“78—19”超声雾化吸入治疗哮喘

目的 观察氯离子通道阻滞剂“７８－１９”（本院配制,暂用代号）对支气管哮喘的治疗效果。方法 中、重度支气管哮喘患者６１例,配对随机分成Ａ组（３０）例和Ｂ组（３１例）。Ａ组接受“７８－１９”超声雾化吸入治疗,Ｂ组接受丙酸倍氯米松喷雾吸入治疗,疗程均为１年。考核临床疗效、肺功能、气道反应性和嗜酸粒细胞计数等参数。结果 Ａ组临床控制率为４０％,显效５０％,总有效率９６．７％,ＦＥＶ１、ＰＥＦＲ、ＰＥＦ变     

支气管肺泡灌洗液细菌定量培养对下呼吸道感染的诊断价值

目的：观察不同方法采样培养对下呼吸道感染病原学诊断价值。方法：采用支气管肺泡灌洗液（ＢＡＬＦ）细菌定量培养,并与保护标本刷（ＰＳＢ） 和痰培养进行比较。结果：感染组１６ 例患者２１ 例次采样,ＢＡＬＦ 法１９次阳性（≥１０５ｃｆｕ／ｍｌ） ,ＰＳＢ法１５ 例次阳性（≥１０３ ｃｆｕ／ｍｌ）,两种方法所获菌株一致率为７２．４％ （２１／２９）,定量培养结果相关程度好（ｒ＝０ ．８０７ ,Ｐ＜ ０．００１） 。非感染组２０ 例,ＢＡＬＦ法３ 例阳性,ＰＳＢ法１ 例阳性。ＢＡＬＦ法和ＰＳＢ法特异性分别为８５－０ ％ 和９５－０％ ,敏感性分别为９０－５ ％ 和７１－４％ ,两种方法的敏感性和特异性无统计学差异。痰标本分别与ＢＡＬＦ和ＰＳＢ标本培养结果比较,需氧菌株一致率分别为３３－３％ （２４／７２）和２３－６ ％（１７／７２）。结论：ＢＡＬＦ细菌定量培养与ＰＳＢ方法对下呼吸道感染的病原菌诊断具有相同的诊断价值,且操作简便安全。     

铍病豚鼠BALF中纤维粘连蛋白,层粘连蛋白和磷脂的变化

以氧化铍（ＢｅＯ）气道染毒方法制备实验性豚鼠铍病模型。用间接酶免疫吸附法测定铍病豚鼠支气管肺泡灌洗液（ＢＡＬＦ）中纤维粘蛋白（ＦＮ）、层粘连蛋白（ＬＭ）水平的变化，结果表明染毒后１周豚鼠ＢＡＬＦ中ＦＮ明显升高，染毒后１０周ＬＭ有下降趋势。用高效液相色谱（ＨＰＬＣ）法测定染毒豚鼠ＢＡＬＦ中磷脂（ＰＬ）组分的变化，初期为ＰＩ和ＰＥ下降，尔后逐渐恢复。     

支气管哮喘血浆内皮素含量变化观察分析

本文采用特异性放免技术测定７０例支气管哮喘急性发作（发作组）、临床控制（缓解组）和１０名健康对照者（对照组）的血浆内皮素（ＥＴ）含量。结果显示：发作组血浆含量（１１６±３．６）ｎｇ／Ｌ分别显著高于缓解组［（６８±２．７）ｎｇ／Ｌ，Ｐ＜０．０１］和对照组（５０±７．３２）ｎｇ／Ｌ；而缓解组和对照组间的差异无显著性；发作组血浆ＥＴ含量分别与血氧分压（ＰａＯ２）及一秒用力呼气容积占用力肺活量比值（ＦＥＶ１％）呈显著负相关（ｒ＝－０．７１７，ｒ＝－０．７０１６，Ｐ＜０．０１）与峰流速变异率（ＰＥＦ％）呈显著正相关（ｒ＝０．６３６４，Ｐ＜０．０１）。上述结果提示ＥＴ参与支气管哮喘急性发作的病理生理过程     

聚合酶链反应检测支气管肺泡灌洗液结核分支杆菌76例分析

本文采用ＰＣＲ法检测７１例疑诊肺结核患者支气管肺泡灌洗液（ＢＡＬＦ）结核菌。结果ＢＡＬＦ ＰＣＲ阳性泫为７３．２％,显著高于ＢＡＬＦ涂片的５６．３％（Ｐ〈０．０５）,也显著高于刷检涂片的１８．３％（Ｐ〈０．０１）。普快速、简便诊断肺结核提供了经验。     

