有毒有害作业工人脂肪肝患病情况调查

目的 探讨有毒有害作业工人脂肪肝发病情况。方法 选择某油漆厂、化工原料生产厂作业工人260名为观察组,多间工厂文职人员130人作为对照组,连续三年进行腹部B超和血脂检查。结果 两组脂肪肝发生率分别为14．23％和10．00％、经统计学处理,两组差别有显著性,p〈0．05。结论 有毒有害作业工人脂肪肝发病率高于文职人员,应引起重视。     

脑苷肌肽注射液治疗血管性痴呆疗效观察

目的观察脑苷肌肽注射液治疗血管性痴呆（VD）临床疗效。方法将67例患者分为治疗组（35例）和对照组（32例），治疗组用生理盐水250ml＋脑苷肌肽注射液10ml静滴，1次／d，连用4周；对照组用生理盐水250ml＋胞二磷胆碱0．5g静滴，1次,／d，连用4周；以简易精神状态量表（MMSE），日常生活能力量表（ADL），神经功能缺损评分作为疗效评分指标。结果治疗4周后治疗组治疗前、后简易精神状态检查量表（MMSE）有显著性提高（P〈0．01），ADL、神经功能缺损评分比较有显著性下降（P〈0．01）；且治疗组MMSE与对照组比较有明显提高（P〈0．05），ADL、神经功能缺损评分比较有明显下降（P〈0．05）。结论脑苷肌肽治疗血管性痴呆能改善脑循环，增加脑灌注，营养脑细胞，提高患者生活质量。     

舒肝宁治疗慢性乙型肝炎的临床疗效观察

目的观察舒肝宁治疗慢性乙型肝炎的疗效。方法慢性乙型肝炎患者120例采用前瞻性研究、双盲随机分成治疗组和对照组各60例。治疗组以10％葡萄糖250ml＋舒肝宁注射液20ml，1；L／d静脉滴注，疗程30d；对照组以10％葡萄糖250ml＋VC5．0g＋门冬氨酸钾镁20ml＋肌苷0．4g，1；K／d静脉滴注．疗程30d：2组均不使用其他抗病毒药及免疫调节制剂。结果治疗组乏力、恶心、呕吐、纳差、肝区疼痛等症状缓解率为93．33％，对照组为51．67％，2组比较差异有统计学意义（P〈0．01）；治疗组总有效率为85．00％．对照组为78．33％，2组比较差异有统计学意义（P〈0．05）；治疗组HBV-DNA阴转7例，对照组HBV．DNA阴转2例，2组比较差异有统计学意义（P〈0．05）。结论舒肝宁能改善和消除肝炎临床症状，降低转氨酶，尤其降低黄疸效果明显，部分患者HBV-DNA定量转阴，临床应用药物不良反应小。     

叶酸结合根除Hp对慢性萎缩性胃炎转归的影响

目的探讨叶酸（FA）对慢性萎缩性胃炎（CAG）的影响。方法将30例慢性萎缩性胃炎患者随机分为治疗组（口服叶酸连续3个月，加奥美拉唑、克拉霉素、灭滴灵治疗1周）和对照组（仅用奥美拉唑、克拉霉素、灭滴灵治疗1周），在治疗前后分别行胃镜及病理检查，观察CAG的转归。结果胃镜观察治疗后治疗组显效2例，有效4例，无效9例，总有效率40．0％，Hp转阴率93．33％；对照组显效0例，有效2例，无效13例，总有效率13．33％，Hp转阴率86．67％；治疗组总有效率明显高于对照组（X^2=5．1675。P〈0．05），而Hp转阴率两组无明显差异（X^2=0．3704，P〉0．05）。病理组织观察发现，叶酸组治疗后能明显改善CAG萎缩（P〈0．05）、肠化（P〈0．05）及炎症（P〈0．05），但对异型增生无明显影响（P〉0．05）；治疗组与对照组比较差异有显著性趋势（P值接近显著性水平）；治疗前后组织病理的萎缩与肠化改变一致（r=0．38，P〈0．05），内镜观察与病理组织学改变同步。结论叶酸结合根除Hp对CAG组织病理有改善作用。     

