同型半胱氨酸C-反应蛋白及纤维蛋白原与冠状动脉粥样硬化的关系分析

目的:分析同型半胱氨酸,C-反应蛋白及纤维蛋白原与冠状动脉粥样硬化的关系。方法:选取2011年1月~2013年8月收治的27例冠状动脉粥样硬化患者为实验组,选择同时期27例身体健康者为对照组,测定比较两组血清同型半胱氨酸(HCY)、C-反应蛋白(CRP)及纤维蛋白原(Fib)含量。结果:实验组HCY、CRP、Fib分别为14.52±6.24μmol/L、6.35±2.85 mg/L、334.21±53.15 mg/dl,均高于对照组,差异存在统计意义(P0.05)。结论:冠状动脉粥样硬化患者血清HCY、CRP、Fib水平高于身体健康者,可将HCY、CRP、Fib作为冠状动脉粥样硬化的临床监测指标。     

妊娠期高血压疾病患者血浆总同型半胱氨酸与维生素B12水平的关系

目的:测定妊娠期高血压疾病患者血浆总同型半胱氨酸(t HCY)和维生素B12水平,以探讨该疾病患者血浆中2者之间的关系。方法:血浆t HCY水平测定采用荧光偏振免疫分析法,血清中维生素B12水平测定采用微粒子酶联免疫分析法。结果:232例妊娠期高血压疾病患者血浆t HCY水平和血清维生素B12水平为(12.46±3.98)μmol/L和(352.35±97.67)pmol/L,232例同期正常妊娠妇女血浆t HCY水平、血清中叶酸和维生素B12水平分别为(6.71±2.43)μmol/L和(438.63±129.45)pmol/L,2组比较均具有统计学差异(P<0.01)。97例重度妊娠期高血压疾病患者血浆中t HCY、血清叶酸及维生素B12水平分别为(15.07±5.22)μmol/L和(315.29±84.17)pmol/L,135例轻度妊娠期高血压疾病患者血浆中t HCY水平、血清中叶酸及维生素B12水平分别为(10.28±3.73)μmol/L和(390.23±114.34)pmol/L,2组比较均具有统计学差异(P<0.01)。相关分析发现,2组血浆t HCY水平与维生素B12水平均为负相关性。结论:妊娠期高血压疾病患者血浆中t HCY浓度呈显著性上升,维生素B12浓度呈显著性下降。伴随病情加重妊娠期高血压疾病患者血浆t HCY浓度呈上升趋势,血清叶酸、维生素B12浓度呈下降趋势。     

神经元特异性烯醇化酶和C反应蛋白对急性脑梗死病情及预后的评价

目的 探讨急性脑梗死患者血清神经元特异性烯醇化酶(NSE)和C反应蛋白(CRP)对其病情和预后的评估价值.方法 测定92例急性脑梗死患者(观察组)和45例健康对照者(对照组)血清NSE和CRP水平,并分析观察组NSE和CRP水平与神经功能损害程度及梗死部位的关系.结果 观察组血清NSE和CRP水平明显高于对照组(P<0.01).观察组采用美国国立卫生院卒中量表(NIHSS)评分,重型者NSE和CRP水平[(35.63±7.12)μg/L、(13.82±3.57)mg/L]显著高于轻、中型者[分别为(17.24±5.32)μg/L、(5.61±2.35)mg/L和(26.08±5.91)μg/L、(9.07±2.14)mg/L](P<0.01).不同梗死部位患者血清NSE、CRP水平比较差异无统计学意义.结论 NSE和CRP是反映脑内神经元损伤或坏死的客观指标,可作为脑梗死早期判断病情和预后的指标.     

