母亲FUT2基因单核苷酸位点多态性对母乳喂养小儿早期生长的影响

【目的】 观察母亲ɑ1,2岩藻糖基转移酶(type α1,2 fucosyltransferase,FUT2)基因单核苷酸位点多态性(single nucleotide polymorphism,SNP)对母乳喂养儿早期体格生长发育及常见疾病发病率的影响。【方法】 选取110对新生儿及母亲进入课题,产后2周收集母亲唾液用于提取DNA行SNP检测。每周记录小儿喂养及疾病情况至12个月,于小儿4、13、26、52周时行体格测量。【结果】 本组小儿感染性疾病发病率与文献相比明显降低;AT基因型母亲与AA、TT型母亲相比,小儿早期体格生长发育更快,13、26周及52周体重,26周及52周身高,52周头围Z分均较高(P<0.05),且中重度呼吸道感染发病率较低(P<0.05);母亲SNP基因型不同的小儿在12月龄内湿疹发病率差异无统计学意义(P>0.05),双亲均有过敏性疾病史的小儿湿疹发病率高于双亲无过敏史者(P<0.05)。【结论】 母乳喂养有助于降低小儿12月龄内常见感染性疾病发病;AT基因型母亲的母乳更利于小儿早期生长;家族遗传风险会影响小儿湿疹发病率。     

喂养方式对婴儿早期碘营养状态的影响

【目的】了解不同喂养方式对婴儿早期碘营养状态的影响。【方法】在非碘缺乏地区的上海随机选取68名母乳喂养儿和54名配方乳喂养儿进行观察性研究。分别于婴儿日龄42 d和90 d时测定其母乳或配方乳中的碘浓度,以及婴儿尿中的碘浓度,对乳母进行48 h回顾性膳食问卷调查。【结果】①母乳和配方乳喂养婴儿在42 d和90 d日龄时的尿碘浓度(中位数)分别为197.9、115.4μg/L和219.2、140.1μg/L;②母乳和配方乳的乳碘浓度(中位数)分别为109.14μg/L和88.9μg/L(P<0.01);③乳母膳食碘摄入量(中位数)为194.05μg/d,<200μg/d的占52.2%;④乳母膳食碘摄入量与母乳碘浓度呈正相关(r=0.558,P=0.000)。【结论】①母乳喂养婴儿的碘营养状态优于配方乳喂养的婴儿,积极鼓励母乳喂养;②母乳中的碘含量高于配方乳中的碘含量;③部分乳母膳食碘摄入不足。     

不同时期母乳及母婴铁、锌和钙特点及相关性研究

目的通过不同时期母乳、母亲及婴儿全血铁、锌、钙含量特点分析,评价哺乳期母乳及母婴矿物质含量变化特点。方法随机选取产后6周及3月龄母亲及婴儿各50对,采用火焰原子吸收法检测母乳中及同期母亲、婴儿全血中铁、锌、钙离子水平,比较不同时期各矿物质水平差异,并分析母乳、母亲以及婴儿之间的相关关系。结果母乳中铁、锌的水平随哺乳时间延长而下降(铁0.102mg/100g vs0.0605mg/100g,P<0.05;锌0.257mg/100g vs 0.171mg/100g,P<0.05)。婴儿血中铁离子水平随月龄增长而下降(392.45mg/L vs 356.80mg/L,P<0.05),母乳中铁、锌、钙离子水平与母亲血中相应元素水平均无相关关系;婴儿血中铁、锌、钙与母亲血中相应元素成正相关关系(r=0.591、0.362和0.435,P=0.000、0.013和0.001)。结论乳腺内的矿物质转运与母亲本身的营养状况并无明显相关。随着哺乳期的延长,母乳中铁离子下降可能是母乳喂养婴儿生理性贫血多发的原因之一。母亲孕期矿物质的水平可能影响生后早期婴儿相应的矿物质水平。     

