不同强度耐力训练对新兵自主神经调节功能的影响

目的评价不同强度的耐力训练对新兵自主神经功能的影响,为优化军事训练提供科学的依据。方法72名健康男性新兵,随机分为现行军体训练组、有氧耐力组、无氧耐力组,进行连续8周训练。分别于训练前、训练末进行5 min心率变异性(HRV)分析、冷加压试验(CPT)及血浆去甲肾上腺素(NE)、肾上腺素(EPI)、肾素活性(RA)及神经肽Y(NPY)检测。结果训练前各指标组间差异无显著性。训练8周末,现行训练组HFn(52±11)较训练前(59±12)显著降低(P<0.05),但LFn(43±12)、LF/HF(0.87±0.35)均较训练前(36±11)、(0.67±0.32)〕有显著增加(P<0.05);有氧耐力组HFn(62±11)均较训练前(53±14)显著增加(P<0.05),但LFn(36±8)、LF/HF(0.64±0.28)与训练前(39±12)、(0.77±0.33)相比呈下降趋势;无氧耐力组HRV无显著变化。训练8周末与静态时比较,无氧耐力组CPT中HR增加值〔(6.46±6.79)b.min-1〕显著低于现行训练组〔(24.00±22.64)b.min-1〕和有氧耐力组〔(17.11±15.22)b.min-1〕的增加值(P<0.05)。现行训练组的NE〔(152.17±31.51)pg.mL-1)〕显著高于有氧耐力组〔(109.31±18.77)pg.mL-1〕和无氧耐力组〔(104.92±19.36)pg.mL-1)〕(P<0.01)。现行训练组RA〔(4.33±2.08)pg.mL-1)〕显著高于有氧耐力组〔(1.97±1.79)pg.mL-1)〕和无氧耐力组〔(2.74±1.06)pg.mL-1)〕(P<0.01)。结论耐力训练对自主神经调节能力的影响主要取决于负荷强度,现行军体训练接近极限强度,其对机体有潜在危害,故应进行规范的有氧、无氧耐力训练。     

急进高原自主神经系统功能变化研究进展

急进海拔3000m以上的高原自主神经系统(ANS)活动发生显著的、具有时间依赖性的变化。近年来大多数研究认为急进高原1d副交感神经活动显著减弱,但有关交感神经活动尚存在较大争议,急进高原的随后数日内交感和副交感神经活动有逐渐恢复至类似平原状态的趋势,交感神经活动甚至可超过平原水平。然而,高原适应能力强的个体急进高原其ANS变化程度较轻,ANS与急性高原病(AMS)密切相关,ANS功能在评估AMS中具有重要意义。     

不同强度耐力训练后模拟急进高原自主神经相关生化指标与急性高原反应之间的关系研究

目的探讨不同强度耐力训练后模拟急进高原自主神经相关生化指标与急性高原反应(AMS)之间关系。方法选择43名经8周不同强度耐力训练后的新兵,其中现行训练组15名,有氧耐力组15名,无氧耐力组13名。在低压氧舱模拟急进高原4500 m 24 h。在进舱24 h时,检测血浆去甲肾上腺素(NE)、肾上腺素(EPI)、肾素活性(PRA)及神经肽Y(NPY),并与训练8周末进行对比,记录AMS评分。结果 (1)模拟急进4500 m高原24 h 3组血浆NE浓度均较训练8周末下降,有氧、无氧耐力组下降幅度小于现行训练组(P0.05);现行训练组、有氧耐力组血浆EPI浓度较训练8周末增加(P0.01)。(2)模拟急进4500 m高原24 h现行训练组、无氧耐力组PRA均较训练8周末下降,且现行训练组下降幅度大于有氧、无氧耐力组(P0.01)。(3)3组训练8周末和模拟急进高原24 h血浆NPY浓度比较差异无统计学意义(P0.05)。(4)AMS症状评分与训练8周末NE、PRA、NPY浓度及模拟急进高原前后NE、PRA变化幅度均呈正相关(P0.05)。(5)AMS发病率为100%,现行训练组AMS症状评分高于无氧耐力组(P0.05);3组症状自评量表(SCL-90)评分比较差异无统计学意义(P0.05),但现行训练组、有氧耐力组AMS与SCL-90评分存在正相关关系(P0.05)。结论现行训练组和有氧耐力组ANS功能在模拟高原1 d内受抑制程度较重,不利于机体对高原环境中的急性适应;而无氧耐力训练ANS功能受抑制较轻,在急进高原环境应激时具有良好适应性。     

