自体卫星细胞移植治疗心肌梗死的临床研究

目的移植自体卫星细胞（SC）修复受损心肌，治疗心肌梗死。方法冠心病并发心梗患者10例，男女各半。术前2周切取股四头肌肌组织2cm×2cm×2cm一块，采用改良Dorfman法体外培养SC，在冠脉搭桥术（CABG）的同时，梗死区注射植入SC。术前、术后3个月分别进行心电图、心脏彩超、99m^Tc单电子发射计算机断层扫描（SPECT）心血池显像、^18 F—FDG心肌灌注显像检查。观察梗死区的细胞代谢情况，测量左室射血分数。结果（1）SC贴壁生长，延迟分瓶或降低培养液中胎牛血清（FBS）浓度，SC生长停滞，相互融合形成肌管；（2）10例患者平均搭桥2.7支，其中一例仅进行了SC移植手术，无住院死亡，3个月后心功能均恢复至Ⅰ级，心绞痛症状消失。（3）术后3个月复查心肌灌注显像显示原细胞代谢缺失区重新出现细胞代谢活动（包括未行CABG手术者），心血池显像提示LVEF增加（9．70±4．17）％，与术前比较差异有统计学意义（P〈0．01）。结论自体SC移植于心肌梗死区后能存活，可能通过参与心脏收缩、舒张活动，软化瘢痕，改善心肌顺应性，促进梗死区血管再生等途径改善心功能。     

骨髓单个核细胞移植后心肌梗死区细胞因子mRNA表达的实验研究

目的观察猪自体骨髓单个核细胞移植后心肌梗死区干细胞因子、基质细胞衍生因子-1、E-选择素、细胞间粘附分子-1、血管细胞粘附因子-1等细胞因子mRNA的表达。方法前降支球囊封堵法建立10头猪急性心肌梗死动物模型，按随机数字表法分为对照组（5头）和移植组（5头）。造模1周后，移植组冠脉内移植自体骨髓单个核细胞，对照组注射1640培养基作为对照。6个月后取梗死区心脏组织观察局部细胞因子的mRNA表达。结果移植组梗死区能检测到基质细胞衍生因子-1、干细胞因子、E-选择素、细胞间粘附分子-1、血管细胞粘附分子-1等细胞因子的mRNA。其表达强度明显高于对照组。结论干细胞移植能促进局部的基质细胞衍生因子-1、干细胞因子、E-选择素、细胞间粘附分子-1和血管细胞粘附分子-1mRNA的表达。     

三种蔬菜粉对小鼠移植肝癌生长的影响

本文用小鼠荷瘤实验观察了蔬菜粉对小鼠移植肝癌生长的影响，将100只ICR小鼠按体重随机分成五组：对照组；5-氟尿嘧啶（5－FU）组；三个蔬菜粉实验组。先分别给各组动物喂饲相同量的基础饲料或实验饲料15无，三种实验饲料中分别加入5％蕹菜粉、青油菜粉、紫油菜粉；然后给全部小鼠移植小鼠肝癌H22瘤株；次日起给5－FU组动物腹腔注射5－FU，隔日一次，共四次。结果表明，紫油菜和蕹菜对雌性小鼠肝癌生长有一定抑制作用；与临床抗癌药物5－FU比较，这两种蔬菜的抑癌作用较低，未见有害作用。未见青油菜有抑制肿瘤的作用。     

抑制碱烧伤兔眼角膜VEGF表达的实验研究

目的：探讨羊膜移植或高压氧治疗对碱烧伤角膜内血管内皮生长因子（vascular endothelial growth factor，VEGF）及角膜新生血管形成的抑制作用。方法：21只兔（42眼）被建立角膜碱烧伤动物模型后随机分为羊膜移植组、高压氧治疗组和对照组，每组7只兔（14只眼）。羊膜移植组、高压氧治疗组分别行羊膜移植和高压氧治疗。采用免疫组化染色检查VEGF蛋白的表达，宏观测量新生血管长度及生长速度，显微镜下微血管计数方法研究角膜新生血管形成及抑制情况。结果：羊膜移植组和高压氧治疗组VEGF蛋白表达下降，新生血管生长速度变慢，微血管数量减少，3组比较差异有统计学意义。VEGF主要表达在角膜受损区的感染细胞胞浆内，其出现时间和位置与角膜新生血管一致。结论：VEGF是一种重要的角膜内新生血管形成因子，其变化与角膜新生血管平行；羊膜移植或高压氧治疗可抑制碱烧伤角膜VEGF的表达及角膜新生血管的形成。     

骨髓单个核细胞移植修复扩张型心肌病慢性心力衰竭大鼠心肌组织

目的：研究骨髓单个核细胞移植对实验性扩张型心肌病慢性心力衰竭大鼠心肌的修复作用及其远期效果。方法：建立扩张型心肌病慢性心力衰竭大鼠模型。造模后实验组直接心肌注射DAP I标记过的骨髓单个核细胞;对照组注射同等剂量PBS溶液;假手术组仅开胸和关胸。于造模后即刻、移植后4、12和24周,分批分组进行免疫组织化学和透射电镜等的检测分析。结果：心脏标本切片：荧光显微镜检查证实在细胞移植区有新生心肌和血管,因细胞核被标记而呈现荧光。透射电镜检查可见不成熟的心肌细胞,胞质中有散在肌丝样物质,还可见内膜不完整的新生血管,阳性物质随时间推移而逐渐增多。对照组和假手术组没有上述改变,并在不同时间段发生死亡病例。结论：骨髓单个核细胞移植能有效防止慢性心力衰竭大鼠心功能恶化,促进心肌和血管再生,有潜在治疗价值。     

