阿托伐他汀对不稳定型心绞痛患者介入术后高敏C反应蛋白及白细胞介素6的影响

目的 探讨阿托伐他汀对不稳定型心绞痛(UAP)患者介入术后高敏C反应蛋白(hs-CRP)及白细胞介素6(IL-6)的影响.方法 选择80例UAP患者,均行经皮冠状动脉介入治疗(PCI),术后按照随机数字表法分为A组和B组,每组40例.A组患者在常规心内科治疗措施基础上给予阿托伐他汀20 mg治疗;B组在常规心内科治疗措施基础上给予阿托伐他汀40 mg治疗.分别于术前、术后24 h、术后3周抽血检测患者血清hs-CRP及IL-6水平,并进行比较.结果 术前A组和B组患者血清hs-CRP及IL-6水平比较差异无统计学意义[(5.6±1.2) mg/L比(5.6±1.1)mg/L和(211.9±21.2) ng/L比(209.6±19.9) ng/L,P＞ 0.05];术后24hA组和B组患者血清hs-CRP及IL-6水平均较术前显著增高,差异有统计学意义(P＜0.05),但A组和B组比较差异无统计学意义[(8.1±1.1) mg/L比(8.5±1.2) mg/L和(311.1±20.9) ng/L比(313.3±18.5) ng/L,P＞0.05];术后3周A组和B组患者血清hs-CRP及IL-6水平均较术前显著下降,差异有统计学意义(P＜0.05),A组和B组比较差异亦有统计学意义[(3.1±1.1) mg/L比(1.9±0.8) mg/L和(163.3±18.5) ng/L比(123.3±19.5) ng/L,P＜ 0.05],术后A组和B组患者均未出现明显的不良反应,肝功能均未见明显异常.结论 行PCI的UAP患者术后给予阿托伐他汀治疗可以明显降低患者血清hs-CRP和IL-6水平,且40 mg较20 mg治疗效果更明显,值得临床推广应用.     

急性冠脉综合征PCI前瑞舒伐他汀干预治疗的心肌保护作用研究

目的观察瑞舒伐他汀干预治疗对经皮冠状动脉介入术PCI术后可溶性P-选择素(sP-selectin)和高敏C反应蛋白(hs-CRP)表达的影响,借此探讨瑞舒伐他汀干预治疗在PCI术后心肌保护方面的作用。方法收集PCI术治疗的冠心病患者120例,随机分成4组(每组30例):对照组、低剂量瑞舒伐他汀组(5 mg)、中剂量瑞舒伐他汀组(10 mg)、高剂量瑞舒伐他汀组(20 mg);酶联免疫吸附双抗体夹心法(ELISA)检测血浆sP-selectin水平;乳胶增强免疫比浊法检测血清hs-CRP水平。结果对照组(A组)、低剂量瑞舒伐他汀干预治疗组(B组)、中剂量瑞舒伐他汀干预治疗组(C组)、高剂量瑞舒伐他汀干预治疗组(D组)4组sP-selectin和hs-CRP的水平在PCI术后24 h达峰值,随后逐渐减低,中、高剂量组术后一周可以恢复至正常水平(P0.05),瑞舒伐他汀的干预治疗可以显著的抑制PCI术后sP-selectin和hs-CRP表达水平的升高(P0.01)。4组PCI术后围手术期心肌梗死发生率分别为23.3%、16.7%、6.7%、3.3%,A组与B组之间无统计学差异(P0.05),但B组的发生率低于A组,A组与C、D组之间差异有统计学意义(P0.05)。结论瑞舒伐他汀干预治疗可以抑制PCI术后sP-selectin和hs-CRP炎症因子的表达水平,中、高剂量瑞舒伐他汀干预治疗对PCI术后心肌具有一定的保护作用。     

