眼底照相及眼底荧光血管造影在糖尿病性视网膜病变的临床分析

目的评价眼底照相及眼底血管荧光造影（FFA）在糖尿病视网膜病变（DRP）的诊断及治疗的临床价值。方法采用APS～B型眼底血管造影仪对1400例（2784只眼）糖尿病患者行眼底摄片或造影。结果根据国际分期法对糖尿病视网膜病变进行分期,并给予指导治疗。结论眼底照相可作为糖尿病视网膜病变早期筛查的金标准,而FFA可作为眼底激光治疗及其疗效评估的指标。     

数码彩色眼底照相对糖尿病视网膜病变早期诊断模式的研究

目的采用直接眼底镜检查、数码彩色眼底照相、荧光素眼底血管造影及光学相干断层扫描等4种方法,对糖尿病视网膜病变患者进行检查和评估,探讨早期糖尿病视网膜病变筛查方法。方法对2009年1月~2010年1月就诊我院眼科门诊的糖尿病患者,进行直接眼底镜检查、数码彩色眼底照相、荧光素眼底血管造影及光学相干断层扫描检查。以荧光素眼底血管造影诊断为标准,分析各种检查结果的敏感性、特异性及与眼底荧光血管造影诊断的一致性。结果以糖尿病视网膜病变1期为筛查阈值时,眼底彩色照相的敏感性、特异性均明显高于直接眼底镜检查,Kappa检验有高度一致性;以糖尿病视网膜病变2期为筛查阈值时,直接眼底镜检查与眼底彩色照相的特异性基本一致,但眼底彩色照相的敏感性明显高于直接眼底镜检查,Kappa检验有高度一致性。同正常组相比,糖尿病视网膜病变1期视网膜各方位厚度并无明显增加,糖尿病视网膜病变2期各方位神经上皮层厚度比相应方位的正常组增加。结论数码彩色眼底照相可作为糖尿病视网膜病变2期以上患者的主要筛查诊断方法。     

眼底血管造影在糖尿病视网膜病变中的应用

目的 探讨眼底血管造影（FFA）在糖尿病视网膜病变（DR）中的应用价值.方法 选取2011年1月-2012年12月于本院进行诊治的168例（320眼）患者为研究对象,采用荧光素眼底血管造影（FFA）检查.结果 眼底血管造影对DR病变分期及检查结果准确率均显著高于眼底镜的检查.结论 眼底血管造影在糖尿病视网膜病变中的应用价值较高,能更早的显示DR的眼底改变,对于了解疾病分期及进展有积极的作用,在判断预后及指导治疗上都有重要的价值     

荧光血管造影与视网膜光学相干断层扫描图像分析在糖尿病性黄斑水肿的临床研究

目的探讨眼底荧光血管造影（FFA）及黄斑区视网膜光学相干断层扫捕（OCT）检查存糖尿病性黄斑水肿中的研究结果,并对其所得罔像进行分析。方法现对诊断为糖尿病视网膜病变的患者100例进行眼底荧光血管造影（FFA）及黄斑区视网膜光学相干断层扫描（OCT）检查。结果100例糖尿病黄斑水肿的患者中：FFA有异常表现者占71％,未见异常者占29％。OCT图像显示视网膜水肿占82％,正常黄斑结构占18％。结论与荧光血管造影等检查相比较,OCT能更直观地显示黄斑的形态结构及组织病理变化,为糖尿病黄斑水肿的早期诊断提供客观依据,以及时指导临床治疗。     

分析眼底荧光造影检查对筛查糖尿病眼底病变的诊断准确率

目的:分析眼底荧光造影检查对筛查糖尿病眼底病变的诊断准确率;方法:选择2013年1月至2015年1月在我院进行眼底荧光造影检查筛查糖尿病眼底病变患者40例(80只眼),对其临床资料进行回顾性分析;结果:全部患者经眼底荧光造影检查,7只眼存在一定程度的糖尿病视网膜眼底病变:其中40只眼存在轻度非增生性糖尿病性眼底病变;26只眼存在中度非增生性糖尿病性眼底病变。6只眼存在重度非增生性糖尿病性眼底病变。结论:临床中在对糖尿病眼底病变进行筛查时,眼底荧光造影检查具确较高的准确率,具有临床推广价值。     

