螺旋CT改良法扫描半月板技术研究

目的 掌握正常半月板在斜冠状位上的CT表现特点,制定CT判断正常半月板的标准,为进一步研究半月板病变的CT诊断提供理论根据。方法 使用螺旋CT机对33位成年人半月板给45~60 ゜角用1~3mm层厚扫描和1mm重建,使半月板图像置于胫骨平台之上,观察半月板的CT特点,并测量、计算其最大厚度和平均CT值。结果 半月板在斜冠状位的CT表现是:轮廓清楚,边缘光滑,密度均匀,厚度逐渐变薄或增厚的带状结构。内侧厚(5.58 ±1.18)mm,外侧厚(7.82 ±1.80)mm;CT值内侧(93.53±16.11)HU,外侧(93.30±18.40)HU,平均(93.72 ±12.68)HU。结论 螺旋CT改良法扫描半月板技术研究,掌握了正常半月板的CT表现。制定了判断正常半月板的标准,可用于CT诊断半月板病变的研究,也可用于胫骨平台及膝关节炎症等病变的检查。     

胸片深吸、呼气相在尘肺病代偿功能诊断中的运用

目的 探讨胸片深吸、呼气相在尘肺病代偿功能诊断中的应用。方法 对100例早期尘肺患者进行深吸、呼气相摄片检查，测量其膈动度，并对其进行肺功能测定。结果膈动度在3～6cm者，肺功能测定结果为正常。结论 结合胸片深吸呼气相是诊断尘肺代偿功能的一个重量的辅助手段。     

孟鲁司特对支气管哮喘患儿肺功能及白细胞介素-6、肿瘤坏死因子-α的影响

目的 探讨孟鲁司特对支气管哮喘患儿肺功能及白细胞介素(IL)-6和肿瘤坏死因子(TNF)-α的影响.方法 将20例6～14岁的轻中度支气管哮喘患儿(观察组)给予孟鲁司特治疗,每日1次,每次5 mg,共治疗4周.分别在治疗前、治疗结束后进行肺功能测定,采用酶联免疫吸附法(EusA)检测IL-6和TNF-α水平,并与健康体检者(对照组)比较.结果 观察组治疗后肺功能指标第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、用力呼气流量(PEF)、25%肺活量最大呼气流量(V25)、50%肺活量最大呼气流量(V50)分别为(86.2±3.6)%、(88.7±2.8)%、(88.9±3.8)%、(90.3±4.2)%、(89.6±3.5)%,均比治疗前的(66.7±2.3)%、(70.5±3.5)%、(69.8±4.3)%、(71.3±3.1)%、(68.6±4.7)%有明显改善(P<0.01);治疗后IL-6、TNF-α分别为(134.30±86.75)μg/L、(1.22±0.51)ng/L,较治疗前的(267.35±112.64) μg/L、(2.83±0.87)ng/L明显降低(P<0.05).结论 孟鲁司特用于支气管哮喘的治疗,可缓解症状并改善肺功能,降低IL-6和TNF-α水平.     

肺表面活性物质对支气管肺发育不良婴幼儿的肺功能评价研究

目的:评价肺表面活性物质(Pulmonary surfactant,PS)对支气管肺发育不良(bronchopulmonary dysplasia,BPD)婴幼儿肺功能的影响。方法:胎龄<32周,出生体重<1 500 g,出院时诊断为BPD的早产儿40例,按有无使用PS分为PS组(20例)和非PS组(20例)。动态监测两组患儿1岁、2岁、3岁时的肺功能情况,主要是潮气呼吸参数中的达峰时间比(TPTEF/TE)、达峰容积比(VPEF/VE)、吸气时间(Ti)、呼气时间(Te)、潮气量(VT)、身高、体重、出院后3年中因呼吸系统疾病再入院次数。结果:1岁时PS组与非PS组的肺功能参数值、身高、体重、均无明显差异(P均>0.05)。2岁及3岁时PS组的各项肺功能参数、身高、体重均优于非PS组,(P均<0.05),差异有统计学意义。出院后3年中因患呼吸系统疾病再入院次数的比较中发现,PS组平均住院(2.63±0.80)次,而非PS组为(4.57±1.22)次,差异有统计学意义(P<0.05)。结论:PS替代治疗可以改善BPD患儿2岁及3岁时的生长发育状况、肺功能状况、并降低BPD患儿再入院次数。     

老年尘肺患者肺功能测定结果分析

随着我国人口老龄化趋势 ,老龄尘肺患者也逐渐见增多。为探讨这一群体的肺功能特征 ,我们从住院及门诊病人中选择6 0岁以上无严重并发症者 17例 ,另择 2 4例 6 0岁以上健康老人进行肺功能对照测定。现将结果报告如下。1　对象与方法1.1　对象　经明确诊断的尘肺患者 71例 ,均为男性 ,其中 期 2 0例 (煤工尘 3例 ,矽肺 1例 ,水泥工尘肺 3例 ,炭黑肺 3例 ) ,平均年龄 6 7.2± 5 .49岁 ,平均身高 16 .79± 5 cm; 期 32例 (煤工炭肺 15例 ,矽肺 10例 ,水泥工尘肺 4例 ,炭黑尘肺 3例 ) ,平均 6 6 .5± 4.7岁 ,平均身高 16 5± 6 .4cm; 期 19例 (…     