阿魏酸钠治疗短暂性脑缺血发作的疗效观察

目的：观察阿魏酸钠治疗短暂性脑缺血（TIA）发作的疗效及血流变学的变化。方法：将符合标准的入选病例101例分为治疗组和对照组。治疗组52例，给予阿魏酸钠0．2g，加入250mL0．9％氯化钠注射液中静脉滴注；对照组49例，给予丹香冠心注射液20mL，加入250mL0．9％氯化钠注射液中静脉滴注，两组疗程均为14d，并于治疗结束后随访60d．结果：2组临床疗效比较，有显著性差异（P〈0．05）；治疗组较对照组的基本治愈率明显提高（75％vs50％，P〈0．05）。结论：阿魏酸钠治疗TIA疗效确切，可降低脑梗塞的发生率。     

不同浓度苯及其同系物对作业人员健康影响的调查

目的：了解不同浓度苯及其同系物对作业员人健康的影响。方法：对工作现场的苯及其同系物的浓度进行测定．并对在岗期间的作业工人进行职业性健康体检。结果：高浓度接触组以神经衰弱、皮肤黏膜刺激为主要表现的不良症状检出率高于低浓度组和对照组（P＜0．05或P〈O．01），而且高浓度接触组的白细胞、血红蛋白、血小板平均值显著低于低浓度组及对照组（P＜0．01）：低浓度接触组与对照组相比较，头晕、睡眠障碍、记忆减退、胸闷等症状的检出率两组差异有显著性（P〈0．05或P〈0．01），其他各项异常症状检出率，差异无显著性（P〉0．05），但血红蛋白、血小板差异有显著性（P〈0．01）。结论：接触不同浓度苯及其同系物对作业人员神经系统及血液系统有不同程度的影响．长期接触会严重影响作业人员的健康。     

复方苦参注射液预防化疗所致肝损害临床观察

目的：研究复方苦参注射液预防化疗所致肝损害的效果。方法：采用随机对照的方法观察2组治疗后肝功能变化情况。其中实验组93例，对照组75例。实验组病例使用化疗加复方苦参注射液治疗，对照组仅使用化疗方案，未加复方苦参注射液。结果：实验组胆红素升高者1例，占1．1％，为Ⅰ度；对照组胆红素升高者3例，占4．2％，均为Ⅰ度。2组差异无显著性（P〉0．05）。实验组转氨酶升高者2例，占2．2％，均为Ⅰ度；对照组升高者8例，占10．7％，其中Ⅰ度7例，Ⅱ度1例。2组间差异有显著性（P〈0．05）。结论：复方苦参注射液不仅具有抗肿瘤作用，而且能有效保护肝细胞免受化疗药物的损伤，值得在临床推广应用。     

复方甘草酸苷注射液联合护肝片治疗抗结核药物性肝炎的疗效

目的：观察复方甘草酸苷注射液联合护肝片治疗抗结核药导致肝损害的疗效。方法：将216例抗结核药导致肝功能损害的患者随机分成试验组和对照组各108例，前者用复方甘草酸苷注射液40mL＋5％葡萄糖注射液250mL，静滴，qd，加护肝片口服3粒，tid。后者用常规疗法1肝泰乐注射剂0．399g＋维生素c注射剂1．0g＋5％葡萄糖注射液250mL，静滴，qd。结果：结核药物性肝炎大多发生于强化期内，试验组在临床症状、体征、肝功能的改善方面（86．7％）较对照组（71．4％）有显著性差异（P〈0．05）。治疗结束后试验组总有效率为100％，对照组为88．9％，两组间比较有显著性差异（P〈0．05）。结论：复方甘草酸苷注射液联合护肝片治疗1周内，可明显改善药物性肝炎表现及恢复肝功能作用，对于结核药物性肝炎有较高疗效且临床应用安全。     

