血清VEGF和MMP-9含量动态变化监测在急性脑梗死患者中的临床意义及研究

[目的]探讨血清VEGF和MMP-9含量动态变化监测在急性脑梗死患者中的临床意义。[方法]2010年2月～2011年2月期间,分别采用ELISA法,检测121例急性脑梗死患者和60例健康对照者血清VEGF和MMP-9水平变化。[结果]急性脑梗死组d1、d3、d7、d14血清VEGF与MMP-9水平均明显高于对照组,两组比较差异有统计学意义(P﹤0.05)。血清VEGF水平d1明显升高,d7达到峰值,d14仍维持的高水平;血清MMP-9水平d1即明显升高,d3达到峰值,随后逐渐降低,但d14后仍维持的较高水平。随着急性脑梗死面积的增加,血清VEGF与MMP-9水平逐渐增高(P﹤0.05)。血清VEGF与MMP-9进行相关性分析发现,两者呈显著正相关(r=0.312,P﹤0.05)。[结论]血清VEGF和MMP-9在急性脑梗死患者中水平发生明显升高,呈动态变化,并且VEGF和MMP-9两者呈显著正相关,其水平与随脑梗死面积的增加不断升高,通过对其监测有助于对脑梗死及时诊断及判定治疗效果。     

血清及支气管肺泡灌洗液中TNF-α、IL-1β、IL-6在急性呼吸窘迫综合症中的变化及意义

[目的]观察血清及支气管肺泡灌洗液中TNF-α、IL-1β、IL-6在急性呼吸窘迫综合症中的变化及意义。[方法]2010年3月～2011年3月,分别检测62例急性呼吸窘迫综合症患者和50例健康对照者血清及支气管肺泡灌洗液中TNF-α、IL-1β、IL-6的水平。[结果]急性呼吸窘迫综合症组血清中TNF-α、IL-1β、IL-6水平明显高于对照组(P﹤0.05)。急性呼吸窘迫综合症组支气管肺泡灌洗中TNF-α、IL-1β、IL-6水平明显高于对照组(P﹤0.05)。[结论]TNF-α、IL-1β、IL-6不论是在急性呼吸窘迫综合症患者血清中还是支气管肺泡灌洗液中水平均明显升高,提示这些细胞因子在急性呼吸窘迫综合症的发生发展中发挥着重要作用。     

不同联合用药方案在急性脑梗死中的效果对比

[目的]比较不同联合用药方案在急性脑梗死中的效果。[方法]选取2008年1月～2011年1月于某院进行治疗的78例急性脑梗死患者为研究对象,将其随机分为A组(依达拉奉联合奥扎格雷组)39例和B组(依达拉奉联合丹参组)39例,后将两组患者的治疗总有效率、不良反应发生率及治疗前、治疗后7d、14d的NIHSS评分、血清CRP、Hcy、SOD、MDA水平进行统计及比较。[结果]A组的治疗总有效率高于B组,NIHSS评分优于B组,血清CRP、Hcy、MDA水平低于B组,SOD高于B组,P﹤0.05或P﹤0.01,有显著性差异或有非常显著性差异,但两组不良反应发生率差异无统计学意义,P﹥0.05。[结论]依达拉奉联合奥扎格雷治疗急性脑梗死疗效更佳,安全性也较高,可在急性脑梗死患者中应用。     

脑梗死患者血清中IGF-1、IL-2及ICAM-1水平与血管狭窄及神经功能的关系

目的分析脑梗死患者血清中IGF-1、IL-2及ICAM-1水平与不同脑血管狭窄程度及NIHSS评分的相关性。方法选取2015年1月-2016年1月于我院就诊的48例急性脑梗死患者,检测患者血清中IGF-1、IL-2、ICAM-1水平,采用NIHSS评价患者的神经功能,并评价血管功能。分析血清中IGF-1、IL-2、ICAM-1水平与患者血管狭窄及神经功能的关系,采用多因素Logistic回归方程分析脑梗死患者死亡的危险因素。结果重度狭窄患者血清中IGF-1、ICAM-1、IL-2水平明显高于轻度狭窄、中度狭窄患者,治疗后ICAM-1、IL-2、IGF-1低水平组患者治疗后7 d、14 d水平均明显低于对应高水平组的患者。结论血清中IGF-1、IL-2及ICAM-1水平与患者血管狭窄程度及神经功能密切相关。     

