红细胞分布宽度、中性粒细胞与淋巴细胞的比值、血小板和淋巴细胞的比值与活动性肺结核的关系

目的探索血液中红细胞分布宽度(RDW)、中性粒细胞与淋巴细胞的比值(NLR)、血小板和淋巴细胞的比值(PLR)与活动性肺结核(ATB)严重程度的关系。方法收集80例活动性肺结核患者作为肺结核组(PTB),另收集80例年龄以及性别相仿的健康人作为对照组进行比对。结果 PTB与对照组相比,嗜中性粒细胞数、淋巴细胞数、PLT、PDW、RDW、NLR、PLR值均显著增高,差异有统计学意义(P0.01)。与轻至中度肺结核的患者相比,重度肺结核患者的WBC、嗜中性粒细胞数、PLT、RDW、NLR及PLR值较高,差异有统计学意义(P0.01)。结论 RDW、NLR及PLR值与活动性肺结核患者病情的严重程度有关,可作为临床管理活动性肺结核的参考指标。     

早产儿中性粒细胞/淋巴细胞比值和血小板指数与动脉导管未闭的相关性

目的探究早产儿中性粒细胞/淋巴细胞比值(NRL)和血小板指数与动脉导管未闭(PDA)的相关性。方法选取2016年8月-2017年12月该院收治的PDA早产儿68例作为PDA组,同时选取同期在该院出生未出现PDA的早产儿作为非PDA组,收集产妇以及新生儿临床资料,应用血液分析仪检测中性粒细胞、淋巴细胞数,并计算二者比值NLR;应用目测镜检法检测血小板计数(PLT)、平均血小板体积(MPV),并计算血小板压积(PCT),采用Logistic回归分析影响PDA早产儿发生的因素,受试者工作特征(ROC)评估NRL、PCT对PDA早产儿的诊断价值。结果PDA组产妇产前CRP水平、羊水异常发生率均高于非PDA组(P<0.05)。PDA组胎龄低于非PDA组,房内径、动脉导管内径均高于非PDA组(P<0.05)。PDA组新生儿中性粒细胞数、NLR高于非PDA组,淋巴细胞数、MPV、PLT、PCT均低于非PDA组(P<0.05)。Logistic回归分析结果显示,NLR、PCT是影响PDA发生的危险因素。ROC曲线分析显示,NLR对早产儿PDA诊断的AUC为0.729,敏感性为76.47%,特异性为51.47%。PCT对早产儿PDA诊断的AUC为0.848,敏感性为85.29%,特异性为64.71%。结论NLR、PCT是影响PDA发生的危险因素,且二者对早产儿PDA诊断具有一定预测价值。     

中性粒细胞与淋巴细胞比值在早期先兆流产中的诊断价值

目的 探讨炎症指标中性粒细胞与淋巴细胞比值(NLR)在早期先兆流产中的诊断价值。方法 采用回顾性随机数字化法搜集2020年1月—2021年10月在本院妊娠就诊的217例早期先兆流产的孕妇的常规资料以及血象资料作为研究组，同时随机数字化法搜集同期217例早期正常妊娠来本院进行人工流产孕妇的资料作为对照组，比较两者的差异，通过logistic回归分析确定影响早期先兆流产的因素，并采用ROC曲线评价NLR在早期先兆流产中的诊断价值。结果 早期先兆流产组的白细胞计数(WBC)、中性粒细胞计数(Neu)、单核细胞计数(Mon)、单核细胞与淋巴细胞比值(MLR)及NLR高于对照组，淋巴细胞绝对值计数(Lym)低于对照组，差异均有统计学意义(P<0.05);而血小板计数(PLT)和血小板与淋巴细胞比值(PLR)差异无统计学意义(P>0.05);logistic回归分析确定NLR是早期先兆流产的唯一影响因素(OR=2.106,P=0.003);ROC曲线显示NLR的曲线下面积(AUC)为0.729(P<0.001)。结论 NLR的升高是早期先兆流产影响因素，具有一定的诊断价值，可以为...     

