血脂正常患者颈动脉斑块与血脂、脂蛋白、载脂蛋白关系的研究

目的：研究血脂正常患者颈动脉斑块与血脂、脂蛋白、载脂蛋白的关系。方法：选择体检发现颈动脉粥样斑块者作为观察组,同期体检未见颈动脉斑块者作为对照组,并进一步分别根据斑块稳定性和血管狭窄程度将观察组分类,检测血液中甘油三酯（TG）、胆固醇（TC）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、载脂蛋白A-Ⅰ（ApoA-Ⅰ）、载脂蛋白B（ApoB）。结果：观察组TC、TG水平与对照组差异无统计学意义（P〉0.05）,LDL、ApoB水平明显高于对照组,HDL、ApoA-Ⅰ水平明显低于对照组;斑块性质越硬、宫腔越狭窄,LDL、ApoB水平越高,HDL、ApoA-Ⅰ水平越低。结论：脂蛋白、载脂蛋白可以更敏感的反应颈动脉斑块的形成情况,LDL、ApoB水平升高、HDL、ApoA-Ⅰ水平降低与颈动脉斑块的形成密切相关。     

胆囊胆固醇结石小鼠模型血脂、胆汁成分、肝脏SOD、MDA及Cav-1的表达特点

目的探讨胆囊胆固醇结石小鼠模型血脂、胆汁成分、肝脏超氧化物歧化酶(SOD)、丙二醛(MDA)、肝细胞小窝蛋白-1(Cav-1)的表达特点。方法选取24只8周龄的C57BL-6小鼠,采用随机数字表法分为结石组(高脂致石饲料喂养4周)、对照组(普通饲料喂养4周),各12只;对比两组小鼠血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、极低密度脂蛋白(VLDL)、胆汁中胆固醇、磷脂、胆汁酸、肝脏中SOD、MDA、Cav-1 mRNA及蛋白的表达差异。结果结石组小鼠的血清TG、TC、HDL、LDL水平均显著高于对照组,差异具有统计学意义(P0.05),结石组的血清VLDL水平显著低于对照组(P0.05);结石组小鼠胆汁中胆固醇、磷脂、胆汁酸的水平均显著高于对照组,差异具有统计学意义(P0.05);结石组小鼠肝脏中MDA水平高于对照组,差异具有统计学意义(P0.05),结石组小鼠肝脏中SOD水平低于对照组,差异具有统计学意义(P0.05);结石组小鼠肝脏中Cav-1 mRNA、Cav-1蛋白表达水平均高于对照组,差异具有统计学意义(P0.05)。结论胆囊胆固醇结石小鼠模型血脂(TG、TC、HDL、LDL)、胆汁(胆固醇、磷脂、胆汁酸)成分均升高,肝脏的抗氧化活性降低、Cav-1表达上调。     

血脂和载脂蛋白测定在尿毒症患者中的应用价值

目的 通过检测尿毒症患者血脂和载脂蛋白的水平，探讨尿毒症患者合并心血管疾病的危险因素和脂质异常的关系。方法 对40例尿毒症患者和26例慢性肾小球肾炎组进行血脂和载脂蛋白的检测，并与对照组进行比较。结果 尿毒症患者血清总胆固醇（TC）、甘油三脂（TG）无显著异常，而高密度脂蛋白胆固醇（HDL—C）、载脂蛋白A1（ApoA1）显著降低，低密度脂蛋白胆固醇（LDL—C）、载脂蛋白B（ApoB）显著升高。结论 在尿毒症患者血清中载脂蛋白异常提示并发心血管疾病的高危因素机率增加。     

慢性肝病患者血清载脂蛋白A检测的临床意义

目的探究血清载脂蛋白A含量与患者肝脏损伤程度的关系。方法281例肝病患者（观察组）。检测其血清中TG、HDL、LDL、Tch、APOA1和APOA2的含量;并与49例健康体检者（对照组）的检测结果进行比较分析。结果观察组血清APOA1、APOA2、HDL、LDL均显著低于对照组,差异有统计学意义（P〈0.05）;血清APOA1、APOA2与HDL、LDL、Tch正相关（P〈0.05）,与TG无相关性（P〉0.05）;经ROC曲线评价,APOA1的灵敏度及特异性分别为93.9%和83.6%,APOA2的灵敏度及特异性分别为93.9%和82.2%。结论血清载脂蛋白A可作为判断肝病患者肝脏受损程度及肝脏合成功能的有效指标,值得临床推广。     