粒细胞集落刺激因子动员治疗急性脑梗死及对患者HGF和VEGF与TGF-β1水平影响的研究

目的探讨粒细胞集落刺激因子（rhG-CSF）动员对脑梗死患者的疗效及其血浆肝细胞生长因子（HGF）、血管内皮生长因子（VEGF）及转化生长因子β1（TGF-β1）水平影响。方法脑梗死患者共80例,随机分组,均常规治疗外,治疗组予rhG-CSF 300μg每日皮下注射,共5 d,对照组不予rhG-CSF,治疗前及治疗15 d后进行神经功能评分。治疗组动员前后,对照组治疗第1天及第6天分别采集外周血3 ml,用ELISA方法检测血浆HGF、VEGF及TGF-β1水平。结果治疗15 d后,治疗组神经功能评分优于对照组,两者差异有统计学意义（P〈0.05）。动员后患者血浆HGF、VEGF及TGF-β1水平明显高于动员前,对照组血浆HGF、VEGF及TGF-β1水平无显著变化。结论rhG-CSF治疗脑梗死安全有效,动员后脑梗死患者血浆HGF、VEGF及TGF-β1水平显著增加。     

缬沙坦对肝硬化患者血TGF-β1、HA、CG浓度的影响

[目的]探讨缬沙坦对肝硬化患者血清TGF-β1、HA、CG浓度的影响。[方法]将40例肝硬化患者随机分为治疗组和对照组各20例。对照组常规治疗,治疗组在常规治疗的基础上加用口服缬沙坦80mg/d,疗程3个月。治疗前后采用酶联免疫吸附试验(ELISA)检测血清TGF-β1浓度,放射免疫法检测血清HA、CG浓度。[结果]治疗组经缬沙坦治疗血清TGF-β1、HA、CG浓度较治疗前显著下降(P﹤0.01);对照组患者血清TGF-β1、HA、CG浓度有所下降,但无统计学意义;两组治疗前后差值比较,差异有统计学意义(P﹤0.01)。[结论]缬沙坦通过降低肝硬化患者血清TGF-β1、HA、CG浓度,可改善肝硬化患者的纤维化程度。     

急性脑梗死患者血管介入治疗后纤溶活性水平的变化分析及疗效的初步观察

[目的]探讨血管介入治疗联合抗凝及抗血小板治疗对急性动脉粥样硬化性脑梗死患者纤溶系统的影响。[方法]将2008年6月～2010年6月本院收治的96例急性动脉粥样硬化性脑梗死患者随机分为A、B、C3组,每组各32例,选择同期健康体检者32例作为对照(D组)。A组给予肠溶阿司匹林150～300mg口服,每天1次;B组给予低分子肝素钠5000IU腹部皮下注射,每天2次,连用3d;C组行经皮腔内血管成形支架置入术,术前给予氯吡格雷75mg口服,术后给予低分子肝素钠5000IU腹部皮下注射,继续口服氯吡格雷和肠溶阿司匹林维持治疗。比较治疗前、治疗后d73组患者血浆血管性假血友病因子(vWF)、组织型纤溶酶原激活物(tPA)及其抑制物-1(PAI-1)水平。[结果]脑梗死患者治疗前血浆vWF、tPA、和PAI-1水平显著升高,与健康者比较,差异有统计学意义(P﹤0.05);治疗后d7C组vWF、tPA水平显著高于A组和B组,血浆PAI-1显著低于A组和B组。[结论]脑血管球囊成形支架置入术联合抗凝及抗血小板治疗急性动脉粥样硬化性脑梗死,患者血液纤溶活性高于单纯抗血小板或抗凝治疗,可能更有利于预防急性期再发血栓形成。     

