铅负荷与T细胞亚群表达的相关性研究

目的 评估铅负荷儿童T细胞亚群表达以及铅水平与T细胞亚群细胞表达的关系.方法 采用石墨炉原子吸收光谱法对太原市环境污染较严重地区的3～6岁儿童120例进行血铅水平测定及免疫荧光法检测T细胞亚群;根据血铅值将儿童分为〈0.24μmol/L组、0.24 μmol/L～和0.48 μmol/L～组,分别为54、40和26例,比较不同血铅水平儿童T细胞亚群阳性细胞比例及血铅水平与T细胞亚群的关系. 结果 血铅水平≥0.24,〈0.48 μmol/L组与〈0.24μmol/L组T细胞亚群CD3、CD4、CD8、CD4/CD8和B阳性细胞百分比比较,差异无统计学意义;血铅0.48 μmol/L～组CD3、CD4/CD8值低于≥0.24,〈0.48 μmol/L组,CD8值高于≥0.24,〈0.48μmol/L组,差异有统计学意义（P〈0.01,P〈0.05）;血铅0.48μmol/L～,血铅水平与T细胞亚群CD3、CD4/CD8呈负相关,与CD8呈正相关. 结论 高铅水平对小儿T细胞亚群表达有不良影响.     

学龄前儿童血铅水平对T淋巴细胞亚群的影响

目的　探讨低水平铅暴露对学龄前儿童CD+ 4CD+ 8双阳性T淋巴细胞的影响。方法　用石墨炉原子吸收光谱法对 2 17名学龄前儿童进行血铅浓度检查 ,并在此基础上用流式细胞仪检测不同血铅水平对学龄前儿童淋巴细胞免疫表型CD+ 4CD+ 8、CD+ 4、CD+ 8的影响。结果　高铅组 (血铅≥ 0 483μmol/L)学龄前儿童CD+ 4CD+ 8、CD+ 4、CD+ 4/CD+ 8与低铅组 (血铅 <0 483μmol/L)比较显著下降 (P <0 0 5 ) ;而CD+ 8细胞显著升高 (P <0 0 5 )。结论　低水平铅暴露对学龄前儿童CD+ 4CD+ 8、CD+ 4、CD+ 8具有不利影响     

铅暴露对难治性佝偻病患儿的骨代谢及免疫功能影响的研究

目的:探讨环境铅暴露对难治性佝偻病患儿骨代谢及免疫功能的影响。方法:在经维生素D(VitD)、钙剂正规治疗的5~36月龄佝偻病患儿中,选取45例治疗2~3个疗程但疗效不佳的活动期佝偻病患儿为实验组,选取20例疗效显著的患儿为对照组;根据所测血铅水平,再将实验组分为高铅组(BLL≥0.483μmol/L)及低铅组(BLL<0.483μmol/L)。应用石墨炉原子吸收光谱法检测两组小儿血铅,实验组应用终点法检测血钙、磷,速率法检测血碱性磷酸酶(ALP),分别应用流式细胞仪和免疫透射浊度法检测实验组小儿外周血淋巴细胞免疫表型CD3+、CD3+CD4+、CD3+CD8+、CD3-CD16+CD56+及免疫球蛋白IgG、IgA、IgM。结果:实验组45例BLL为0.349~1.061μmol/L,几何均数为(0.479±0.172)μmol/L,有16名患儿BLL≥0.483μmol/L;对照组20例血铅浓度为0.200~0.559μmol/L,几何均数为(0.368±0.109)μmol/L,有4例BLL≥0.483μmol/L。两组比较差异显著,P<0.005。经直线相关分析,血铅与血钙负相关(r=0.622,P<0.001),与血磷无明显直线相关关系(r=0.086,P>0.05)。实验高铅组与实验低铅组比较:高铅组血钙浓度显著低于低铅组(P<0.01);ALP明显高于低铅组(P<0.05);血磷无统计学差异(P>0.05);CD3+CD4+T细胞水平,CD3+CD4+/CD3+CD8+及IgG、IgA水平低于低铅组,且具有统计学意义(P<0.05);CD3+、CD3+CD8+、CD3-CD16+CD56+、IgM水平无显著差异。结论:环境铅暴露可干扰儿童的骨代谢,可能是部分佝偻病难治的重要原因,并可对患儿的免疫功能产生不利影响。     

