OSAHS患者体质指数和日间嗜睡在睡眠紊乱对血压影响中的多重中介作用

目的:探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者体质指数（BMI）和日间嗜睡在睡眠紊乱对血压影响中的多重中介作用。方法:以2015年1月至2019年8月在北京大学国际医院睡眠中心首次确诊的530例成年住院OSAHS患者为研究对象,收集患者的多导睡眠图监测数据和爱泼沃斯嗜睡量表数据,基于结构方程模型构建多重中介...     

CPAP、BiPAP呼吸机治疗OSAHS患者300例对比分析

目的:研究我科2011年10月以来通过多导睡眠监测(PSG)确诊的睡眠呼吸暂停低通气综合征(OSAHS)患者,使用持续正压通气呼吸机(CPAP)及双水平气道正压通气呼吸机(Bi PAP)治疗的效果对比。方法:通过PSG监测,比较OSAHS患者使用CPAP呼吸机及Bi PAP呼吸机治疗后呼吸紊乱指数(AHI)、夜间最低指测氧饱和度(Sp O2Low)及睡眠效率改善情况的差异。结果:在重度OSAHS患者中,CPAP呼吸机及Bi PAP呼吸机治疗效果无明显差异,在轻至中度OSAHS患者及重叠综合症患者中(COPD呼吸衰竭合并OSAHS患者),Bi PAP呼吸机治疗效果优于CPAP呼吸机治疗效果。结论:CPAP呼吸机主要适用于单纯OSAHS患者,尤其重症OSAHS患者,因其在改善肺通气过程中,有利于患者呼吸肌锻炼;但本研究的结果显示,对于轻、中度OSAHS患者及OSAHS合并有COPD呼吸衰竭患者,Bi PAP呼吸机有着更好的疗效。     

持续气道正压通气对OSAHS合并不同血压昼夜节律的高血压病患者夜间血压的影响

目的:分析持续气道正压通气（CPAP）对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）合并不同血压昼夜节律的高血压病患者夜间血压的影响。方法:选择2020年1月至2021年4月在南京医科大学附属淮安第一医院睡眠医学中心行多导睡眠图（PSG）监测并符合本研究入组标准的61例OSAHS患者作为研究对象。在PSG监测时同步对其...     

睡眠监测阻塞定位仪在阻塞性睡眠呼吸暂停低通气综合征阻塞部位分析中的应用价值

目的探讨睡眠监测阻塞定位仪在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)阻塞部位分析中的应用价值。方法选择2018年9月至2019年9月于医院进行手术治疗的80例OSAHS患者作为研究对象,所有患者均使用睡眠监测阻塞定位仪进行睡眠监测和上气道测压检查,以综合检查结果为金标准,分析睡眠监测阻塞定位仪对OSAHS患者呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO2)的检测结果及对阻塞部位的诊断结果。结果睡眠监测阻塞定位仪监测结果显示,OSAHS患者AHI为5.11~78.69次/h,平均(45.46±9.85)次/h,LSaO2为0.43~0.90,平均(0.74±0.13);睡眠监测阻塞定位仪检出单纯上部阻塞9例,上下部联合阻塞71例,其中上下部联合阻塞中以上部阻塞为主36例、以下部阻塞为主35例,诊断准确度为96.25%。结论睡眠监测阻塞定位仪在诊断OSAHS阻塞部位方面的准确度较高,能够反映OSAHS患者的病情,为临床治疗提供可靠依据。     

