海员肺功能相关影响因素调查分析

Objective To investigate and analyze factors influencing the pulmonary function of seafarers. Methods The pulmonary function of seafarers and the control group was measured by Jaeger MS Diffusion Pulmonary Function Analyzer and the influencing factors were also investigated. Results Pulmonary function of seafarers decreased as the length of service increased, but had no significant differences. FEV1, FEV1/FVC ,PEF and MVV of the seafarers who smoked were significantly less than those who didn't smoke. FVC, FEV1/FTC and MVV of seafarers who worked in cabins were significantly lower than those who worked ondeck. The pulmonary funetion of seafarers who smoked were worse than that of the workers on the land, hutwithout significant difference. FEFso～ and FEF～ of seafarers who didn' t smoke were significantly lower thanthose of the workers on the land who didn' t smoke. Conclusions Smoking and work environment are thefactors influencing pulmonary function of seafarers, to which more attention should be paid.     

阿托伐他汀钙片对稳定期慢性阻塞性肺疾病患者血清C反应蛋白、白介素-6及肺功能的影响

ObjectiveTo observe the effect of atorvastatin calcium tablets on C reactive protein（CRP）, IL-6 and pulmonary function in chronic obstructive pulmonary disease patients of stationary phase. MethodsSixty patients in stationary phase of chronic obstructive pulmonary disease （COPD） were randomly divided into treatment group and control group. Patients in the control group (n=30) were treated with conventional therapy, and those in the treatment group were given oral atorvastatin calcium tablets 20 mg on the basis of routine treatment, once per night. The course of treatment was 1 year. The levels of CRP, interleukin （IL）-6 and the CAT scores and pulmonary function were measured before and after treatment, continuously followed for 2 years. ResultsThe difference in the levels of of CRP, IL 6 and the CAT scores between the two group before treatment were not statistically significant (P>0.05). After 1 year of treatment, levels of CRP, IL-6 in the treatment group were significantly lower than those in the control group (P<0.05). CAT scores of the treatment group was significantly better than the control group (P<005). ConclusionAtor vastatin calcium tablets can reduce levels of CRP, IL 6 in COPD patients of stationary phase and improve the quality of life.     

胸部开放伤后海水浸泡对犬肺损伤程度的影响及肺表面活性蛋白A、B的变化

Objective To compare the extent of acute lung injury (ALl) and changes in surfactant proteins A (SP-A) and B (SP-B) induced by seawater and freshwater immersion following open chest injury in dogs. Methods The animal model was established by seawater and freshwater injection into the thoracic cavity after open chest injury. All the experimental animals were observed for 6 hours, during which blood gas analysis, levels of TNF-α and IL-8, contents of SP-A and SP-B in the lung and blood serum were measured at different time points. Pulmonary histopathology and SP-B immuno-histochemistry were measured after the animals were sacrificed at the end of the experiment. Results Both seawater immersion and freshwater immersion could induce hypoxemia, with the extent of hypoxemia for the seawater immersion group (SG) being obviously much severer than that of the freshwater immersion group (FG) (P < 0.05). The levels of IL-8 and TNF-α in blood serum and BALF of both experimental groups were significantly higher than those of the control group (CG) (P<0.05). Pulmonary pathological lesion was noted in both SG and FG, with that of SG being severer than that of FG. The levels of SP-A and SP-B in BALF in SG and FG all decreased significantly(P <0.05) ,while the levels of SP-A and SP-B in blood serum increased gradually (P < 0.05). Type Ⅱ alveolarepithelial cells with SP-B positive in the lung decreased in both experimental groups, with grey scale values being significantly lower than that of CG. And significant deviation was observed between SG and FG (P <0.05). Conclusions Pulmonary lesion induced by seawater immersion after open chest injury was severer than that induced by freshwater immersion.     

胸部开放伤后海水浸泡对犬肺损伤程度的影响及肺表面活性蛋白A、B的变化

Objective To compare the extent of acute lung injury (ALl) and changes in surfactant proteins A (SP-A) and B (SP-B) induced by seawater and freshwater immersion following open chest injury in dogs. Methods The animal model was established by seawater and freshwater injection into the thoracic cavity after open chest injury. All the experimental animals were observed for 6 hours, during which blood gas analysis, levels of TNF-α and IL-8, contents of SP-A and SP-B in the lung and blood serum were measured at different time points. Pulmonary histopathology and SP-B immuno-histochemistry were measured after the animals were sacrificed at the end of the experiment. Results Both seawater immersion and freshwater immersion could induce hypoxemia, with the extent of hypoxemia for the seawater immersion group (SG) being obviously much severer than that of the freshwater immersion group (FG) (P < 0.05). The levels of IL-8 and TNF-α in blood serum and BALF of both experimental groups were significantly higher than those of the control group (CG) (P<0.05). Pulmonary pathological lesion was noted in both SG and FG, with that of SG being severer than that of FG. The levels of SP-A and SP-B in BALF in SG and FG all decreased significantly(P <0.05) ,while the levels of SP-A and SP-B in blood serum increased gradually (P < 0.05). Type Ⅱ alveolarepithelial cells with SP-B positive in the lung decreased in both experimental groups, with grey scale values being significantly lower than that of CG. And significant deviation was observed between SG and FG (P <0.05). Conclusions Pulmonary lesion induced by seawater immersion after open chest injury was severer than that induced by freshwater immersion.     

