库普弗细胞异常在大鼠非酒精性脂肪肝病发生发展中的作用

目的探讨库普弗细胞（KCs）异常在高脂饲养大鼠非酒精性脂肪肝病（NAFLD）发病中的作用。方法24只雄性SD大鼠随机分为模型组和正常组各12只,分别予高脂饲料和普通饲料饲养12周。然后测定体重、肝重、空腹血清丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、甘油三酯（TG）、总胆固醇（TC）水平;HE染色观察肝组织切片病理学改变,并观察KCs形态变化及分泌肿瘤坏死因子-α（TNF-α）、一氧化氮（NO）的水平。结果模型组大鼠体重、肝指数、血清ALT、AST、TG、TC水平、肝脏KCs产生的TNF-α及NO水平均高于正常组（P〈0．05）;与正常组相比,模型组肝小叶内KCs发生形态及功能改变,该变化与肝组织病理学改变呈正相关（r=0．702,0．810,0．587,0．765,P均〈0．05）。结论高脂饮食大鼠肝脏库普弗细胞呈现形态及功能异常,该异常可能与NAFLD脂肪变性及炎症坏死的发生有关。     

活血化瘀法对慢性盆腔炎雌性大鼠血清前炎症细胞因子TNF-α、IL-1β、IL-8水平的影响

目的：探讨活血化瘀法对慢性盆腔炎雌性大鼠血清前炎症细胞因子肿瘤坏死因子-α（TNF-α）、白介素-1β（IL-1β）、白介素-8（IL-8）水平的影响。方法：采用混合细菌加机械损伤方法,建立慢性盆腔炎大鼠模型,将60只造模后大鼠随机分为慢性盆腔炎造模组（模型组）、桂枝茯苓胶囊治疗高、中、低剂量组（高、中、低剂量实验组）、少腹逐瘀胶囊治疗组（对照组）,各组均为12只,另选假手术慢性盆腔炎造模大鼠（假手术组）、正常饲养未干预大鼠（正常组）各12只。运用酶联免疫吸附测定法,分别检测各组大鼠血清TNF-α、IL-1β、IL-8的水平。结果：（1）血清TNF-α、IL-8水平,模型组较正常组、假手术组明显升高（P〈0.01）;中剂量实验组较模型组明显降低（P〈0.01）,且接近正常组水平（P〉0.05）;中剂量实验组较对照组降低,差异有统计学意义（P〈0.05）,高、低剂量实验组均较对照组升高（P〉0.05或P〈0.01）;中剂量实验组较高、低剂量实验组明显降低（P〈0.01）。（2）血清IL-1β水平,模型组较正常组、假手术组明显升高（P〈0.01）;高、中剂量实验组、对照组较模型组明显降低（P〈0.01）,且接近正常组水平（P〉0.05）;高、中剂量实验组较对照组降低,但差异无统计学意义（P〉0.05）;高、中剂量实验组较低剂量实验组明显降低（P〈0.01）。结论：活血化瘀法通过影响慢性盆腔炎大鼠血清前炎症细胞因子TNF-α、IL-1β、IL-8水平,以抑制炎症反应,这可能是活血化瘀法治疗慢性盆腔炎和预防、缓解盆腔粘连的作用机制之一。     

甲状腺相关性眼病血清细胞因子水平及免疫机制的临床关系研究

目的 研究甲状腺相关性眼病患者血清IL-2、IL-6和TNF-α的水平及其与免疫的关系.方法 采用RIA法分析25例GD、25例GO患者及20例对照组血清中IL-2、IL-6、TNF-α、TRAb值;化学发光法测定TGAb、TPOAb、FT3、FT4、TSH.结果 在GO、GD组,IL-6、TNF-α水平均高于对照组（P〈0.01,P〈0.05）;GO组高于GD组（P〈0.01,P〈0.05）;两组患者TGAb、TPOAb值均高于对照组（P〈0.05）;TRAb值在三组间两两比较差异有统计学意义（P〈0.01）、GO组明显高于另两组（P〈0.01）;TRAb与TNF-α、IL-6及甲状腺功能呈正相关（r=0.608,0.827,P〈0.05）.结论 GDGO患者IL-6、TNF-α增高,Th1、Th2细胞因子表达增强,TRAb与GO细胞因子相关,细胞介导和体液免疫在发病机制中起重要作用.     

