妊娠相关蛋白酶-A、C-反应蛋白变化与急性冠脉综合征相关性研究

目的　观察妊娠相关蛋白酶 -A(PAPP -A)、C -反应蛋白 (CRP)在急性冠脉综合征 (ACS)中的变化及其相关性。方法　68例经冠状动脉造影证实的冠心病患者 ,其中ACS患者 43例 ,稳定性心绞痛患者 2 5例 ,另选 2 0例正常健康人为对照组 ,采用酶联免疫吸附法 (ELISA)检测血浆PAPP -A水平 ;采用超敏免疫透射比浊法测血浆CRP。结果　ACS组PAPP -A、CRP均明显高于对照组[(PAPP -A :( 17 9± 8 7)mIu/LVS ( 7 1± 4 2 )mIu/L ,P <0 0 1;CRP :( 4 3 1± 0 3 8)mg/LVS ( 2 0 1± 0 14 )mg/L ,P <0 0 1) ] ;ACS组PAPP-A、CRP显著高于稳定性心绞痛组 [(PAPP -A :( 17 9± 8 7)mIu/LVS ( 8 5± 5 6)mIu/L ,P <0 0 1;CRP :( 4 3 1± 0 3 8)mg/LVS ( 2 13±0 2 8)mg/L ,P <0 0 5 ) ] ;经logistic回归分析 ,PAPP -A和CRP的风险比值 (OR)均 >1,均是ACS的危险因素 ,经前进法观察PAPP -A和CRP在ACS中的作用是相互独立的。结论　ACS患者PAPP -A、C -反应蛋白升高 ,二者可能是ACS发生的独立危险因素。     

阿托伐他丁对心脏X综合征患者hs-CRP水平的影响

目的　观察心脏X综合征病人血循环中高敏C反应蛋白的变化以及阿托伐他丁的可能影响。方法　选取 2 5例心脏X综合征病人和 10例健康人。⑴比较心脏X综合征病人和健康人血清hs -CRP水平 ;⑵比较胸痛频率每周≥ 5次 (n =14 )和 <5次 (n =11)两组心脏X综合征病人血清hs -CRP的水平 ;⑶比较胸痛持续时间≥ 15min(n =13 )和 <15min(n =12 )两组血清hs -CRP的水平 ;⑷ 2 5例病人分为对照组 (n =12 ,予以消心痛 10mgTid和地尔硫卓 3 0mgTid)和治疗组 (n =13 ,在前者基础上加阿托伐他丁 2 0mgQD) ,持续 12周 ,比较两组胸痛症状和hs -CRP的变化。结果　⑴心脏X综合征病人血清hs -CRP显著高于健康人[( 3 7± 3 2mg/Lvs 0 9± 0 5mg/L ,P <0 0 1) ] ;⑵胸痛频率每周≥ 5次组血清hs -CRP高于 <5次组 [( 3 8± 2 4mg/Lvs 2 6± 2 6mg/L ,P <0 0 5 ) ] ;⑶胸痛持续时间≥ 15min组血清hs -CRP高于 <15min组 [( 3 9± 3 0mg/Lvs 2 7± 1 7mg/L ,P <0 0 1) ] ;⑷阿托伐他丁治疗组血清hs -CRP下降较对照组显著 [( 1 3± 1 6mg/Lvs 2 8± 3 1mg/L ,P <0 0 1) ] ,胸痛症状缓解更明显。结论　⑴hs -CRP可能与心脏X综合征的发病相关 ;⑵阿托伐他丁有助于降低心脏X综合征病人的hs -CRP水平并缓解症状     