三维适形放疗联合金龙胶囊治疗原发性肝癌52例疗效分析

目的探讨三维适形放疗联合金龙胶囊治疗原发性肝癌的临床疗效。方法52例原发性肝癌患者随机分为两组，单纯三维适形放疗组（对照组）和三维适形放疗联合金龙胶囊组（治疗组）各26例。观察两组治疗的近期疗效、临床受益反应率和不良反应。结果治疗组近期疗效76．9％，对照组57．6％，两组比较有显著性差异，P〈0．05；治疗组临床受益率76．9％，对照组61．6％，两组比较有显著性差异，P〈0．05。两组不良反应发生率比较，均无显著性差异，P〉0．05。结论三维适形放疗联合金龙胶囊治疗原发性肝癌安全有效，值得推广。     

五加生化胶囊对缩短药物流产后阴道流血时间的探讨

目的：观察五加生化胶囊缩短药物流产后阴道流血时间的作用。方法：200例早孕妇女分为两组，观察组于第3天口服米索前列醇600ug后开始加服五加生化胶囊6粒2次／d，共4d；对照组于第3天口服米索前列醇600ug后开始加服消炎药，共4d。结果：观察组完全流产率为95．0％，对照组为89．0％，两组有显著性差异（P〈0．05）；观察组治愈率为89．0％，总有效率94．0％，而对照组治愈率为68．0％，总有效率为82．0％，均有显著性差异（P〈0．05）。结论：五加生化胶囊有缩短药物流产后阴道流血时间的作用。     

苯接触工人白细胞中性粒细胞碱性磷酸酶活性的研究

目的 探讨苯接触工人外周血白细胞中性粒细胞碱性磷酸酶（neutrophil alkaline phosphatase,NAP）的活性.方法 对接触苯的207名工人（接触组）和健康人员94名（对照组）进行NAP检测,并进行比较.结果 接触组NAP活性（67.40±16.12）与对照组比较（38.69±11.53）升高,差异有统计学意义（P＜0.001）,不同性别的接触组NAP活性差异无统计学意义（P＞0.05）,不同工龄接触组间NAP活性差异无统计学意义（P＞0.05）,高浓度接触组（57.27±18.78）与低浓度接触组（74.26±15.81）的NAP活性差异有统计学意义（P＜0.001）,高浓度接触组与高浓度退休组（49.03±16.62）的NAP活性差异有统计学意义（P＜0.05）.结论 苯接触工人NAP活性较健康人群升高,开展NAP检测对苯接触工人的健康监护有一定意义.     

Assessment of micronuclei and sister chromatid exchange frequency in the petroleum industry workers in province of Vojvodina,Republic of Serbia

Persons who work with petroleum and petroleum derivatives (PPD) are potentially at risk of developing cancer mostly due to the carcinogenity of benzene. Therefore, the aim of this study was to determine in which degree occupational exposure of workers to PPD causes damage to DNA by analysis of micronuclei (MN), sister chromatid exchanges (SCE) and proliferation index (PI). 30 workers of refinery in Novi Sad, participated in the study as exposed and 30 volunteers as control group. Workers exposed to PPD had significantly higher values of MN and SCE in comparison to controls. Exposition time to PPD and type of working place have also significantly effects to DNA damage. The influence of confounding factor such as smoking and age were also evaluated.     

茂名市某钓鱼竿厂苯、甲苯、二甲苯危害的调查分析

目的了解茂名市某钓鱼竿厂苯、甲苯、二甲苯（“三苯”）对作业人员健康的危害程度。方法对茂名市某钓鱼竿厂工作场所进行“三苯”浓度测定,并对50例“三苯”作业工人（接触组）和68例不接触“三苯”工人（对照组）进行体检。结果该厂工作场所空气中的苯、甲苯、二甲苯时间加权平均容许浓度（PC—TWA）、短时间接触容许浓度（STEL）均未超标。接触组头痛、头晕、失眠、记忆力减退的发生率高于对照组,差异有显著性（P〈0．05或P〈0．01）。血常规检查结果显示,接触组白细胞减少的检出率高于对照组（P〈0．01）。结论该厂“三苯”对作业工人的健康存在一定的潜在危害,应做好“三苯”危害的预防工作。     

Determination of chromosome aberrations in workers in a petroleum refining factory

