鱼油脂肪乳对重症脑卒中病人免疫功能的影响

目的:探讨鱼油脂肪乳对重症脑卒中病人康复过程中免疫功能的影响。方法:将86例符合入组条件的重症脑卒中病人随机分为观察组(添加鱼油脂肪乳治疗,n=46)和对照组(常规营养治疗,n=40),其他治疗两组无差异。通过检测两组治疗前和治疗后2周免疫球蛋白(Ig G、Ig A、Ig M)、血总淋巴细胞计数(TLC)和T细胞亚群(CD3+、CD3+CD4+、CD3+CD8+、CD4+/CD8+)水平,并对两种治疗方法的结果进行比较。结果:治疗前两组病人各指标无显著性差异。2周后,观察组病人Ig G、Ig A、Ig M和TLC高于对照组,其中Ig G、Ig M和TLC明显升高(P0.05)。T细胞亚群水平中CD3+、CD3+CD4+、CD4+/CD8+水平明显高于对照组(P0.05),而抑制T细胞(CD3+CD8+)的计数无明显变化(P0.05)。结论:鱼油脂肪乳在重症脑卒中病人的康复过程中起着调节和改善免疫功能的作用。     

支原体肺炎儿童的免疫功能变化分析

目的探讨支原体肺炎儿童的免疫功能变化情况,为临床儿童支原体肺炎的诊治提供依据。方法选择2013年1月-2014年12月在浙江绿城心血管病医院儿科被诊断为支原体肺炎的儿童55例作为实验组,同期儿童作为对照组,实验组根据病情分为重症型和非重症型。分析支原体肺炎患儿和对照组儿童的CD4+、CD8+和CD4+/CD8+检测情况、血清Ig G、Ig A和Ig M监测情况以及血清IL-10、IL-8、IL-2检测情况。结果支原体肺炎患儿急性期和恢复期的CD4+和CD4+/CD8+均明显低于对照组(P0.05),急性期的CD4+和CD4+/CD8+均明显低于恢复期(P0.05);急性期和恢复期的CD8+明显高于对照组(P0.05),急性期的CD8+明显高于恢复期(P0.05)。支原体肺炎患儿重症型的CD4+和CD4+/CD8+明显低于非重症型(P0.05),支原体肺炎患儿重症型的CD8+明显高于非重症型(P0.05)。支原体肺炎患儿急性期的Ig A和Ig M均明显高于对照组(P0.05),恢复期的Ig G、Ig A和Ig M均明显高于急性期和对照组(P0.05)。支原体肺炎患儿重症型的Ig G、Ig A和Ig M明显高于非重症型(P0.05)。支原体肺炎患儿急性期的IL-10和IL-2均明显低于恢复期和对照组(P0.05),急性期的IL-8明显高于恢复期和对照组(P0.05);恢复期的IL-2均明显低于对照组(P0.05),恢复期的IL-8明显高于对照组(P0.05)。支原体肺炎患儿重症型的IL-10和IL-2明显低于非重症型(P0.05),支原体肺炎患儿重症型的IL-8明显高于非重症型(P0.05)。结论在支原体肺炎患儿中存在细胞免疫、体液免疫和细胞因子等免疫功能的异常,免疫功能在支原体肺炎中发挥重要作用。     

阿奇霉素联合孟鲁司特钠对支原体肺炎患儿炎症感染指标、趋化因子及免疫功能的影响

目的探讨阿奇霉素联合孟鲁司特钠对支原体肺炎患儿炎症感染指标、趋化因子及免疫功能的影响。方法选取2018年1月-12月本院收治的110例支原体肺炎患儿作为研究对象,随机分为观察组55例和对照组55例。对照组首先给予注射用乳糖酸阿奇霉素,监测患儿体温恢复正常后改用阿奇霉素干混悬剂,观察组在对照组的基础上联合应用孟鲁司特钠咀嚼片。检测并比较2组患儿CRP、PCT、IL-6、TNF-α、MCP-4、Cys LTs、CD4~+、CD8~+、CD4~+/CD8~+及Ig A、Ig G、Ig M。结果治疗后,2组患者的CRP、PCT、IL-6、TNF-α、MCP-4、Cys LTs水平均比治疗前降低,且观察组的各指标水平均低于对照组,差异均有统计学意义(P0.05)。治疗后,2组患者的CD4~+、CD4~+/CD8~+均比治疗前升高,且观察组的CD4~+、CD4~+/CD8~+高于对照组,差异均有统计学意义(P0.05);治疗后,2组患者的CD8~+、Ig A、Ig G、Ig M均比治疗前降低,且观察组的CD8~+、Ig A、Ig G、Ig M均低于对照组,差异均有统计学意义(P0.05)。结论阿奇霉素联合孟鲁司特钠能够有效改善支原体肺炎患儿的炎症因子、趋化因子及免疫功能。     

