白内障乳化摘除人工晶体植入治疗闭角型青光眼临床观察

目的观察白内障超声乳化加人工晶体植入治疗原发闭角型青光眼的疗效。方法白内障超声乳化吸除人工晶体植入治疗原发闭角型青光眼31例39眼,对其手术后的视力、眼压、房角形态进行对照观察。结果（1）术后视力提高两行以上36眼;（2）术后眼压正常。3周后有2眼出现眼压升高达25～30mmHg,行小梁切除术后,眼压恢复正常;（3）术后2—3个月查UBM37眼房角均开放。结论白内障超声乳化吸除或白内障超声乳化吸除联合房角分离术能有效治疗合并白内障的原发闭角型青光眼。     

超声乳化人工晶体植入联合小梁切除术治疗白内障合并青光眼12例临床分析

[目的]观察白内障超声乳化吸除人工晶体植入联合小梁切除术治疗青光眼合并白内障的临床疗效。[方法]回顾分析患青光眼白内障在我院行超声乳化白内障吸除人工晶体植入联合小梁切除术的患者12例（12眼）。[结果]术后眼压基本控制在正常范围，平均眼压为13.25mmHg。均一期植入后房型人工晶体，12例均获得了良好的视力0.1～0.6之间。并发症角膜水肿3眼，6眼术后出现前房及瞳孔纤维素性渗出经对症治疗平均7d消失。[结论]超声乳化白内障吸除人工晶体植入联合小梁切除术，可安全有效治疗青光眼合并白内障     

不同手术方式对原发性闭角型青光眼合并白内障的疗效分析

目的:对比三种不同的手术方式对于治疗原发性闭角型青光眼合并白内障的治疗效果.方法:选取2015年5月至2017年5月进行治疗的原发性闭角型青光眼合并白内障患者160例,根据手术方法的不同平均分为四组,A、B组患者房角粘连小于180度,治疗方式分别为超声乳化白内障吸除+人工晶体植入+房角分离术以及超声乳化白内障吸除+人工晶体植入;C、D组患者房角粘连大于180度,治疗方式分别为超声乳化白内障吸除+人工晶体植入+房角分离术以及超声乳化白内障吸除+人工晶体植入+小梁切除术.每组40例.手术结束以后,随访调查患者的眼压、视力以及相应的并发症发生情况.结果:实验结果显示,手术后一个月四组患者的平均眼压分别为12.34±3.98 mmHg、17.55±4.09 mmHg、15.03±5.33 mmHg、13.02±6.23mmHg,与手术之前相比,差异具有明显的统计学意义;四组患者的视力相比手术之前具有明显的好转,而且没有严重的并发症出现,对于患者的眼部安全提供了必要的保障.结论:本实验所提出的三种手术方式对于治疗原发性闭角型青光眼合并白内障都具有明显的疗效,在实际治疗的过程中,应该根据患者的病情以及患者家庭的经济状况进行综合考虑,进而为患者选择合适的治疗方案.     

白内障超声乳化人工晶体植入联合房角分离术治疗闭角型青光眼合并白内障的临床效果

目的:观察白内障超声乳化人工晶体植入联合房角分离术治疗闭角型青光眼合并白内障的临床效果。方法:选取在本院接受治疗的72例闭角型青光眼合并白内障作为研究对象,依据治疗方法不同将患者分为两组,观察组患者行房角分离术+超声乳化人工晶体植入治疗,对照组行小梁切除术+超声乳化人工晶体植入治疗。比较两组患者治疗前后的眼压和视力,前房角宽度和前房深度。结果:术前两组患者的眼压和视力,前房角宽度和前房深度比较,P>0.05,均无统计学意义,具有可比性。术后,观察组患者的眼压和视力较对照组改善更好,前房角宽度和前房深度较对照组宽度更宽、深度更深,组间P<0.05,具有统计学意义。结论:对闭角型青光眼合并白内障患者使用超声乳化人工晶体植入联合房角分离术治疗,能有效改善患者的视力和眼压,加深前房深度、开放房角,安全性好,是有效的治疗方法。     

不同手术方法治疗老年青光眼合并白内障的疗效观察

目的探讨3种手术方式治疗老年青光眼合并白内障的临床疗效。方法 120例（142只眼）老年青光眼合并白内障患者随机分为3组,A组行超声乳化白内障吸除人工晶状体植入术,B组行超声乳化白内障吸除人工晶状体植入联合小梁切除术,C组行超声乳化吸除联合房角黏连分离术,观察3组手术前后视力、眼压变化和术后并发症。结果 3组术后1周、1、3、6个月的视力和平均眼压明显比术前改善,P〈0.05,B、C组改善比A组显著,P〈0.05;但组间比较,差异无统计学意义,P〉0.05。3组术后均无严重并发症出现。结论超声乳化白内障吸除人工晶状体植入联合小梁切除术和超声乳化吸除联合房角黏连分离术是治疗老年青光眼合并白内障患者的有效手术方法,二者疗效无明显差别。     