吸烟气道炎症气道粘膜的免疫组化研究

目的　探讨吸烟气道炎症气道粘膜的免疫组织化学反应。　方法　以 8例健康吸烟者为研究对象 ,收集支气管肺泡灌注液 (BALF)及支气管粘膜活检 ,免疫组织化学方法检查T淋巴细胞 (CD45RO)、B淋巴细胞 (CD2 0 )、淋巴细胞白细胞 (LCA)、组织细胞 (CD68) ,与其健康不吸烟者作对照。　结果　 ( 1)BALF回收率 :对照组 [( 5 1 5± 3 4) % ]略高于吸烟组 [( 4 9 1± 8 5 ) % ,P >0 0 5 ] ;吸烟组细胞总数 [( 11 3 9± 7 3 3 ) 10 8/L]明显高于对照组 [( 1 2 7± 0 1) 10 8/L ,P <0 0 5 ] ;吸烟组肺泡巨噬细胞 (AM ) [( 9 74± 5 75 ) 10 8/L] ,明显高于对照组 [( 1 11± 0 15 ) 10 8/L ,P <0 0 5 ] ;吸烟组多形核白细胞 (PMN)绝对值 [( 5 71± 6 5 6) 10 7/L]及百分率 [( 3 63± 3 11) % ]亦高于对照组 [( 0 0 2± 0 0 1) 10 7/L、( 0 18±0 0 1) % ] ;( 2 )免疫组化 :吸烟组CD45Ro标记 8例均呈阳性表达 ( 10 0 % ) ;LCA标记 6例阳性 ,1例弱阳性 ,1例阴性 ,阳性率 87 5 % ;CD2 0 标记 8例均呈阴性 ;CD68标记 8例均呈阳性表达 (仅见极少量淋巴细胞 )。　结论　吸烟气道肺局部炎症以AM、PMN为主 ;免疫组化以T淋巴细胞 (CD45Ro)、淋巴细胞白细胞 (LCA)、组织细胞 (CD68)反应为主。     

血清免疫球蛋白IgM和C-反应蛋白联合测定对诊断新生儿早期细菌感染的意义

目的　探讨血清免疫球蛋白IgM和C 反应蛋白(CRP)联合测定在新生儿早期细菌感染诊断中的意义。方法　采用散射比浊法测定5 0例发生细菌感染的新生儿(感染组)、2 5例正常足月新生儿(对照组)和36例非感染病症新生儿(未感染组)的血清IgM和CRP水平。结果　对照组IgM和CRP值分别为0 .2 1±0 .0 7g/L和1.0 0±0 .30mg/L;感染组IgM和CRP值分别为0 .4 4±0 .2 1g/L和4 5 .19±2 5 .79mg/L,均较对照组明显升高(P <0 .0 0 5 )。未感染组IgM值为0 .19±0 .0 2 g/L,与对照组比较,差异无显著性(P >0 .0 5 ) ,与感染组比较,差异有显著性(P <0 .0 0 5 ) ;CRP值为39.0 9±18.37mg/L,与对照组比较,差异有显著性(P <0 .0 0 5 ) ,与感染组比较,差异无显著性(P >0 .0 5 )。结论　血清IgM与CRP联合测定可作为诊断新生儿早期细菌感染的指标。     

肺成纤维细胞增殖与其合成胶原功能间的关系

目的　探讨肺成纤维细胞 (FB)增殖与其合成胶原功能间的关系。方法　通过卟啉醇肉豆蔻酸乙酸乙酯 (PMA)和 1 (5 异喹啉基 ) 2 甲基哌嗪 (H 7)改变肺FB的增殖状态 ,观察肺FB数、细胞内DNA中3 H 胸腺嘧啶核苷 (3 H TdR)掺入量与细胞新合成蛋白质中3 H 脯氨酸 (3 H Pro)掺入量的关系。结果　 2 0nmol/L的PMA作用 3d时 ,肺FB数 [(12 .2± 2 .3)× 10 4 个 /孔 ]和细胞内DNA中3 H TdR掺入量 [(1.89± 0 .0 9)× 10 3 Bq]分别较对照组 [(7.5±1.1)× 10 4 个 /孔、(1.6 7± 0 .16 )×10 3 Bq]明显增多 ,差异有显著性 (P <0 .0 1) ;但细胞分泌的蛋白质中3 H Pro掺入量 [(6 87.5± 2 0 0 .5 )Bq/ 10 5cells]比对照组 [(1181± 147.5 )Bq/ 10 5cells]却明显减少 ,差异有显著性 (P <0 .0 1)。5 0 μmol/L的H 7作用 3d时 ,肺FB数 [(4.2± 0 .8)× 10 4 个 /孔 ]和细胞内3 H TdR掺入量 [(0 .72±0 .13)× 10 3 Bq]分别较对照组 [(7.5± 1.1)× 10 4 个 /孔、(1.12± 0 .0 8)× 10 3 Bq]明显减少 ,差异有显著性 (P <0 .0 1) ,但3 H Pro掺入量 [(170 5 .5± 2 5 1.5 )Bq/ 10 5cells]比对照组 [(1181± 147.5 )Bq/ 10 5cells]明显增多 ,差异有显著性 (P <0 .0 1)。结论　肺FB合成胶原蛋白的功能与其增殖状态有关。肺     