慢性肝炎患者同型半胱氨酸检测定的临床观察

目的分析慢性肝炎血清中同型半胱氨酸(HCY)的临床价值。方法利用荧光偏振法和全自动生化仪分别测定52例健康者和67例慢性肝炎患者的HCY、肝功能指标血清水平。结果健康对照组和慢性肝炎患者组的HCY分别为(6.45±4.54)μmol/L和(15.93±4.76)μmol/L,二者差异有统计学意义(P<0.01)。HCY阳性率与谷丙转氨酶(ALT)、谷草转氨酶(AST)、L-r-谷氨酰基转移酶(GGT)之间差异无统计学意义(P>0.05),与前白蛋白(PA)、碱性磷酸酶(ALP)、总胆红素(TB)、白蛋白(ALB)、白球比(A/G)差异有统计学意义(P<0.05,P<0.01)。结论慢性肝炎患者血清中HCY浓度明显升高,检测HCY对慢性肝炎患者诊断有临床价值。     

联合检测降钙素原和C-反应蛋白在感染性疾病诊断中的应用

目的:评价血降钙素原(PCT)与C-反应蛋白(CRP)在诊断及治疗感染性疾病的应用价值。方法:检测我院50例细菌感染患者血清PCT、CRP的含量,将50例细菌感染患者分为重症感染组和局部感染组,并与病毒感染组进行分析比较。结果:重症细菌感染组血清PCT、CRP浓度分别为14.5±3.5μg/L和89.3±12.8mg/L;局部细菌感染组血清PCT、CRP中位数分别为2.1±1.4μg/L和48.3±13.5mg/L;重症感染组和局部感染组血清PCT、CRP浓度均明显升高,与病毒感染组比较,差异有统计学意义(P<0.01)。结论:PCT和CRP测定均可用于感染性疾病的辅助诊断,但CRP的特异性较差,动态监测PCT水平有助于临床判断病情的转归和恶化。     

2型糖尿病合并冠心病患者循环内皮细胞与CRP的关系及意义

目的:探讨2型糖尿病合并冠心病患者血清CRP与循环内皮细胞水平及两者的相关性。方法:以26例2型糖尿病合并冠心病患者为研究对象,以43例不合并糖尿病的冠心病患者和28例健康体检者为对照组,测定外周血循环内皮细胞数量及血清CRP水平。结果:2型糖尿病合并冠心病患者组CEC数量(8.3±2.4/0.9μl)和CRP水平(6.41±2.12 mg/L)明显高于冠心病组(7.2±3.1/0.9μl、4.63±1.88 mg/L)(P<0.01)和健康对照组(3.6±2.0/0.9μl、2.31±1.26 mg/L)(P<0.01)。2型糖尿病合并冠心病患者CEC数量和CRP水平呈正相关(r=0.682,P<0.01)。结论:2型糖尿病合并冠心病患者的血管内皮损伤可能与CEC及CRP有关,二者的协同作用可能在其微血管病变的发病机制中发挥重要作用。     

阿尔茨海默病与维生素B12及同型半胱氨酸的相关性

目的研究阿尔茨海默病(AD)与血清维生素B12、叶酸及血浆同型半胱氨酸水平之间的关系。方法采用简易精神状态量表(MMSE)对30例AD患者和30例同龄健康人进行评分,并用放射免疫分析法测定血清维生素B12及叶酸水平;用荧光偏振免疫法测定血浆同型半胱氨酸。结果AD组维生素B12水平为(217.3±134.2)pmol/L明显低于对照组(313.6±184.7)pmol/L,两者差异有极显著性(P<0.001)。AD组血浆同型半胱氨酸为(18.9±6.8)μmol/L高于对照组(9.4±4.1)μmol/L,差异有极显著性(P<0.001)。AD组叶酸水平为(29.2±12.7)nmol/L低于对照组(37.2±21.2)nmol/L,但差异无显著性(P>0.05)。AD患者血清维生素B12水平与MMSE得分呈正相关(r=0.87,P<0.01)。结论AD患者血浆维生素B12水平与智能障碍及其程度有关。     

开颅术后颅内感染患者血清与脑脊液相关指标测定的临床意义

目的检测开颅术后颅内感染患者血清和脑脊液中神经元特异性烯醇化酶(NSE)、C-反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子-a(TNF-a)及一氧化氮(NO)含量,为颅内感染诊断提供新的思路。方法将2010年9月-2012年9月在医院行开颅术后发生颅内感染患者42例作为病例组、开颅术后未发生颅内感染患者32例作为对照组,分别检测两组患者血清和脑脊液中CRP及PCT含量,测定血清和脑脊液中NSE、TNF-a及NO水平,采用SPSS13.0软件进行统计分析,比较各项指标在两组患者之间的差异。结果病例组与对照组患者血清中NSE、CRP、PCT、TNF-a及NO含量均显著增高,其中NSE分别为(12.43±5.21)μg/ml与(2.43±1.29)μg/ml;CRP分别为(42.63±5.21)mg/L与(3.41±2.07)mg/L;PCT分别为(5.21±5.36)μg/L与(0.19±0.04)μg/L,两组患者脑脊液各项指标也明显升高,差异均有统计学意义(P<0.05)。结论联合测定NSE、CRP、PCT、TNF-a及NO含量的变化,有助于开颅术后颅内感染的诊断及脑损害严重程度的判断。     

