宁夏地区472例胆石病胆石红外光谱法定性实验分析

目的探讨宁夏地区胆石类型及分布特点。方法调查472例胆结石患者临床资料,红外光谱法测定胆石主成分红外光谱与标准样品的红外光谱比较,确定结石类型。结果胆固醇类结石占86.44%,胆色素类结石占5.72%,混合性结石占6.36%,其他类结石占2.4%;胆囊结石占90.68%,胆管结石占9.32%。喜食高热量饮食、肥胖、高血脂城镇患者易患胆囊胆固醇类结石,反复胆道感染患者易患胆管结石。回族胆石类型及分布与汉族比例接近。结论宁夏地区以胆囊胆固醇类结石为主,性别、年龄、职业、饮食结构、居住环境等因素影响胆石类型或分布,回族与汉族胆石类型及分布差异无统计学意义。     

胆结石10问

胆结石又称胆石病,是胆管系统结石(包括:胆囊结石、胆总管结石和肝内胆管结石)的统称。在我国,胆结石是常见病和多发病,大家对这个病名都不陌生,看完了以下的10个问题,将会使您增加对它的了解。1问:胆结石的主要成分是什么?答:胆结石的主要成分是胆固醇和胆红素。以胆固醇为主要成分的结石质地坚硬,外观呈棕褐色、圆形、椭圆形或多面体形,表面光滑,一般较大,呈单发或多发。此种成分的结石可发生在胆管系统的任何部位,但以在胆囊内者居多。以胆红素为主要成分的结石质地松脆,呈薄片状、球形或其他不规则状,压之易碎,外观呈棕色、黑色或橘黄色…     

胆石的形成机制

胆石病在临床上比较常见,因胆石化学成分不同而形成了不同类型的胆石,一般分为以胆红素钙为主和以胆固醇为主两大类型。两类胆石的形成机制也各有不同。一、胆红素钙石的形成: 胆红素钙结石患者的胆汁或分为游离胆红素钙盐的过饱和。促进胆红素钙盐沉淀的因素很多,酸性粘多糖蛋白,胆道内细菌及寄生虫感染、饮食因素等均促进胆汁理化成分和流体力学的改变,导致胆红素钙结石的形成。     

又一个富贵病——胆结石

胆 结石是俗名,正式名称为胆石症。它是在胆道 系统中,胆汁的某些成分(如胆色素、胆固醇黏液物质及钙等)可以在各种因素作用下析出、凝集而形成结石。发生于各级胆管内的结石称为胆管结石,发生于胆囊内的结石称胆囊结石,两者统称胆石症。胆石症是我国的一种常见病,其发生率在自然人群中达10%。 胆结石按组成成分为以下三种:　①胆固醇结石此类结石在我国较欧美发达国家少,但近来此类结石临床上明显增加。结石呈圆形或椭圆形或多面体表面光滑,黄色或黄白色,含胆固醇70%～95%,中心有少量胆色素。此类结石多见于胆囊,…     

就胆结石病答读者问

一、胆结石病是怎么回事? 胆石病是人体胆道系统里有类似石头样颗粒,大小不等,有的是单个存在,也有的是多发的,由于胆石在胆系里的部位不同,又分为胆囊结石、胆总管结石、肝内胆管结石。 在我国有胆石病的人并不少,据上海第二医科大学对5万多人的抽样调查表明,胆石病发病率为5.6%。有胆石的人并不是都有感觉,大多数是没有什么症状,自己不知道有胆石,多数只感觉消化不好,有时犯心口痛病。40岁以上的人发病率高。如果胆囊结石较大,有时可嵌在胆管某一段狭窄部门,堵塞了胆汁下行的通道,医学上称为胆道梗阻。     

胆石与饮食

胆石病是指胆道系统(包括胆囊及胆管)的任何部位发生结石的疾病,其临床表现取决于结石是否已引起胆道感染、胆道梗阻以及梗阻的部位和程度。胆石病的发病原因尚不十分确切,但已知许多因素与之相关。其中重要因素之一是饮食。 长期高脂饮食,特别是含胆固醇高的食物,如脑、肝、肾、鱼子、蛋黄等,可致血液和胆汁中胆固醇升高;若同时伴胆汁郁积、胆盐或卵磷脂下降,极易产生胆石。长期高脂饮食使人体肥胖,胆囊肌肉张力下降,以致排空延缓,胆汁郁积,形成结石。 长期低脂肪饮食,影响机体对营养的吸收,造成胆汁缺乏及     

腹腔镜胆囊切除术

胆囊结石病是外科的常见病及多发病。随着人民生活水平的提高,胆囊结石的发病率明显增高。下面介绍一些关于胆囊结石的基本知识。●胆囊结石是不是石头?它的成分是什么?胆结石不是石头。胆结石的化学成分是胆固醇和胆红素,这两者本是胆汁中的化学组成成分,由于比例失衡,结晶析出,最终形成了结石。●胆结石根据发生部位分为:胆囊结石、胆总管结石、肝内总管结石。●胆结石是怎样形成的?胆囊贮存肝脏生成的胆汁,胆管将胆汁送至小肠,帮助消化脂肪,如果胆汁的化学成分之间失去平衡,胆汁就会由清逐渐变浊,容易沉淀,最终形成胆泥和结石。     

