大肠癌组织中转化生长因子-β1和血管内皮生长因子的表达与微血管密度的关系及意义

目的　探讨转化生长因子 - β1(TGF - β1)和血管内皮生长因子 (VEGF)在大肠癌中的表达以及TGF - β1和VEGF表达与肿瘤内微血管密度 (MVD)的关系。方法　应用免疫组织化学SP法检测 6 0例大肠癌中TGF - β1、VEGF的表达及MVD值 ,并以 10例大肠腺瘤和 10例正常大肠黏膜组织作对照 ,分析大肠恶性肿瘤组织中TGF- β1与VEGF的表达与MVD的关系。结果　 6 0例大肠癌中 ,TGF - β1阳性 14例 (2 3.3%) ,VEGF阳性 2 1例(35 %) ,MVD为 5 0 .7± 9.49。TGF - β1表达与肿瘤的分化程度、浸润深度、临床分期和生存率有关 ,与VEGF表达、MVD呈明显正相关 (P <0 .0 5 )。结论　TGF - β1是大肠癌血管生成的重要因子 ,其表达与细胞本身分化程度有关 ,可通过高调控VEGF的表达促进血管生成 ,是有价值的预后因素。     

MMP-2和肿瘤DNA含量预测胃癌预后的意义

目的　探讨胃癌浸润转移的生物学指标。方法　应用免疫组化S -P法对 83例胃癌组织、2 5例正常胃组织进行MMP - 2表达的测定 ,同时以经典的Feulgen染色法及图象分析技术对癌细胞DNA含量进行测定 ,分析与胃癌侵袭转移之间的关系。结果　MMP - 2在正常胃黏膜中呈阴性表达 ,在胃癌组织中表达呈阳性 ,阳性率为 78.3%(6 5 83) ,MMP - 2表达强度与胃癌分化程度、淋巴结转移、生长方式、浸润深度、TNM分期显著相关 (P <0 .0 5 )。DNA指数在胃癌组织和正常胃组织中分别为 1.4 7± 0 .2 3和 0 .97± 0 .15 ,差异有显著性 (P <0 .0 1) ,且与胃癌的分化程度、淋巴结转移、生长方式、浸润深度显著相关 (P <0 .0 1)。结论　MMP - 2表达和DNA含量与胃癌浸润转移密切相关 ,对其检测有助于对胃癌病人的转移及预后作出判断。     

真核细胞转录起始因子4E表达与乳腺癌血管生成及淋巴结转移的关系

目的　探讨乳腺癌中真核细胞转录起始因子 4E(eIF - 4E)基因表达与血管生成及转移的关系。方法　以Western-blot法检测 5 7例手术切除乳癌标本匀浆中eIF - 4E基因表达 ,免疫组化法检测乳癌组织微血管密度(MVD)表达 ,结合临床资料进行分析。结果　 34例淋巴结阳性组织中eIF - 4E水平上调 10 .11± 0 .30 ,MVD升高32 .2 8± 7.4 2 ,与淋巴结转移阴性组 (5 .94± 0 .13,2 4 .6 7± 8.12 )比较差异显著 (t=4 .37、2 .5 1,P <0 .0 5 )。相关分析表明 ,eIF - 4E表达与乳癌血管生成及淋巴结转移正相关。结论　eIF - 4E基因通过调控乳癌血管生成参与淋巴结转移。eIF - 4E表达可作为乳癌淋巴结转移的判定因素     

人胃癌组织中一氧化氮合酶的表达及其与血管形成机制的探讨

目的　研究诱导型一氧化氮合酶 (iNOS)在人胃癌组织中的表达及其与胃癌微血管形成的关系。方法　采用免疫组化SP法检测 5 0例原发性胃癌中iNOS的表达 ,同时检测微血管密度 (MVD) ,以CD3 4 标记。结果　iNOS阳性表达率为 70 %,在iNOS阴性表达组MVD均值为 (11 8± 5 9) ,在iNOS阳性表达组中MVD均值分别为 (18 7± 6 3) ,(2 4 5± 5 6 ) ,(30 1± 9 4 ) ,iNOS阴性组和阳性组MVD均值差异有显著统计学意义 (P <0 0 1)。结论　iNOS在胃癌组织中有高表达 (70 %) ,与肿瘤微血管形成有关。     

