过敏性紫癜患儿血浆D-二聚体与尿微量蛋白的相关性探讨

目的分析过敏性紫癜患者血D-二聚体以及尿微量蛋白的相关性。方法回顾性分析80例过敏性紫癜患儿的临床资料。所有入选患者均检测D-二聚体及尿微量白蛋白、尿α1-微球蛋白等。同时选择健康体检儿童40例作为对照组,将2组相关指标检测结果进行对照分析。结果疾病组D-二聚体、尿微量白蛋白、α1-微球蛋白阳性率均高于对照组,差异有统计学意义(P0.01)。尿常规异常组与尿常规正常组患儿D-二聚体、尿微量白蛋白、α1-微球蛋白含量均显著高于对照组,差异有统计学意义(P0.01)。尿常规异常组患儿D-二聚体水平显著高于尿常规正常组,差异有统计学意义(P0.05)。结论过敏性紫癜患儿机体的高凝状态与其肾脏功能损伤具有一定的相关性。     

低分子肝素钠预防过敏性紫癜性肾炎合并高凝状态的临床观察

目的:观察过敏性紫癜患儿首次或复发时应用低分子肝素钠预防紫癜性肾炎的有效性和安全性。方法:将50例过敏性紫癜患儿随机分为肝素治疗组(25例)和对照组(25例),检验尿β2-微球蛋白(β2-M),尿微量白蛋白(A lb),凝血酶原时间(PT),部分凝血活酶时间(APTT)以及血小板计数(PTS)。结果:两组在治疗前尿β2-M和尿A lb、PT、APTT、PTS差异无显著性(P>0.05),治疗后1周、2周化验PT、APTT、PTS明显低于对照组,差异有显著意义(P<0.05),肝素治疗组在3个月、6个月复查β2-M和A lb两组比较有显著意义(P<0.01)。结论:肝素钠可预防过敏性紫癜性肾炎、肾损害,同时有降粘、抗凝、抗血栓的作用且安全可靠。     

尿中微量蛋白和尿N-乙酰-β-D-氨基葡萄糖苷酶的检测对儿童过敏性紫癜肾炎的意义

目的探讨尿中微量蛋白和N-乙酰-β-D-氨基葡萄糖苷酶(NAG)的检测对儿童过敏性紫癜肾炎的意义。方法根据尿常规结果将过敏性紫癜患儿分为过敏性紫癜(HSP)组和过敏性紫癜肾炎(HSPN)组,同时选取健康儿童为对照组。比较各组尿中m Alb、α_1-MG、β_2-MG、TRf、Ig G和NAG的水平。结果 HSPN组中尿m Alb、α_1-MG、β_2-MG、TRf、NAG和Ig G的含量均明显高于HSP组和对照组,差异有统计学意义(P0.05);HSP组中尿m Alb、α_1-MG、β_2-MG、TRf和NAG的含量均高于对照组,差异有统计学意义(P0.05);Ig G含量与对照组比较,差异无统计意义(P0.05)。HSP组中尿中微量蛋白和NAG联合检测阳性率为77.8%,明显高于各单项检测的阳性率,差异均有统计学意义(P0.05)。结论联合检测尿中微量蛋白和NAG的水平可较好的反映过敏性紫癜患儿的早期肾损伤。     

测定尿系列微量蛋白在急性肾小球肾炎恢复期的临床评价

目的探讨急性肾小球肾炎恢复期检测尿系列微量蛋白的临床价值.方法对30例急性肾小球肾炎恢复期患儿和25例正常对照组,采用酶联免疫吸附法检测尿微量白蛋白(mALb),转铁蛋白(uTf),α1-微球蛋白(α1-mG)含量.结果急性肾小球肾炎恢复期患儿尿mALb为(3.42±1.58)×10-2g/L,uTf为(0.19±0.11)×10-2g/L,α1-mG为(1.02±0.46)×10-2g/L.其检测的阳性率mALb 36.6%,UTf23.3%,α1-mALb 36.6%,uTf 23.3%α1-mG 3.3%.正常对照组尿mALb为(1.69±0.31)×10-2g/L,uTf为(0.12±0.04)×10-2g/L,α1-mG为(0.93±0.51)×10-2g/L.结论测定尿系列微量蛋白在急性肾小球肾炎恢复期是判定肾脏功能远期变化的灵敏而可靠的检查方法.     

纤维蛋白原与尿微量蛋白在过敏性紫癜肾炎早期诊断中的意义

目的探讨纤维蛋白原与尿微量蛋白在过敏性紫癜肾炎早期诊断中的临床意义。方法按照尿常规检测结果将过敏性紫癜患儿分为尿常规阳性组和尿常规阴性组,并比较这两组患儿与正常健康对照组儿童的纤维蛋白原与尿微量蛋白水平差异。结果 3组儿童的β2-微球蛋白(尿β2-MG)、尿清蛋白(尿-Alb)、尿免疫球蛋白G(尿-lgG)等尿微量蛋白相比,差异有统计学意义(F=68.24、30.21、104.45,P均﹤0.05)。对3组儿童的尿微量蛋白组间检测结果进行比较,发现尿常规阳性组与尿常规阴性组患儿的尿β2-MG水平间差异无统计学意义(P﹥0.05);而这两组的尿-Alb和尿-lgG水平比较差异有统计学意义(P﹤0.05)。尿常规阳性组与对照组儿童进行两两比较,尿β2-MG、尿-Alb及尿-lgG水平差异均有统计学意义(P﹤0.05)。尿常规阴性组与对照组儿童进行两两比较,尿β2-MG水平间差异无统计学意义(P﹥0.05);而这两组的尿-Alb和尿-lgG水平比较差异有统计学意义(P﹤0.05)。3组儿童的纤维蛋白原水平相比,差异有统计学意义(F=27.52,P﹤0.05)。对3组儿童的尿微量蛋白组间检测结果进行比较,发现尿常规阳性组与尿常规阴性组患儿的纤维蛋白原水平相比较差异有统计学意义(P﹤0.05)。尿常规阳性组与对照组儿童进行两两比较,纤维蛋白原水平差异有统计学意义(P﹤0.05)。尿常规阴性组与对照组儿童进行两两比较,纤维蛋白原水平差异有统计学意义(P﹤0.05)。结论纤维蛋白原与尿微量蛋白检测能较早反映过敏性紫癜患儿肾损害的发生及程度,为早期诊断和治疗过敏性紫癜肾炎提供临床依据。     

