精氨酸增强的TPN与常规TPN对大肠癌病人免疫功能影响的比较研究

目的：探讨精氨酸增强的ＴＰＮ对大肠癌病人免疫功能及粘膜免疫屏障的作用。方法：２０例大肠癌病人随机分为常规ＴＰＮ组和ＴＰＮ＋Ａｒｇ组，分别接受常规ＴＰＮ和ＴＰＮ＋Ａｒｇ治疗共５天，检测基前、后外周血ＣＤ３、ＣＤ４、ＣＤ８、ＩｇＧ、 ＩｇＭ、ＩｇＡ和粘膜固有层用药第５天ＣＤ３、ＣＤ４、ＣＤ８的变化。并观察用药５天的小笔工、密度。结果：（１）常规ＴＰＮ组行ＴＰＮ后外周血ＣＤ３、ＣＤ４下降，ＣＤ８升高，Ｃ     

全肠外营养添加免疫调节剂的临床应用研究

作者将全肠外营养添加免疫调节剂黄芪应用于进展期胃癌根治术病人，观察其营养指标和免疫指标的变化。结果显示，氮平衡和纤维连接蛋白明显改善：ＩｇＧ、ＩｇＭ、Ｃ３、ＣＤ３＾＋，ＣＤ４＾＋，ＣＤ４＾＋／ＣＤ８＾＋和ＮＫＣ明显升高，ＴＮＦ和ＩＬ－２Ｒ明显下降，与ＴＰＮ组相比差异显著，且接近正常地照值水平，结果说明，营养状况和免疫功能的改善是ＴＰＮ和黄芪双重作用的结果，并达到较理想状态。     

术前精氨酸强化PN对结直肠癌病人免疫功能的影响

目的：探讨术前精氨酸强化肠外营养（ＰＮ）对结直肠癌病人免疫功能的影响。 方法：选择经病理证实的结直肠癌病人作为研究对象,术前随机分为三组,即对照组给常规术前准备,常规ＰＮ组和精氨酸强化ＰＮ组除常规准备外,分别给予常规ＰＮ和精氨酸强化ＰＮ７天,术前７天和手术当天早晨７：００采集外周静脉血,测定ＣＤ３、ＣＤ４、ＣＤ８、ＩＬ－２、ＮＫ细胞和ＮＫ细胞活性;取同期进行腹股沟疝手术的病人作为正常对照。 结果：     

大肠癌围手术期营养支持

为探讨围手术期全肠外营养在大肠癌病人的应用价值，我们有选择地对１５例病人围手术期进行ＴＰＮ８￣１０ｄ，结果术前病人均有营养不良和细胞免疫功能抑制，术后营养状况明显改善，获得正氮平衡，前白蛋白，转铁蛋白明显增加，细胞免疫功能明显改善，ＣＤ＾３＋、ＣＤ４＾＋细胞百分率明显增加，ＣＤ８＾＋细胞百分率明显下降，ＣＤ４＾＋／ＣＤ８＾＋比值明显增加，我们认为围手术期ＴＰＮ能使中、重度营养不良的大肠癌病人受益。     

自体异构化肿瘤疫苗对细胞免疫功能的影响

对２４例恶性肿瘤患者应用自体异构化瘤苗治疗,并与相应对照组比较,通过治疗前后外周血Ｔ淋巴细胞亚群ＣＤ３＾＋、ＣＤ４＾＋、ＣＤ８＾＋、ＣＤ４＾＋／ＣＤ＾＋有ＮＫ细胞活性的检测,观察患者细胞免疫功能的变化的情况。结果,研究组治疗后ＣＤ３＾＋、ＣＤ４＾＋、ＣＤ＾４＋／ＣＤ＾８比值和ＮＫＣ活性都比治疗前显著增加（Ｐ〈０．０１）,而对照组无明显变化（Ｐ〉０．０５）。提示异构化瘤苗能有效地解助恶性肿瘤病人重建     

反复呼吸道感染儿童细胞免疫与体液免疫研究

摘要：目的　探讨细胞免疫状态和体液免疫状况与儿童反复呼吸道感染（ｒｅｃｕｒｒｅｎｔｒｅｓｐｉｒａｔｏｒｙｉｎｆｅｃｔｉｏｎ, ＲＲＴＩ）的关系。方法　选取２０１２年７月至２０１６年７月,南京医科大学附属江宁医院确诊为ＲＲＴＩ的患者 ９０例（ＲＲＴＩ组）,并以同期９０例社区获得性肺炎患儿（肺炎组）和９０例健康体检儿童（正常组） 作为对 照,采用流式细胞仪检测所有患儿Ｔ 细胞亚群,采用酶联免疫吸附法检测血清中免疫球蛋白,采用ｌｏｇｉｓ ｔｉｃｓ回归探讨患儿反复呼吸道感染发生的风险因素。结果　ＲＲＴＩ组、肺炎组和正常组患儿ＣＤ３＋ 、ＣＤ４＋ 、 ＣＤ４＋／ＣＤ８＋ 水平间差异均有统计学意义（犉＝４．２１、３．９２、４．０８,犘＜０．０５）。三组患儿ＩｇＡ、ＩｇＧ、ＩｇＭ 水平间的差异均有统计学意义（犉＝４．７６、５．１４、５．５３,犘＜０．０５）。多因素ｌｏｇｉｓｔｉｃ分析显示,低水平ＩｇＡ （犗犚＝１．７８,９５％犆犐：１．０６～２．２３） 和ＣＤ４＋／ＣＤ８＋ （犗犚＝１．６５,９５％犆犐：１．５２～２．３２） 是ＲＲＴＩ的独立 危险因素。结论　血清中ＩｇＡ 和ＣＤ４＋／ＣＤ８＋ 水平低是患者发生ＲＲＴＩ的独立危险因素。 关键词：反复呼吸道感染;体液免疫;细胞免疫;预后;儿童 中图分类号：Ｒ７２５．６　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１９）０２ ０１３６ ０３     