睡眠呼吸紊乱对各睡眠时期血糖变化的影响

目的探讨不同睡眠时期之间血糖的差异及睡眠呼吸紊乱对血糖的影响。方法选取71例患者行多导睡眠图监测和动态血糖监测,根据多导睡眠图监测分为阻塞性睡眠呼吸暂停低通气综合征(OSAHS)组和非OSAHS组,计算各睡眠时期的平均血糖水平及AHI,采用t检验对比不同睡眠时期平均血糖水平的差异。结果 OSAHS组患者睡眠时期平均血糖水平高于非OSAHS组患者;非OSAHS组患者中REM期平均血糖水平低于NREM期;OASHS组患者中,REM期与NREM期平均血糖水平差异无统计学意义,REM-no-SDB期平均血糖水平低于NREM-no-SDB期,REM-SDB期平均血糖水平高于REM-no-SDB期,NREM-SDB期与NREM-no-SDB期平均血糖水平差异无统计学意义。结论非OSAHS患者REM期血糖有下降趋势,而睡眠呼吸紊乱导致这种血糖变化趋势不复存在。     

阻塞性睡眠呼吸暂停低通气综合征患者睡眠体位与呼吸紊乱指数关系分析

目的　了解阻塞性睡眠呼吸暂停低通气综合征 (OSAHS)患者睡眠体位与呼吸紊乱指数 (RDI)之间的关系。方法　回顾性分析经多导睡眠图 (PSG)确诊的 2 0 2例OSAHS患者的PSG结果 ,对RDI、睡眠体位及两者之间的关系进行归纳分析。结果　OSAHS患者随病情的加重 ,侧卧位睡眠时间与仰卧位睡眠时间比增加 ,该比值与RDI有显著相关性 ;侧卧位时RDI较仰卧位时低 ,有显著性差异。结论　OSAHS患者随病情加重 ,侧卧位睡眠时间与仰卧位睡眠时间比增加 ,可能是机体的一种自我调节机制。     

60岁以上男性睡眠呼吸暂停合并高血压患者临床研究

目的探讨60岁以上男性阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并高血压的发生率及临床特点。方法选取2011年1月~2013年1月在海军总医院诊治的305例60岁以上确诊OSAHS的男性患者,收集其临床资料及多导睡眠呼吸监测结果,根据是否合并高血压病分为非高血压OSAHS组和高血压OSAHS组。结果 60岁以上男性OSAHS患者中合并高血压的患者达60.66%。高血压OSAHS组的睡前及醒后血压均明显高于非高血压OSAHS组(P0.05),呼吸暂停低通气指数(AHI)也高于非高血压OSAHS组(P0.05),最低血氧饱和度低于非高血压OSAHS组(P0.05)。结论 60岁以上男性OSAHS患者中高血压的发生率较高,老年OSAHS患者合并高血压会加重OSAHS的病情程度和高血压的难治程度,对于OSAHS患者有血压增高的趋势应及时干预治疗。     

昆明市100例OSAHS患者睡眠习惯的调查与分析

通过对昆明市100例OSAHS患者睡眠习惯进行调查发现,该病患者普遍存在睡眠剥夺及睡眠不规律,由此推想不良的睡眠习惯可能是OSAHS发病的危险因素之一,并且可能与该病的发展有关。     

浅析实施全程护理对阻塞性睡眠呼吸暂停综合征患者正压通气治疗依从性的影响

目的:探究实施全程护理对阻塞性睡眠呼吸暂停综合征(Obstructive Slee Apnea Hypopnea,OSAHS)患者正压通气治疗依从性的影响.方法:选取2018年6～2019年7月行正压通气治疗的62例OSAHS患者为研究对象,根据收治的时间顺序将患者分为对照组(2018年6～12月收治)与研究组(201...     

手术对OSAHS患者P-selectin及t-PA影响

本文探讨重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血栓形成机制及手术对其影响。作者选择经多导睡眠监测(PSG)确诊的重度OSAHS患者54例为OSAHS组，并设正常对照组20例，检测两组血浆P-选择素，组织型纤溶酶原激活物(LPA)水平。并比较OSAHS组手术后半年上述指标的差异。结果显示，OSAHS患者存在血小板活化，凝血激活及纤溶活性下降，并与夜间低氧血症密切相关，手术可有效逆转上述改变。     

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.     

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.     

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.     

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.