阿托伐他汀强化治疗对ACS合并糖尿病患者介入术后 C一反应蛋白的影响

目的:研究不同剂量阿托伐他汀对合并糖尿病的ACS患者经皮冠状动脉介入(PCI)治疗术后炎症因子、调脂疗效的影响.方法:对72例合并糖尿病的ACS患者行冠状动脉介入术,随机分为阿托伐他汀20mg组(A组)36例,40mg组(B组)38例,手术当天、术后24小时、术后2周、术后4周空腹采血,测定血清高敏C-反应蛋白(hs.CRP)以及血脂水平.结果:阿托伐他汀40mg组较20mg组PCI术后血清hs-CRP浓度降低更明显.2组术后2周血脂水平较术前略有降低,但无统计学意义,两组术后4周血脂水平较术前降低,阿托伐他汀40mg组较20mg组PCI术后血清低密度脂蛋白(LDL-C)浓度降低更明显.结论:冠脉介入术后患者血清hs-CRP升高;阿托伐他汀能降低冠脉介入术后患者血清hs-CRP,LDL-C水平40mg阿托伐他汀治疗较20mg阿托伐他汀疗效更好.     

大剂量阿托伐他汀对急性冠状动脉综合征患者经皮冠状动脉介入治疗围手术期心肌保护作用

目的 观察大剂量阿托伐他汀对急性冠状动脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)围手术期的心肌保护作用.方法 120例择期行PCI的ACS患者,按随机数字表法分为两组,每组60例,A组术前3d口服阿托伐他汀80mg/d,B组术前3d口服阿托伐他汀20mg/d.两组患者均于术前、术后6 h、术后12 h测定肌钙蛋白Ⅰ(cTnI)、肌酸激酶同工酶MB(CK-MB)、超敏C反应蛋白(hs-CRP)、白细胞介素(IL)-6.于术前、术后3d测定总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C),并进行比较.结果 两组术后6 h及术后12 h cTnI、CK-MB、hs-CRP、IL-6水平均明显高于术前,差异有统计学意义(P<0.05).术后6 h A组cTnI、CK-MB水平明显低于B组[(0.35±0.18)μg/L比(0.48±0.16)μg/L,(3.78±0.45)μg/L比(4.56±0.55)μg/L],术后12 h A组hs-CRP、IL-6水平明显低于B组[(4.53±0.98)mg/L比(7.03±0.88)mg/L,(30.6±11.2)ng/L比(43.8±12.1)ng/L],差异均有统计学意义(P<0.05).两组患者术前、术后TC、TG、LDL-C、HDL-C水平比较差异无统计学意义(P>0.05).结论 择期行PCI患者术前3d口服阿托伐他汀80 mg/d,其心肌保护作用优于口服阿托伐他汀20 mg/d,可在临床应用.

Abstract：

Objective To observe the perioperative myocardial protection of high-dose atorvastatin to acute coronary syndrome(ACS) patients during percutaneous coronary artery interventional therapy(PCI).Methods One hundred and twenty patients with ACS undergoing elective PCI were divided into group A and group B with different oral dose of atorvastatin ( 80 mg/d and 20 mg/d ) for 3 days before operation by random digits table. Troponin I (cTnI), creatine kinase isozyme MB (CK-MB), high sensitive C-reactive protein (hs-CRP), interleukin (IL)-6 levels were measured before operation, 6 hours, 12 hours after operation and total cholesterol (TC), triglyeride (TG), low desity lipeprotein cholesterol (LDL-C), high density lipeprotein cholesterol (HDL-C) levels were measured before operation and 3 days after operation.Results cTnI,CK-MB,hs-CRP and IL-6 levels in the two groups were increased significandy 6 hours and 12 hours after operation (P <0.05). Six hours after operation, cTnI and CK-MB levels in group A were significantly lower than those in group B [(0.35±0. 18 ) μg/L vs. (0.48±0. 16 ) μg/L, ( 3.78±0.45 )μg/Lvs. (4.56±0.55 )μg/L] (P < 0.05 ). Twelve hours after operation , hs-CRP and IL-6 levels in group A were significantly lower than those in group B [(4.53±0.98 ) mg/L vs. (7.03±0.88 ) mg/L, ( 30.6±11.2) ng/L vs.(43.8±12.1) ng/L] (P <0.05). TC, TG, LDL-C, HDL-C levels in the two groups did not change significantly before and after operation (P >0.05). Conclusions Myocardial protective effects of ACS patients treated with atorvastatin 80 mg/d for 3 days are better than those treated with oral atorvastatin 20 mg/d. High-dose atorvastatin can produce more beneficial effects.     

