某高校医院268例发热学生临床特征分析

目的 分析某高校医院发热学生的临床特征，为临床诊疗及预防发热性疾病提供依据。方法 对2021年11月—2022年4月就诊于北京某高校医院268例发热学生病例资料进行统计分析。结果 发热患者以低、中度热为主，占发热总数的89.9%。血常规检查白细胞计数正常范围者最多，占57.8%；白细胞计数升高者占41.1%；白细胞计数减低者占1.1%。胸部CT检查97.6%的病例未见异常；肺部炎症改变者仅占2.4%。发热病因主要为上呼吸道感染，占72.0%。结论 上呼吸道感染是高校学生发热的主要病因。血常规检查有助于感染类型的鉴别，应作为发热学生的常规检查。高校医院应探索有效的防控措施预防呼吸道疾病，减少发热患者。     

发病初期SARS患者与发热门诊患者临床特征对比研究

目的 探讨并比较2003—03～2003—06 SAILS患者与发热门诊发热患者的临床特征。方法 对收治的45例严重急性呼吸综合征(SARS)患者、发热门诊150例医学观察和1200例回家观察患者发病初期的临床资料进行回顾分析。结果 SARS组患者全部有SARS密切接触史，其平均体温高于医学观察组和回家观察组；血常规检查回家观察组WBC总数、淋巴分类比例明显高于SARS组和医学观察组，医学观察组白细胞各项指标与SARS组没有显著差异；SARS组45例肺部均存在斑片状、云雾样阴影，其中21例(46．7％)阴影在几天内出现了迅速扩散，明显高于医学观察组和回家观察组。结论 流行病史和X线肺部炎性改变可能是诊断SARS的关键，发热症状和外用血白细胞检查是筛选SARS的重要线索。     

三氯化磷气体吸入致肺部损害的X线分析

目的探讨三氯化磷气体吸入致肺部损害的X线表现及变化规律。方法21名患者，有典型的三氯化磷气体吸入史及临床症状，分别于第1、7天及第3、4周行胸部X线检查，结合病理及临床过程对胸部X线表现进行分析。结果三氯化磷气体吸入致肺部损害的X线表现主要有急性肺水肿、中毒性支气管炎和支气管肺炎、阻塞性肺不张和肺气肿，治疗后随时间发展而逐渐吸收，少数病例形成机化性肺炎和肺间质纤维化。结论三氯化磷能导致肺部严重损害，X线能准确地反映病情的发生、发展及预后，对指导临床治疗有重要作用。     

肾综合征出血热136例X线胸片临床分析

本组136例均为住院病人，按1987年南京《全国流行性出血热防治方案》会议制定的诊断及分型标准，在136例病人中均有不同程序发烧、出血、三痛和肾损，且呼吸系统症状及体征表现突出，进行胸部X线片检查，发热期拍片38例，胸部X线主要显示是：肺纹理普遍增多、紊乱、肺门增宽。低血压期12例，胸部X线片显示是肺纹理明显增粗，肺门增宽，阴影增大，甚至有肺的透光度降低，呈面纱样改变或网织影，片状阴影，类似于小叶性肺炎和胸膜增厚，胸腔积液，膈肌升高，心影增大，多尿期36例，随着临床上治疗，病人肾功能得到好转，尿量亦趋于恢复增多，此期病人胸部X线片显示异常的改变开吸收或明显消散，肺纹理及肺门阴影日趋变浅，肺叶透明度接近正常，胸水消失，增大的心影较前缩水。出血热的胸部X线片异常表现是由病程中的早期简单征，随着病情进展而发展为多样化，复杂化。在少尿阶段，胸部X线片异常表现为十分严重，当病程一旦进入多尿阶段后，胸部异常病变很快被吸收。呼吸道症状和体征亦开始好转起来。病变吸收快与慢是与尿量多和少为成正相关。病情愈重，胸部X线片殿堂病变愈明显。出血热的胸部X线片异常病变化是没有特异性，需结合临床，方可不误诊为其它疾病。在治疗肾综合征出血热同时，不可忽视对肺部病变的治疗。     

