单导胎儿心电记录仪的研制

介绍了一种单导胎儿心电记录仪。系统以PC机为核心，采用奇异值分解方法提取胎儿心电信号。临床实验表明，该仪器操作简便，可靠。     

基于WiFi数据传输的胎儿心电检测系统

胎儿心电监护是一种能实时反应宫内胎儿心脏变化情况的常规临床检测手段,目前临床胎儿心率检测大多采用的是超声多普勒,这种方式技术难度大,操作专业性强,且价格昂贵。介绍了一种基于母体腹部电极法的胎儿心电检测系统,通过母体腹部电极感知微弱胎儿心电变化,并通过相应的放大滤波电路得到混合心电信号,最后将所得到的信号通过WiFi传输至上位机。上位机利用自适应滤波算法得到胎儿心电信号估计。该系统可行性强、操作专业性低、成本低且较为便利。     

一种胎儿中央监护与远程监护系统的研制

新型胎儿监护系统由一台中央主机和或干台床连监护仪联网组成，在医院院区内床边监护仪与中央机以专线连网，远程终端采用程控电话网作为信息传递的媒介。     

面向社区医疗服务网络的胎儿监护系统

以优生优育、提高人口素质为目标,建立面向社区医疗服务网络的胎儿监护系统,将为围产期孕妇自我监护提供一种可靠、敏感、实用的方法。采用基于调制解调器(modem)的系统模式实现远程家庭胎儿监护,孕妇只要租借该系统的前端机,便可安坐家中自我监护,必要时通过调制解调器拨号上网与中心站通讯,接受医师指导。     

基于DSP的胎儿心率信号检测处理方法

介绍了一种采用DSP组成的胎儿心率监护仪的基本结构和工作原理．重点说明了胎儿心率算法的实现。通过实际验证，基本上能准确实时得到胎儿心率。     

胎儿心电图机的临床应用

胎儿心电图机的临床应用安徽省马鞍山市第二人民医院江世霞ＦＥＣＧ—Ｄ型胎儿心电图机采用非浸入性无创伤检测手段，将胎儿心脏活动时产生的生物电流描绘成图谱。胎儿心电图（ＦＥＣＧ）是胎心活动的客观指标，掌握其正常和异常变化，有助于了解胎儿宫内缺氧、窘迫。为孕...     

胎儿唇裂畸形的超声诊断体会

目的探讨超声诊断胎儿唇裂畸形的价值及声像图表现。方法采用彩超对孕18-41w的胎儿进行唇面部超声检查，观察记录胎儿唇裂畸形的发生情况。结果在9263例孕妇中发现唇腭裂10例，超声产前检出8例，漏诊2例，检出率80％。结论超声检查是发现胎儿唇裂畸形的重要辅助诊断方法：胎儿上唇回声连续性中断是唇裂的常见声像图。     

早孕期胎儿颈项透明层超声检测联合胎儿DNA无创产前检测对高龄孕妇胎儿性别发育异常的诊断价值

目的探讨早孕期(胎龄为11～13^＋6孕周)胎儿颈项透明层(NT)超声检测联合胎儿DNA无创产前检测(NIPT)，对于高龄(≥35岁)孕妇胎儿性别发育异常(DSD)的临床诊断价值。 方法根据孕妇入院时的顺序编号，采用随机数字表简单随机抽样方法，选取2016—2018年于中国人民解放军联勤保障部队第901医院最终活产的198例高龄孕妇的单胎妊娠胎儿为研究对象。198例高龄孕妇接受早孕期胎儿NT超声检测与胎儿DNA的NIPT。以多学科协作诊疗团队(MDT)专家根据新生儿临床表现及相关检查结果做出诊断，作为诊断胎儿DSD的"金标准"，计算早孕期胎儿NT、胎儿DNA的NIPT及二者联合检测对于诊断高龄孕妇胎儿DSD的敏感度、特异度及准确度。本研究遵循的程序符合2013年新修订的《世界医学协会赫尔辛基宣言》要求。所有受试儿监护人知情同意，并且签署临床研究知情同意书。 结果本组198例胎儿中，28例经MDT综合评估，最终被诊断为DSD。①早孕期胎儿NT超声检测对诊断高龄孕妇胎儿DSD的敏感度为89.3%，特异度为71.2%，准确度为73.7%。②胎儿DNA的NIPT对于诊断高龄孕妇胎儿DSD的敏感度为85.7%，特异度为78.2%，准确度为79.3%。③早孕期胎儿NT超声检测联合胎儿DNA的NIPT对于诊断高龄孕妇胎儿DSD的敏感度为96.4%，特异度为88.2%，准确度为89.4%。 结论早孕期胎儿NT超声检测联合胎儿DNA的NIPT，对诊断高龄孕妇胎儿DSD具有一定价值。由于本研究仅为单中心研究，纳入样本量较小，早孕期胎儿NT联合胎儿DNA的NIPT对诊断高龄孕妇胎儿DSD的价值，尚待大样本、多中心、随机对照试验进一步证实。     

胎儿窘迫相关临床因素351例分析

目的：探讨胎儿窘迫相关因素及处理方法。方法：2002年1月至2006年12月恩施市中心医院采用回顾性方法分析351例胎儿窘迫的相关的因素。结果：351例胎儿窘迫的相关因素分别是脐带因素占48．15％，胎盘因素占18．38％，羊水因素占儿．40％，母体因素3．99％，胎儿因素占2．71％，产力因素占6．13％．原因不明占9．26％。分娩方式对胎儿窘迫发生率有较大的影响，以臀位助产发生率最高（P〈0．01）。结论：胎儿窘迫受多种因素影响，一旦发生对胎儿影响较大，故及时恰当地进行干预，有助于降低新生儿窒息的发生率。     

超声诊断胎儿严重软骨发育不全中的临床意义

目的了解并掌握胎儿严重软骨发育不全临床超声特点。方法采用回顾性分析的方法，通过47396例产科超声诊断筛查胎儿严重软骨发育不全病例。结果47396例产科超声诊断中确诊5例，比例为0．0105％（5／47396）。结论胎儿严重软骨发育不全临床超声特点为，胎头大而圆，前额突出，双顶径增大，胸腔狭窄，腹部膨隆，脊柱平直，胎儿四肢短小、弯曲，躯干长度与四肢长度不成比例，羊水过多。     

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.     

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.     

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.     

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.