慢性乙型肝炎患者外周单个核细胞分泌细胞因子的实验研究

目的探讨慢性乙肝患者外周血单个核细胞(PBMC)分泌肿瘤坏死因子α(TNF-α)、干扰素γ(IFN-γ)、白细胞介素6(IL-6)水平及与病毒载量的关系。方法采用ELISA法测定60例正常人和138例不同病程慢性乙肝患者PBMC中经植物血凝素(PHA)刺激前后TNF-α、IFNγ-、IL-6在上清液中的表达水平,并用荧光定量PCR法检测PBMC中HBV DNA水平。结果正常对照组及各种慢性乙肝患者PBMC上清液中TNF-α、IFNγ-、IL-6均有表达,HBV感染者三种细胞因子表达水平高于对照组,随着病情程度加重,表达水平逐渐增高(P<0.05);经PHA刺激后对照组及患者组TNFα-、IFN-γ、IL-6水平均有明显增高(P<0.01),但患者组升高水平均低于对照组(P<0.05);随着HBV DNA水平增高,PBMC中TNF-α、IFN-γ表达水平逐渐减低,而IL-6活性逐渐增高(P<0.05)。结论慢性乙肝患者PBMC可分泌TNF-α、IFNγ-、IL-6,其表达水平与宿主病毒载量有关。Th1/Th2细胞因子失衡在PBMC抗病毒免疫受抑,乙型肝炎慢性化进程中起着重要作用。     

急性肝衰竭大鼠血清TNF-α和IFN-γ/IL-4表达

目的研究肿瘤坏死因子α（TNF-α）和γ-干扰素/白细胞介素4（IFN-γ/IL-4）在D-氨基半乳糖/内毒素所致大鼠急性肝衰竭中的表达。方法取30只Wistar大鼠,腹腔内注射D-氨基半乳糖/内毒素诱导大鼠急性肝衰竭模型（AHF组）;另取30只腹腔内注射等量生理盐水为正常对照组（N）。2组动物于建模后3,6,12,24,48,72 h各取5只动物检测其血清丙氨酸转氨酶（ALT）并观察肝组织的病理形态学变化。酶联免疫吸附试验（ELISA）检测不同时间点动物血清中TNF-α和IFN-γ/IL-4水平的变化。结果结果显示,AHF组肝组织炎性细胞浸润和明显坏死的急性肝衰竭特征,且各时间点血清ALT值均明显高于对照组（P〈0.05）;AHF组与对照组比较,血清内TNF-α在3 h（P〈0.01）、6 h（P〈0.05）增高;IFN-γ在3 h（P〈0.01）、6 h（P〈0.01）增高;IL-4水平在各时间点无明显变化（P〉0.05）。结论在D-氨基半乳糖/内毒素所致大鼠急性肝衰竭模型中,TNF-α和IFN-γ对急性肝衰竭早期损伤起重要作用;IL-4可能不参与此种动物模型的病理过程。     

生脉散对大肠杆菌脂多糖诱导慢性肝衰竭大鼠细胞因子水平的影响

目的探讨生脉散对慢性肝衰竭大鼠大肠杆菌脂多糖（LPS）诱导细胞因子水平的影响。方法采用CCl。混合液腹腔注射复制慢性肝衰竭大鼠模型,观察LPS诱导2h后生脉散后对血清内毒素、细胞因子水平的影响。结果CCl。混合液能明显增加大鼠血清IL-6[（64．50±18．79）pg／mlVS（4．79±0．57）pg／m1]、ICAM-1[（25100．00±5258．85）pg／mlVS（4215．50±942．79）pg／m1]和TNF-α[（17．55±2．39）pg／mlVS（10．92±5．02）pg／m1]水平（P〈0．05）,但对血清LPS水平无明显影响[（0．058±0．007）EU／mlVS（0．040±0．002）EU／ml,P〉0．05];中药生脉散能显著降低CCl。慢性肝衰竭大鼠血清IL-6、ICAM-1和TNF-α水平[分别为（17．20±3．12）pg／ml、（9490．00±2725．78）pg／ml、（3．00±1．00）pg／ml,P〈0．05]。LPS攻击2h后能明显升高CCI。混合液大鼠血清LPS、TNF-α、IL-6、ICAM-1水平[分别为（0．501±0．019）EU／ml、（19750．00±9655．17）pg／ml、（5615．00±490．50）pg／ml、（41000．00±589．88）pg／ml,P〈0．01]。结论在慢性肝衰竭模型中,LPS能增加TNF-α,IL-6和ICAM-1等炎症因子水平,中药生脉散可降低LPS水平,并抑制LPS诱导的炎症因子水平,阻断了炎性介质及LPS本身对机体的损伤。     