C反应蛋白--缺血性脑卒中预后的重要标志物

目的　研究C反应蛋白 (CRP)水平与脑梗死灶体积、颈动脉斑块及脑卒中预后的关系。方法　对纳入研究的 12 1例缺血性脑卒中患者在发病后 72h内抽取血清测定CRP水平 ,按脑卒中患者临床神经功能缺损程度评分标准 (CNFDS)进行评分 ,所有患者进行CT/MRI及颈动脉超声检查。结果　CRP异常组患者入院时血糖水平为 ( 8 0 6± 5 47)mg/L ,白细胞数为 ( 10± 4)× 10 9/L ,明显高于CRP正常组的 ( 6 43± 2 78)mg/L和 ( 9± 3)× 10 9/L ;脑梗死发生率 ( 42例 )明显高于腔隙性脑梗死 ( 2 3例 ) ;颈动脉斑块的发生率也较CRP正常组高 ( 32例 ,17例 )。CRP的异常组患者CNFDS评分较高 ,中位数为 18( 6～ 35 ) ,且预后不良。结论　CRP水平是反映颈动脉斑块及脑卒中患者预后的一个重要标志物。     

蔺草染土尘致大鼠肺部病变的实验研究

目的　研究蔺草染土粉尘的致尘肺作用。方法　SD雄性大鼠以非暴露式气管内染尘(5 0mg/只 ) ,于染尘后 3、6、12个月 ,取大鼠肺和肺淋巴结作病理和电镜观察 ,测定肺组织胶原蛋白和血清铜蓝蛋白 (CP)含量。结果　染尘后 12个月 ,蔺草染土尘组大鼠肺湿重 (2 .6 9± 0 .2 2 )g ,高于对照组 [(1.87± 0 .2 5 )g]和TiO2 组 [(2 .2 5± 0 .2 6 )g],但低于SiO2 组 [(11.4 1± 1.6 3)g];蔺草染土尘组大鼠肺干重 (0 .4 7± 0 .0 3)g ,高于对照组 [(0 .32± 0 .0 3)g]和TiO2 组 [(0 .4 1± 0 .0 8)g],但低于SiO2 组 [(2 .0 6± 0 .2 8)g];蔺草染土尘组大鼠肺胶原蛋白含量 [(10 3.0 8± 14 .79)mg]高于对照组 [(75 .96± 13.91)mg]和TiO2 组 [(85 .84± 17.6 2 )mg],但低于SiO2 组 [(497.5 0± 10 0 .80 )mg];蔺草染土尘组大鼠血清CP含量为 (18.0 3± 1.87)U/L ,高于对照组 [(15 .0 5± 2 .2 4 )U/L]和TiO2 组 [(16 .92± 1.6 7)U/L],但低于SiO2组 [(2 5 .37± 3.5 8)U/L]。以上各指标各组间的差异均有显著性 (P <0 .0 5或P <0 .0 1)。蔺草染土尘组大鼠病理观察可见肺巨噬细胞肺泡炎、Ⅱ型肺泡上皮细胞增多及肺泡间隔增宽 ,有 1～ 2级矽结节和少量胶原纤维性变。电镜下可见 ,蔺草染土尘组大鼠肺有初级和次级溶酶体及     