辛伐他汀预处理减轻缺血再灌注心肌损伤的实验研究

Objective To investigate the effects of pretreatment with simvastatin on iscbemia reperfusion induced myocardial injury, and to further explore related mechanism with respect to inflammation modulation. Methods The rat myocardial ischemia reperfusion model was established by the method of coronary artery ligation. The animals were divided into 3 groups: the sham group, the control group and the simvastatin group. In the simvastatin group, the animals were pretreated with simvastatin (5 mg/kg) one week before by intragastric administration. Ventricular arrhythmia was monitored and scored, infarct size and area at risk of myocardium were determined, and uhrastructural changes were observed. The serum levels of myocardial enzymes and lipids were measured. The content of myocardial inflammatory cytokines [tumor necrosis factor (TNF) -α、interleukin(IL) -6, and monocyte chemoattractant protein(MCP) - 1]were also evaluated. Results When compared with those of the control group, the amount and duration of ventricular arrhythmia in simvastatin group were less and score of ventricular arrhythmia was significantly lower. When pretreated with simvastatin, the serum levels of CK-MB and LDH in simvastatin group were significantly lower than those of the control group. The infarct size/area at risk ratio of the simvastatin treated group was significantly less than those of the control group. The uhrastructures of myocardial cells were better maintained in simvastatin group. No significant differences were observed in the serum concentrations of total cholesterol, triglycerides, low density lipoprotein and high density lipoprotein when comparisons were made each other among the three groups. However, the levels of TNF-α,IL-6 and MCP-1 in heart tissue of the treated animals were significantly lower than those of the control group. Conclusions Pretreatment with simvastatin ameliorates ischemia reperfusion induced myocardial injury, which is partly related with the down-regulation of inflammatory cytokines expression in heart tissue but independent of its role of lipids modulation.     

辛伐他汀预处理减轻缺血再灌注心肌损伤的实验研究

Objective To investigate the effects of pretreatment with simvastatin on iscbemia reperfusion induced myocardial injury, and to further explore related mechanism with respect to inflammation modulation. Methods The rat myocardial ischemia reperfusion model was established by the method of coronary artery ligation. The animals were divided into 3 groups: the sham group, the control group and the simvastatin group. In the simvastatin group, the animals were pretreated with simvastatin (5 mg/kg) one week before by intragastric administration. Ventricular arrhythmia was monitored and scored, infarct size and area at risk of myocardium were determined, and uhrastructural changes were observed. The serum levels of myocardial enzymes and lipids were measured. The content of myocardial inflammatory cytokines [tumor necrosis factor (TNF) -α、interleukin(IL) -6, and monocyte chemoattractant protein(MCP) - 1]were also evaluated. Results When compared with those of the control group, the amount and duration of ventricular arrhythmia in simvastatin group were less and score of ventricular arrhythmia was significantly lower. When pretreated with simvastatin, the serum levels of CK-MB and LDH in simvastatin group were significantly lower than those of the control group. The infarct size/area at risk ratio of the simvastatin treated group was significantly less than those of the control group. The uhrastructures of myocardial cells were better maintained in simvastatin group. No significant differences were observed in the serum concentrations of total cholesterol, triglycerides, low density lipoprotein and high density lipoprotein when comparisons were made each other among the three groups. However, the levels of TNF-α,IL-6 and MCP-1 in heart tissue of the treated animals were significantly lower than those of the control group. Conclusions Pretreatment with simvastatin ameliorates ischemia reperfusion induced myocardial injury, which is partly related with the down-regulation of inflammatory cytokines expression in heart tissue but independent of its role of lipids modulation.     

