,探讨TCE药疹样皮炎发生过程中可能存在的机制。方法选用体重250 g左右白色雌性豚鼠,随机分成空白对照组、溶剂对照组、TCE处理组、2,4-二硝基氯苯(DNCB)阳性对照组,用豚鼠最大值实验(guinea pig maximization test,GPMT)方法建立动物致敏模型,并在终末激发后依据致敏结果以及取材时点的不同(分别于24 h、72 h取材),将TCE处理组分为TCE致敏24 h组、72 h组和TCE未致敏24 h组、72 h组;DNCB阳性对照组分为DNCB 24h组和DNCB 72h组。采用Elivison二步法免疫组织化学法检测各组皮肤组织中TNF-α和IL-1的表达。结果TCE处理组致敏率为62.1%;TCE致敏24 h组和TCE致敏72 h组的TNF-α及IL-1水平显著高于溶剂对照组,差异有统计学意义;同时TCE致敏与未致敏24 h组、TCE致敏与未致敏72 h组比较差异也有统计学意义。结论TCE对豚鼠皮肤具有致敏作用,TNF-α和IL-1在TCE药疹样皮炎发生过程中具有重要意义。 更多还原     

14例三氯乙烯药疹样皮炎患者肝损害病例分析

目的 分析三氯乙烯(TCE)药疹样皮炎患者肝功能损害的临床资料,为临床治疗提供依据.方法 对病例组14名TCE药疹样皮炎患者肝功能指标进行分析,并与接触对照组16名接触TCE但未发病者和健康对照组15名健康者进行比较.结果 病例组血清中的直接胆红素(DBIL) 44.2(7.6～166.0) μmol/L、丙氨酸转氨酶(ALT) 681.5( 169.0～1 815.0) U/L和天冬氨酸转氨酶(AST) 191.5(48.0～1 690.0)U/L均明显升高,而白蛋白(ALB)下降明显,为30.3(26.6 ～33.8)g/L,上述指标与健康对照组和接触对照组比较,差异均有统计学意义(均P ＜0.01);接触对照组DBIL、ALT、AST与ALB水平与健康对照组比较,差异均无统计学意义(均P＞0.05).结论 TCE药疹样皮炎患者肝脏损害严重,应加强防范.     

三氯乙烯及其代谢产物的豚鼠皮肤致敏试验

目的　探讨三氯乙烯及其代谢产物三氯乙酸、三氯乙醇及水合三氯乙醛对豚鼠的皮肤致敏作用。方法　按豚鼠最大值试验 (GPMT)法 ,用三氯乙烯、三氯乙酸、三氯乙醇及水合三氯乙醛分别对白化豚鼠进行皮内和涂皮结合法致敏试验 ,并设阳性对照 (二硝基氯苯 )、溶剂对照 (橄榄油 )和福氏完全佐剂 (FCA)对照 ,观察各组动物皮肤的红斑和水肿等情况 ,求出致敏率和平均反应值。结果　三氯乙烯、三氯乙酸和二硝基氯苯的致敏率分别为 71 4%、5 8 3 %和10 0 % ,平均反应值分别为 2 3、1 1和 6 0。三氯乙醇和水合三氯乙醛的致敏率均为 0。结论　三氯乙烯是强度致敏物 ;三氯乙酸是中度致敏物 ;三氯乙醇及水合三氯乙醛未见致敏作用。     

三氯乙烯药疹样皮炎患者体内补体等变化情况观察

目的探索三氯乙烯药疹样皮炎发病机制。方法对三氯乙烯药疹样皮炎患者部分免疫相关血液生化指标进行分析,观察各指标随病程变化情况。收集13例确诊三氯乙烯药疹样皮炎患者入院时和治疗1个月后血液生化检查中部分免疫相关指标(包括IgG、IgA、IgM、C3、C4等),比较治疗前后这些指标是否发生变化。结果治疗前C3含量和IgM含量明显低于治疗后(近似正常状态)(0.846vs1.402,0.818vs0.949,均P<0.05),其他指标差异无显著性。结论三氯乙烯药疹样皮炎患者病程中可能存在补体活化,从而引起脏器损伤。     

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.     

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.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.     

The reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

Function of the protein RPE65 in the visual cycle

A protein called RPE65 performs a key role in the trans-cis isomerization of retinol in the retinal pigment epithelium of the eye. The palmitoylation of RPE65 serves to switch off the visual cycle in darkness and to switch it on in the light.     

Acute symptoms following work with pesticides

BACKGROUND: Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms. AIM: To explore the frequency, nature and determinants of acute symptoms following work with pesticides. METHODS: A postal survey of men in three rural areas of England and Wales provided data on occupational use of five categories of pesticide, occurrence of 12 specified symptoms within 48 h of using pesticides and tendency to somatize. Risk factors for pesticide-related symptoms were assessed by modified Cox regression. RESULTS: Of 10 765 responders (response rate = 31%), 4108 had at some time used pesticides occupationally, including 935 (23%) who reported symptoms following such work on at least one occasion. In two areas, acute symptoms were most frequent following use of sheep dip (29 and 32% of users), but in the third area the rate was significantly lower (13% of users). The relative frequency of symptoms was similar for all five categories of pesticide, and flu-like symptoms did not cluster unusually among users of sheep dip. Risk of pesticide-related symptoms increased with somatizing tendency (prevalence ratio for highest versus lowest category 2.4, 95% confidence interval 2.0-3.0) and was higher in men who had used pesticides most often or handled concentrate. CONCLUSION: Acute symptoms are common following work with pesticides, but in many cases the illness may arise through psychological rather than toxic mechanisms.     

The Life Events Inventory: re-scaling based on an occupational sample.

The objective of this study was to compare the validity of the original weightings used by the Life Events Inventory (LEI) with those obtained from a contemporary occupational sample. Fifty male and 62 female manufacturing employees (age range 16-55 years) assigned scores to each item on a slightly modified version of the LEI scale. The current sample consistently assigned higher weights to events/items than did the original sample, but there was high agreement in terms of item ranking. Some distinct age and gender differences in scoring were apparent, and are discussed further. It was concluded that when separate weightings are employed for age and gender groups, the LEI remains a useful tool for quantifying background levels of stress in both workplace stress audits and epidemiological studies where statistical control for non-occupational sources of stress is required.     

Maxillofacial injuries related to work accidents: a new concept of a hospital-based full electronic occupational trauma surveillance system

The objective of this study was to investigate the occurrence of occupational maxillofacial injuries using a newly installed relational database. Twenty-six injuries were identified out of 28,624 patients admitted to the emergency unit during a 12 month period. Falls from height or being struck by moving objects were common causes of these injuries. Two-thirds of those identified were construction workers. This paper demonstrates the power of modern databases to identify specific occurrences that may provide the basis for prevention in the future.     

Rôles physiologiques des endocannabinoïdes dans le contrôle de l’homéostasie énergétique

Endocannabinoids are endogenous lipids which modulate the release of neurotransmitters and activate different signaling pathways, through the binding to cannabinoïd receptors, CB1 and CB2. Endocannabinoids are involved in the control of a variety of behavioural and neuroendocrine functions, including feeding behaviour. In the central nervous system, they essentially modulate the expression of orexigen or anorexigen neuropeptides thus resulting in the stimulation of food intake. Their peripheral targets are mainly the liver and the white adipose tissue where they stimulate lipogenesis, through the modulation of several enzymes and proteins expressions. Cannabinoïd receptor agonists are nowadays prescribed to improve appetite of people suffering from cancer or AIDS. In the same way, CB1 antagonist, such as Rimonabant, could provide efficient treatment of obesity.