94例无淋巴结转移乳腺癌MVD、Neu基因及ER的表达及预后的相关性研究

目的　探讨微血管密度 (MVD)、癌基因 (c -erbB -2 /Neu)及雌激素受体 (ER)在无淋巴结转移乳腺癌患者的表达及与预后的关系。方法　选择经手术根治的无淋巴结转移乳腺癌患者 94例 ,检测手术根治后标本中MVD、Neu基因及ER。结果　 94例患者MVD 3 5 4± 9 8,Neu基因阳性表达为 44 % ( 4 1/94) ,ER阳性表达为 61% ( 5 8/94)。本组病例 3年内复发 16例 ,复发者其MVD 42 5± 10 6明显高于未复发者 3 1 4± 8 7,P <0 0 5 ,有显著性差异 ;且复发者Neu基因均为阳性表达 ,ER阳性 5例。MVD、Neu基因及ER与复发的关系经直线相关分析提示为 (γ =0 745 ,0 867,P <0 0 1和γ =0 186,P >0 0 5 )。讨论　淋巴结有无转移通常被认为是判断乳腺癌预后的一个重要因素 ,然而淋巴结无转移者仍有部分患者在手术根治后出现复发转移 ,本研究提示MVD、Neu基因是判断无腋淋巴结转移乳腺癌患者预后的重要指标 ,其中MVD计数高并Neu基因阳性的患者预后不良     

乳腺癌和癌旁组织中p53、VEGF与MVD的差异表达及其临床意义

目的　检测抑癌基因p5 3 ,血管内皮生长因子 (VEGF)和微血管密度 (MVD)在乳腺癌及乳腺癌旁组织中的表达 ,探讨其相关性及其在乳腺癌发生发展过程中的作用。方法　采用免疫组织化学SP法检测 110例乳腺癌及其癌旁乳腺组织中p5 3 ,VEGF表达水平 ,比较MVD的大小。结果　VEGF ,p5 3在乳腺癌组织中的阳性表达率分别为 90 0 % ( 99/ 110 ) ,42 7% ( 4 7/ 110 ) ;癌旁乳腺组织中阳性表达率则分别为 3 5 5 % ( 3 9/ 110 ) ,4 5 % ( 5 / 110 ) ,两者间具有高度显著性差异 (P <0 0 1)。乳腺癌组织微血管密度MVD均值为 ( 16 4± 12 3 ) ,癌旁乳腺组织则为 ( 7 3± 6 8) ,两者间具有高度显著性差异 (P <0 0 1)。MVD值在p5 3、VEGF阳性表达的组织中明显高于p5 3、VEGF阴性表达的组织 ,二者比较差异显著 (P <0 0 1、P <0 0 5 )。结论　联合检测p5 3、VEGF和MVD的表达可作为判断乳腺癌生物学行为和预后的重要指标。     

哮喘缓解期患者外周血白细胞介素-5 mRNA的表达及牛磺酸的治疗

目的　观察口服牛磺酸对哮喘症状的改善和外周血白细胞介素 - 5 (IL - 5 )mRNA表达的影响 ,探讨牛磺酸对支气管哮喘的防治作用。方法　采用随机、对照、双盲、前瞻性研究方法 ,对 84例轻、中度哮喘患者 ,从病情进入缓解期开始口服牛磺酸 (A组 )和安慰剂 (B组 ) ,疗程 1年 ,以门诊健康体检的 10例病人为基础对照 (C组 ) ,比较治疗前后哮喘症状的改善以及外周血IL - 5mRNA和牛磺酸浓度的变化。结果　治疗后的哮喘症状积分和肺功能A组与B组分别为 (12 .5± 4 .8)分 月、(15 .2± 5 .1)分 月 ;FEV1 (2 .6± 0 .5 )L、(2 .2± 0 .8)L ,差异显著 (P <0 .0 5 )。A ,B两组IL - 5mRNA初始表达均显著高于C组 (0 .36± 0 .17、0 .4 3± 0 .2 0、0 .12± 0 .0 5 ,P <0 .0 5 ) ,治疗后A组IL - 5mRNA表达较B组下降显著 (0 .2 1± 0 .0 9、0 .35± 0 .14 ,P <0 .0 5 ) ,A组患者外周血IL - 5mRNA表达与哮喘的症状积分呈显著正相关 (r=0 .4 2 ,P <0 .0 5 ) ;A组牛磺酸血药浓度与IL - 5mRNA表达呈显著正相关 (r=0 .5 1,P <0 .0 1)。结论　IL - 5在哮喘缓解期仍存在过度表达且反映了哮喘病情的严重程度 ;口服牛磺酸无明显副作用 ,可显著抑制哮喘缓解期的临床症状和外周血IL - 5mRNA的表达     