支原体感染盆腔炎患者血清高迁移率族蛋白B1的临床价值

目的探讨支原体感染盆腔炎患者血清高迁移率族蛋白B1(High mobility histone B1,HMGB1)水平及其临床价值。方法选择安吉县人民医院妇产科2016年1月-2017年12月收治的支原体感染盆腔炎患者110例作为盆腔炎组,同期健康体检女性110名作为对照组,盆腔炎组根据感染严重程度分为轻度感染29例,中度感染48例,重度感染33例。测定治疗前后血清HMGB1和C-反应蛋白(CRP)水平。结果盆腔炎组患者治疗前血清HMGB1和CRP分别为(14.36±1.64)μg/L和(12.14±1.03)mg/L高于对照组(P<0.05)。治疗前中度感染患者和重度感染患者血清HMGB1、CRP分别为(14.63±1.57)μg/L、(11.54±1.21)mg/L和(19.54±1.71)μg/L、(16.37±1.12)mg/L高于轻度感染组(P<0.05),重度感染组血清HMGB1和CRP水平高于中度感染组(P<0.05)。盆腔炎患者治疗后血清HMGB1和CRP低于治疗前(P<0.05)。支原体感染盆腔炎患者血清HMGB1和CRP水平呈正相关(r=0.594,P<0.001)。血清HMGB1诊断支原体感染盆腔炎的ROC曲线下面积为0.817,灵敏度为89.54%,特异度为82.13%;血清CRP诊断支原体感染盆腔炎的ROC曲线下面积为0.778,灵敏度为92.14%,特异度为86.25%。结论支原体感染盆腔炎患者血清HMGB1升高,HMGB1水平在支原体感染盆腔炎的诊断、治疗效果及病情严重程度评估中具有重要意义。     

甲状腺癌病理分化类型与EB病毒感染及感染标志物水平的关联性分析

目的分析甲状腺癌病理分化类型与EB病毒感染及感染标志物水平的关联性,阐明感染性疾病在恶性肿瘤发生和发展中的作用机制。方法选取2017年2月-2018年2月80例医院收治的甲状腺癌患者作为研究组,选取同期80例甲状腺腺瘤患者作为对照组,对两组患者的EB病毒感染率、血清白介素-6(IL-6)、C-反应蛋白(CRP)及外周血白细胞计数(WBC)水平进行观察和比较。结果研究组患者EB病毒感染率及血清IL-6、CRP和WBC水平分别为46.25%、(0.56±0.18)μg/L、(5.26±0.71)mg/L、(7.65±2.82)×109/L,均高于对照组(P<0.05)。乳头状癌、滤泡状癌患者血清IL-6、CRP和WBC水平分别为(0.81±0.23)μg/L、(7.81±0.96)mg/L、(9.25±3.16)×109/L;(0.82±0.22)μg/L、(7.76±0.98)mg/L、(9.56±4.63)×109/L,高于髓样癌、未分化癌患者(P<0.05)。合并EB病毒感染甲状腺癌患者血清IL-6、CRP和WBC水平分别为(0.95±0.21)μg/L、(9.24±1.56)mg/L、(10.06±4.18)×109/L,均高于未合并EB感染患者(P<0.05)。结论甲状腺癌患者的EB病毒感染率和感染标志物水平均高于良性甲状腺肿瘤患者,EB病毒感染可能与甲状腺癌患者的炎症反应具有关联性,某些病理分化类型甲状腺癌患者的EB病毒感染率较高,但尚未观察到与其他病毒类型存在显著的差异,还需要进一步的研究予以证实和讨论。     

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.