氟伐他汀缓释片对急性冠状动脉综合征合并糖尿病老年患者经皮冠状动脉介入治疗后的影响

目的 评价氟伐他汀缓释片对急性冠状动脉综合征(ACS)合并糖尿病老年患者经皮冠状动脉介入治疗(PCI)后的影响及药物安全性.方法 选择2009年12月至2011年12月收治年龄≥65岁的ACS合并糖尿病行PCI患者78例,均应用药物洗脱支架行PCI,按随机数字表法分为A组(氟伐他汀缓释片80 mg/d)和B组(氟伐他汀缓释片160 mg/d),每组39例,术前、术后24h、术后7d检测血清高敏C反应蛋白(hs-CRP)、基质金属蛋白酶9(MMP-9)、单核细胞趋化蛋白1 (MCP-1)和血脂水平.随访180d观察药物不良反应和心血管事件.结果 两组术前、术后血脂水平无显著性变化.两组术后24h血清hs-CRP、MCP-1、MMP-9水平均高于术前[A组:(12.14±2.71) mg/L比(8.76±2.25) mg/L、(491.75±19.29) ng/L比(440.56±13.15) ng/L、(449.6±11.8)μmol/L比(353.8±16.0) mol/L;B组:(11.39±2.38) mg/L比(9.30±1.99)mg/L、(488.56±17.61) ng/L比(436.06±15.36) ng/L、(444.9± 19.1)μmol/L比(349.8±13.6)μmol/L],差异有统计学意义(P＜0.05).两组术后7d及随访180 d血清hs-CRP、MCP-1、MMP-9水平较术后24h下降,且B组比A组下降明显[术后7 d:(4.51±1.16) mg/L比(5.43±1.44) mg/L、(306.06±18.49) ng/L比(384.64±13.23) ng/L、(206.2±16.8) μmol/L比(263.4±15.4)μmol/L;随访180 d:(4.23±1.08) mg/L比(4.68±1.46) mg/L、(280.16±14.54) ng/L比(354.64±11.32) ng/L、(187.2±14.2)μmol/L比(225.4±12.7)μmol/L],差异有统计学意义(P＜0.05).随访180d两组均未发生严重药物不良反应,B组总的心血管事件发生率低于A组[7.7％(3/39)比25.6％(10/39)],差异有统计学意义(P＜0.05).结论 强化降脂更能降低ACS合并糖尿病老年患者PCI术后炎性因子水平,减少心血管事件,并具有很好的安全性.     

瑞舒伐他汀与阿托伐他汀对不稳定型心绞痛患者血脂及超敏C反应蛋白的影响

目的 观察瑞舒伐他汀与阿托伐他汀对不稳定型心绞痛患者血脂及超敏C反应蛋白(hs-CRP)的影响.方法 将140例不稳定型心绞痛患者按随机数字表法分为阿托伐他汀组和瑞舒伐他汀组,每组70例.阿托伐他汀组在常规治疗的基础上给予阿托伐他汀20 mg,每晚1次口服;瑞舒伐他汀组在常规治疗基础上给予瑞舒伐他汀20 mg,每晚1次口服,疗程均为3个月.分别测定治疗前和治疗后患者血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、hs-CRP、左室射血分数(LVEF)及心绞痛发作次数.结果 治疗后阿托伐他汀组和瑞舒伐他汀组TC、TG、LDL-C、hs-CRP、LVEF均较治疗前明显改善[阿托伐他汀组:(4.3 ±0.4) mmol/L比(5.6±0.8) mmol/L、(2.2±0.5) mmol/L比(2.8±0.8) mmol/L、(2.6±0.3)mmol/L比(3.2±0.6) mmol/L、(18.4±2.2) mg/L比(24.3±2.6) mg/L、(39.8±6.4)％比(34.6±6.2)％;瑞舒伐他汀组:(3.6t0.6) mmol/L比(5.4±1.2) mmol/L、(1.8±0.4) mmol/L比(2.6±0.6) mmol/L、(1.9±0.4) mmol/L比(3.4±0.8) mmol/L、(12.4±2.6) mg/L比(22.8±2.4) mg/L、(44.6±5.2)％比(32.8±7.4)％],差异有统计学意义(P＜0.05);且瑞舒伐他汀组治疗后均明显优于阿托伐他汀组,差异有统计学意义(P＜0.05).瑞舒伐他汀组心绞痛发作次数明显少于阿托伐他汀组[(2.1±0.8)次比(4.2±1.4)次],总有效率明显高于阿托伐他汀组[95.7％(67/70)比81.4％ (57/70)],差异均有统计学意义(P＜0.05).结论 瑞舒伐他汀和阿托伐他汀均可以有效降低不稳定型心绞痛患者的血脂及血清hs-CRP水平,且瑞舒伐他汀效果更佳.     

