慢性应激对大鼠免疫功能损伤机制的实验研究

[目的]研究慢性应激对大鼠免疫功能的影响及其作用机制.[方法]通过建立慢性应激动物模型,免疫组织化学法检测脾脏T淋巴细胞亚群的阳性率,电镜观察脾脏超微结构的改变,黄嘌呤氧化酶法测定超氧化物歧化酶(SOD)活性,硫代巴比妥酸(TBA)法测定丙二醇(MDA)含量,彗星实验评价大鼠外周血淋巴细胞DNA损伤情况.[结果]与对照组相比,实验组大鼠脾脏超微结构异常明显,T淋巴细胞亚群比例异常,CD3 T细胞百分率、CD4 /CD8 值均下降(P＜0.05),CD8 T细胞百分率升高(P＜0.01),血清SOD活性(56.70±15.65)U/ml降低,MDA含量(9.21±2.75)nmol/ml升高(P＜0.05),彗星细胞发生率升高(P＜0.05).淋巴细胞DNA损伤与MDA含量呈正相关,SOD活性与CD3 T细胞、CD4 /CD8 比值呈正相关;MDA含量与细胞免疫功能下降水平呈正相关,淋巴细胞DNA损伤与细胞免疫功能下降水平呈正相关.[结论]慢性应激使大鼠血清MDA含量增加,SOD活性下降,脾脏超微结构改变,损伤外周血淋巴细胞DNA,从而影响机体的免疫功能.     

长期铅暴露对小鼠胸腺细胞亚群分化的影响

目的探讨铅暴露对小鼠胸腺细胞不同亚群的影响。方法将24只健康初断乳21日龄清洁级雄性KM小鼠随机分为4组,分别为对照(蒸馏水)组和低(200 mg/L)、中(400 mg/L)、高(800 mg/L)剂量乙酸铅染毒组,每组6只。采用自由饮水方式进行染毒,连续染毒12周。采用流式细胞技术检测小鼠外周血和胸腺内不同T细胞亚群的百分率。结果与对照组比较,中、高剂量乙酸铅染毒组小鼠外周血和胸腺中αβT细胞百分率和CD4+T细胞百分率明显降低,γδT细胞百分率明显增加(P<0.05),各剂量乙酸铅染毒组小鼠αβT/γδT值和CD4/CD8比例均明显下降(P<0.05);中、高剂量乙酸铅染毒组小鼠外周血中CD8+T细胞明显增加(<0.05),CD4+T细胞百分率明显下降(P<0.05),而在胸腺中CD4+T细胞和CD8+T细胞百分率均明显减少(P<0.05)。且随着乙酸铅染毒剂量的升高,小鼠外周血和胸腺αβT细胞百分率、CD4+T细胞百分率、αβT/γδT值以及胸腺CD4/CD8值均呈现下降,而外周血和胸腺γδT细胞百分率以及外周血CD8+T细胞百分率均呈现上升趋势。结论长期铅暴露可导致小鼠胸腺细胞亚群异常导致免疫损伤。     