急性脑梗死患者血清IL-1β、IL-6水平测定及临床意义

目的 研究急性脑梗死患者血清白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)水平的变化,并探讨其临床意义.方法 采用双抗体夹心ELASA法检测60例急性脑梗死患者发病后1,3和7 d血清IL-1β、IL-6水平,同时与正常对照组比较.结果 急性脑梗死患者血清IL-1β、IL-6水平在发病后1、3和7 d均高于正常对照组(P＜0.01);梗死灶体积越大,则血清IL-1β、IL-6水平越高,其增高程度有统计学意义(P＜0.01);神经功能缺损程度重度组血清IL-1β、IL-6水平显著高于中、轻度组(P＜0.01),但中度与轻度组比较差异无统计学意义(P＞0.05).结论 急性脑梗死患者血清IL-1β、IL-6水平显著增高,增高程度与脑梗死体积大小和神经功能受损程度相关.     

过敏性紫癜患儿血、尿TGF-β_1检测及临床意义

[目的]通过检测过敏性紫癜(HSP)患儿以及过敏性紫癜肾损伤患儿血清及尿液转化生长因子-β1(TGF-β1)水平,探讨早期诊断过敏性紫癜(HSP)肾损伤的敏感检测指标及HSP的免疫变化。[方法]依据《实用儿科学》第7版关于过敏性紫癜诊疗标准选择病例。血清及尿液TGF-β1测定采用酶联免疫吸附法(双抗体夹心ELISA法)。各指标结果均以均数±标准差(x±s)表示。应用SPSS12.0统计软件对数据进行分析处理。[结果]HSP组患儿TGF-β1水平高于正常对照组儿童,差异有统计学意义(P﹤0.001);有早发肾损伤组TGF-β1水平高于无肾损伤者,差异有统计学意义;治疗前后HSP患儿TGF-β1水平比较差异有统计学意义(P﹤0.001);随病程的延长,HSP患儿血清及尿液TGF-β1逐渐降低,且差异有统计学意义;血清及尿液TGF-β1呈正相关(P﹤0.001);且血清及尿液TGF-β1检测结果与尿常规检测结果比较,优于尿常规(P﹤0.05)。[结论]过敏性紫癜患儿血清及尿液TGF-β1水平升高;过敏性紫癜合并早期肾损伤患儿血清及尿液TGF-β1水平均高于无早期肾损伤者,经治疗后水平下降。与尿常规检测结果相比,优于尿常规。     

子宫内膜异位患者TGF-β、VEGF和ICAM-1水平及与临床分期关系

目的:观察子宫内膜异位症(EMS)患者纤维化因子转化生长因子-β(TGF-β)、血管内皮生长因子(VEGF)和细胞间黏附分子-1(ICAM-1)水平,并分析其临床意义。方法:选取2017年2月-2018年8月本院接受治疗的子EMS患者100例为观察组,同期体检健康女性100例为对照组。比较两组及观察组不同临床分期患者TGF-β、VEGF和ICAM-1水平,Pearson相关分析法分析观察组TGF-β水平与VEGF、ICAM-1水平的相关性。结果:观察组TGF-β(389.25±12.36pg/ml)、VEGF(178.45±10.02pg/ml)和ICAM-1(186.34±13.15μg/ml)高于对照组(322.16±15.04pg/ml、120.27±8.45pg/ml、104.28±12.93μg/ml(均P<0.001);观察组临床分期Ⅲ-Ⅳ期患者TGF-β、VEGF和ICAM-1水平(411.35±12.95pg/ml、192.92±8.35pg/ml、204.15±15.17μg/ml)高于Ⅰ-Ⅱ期患者(352.94±15.24pg/ml、155.36±7.28pg/ml、168.28±10.02μg/ml)(均P<0.001);TGF-β水平与VEGF、ICAM-1水平正相关(r=0.523、0.489,P<0.05)。结论:子宫内膜异位症患者的TGF-β、VEGF和ICAM-1水平较正常者高,且临床分期高者水平更高。TGF-β与VEGF、ICAM-1水平正相关。     

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 occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.