不同泌乳期母乳中唾液酸含量的变化

目的 分析随着泌乳期的延长,成熟母乳中唾液酸含量的变化情况,为提高母亲乳汁质量提供依据.方法 采用纵向研究的方法,应用荧光-高效液相色谱法对选取的102例健康乳母分别采集产后第30、90、150天乳汁10～15 ml,进行唾液酸测定.结果 3个不同泌乳期母乳中的总唾液酸浓度分别为(714.3±64.4)mg/L、(437.2±42.8)mg/L和(342.8±47.7) mg/L,并且乳汁中的唾液酸主要与低聚糖结合,占80 %左右,而游离唾液酸的含量只有2 %～3 %左右;产后第90天游离唾液酸与产后第150天游离唾液酸含量比较,差异无统计学意义;产后第30天 游离唾液酸与产后第90天、第150天比较,差异有统计学意义;3组乳汁总唾液酸、低聚糖唾液酸、蛋白质结合唾液酸比较,差异均有统计学意义.结论 母乳中的唾液酸主要是与低聚糖结合.随着泌乳期的延长,母乳唾液酸的含量逐渐下降,且趋势渐缓;这种动态变化可能是人类泌乳机制长期进化的结果,母体的泌乳机能可以根据生理的需要进行自身调整.     

母乳中脂联素水平及其影响因素的研究

【目的】调查母初乳和成熟乳中脂联素水平并探讨其与母婴之间的关系。【方法】应用ELISA测定母乳脂联素水平,分析母乳脂联素与母亲体质指数(body mass index,BMI)及母、脐血糖、胰岛素水平的关系。【结果】母乳中含有丰富的脂联素,初乳中脂联素水平(27.9μg/L,5.7-367.1μg/L)明显高于成熟乳(10.9μg/L,3.0-179.6μg/L)(P<0.01)。进一步,母初乳中脂联素水平与母亲妊娠晚期BMI呈临界相关(r=0.33,P=0.069),与母血脂联素水平呈显著正相关(r=0.53,P<0.01),母初乳脂联素水平亦与脐血糖(r=0.52,P<0.01)及脐血胰岛素水平正相关(r=0.53,P<0.01)。【结论】母乳中含有丰富的脂联素,且与母血及母亲BMI相关。母乳中持续存在的脂联素在母乳喂养儿代谢发育中可能有着潜在的意义。     

急性时相反应对学龄前儿童维生素A与铁评价指标的影响

【目的】了解急性时相反应对学龄前儿童维生素A和铁状况评价指标的影响。【方法】检测385名学龄前儿童血清视黄醇、铁蛋白、血红蛋白以及C-反应蛋白(C-reaction protein,CRP)水平并分析指标间内在关系。【结果】不同CRP水平儿童的血红蛋白浓度无明显差异(P0.05),CRP≥10 mg/L儿童血清视黄醇浓度明显低于CRP10 mg/L儿童,铁蛋白则相反(P0.05)。CRP≥10 mg/L儿童维生素A不足发生率显著高于CRP10 mg/L儿童。调查对象维生素A不足发生率为34.03%,但1.56%儿童伴感染;铁储备正常率为53.25%,但3.12%儿童伴感染。【结论】急性时相反应对维生素A和铁等营养评价指标有明显影响,人群营养评价应同时考虑感染的影响。     

宁夏回族儿童MBL基因多态性及血浆MBL浓度分析

【目的】了解宁夏回族健康儿童甘露糖结合凝集素基因mbl2外显子1区54密码子( 230位点)和启动子区(-550,-221位点)的单核苷酸多态性(single nucleotide polymorphisms,SNP),并分析其与血浆MBL浓度的关系。【方法】用ELISA法测血浆MBL含量。MBL基因多态性分析采用序列分析法。统计采用SPSS软件11.0版,遗传学分析采用SHEsis软件。【结果】在抽样的69例样本中,宁夏回族儿童MBL血浆浓度范围为0~5 220μg/L,中位数为1 909μg/L。序列分析显示,外显子1区 230位点的等位基因突变频率0.268,等位基因分布符合Hardy-Weinberg平衡(χ2=0.372,P=0.542),无C型和D型外显子发现。外显子1的型别和MBL浓度关系是A/A型>A/B型>B/B型。启动子区-550和-221位点等位基因突变频率分别为0.413和0.123,等位基因分布均符合Hardy-Weinberg平衡。【结论】本研究回族人群中外显子1区( 230位点)和启动子区(-550,-221位点)表现不同的基因多态性分布,外显子1区 230位点基因变异明显影响血浆MBL浓度的表达。     