吡格列酮对糖尿病大鼠脾脏免疫损伤的预防性治疗作用

目的 探讨链脲佐菌素(STZ)诱导的糖尿病大鼠脾脏免疫损伤及吡格列酮的干预作用.方法 48只8周龄健康雄性SD大鼠,随机分为糖尿病吡格列酮干预组(Pio组)、糖尿病甘精胰岛素干预组(INS组)、单纯糖尿病组(DM组)、正常对照组(CON组).采用尾静脉注射STZ(45 mg/kg)方法建立糖尿病模型后,Pio组给予吡格列酮[20 mg(kg·d)灌胃和生理盐水(0.1 ml/d)皮下注射,INS组给予甘精胰岛素[4 U/(kg·d)]皮下注射和生理盐水(2 ml/d)灌胃,DM组和CON组大鼠给予生理盐水(0.1 ml/d)皮下注射和生理盐水(2 ml/d)灌胃.各组大鼠同步饲养,自由进食和饮水.于造模成功后第16周末,处死大鼠并留取大鼠脾脏,分别进行测量重量,通过免疫组化的方法观察CD4+、CD8+T细胞变化,通过免疫荧光及Masson染色方法观察脾脏免疫球蛋白和胶原纤维含量的变化.结果 与CON组比较,DM组大鼠脾脏重量降低,脾脏CD4+T细胞和CD8+T细胞增加,而CD4+/CD8+T细胞比值降低,免疫荧光IOD值和胶原纤维量均增加(均P<0.05);而Pio组大鼠脾脏重量高于DM组,脾脏CD8+T细胞低于DM组,CD4+/CD8+T细胞比值高于DM组,免疫荧光IOD值低于DM组,胶原纤维量低于DM组(均P<0.05);与INS组比较,Pio组大鼠脾脏免疫荧光IOD值低于INS组(P<0.01),脾脏重量高于INS组(P<0.05).结论 糖尿病大鼠脾脏出现T细胞亚群数目、比例的异常,免疫球蛋白的沉积和纤维化,脾脏萎缩,脾脏受到免疫损伤.吡格列酮可以一定程度上防止脾脏的上述改变,保护脾脏.     

小儿腹泻与T淋巴细胞亚群、血清维生素D3水平的关系

目的研究小儿腹泻病与T淋巴细胞亚群、血清维生素D3的关系。方法临床纳入143例我院2012年8月至2015年3月期间收治的腹泻患儿作为观察组,另选取120例同期来我院进行体检的健康儿童作为对照组,对两组儿童的T淋巴细胞亚群、血清维生素D3水平进行检查,观察T淋巴细胞亚群、血清维生素D3水平与小儿腹泻的关系。结果观察组的CD3~+、CD4~+、CD4~+/CD8~+水平显著低于对照组,CD8~+水平显著高于对照组,差异有统计学意义(P<0.05)。观察组的维生素D水平为(25.14±6.37)ng/m L,显著低于对照组的(38.41±6.26)ng/m L,差异有统计学意义(P<0.05)。T淋巴细胞亚群、维生素D均是影响小儿腹泻的危险因素,且维生素D水平与T淋巴细胞亚群水平呈正相关。结论对于腹泻小儿需要适当增加维生素D水平,提高患儿的免疫力,提高治疗的效果。     

哮喘孕妇血清微量元素和免疫功能指标的水平及意义

目的 检测哮喘孕妇血清微量元素和免疫功能指标水平,分析其相关性及意义。方法 选取2018年6月—2020年6月湖州市中心医院呼吸科门诊收治的30例哮喘孕妇为哮喘组,同期在湖州市中心医院进行产检的30例健康孕妇为对照组。检测并比较两组孕妇血清微量元素(铁、锌、铜)和免疫功能指标(CD3⁺ T淋巴细胞亚群、CD4⁺ T淋巴细胞亚群、CD4⁺/CD8⁺ T淋巴细胞亚群比值、IgG、IgA及IgM)水平,采用Pearson法分析哮喘组血清微量元素与免疫功能指标的相关性。结果 对照组患者血清CD3⁺ T淋巴细胞亚群、CD4⁺ T淋巴细胞亚群、CD4⁺/CD8⁺ T淋巴细胞亚群比值、IgG、IgA及IgM水平分别为(1.40±0.17)×10⁹/L,(610.00±87.20)×10⁶/L,(1.66±0.32),(13.98±1.11)g/L,(2.87±0.60)g/L及(2....     