尿微量蛋白测定在儿童过敏性紫癜早期肾损伤中的意义

目的 探讨尿微量蛋白在过敏性紫癜(HSP)患儿早期肾损伤中的作用和临床意义.方法 采用放射免疫法测定30例多次尿常规检查正常的HSP患儿尿微量白蛋白(mAlb)、尿液转铁蛋白(TRF)、尿α1微球蛋白α1-MG)、尿β-微球蛋白(β-MG)为观察组,同时检测血尿素氮(BUN)、肌酐(Cr)水平,30例健康体检儿童作为对照组.结果 30例HSP患儿肾功能均正常,BUN为(4.78±0.73)mmol/L,Cr为(48.32± 14.59)μmol/L;HSP 患儿尿微量蛋白中mAlb为(28.45±10.22)mg/L、TRF为(1.56±0.98)mg/L、α1-MG为(10.20±6.23)mg/L、β-MG为(0.54±0.22)mg/L,均高于对照组的(4.11±1.35、0.60±0.15、2.30±1.46、0.25±0.16)mg/L,差异有统计学意义(P＜0.05).结论 尿微量蛋白是早期诊断HSP肾损害的灵敏指标;尿微量蛋白指标综合检测可作 为临床早期诊断、治疗以及降低肾损伤程度的可靠依据.     

尿液肾功能指标检测在儿童紫癜性肾炎中的临床意义

目的:研究尿液肾功能有关指标与儿童紫癜肾脏功能改变的关系。方法:对47例紫癜患儿进行尿液β2-微球蛋白(β2-MG)、视黄醇结合蛋白(RBP)、微量白蛋白(umALB)、N-乙酰基-β-D-氨基葡萄糖苷酶(NAG)、尿转铁蛋白(TRF)、尿α1-微球蛋白(α1-MG)及尿液肌酐含量检测,并与对照组30例健康儿童尿液肾功能进行比较。结果:观察组β2-MG、RBP及尿umALB、NAG、TRF、α1-MG含量均高于对照组,除RBP及NAG外P均<0.05有统计学意义,其中TRF、β2-MG异常率最明显分别为63.83%和68.08%。结论:HSPN早期即出现肾小球及肾小管的损伤,测定上述指标对于早期监测HSP患儿肾损伤、及早采取干预措施、阻止病情进展具有重要意义。     

肥胖儿童32例肾脏损害情况分析

【目的】 探讨肥胖儿童肾脏损害,为早期干预提供理论依据。 【方法】 对32例肥胖儿童行尿α1-微球蛋白(α1-M)、微量白蛋白(m-Alb)、免疫球蛋白G(IgG)检测,并以20例健康儿童作为对照。同时检测尿常规、血尿素氮、肌酐、甘油三脂、胆固醇、血糖等。 【结果】 32例肥胖儿童尿四联蛋白虽然均在正常范围,但与正常对照组比较,除α1-M与正常组比较无显著差异外,其它各指标差异均有统计学意义(P均<0.05)。血尿素氮、肌酐、血糖均在正常范围,与正常组比较差异均无统计学意义(P均> 0.05),但血甘油三脂、胆固醇与正常对照组比较均显著增高,差异均有统计学意义(P均<0.05)。 【结论】 肥胖儿童存在肾功能损害。尿微量蛋白作为早期发现肾脏损害的敏感指标可进一步探讨。     

过敏性紫癜患儿血,尿β2—μG测定

我们采用放射免疫法测定过敏性紫癜患儿血及尿β_2微球蛋白(β_2—μG),探讨过敏性紫癜患儿肾功能损害情况。1 对象与方法1.1 研究对象 (1)紫癜组共80例,为1990～1995年6年间我科住院患儿,全部符合过敏性紫癜的诊断。其中36例合并紫癜性肾炎,依临床表现分为3型:轻型20例,仅有程度不等的无症状性血尿;肾炎     

尿微量蛋白对过敏性紫癜儿童肾损害的诊断价值研究

目的探究尿液中微量白蛋白(m Alb)、转铁蛋白(TRF)、免疫球蛋白G(Ig G)、及α1-微球蛋白(α1-MG)对过敏性紫癜(HSP)患儿早期肾损伤的临床诊断价值。方法选取2016年2月-2017年2月在本院收治的61例HSP儿童(观察组)及60例健康体检者(对照组),采用免疫比浊法对其各项尿液指标进行检测,并通过受试者工作特征曲线(ROC曲线)评估各项指标对过敏性紫癜患儿肾损伤的诊断价值。结果观察组4项尿蛋白指标阳性率及排出量均高于对照组,差异有统计学意义(P0.05)。尿m Alb、TRF、Ig G和α1-MG诊断过敏性紫癜患儿肾损伤的曲线下面积分别为0.836、0.771、0.711和0.614,诊断性能m Alb最佳。结论尿m Alb、TRF、Ig G和α1-MG均可作为评价过敏性紫癜儿童早期肾损伤的有效指标,对患儿肾损伤的早期诊断和及时治疗具有重要意义。     

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.     

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.     

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.     

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.