65例伴中央颞区棘波儿童良性癫痫的脑电图分析

目的 探讨伴中央颞区棘波儿童良性癫痫(BECT)的脑电图特征.方法 对65例2～ 14岁BECT患儿的动态脑电图监测结果进行分析总结.结果 65例BECT患儿在动态脑电图监测中均未记录到发作期脑电图.发作间期脑电图背景活动正常,醒-睡各期均可见癫痫样波形48例,只在睡眠期(以浅中睡眠期为主)出现癫痫样波形17例.癫痫样波形以局限于中央为主8例,以局限于中颞区为主12例,中央和中颞区均出现并波及顶枕及后颞区42例,以额区为主1例,以枕和后颞区为主2例,其中有3例除可见局限性癫痫样波形外,睡眠期还可见广泛性3 ～4 Hz高幅棘慢复合波.其异常波形的特点主要为负相尖波,其前有明显的正相成分,尖波后有负相慢波.结论 BECT是与年龄和睡眠密切相关的儿童良性癫痫,认识其临床和脑电图特征及其演变规律,并加以鉴别,可提高对BECT的正确诊断率.     

睡眠诱发脑电图在小儿癫痫诊断中的意义

目的:探讨睡眠脑电图在小儿癫痫诊断中的意义。方法:对1998年7月～1999年7月疑为癫痫的患儿脑电图进行总结,对其中130例确诊为癫痫的患儿进行自身对照回顾性研究,同一患者既做清醒状态脑电图,又做睡眠脑电图。睡眠脑电图均在自然或剥夺睡眠状态下进行。出现棘波、尖波、棘慢复合波、尖慢复合波或多棘慢复合波认为脑电图检查阳性。结果:疑为癫痫患者605人次,清醒脑电图阳性率36.8%(99/269),睡眠脑电图阳性率51.2%(172/336),睡眠脑电图阳性率较清醒脑电图更高(χ2=12.5,P=0.0004)。130例中清醒脑电图阳性38例,阳性率29.2%(38/130),同组患者睡眠脑电图阳性率净增加92例(即不包括清醒阳性的38例),净增70.8%(92/130)。结论:睡眠脑电图能明显提高癫痫确诊率,疑为癫痫的患儿在做清醒状态脑电图的同时应作睡眠脑电图。     

脑电图在小儿癫痫中的诊断价值探讨

目的探讨脑电图在小儿癫痫中的诊断价值。方法选取自2007年1月—2012年12月500例癫痫患儿,有患儿均在发作间期,意识清醒的状态下进行检查,检查仪器应用日本光电1518型脑电图仪,按国际10/20系统安放电极,采用单极和双极导联描记进行脑电图检查。结果 500例癫痫患儿中,脑电图示正常者85例,占总例数17%,脑电图异常者415例,占总例数83%,部分病人描记中见临床发作。异常脑电图表现为棘波、尖波、棘(尖)慢波等痫样放电等。结论脑电图对于小儿癫痫有较高的诊断率,但癫痫的诊断应以临床表现及脑电图表现相结合,脑电图正常并不提示无癫痫发生,脑电图有癫痫样波也并不能诊断为癫痫。     

伴有中央-颞部局灶放电儿童良性癫痫的脑电图分析

目的分析探讨伴中央-颞部局灶放电的儿童良性癫痢（BECCT）的脑电图（EEG）特点。方法对74例BECT患儿的临床资料和脑电图进行分析。结果BECCT主要表现为面肌抽搐、口角抽动、流涎、喉咽发声、发作性肢体阵挛或强直；且发作与睡眠密切相关，脑电图背景活动正常，发作间期脑电图有一侧或双侧中央和（或）中颞区棘波或尖波。可向其他部位扩散；入睡后局灶放电频率明显增加；神经系统检查未发现异常，预后良好。结论BECCT是一种特征性癫痫综合征，临床发作和睡眠密切相关；发作间期EEG是诊断本病的主要依据，及时而正确的诊断有助于治疗及判断预后。     

具有中央-颞区棘波的儿童良性癫痫临床及脑电图特点

目的 总结具有中央一颞区棘波的儿童良性癫痫(BECCT)的临床及脑电图(EEG)特点。方法 对78例BECCT患儿的临床资料和脑电图进行回顾性分析。结果 发病年龄3-14a，其中5～10a发病者62例(80％)；发作频度变异大，以短期发作数次者及偶发者为主，占67％(67／78)；72例(92．3％)发作与睡眠密切相关；部分性发作63例(80．8％)，其中继发全身性发作者24例，发现时即为全身性发作15例(19．2％)；发作间期脑电图可见一侧或双侧中央和／或中颞区有尖波或棘波发放，清醒脑电图阳性率55．4％，睡眠脑电图阳性率92％；绝大多数患儿应用抗癫痫药物(AEDs)治疗疗效满意，占93．2％(69／74)，但发作停止≥1年者复查EEG仅部分恢复正常。结论 BECCT是一种与睡眠密切有关的部分性癫痫，发作的基本类型为部分性发作，部分患儿可伴有全身泛化，脑电图为中央、颞区局灶发电，脑电图睡眠诱发试验可提高脑电图辅助诊断的阳性率。本病预后良好，早期诊断有助于对患儿的良好预后尽早做出判断，从而减轻患儿及家庭的心理负担。     