不同过敏体质母亲母乳中PUFAs与免疫因子的差异及相互性研究

目的 探讨不同过敏体质母亲母乳中多不饱和脂肪酸(PUFAs)和免疫因子的改变,同时分析体内多不饱和脂肪酸组成对免疫因子的影响。方法 随机选取符合标准的80例母亲进入课题,产后2周和4周收集母乳,问卷调查母亲过敏史。采用高效毛细气相色谱分析技术检测母乳中脂肪酸浓度,分别采用酶联免疫吸附法和BioPlex悬液芯片技术测定母乳中免疫因子sCD14(soluble CD14)、IgE和IL-1β(interleukin-1β)、Eotaxin浓度。结果 过敏性皮炎母亲2周母乳ALA(α -linolenic acid,ALA)和n-6 PUFAs代谢系数(n-6LCPUFAs/LA)低于非过敏母亲,2周和4周母乳中LA/ALA(linoleic acid,LA)均高于非过敏母亲(P<0.05)。过敏性鼻炎母亲2周母乳ALA、EPA(eicosapentaenoic acid,EPA)、DHA(docosahexaenoic acid,DHA)含量均低于非过敏母亲(P<0.05)。无论过敏母亲还是非过敏母亲,母乳中多种n-3PUFAs(ALA、EPA、C20:3n-3)与sCD14呈正相关,与IgE负相关(P<0.05);母乳中多种n-6PUFAs(C18:3n-6,C20:3n-6,C22:2n-6)与sCD14呈负相关,与Eotaxin和IL-1β正相关(P<0.05)。结论 不同过敏体质母亲与非过敏母亲母乳多不饱和脂肪酸组成存在差异;体内多不饱和脂肪酸组成对免疫因子的分泌具有重要影响。     

母乳IGF-Ⅱ与婴儿体格生长指标关联性分析及影响因素研究

目的 描述哺乳期各阶段母乳IGF-Ⅱ浓度的变化,探讨哺乳期不同阶段母乳IGF-Ⅱ与婴儿体格生长指标的关联,以及可能影响母乳IGF-Ⅱ浓度的因素。方法 2020年10月至2021年9月于北京大学人民医院招募32名满足纳入排除标准的分娩妇女,分别于分娩后48 h、产后15 h、产后42 h、6个月、9个月及12个月采集妇女母乳标本,同时收集婴儿身长、体重等生长发育指标。采用酶联免疫吸附方法检测母乳IGF-Ⅱ水平。使用广义估计方程(GEE)分析母乳IGF-Ⅱ水平与婴儿体格生长指标之间的关联以及可能影响母乳IGF-Ⅱ水平的因素。结果 母乳IGF-Ⅱ中位浓度在12月成熟乳中最高(82.5 ng/mL),6月成熟乳中最低(55.3 ng/mL),呈先下降再升高趋势,但各阶段中位浓度间未见明显差异;在调整母亲年龄、孕前BMI、孕周、母亲民族、孕产史、孕期并发症情况(妊娠期糖尿病、妊娠期高血压、妊娠期甲状腺疾病)、婴儿喂养方式及婴儿性别后,研究结果显示初乳中IGF-Ⅱ含量与婴儿身长呈正相关关系(β=0.9,P<0.01),初乳、42d成熟乳、12月成熟乳中的IGF-Ⅱ含量与婴儿体重呈正相关关系(...     

抗Leb引起的交叉配血不合1例

1 病例简介 患者,女,蒙族,48岁,生育2个子女,有输血史。现因左腹部肿瘤住院治疗。查红细胞1.1×10~(12)/L,血红蛋白30g/L,为解决临床手术及治疗用血,经血型血清学检查ABO系统为AB型。Rh系统为Rh(D)阳性。Lewis系统为Le(a b-)。患者于1周前输AB型血200ml,输血后病情加重。此后到我血液中心交叉配血,实验中发现病人ABO血型正反定型不符,经确定病人血清中有抗Le~b,并且A抗原减弱或消失,病人血型为AB型。输入配血相合的AB型血200ml后,查红细胞1.8×10~(12)/L血红蛋白56g/L,病情有所好转。     

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.