三价铬对热应激大鼠免疫功能的影响

[目的]研究三氯化铬(CrCl3)和吡啶羧酸铬(CrPic)对热应激大鼠免疫功能的影响.[方法]分别以CrCl3和CrPic形式补充300 μg·kg-1铬饲喂SD大鼠6周后测定血清中免疫球蛋白、补体、溶菌酶、胰岛素、皮质醇水平以及外周血、脾脏淋巴细胞体外转化率.[结果]CrPic提高了大鼠血清中免疫球蛋白IgG、IgM和溶菌酶的水平,同时降低了血清中胰岛素和皮质醇水平(P＜0.05);添加CrCl3降低了SD大鼠血清中胰岛素和皮质醇水平(P＜0.05);CrPic能增强外周血和脾脏T/B淋巴细胞转化率(P＜0.05),而添加CrCl3并不能提高T/B淋巴细胞转化率.[结论]补充三价铬能增强热应激大鼠的免疫功能,CrPic增进免疫的能力要强于CrCl3.     

肺炎支原体肺炎患儿免疫功能变化及结果分析

目的观察肺炎支原体肺炎（MPP）患儿外周血淋巴细胞亚群、辅助性T淋巴细胞亚群、B细胞以及免疫球蛋白的含量变化,并探讨其在MPP发病机制中的意义。方法采用流式细胞仪技术检测了43例支原体肺炎患儿和40例正常对照组儿童外周血T淋巴细胞亚群、B淋巴细胞亚群以及Th1、Th2细胞的百分比;并用速率散射比浊法检测血清免疫球蛋白IgG、IgA和IgM的含量。结果MPP患儿外周血CD3＋、CD4＋T细胞百分率分别为50.03±9.37和30.25±7.11,较对照组65.88±8.83和36.55±6.01显著降低（P〈0.05）,CD8＋T细胞较对照组无显著差别;患儿外周血Th1细胞百分率为14.26±5.78,对照组为21.08±6.83,两者差异极为显著（P〈0.01）。Th1/Th2比值较对照组显著降低（P〈0.05）。B淋巴细胞和B1细胞较对照组均显著增高（P〈0.05）。43例患儿血清免疫球蛋白与正常对照组比较,IgG和IgA均无明显差异,IgM较对照组稍高,其差别有统计学意义（P〈0.05）。结论MPP患儿存在机体免疫功能减低,免疫调节功能紊乱,Th1/Th2失衡,且Th1型细胞受抑制,而Th2型细胞介导的免疫反应占相对优势状态。     

饮水砷暴露对儿童免疫功能的影响

目的 研究高砷饮水对儿童免疫功能的影响.方法 于2006年选择某高砷饮水地区194名9～13岁小学生作为研究对象,采集家庭饮用水样和空腹晨尿,测定水砷和尿砷含量,按照水砷含量分为对照组(P＜0.05mg/L)、暴露组(≥0.1mg/L),进行T淋巴细胞亚群、免疫球蛋白IgG、IgM、IgA和白细胞介素2(IL-2)测定,并对家庭一般情况、饮水水源情况、儿童健康状况、父母健康及职业暴露情况等进行问卷调查.结果 对照组、暴露组儿童尿砷含量中位数分别为0.02和0.12 mg/L,尿砷与水砷含量呈统计学相关.暴露组儿童T淋巴细胞(CD3~+)、CD4~+、CD8~+亚群百分含量均值和CD4~+/CD8~+的均值低于对照组,经t检验,暴露组CD~(4+)亚群百分含量和CD4~+/CD8~+显著低于对照组(P<0.05),而两组间T淋巴细胞(CD3~+)、CD8~+亚群百分含量差异均无统计学意义(P＞0.05).暴露组男生T淋巴细胞CD~(4+)亚群百分含量显著低于对照组(P＜0.05),暴露组女生CD4~+亚群百分含量和CD4~+/CD8~+显著低于对照组(P<0.05).暴露组儿童血清IgG含量高于对照组(P<0.05),血清IgM含量低于对照组(P<0.05),血清IgA含量两组间差异无统计学意义(P>0.05);对照组和暴露组男生血清免疫球蛋白含量分布情况与全体学生近似,女生血清免疫球蛋白含量差异无统计学意义.两组儿童白细胞介素2含量差异无统计学意义(P>0.05).结论 长期饮用砷含量在0.1 mg/L以上的高砷水对儿童的免疫功能可能造成不利影响.儿童外周血T淋巴细胞亚群是水砷暴露非常敏感的健康效应指标之一.     

