核型自动扫描系统在淋巴细胞染色体畸变检测中的价值

目的 探讨核型自动扫描成像系统在淋巴细胞染色体畸变检测中的优点。方法 以192名医疗单位的放射工作人员为研究对象,分别用核型自动扫描系统检测法和人工双盲检测法对其外周血淋巴细胞染色体畸变细胞率和染色体畸变率进行检测分析。结果 对同一批标本阅片,扫描组平均用时（15.3 ±0.69） min小于人工组（42.0 ±0.56） min,差异有统计学意义（P < 0.05）。对同一批标本,扫描组的染色体畸变细胞率（0.193%）和染色体畸变率（0.227%）均高于人工组（0.065%,0.102%,）,差异均有统计学意义（P < 0.05）。结论 核型自动扫描系统可以提高淋巴细胞染色体畸变的检出率,提高阅片的速度,缩短发报告的周期,减轻实验室人员的工作量,适合标本量较多的单位使用。     

尘肺病治疗中国专家共识(2018年版)

  目的  了解江苏省南京市1956 — 2021年尘肺患者的生存状况及可能的影响因素,进一步探究其疾病负担水平,为制定新时代尘肺防治措施提供科学依据。  方法  于2022年10月整群抽取江苏省职业病防治信息管理系统中1956年1月1日 — 2021年12月31日南京市上报的3456例尘肺确诊患者进行随访调查,采用寿命表法和Kaplan-Meier法进行生存分析,应用Cox比例风险回归模型对生存时间的相关因素进行分析,并采用伤残调整寿命年（DALY）、因早死造成健康生命年的损失（YLL）和因伤残造成的健康寿命年的损失（YLD）综合分析尘肺的疾病负担。  结果  南京市1956 — 2021年累计报告尘肺病例3333例,以男性（89.3%）、初次诊断分期为I期（89.3%）、矽肺（72.1%）为主。生存分析结果显示,截至2021年12月31日,南京市尘肺患者中位数生存时间为30.20（95%CI = 29.53～30.86）年。多因素Cox比例风险回归分析结果显示,诊断年龄 ≥ 30岁和初次诊断分期为III期是南京市尘肺患者存活的危险因素,女性和制造业是南京市尘肺患者存活的保护因素。疾病负担分析结果显示,1956 — 2021年南京市尘肺共造成累计DALY损失27529.49人年,例均DALY损失8.26年;累计YLD损失23440.46人年,例均YLD损失7.03年;累计YLL损失4089.03人年,例均YLL损失2.53年。南京市1956 — 2021年因尘肺造成的例均YLD、例均YLL和例均DALY总体均呈下降趋势（χ²_趋势 = 776.437、206.153和1040.571,均P < 0.001）,YLD和DALY在1991 — 2000年造成的损失最大,分别为10042.02人年和10619.59人年,YLL则随时间的推移逐渐变大,2011 — 2021年造成的损失最大为1956.35人年。  结论  南京市1956 — 2021年尘肺的防控形势整体可控,但造成的疾病负担不容忽视,建议相关部门加强对重点人群、重点病种及重点行业的防控。     

β-烟酰胺单核苷酸对尘肺大鼠呼吸肌疲劳的改善作用及其线粒体相关机制

采用大鼠尘肺模型,探讨β-烟酰胺单核苷酸（NMN）对呼吸肌功能的改善作用及线粒体相关机制。通过气管注射石英粉尘建立大鼠慢性尘肺模型,造模3个月后,治疗组灌胃给予NMN 300,150 mg/kg,给药4周后进行各项指标检测。结果显示,尘肺模型大鼠出现明显的呼吸异常和通气障碍,表现为呼吸频率增加,呼吸幅度下降（P < 0.01）,血液pH、PaO₂和SaO₂均显著降低,而PaCO₂显著升高（P < 0.01）,NMN 给药可以明显改善模型大鼠的呼吸功能,增加血氧饱和度。NMN可明显增强离体膈肌的收缩功能和ATP含量,改善肌肉疲劳状态（P < 0.05,P < 0.01）。尘肺大鼠膈肌线粒体膜电位显著降低（P < 0.01）,琥珀酸脱氢酶（SDH）活力显著下降（P < 0.01）,同时超氧化物歧化酶（SOD）活力下降、丙二醛（MDA）水平增加（P < 0.05）,表明膈肌线粒体氧化代谢障碍和氧化应激损害,NMN对这些膈肌线粒体功能相关改变具有明显的改善。NMN可以显著上调尘肺大鼠膈肌Sirt1、Pgc-1α、Nrf1和Tfam等线粒体生物发生相关基因的mRNA水平。结果表明,NMN灌胃给药可以调节尘肺模型大鼠膈肌线粒体功能,改善膈肌能量代谢,增强膈肌收缩功能,进而改善呼吸和通气状态,此作用可能是通过促进膈肌线粒体生物发生而介导的。     