急性高原病发病前后血管内皮生长因子及其受体水平变化

目的探讨人群急进高原前后血管内皮生长因子(vascular endothelial growth factor,VEGF)和受体VEGFR-1(fms-like tyrosine kinase-1,flt-1)、VEGFR-2(fetal liver kinase-1/kinase insert domain-containing receptor,flk-1/KDR)的表达变化及其与急性高原病(acute mountain sickness,AMS)发病的关系,为发现和保护易感人群提供理论依据。方法以2000名健康新兵为研究对象,分别在急进高原前后抽取静脉血备用。以症状评分法调查急进高原后AMS的发病率,随机选取20名AMS发病对象为AMS组,20名未发病对象为对照组,采用ELISA法检测急进高原前后两组血浆VEGF、VEGFR-1、VEGFR-2浓度的变化。结果 2000名研究对象中AMS的发病率为34.3%。与平原地区相比,AMS组急进高原后血浆VEGF浓度明显升高且差异有统计学意义(t=2.799,P=0.011),血浆VEGFR-1和VEGFR-2浓度无明显变化;对照组急进高原后血浆VEGF、VEGFR-1和VEGFR-2浓度变化无统计学意义(P0.05)。急进高原前后AMS组血浆VEGF浓度均明显高于对照组(t=2.461,P=0.018;t=2.698,P=0.010),而血浆VEGFR-1、VEGFR-2浓度与对照组相比均无明显差异。结论血浆VEGF浓度有可能作为一个敏感指标在急进高原前筛选AMS易感者,而血浆VEGFR-1、VEGFR-2浓度与AMS的发生无相关性。     

藏药红景天预防急性高原病和提高运动能力的作用

目的 在高原现场对藏药红景天预防急性高原病(AMS)和提高运动能力的作用进行评估.方法 选择来自格尔木的登山队员41名,其中男性35名,女性6名.随机分为红景天组、醋氮酰胺组和未服药组.分别在海拔2 900 m、5 050 m和5 600 m不同高度检测登山队员的SaO2、HR、BP和调查 AMS 症状,并结合一些体征、登山成功率及AMS发生率评价红景天抗缺氧作用.结果 在海拔5 050 m,红景天组SaO2[(74.7±8.5)%]明显高于未服药组[(66.0±8.9)%](P<0.01),略低于醋氮酰胺组;在5 600 m略下降,仍比未服药组高(P<0.05),与醋氮酰胺组比较差异无显著性(P>0.05);在海拔5 050 m,红景天组HR[(94.2±14.7)b/min]显著低于未服药组[(110.1±11.0)b/min](P<0.01);在海拔2 900 m和5 600 m,3个组HR无明显差异.3个组成功登上6 178 m顶峰的人数中,醋氮酰胺组占本组队员84.6%;红景天组占本组队员66.7%,未服药组仅占本组队员36.8%.根据AMS评分,未服药组2人患AMS,而红景天和醋氮酰胺组未出现AMS.结论 红景天不仅有预防AMS作用,而且能提高机体在低氧条件下的运动能力.     

3种抗缺氧制剂对高原人体脑血流的影响

目的评价3种抗缺氧制剂对改善高原人体脑供血状况的效果,为高原临床应用提供实验依据。方法将拉萨地区40名健康志愿者随机均分为食品组、多维电解质泡腾饮片(简称多维泡腾片)组、红景天组和对照组;采用多功能阻抗测试仪分析服用3种抗缺氧制剂前后脑血流图的变化。结果志愿者服用3种抗缺氧制剂后,食品组脑血流图主波波幅上升时间〔(0.110±0.033)s〕较服用前〔(0.174±0.072)s〕显著减少(P<0.05);血液流入时间〔(0.262±0.043)s〕较服用前〔(0.306±0.019)s〕显著缩短(P<0.05);流入阻力指数(0.986±0.044)较服用前(0.916±0.01)显著增大(P<0.05)。多维泡腾片组主波波幅上升时间〔(0.111±0.024)s〕较服用前〔(0.151±0.054)s〕显著减少(P<0.05),流入容积速度〔(1.476±0.405)Ω/s〕较服用前〔(0.916±0.395)Ω/s〕显著增大(P<0.05);红景天组前后对比无统计学意义。结论在3种抗缺氧制剂中,抗缺氧食品和多维泡腾片对于改善人体在高原低氧环境下的脑血液循环具有显著作用。     