骨髓单个核细胞移植治疗慢性心力衰竭的疗效观察

目的探讨自体骨髓单个核细胞移植治疗慢性心力衰竭患者的可行性。方法入选慢性心力衰竭患者80例，分为骨髓细胞移植组（48例）和标准药物治疗组（32例），骨髓细胞移植组将骨髓单个核细胞悬液在冠状动脉造影时经导管注入冠状动脉内。标准药物治疗组仅采用常规治疗。用超声心动图、血浆脑钠肽（BNP）和单光子发射计算机断层扫描（SPECT）比较两组治疗前后心功能指标和心肌灌注缺损区面积。结果骨髓细胞移植组和标准药物治疗组治疗前LVEF分别为（42．1±5．8）％、（43．9±6．7）％，术后1年随访分别为（54．1±4．8）％、（49．8±7．7）％；治疗前BNP分别为（699±101）ng／L、（687±95）ng／L，随访分别为（305±78）ng／L、（399±89）ng／L；治疗前心肌灌注缺损面积分别为（26．8±8．6）％、（26．3±6．5）％，随访分别为（15．8±4．3）％、（20．5±7．8）％，两组随访比较差异均有统计学意义；骨髓细胞移植组术中和术后均无并发症发生。结论骨髓单个核细胞移植治疗慢性心力衰竭患者安全可行，术后能改善心功能及心肌血流灌注。     

骨髓单个核细胞缺血肢体局部移植对缺血组织血管再生作用的研究

目的分析骨髓单个核细胞局部移植对缺血组织血管再生的作用及机制。方法从大鼠胫骨及股骨采集骨髓细胞，密度梯度离心法分离出骨髓单个核细胞分离、切断近交系Wistar大鼠右侧股动脉及其分支，建立单侧后肢缺血模型。分7点局部注射单个核细胞悬液(移植组)或磷酸盐缓冲液(对照组)术后第3、7、14d获取内收肌制作组织匀浆，ELISA法测定匀浆中bFGF、VEGF和IL-18因子水平；术后第2,4周免疫组化法分析肌肉组织毛细血管密度。结果术后第3d，移植组bFGF表达水平高于对照组(P＜0．01)。术后第3、7d，移植组IL-1β水平高于对照组(P＜0．01)术后第2、4周移植组内收肌毛细血管密度高于对照组(P＜0.01)。结论在大鼠缺血后肢局部直接植入骨髓单个核细胞可诱导新生血管形成；骨髓单个核细胞分泌bFGF、IL-1β等多种因子在局部直接植入骨髓单个核细胞促进血管再生的机制中可能起主要作用。     

GFP修饰的骨髓基质干细胞在移植癫痫大鼠脑中存活及迁移

目的探讨骨髓基质干细胞定向移植后在脑中存活时间,为进一步的细胞治疗提供实验基础。方法腹腔注射青霉索建立癫痫模型。24只健康Sprague-DawleySD大鼠,用立体定向仪进行移植。移植骨髓基质干细胞后,分为7d组（8只）,14d组（8只）,28d组（8只）。分别于移植后7d,14d,28d天脑灌注取材,通过荧光观察比较骨髓基质干细胞移植后,7d,14d及28d组的细胞存活数。结果骨髓基质干细胞移植后14d组细胞数少于7d组（P〈0.01）,28d组少于14d组（P〈0.01）。结论移植于癫痫鼠海马内的骨髓基质干细胞移植可以存活,部分细胞会发生迁移,但随时间延长,细胞数逐渐减少。     

电针加穴位注射治疗周围性面神经麻痹的临床疗效观察

目的探讨电针加穴位注射治疗周围性面神经麻痹的临床疗效。方法将62例周围性面神经麻痹患者随机分为实验组和对照组各31例；实验组采取电针加穴位注射治疗；对照组予常规药物治疗。结果20天后临床观察实验组有效率（96．77％），对照组有效率（48．39％），比较差异有统计学意义（P〈0.05）。结论电针加穴位注射治疗急性面神经麻痹的临床疗效确切，有推广使用价值。     

关节腔内注射洛伐他汀预防骨关节炎软骨退变

目的研究洛伐他汀关节腔内注射对骨关节炎（OA）模型关节软骨退变及对基质金属蛋白酶（matrix metalloproteinase-1，3）mRNA表达的影响。方法30只6个月龄新西兰大白兔行右膝关节前交叉韧带切断术。手术后将动物随机分为实验组和对照组，实验组术后立即给予关节腔内注射0．5mg／ml洛伐他汀0．2ml／kg，每周1次，连续6周；对照组则关节腔内注射等容量的生理盐水。术后6周处死动物。在解剖镜下观察股骨内髁关节软骨的大体形态学改变并评分。用反转录一聚合酶链式反应检测软骨及滑膜中MMP-1，3mRNA的表达。结果解剖镜下实验组软骨退变程度较对照组明显减轻；实验组关节液中IL-1水平较对照组明显降低；实验组滑膜中MMP-1，3mRNA的表达水平显著低于对照组（P〈0．05），而软骨中的MMP-1，3mRNA的表达较对照组差异无统计学意义（P〉0．05）。结论在OA早期关节腔内注射L洛伐他汀能够明显降低MMP-1，3mRNA的表达，减轻骨关节炎软骨的退变。     

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.