重组人生长激素对腹腔大肠埃希菌感染大鼠内毒素血症影响的实验研究

目的　观察重组人生长激素 (rh GH)对严重腹腔内大肠埃希菌感染大鼠内毒素血症的影响。方法　SD大鼠 75只 ,随机分为正常对照组、感染组和治疗组 (后两组又再分为 1d、3d两个亚组 ) ,每组 15只 ;感染组 :腹腔注射鸵鸟株大肠埃希菌标准菌株悬液 (1× 10 10 CFU/L ,15ml/kg) ;治疗组 :腹腔注射大肠埃希菌后给予rh GH(2 .2 5U·kg 1·d 1)肌内注射治疗 ;于注射后 2 4、72h分别测定各组大鼠的血浆内毒素含量、血浆TNFα浓度、白细胞总数和分类计数及平均动脉压 (MAP)。结果　感染组血浆内毒素含量显著升高 ,2 4h和 72h分别为 (0 .2 5 6±0 .0 5 2 )和 (0 .189± 0 .0 5 2 )EU/ml,明显高于对照组 [(0 .111± 0 .0 5 3)EU/ml,P <0 .0 1],血TNFα明显升高 [(3.5 9± 0 .6 9) / (2 .88± 0 .74 ) μg/L ,P <0 .0 5 ],呈现典型而严重的感染性休克临床经过 ,MAP显著降低 [(8.99± 3.0 1) / (16 .6 1± 1.85 )kPa,P <0 .0 1];治疗组血浆内毒素含量在感染后 2 4h轻度升高 [(0 .15 0± 0 .0 39)EU/ml],72h降至正常对照水平 [(0 .10 8± 0 .0 4 2 )EU/ml],与感染组比较 ,两个时点差异均有显著性 (P <0 .0 1) ,72h血TNFα浓度 [(1.5 4± 0 .36 ) μg/L]明显低于对照组 [(2 .88± 0 .74 ) μg/L ,P <0 .0 1]和感染组 [(2     

高频喷射通气对单肺通气患者氧化应激反应的影响

Objective To determine the effects of high-frequency jet ventilation (HFJV) on oxidative stress in patients during one-lung ventilation (OLV). Methods Forty-five patients undergoing elective radical esophageal cancer resection were divided into three groups with 15 cases each by random digits table: two lung ventilation group ( group A), OLV group (group B), HFJV- OLV group ( group C, working pressure 1 kg/cm2 and frequency 100 times/min). Venous blood samples were taken before induction (T0),at30min (T1),90min (T2),150min (T3) after OLV and the end of operation (T4) for measuring serum superoxide dismutase(SOD),malondialdehyde (MDA) and nitric oxide (NO). Results SOD was lower at T2-T4 in group B[(47 ± 10), (37 ±9), (41 ±7) kU/L] and group C[(58 ± 12), (51 ± 11), (49 ± 9) kU/L] than those in group A [(78 ±8), (75 ±7), (79 ±6) kU/L](P＜ 0.05),and MDA and NO were lower at T1-T4 in group B and group C than that in group A(P＜ 0.05). SOD was higher at T3 in group C than that in group B (P ＜ 0.05), MDA at T1-T4 and NO at T2-T4 were lower in group C than those in group B (P ＜ 0.05). Conclusion HFJV can effectively decrease oxidative stress in patients during OLV.     

白细胞计数和C-反应蛋白诊断急性阑尾炎的准确性与患者症状持续时间关联性的探讨

目的探讨白细胞计数(WBC)和C-反应蛋白(CRP)诊断急性阑尾炎(AA)的准确性是否与患者的症状持续时间有关。方法选取本院门诊和急诊877例疑似急性阑尾炎患者的资料。依据最终诊断分成AA组和非急性阑尾炎(NAA)组;再根据患者的症状持续时间分成24 h组、24 h~48 h组、48 h组。分别计算WBC10×10~9/L、WBC15×10~9/L、WBC为20×10~9/L,CRP10 mg/L、CRP50 mg/L、CRP100 mg/L,WBC10×10~9/L且CRP10 mg/L、WBC15×10~9/L且CRP50 mg/L、WBC20×10~9/L且CRP100 mg/L诊断AA的敏感度、特异度、阳性预测值、阴性预测值。结果 WBC诊断AA的敏感度和阳性预测值最高的是24 h~48 h组,特异度相对较高的是24 h组;CRP诊断敏感度最高的是48 h组,特异度和阳性预测值较高的是24 h组;CRP+WBC联合诊断时阳性预测值最高的是48 h组。结论结合患者的症状持续时间时,WBC、CRP诊断AA的准确性没有提高。     

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.     

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.