ICU患者进行肠内营养支持治疗前后免疫功能的变化研究

目的 研究肠内营养支持对ICU患者免疫功能的影响.方法 选取2009年1月～2011年1月某院ICU收治并进行肠内营养的16例患者为观察组研究对象,对比其接受肠内营养支持治疗前后细胞免疫和体液免疫的变化,另选取10例在该院体检中心查体的健康体检者作为对照.结果 (1)观察组患者肠内营养支持前CD4+淋巴细胞亚群水平(31.2±8.6)以及CD4+/CD8+比值(1.4±0.4)均低于正常对照组,比较差异有统计学意义(P＜0.05);CD3+、CD8+T淋巴细胞亚群水平虽低于正常对照组,但比较差异无统计学意义(P＞0.05);NK细胞水平略高于正常对照组,比较差异无统计学意义(P＞ 0.05); IL 2浓度(8.6±2.4) mg/L低于正常对照组,比较差异有统计学意义(P＜0.05).观察组患者肠内营养支持后CD3+、CD4+淋巴细胞亚群水平(76.5±13.7、49.2±12.4)以及CD4+/CD8+比值(2.9±0.9)高于治疗前和正常对照组,比较差异有统计学意义(P＜ 0.05); CD8+T淋巴细胞亚群水平虽高于治疗前和正常对照组,但比较差异无统计学意义(P＞0.05);NK细胞水平高于治疗前和正常对照组,比较差异无统计学意义(P＞0.05);IL 2浓度(12.2±3.9) mg/L高于支持前,比较差异有统计学意义(P＜0.05);与正常对照组比较差异无统计学意义(P＞0.05).(2)观察组患者肠内营养支持前IgG、IgM、IgA浓度[(10.3±1.2) g/L、(1.2±0.6) g/L、(2.2±0.2) g/L]均低于正常对照组,比较差异有统计学意义(P＜0.05).观察组患者肠内营养支持后IgG、IgM、IgA浓度[(13.8±2.3) g/L、(2.1±0.4) g/L、(3.1±0.6) g/L)均高于支持前,比较差异有统计学意义(P＜0.05);与正常对照组比较差异无统计学意义(P＞0.05).结论 肠内营养支持可改善ICU危重症患者的细胞免疫和体液免疫功能.     

大鼠急性胰腺炎模型脾脏免疫状态的研究

目的 检测大鼠急性胰腺炎模型外周血及脾脏T淋巴细胞亚群，探讨急性胰腺炎病情发展过程中脾脏免疫功能状态的改变。方法 雄性SD大鼠随机分为对照组和实验组，胰管内逆行注射4％牛磺胆酸钠建立实验组胰腺炎模型，两组分别在3、6、12h分3批处死，每批12只。每只大鼠取胰腺组织观察病理改变，取股静脉血2ml及脾脏2g制成单细胞悬液，用流式细胞仪测定T淋巴细胞亚群CD3^ 、CD4^ 、CD8^ 及CD4^ ，／CD8^ 比值。结果 在胰腺组织炎性水肿阶段T淋巴细胞亚群无明显改变，在出血坏死阶段外周血CD3^ 、CD4^ 降低、CD8^ 轻度升高、CD4^ ／CD8^ 明显降低，脾脏细胞与外周血相比CD3^ 、CD4^ 及CD4^ ／CD8^ ，明显降低，脾脏呈现负性免疫状态，且随着炎症的加重变化更加明显。结论脾脏在重症急性胰腺炎中起负性免疫作用，加重SAP病情发展。     

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.     

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.