河南省城市学龄前儿童血铅水平与相关因素分析

目的调查河南省城市学龄前儿童血铅水平及影响因素,为制定防治环境铅污染,保护儿童健康政策提供科学依据。方法采用双阶整群抽样法对河南省3个城市8所幼儿园502名3～5岁儿童进行调查。取肘静脉血,用微波消解电感耦合等离子质谱仪(ICPMASS)测定血铅,同时进行相关因素问卷调查,采用SPSS10.0软件进行统计分析。结果502名学龄前儿童血铅均值为0.65μmol/L,其中≥0.48μmol/L者405人,占80.7%;男性儿童均值为0.65μmol/L;女性均值为0.63μmol/L。相关分析表明:工业区儿童血铅[(0.72±0.20)μmol/L]明显高于非工业区[(0.59±0.20)μmol/L],差异有统计学意义(P<0.05);父母文化程度越高,儿童血铅水平越低,差异有统计学意义(P<0.05);父、母亲从事接铅职业,孩子的血铅均值[(0.69±0.20)μmol/L、(0.68±0.19)μmol/L]均高于父母不从事接铅职业的孩子[(0.60±0.20)μmol/L、(0.63±0.21)μmol/L],差异有统计学意义(P<0.01,P<0.05)。结论河南省学龄前儿童血铅水平明显高于附近省市,是铅污染较严重的地区之一,应引起高度重视。     

甲醛对淋巴细胞亚型影响及机制研究

采用脾细胞体外研究方法,用流式细胞仪法进行小鼠淋巴细胞亚型、细胞凋亡及细胞周期的检测。结果显示,随着甲醛浓度的升高,CD4+CD8-细胞百分数呈先降低再升高的趋势,与对照组比较差异无统计学意义;细胞亚群CD4-CD8+细胞百分数下调;20、100和500μmol/L剂量组细胞凋亡发生率显著高于对照组;与对照组相比,500μmol/L组G0/G1细胞明显减少,S期细胞明显增多,而G2/M期细胞基本不变。提示甲醛可能通过G2/M期细胞周期阻滞引起脾细胞CD8+T亚群凋亡的增加,进而影响细胞的免疫功能。     

铅暴露对学龄前两性儿童免疫系统的影响

目的 :探讨环境铅暴露对学龄前儿童免疫系统影响的性别差异。方法 :石墨炉原子吸收光谱仪对 2 17名学龄前儿童进行血铅测定 ,流式细胞仪检测铅中毒对不同性别学龄前儿童 T淋巴细胞亚群 CD+3、CD+3CD+4 、CD+3CD+8以及 B细胞 (CD- 3CD+1 9)、NK细胞 (CD- 3CD+1 6 CD+56 )的影响 ;散射比浊法检测免疫球蛋白 Ig G、Ig M水平。结果 :铅中毒的女童 CD+3CD+4 、CD+3CD+4 / CD+3CD+8、Ig G、Ig M与对照组比较均出现明显下降 (P<0 .0 5 ) ,而男童与对照组间差异无显著性 (P>0 .0 5 )。结论 :铅中毒对学龄前女童免疫系统的影响大于男童     

稀土暴露对儿童免疫功能影响的研究

目的探讨稀土暴露对儿童免疫功能的影响.方法采用免疫消浊比色法对江西某稀土矿区和对照区205例7～10岁儿童血清中IgA、IgG、IgM和补体C3、C4进行测定;采用化学免疫发光法测定稀土暴露组和对照组各35名儿童血清中IgE;采用流式细胞仪对17名稀土暴露组和20名对照组儿童血中淋巴细胞亚群CD+3、CD+4、CD+8、CD+4/CD+8及NK细胞进行测定;并使用ICP-MS对69名稀土暴露组和43名对照组儿童血样进行稀土水平测定,同时用多元逐步回归分析稀土暴露情况与儿童免疫功能的关系.结果儿童血样中15种稀土元素均可检出,且稀土暴露区儿童血中稀土总含量2.18±1.08(ng/g),比对照组1.26±0.35(ng/g)高出1.73倍,差异有显著性意义(P＜0.01).稀土暴露区儿童体液免疫有所改变,稀土暴露组IgM为0.87±0.21(g/L),对照组为0.94±0.18(g/L),差异有显著性意义(P＜0.05),而IgG、IgA、IgE补体C3、C4两组没有明显变化.儿童T淋巴细胞亚群测定结果显示,CD+3、CD+8、CD+4/CD+8有明显改变(P＜0.05),稀土暴露组儿童血中CD+3(54.05%±7.55%)和CD+8(22.65%±5.18%)比对照组CD+3(62.84%±7.05%)、CD+8(29.25%±3.90%)明显降低,而CD+4/CD+8比值则有所升高.稀土暴露组为1.38±0.36,对照组为1.12±0.18,均有统计学意义(P＜0.05).多因素分析显示,血稀土总含量被引入IgM指标的回归方程,其标准回归系数为-0.296.结论稀土暴露可对儿童免疫系统功能产生影响.     