表皮生长因子、抗心磷脂抗体与胎儿生长发育的关系

【目的】测定母血、脐血表皮生长因子(epidermal growthfactor,EGF)与脐血抗心磷脂抗体(anticardiolip-in antibodies,ACA)水平与胎儿生长发育的关系。【方法】收集小于胎龄儿(small for gestational age,SGA)组(18例)、适于胎龄儿(appropriate for gestational age,AGA)组(20例)、大于胎龄儿(large for gestational age,LGA)组(17例)的脐血5ml及其母产后第2d肘静脉血2ml,酶联免疫法测EGF、ACA-IgG和ACA-Ig M。【结果】①SGA组脐血EGF含量显著高于AGA组、LGA组(P<0.05),胎儿出生体重与胎儿自身EGF水平呈现明显负相关(r=-0.573,P<0.001),胎儿出生身长与胎儿自身EGF水平呈现负相关(r=-0.343,P<0.05);②SGA组母血EGF含量明显低于AGA组、LGA组,胎儿出生体重与母亲血EGF水平呈现正相关(r=0.391,P<0.05),胎儿出生身长与母亲血EGF水平无相关(r=0.264,P>0.05);③母血与脐血EGF水平差异无显著性(P>0.05);④新生儿ACA-IgG阳性与宫内生长迟缓(intrauterine growth retardation,I UGR)、胎膜早破、宫内窘迫的发生有关。【结论】胎儿体重与母血和胎儿EGF水平变化有关,胎儿身长与胎儿EGF水平变化有关,证实EGF对胎儿的调节作用;脐血ACA-IgG与I UGR的发生有关。     

外周血淋巴细胞/单核细胞比值与急性脑梗塞的预后关系

目的探讨淋巴细胞/单核细胞比值(LMR)等炎症指标与脑梗塞发生和预后的关系。方法回顾性分析2015年1月-12月本院的150例脑梗塞患者为缺血性脑梗塞组,另收集同期健康体检者150例为健康对照组,评估2组LMR等炎症指标与脑梗塞发生以及预后的关系。结果 LMR等炎症指标在缺血性脑梗塞组和健康对照组中的分布差异有统计学意义(P0.01)。但多因素分析以及受试者工作特征(ROC)曲线分析表明仅有中性粒细胞绝对值4.23、单核细胞绝对值0.37、淋巴细胞绝对值1.32、PLR106为脑梗塞的危险因素(P0.05)。相关性分析表明,中性粒细胞绝对值、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、淋巴细胞绝对值、LMR均与入院时、出院时、出院后90 d时的mRS评分相关(P0.05),多因素分析表明仅有LMR与出院时、出院90 d时mRS评分有关(P0.05)。结论 LMR与脑梗塞患者的预后相关;淋巴细胞、单核细胞、中性粒细胞绝对值、PLR与脑梗塞的危险性相关。     

探讨卵巢癌手术减瘤结局及病理分期与血细胞计数的关系

目的:研究卵巢癌手术减瘤结局及病理分期与血细胞计数的关系。方法 :将98例卵巢癌手术患者,按照病理分期分为早期组和晚期组,对比两组血细胞计数情况;按照手术减瘤结局分为效果好(A组)和效果差(B组)两组,比较两组血细胞计数情况。结果 :早期组在白细胞、中性粒细胞、单核细胞、血小板、中性粒细胞/淋巴细胞比值(NRL)和血小板/淋巴细胞比值(PRL)上均低于对照组(P0.05)。B组单核细胞、血小板、中性粒细胞/淋巴细胞比值和血小板/淋巴细胞比值比A组高(P0.05)。结论 :血细胞计数情况可以反映出手术减瘤结局和病理分期情况,可以作为临床诊断的依据,也可以作为对患者进行病情监测的依据。     

济南市低剂量电离辐射工作者外周血细胞效应分析

本文报道对济南市150个单位、818例从事低剂量电离辐射工作者和134例对照着的外周血细胞检查结果表明,电离辐射组所差12项血液学指标中有8箱低于对照组,有2项高于对照组。其主要变化特点是:以嗜中性粒细胞为主的白细胞降低,嗜中性粒细胞绝对值减少,淋巴细胞、单核细胞比值增高,血红蛋白、红细胞、血小板、网织红细胞下降,但其均值都在正常范围之内;电离辐射组异常血象检出率明显高于对照徐:白细胞下降的幅度及细胞质变与放射工龄有相关性;不同作业人员中,医用同位素组血象异常指标及细胞质变着较明显。     