血清肿瘤坏死因子-α检测对结核性和癌性胸腔积液鉴别诊断价值的研究

目的　评价肿瘤坏死因子 -α(TNF -α)对结核性胸腔积液 (以下简称结核组 )及非小细胞肺癌引起的癌性胸腔积液鉴别诊断的价值。方法　采用双抗体夹心免疫酶标法 (ELISA)检测 2 5例结核性胸腔积液、4 7例癌性胸腔积液 (其中肺腺癌 2 6例、肺鳞癌 2 1例 )患者血清及 2 0例正常人血清中TNF -α水平。结果　肺腺癌组(12 1 75± 6 0 82 )和肺鳞癌组 (16 7 5 4± 6 9 76 )患者血清TNF -α水平 (6 2 6 4± 18 0 0 )明显高于结核组 (P <0 0 1) ,三组均高于正常对照组 (43 79± 2 3 82 ) ;选择结核组血清TNF -α水平的P75数值作为判断界限 ,血清TNF -α水平作为鉴别这两种不同性质胸腔积液的灵敏度、特异性、准确度分别为 77 70 %、72 0 0 %、90 19%。结论　血清TNF -α检测对鉴别结核性及非小细胞肺癌引起的癌性胸腔积液有较高的参考价值 ,可作为辅助诊断指标     

哮喘儿童IL-13水平和肺功能1秒钟用力呼气容积变化的研究

目的:观察哮喘急性发作期儿童经GINA方案的系统治疗前后外周血单个核细胞(PBMC) 培养上清液中IL-13和肺功能1秒钟用力呼气容积(FEV1 ) 的变化及相互关系。方法: 采用双抗体夹心ELISA法测定23例中度急性发作期哮喘患儿治疗前后、正常对照组儿童(20例) PBMC培养上清液中IL-13水平, 并同时测肺功能1秒钟用力呼气容积(FEV1 ) 占预计值的百分比。结果: 哮喘患儿急性发作期PBMC培养上清液中IL-13水平( 169. 66±14. 51 ) ng/L较正常对照组( 92 .68±13. 80) ng/L为高, 差别非常显著(P<0 .01)。同时显示, 哮喘患儿急性发作期FEV1 值占预计值的百分比为(69. 78±8 .30),明显低于正常对照组(98 .35±5 .36), 差别非常显著(P<0 .01)。哮喘患儿治疗前、后PBMC培养上清液中IL-13测定: 治疗后为(120 .21±16 .35) ng/L明显低于急性发作期, 仍高于正常对照组, 差别非常显著(P<0 .01)。FEV1 占预计值的百分比测定: 治疗后为(82 .56±10. 40) 明显高于急性发作期, 肺功能有所改善, 但仍低于正常对照组, 差别非常显著(P<0. 01)。直线相关分析表明, 哮喘急性发作期IL-13与FEV1 占预计值的百分比呈负相关(r=-0 493, P<0 05)。结论: IL-13在哮喘的急性发病中起着重要作用, 其可能是构成气道慢性炎症的各类因素之一。IL-13水?     

石棉肺及可疑石棉肺(O~+)的MTT、MTTp测定

经“t”检验证明,可疑石棉肺(O~+)与Ⅰ期石棉肺的MTT测定值均较正常人(O)显著延长(P<0.05)和非常显著延长(P<0.01)。Ⅰ期石棉肺的MTTp测定值较正常人显著延长(P<了用力呼气肺量图平均通过时间(MTT)及用力呼气肺量图部分通过时间(MTTp)测定,结果如表所示。     

卵巢纤维瘤的CT诊断

目的 探讨卵巢纤维瘤的CT表现特点.方法 回顾性分析经手术病理证实的12例卵巢纤维瘤CT资料.结果 9例表现为边界清晰单侧附件区实质性占位,实质部分密度均匀,平扫CT值为32～63 HU,增强动脉期较平扫CT值增加4～19 HU,平均(9.3±4.1)HU,实质期较平扫CT值增加7～24 HU,平均(14.7±5.2)HU.3例肿块内部出现不同程度条片状及囊状坏死区,但肿瘤外缘轮廓尚光整,其中1例同时出现了胸腹腔积液,2例肿瘤内部出现点片状钙化.结论 卵巢纤维瘤的CT表现具有一定特征性.肿瘤多数表现为附件区边界清晰的实质性肿块,增强后轻度强化,少数内部囊变坏死伴腹水者与卵巢恶性肿瘤鉴别困难,有赖于病理学检查.     

94例棉尘作业女工肺通气功能测定分析

棉尘对其接触者可造成呼吸系统损伤[1]。为了解棉尘作业工人肺功能情况,我们对某棉纺厂94名接触棉尘女工进行了肺通气功能测定分析,现将结果报告如下。1　对象和方法11　对象接尘组为接触棉尘女工94人,年龄19～42岁,平均(27.28±5.14)岁,接尘工龄1～11年,平均(7.00±2.41)年,身高147～165ｃｍ,平均(156.49±4.60)ｃｍ。对照组为该厂不接触尘毒的医护、　　表1接尘组与对照组各项肺功能比较(ｘ±ｓ)项目接尘组(ｎ=94)　班前　班后　Ｐ值对照组(ｎ=50)　班前　班后Ｐ值ＦＶＣ99.02±10.9299.53±12.410.383　99.44±9.94　99.54±9.790.676Ｆ…     

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.     

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.     

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.