糖尿病性视神经病变的临床探析

目的：对糖尿病相关性视神经病变（DON）所产生的眼底表现以及荧光血管造影（FFA）特点进行分析。方法选择140例糖尿病视网膜病变（DR）患者,对其荧光血管造影以及眼底表现临床病例进行回顾性分析。结果140例患者的视网膜病变在临床上各有不同表现,视神经发生病变对视力可能不会造成损害,也可能会导致视力严重下降。对其眼底进行检查,所出现的情况主要有以下几种：出血、充血、视盘水肿以及色淡等。其FFA表现包括以下几种：视盘新生血管以及充盈缺损、视盘晚期染色以及荧光渗漏。在这些患者中有65例患者是合并视神经病变。结论糖尿病相关性视神经病变,其发生几率是随着糖尿病视网膜病变不断发展而逐渐升高的。所以糖尿病视网膜病变各个时期内对于糖尿病相关性视神经病变都要加强注意,FFA检查对该病早期诊断有一定帮助。     

倍频Nd：YAG（532）激光治疗糖尿病性视网膜病变83例的护理报告

目的总结应用倍频Nd：YAG（532）激光治疗糖尿病性视网膜病变83例的护理体验。方法根据眼底血管荧光造影,应用倍频Nd：YAG（532）激光治疗83例（137眼）糖尿病性视网膜病变患者,配合医生做好诊断时的眼底血管荧光造影检查、术前的心理护理和术前准备、以及术后的宣教回访等护理工作。结果83例（137眼）糖尿病性视网膜病变患者的光凝有效率达89．7％。结论对糖尿病性视网膜病变患者及时进行激光光凝术,配合全面、细致、周到的护理,可使绝大部分患者避免失明,提高其生活质量。     

糖尿病视网膜病变造影诊断与激光治疗的临床应用

目的探讨造影诊断糖尿病视网膜病变的临床价值和激光治疗的临床疗效。方法选择2013年6月至2015年6月接受治疗的糖尿病视网膜病变患者90例为研究对象,以患者的荧光素眼底血管造影诊断结果为依据对患者的病情进行分级,根据分级结果将其分为两组,对照组采用常规内科疗法,观察组实施激光治疗,对比两组患者治疗后的临床疗效。结果观察组治疗的有效率远高于对照组,差异有统计学意义(P<0.01)。结论荧光素眼底血管造影法应用于糖尿病视网膜病变的诊断大大提高了分级的准确性,激光治疗应用于糖尿病视网膜病变的治疗效果显著,值得大力推广。     

眼底荧光血管造影对多发性大动脉炎的诊断价值

目的研究眼底荧光血管造影对多发性大动脉炎的诊断价值。方法回顾性分析15例以眼底病变首诊、眼底荧光血管造影确诊多发性大动脉炎以及30例多发性大动脉炎会诊患者眼底荧光造影表现。结果多发性大动脉炎是累及多支大血管及其主要分支的非特异性炎症,眼底荧光血管造影所反映的眼底血管情况可直接反映患者全身病变累及的部位及程度,部分患者眼底表现早于全身症状出现,其中部分患者荧光血管造影改变早于眼底改变。结论眼底荧光血管造影能够很好地反映眼底血液循环及血管病变情况,对组织的缺血炎症浸润的程度和范围能给予呈现。从而直接反映多发大动脉炎患者病变累及的部位及程度,因眼底血管是全身唯一无创下可见完整结构的血管,造影剂用量小且安全性高,所以眼底荧光血管造影是诊断多发性大动脉炎的安全有效方法之一。     

1例糖尿病性视网膜病变患者的护理分析

糖尿病性视网膜病变是最常见的一种视网膜血管病。糖尿病性视网膜病变无特殊药物治疗,重点是预防,单纯型定期眼底检查,必要时眼底荧光血管造影,一旦患者进入增殖前期,考虑激光行全视网膜光凝,以防止新生血管生成。增殖型者,采用全视网膜光凝治疗新生血管并同时行眼内全视网膜光凝。此外,要积极控制血糖血压血脂。     

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.     

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.     

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.     

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.