同种异体肾移植病人早期肠内免疫营养的临床疗效研究

目的 :研究对肾移植病人术后早期进行肠内免疫营养的有效性和安全性。方法 :将46例肾移植术后病人按营养方式随机分为肠内免疫营养组(实验组)和肠内普通营养组(对照组),分别进行免疫营养和普通营养,分别监测病人术前、术后第1天、第7天、第28天的免疫学指标:Ig G、Ig M、Ig A、CD3+淋巴细胞、CD4+淋巴细胞、CD8+淋巴细胞、CD4+/CD8+,同时监测相同时间点的营养学指标:白蛋白、前白蛋白、血红蛋白、胆固醇,比较两组的差异性。结果 :术后第1天,两组的免疫学指标无显著差异(P0.05);术后第7天,实验组的Ig M和Ig A均显著高于对照组(P0.05),两组的Ig G无明显差异(P0.05);实验组CD3+淋巴细胞较对照组有显著升高(P0.05),CD4+淋巴细胞、CD4+/CD8+两组间无显著性差异(P0.05);术后第28天,实验组Ig G、Ig M、Ig A、CD3+淋巴细胞、CD4+淋巴细胞、CD4+/CD 8+均显著高于对照组(P0.05)。两组的营养学指标,各个时间点均无显著性差异,但两组第28天的营养学指标除胆固醇外,均优于术后第1天,有显著性差异(P0.05)。术后30 d内,两组均未发生排异反应。结论 :肾移植病人术后早期应用肠内免疫营养在促进病人免疫功能恢复方面明显优于普通肠内营养,且不会增加排异反应发生。     

早期肠内营养对混合型顽固性便秘病人金陵术后免疫功能和临床结局的影响

目的:探讨早期肠内营养(EEN)对混合型顽固性便秘病人金陵术后免疫功能和临床结局的影响。方法:选取行金陵术(结肠次全切除联合升结肠-直肠侧侧吻合术)的混合型顽固性便秘病人,随机分为术后EEN组和术后传统治疗方案的非EEN组(N-EEN),每组各20例。两组病人分别于术前1 d和术后第1、3、7天检测免疫学指标:CD3+、CD4+、CD8+、CD4+/CD8+比值、Ig A、Ig G、Ig M;营养学指标:血清总蛋白(TP)、清蛋白(ALB)、前清蛋白(PA)、转铁蛋白(TF)和血电解质:钠(Na+)、钾(K+)、氯(Cl-)等水平。并记录病人术后首次排气时间、术后住院时间、住院总费用、术后不适症状和并发症等。结果:EEN组病人术后第3、7天,CD4+、CD8+和CD4+/CD8+均明显高于N-EEN组,差异有显著性统计学意义(P0.05)。术后第7天,ALB和PA明显高于N-EEN组,差异有显著性统计学意义(P0.05)。两组病人电解质水平无显著性差异(P0.05)。与N-EEN组比,EEN组首次排气时间明显缩短,术后住院天数明显缩短,住院费用明显减少,术后不适症状总体发生率明显减低,差异均有显著性统计学意义(P0.05,P0.01)。结论:金陵术后病人给予EEN治疗可改善病人的免疫功能和营养状态,并促进胃肠道功能的早期恢复。     

乳腺癌患者的免疫功能分析

目的分析乳腺癌患者外周血T淋巴细胞亚群、免疫球蛋白的变化,探讨乳腺癌患者的免疫功能状况。方法用流式细胞仪测定65例乳腺癌患者、35例同期乳腺良性病患者和30例健康人组外周血T淋巴细胞亚群,采用免疫比浊法测定血清Ig A、Ig G、Ig M含量。结果乳腺癌患者全血CD8+明显高于健康对照组(P0.05),而血CD3+、CD4+及CD4+/CD8+比值则显著低于健康对照组(P0.05)。Ig G、Ig M水平均高于对照组(P0.05),而Ig A水平两组差异无统计学意义(P0.05)。外周血T淋巴细胞亚群和免疫球蛋白的改变与癌症组病理分期有关,分期越晚,CD3+、CD4+及CD4+/CD8+比值越低,CD8+、Ig G、Ig M水平越高,Ⅱ期与Ⅲ期、Ⅳ期之间差异有统计学意义(P0.05)。结论乳腺癌患者细胞免疫功能降低,体液免疫功能增强。外周血T细胞亚群和免疫球蛋白的检测对判断乳腺癌患者的病情、预后以及机体的免疫功能状态有一定意义。     