抗缺氧制剂对高原战士肺功能和血氧饱和度的影响

目的研究抗缺氧功能制剂对高原移居者肺功能和血氧饱和度(SaO2)的影响,为促进高原习服、改善高原劳动能力提供新的措施。方法海拔3700m驻守>1年的男性士兵60名,随机分为抗缺氧食品组(A组),多维电解质泡腾片组(B组)和对照组(C组),每组20人,A、B组连续服用实验品14d,测量参试者服用实验品前和服用14d后的肺功能指标、安静状态SaO2以及3km越野跑前后SaO2变化幅度。结果3km越野跑后,A组SaO2下降幅度为3.80%,B组为6.65%,均明显低于服食前(A组14.60%、B组16.20%,P<0.01);C组服食前(14.01%)与服食后(15.40%)比较差异无显著性;服食后B组最大通气量为(118.2±3.2)L/min,明显高于服食前〔(108.8±12.8)L/min(P<0.05)〕。结论抗缺氧食品和多维电解质泡腾饮片可以显著提高机体低氧环境下运动后SaO2,对改善人体高原劳动能力具有明显作用。     

急进高原和高原训练对武警新兵血氧血压综合参数的影响

目的观察武警新兵急进高原和高原训练对血氧血压综合参数的影响,为探讨新兵高原习服提供科学依据。方法将受试者分为平原男性组、平原女性组、高原男性组和高原女性组。平原男性组分别在平原、急进高原的第1、第3、第5、第7天和新兵训练结束后测试。平原女性组在平原和高原训练前后测试。高10原男性组和高原女性组在高原训练前后测试。实验于2008年在成都和拉萨完成。结果平原男性组、平原女性组急进高原动脉血氧饱和度降低,差异有统计学意义(P<0.01);平原男性组在急进高原的第7天恢复到世居同龄人水平;高原训练前后血氧饱和度差异无统计学意义。平原女性组急进高原后血压升高,差异有统计学意义(P<0.01,P<0.05);平原男性组和平原女性组急进高原后脉率增快,差异有统计学意义(P<0.05,P<0.01)。结论血氧饱和度在急进高原7 d时基本习服,高原训练对血氧饱和度的影响不显著。     

硫酸镁与硝苯地平联合对中重度妊娠期高血压疾病患者的有效性评价

目的观察并探讨硫酸镁(Mg SO4)联合硝苯地平(NIP)对中重度妊娠期高血压疾病的疗效。方法选择自2011年1月-2014年12月在湖州市妇幼保健院治疗的中重度妊娠期高血压疾病患者100例,将所有患者分为观察组和对照组各50例,对照组采用MgSO_4治疗,观察组在对照组的基础上给予NIP治疗。治疗前后监测两组患者的收缩压(SBP)、舒张压(DBP)、心率(HR)、血液黏度(BV)、血细胞压积(PCV)和24 h尿蛋白定量(24h UP),并随访至获得妊娠结局进行比较。结果两组治疗前SBP、DBP、HR、BV、PCV和24h UP相比,差异无统计学意义(P0.05);治疗后观察组SBP、DBP和HR分别为(111.8±10.7)mmHg、(85.1±6.3)mmHg和(64.9±7.2)次/min,对照组为(129.8±13.5)mmHg、(95.2±6.5)mmHg和(77.3±7.2)次/min,两组比较,差异有统计学意义(P0.05);治疗后,观察组BV、PCV和24h UP明显低于对照组(P0.05);观察组不良妊娠率为14.0%,对照组为32.0%,两组比较,差异有统计学意义(P0.05)。结论 Mg SO4联合NIP治疗能明显改善中重度PIH患者的血压水平,且有利于不良妊娠结局的控制和改善。     

利氧灵提高人体高原劳动能力效果评价

本文通过高原现场观察,对利氧灵提高人体高原劳动能力的效果进行了评价。20名受试者以配对实验设计分为实验组(利氧灵组)和对照组,每组10人。先在平原测量无氧阈(AT_(GE)),PWC_(170)和定量负荷运动心率(HR)。而后,乘飞机到达海拔4370m高原,重复上述指标的测量。结果表明,在该高度上停留一周时间里,两组的AT_(GE)、PWC_(170)明显低于平原对照值,HR明显高于平原对照值。但在同一时间里,实验组的上述指标明显好于对照组,如第5天,实验组的TI_(GE)、PWC_(170)和HR分别为529.2kg·m/min,1216.4kg·m/min和160b/min;对照组分别为362.6kg·m/min(P<0.05),1016.1kg·m/min(P<0.05)和170b/min(P<0.05)。可见,利氧灵对提高人体高原劳动能力有一定作用。     

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.