那素达联合聚乙二醇眼液在自体角膜缘干细胞移植治疗翼状胬肉中的应用研究

目的评价那素达联合聚乙二醇眼液在自体角膜缘干细胞移植治疗翼状胬肉的临床效果。方法采用前瞻性队列研究,按照纳入及排除标准收集48例(62眼)翼状胬肉切除联合自体角膜缘干细胞移植术患者,将患者随机分为联合用药组和对照组;联合用药组在术前、术中、术后使用那素达、聚乙二醇和典必殊眼液,对照组仅术后用典必殊眼液。比较联合用药组与对照组患者在复发率、上皮愈合时间、眼表功能、并发症等之间的差异。结果联合用药组复发率为2.78%,对照组复发率为7.69%,2组差异无统计学意义(P0.05);联合用药组平均上皮愈合时间为(5.07±1.23)d,对照组为(5.83±1.59)d,2组差异有统计学意义(P0.05)。联合用药组与对照组患者手术前泪液分泌量、泪膜破裂检查时间测定值之间差异均无统计学意义(P0.05);与手术前相比,联合用药组与对照组患者术后1个月的泪液分泌量、泪膜破裂检查时间均明显增加,差异均有统计学意义(P0.01);联合用药组患者手术1个月后泪液分泌量、泪膜破裂检查时间亦均高于对照组患者,差异有统计学意义(P0.01)。结论那素达联合聚乙二醇眼液在翼状胬肉切除联合自体角膜缘干细胞移植治疗中可缩短上皮愈合时间,改善眼表功能。     

翼状胬肉切除术联合自体角膜缘干细胞移植术治疗翼状胬肉患者的临床效果

目的探究翼状胬肉切除术联合自体角膜缘干细胞移植术治疗翼状胬肉患者的临床效果。方法选取2016年5月至2018年6月于医院就诊的60例翼状胬肉患者作为研究对象,采用随机数字表法分为对照组和试验组,各30例。对照组采用翼状胬肉切除术治疗,试验组在对照组基础上采用自体角膜缘干细胞移植术治疗,比较两组治疗效果、泪膜稳定性及复发率。结果试验组治疗有效率高于对照组,差异有统计学意义(P<0.05);试验组术后泪膜脂质层厚度(LLT)、泪河高度(TMH)均高于对照组,泪膜破裂时间(BUT)长于对照组,差异有统计学意义(P<0.05);试验组复发率低于对照组,差异有统计学意义(P<0.05)。结论翼状胬肉切除术联合自体角膜缘干细胞移植术治疗翼状胬肉患者疗效显著,可增加泪膜稳定性,降低疾病复发率。     

氟米龙滴眼液对翼状胬肉患者术后康复的影响

目的探讨氟米龙滴眼液对行翼状胬肉切除联合自体角膜缘干细胞移植术后康复的影响。方法选取2018年6月-2019年3月遂溪晶亮眼科医院接诊的1 012例翼状胬肉患者,按随机数字表法分为观察组和对照组各506例。入组患者均接受翼状胬肉切除联合自体角膜缘干细胞移植术治疗,对照组术后给予左氧氟沙星滴眼液,在此基础上,观察组给予0.02%氟米龙滴眼液。观察比较两组术后眼部指标、舒适度、泪膜功能、治愈率和复发率。结果观察组移植结膜瓣水肿时间短于对照组[(16.75±3.23)d vs(22.48±6.05)d],舒适度评分低于对照组[(5.39±0.96)分vs(8.78±1.01)分],差异均有统计学意义(P<0.05);两组角膜上皮修复时间比较,差异无统计学意义(P>0.05);观察组基础泪液分泌试验(SIT)、治愈率高于对照组,泪膜破裂时间(BUT)短于对照组、复发率均低于对照组,差异均有统计学意义(P<0.05)。结论 0.02%氟米龙滴眼液可缩短翼状胬肉切除联合自体角膜缘干细胞移植术后患者移植结膜瓣水肿时间,提高治愈率、舒适度,改善泪膜功能,降低复发率,值得临床推广。     