食管正常黏膜及鳞癌中TGF-β1、CDK4蛋白水平的研究

目的　研究食管鳞癌中TGF -β1 、CDK4的表达。方法　用免疫组织化学方法 (SABC法 )研究TGF -β1 和CDK4蛋白表达 ,显微镜下计数阳性细胞指数 (LI) ,并进行统计分析。结果　 1、TGF -β1 的表达 :正常食管黏膜阳性率达 2 0 %( 2 /10 ) ,食管鳞癌组织 62 %( 3 1/5 0 )两者差异有显著性 (P =0 0 5 ) ;LI分别为 ( 5 5 88± 6 186)及 ( 2 9 469± 2 7 481) ,后者高于前者 (P =0 0 1) ,正常食管黏膜弱阳性 2例。 2 .CDK4表达 :正常食管黏膜组织阳性率为 10 %( 1/10 ) ,食管鳞癌组织为 5 0 %( 2 5 /5 0 ) ,两者比较差异有显著性 (P<0 0 5 ) ,LI分别为 ( 3 15 8± 4 40 0 )、( 2 4 0 11± 2 6 965 ) ,(P =0 0 5 ) 1例正常食管黏膜阳性者为弱阳性 (LI <2 5 %)。结论　食管鳞癌中存在TGF -β1 的高表达 ,与正常粘膜差别显著 ,TGF -β1 的检测有辅助诊断作用 ;CDK4在食管鳞癌中高表达 ,促进了细胞生长和肿瘤发展 (G1 →S过渡 ) ,反映了肿瘤的生物学特性 ,是食管癌发生发展中的重要事件。     

大肠癌Survivin的表达与血管生成的关系

目的　观察Survivin在大肠癌中的表达及其与微血管密度 (microvesseldensity ,MVD)的关系。　方法　采用免疫组化S -P法检测 64例大肠癌组织Survivin、CD3 4的表达 ,以CD3 4标记肿瘤微血管 ,并在显微镜下计数微血管密度 (MVD)。　结果　癌旁组织中无Survivin表达 ,Survivin在大肠癌表达阳性率为 5 3 % ,其表达与大肠癌分化程度、淋巴结转移相关 (P <0 .0 5 ) ,而与侵犯深度无关 (P >0 .0 5 ) ;Survivin的表达与MVD呈正相关 ,Survivin阳性表达组中MVD明显高于Survivin阴性表达组 (P <0 .0 5 )。　结论　Survivin在大肠癌中高表达 ,在大肠癌的发生、发展中起重要的作用 ,与大肠癌的分化程度、淋巴结转移、血管生成有关。     

nm23-H1与胃癌的分化、浸润转移的关系

目的　分析nm2 3-H1在胃癌分化、浸润转移中的作用及其表达的临床意义。方法　应用ABC免疫组化方法 ,研究 4 6例原发性胃癌组织及其转移淋巴结nm2 3-H1的表达。结果　 4 5 6 % (2 1/46 )的胃癌nm2 3-H1表达下降。nm2 3-H1的高表达与Borrmann分型、组织学分型无关 (P >0 .0 5 ) ,而与肿瘤大小、胃癌浸润深度、临床病理分期、淋巴结转移密切相关 (P <0 .0 5 )。另外 5 4 4 %的分化型胃癌nm2 3-H1的表达高于其淋巴结转移癌 ,而在低分化型胃癌中有 5 3 8%。结论　nm2 3-H1可能对胃癌的浸润、淋巴结转移有抑制作用 ,但与胃癌的分化无关。     

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.     

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.     

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.     

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.     

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.