304例矽肺患者的死因分析

目的探讨矽肺患者死因的特点。方法回顾性调查某钨矿304例矽肺患者的死因情况。结果矽肺全死因前3位为肺结核(54.3%)、肺心病(18.8%)和尘肺病(6.6%)。矽肺和肺结核病死率随着期别增加而升高(P<0.01),肺癌和其他癌症病死率随着期别增加而降低(P<0.05)。矽肺<60岁者病死率显著高于≥60岁者(P<0.01),肺心病和其他心血管病的病死率<60岁患者明显低于≥60岁者(P<0.01)。90年代矽肺病死率显著高于60、70年代(P<0.05),且肺结核病死率明显低于其他年代(P<0.01)。凿岩工矽肺、肺结核和肺心病的病死率明显高于其他工种(P<0.01)。结论矽肺主要死因为肺结核、肺心病和尘肺病。矽肺死因与矽肺期别、年龄、年代和工种有关。矽肺防治工作重点,应放在治疗和预防肺结核和肺心病。     

开滦煤矿地区煤矿工人尘肺合并肺结核发病情况调查分析

目的调查开滦煤矿地区煤矿工人尘肺(CWP)合并肺结核的发病情况及其影响因素,为CWP结核的防治提供依据。方法收集开滦煤矿地区煤矿工人最近3个月内临床确诊的CWP患者512例的健康档案,对患者进行问卷调查,受检人数为450例,受检率为87.9%,将所得资料数据进行统计学分析。结果①接受调查的450例病例中尘肺合并肺结核的煤工有40例,占8.9%。其中煤工尘肺合并结核率Ⅰ期为6.5%%,Ⅱ期11.5%,Ⅲ期为15.5%,煤工尘肺合并结核率随期别增加而显著增高,差异具有统计学意义(χ2=6.23,P<0.05);②煤工尘肺合并结核率随发病年龄升高而升高,差异具有统计学意义(χ2=21.71,P<0.05);③煤工尘肺合并结核率随工龄升高无明显改变,差异无统计学意义(χ2=1.98,P>0.05);④煤工尘肺结核患者死因构成比:肺结核大咯血占35.5%,肺心病占29.0%,肺癌占16.1%,肺部感染占12.9%,其他疾病为6.5%。结论 CWP易并发结核,CWP合并结核的发生与煤工的尘肺期别、煤工年龄有关,病死率较高,应注意加强防治。     

某有色金属集团公司矿山矽肺发病情况分析

目的 探讨金属矿山近十年来矽肺发病特点,为金属矿山开采的矽肺病防治提供参考依据.方法 对2004～2011年底健康监护资料中新诊断为矽肺壹期30例,分析其发病率、发病年龄、工种、接尘工龄、粉尘浓度关系进行比较分析.结果 凿岩工种粉尘浓度由2004年的2.3 mg/m3下降至2011年底的1.30 mg/m3;矽肺的发病率逐年下降,由2004年矽肺发病率0.54％降至至2011年的0.14％,差异有统计学意义(x2=8.76,P=0.003);不同年限诊断的矽肺患者发病年龄、平均接尘工龄经比较分析差异无统计学意义.但比全国尘肺流行病学调查的矽肺发病年龄及平均发病工龄(51.34岁,21.5年)缩短;凿岩工矽肺患者的发病年龄及接尘工龄均比其他工种短,差异有统计学意义(t=2.118,P=0.046;t=2.153,P=0.043).结论 该集团公司矿山开采工人矽肺发病率在不断下降;凿岩工种的发病率相对较高,其发病年龄、发病工龄相对缩短,应引起高度重视.建议在现有设备条件下凿岩工作人员应使用防尘效果更好的防尘口罩、工作年限3～5年后轮换制度、每年1～2次预防性肺灌洗治疗是预防矽肺病发生的重要措施.     

2009年某县煤工尘肺流行病学调查分析

目的:观察某县2009年煤工尘肺患病情况及其影响因素,为制定相应的预防措施、降低煤工尘肺的患病率提供理论依据.方法:对某县2009年煤工尘肺患病情况进行分析.结果:某县2009年煤工尘肺患病率3.89%,以Ⅰ期煤工尘肺为主.不同工种煤工尘肺患病率不同.掘进325.45%,采煤工3.53%,井下运输工1.19%,其他工种1.52%,各工种间煤工尘肺患病率差异均具有显著性(P<0.05).煤工尘肺患者的平均接尘工龄为10年,以接尘工龄5～15年患病率最高,患病率与接尘工龄呈正相关(R=0.81,P<0.05);接尘工人各工龄段.主要以Ⅰ期煤工尘肺为主.但随着接尘工龄的增加Ⅲ期煤工尘肺的患病率也在增加(P<0.05).结论:某县2009年煤工尘肺患病率较低,以Ⅰ期煤工尘肺为主;不同的工种之间煤工尘肺的患病率不同,其中以掘进作业工人患病率最高;接尘工龄越高,煤工尘肺患病率越高.病情也越严重.     