儿童肺炎支原体感染中免疫功能及抗炎、促炎因子的检测分析

目的探讨儿童肺炎支原体感染中免疫功能及抗炎因子、促炎因子的水平变化。方法选取120例支原体肺炎患儿,根据病程分为急性期组与恢复期组,另选取健康儿童60例作为对照组,检测各组对象的免疫功能及抗炎、促炎因子指标。结果急性期组Ig A、CD3+、CD4+、CD4+/CD8+水平低于恢复期组与对照组,恢复期组低于对照组;恢复期组Ig G水平高于急性期组与对照组;急性期组Ig M、C3、C4水平高于恢复期组与对照组。急性期组CD8+高于恢复期组与对照组,恢复期组高于对照组。急性期组TNF-α、IL-8、IL-13高于恢复期组与对照组,恢复期组高于对照组;急性期组IL-10低于恢复期组与对照组,恢复期组低于对照组,以上差异均有统计学意义(P0.05)。结论儿童肺炎支原体感染后存在免疫功能、抗炎因子及促炎因子异常。     

复方苦参注射液对浅表性膀胱癌患者炎症因子及免疫功能的影响

目的 探究复方苦参注射液对浅表性膀胱癌患者炎症因子及免疫功能的影响。方法 将在本院就诊的浅表性膀胱癌患者随机分为对照组(吡柔比星术后即刻膀胱灌注)和观察组(复方苦参注射液联合吡柔比星术后即刻膀胱灌注),各60例,分析2组患者临床效果。结果 治疗后,观察组肾功能指标(BUN、Cre)显著低于对照组(P 0. 05);观察组CD3+、CD4+和CD4+/CD8+均显著高于对照组(P 0. 05),CD8+显著低于对照组(P 0. 05);观察组Ig G、Ig A、Ig M均显著高于对照组(P 0. 05);观察组IL-6、CRP、TNF-α显著低于对照组(P 0. 05),IFN-γ显著高于对照组(P 0. 05)。结论 对浅表性膀胱癌术后患者实施中西联合治疗,能够有效改善患者肾功能,提升免疫功能,疗效较好。     

L-精氨酸对围手术期胃癌病人炎性反应和免疫功能的影响

目的:研究L-精氨酸(L-Arg)对围手术期胃癌病人炎性反应和免疫功能的影响. 方法:将围手术期胃癌病人随机分为研究组和对照组,研究组(n=33)行营养支持加L-Arg治疗,L-Arg 0.4g/(kg·d)通过静脉给予;对照组(n=30)行营养支持治疗加等量的等渗盐水.能量供给为125.4 kJ/(kg·d),氮量为0.2g/(kg·d),治疗10d.观察胃癌病人术前3d、术后第3和第7天血清C-反应蛋白(CRP)、白细胞介素-2(IL-2)、IL-6、IL-10、肿瘤坏死因子-α(TNF-α)、T淋巴细胞亚群CD4+、CD8+水平和CD4 +/CD8+比值的变化. 结果:术后第7天,研究组病人血IL-2、TNF-α水平和CD4+/CD8+比值均明显高于对照组和术前3d,而血液CRP和IL-10水平明显低于对照组和术前3d.术后第7天,CRP水平明显低于术后第3天. 结论:L-Arg可影响胃癌病人的炎性反应水平,下调具有促进肿瘤生长能力的炎性因子水平,上调胃癌病人细胞免疫应答.     

哮喘患儿血清T细胞亚群、细胞因子和免疫球蛋白的动态变化及意义

目的 探讨哮喘患儿血清T细胞亚群、细胞因子和免疫球蛋白的动态变化及临床意义,为哮喘的发病机制及抗变态反应治疗提供理论依据.方法 对40例哮喘患儿(哮喘发作组和哮喘缓解组)及25例健康体检儿童(对照组)应用流式细胞仪测定CD3+、CD4+、CD8+T细胞,应用ELISA法测定TNF-α、白细胞介素(IL)-6、IL-8和IgE,应用免疫比浊法测定Igc、IgA和IgM.结果 哮喘发作组CD3+、CD4+T细胞及CD4+/CD8+.显著高于对照组(P＜0.01),CD4+T细胞及CD4+/CD8+明显高于哮喘缓解组(P＜0.05);哮喘缓解组CD4+T细胞及CD4+/CD8+明显高于对照组(P＜0.05).哮喘发作组IL-6、IL-8及TNF-α.均明显高于哮喘缓解组和对照组(P＜0.05或＜0.01).哮喘缓解组TNF-α与对照组比较差异有统计学意义(P＜0.05).哮喘发作组I-E及IgG水平显著高于哮喘缓解组和对照组(P＜0.01或＜0.05),IgA水平显著低于对照组(P＜0.01);哮喘缓解组IgE水平仍显著高于对照组(P＜0.01).结论 哮喘患儿发作期和缓解期均存在免疫失衡,提示哮喘患儿应长期抗变态反应治疗.     

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.