自体角膜缘干细胞移植术治疗翼状胬肉的效果研究

目的 研究探讨自体角膜缘干细胞移植术治疗翼状胬肉的效果。方法 将2018年1月-2020年12月在安徽省灵璧县人民医院接受治疗的翼状胬肉患者650例作为本次研究的对象,所有患者随机分组,分为对照组和观察组,每组325例。对照组患者行单纯翼状胬肉切除术治疗;观察组患者行翼状胬肉切除联合自体角膜缘干细胞移植术治疗。观察对比两组患者治疗后的情况。结果 观察组患者的各项指标更佳;观察组患者的视觉质量改善更佳,两组对比差异具有统计学意义(P<0.05);观察组患者的各项指标更佳,两组对比差异具有统计学意义(P<0.05);观察组患者的泪膜功能改善情况更佳,两组对比差异具有统计学意义(P<0.05);观察组患者的并发症发生率更低,差异具有统计学意义(P<0.05)。结论 自体角膜缘干细胞移植术治疗翼状胬肉的效果十分显著,可明显改善患者的角膜屈光、泪膜功能以及视觉质量,降低治疗的并发症发生率和复发率,非常具有临床价值,值得大力运用和推广。     

自体角膜缘干细胞移植术对翼状胬肉患者角膜散光度及复发的影响

目的探讨自体角膜缘干细胞移植术对翼状胬肉患者角膜散光度及复发的影响。方法选择2014年6月—2015年12月收治的88例翼状胬肉患者作为研究对象,均为单眼发病,根据入院先后顺序分为观察组与对照组,各44例。对照组采用翼状胬肉切除术治疗,观察组采用自体角膜缘干细胞移植术治疗,比较两组临床疗效、角膜散光度及复发率。计量资料比较采用t检验,计数资料比较采用χ~2检验;P0.05为差异有统计学意义。结果观察组恢复情况优于对照组,差异有统计学意义(P0.05);与术前相比,两组术后不同时间角膜散光度均显著下降,且术后1个月、3个月角膜散光度水平明显低于术后1周,差异有统计学意义(均P0.05);但两组相比差异无统计学意义(P0.05);观察组复发率低于对照组,差异有统计学意义(P0.05)。结论翼状胬肉患者采用自体角膜缘干细胞移植术治疗能缩短患者修复时间,降低复发率。     

翼状胬肉切除术联合自体角膜缘干细胞移植术治疗翼状胬肉疗效探讨

目的 探讨翼状胬肉切除术联合自体角膜缘干细胞移植术治疗翼状胬肉的应用价值。方法 收集2021年1月—2022年1月三河燕郊二三医院收治的翼状胬肉患者116例(116眼),按照手术方式分为联合手术组81例(81眼)和单纯手术组35例(35眼)。联合手术组接受翼状胬肉切除术联合自体角膜缘干细胞移植术;单纯手术组仅接受翼状胬肉切除术,比较两组患者的治疗效果。结果 联合手术组角膜上皮愈合时间短于单纯手术组,差异有统计学意义(P<0.05)。术后6个月两组患者患眼裸眼视力、泪膜破裂时间和泪液分泌试验结果均得到显著改善,且联合手术组优于单纯手术组,差异有统计学意义(P<0.05)。联合手术组术后并发症发生率及术后1年复发率均低于单纯手术组,差异有统计学意义(P<0.05)。结论 翼状胬肉切除术联合自体角膜缘干细胞移植术治疗翼状胬肉临床效果更优秀,且术后并发症发生率更低。     

明目四物汤联合针刺治疗干眼症临床观察

目的探究明目四物汤联合针刺疗法治疗干眼症的临床疗效和安全性,为临床治疗干眼症提供依据。方法本次研究纳入天津市中医药研究院附属医院眼科2018年8月—2020年2月收治的干眼症患者70例,随机分为观察组和对照组各35例。对照组患者采取西药玻璃酸钠滴眼液治疗,观察组患者在对照组治疗基础上联合明目四物汤及针刺疗法治疗,比较两组患者疗效、治疗前后泪液分泌试验以及泪膜破裂时间、不良反应发生情况。结果观察组治疗总有效率为97.14%,明显高于对照组的80.00%,差异有统计学意义(P0.05);治疗前两组患者泪液分泌试验情况、泪膜破裂时间差异均无统计学意义(P0.05),治疗后两组患者泪液分泌试验情况、泪膜破裂时间均改善,观察组优于对照组,差异均有统计学意义(P0.05);两组不良反应发生率差异无统计学意义(P0.05)。结论明目四物汤联合针刺疗法治疗干眼症临床疗效明显,且患者症状改善,泪液分泌试验、泪膜破裂时间均改善,安全性高,值得临床推广应用。     