河南地区健康儿童淋巴细胞亚群参考区间的建立

目的建立适合河南地区年龄、性别相关的健康儿童淋巴细胞亚群参考区间。方法采用多阶段分层整群随机抽样的方法,抽取河南省5个地市1 027名<7岁健康儿童,分婴儿组(4~12月龄,n=45)、幼儿组(1~3岁,n=190)和学龄前组(3~7岁,n=792)进行研究。用流式细胞术双平台法检测淋巴细胞亚群百分比和绝对计数。结果学龄前组不同性别健康儿童之间,淋巴细胞免疫亚群CD3^+、CD3^+CD4^+、CD3^+CD8^+、CD4^+/CD8^+和CD3^+CD16^+CD56^+百分比差异均有统计学意义(P值均<0.01),绝对计数CD3^+CD4^+、CD3^+CD8^+、CD3^+CD16^+CD56^+差异均有统计学意义(P值均<0.01);不同年龄组健康儿童之间淋巴细胞亚群百分比和绝对计数差异均有统计学意义(P值均<0.01)。与国内已发表的淋巴细胞亚群百分比相关文献比较,相同年龄段淋巴细胞亚群相对计数参考区间明显不同。结论年龄、性别影响健康儿童淋巴细胞亚群的分布,本研究可为建立河南省健康学龄前儿童年龄和性别相关的淋巴细胞亚群参考区间提供依据。     

慢性湿疹患者外周血淋巴细胞亚群及总IgE水平的检测分析

目的探讨慢性湿疹患者的外周血淋巴细胞亚群与总IgE水平相关性。方法通过流式细胞仪和BNII特定蛋白分析仪检测400例慢性湿疹患者外周血中淋巴细胞亚群及总IgE,并对其相关性进行分析。结果与正常组相比较,慢性湿疹组总IgE水平明显高于正常组,差异有统计学意义(P0.05);CD3~+T细胞、CD4~+T细胞、CD4~+/CD8~+比值均降低,CD8~+T细胞、CD3-CD16+56+NK细胞升高,差异有统计学意义(P0.05)。不同程度总IgE患者组的免疫功能相比较,CD3~+细胞与CD3-CD16+56+细胞差异有统计学意义(P0.05)。结论免疫功能的紊乱是慢性湿疹患者发病的一个重要机制,在慢性湿疹的发生、发展过程中可能起到重要的作用。     

铅暴露对学龄前儿童免疫球蛋白IgE影响的研究

目的 :探讨低水平铅暴露对学龄前儿童免疫球蛋白 Ig E的影响。方法 :用石墨炉原子吸收光谱法对 2 1 7名学龄前儿童进行血铅浓度筛查 ,用酶联免疫吸附试验 ( ELISA)检测不同血铅水平对学龄前儿童免疫球蛋白 Ig E的影响。结果 :高铅组 (血铅≥ 0 .48μmol/L)学龄前儿童Ig E水平与低铅组 (血铅 <0 .48μmol/L)比较具有升高趋势 ,但无统计学意义 ( P>0 .0 5 ) ;高铅组血铅浓度与 Ig E水平呈正相关 ( r=0 .5 0 ,P<0 .0 1 ) ;女童高铅组 Ig E水平与低铅组比较显著升高 ( P<0 .0 5 )。结论 :铅中毒具有刺激学龄前儿童 Ig E的产生 ;铅暴露对学龄前儿童 Ig E水平的影响具有性别差异     

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.