脂蛋白胆固醇和载脂蛋白水平对乳腺癌发生及预后的预测价值

目的 探讨脂蛋白胆固醇和载脂蛋白水平对乳腺癌发病风险及预后的预测价值。方法 收集病例组418例首诊乳腺癌女性患者初次入院时和对照组418例正常女性健康体检时的高密度脂蛋白胆固醇（HDL - C）、低密度脂蛋白胆固醇（LDL - C）、载脂蛋白A1（ApoA1）和载脂蛋白B（ApoB）等资料,并对所有乳腺癌病例进行76个月的随访。采用logistic和cox回归模型分析脂蛋白胆固醇和载脂蛋白与乳腺癌风险和预后的相关性。结果 HDL - C（OR = 3.70, 95%CI:2.29～5.96）的增加与乳腺癌发生的风险相关,而LDL - C（OR = 0.47, 95%CI:0.39～0.58）则可降低风险。ROC曲线显示HDL - C与LDL - C联合时,AUC为0.702,对罹患乳腺癌的预测能力优于单一指标。50岁以下乳腺癌患者ApoA1水平与乳腺癌的预后有关,高ApoA1（≥1.32 g/L）可降低50岁以下乳腺癌患者的死亡风险。结论 脂蛋白胆固醇和载脂蛋白的水平变化在乳腺癌发生发展中具有重要作用,与乳腺癌的发病风险和预后有关。     

妊娠高血压综合征与血脂、载脂蛋白及脂蛋白（a）的关系

目的探讨妊娠高血压综合征（简称妊高征）患者血脂代谢水平的变化及其，临床意义。方法测定正常孕妇及妊高征患者的血清甘油三脂（TG）、总胆固醇（TC）、载脂蛋白AI（ApoAI）、载脂蛋白B（ApoB）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）及脂蛋白（a）水平。结果妊高征组血清TG（P〈0．01）、ApoB（P〈0．01）、LDL—c（P〈0．05）及LP（a）（P〈0．05）较正常孕妇显著升高，ApoAI、HDL—C则显著降低（P〈0．05），TC在两组间差别无显著性意义（P〉0．05）。在轻、中、重妊高征患者之间，ApoAI（P〈0．05）及HDL—C（P〈0．01）依次降低，组间比较有显著性意义，LDL—C（P〈0．01）及LP（a）（P〈0．01）依次升高，组间有极显著性差异。TG、TC和ApoB组间比较，差别无显著性意义。结论血脂代谢异常可能在妊娠高血压疾病的发病中起一定作用。     

女性高血压患者绝经前后脂类代谢指标测定结果分析

目的 探讨女性高血压患者绝经前后的血脂、脂蛋白及载脂蛋白的代谢情况。方法 早晨空腹静脉血分离血清,测定TC、TG、HDL－c,LDL-c,Apo-A1,Apo-B值。结果 高血压组TC,TG,LDL-c,Apo-B,TC/HDL-c显著高于对照组,而HDL－c,Apo-A1则明显低于对照组。TC,TG,LDL－c,Apo-B,TC/HDL-c高血压绝经后组显著高于绝经前组。结论 女性高血压患者绝经后前后存在血脂代谢改变,绝经后妇女血脂增高与内源性雌激素水平下降有关,血脂代谢紊乱,增加冠心病的危险性,应及早加强健康教育和其它防治措施。     