某煤矿煤工尘肺流行病学调查分析

目的了解某煤矿煤工尘肺(CWP)发病特征。方法对某煤矿96例CWP患者进行了流行病学调查。结果该某煤矿累计CWP患病比2.77%。发病年龄(49.94±6.66)岁。发病接尘工龄(27.76±5.48)年。以1991～1995年CWP发病最多(42.71%)。工种患病率最高为掘进工(4.66%),其次为混合工(3.66%)。CWPⅠ期晋升Ⅱ期和Ⅱ期晋升Ⅲ期平均时间分别为(8.82±6.68)年及(7.79±2.51)年。CWP并发结核率4.17%。病死率6.25%。结论CWP发病特征为患病比和病死率较高、并发结核率较低、发病接尘工龄较长、发病以掘进工和混合工多见、CWP晋期时间较长。应重视做好CWP预防控制工作。     

退伍工程兵晚发性矽肺调查分析

目的探讨退伍工程兵晚发性矽肺的发生、发展特征。方法对退伍工程兵350人进行矽肺流行病学调查。结果在350例退伍工程兵中,检卅晚发性矽肺33例（Ⅰ期13例,Ⅱ期8例,Ⅲ期12例）,检出率为9．43％。患者发病年龄平均（57．85±8．18）岁,接尘工龄平均（5．52±2．23）年,脱尘至确诊矽肺时间平均（33．91±8．28）年,胸片表现以圆形小阴影“q”影为主。矽肺并发肺结核率为30．30％。结论退伍工程兵晚发性矽肺特征为检出率高,发病年龄较大,接尘工龄短,脱尘时间长,并发症多。     

矽肺并发肺结核38例分析

矽肺是一种以肺组织纤维化为主的全身性疾病 ,呈慢性、不可逆性进展 ,肺结核是矽肺主要又严重的并发症 ,治疗效果差 ,是矽肺的主要死亡原因之一。近年我院收治 314例矽肺患者 ,其中并发肺结核 38例 ,现分析如下。1　临床资料1.1　一般资料 :本组 314例中 期矽肺 12 7例 , 期矽肺 116例 , 期矽肺 71例 ,均为男性 ;年龄 30～ 72岁 ,平均 5 1岁。工龄最短 1年 ,最长 2 3年 ,平均 12年。工种有风钻工、掘进工、采掘工、打石工、石材加工工等。并发肺结核 38例 ,并发率为 12 .1%。1.2　临床表现 :本组 38例矽肺结核患者均有不同程度的胸闷、胸痛…     

纤维支气管镜介入在矽肺合并肺结核治疗中的应用效果分析

目的探讨纤维支气管镜介入在矽肺合并肺结核治疗中应用效果。方法所选的48例矽肺Ⅰ期合并肺结核患者均为我院2008年10月至2013年10月期间收治患者,均为痰菌涂阳患者,上述患者随机分为观察组和对照组,两组均常规抗矽治疗。对照组给予常规抗结核治疗方案(2HRZE/10HRE)。观察组患者在上述治疗基础上,同时行纤维支气管镜介入治疗。评定两组治疗效果。结果观察组患者在强化期末的痰菌转阴21例,痰菌转阴率为87.5%;对照组在强化期末的痰菌转阴16例,痰菌转阴率为66.7%;观察组强化期末的痰菌转阴率高于对照组,差异有统计学意义(P<0.05);观察组患者肺完全复张16例,复张率为66.7%;对照组患者肺完全复张10例,复张率为41.7%;观察组患者肺完全复张率高于对照组,差异有统计学意义(P<0.05)。对照组病灶吸收15例,吸收率为62.5%;观察组病灶吸收22例,吸收率为91.7%;观察组病灶吸收率高于对照组,差异有统计学意义(P<0.05)。结论纤维支气管镜介入在矽肺合并肺结核治疗中应用效果显著,值得借鉴。     

344例矽肺患者死亡原因分析

目的回顾某钨矿自1957年8月13日至1981年12月31日共24年4个月内死亡(包括矽肺、矽肺结核)344例。方法344例死亡矽肺患者中首次诊断为矽肺工期276例;越期68期,工期矽肺中49年及其以前始触矽尘48例;1950至1957年始触228例。对工期矽肺的发病年龄、工龄、时间进行分析。结果①历年来矽肺患者死亡数由最少的1958年1例上升至最多的1976年28例;病死率最低是1957年1.16%,最高是1966年5.35%,由1957年2.06%上升至1981年3.35%。死亡数及病死率都在上升。②25年来矽肺、矽肺结核病程年限及死亡年龄平均由1957至1961年的35岁上升到1972至1981年52.8岁;总平均48.11岁。③本组矽肺结核死亡数340例(69.77%),矽肺104例(30.23%),前者>后者1倍多。④从死亡年度看,二者死亡病例在逐年增加,由1957年前的2例增加到1981年23例。死亡最多的是1976年28例,平均每月死亡2例多。结论本文科学反映了矽尘危害的严重和矽肺防治的任务艰巨。反映该矿1958年起综合防尘效果显著,同时表明对触尘工人防痨要高度重视。     

一石料加工厂工人矽肺发病情况调查分析

某石料加工厂属民营企业,加工进口石料,产品为首饰、装饰品,共有接尘工人43人（含切割、打磨、雕刻工）：接尘工龄4个月～8年,平均值为3．06年。经胸片检查,省尘肺病鉴定委员会鉴定,共初诊发现Ⅱ期矽肺1例（接尘工龄5．3年）,Ⅰ期尘肺2例（接尘工龄分别为5．5年,4．5年）,无尘肺（0＋）3例（接尘工龄2～4．5年）;现场监测：湿式作业为主,空气粉尘浓度10～16．8mg／m^3,游离二氧化硅含量76．8％～78．2％。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.