精氨酸对结肠,直肠癌病人免疫功能及肿瘤细胞增殖活性的影响

目的：研究精氨酸（Ａｒｇ）对结肠、直肠癌病人的免疫功能和肿瘤细胞增殖活性的影响。方法：结、直肠腺癌病人３０例，随机分为实验组、对照组。实验组每天静脉输注Ａｒｇ２５ｇ，连续３天。检测细胞免疫指标〔Ｔ细胞亚群（ＣＤ３＾＋、ＣＤ４＾＋、ＣＤ８＾＋）、ＮＫ细胞活性、淋巴细胞转化率〕、红细胞免疫指标〔红细胞Ｃ３ｂ受体花环率（ＲＢＣ－Ｃ３ｂＲＲ）、红细胞免疫复合物花环率（ＲＢＣ－ＩＣＲ）〕、体液免疫指标（免疫     

铝对小鼠免疫系统影响的研究

为探讨铝对免疫系统的影响,给小鼠每天腹腔注射氯化铝（ＡｌＣｌ３）溶液〔１０,２５,４０ｍｇ／（ｋｇｄ）〕,连续注射２,４,６周。结果表明：染铝４周后脾重及２５ｍｇ／ｋｇ、４０ｍｇ／ｋｇ组的ＰＦＣ值、ＣＤ３＋、ＣＤ４＋、ＣＤ４＋／ＣＤ８＋、ＡＮＡＥ阳性率均显著增加,６周后各剂量组的脾重、ＰＦＣ值及２５ｍｇ／ｋｇ组的ＣＤ４＋,ＣＤ４＋／ＣＤ８＋、ＡＮＡＥ和４０ｍｇ／ｋｇ组的ＣＤ３＋、ＣＤ４＋、ＣＤ８＋、ＡＮＡＥ均显著增加,并且随染铝时间延长,４０ｍｇ／ｋｇ组的ＰＦＣ值、ＣＤ３＋、ＣＤ４＋、ＣＤ４＋／ＣＤ８＋及ＡＮＡＥ呈先升高后下降趋势,而ＣＤ８＋呈上升趋势,提示铝对小鼠免疫系统具有影响作用,呈双向性     

青年胃印戒细胞癌细胞免疫状态及γδT细胞应用研究

青年胃印戒细胞癌是临床上预后较差的恶性肿瘤。为了研究该肿瘤患者的免疫状态及应用γδＴ淋巴细胞治疗可能性，对４例青年胃印戒细胞癌患者、６例正常人外周血作了免疫细胞表型分析（ＣＤ３、ＣＤ４、ＣＤ８、ＣＤ１６、ＣＤ２５、ＣＤ５６、Ｔγδ）及肿瘤坏死因子（ＴＮＦ）和白细胞介素６（ＩＬ－６）检测。并对４例患者采用γδＴ细胞／ＩＬ－２过继免疫治疗（ＡＣＩＴ），观察细胞免疫动态变化。结果表明：４例青年胃印戒细胞癌患者外周血ＣＤ＋３、ＣＤ＋４、ＣＤ＋４／ＣＤ＋８比值均低于正常组。ＴＮＦ、ＩＬ－６水平均高于正常组；γδＴ细胞治疗后，外周血ＣＤ＋３、ＣＤ＋４、ＣＤ＋４／ＣＤ＋８比值均升高。随访病人１０～２５个月，未见转移、复发，身体情况均好     

氨茶碱对支气管哮喘外周血T淋巴细胞亚群比值影响的临床观察

目的：探讨氨茶碱对支气管哮喘外周血Ｔ淋巴细胞亚群比值有何影响，对支气管哮喘的治疗起何作用。方法：选择支气管哮喘病人３６例分成两组，分别给予氨茶碱和未用氨茶碱类止喘药，并在治疗前后进行Ｔ淋巴细胞亚群的测定。结果：用药前两组ＣＤ＋８、ＣＤ＋４／ＣＤ＋８比值无显著性差异（Ｐ＞０．０１）。用药后，氨茶碱组ＣＤ＋８增高，ＣＤ＋４／ＣＤ＋８比值恢复正常（（Ｐ＞０．０１）；而未用氨茶碱组ＣＤ＋８、ＣＤ＋４／ＣＤ＋８比值无明显改变（Ｐ＞０．０１）。结论：氨茶碱可发挥免疫调节作用，使支气管哮喘外周血Ｔ淋巴细胞发生改变，使ＣＤ＋８数量和功能增高，恢复ＣＤ＋４／ＣＤ＋８比值，ＣＤ＋８能抑制嗜酸细胞及Ｂ淋巴细胞释放炎性介质，阻断哮喘发作。     

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.