2型糖尿病人群脂代谢紊乱与血清尿酸水平变化的相关性分析

目的:探讨2型糖尿病(T2DM)人群脂代谢紊乱与血清尿酸(SUA)水平变化的相关性.方法:88例健康体检者为对照组,110例经临床确诊T2DM患者为观察组,采用全自动生化分析仪检测血清甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL—C)、高密度脂蛋白胆固醇(HDL— C)、血清载脂蛋白Al (ApoAl)、载脂蛋白B(ApoB)、ApoAl/ApoB、HDL—C/LDL—C、HDL— C/TC及血清SUA浓度,并进行统计学分析.结果:与对照组比较,观察组人群TG、TC、LDL—C、ApoB、SUA水平明显升高,HDL—C、ApoAl、ApoAl/ApoB、HDL—C/LDL—C、HDL—C/TC浓度明显降低;差异均有统计学意义(P＜0.01或P＜0.05);经多元回归分析:T2DM人群血清TG、TC、LDL—C、ApoB与SUA水平呈正相关;HDL—C、ApoAl与SUA水平呈负相关.结论:T2DM人群脂质代谢发生紊乱,血清TG、TC、LDL—C、ApoB、SUA水平明显升高,HDL—C、ApoAl、ApoAl/ApoB、HDL—C/LDL—C、HDL—C/TC浓度明显降低;其脂代谢紊乱及SUA增高是造成动脉粥样硬化(AS)危险因素.     

黏蛋白、免疫球蛋白及电解质在胆固醇结石形成中的相关性研究

目的 通过对胆汁中分泌型黏蛋白、免疫球蛋白和游离电解质浓度的分析，探讨黏蛋白、免疫球蛋白、游离钠离子和游离钙离子在胆囊胆固醇结石形成中的作用机制。方法 分别测定27例胆囊胆固醇结石患者（胆囊结石组）和18例胆囊胆固醇息肉患者（对照组）胆汁中黏蛋白、免疫球蛋白（IgA、IgM、IgG）和游离钠离子与游离钙离子浓度。结果 胆囊结石组黏蛋白浓度、IgG浓度较对照组明显增高，P〈0．05；胆囊结石组游离钠离子浓度明显低于对照组，P〈0．05。胆囊结石组游离钙离子浓度明显高于对照组，P〈0．05；黏蛋白浓度与游离钙离子浓度、IgG浓度呈正相关，游离钠离子浓度与黏蛋白浓度呈明显负相关。结论胆固醇结石形成与细菌感染产生的感染相关蛋白密切相关，其中分泌型黏蛋白、免疫球蛋白IgG等感染相关蛋白在胆石形成中通过与某些离子或其他分子结合形成不溶性物质而起重要作用。低张钠离子能加强钙离子与黏蛋白及免疫球蛋白的结合形成难溶性物质，促使结石形成。     

血管紧张素转化酶抑制剂联合他汀类降脂药治疗糖尿病肾病的临床疗效观察

目的观察血管紧张素转换酶抑制剂联合他汀类降脂药治疗糖尿病肾病的临床疗效。方法糖尿病肾病Ⅳ期患者84例,随机分为对照组（福辛普利钠治疗）和治疗组（辛伐他汀十福辛普利钠治疗）。治疗12周后测定24h尿蛋白定量（UAE）、血肌酐（Cr）、血尿素氮（BUN）、血尿酸（uA）、空腹血糖（FBG）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL）、低密度脂蛋白胆固醇（LDL）、血清胱抑素（Cystatin C）。结果①治疗组及对照组患者治疗前组间比较：两组患者上述指标比较差异无统计学意义。②治疗组与对照组治疗前后比较：两组患者24h—UAE、CystatinC治疗后均较治疗前降低（P〈0．05）;治疗组患者TG、TC、LDL较治疗前减低,HDL较治疗前升高;治疗组及对照组患者治疗前后FBG、Cr、BUN、UA均无明显变化。③治疗组及对照组治疗后组间比较：治疗组患者24h—UAE、CystatinC、TG、TC、LDL均较对照组低,HDL较对照组高;而治疗后两组患者FBG、Cr、BUN、UA均无明显变化。结论他汀类降脂药联合血管紧张素转换酶抑制剂可通过有效改善早期糖尿病肾病而达到延缓肾功能衰竭进展的目的。     

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.