我国首批女实习舰员长远航心理健康状况调查分析

目的 了解执行"和谐使命-2010"任务女实习舰员的心理健康状况及影响因素,为更好地维护女舰员心理健康及未来女舰员的选拔提供科学依据.方法 以参加此次任务的女实习舰员、女医务人员、男舰员为调查对象,以整群抽样和分层随机抽样相结合,采用症状自评量表(SCL-90)进行4次跟踪问卷调查,同时使用自制的一般资料问卷进行访谈.结果 女实习舰员长远航期间心理健康问题总体检出率为21.8%.长远航中期各因子分超出正常的人数明显增加,长远航后期各因子分超出正常的人数略有降低.女实习舰员长远航前、早期与中、后期比较,心理健康水平差异有统计学意义(P<0.05),躯体化、抑郁、恐怖、其他因子分均显著高于中国军人常模(P<0.05),人际敏感、焦虑、偏执因子分低于中国军人常模,但差异无统计学意义.女实习舰员在航行中、晚期较同期男舰员、女医务人员心理健康状况差(P<0.05).结论 长远航明显降低女实习舰员的心理健康水平,应及时对女实习舰员的心理健康进行必要的干预.

Abstract：

Objective To investigate the mental health status of the midshipwomen involved in Mission Harmony-2010 and its influencing factors, and also to provide scientific basis for the maintenance of mental health and selection of female ship crew.Methods With midshipwomen, female medical personnel, male shipcrew as study subjects, and with cluster sampling and stratified random sampling as study methods, questionnaires were conducted 4 times by using symptom checklist (SCL-90) and routine interviews were also made during our study.Results During the prolonged seagoing deployment, the rate of detection for mental health problems among the midshipwomen was 21.8%. Scores of various factors during the mid stage of deployment were obviously higher than those of the normal people. However, in the later stage, scores of various factors were slightly lower than those of the normal people. Statistical significance was shown in the mental health status of the midshipwomen, when a comparison was made between pre-deployment,early stage of deployment and the mid and later stages of deployment(P<0.05). Scores of somatization, depression, phobia and other factors were significantly higher than those of the norms of Chinese military personnel (P<0.05). Scores of interpersonal sensitivity, anxiety and paranoia were lower than those of the norms of Chinese military personnel, but without statistical significance. During the mid and later stage of the prolonged seagoing deployment, the mental health status of midshipwomen was worse than that of the male ship crew and female medical personnel(P<0.05).Conclusions Prolonged seagoing deployment could significantly worsen the mental health status of midshipwomen. It was necessary to give in-time psychological intervention so as to ensure the mental health of midshipwomen.     

常规MRI和1H-MRS在职业性锰暴露致中枢神经损害中的应用价值

Objective MRI and MR hydrogen proton spectroscopy (1H-MRS) were used to detect the abnormal signal and alteration of metabolites, in order to explore the efficacy of these method in evaluating the damages of central nervous system (CNS) induced by occupational manganese exposure.Methods Eighteen workers exposed to manganese without any manganism symptoms, 12 workers with slightly chronic manganese poisoning, and 19 healthy workers were scanned using routine MRI sequence and 1H-MRS.The blood manganese concentration was also collected for each subject.On cerebral axial T1 WI,the signal intensities of ipsilateral globus pallidus and frontal white matter were measured in the visually brightest area (try to select the signal homogeneous region), and the globus pallidus index (PI) was then calculated.The 1H-MRS data was calculated to get the values of the peak height of N-acetylaspartate (NAA), choline (Cho), inositol (mI) and creatine (Cr) and the ratios of NAA/Cr, Cho/Cr, and mL/Cr were also calculated.One way ANOVA was used to compare the values of PI, NAA/Cr, Cho/Cr, mI/Cr and MnB among the three groups, and the correlations between PI and the time span of manganese exposure or blood manganese concentration were analyzed by Pearson correlation analysis.Eight workers exposed to manganese were followed up one year, and their PI , NAA/Cr before and after follow-up were compared by t test.Results Fourteen of 18 cases exposed to manganese without any manganism symptoms showed symmetrically high intensity signal on T1 WI, while the T2 WI were normal.No high signal intensity was observed on T1WI in any of the healthy workers or manganese poisoning workers.We found that the average PI in manganese exposed group (1.16 ±0.09) was significantly higher (F =24.79 ,P =0.O00)than those of the poisoning ( 1.05 ± 0.07 ) and control groups ( 1.01 ± 0.05 ).The blood manganese concentration in manganese exposed group, the poisoning group and the control group were (0.051 ±0.024), (0.047 ±0.018 ), ( 0.043 ± 0.020 ) μg/ml respectively, which was not significantly different ( F = O.623, P =0.541 ) and did not exceed the upper limit of normal reference value ( < 0.10 μg/ml ).There was a significantly correlation between PI and the time span of manganese exposure ( r = 0.67, P = 0.002 ),however, there was no correlation between PI and blood manganese concentration ( r = 0.20, P = 0.427 ).Furthermore, the NAA/Cr ratio decreased variously in the manganese poisoning group ( 1.22 ± 0.07 ) which was significantly lower( F = 4.120, P = 0.023 ) than those of the poisoning( 1.33 ± 0.13 ) and control groups ( 1.31 ±0.13).No statistical significanees were found in the ratios of Cho/Cr and mI/Cr among these three groups(P>0.05).No obvious changes of the PI and NAA/Cr were found in the 8 manganese exposed workers after 1 year follow-up.Conclusion Manganese exposure could lead to the high intensity signal on T1 WI, therefore the increased PI may be the biomarkers of central nerve system damages caused by the occupational manganese exposure.     