胰岛素葡萄糖钾盐与胰岛素体外抗炎效果比较研究

目的: 观察葡萄糖钾盐是否具有协同增强胰岛素对外周血单个核细胞群(PBMCs)分泌促炎细胞因子和抗炎细胞因子的作用. 方法: 用Ficoll-Hypaque液分离10例健康人PBMC,随机分为胰岛素葡萄糖钾盐(GIK)组、胰岛素(INS)组、葡萄糖钾盐(GK)组和基础对照(C)组. 四组PBMC培养24 h后,加脂多糖继续培养48 h后,离心收集培养上清液.用ELISA法检测TNF-α,IL-6和IL-4,IL-10含量. 结果: GIK组和INS组TNF-α,IL-6含量均明显低于C组(P<0.01),IL-4和IL-10含量却均明显高于C组(P<0.01);GIK组IL-4和IL-10含量明显高于INS组(P<0.01),但GIK组TNF-α和IL-6含量降低,与INS组比较无统计学意义(P>0.05). 结论: 胰岛素葡萄糖钾盐和胰岛素均能直接抑制内毒素刺激的PBMCs分泌促炎细胞因子,同时提高内毒素刺激的PBMC分泌抗炎细胞因子水平.葡萄糖钾盐对胰岛素促进PBMCs分泌抗炎细胞因子有协同增强作用.     

妊娠期肝内胆汁瘀积症肝功能、炎症细胞因子变化临床分析

目的探讨妊娠期肝内胆汁淤积症(ICP)肝功能、白细胞介素-6(IL-6)、IL-8、IL-10及肿瘤坏死因子-α(TNF-α)的变化及其相互关系。方法选取58例ICP患者为研究对象,另选取50例正常妊娠妇女为对照组,采用ELISA法测定两组血清IL-6、IL-8、IL-10、TNF-α水平,应用全自动生化分析仪测定两组肝功能指标。结果 ICP组患者血清IL-6、IL-8、IL-10、TNF-α、TBA、AST、ALT水平显著高于对照组,差异有统计学意义(P0.05);ICP组中重度患者血清IL-6、IL-8、IL-10、TNF-α、TBA、AST、ALT水平高于轻度患者,差异有统计学意义(P0.05)。经Pearson相关因素分析显示,IL-6、IL-8、TNF-α与TBA、AST、ALT水平均呈正相关(P0.05),IL-10与TBA、AST、ALT水平呈负相关(P0.05)。结论炎症细胞因子水平失衡及肝功能损害可能与ICP患者病情发生及不良妊娠结局有密切的关系,通过测定孕妇细胞炎症因子及肝功能指标,对预测患者不良妊娠结局、改善患者预后具有积极的作用。     

异甘草酸镁对大鼠肝脏缺血再灌注损伤保护作用的研究

目的：探讨异甘草酸镁对大鼠缺血再灌注损伤的保护作用及机制。方法：建立大鼠缺血再灌注损伤模型,将SD大鼠随机分为缺血再灌注对照组（IR组,n=36）,异甘草酸镁治疗组（T＋RI组,n=36只）。T＋RI组在门静脉阻断5min前应用异甘草酸镁（0.2mg/kg）预处理。2组分别于术后第6、12、24h各处死12只大鼠,经下腔静脉采血5mL备用。采用酶联免疫吸附的方法检查血清TNF-α、IL-1β、IL-6等指标。结果：T＋RI组各个时间点血清的TNF-α、IL-1β、IL-6水平均明显低于IR组,两组间差别有统计学意义（P〈0.001）。结论：异甘草酸镁能够降低肝脏缺血再灌注损伤后血清中细胞因子TNF-α、IL-1β、IL-6水平,减轻肝组织炎症细胞浸润,具有保护肝脏缺血再灌注损伤的作用。     

血清中TNF-α、IL-6含量在重症急性胰腺炎早期诊断中的价值

目的探讨急性胰腺炎（AP）患者血清中肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）的含量对病情严重程度的评估价值。方法将28例AP患者分为轻症急性胰腺炎（MAP）组16例和重症急性胰腺炎（SAP）组12例,选取10例健康志愿者为对照组。采用ELISA法检测血清中TNF-α和IL-6水平。结果2种细胞因子血清水平均为SAP组最高,对照组最低,且在对照组与SAP组之间,MAP与SAP组之间差异有统计学意义（均P〈0.01）;对照组与MAP组IL-6含量比较,差异有统计学意义（P〈0.05）。结论TNF-α、IL-6对早期诊断、鉴别轻症胰腺炎和重症胰腺炎均有重要的临床意义。     

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.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.