翼状胬肉切除联合角膜缘干细胞移植术治疗翼状胬肉的临床效果观察

目的探讨翼状胬肉切除联合角膜缘干细胞移植术治疗翼状胬肉的临床效果。方法选取92例原发性翼状胬肉患者,随机分为观察组和对照组各46例。对照组行翼状胬肉切除术治疗,观察组行翼状胬肉切除联合角膜缘干细胞移植术治疗,比较两组的临床效果、并发症情况及术前和术后3个月的角膜散光、 BUT、裸眼视力。结果观察组的治愈率、复发率分别为91.18%、 8.82%,均优于对照组的79.17%、 20.83%(P <0.05)。术前,两组患者的角膜散光、 BUT、裸眼视力比较无统计学差异(P>0.05);术后3个月,两组患者的角膜散光、 BUT、裸眼视力均显著改善,且观察组的角膜散光、 BUT、裸眼视力显著优于对照组(P <0.05)。观察组的并发症发生率为4.41%,显著低于对照组的19.44%(P <0.05)。结论翼状胬肉切除联合角膜缘干细胞移植术治疗翼状胬肉效果显著,可显著降低患者的复发率,加速其视力恢复,值得推广。     

自体角膜缘干细胞移植和羊膜移植治疗翼状胬肉疗效探讨

目的:分析自体角膜缘干细胞移植和羊膜移植治疗翼状胬肉的临床应用价值。方法:选取我院2015年3月至2016年3月诊断并接受治疗的翼状胬肉患者91例(116眼),根据我院就诊时间的先后顺序分为研究组和对照组,对照组45例(56眼),研究组46例(60眼)。对照组采取羊膜移植治疗方式,研究组采取自体角膜缘干细胞移植治疗方式,术后进行随访,时间在2~4个月内,且对比两组患者移植的治疗效果、视力改善情况及并发症状况。结果:两组患者治疗后跟治疗前相比较的视力改善情况显然得到了提高(P0.05),两组患者的对比没有明显差异,无统计学意义(P0.05);研究组与对照组的角膜上皮创面愈合时间差异有统计学意义(P0.05);研究组7例5眼翼状胬肉复发,复发率6.66%;对照组6例9眼翼状胬肉复发,复发率16.1%,研究组的翼状胬肉复发率明显低于对照组,两组存在差异有统计学意义(P0.05)。结论:在治疗翼状胬肉患者时,可选用自体角膜缘干细胞移植和羊膜移植的治疗方式。但是,采取自体角膜缘干细胞移植的临床治疗方式,其效果显著,不仅能够有效地减少患者的创面愈合时间,降低翼状胬肉复发率,而且还能改善患者的病情状况,有助于患者康复。所以,这种治疗方式值得被广泛使用和推广。     

联合检测PAI-1、t-PA水平在2型糖尿病大血管病变的临床意义

目的 探讨联合检测合并大血管病变的2型糖尿病患者血浆纤溶酶原激活物抑制物-l(PAI-1)、组织纤溶酶原激活剂(t-PA)水平的临床价值.方法 检测36例合并大血管病变的2型糖尿病患者(A组)、32例无并发症的2型糖尿病患者(B组)和30例健康体检者(对照组)的血浆PAI-1、t-PA水平,同时检测三组研究对象的血糖、血脂等常规生化指标,并对结果进行统计学处理分析.结果 A组患者血浆PAI-1、t-PA水平与B组患者及正常对照组比较差异均有统计学意义(P＜0.05);A组患者FPG、HbA1c、TG、TC、LDL-c等指标与B组患者比较差异无统计学意义(P＞0.05),与正常对照组比较差异有统计学意义(P＜0.01);A组患者HDL-c与B组患者及正常对照组比较差异无统计学意义(P＞0.05).结论 PAI-1、t-PA水平与2型糖尿病患者大血管病变密切相关,联合检测2型糖尿病患者的PAI-1、t-PA水平对大血管并发症的诊断、预防和治疗具有很好的价值.     

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.     

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.     

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.     

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.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.