胆结石与饮食

胆石病是一种多发病,可发于任何年龄段,但以中老年人居多,尤其是妇女。至今胆石病的发病机理仍不十分清楚,只知道它与胆固醇代谢、胆囊因素、感染、年龄、遗传、肥胖、饮食、血清低HDL(高密度脂蛋白)高甘油三酯、性别、生育等因素有关。胆结石分为胆固醇结石和胆色素结石两种。由于饮食与胆石病有密切关系,所以就此作一介绍。     

胆石症“摘胆”后应该怎么吃?

正胆石症指的是胆囊或胆管内形成了结石。胆囊的主要功能是浓缩、储存和排泄肝脏生成的胆汁。胆汁的主要成分包括胆固醇、胆红素和胆盐。这些结石即是"超浓缩"的胆汁。胆石症的成因1当不易察觉的轻度慢性感染引起胆囊黏膜改变,过量的水分或胆汁酸被吸收,而胆固醇、胆红素、钙盐沉积在胆囊中未能有效输出,即可形成结石。     

无“胆”问题不大——谈谈胆结石的防和治

人体的胆道系统由肝内胆管、肝外胆管、胆囊组成,胆道系统发生的结石病,按结石所在部位可分为胆囊结石、肝内胆管结石和肝外胆管结石。按结石的化学成分可分为胆固醇结石、胆红素结石和混合性结石。     

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.     

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.     

Assessing occupational and environmental exposure

Exposure assessment is a poorly understood component of the science of epidemiology. The relationship between exposure to chemicals and ill-health outcomes is often calculated using crude exposure measures such as ever/never exposed or duration. When investigating subtle effects, exposures need to be characterized much more fully in terms of intensity, frequency, duration and route. While occupational exposures tend to be much greater than those experienced from the wider environment there is a need to remember that, for many chemicals, exposure can occur occupationally, environmentally and through consumer use of products containing the material of interest. Inhalation exposure has generally been the traditional focus for most epidemiological investigations but there is now growing awareness of the importance of the dermal and ingested routes of contact and internalization. Quantification of the exposure also needs to be related to a biological mechanism of action and exposure metrics need to be selected accordingly. Occupational exposures can generally be measured using simple well-validated techniques. Environmental exposures require much more sensitive instruments and are more difficult to assess. Exposure modelling, particularly for the environmental fate of chemicals has undergone many recent developments and Monte Carlo techniques can be used to characterize model uncertainty and variability. This approach to exposure assessment can now be used in the setting of the wider environment and will enable a far better understanding of the relationship between exposure and disease.     

Mercury toxicity due to the smelting of placer gold recovered by mercury amalgam

A 19-year-old man developed tremor in both hands and fatigue after starting work at a placer gold mine where he was exposed to mercury-gold amalgam. Examination revealed an intention tremor, dysdiadochokinesis and mild rigidity. The 24-h urinary mercury concentration reached a peak of 715 nmol/l (143 ug/l) shortly before the clinical examination, after which he was removed from working in the gold room [Mercury No. Adverse Effect Level: 250 nmol/l (50 ug/l)]. On review 7 weeks later his tremor had almost resolved and the dysdiadochokinesis and rigidity had gone. The 24-h urinary mercury concentration had fallen to 160 nmol/l (32 ug/l). The principal exposure to mercury was considered to be the smelting of retorted gold with previously unrecognized residual mercury in it. The peak air concentration of mercury vapour during gold smelting was 0.533 mg/m3 (Mercury Vapour ACGIH TLV: 0.05 mg/m3 TWA). Several engineering and procedural controls were instituted. This episode occurred at another mine site, unrelated to Mount Isa Mines Limited.     

How Adults with Acquired Brain Damage Perceive Computer Training as a Rehabilitation Tool: A Focus-group Study

The aim of this study was to explore and describe how adult outpatients with acquired brain damage and referred to occupational therapy perceive computer training with the RehaCom programs, in order to evaluate the method of treatment as a tool in the rehabilitation of persons with cognitive disorders. By using focus-group discussions as a qualitative method of research when analysing the result, five themes with corresponding categories emerged, describing a development of understanding and learning about capacities. Themes describing how the participants could apply strategies to overcome shortcomings in daily occupations and the therapeutic role of the occupational therapist were identified as well. The result shows that a computer training program such as RehaCom can be used as an educational tool, for example, to guide a person who is trying to adopt compensatory strategies to avoid overload by taking pauses. It was found that anything the participants learned was also applicable to occupational performance in daily life.