Human exposure to benzene is derived occupationally from the petrochemical and petroleum refining industries. This study was performed to determine whether the frequencies of chromosome aberrations in workers exposed to low levels of benzene in a petroleum refining factory were elevated compared to an unexposed control group. The study population was comprised of 178 exposed workers and 36 unexposed workers. The frequencies of chromatid deletions and total chromosome aberrations in workers exposed to benzene were significantly higher compared to the unexposed control group. The frequency of total chromosome aberration was 4.20 per 500 metaphase cells in the exposed workers, whereas the frequency was 2.24 per 500 metaphase cells in the unexposed control group. The frequencies of total chromosome aberrations were significantly associated with benzene concentration after adjusting for confounding variables such as age, smoking status, and alcohol intake. The frequencies of chromosome aberrations were significantly increased in workers with low white blood cell counts (below 4000 cells/mm3) compared to those with high white blood cell counts (above 4000 cells/mm3). A reduced white blood cell count (below 4000/mm3) is suggestive of chronic exposure to benzene. In conclusion chronic benzene exposure and preclinical signs, such as reduced white blood cell counts, may be monitored by chromosome aberrations analysis.     

Prevalence of Abnormal Liver function Tests in Laboratory Workers

Abstract

Standard clinical biochemical tests were reviewed from 170 asymptomatic and presumably healthy volunteers who participated in 14 drug research projects in order to determine the prevalence of abnormal liver function tests (LFT) in laboratory vs. non-laboratory workers. Forty percent of the laboratory workers had abnormal LFT while LFT were abnormal in only 10.5% of non-laboratory exposed persons (p = >0.005). Total serum billrubin was increased in 18.7% of the laboratory workers as opposed to only 4.7% of non-laboratory workers (p => 0.005). Twenty-one percent of the laboratory workers had an abnormal LFT other than total bilirubin as compared to only 5.9% of the non-laboratory workers (p = > 0.005). There was no evidence for Hepatitis B in any person with abnormal LFT. We postulate that the abnormal LFT seen in laboratory workers most likely results from chronic low-dose exposure to xenobiotics found in the laboratory work situation. Drug study volunteers from this occupational group should be chosen with care.     

Measuring the effects of pesticides on occupationally exposed humans with the comet assay

In this study we examine the effects of a mixture of pesticides on occupationally exposed agricultural workers. The study was performed on 149 people, 84 agricultural workers and 65 healthy men from the same area, who served as the control group. The exposed group was divided into a subgroup with 65 individuals moderately exposed (39 men and 26 women) and a highly exposed subgroup consisted of 19 men. The statistical analysis of the comet assay results showed that there were no significant differences in basal DNA damage between pesticide-exposed workers and the control group nor between moderately and highly exposed ones. In addition, exposure of peripheral blood lymphocytes to hydrogen peroxide or gamma-irradiation led to a similar degree of DNA damage and subsequent repair for all the studied populations.     

Specific immune responses in workers exposed to benzene

The aim of this study was to elaborate a method for detection of specific IgG antibodies (Abs) to the haptenes p-benzoquinone (p-BQ) and hydroquinone (HQ) for assessment of specific humoral immune responses. Plasma and urine, collected from petrochemical plant workers have been analyzed. The workers were divided into three professional groups in ascending order of benzene exposure. The concentration of benzene in the air was determined by gas chromatography with mass-spectrometry and trans,trans-muconic acid (biomarker of benzene exposure) in urine-by liquid chromatography with UV-detection. Specific IgG Abs to haptenes p-BQ and HQ in plasma were determined with newly developed ELISA. The relationships "exposure-effect," revealed increased levels of specific IgG to haptens correlating with the benzene exposure. The "exposure-response" relationships demonstrated that workers with value of OD over X+2SD were 62% low exposure group, 68% in group with level of exposure on Threshold Limit Value (TLV) and 91% in the highest exposure group. The data obtained show that there is a good correlation between antibody production and the biomarker of exposure t,t-muconic acid. CONCLUSION: The newly developed method is applicable for assessment of specific humoral immune responses in workers exposed to benzene. There was a good correlation between benzene exposure and formation of antibodies against benzene metabolites.     