超声乳化人工晶体植入联合房角分离术治疗闭角型青光眼合并白内障的效果观察

目的观察超声乳化人工晶体植入联合房角分离术治疗闭角型青光眼合并白内障的临床效果。方法选取我院2015年1月至2017年2月期间收治的60例闭角型青光眼合并白内障患者,随机平均分为两组。常规组采用小梁切除术+超声乳化+人工晶体植入,观察组采用房角分离术+超声乳化+人工晶体植入。观察两组患者的术后并发症情况,对比两组患者入院时及治疗后的前房深度、眼压、视力情况。结果观察组的术后并发症发生率为10.0%,显著低于常规组的20.0%(P<0.05)。入院时两组患者的前房深度、眼压、视力比较均无统计学差异(P>0.05);治疗后,两组患者的前房深度、眼压、视力均有明显改善,且观察组的前房深度、眼压、视力均明显优于常规组(P<0.05)。结论超声乳化人工晶体植入联合房角分离术治疗闭角型青光眼合并白内障,患者的眼压明显降低,视力恢复良好。     

超声乳化联合小梁切除术治疗青光眼

目的评价晶状体超声乳化吸出联合小梁切除术治疗白内障合并青光眼的手术效果。方法对42例（45眼）白内障合并青光眼患者采用超声乳化白内障吸除、人工晶体植入联合小梁切除术,术后随访6个月。结果术后最佳校正视力,较术前显著提高;患者术后3个月眼压平均为（13．5±3．2）mmHg,较术前用药前后眼压相比均明显下降;前房角镜检查发现术后前房角均有增宽,房角关闭及周边虹膜前粘连范围减小。结论晶状体超声乳化白内障摘出联合小梁切除术可有效降低眼压、提高视力,为青光眼同时合并白内障患者安全有效的治疗途径之一。     

白内障超声乳化人工晶体植入术联合小梁切除术治疗青光眼合并白内障术后观察

目的观察白内障超声乳化吸出人工晶体植入术联合小梁切除术治疗青光眼合并白内障患者术后疗效。方法32例（48眼）行白内障超声乳化吸出人工晶体植入联合小梁切除术治疗。术后随访6～12个月,平均9．6个月。结果术后视力显著提高（X^2=9．38,P〈0．01）;术后平均眼压为（12．06±2．54）mmHg,较术前显著下降（P〈0．01）;术后前房深度明显加深,房角开放,与术前有显著性差异。结论自内障超声乳化吸出人工晶体植入联合小梁切除术治疗青光眼合并白内障,视力恢复好,良好控制术后眼压,开放房角,并发症少,是一种良好的手术方法。     

小梁切除联合白内障超声乳化及折叠式人工晶体植入术治疗闭角型青光眼临床观察

目的探讨小梁切除联合白内障超声乳化及折叠式人工晶体植入术(三联手术)治疗闭角型青光眼病人的有效性和安全性。方法闭角型青光眼合并白内障患者共81例(81只眼),房角关闭大于1/2,分为两组,A组为三联手术组,40例40眼,接受角巩膜分开切口的三联手术,B组为对照组,41例41眼,单纯接受小梁切除术。结果术后3月眼压均控制在正常范围内,平均眼压为(11.195±2.7222)mmHg,A组40例视力较术前提高,视力≥0.5者20眼(50%),术中、术后均未发生严重并发症。结论小梁切除联合白内障超声乳化及折叠式人工晶体植入术(三联手术)在闭角型青光眼病人治疗中具有安全、视力恢复快,降眼压效果确实、并发症少的优点。     

单切口与双切口青光眼白内障联合手术两种术式的比较

目的:比较单切口和双切口晶状体超声乳化加人工晶状体植入联合复合式小梁切除术两种不同术式治疗闭角型青光眼合并老年性白内障的疗效。方法:选取76例86眼闭角型青光眼合并白内障的病例,随机分为两组,分别行单切口和双切口白内障超声乳化吸出、人工晶状体植入联合小梁切除术,对结果进行统计学分析。结果:术后随访半年视力均有明显提高(P0.01),眼压明显下降(P0.01),功能性滤过泡两组之间无明显差异(P0.05)。术中、术后并发症轻微。结论:单切口或双切口白内障超声乳化吸除、人工晶状体植入联合复合式小梁切除术均为治疗闭角型青光眼合并老年性白内障安全、有效的方法.两种手术方式的术后视力、眼压、功能性滤过泡的数量及术后并发症方面比较而言没有明显的统计学意义。     

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.     

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.