山茱萸总萜对KKay糖尿病小鼠的治疗作用研究

目的 观察山茱萸总萜对KKay糖尿病小鼠的治疗作用。方法 选择KKay糖尿病小鼠模型,分别以低、中、高剂量（0.05、0.10、0.20 g/kg）的山茱萸总萜ig给药5周。每天给药前观察动物一般状况;给药前及给药期间每周测定1次小鼠体质量、空腹血糖;给药第5周,进行ip葡萄糖耐量试验（IPGTT）,采血测定胰岛素（Ins）、糖化血红蛋白（HbA1c）、糖化血清蛋白（GSP）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）水平,计算胰岛素抵抗指数（IR）。结果 与模型组比较,山茱萸总萜可以剂量相关性地减轻KKay小鼠体质量,高剂量组第1、2和5周差异显著（P<0.05）;各剂量组自给药第1周起即可显著降低空腹血糖水平（P<0.05、0.01）;高剂量组显著降低IPGTT中小鼠血糖-时间曲线下面积（P<0.05）;山茱萸总萜可以剂量相关性地降低Ins、HbA1c、GSP、TC、TG、LDL水平、降低IR。结论 山茱萸总萜对于KKay小鼠糖尿病相关症状和指标具有剂量相关性的改善作用,可改善脂质代谢紊乱,提示其在治疗伴有胰岛素抵抗和脂质代谢紊乱的轻、中度2型糖尿病方面具有良好的应用前景。     

Acute Pesticide Poisoning in Jiangsu Province,China, from 2006 to 2015

This study aimed to investigate the characteristics of pesticide poisoning in Jiangsu Province, China, and to provide a scientific basis for developing effective interventional measures and preventive strategies. From 2006 to 2015, a total of 35,308 cases of pesticide poisoning were reported in Jiangsu Province. Non‐occupational poisoning accounted for 73.79% of all poisoning cases. A comparison of the data collected before(2006) and after(2015) this study showed a decrease in non‐occupational pesticide poisoning. Pesticide poisoning showed an age central tendency of 30 to 44 years, area central tendency for northern Jiangsu, and seasonal central tendency of occupational pesticide poisoning in autumn. Pesticide poisoning remains a major health concern in China. Government agencies together with scientists should focus their efforts on the prevention of potential threats to vulnerable groups such as the elderly, women, and children.     

生活性汞接触者行驱汞试验的必要性研究

目的 探讨尿汞在4～35μg/gCr之间的生活性汞接触者驱汞试验的必要性。方法 回顾性研究南京市职业病防治院2016年6月—2021年4月门诊尿汞在4～35μg/gCr之间的生活性汞接触者,按是否行驱汞试验分为驱试组(n=24)和对照组(n=52)。驱试组给予二巯基丙磺酸钠行驱汞试验,对照组自然排汞,比较两组基线尿汞、症状及体征及一、三、六月后随访情况。结果 驱汞试验前,驱试组和对照组两组患者年龄、基线尿汞、各组症状及体征差异均无统计学意义(P>0.05)。驱试组尿汞随访一、三、六月后分别下降至(4.69±1.63)、(3.18±0.84)、(1.90±0.72)μg/gCr,对照组尿汞分别下降至(12.60±4.29)、(6.79±2.62)、(3.63±1.31)μg/gCr,差异均有统计学意义(P<0.001)。一、三月后随访,驱试组神经衰弱综合征、水肿及尿微量白蛋白异常好转率明显高于对照组,差异均有统计学意义(P<0.05)。六月后随访,驱试组和对照组神经衰弱综合征、口腔-牙龈炎、震颤、水肿、尿蛋白阳性及尿微量白蛋白异常好转差异均无统计学意义(P>0.0...     

Expenditure and financial burden for the diagnosis and treatment of colorectal cancer in China: a hospital-based,multicenter,cross-sectional survey

Background:The increasing prevalence of colorectal cancer (CRC) in China and the paucity of information about relevant expenditure highlight the necessity of better understanding the financial burden and effect of CRC diagnosis and treatment.We performed a survey to quantify the direct medical and non-medical expenditure as well as the resulting financial burden of CRC patients in China.Methods:We conducted a multicenter,cross-sectional survey in 37 tertiary hospitals in 13 provinces across China between 2012 and 2014.Each enrolled patient was interviewed using a structured questionnaire.All expenditure data were inflated to the 2014 Chinese Yuan (CNY;1 CNY =0.163 USD).We quantified the overall expenditure and financial burden and by subgroup (hospital type,age at diagnosis,sex,education,occupation,insurance type,household income,clinical stage,pathologic type,and therapeutic regimen).We then performed generalized linear modeling to determine the factors associated with overall expenditure.Results:A total of 2356 patients with a mean age of 57.4 years were included,57.1％ of whom were men;13.9％ of patients had stage Ⅰ cancer;and the average previous-year household income was 54,525 CNY.The overall average direct expenditure per patient was estimated to be 67,408 CNY,and the expenditures for stage Ⅰ,Ⅱ,Ⅲll,and Ⅳ disease were 56,099 CNY,59,952 CNY,67,292 CNY,and 82,729 CNY,respectively.Non-medical expenditure accounted for 8.3％ of the overall expenditure.The 1-year out-of-pocket expenditure of a newly diagnosed patient was 32,649 CNY,which accounted for 59.9％ of their previous-year household income and caused 75.0％ of families to suffer an unmanageable financial burden.Univariate analysis showed that financial burden and overall expenditure differed in almost all subgroups (P ＜ 0.05),except for sex.Multivariate analysis showed that patients who were treated in specialized hospitals and those who were diagnosed with adenocarcinoma or diagnosed at a later stage were likely to spend more,whereas those with a lower household income and those who underwent surgery spent less (all P ＜ 0.05).Conclusions:For patients in China,direct expenditure for the diagnosis and treatment of CRC seemed catastrophic,and non-medical expenditure was non-ignorable.The financial burden varied among subgroups,especially among patients with different clinical stages of disease,which suggests that,in China,CRC screening might be cost-effective.