支气管肺泡灌洗术排尘治疗矽肺的实验研究

通过观察染尘后不同时间矽肺大鼠支气管肺泡灌洗液（ＢＡＬＦ）中ＳｉＯ２含量、细胞总数、ＬＤＨ活性．蛋白和脂质过氧化物（ＬＰＯ）含量，结合矽肺病理变化情况，对支气管肺泡灌洗术（ＢＡＬ）治疗矽肺的可能性及有关机制进行初步探讨。实验结果表明：当染尘后不同时期ＢＡＬＦ中细胞总数、ＬＤＨ活性、总蛋白及ＬＰＯ含量均高于相应对照组，且差别有显著或非常显著意义（Ｐ＜０．０５或Ｐ＜０．０１）。随着染尘时间延长，ＢＡＬＦ中ＬＤＨ含量、细胞总数、ＬＤＨ活性和总蛋白含量呈下降趋势，而矽肺病变则逐渐加剧。提示：ＢＡＬ可以通过排出肺内部分粉尘、细胞和非细胞成份，对减少肺内纤维化机会，延缓矽肺病变的发生发展将有积极作用。且以早期或急性矽肺施行ＢＡＬ为宜。     

肺癌患者血清与支气管肺泡灌洗液四项放免肿瘤指标同步检测的结果分析

对３８例肺癌患者的血清和支气管肺泡灌洗液（ＢＡＬＦ）同步进行ＣＥＡ、ＣＡ－５０、ＡＦＰ、ＳＦ的检测。结果显示：肺癌ＢＡＬＦ的ＣＥＡ浓度测值７３％明显高于血清中ＣＥＡ浓度;ＣＡ－５０浓度测值６８％高于血清;ＳＦ９２％明显低于血清中测值;而ＡＦＰ在肺癌患者无论血清及灌洗液中,阳性率均低于７％,但仍是ＢＡＬＦ的浓度测值敏感于血清。提示支气管肺泡灌洗液的ＣＥＡ、ＣＡ－５０与血清的同步检测是目前肺癌早期诊断的主要优选方法之一。     

二苯甲烷二异氰酸酯作业工人嗜碱粒细胞释放能力的研究

３０例二苯甲烷二异氰酯酯作业开人和１２例哮喘患者的嗜碱粒细胞脱颗粒指数和嗜柘粒细胞脱颗粒试验阳性率均非常显著地高于３５例不接触ＭＤＩ的对照者；哮喘组ＤＩ与抗原特异性ＩｇＥ ＯＤ值高度相关，与非特异性支气管激发试验的阳性符合率为７７．７８％；ＨＢＤＴ的诊断指数为１７２．１％。结果表明，嗜碱粒细胞释放能力依赖于ＩｇＥ水平，在ＭＤＩ哮喘发病中起重要作用，可结合临床用于ＭＤＩ哮喘诊断。     

从氨基胍对肺损伤的保护探讨内源性一氧化氮在其中的作用

本实验以内毒素（ＬＰＳ）造成大鼠急性肺损伤模型，观察一氧化氮（ＮＯ）在ＬＰＳ所致急性肺损伤中的作用。结果显示：ＬＰＳ组肺系数，支气管肺泡灌洗液（ＢＡＬＦ）中乳酸脱氢酶（ＬＤＨ）和蛋白（Ｐｒ）含量均增高；光镜下见肺充血、水肿，透射电镜见血管内皮细胞明显损伤。ＮＯ诱生酶抑制剂（ＡＧ）予处理后，肺系数明显变小（０．７８±０．０４：１．０３±０．１２），支气管肺泡灌洗液（ＢＡＬＦ）中ＬＤＨ（２２４．１１±２０．６０Ｕ／Ｌ：４５８．２０±６９．１０Ｕ／Ｌ）和蛋白（０．９２±０．１３：２．４３±０．５８ｍｇ／Ｌ）含量明显降低；光镜、电镜均证实肺损伤得到保护。以上结果提示内源性ＮＯ介导了ＬＰＳ所致的急性肺损伤     

实验性铍病支气管肺泡灌洗液中细胞免疫学观察

以氧化铍气道染毒豚鼠，观察铍病豚鼠支气管肺泡灌洗液细胞成分、淋巴细胞对铍盐的增殖反应及肺泡巨噬细胞产生白细胞介素－１（ＩＬ－１）的变化。发现铍染毒早期ＢＡＬＦ中多形核粒细胞显著增加，后期则淋巴细胞增加明显。与外周血铍淋转比较，ＢＡＬＦ淋巴细胞对铍盐刺激的增殖反应更为第三。     

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.     

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.