T细胞活化连接蛋白和血管内皮生长因子在正常肝组织、肝硬化及肝癌中的表达及关系的探讨

目的分析T细胞活化连接蛋白（LAT）和血管内皮生长因子（VEGF）在原发性肝细胞性肝癌（HCC）中的表达及两者之间的关系。方法分别应用免疫组化S-P法检测HCC50例、肝硬化30例、正常肝组织10例中LAT蛋白、VEGF蛋白的表达情况。结果LAT和VEGF在HCC、肝硬化和正常肝组织中的表达差异有统计学意义（P〈0．05）,LAT在HCC中的表达高于肝硬化（P〈0．05）,而VEGF在肝硬化组织中的表达高于HCC中的表达（P〈0．05）。结论经统计分析LAT、VEGF在HCC中的表达关系不密切;但LAT和VEGF各自的异常表达与HCC的发展密相关,在HCC的发生、发展过程中起非常重要的作用。     

肝硬化、肝细胞肝癌中PTEN的表达及其临床意义

目的:探讨PTEN在肝硬化、肝癌组织中的表达及其临床意义.方法:用S-P免疫组织化学方法分别检测71例肝细胞性肝癌(HCC)15例肝硬化及10例正常肝脏PTN蛋白表达.结果:10例正常肝组织中PTEN蛋白均为阳性表达.HCC中PPTEN蛋白的阳性率为69.0%(49/71),明显低于肝硬化组(93.3%)及正常肝组织(100%)(P<0.01).PTEN蛋白在高分化、中分化、低分化肝细胞性肝癌中的阳性率分别为73.5%、69.6%和57.1%,肝细胞性肝癌中PTEN蛋白阳性表达率与肿瘤的组织分化及其它临床病理因素无关(P>0.05).肝癌PTEN蛋白阳性表达率与有无合并肝硬化无关(P>0.05).结论:PTEN表达缺失在肝细胞性肝癌的发生和发展过程中发挥重要作用,检测PTEN蛋白表达有助于肝细胞性肝癌的诊断.     

环氧化酶-2基因在肝细胞癌中的表达及其意义

目的探讨环氧化酶-2（COX-2）在肝细胞癌发生发展中的作用及其意义.方法用免疫组织化学的方法检测41例肝细胞癌组织、16例乙型肝炎后肝硬化组织及5例正常肝脏组织中COX-2蛋白的表达情况,并分析COX-2蛋白表达与肝细胞癌临床生物学特征的关系.结果COX-2蛋白在肝细胞癌和肝硬化组织中的表达率分别为61.0%（25/41）和56.3%（9/16）,正常肝脏组织中无表达,与以上各病变组织COX-2蛋白表达差异有显著性（P＜0.05）;而在肝硬化组织与肝细胞癌组织COX-2蛋白表达差异无显著性（x^2=0.11,P＞0.05）.COX-2蛋白表达与肝细胞癌组织分化程度、癌肿转移状况有关（x^2=10.3,4.81,P＜0.05）.结论COX-2蛋白在肝硬化、肝细胞癌组织中表达上调,在肝细胞癌发生发展过程中可能起重要作用.     

一氧化氮合酶与肝癌血管生成的关系

目的:观察一氧化氮合酶(NOS)在正常肝组织、肝硬化和原发性肝癌中表达的不同情况,分析其与微血管密度(MVD)之间的关系,探讨在原发性肝癌血管生成和肝癌细胞转移中的作用.方法:应用原位杂交技术,检测80例原发性肝癌、40例肝硬化、20例正常肝组织中NOS的表达定位情况,并用免疫组化技术检测微MVD.结果:肝癌、肝硬化中内皮细胞NOSmRNA的表达显著高于正常肝组织(P<0.01);肝癌细胞中NOSmRNA阳性率明显高于肝硬化中肝细胞,而后者又明显高于正常肝脏中肝细胞(P<0.01),此外,肝癌组织内皮细胞上NOSmRNA表达阳性者MVD显著高于阴性者(P<0.01).结论:①肝癌细胞cNOS的表达参与肝癌的发生过程;②肝癌血管内皮细胞NOS的表达在肝癌的血管生成中起重要作用.     