常规MRI和1H-MRS在职业性锰暴露致中枢神经损害中的应用价值

Objective MRI and MR hydrogen proton spectroscopy (1H-MRS) were used to detect the abnormal signal and alteration of metabolites, in order to explore the efficacy of these method in evaluating the damages of central nervous system (CNS) induced by occupational manganese exposure.Methods Eighteen workers exposed to manganese without any manganism symptoms, 12 workers with slightly chronic manganese poisoning, and 19 healthy workers were scanned using routine MRI sequence and 1H-MRS.The blood manganese concentration was also collected for each subject.On cerebral axial T1 WI,the signal intensities of ipsilateral globus pallidus and frontal white matter were measured in the visually brightest area (try to select the signal homogeneous region), and the globus pallidus index (PI) was then calculated.The 1H-MRS data was calculated to get the values of the peak height of N-acetylaspartate (NAA), choline (Cho), inositol (mI) and creatine (Cr) and the ratios of NAA/Cr, Cho/Cr, and mL/Cr were also calculated.One way ANOVA was used to compare the values of PI, NAA/Cr, Cho/Cr, mI/Cr and MnB among the three groups, and the correlations between PI and the time span of manganese exposure or blood manganese concentration were analyzed by Pearson correlation analysis.Eight workers exposed to manganese were followed up one year, and their PI , NAA/Cr before and after follow-up were compared by t test.Results Fourteen of 18 cases exposed to manganese without any manganism symptoms showed symmetrically high intensity signal on T1 WI, while the T2 WI were normal.No high signal intensity was observed on T1WI in any of the healthy workers or manganese poisoning workers.We found that the average PI in manganese exposed group (1.16 ±0.09) was significantly higher (F =24.79 ,P =0.O00)than those of the poisoning ( 1.05 ± 0.07 ) and control groups ( 1.01 ± 0.05 ).The blood manganese concentration in manganese exposed group, the poisoning group and the control group were (0.051 ±0.024), (0.047 ±0.018 ), ( 0.043 ± 0.020 ) μg/ml respectively, which was not significantly different ( F = O.623, P =0.541 ) and did not exceed the upper limit of normal reference value ( < 0.10 μg/ml ).There was a significantly correlation between PI and the time span of manganese exposure ( r = 0.67, P = 0.002 ),however, there was no correlation between PI and blood manganese concentration ( r = 0.20, P = 0.427 ).Furthermore, the NAA/Cr ratio decreased variously in the manganese poisoning group ( 1.22 ± 0.07 ) which was significantly lower( F = 4.120, P = 0.023 ) than those of the poisoning( 1.33 ± 0.13 ) and control groups ( 1.31 ±0.13).No statistical significanees were found in the ratios of Cho/Cr and mI/Cr among these three groups(P>0.05).No obvious changes of the PI and NAA/Cr were found in the 8 manganese exposed workers after 1 year follow-up.Conclusion Manganese exposure could lead to the high intensity signal on T1 WI, therefore the increased PI may be the biomarkers of central nerve system damages caused by the occupational manganese exposure.     

歼(强)击机飞行员心理健康影响因素的路径分析

Objective To probe into the influences and ways of personality,coping style and emotion to fighter (attacker) pilot's mental health. Methods One hundred fighter pilots were evaluated by SCL-90,Eysenck's personality questionnaire (EPQ),trait anxiety inventory (TAI) and coping style questionnaire (CSQ).The software SPSS 15.0 and Amos 7.0 were used to establish database and implement path analysis. Results ①The scores of somatization ,obsession compulsive ,interpersonal sensitivity,depression,anxiety,hostility,phobic anxiety,paranoid ideation,psychoticism,and total score of SCL-90 were significantly lower in the 100 pilots than those in Chinese healthy people norm (t=3.70-9.97,P<0.01);the scores of somatization,obsession compulsive,interpersonal sensitivity,depression,anxiety,hostility,phobic anxiety,paranoid ideation,psyehoticism,total scores and positive items of SCL-90 were significantly lower in 100 pilots than those in Chinese army man norm (t=6.28-17.86,P<0.01).②neuroticism (0.22相似文献   

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.