肺部炎症200例的X线诊断分析

目的 探讨肺部炎症的X线特征及临床表现,总结其临床诊断意义.方法 选择我院2009年6月至2011年6月200例肺部炎症的患者,对其X线诊断资料进行回顾性分析.结果 200例肺部炎症的X线片中,诊断为大叶性肺炎54例,占27.0％,支气管肺炎72例,占36.0％,金黄色葡萄球菌肺炎有41例,占20.5％,急性肺脓肿23例,占11.5％,炎性假瘤10例,占5.0％.结论 肺部炎症的X线胸片可表现为间质型、实质型和混合型,胸部摄片是诊断并鉴别诊断肺部炎症疾病的重要手段,临床上主张将患者的病史、体征、临床表现、实验室检查结果及X线检查相结合,为临床准确诊疗提供科学可靠的依据.     

什么是非典型肺炎

非典型肺炎是指由病毒、支原体、衣原体、立克次氏体和军团菌等引起的肺炎。症状相对典型性肺炎来说不典型。多表现为急性起病 ,以发热为首发症状 ,偶有畏寒 ,同时伴有头痛、全身和关节酸痛、乏力特点 ,并有干咳与少痰等明显呼吸道症状 ,个别病人偶有血丝痰 ,部分病人出现呼吸加速 ,气促等上呼吸道感染症状。极个别病人会发展为Ⅰ型呼吸衰竭。血常规化验白细胞不升高 ,Ｘ线胸部检查肺部有片状浸润性阴影。该病有一定传染性 ,可以通过近距离飞沫、接触呼吸道分泌物等途径传播。而典型性肺炎通常指肺炎链球菌等常见细菌引起的肺炎。症状比较典…     

发热门诊传染性非典型肺炎监测结果分析

目的及时发现和监控传染性非典型肺炎(SARS),分析发热门诊患者的特点.方法柳州市人民医院自2003年4月在发热门诊对每位发热患者进行详细登记,测量体温,流行病学调查,化验室检查及胸部X线检查等.结果 1年间监测发热患者158例未发现SARS患者,发热患者年龄以15～34岁多见,男性多于女性,病因以上呼吸道感染为主.结论监测期间,该院发热门诊以普通发热病人为主,无SARS病例发现.     

氨中毒的胸部X线表现

目的:回顾性研究急性氨中毒致肺部损伤的X线表现。方法:对37例急性氨中毒致肺部损伤病例的胸部X线表现进行分析,并进行一年随访观察。结果:早期损伤表现为肺纹理增多、小叶性肺炎、间质性肺气肿、肺水肿等改变;晚期出现慢性支气管炎、肺间质纤维化及肺大泡等改变。结论:急性氨中毒的肺部损伤是不可逆转的损伤。     

SARS的临床及胸部X线表现

严重急性呼吸综合征 (severeacuterespi ratorysyndrome,SARS)又称之为传染性非典型肺炎 (infectiousatypicalpneumonia,IAP) ,是一种由新型变异冠状病毒引起的急性传染性呼吸道疾病 ,其传播途径主要为近距离飞沫传播和密切接触传播。临床和X线表现与一般的典型肺炎相似 ,但又具有自身的特点和规律。本文报告我院3例临床确诊SARS患者病例 ,并结合文献进行影像和临床分析 ,以利于提高对本病的认识。1病例简介病例1男 ,38岁。2003年1月12日出现咽痛 ,无咳嗽、咳痰及发热等 ;1月18日出现发热 ,体温最高达39.3℃ ,发热时伴全身乏力、头晕 ,…     

146例小儿肺炎X线诊断

目的:探讨小儿急性肺部感染的X线表现及其在诊断和治疗中的价值。方法:新生儿及婴幼儿采用婴幼儿多方位摄片固定防护装置,低能量胸部X线检查。结果:新生儿吸入性肺炎66例,婴幼儿支气管肺炎42例,4~5岁儿童支气管肺炎38例,全部病例摄胸部正位片,部分病例摄患侧侧位片。结论:小儿急性肺部感染的X线表现在临床应用中对其诊断具有重要意义,不但可显示病变部位、范围和有无并发症,还可根据治疗后的动态变化做出预后判断。     

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.