原发性肝癌基质金属蛋白酶-9基因表达的研究

目的了解原发性肝癌患者基质金属蛋白酶-9（MMP-9）基因表达的情况。方法：33例原发性肝细胞癌患者术中取癌组织及癌旁组织；提取组织总KNA；用逆转录共扩增定量PCR方法测定基质金属蛋白酶-9（MMP-9）基因表迭水平。结果：肝癌组织基质金属蛋白酶-9基因表达水平明显高于癌旁的肝硬化组织及正常肝组织。肝癌患者基质金属蛋白酶-9基因表达水平与血清AFP浓度、肿瘤大小无关。结论：基质金属蛋白酶-9在原发性肝癌的进展中可能起重要作用。     

Survivin基因蛋白在原发性肝细胞癌的表达及意义

作者采用免疫组化SP方法，检测20例肝癌，21例肝硬化，和10例正常肝组织中Survivin的表达，结果表明该基因在肝癌中表达阳性率为75%（15/20），肝硬变组织为4.76%(1/21），正常肝组织均无表达，Survivin有可能作为肝癌标志物。     

Survivin在肝癌中的表达及其与PCNA和P53表达的关系

目的研究生存素survivin在肝癌中的表达以及这种表达与肝癌临床病理特征、肝癌增殖活性及p53基因状态间的相互关系。方法采用免疫组织化学ABC染色法,检测survivin、增殖细胞核抗原(PCNA)及p53蛋白在31例肝细胞癌组织以及4例正常肝和8例肝硬化组织中的表达水平。结果31例肝细胞癌组织中19例(61.3%)有不同程度的survivin表达,相反在所有正常肝和肝硬化组织中survivin表达均为阴性。Survivin表达与肝癌分化程度及肝癌增殖活性有关,低分化肝癌其survivin表达阳性率(16/20)明显高于高分化肝癌(3/11);survivin表达阳性的肿瘤其PCNA平均指数[(47.2±20.5%)]明显高于survivin表达阴性的肿瘤[(24.6±15.8%)]。p53蛋白积聚与survivin高表达有关,肝癌组织p53表达阳性组与阴性组中,survivin蛋白表达阳性率分别为85.7%(12/14)和41.2%(7/17)。结论Survivin蛋白在肝癌中呈特异性高表达,这种表达与肝癌的分化及增殖有关。Sur-vivin可能通过影响细胞周期的进展介导癌细胞的分化和增殖。p53基因的突变可能是survivin基因异常表达的原因之一。     

HIF-2α在肝癌组织中的表达及其临床意义

目的研究缺氧诱导因子-2d（HIF-2α）mRNA及蛋白在肝癌组织中的表达。方法免疫组织化学SP法和半定量RT—PCR法检测67例肝细胞肝癌标本及21例正常肝组织中HIF-2αmRNA和蛋白的表达。结果HIF-2αmRNA和蛋白在肝癌组织中的阳性表达率显著性高于癌旁组织和正常肝组织。肝癌组织中HIF-2αmRMA和HIF-2α蛋白表达在大小肝癌之间、是否伴有坏死之间和是否为浸润性生长之间差异有统计学意义;而在肝癌不同组织类型之间其表达差异无统计学意义。结论HIF-2α在肝癌组织中的表达较为普遍,其表达增高与肝癌的恶性生长有关。     

原发性肝癌组织中b-FGF、DNA含量与肝癌侵袭性的关系

目的研究碱性成纤维细胞生长因子（b-FGF）在人肝癌组织中的表达及癌细胞DNA含量与肝癌转移、复发特性之间的关系。方法应用免疫组织化学SABC法研究了56例原发性肝癌（下称肝癌）组织中b-FGF基因的表达，同时应用CM I-ASD-B真彩色图像分析系统对癌细胞DNA含量进行测定，分析与肝癌转移、复发特性之间的关系。结果正常肝组织、肝硬化组织中b-FGF蛋白表达呈阴性，肝癌组织中b-FGF基因表达明显升高，在侵袭性与非侵袭性肝癌差异有统计学意义（P〈0.05），在复发性肝癌与非复发性肝癌差异有统计学意义，与肝癌的大小、分级无关，肝癌组织DNA指数（DI）与癌灶的包膜情况、是否复发有关（P〈0.05）。结论b-FGF基因的表达升高与肝癌的浸润、复发特性有相关，同时结合癌细胞DNA含量的测定，可以更准确地判断肝癌的恶性程度和癌症患者的预后。     

IgG在人肝细胞肝癌中的表达及其临床意义

目的：研究肿瘤源性IgG在人肝细胞肝癌中的表达和分布情况及其与临床病理学指标的关系。方法：分别应用免疫组化二步法和原位杂交检测60例肝细胞肝癌组织及其周围正常肝组织中IgG蛋白和IgG mRNA的表达,分析IgG的表达水平与9项肝细胞肝癌的临床病理学指标之间的关系。结果：肝癌组织中IgG的表达明显高于其周围正常肝组织,且两者表达程度比较差异有统计学意义（P=0.001）;IgG在肿瘤组织中的异常高表达与肿瘤分化程度和pTNM分期呈负相关（r=-0.357,P=0.005;r=-0.296,P=0.021）,与血浆AFP浓度呈正相关（r=0.336,P=0.009）,与年龄、性别、肿瘤包膜的完整性、肿瘤大小、肿瘤个数和一年内是否复发或转移无相关性（P〉0.05）。结论：肝癌细胞所产生的IgG与肿瘤的分化、pTMN分期相关,可能作为辅助肝细胞肝癌病理学诊断和预后评估的一项重要指标。     

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.