孕中晚期胎儿血细胞成分的研究

目的建立孕周为19~37周各胎龄段的正常胎儿脐血血细胞成分的参考值范围,了解胎儿血细胞的生成情况,为产前和早产儿血液学疾病的诊断提供依据。方法采用Cou lter GENS system2型全自动血液分析仪检测182例胎儿血常规12项参数,并用显微镜人工镜检分类。结果从19~37周WBC从3.58×109/L增加到5.76×109/L,随孕周的增加WBC是逐渐增加的,WBC分类结果显示以淋巴细胞为主,中性粒细胞较少,随孕周的增加,淋巴细胞逐渐减少,中性粒细胞逐渐增加,有核红细胞随孕周的增加而逐渐减少,单核细胞、嗜酸性粒细胞、嗜碱性粒细胞随孕周的变化不明显;RBC、HGB、HCT随着孕周的增加而逐渐增加,而MCV则是随着孕周的增加而逐渐减少,MCH、MCHC在各胎龄段之间的差异无统计学意义;PLT在各胎龄段之间的变化不明显,基本维持在210×109/L的水平,PDW、MPV、PCT在各胎龄段之间差异亦无统计学意义。结论胎儿脐血血细胞成分处在一个动态的变化过程中,建立不同胎龄段胎儿脐血中血细胞成分的参考值范围有助于产前和早产儿疾病的诊断。     

新生儿晚发型败血症病原菌及诊断方法

目的探究血小板计数(PLT)、未成熟中性粒细胞/成熟中性粒细胞比值(I/T)、C-反应蛋白(CRP)联合用于新生儿晚发型败血症的诊断价值。方法选择2015年3月-2019年5月上饶市人民医院收治的80例败血症晚发型足月新生儿及100例住院非感染新生儿作为研究对象,分别为败血症组及对照组。采集败血症患儿血标本进行病原菌检测及耐药性分析,测定两组患儿PLT、I/T、CRP水平,分析单独或联合检测诊断败血症的临床价值。结果 80例败血症患儿血培养共分离出82株病原菌,其中包括革兰阳性菌48株占58.54%,革兰阴性菌33株占40.24%,真菌1株占1.22%。革兰阴性菌中大肠埃希菌、肺炎克雷伯菌对亚胺培南、美罗培南等抗菌药物耐药率较低;革兰阳性菌中表皮葡萄球菌、溶血性葡萄球菌对万古霉素、利福平等抗菌药物耐药率较低。与对照组比较,败血症组患儿PLT计数显著降低,I/T比值及CRP水平均显著升高,两组比较差异有统计学意义(P0.05)。PLT计数、I/T比值、CRP水平诊断新生儿败血症的曲线下面积分别为0.750、0.667、0.718。3种指标联合检测诊断曲线下面积为0.842,均高于两指标联合及单独检测。结论晚发型败血症患儿血培养检出病原菌以革兰阳性菌为主,PLT计数、I/T、CRP指标联合检测诊断价值优于单一指标。     

血常规检测对慢性阻塞性肺疾病患者预后预测作用

目的 探讨血常规检测结果与慢性阻塞性肺疾病(COPD)患者疾病严重程度相关性。方法 从阜新市某医院病历管理信息系统中抽取2017年1—12期间有2次及以上血常规检测结果的确诊为COPD的患者完整资料(病例组)及在体检中心随机抽取与病例数相当的健康体检者100人(对照组)进行分析。结果 符合要求的COPD病例100例,对照组健康体检者100人,病例组和对照组的性别构成、年龄分布和BMI差异均无统计学意义(均P>0.05)。病例组中性粒细胞、嗜碱性粒细胞、中性粒细胞与淋巴细胞比值(NLR)与血红蛋白水平均明显高于对照组,淋巴细胞、嗜酸性粒细胞、嗜酸性粒细胞与嗜碱性粒细胞比值(EBR)水平均明显低于对照组(均P<0.01)。预后良好患者中性粒细胞、嗜碱性粒细胞及NLR均明显低于预后不良者(P<0.05或P<0.01),淋巴细胞、嗜酸性粒细胞、EBR及血红蛋白水平均明显高于预后不良者(均P<0.01)。中性粒细胞、嗜碱性粒细胞及NLR与COPD严重程度呈正相关关系(均P<0.05),淋巴细胞、嗜酸性粒细胞、EBR及血红蛋白水平与COPD严重程度呈显著负相关关系(均P<0.05)。结论 COPD患者病情严重程度与嗜碱性粒细胞及NLR显著正相关,与淋巴细胞、嗜酸性粒细胞、EBR及血红蛋白水平显著负相关,血液常规检测可作为预测COPD患者病情与预后的指标。     

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.