伴有中央-颞部局灶放电儿童良性癫癎的脑电图分析

目的分析探讨伴中央-颞部局灶放电的儿童良性癫癎(BECCT)的脑电图(EEG)特点。方法对74例BECCT患儿的临床资料和脑电图进行分析。结果BECCT主要表现为面肌抽搐、口角抽动、流涎、喉咽发声、发作性肢体阵挛或强直;且发作与睡眠密切相关,脑电图背景活动正常,发作间期脑电图有一侧或双侧中央和(或)中颞区棘波或尖波,可向其他部位扩散;入睡后局灶放电频率明显增加;神经系统检查未发现异常,预后良好。结论BECCT是一种特征性癫癎综合征,临床发作和睡眠密切相关;发作间期EEG是诊断本病的主要依据,及时而正确的诊断有助于治疗及判断预后。     

89例儿童中央-颞区尖(棘)波放电灶的脑电图分析

目的探讨儿童良性癫痫(BECCT)患病儿童中央-颞尖(棘)波放电灶的EEG与头痛患儿中央-颞尖(棘)波放电灶EEG的相关性。方法选择89例EEG有中央-颞区尖(棘)放电灶的儿童。其中56例符合BECCT的患儿与33例头痛标准不明的患儿进行了常规EEG及禁睡后睡眠EEG检查并进行分析。结果 56例BECCT患儿,常规EEG异常率为67.9%(38/56),而禁睡后,睡眠EEG的异常率为100%(56/56),且在浅睡期尖(棘)波放电频繁增多。33例头痛的患儿,虽然常规EEG均出现尖波放电,但尖波的形态、波幅、出现方式均有别于BECCT的放电形式,且在浅睡期无增多现象。结论儿童中央-颞尖(棘)放电,不仅仅是BECCT的EEG特征。而头痛的患儿也可见到,但放电形式有一定的差异。因此诊断上除EEG外,应注重于临床表现,更要注重睡眠EEG的检查,以资鉴别。     

小儿热性惊厥的临床特点及脑电图分析

目的 探讨小儿热性惊厥的临床特点和脑电图特征.方法 对168例热性惊厥患儿的临床特点、脑电图特征及预后进行回顾性分析.结果 168例热性惊厥患儿首次发病年龄6个月至3岁者128例,占76.2%,有热性惊厥家族史30例,占17.9%.脑电图异常率为61.9%(104/168),脑电图异常率与热性惊厥一次热程发作次数、发作持续时间、发作类型有关(P＜0.01或＜0.05).14例患儿多次脑电图检查一直有棘波、尖波以及棘-慢波、尖-慢波发放.异常脑电图患儿随访2年,其中9例(5.4%)最后诊断为癫痫.结论 热性惊厥的发生与小儿特定年龄和遗传因素有较密切的关系;热性惊厥一次热程发作次数、发作持续时间、发作类型是影响热性惊厥患儿脑电图的重要因素;脑电图持续异常对小儿脑功能产生一定不良影响,部分可转化为癫痫.     

视频脑电图监测在儿童癫痫诊断中的价值探讨

目的评价视频脑电图(VEEG)监测在儿童癫痫的临床诊断中的应用价值。方法对152例临床拟诊为癫痫的患儿进行连续3~18 h的包括清醒及睡眠的VEEG监测。结果152例患儿中,22例(14.5%)在发作期伴有痫样放电,证实为癫痫性发作;11例(7.2%)在发作间期和发作期均未见痫样放电者,判定为非癫痫性发作(NES)。结论VEEG有助于癫痫发作与非癫痫发作的鉴别与癫痫的分型,且应尽量行睡眠脑电图描记。     

1例儿童无症状性脑电图痫样放电

目的探讨以发热为首发症状,对症处理后脑电图持续痫样放电。方法对患儿进行脑电图、影像学等检测。结果经相应治疗后发热等轻微症状得到有效治疗后脑电图多次复查均呈阵发尖-棘慢波的持续痫样放电。结论脑电图检查的临床价值是不可忽视的。     

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.     

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.     

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.     

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.     

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.