胃癌患者血清肝细胞生长因子的检测及意义

目的探讨血清肝细胞生长因子（HGF）在胃癌患者血清水平变化的临床意义。方法选取手术和临床病理证实为胃癌的60例患者,采用酶联免疫吸附法（ELISA）检测其血清HGF水平,其中40例行胃癌根治术,20例患者因已有远处转移而丧失根治手术机会。分别检测胃癌患者术前、术后7d和3个月者血清HGF的水平;同时选取加例慢性胃炎患者以及40例门诊健康体检者作为对照。结果胃癌患者血清HGF水平明显高于慢性胃炎组和正常对照者（P〈0．01）。肿瘤血管侵犯者血清HGF明显升高（P〈0．05）;有淋巴结转移者,血清HGF水平明显高于无淋巴结转移者（P〈0．05）;肝脏转移者血清HGF水平明显高于无肝脏转移者（P〈0．05）;肿瘤最大直径t〉3cm的胃癌患者血清HGF水平明显高于最大直径〈3cm的胃癌患者（P〈0．05）;按胃癌TNM分期标准,Ⅰ期和Ⅱ期患者血清HGF水平明显低于Ⅲ期和Ⅳ期患者（P〈0．05）;胃癌患者血清HGF水平与性别、年龄及组织学类型无明显关系（P〉0．05）。40例手术治疗患者术后1周血清HGF水平明显降低,术后3个月降低更为明显（P〈0．05和P〈0．001）。结论HGF在胃癌的发生发展过程中可能起重要作用,血清HGF水平的检测可成为胃癌病情程度监测和预后判断的重要指标。     

铅接触对男性生殖系统影响的研究

目的探讨化学因素中的重金属因素对男性生殖功能的影响。方法选取本市某家具厂中200名与铅长期接触超过1年的男性工人作为本次研究的观察组,另外选取本市不接触铅和其他有害物质的男性200名作为对照组。采用问卷调查和测定被试精液当中计算精子数、顶体酶活性、雄激素、促卵泡素、促间质细胞激素的含量。结果观察组中生殖症状率为28.2%,对照组为13.6%,性欲减退观察组为23.3%,对照组为10.1%,配偶流产率观察组为2.0%,对照组为8.0%,配偶早产率观察组为18.0%,对照组为9.0%,差异均有统计学意义(P<0.05)。而两组工人在阳痿和早泄方面的症状差异均无统计学意义(P>0.05);精液检查结果显示,两组患者的精子数的差异无统计学意义(P>0.05)。而在顶体酶活性、雄激素、促卵泡素、促间质细胞激素方面差异均有统计学意义(P<0.05)。结论铅接触对男性生殖系统会有一定程度的影响,对顶体的酶活性起到较为显著的作用,同时对男性性欲、勃起等性功能也会起到弱化的作用,因此提示应该对铅接触工人增加工作保护措施和改善工作条件,必要时可暂停育龄男性铅接触的工作,以增加男性工人生殖系统的健康。     

Metallothionein excretion in urine upon cadmium exposure: Its relationship with liver and kidney cadmium

The relationships between quantities of accumulated cadmium in the liver and kidney and those of metallothionein in urine was studied in occupationally exposed workers and experimentally exposed rats. Cadmium-exposed workers who had been employed at a cadmium production plant for periods of 8–29 years had significantly higher levels of cadmium in both liver and kidney and excreted significantly larger amounts of metallothionein in urine when compared with workers who had been employed for less than 1 year, with office workers at the plant or with control subjects having no known occupational exposure to cadmium. The excretion of metallothionein in urine of the cadmium-exposed workers appeared to be related to the levels of cadmium in both liver and kidney. A similar dose-effect relationship was also observed among rats given repeated subcutaneous injections of 5 μmol CdCl₂/kg. However, in the rats the metallothionein excretion increased markedly when the liver and renal cortex Cd levels exceeded approximately 300 μg/g and 200 μg/g, respectively. It appears that urinary metallothionein may be a useful biological indicator of liver and kidney cadmium levels.