PCI术后口服不同剂量阿托伐他汀对STEMI患者预后的影响

目的 探讨经皮冠状动脉介入(PCI)术后口服不同剂量阿托伐他汀对急性ST段抬高型心肌梗死(STEMI)患者预后的影响。方法 入选118例既往未服用他汀类药物的急性STEMI患者随机两组:观察组60例和对照组58例。观察组患者术后口服阿托伐他汀40 mg/d,1月后改为20 mg/d;对照组患者术后口服阿托伐他汀20 mg/d。观察PCI术后8 h、术后24 h肌酸激酶同工酶(CK-MB)、肌钙蛋白I (cTnI)及超敏C反应蛋白(hs-CRP)的变化。随访1月记录主要终点事件发生率。结果 两组患者CK-MB、cTnI及hs-CRP在PCI术后8 h、PCI术后24 h分别同PCI术前比较,数值明显升高(P< 0.05);与对照组比较,观察组CK-MB、cTnI及hs-CRP增高程度显著降低(P< 0.05)。随访1月后,观察组主要终点事件的发生率明显降低(P< 0.05)。结论 STEMI患者PCI后口服阿托伐他汀,能减少PCI术后1月主要不良心血管事件的发生。     

经皮冠状动脉介入术前阿托伐他汀强化治疗对血清炎性细胞因子的影响

目的 探讨经皮冠状动脉介入(PCI)术前阿托伐他汀强化治疗对急性冠状动脉综合征(ACS)患者的临床效果及其对血清白细胞介素(IL)-6、IL-8的影响.方法 60例ACS患者根据治疗方法不同分为观察组和对照组,每组30例.对照组给予常规治疗方案,观察组在常规治疗方案的基础上给予PCI术前强化阿托伐他汀治疗.于PCI术前、术后24h、术后3d和术后6个月测定血清IL-6、IL-8水平,观察术后30d内心脏不良事件的发生情况.结果 观察组和对照组术前血清IL-6、IL-8水平比较差异无统计学意义(P＞0.05).观察组术后24h、术后3d、术后6个月血清IL-6、IL-8水平显著低于同时间对照组[IL-6:(11.56±4.95) ng/L比(20.24±8.67) ng/L、(8.51±3.65)ng/L比(18.83 ±8.07) ng/L、(5.60±2.40)ng/L比(10.02±4.29) ng/L; IL-8:( 50.34±21.57) ng/L比(74.50±31.93) ng/L、(30.80±13.20)ng/L比(53.30±22.84)ng/L、(26.00± 11.14) ng/L比(40.61±17.40)ng/L](P＜0.05).观察组在PCI术后30d内无心脏不良事件发生.对照组在PCI术后16d时,有1例患者出现心绞痛,经紧急对症处理症状消失.结论 PCI术前阿托伐他汀强化治疗可以有效降低ACS患者体内IL-6和IL-8水平,具有抗炎和保护心肌受损的作用.     

强化调脂对急性冠状动脉综合征患者促炎和抗炎失衡的影响

目的 观察强化调脂对急性冠状动脉综合征(ACS)患者促炎和抗炎失衡的影响,探讨阿托伐他汀抗炎和稳定斑块的机制.方法 检测82例ACS患者、17例稳定型心绞痛(SAP)患者和22例对照者的高敏C反应蛋白(hs-CRP)和IL-10水平.将41例应用阿托伐他汀调脂治疗的ACS患者随机分为标准治疗组(阿托伐他汀10 mg/d)及强化治疗组(阿托伐他汀40 mg/d),观察治疗前和治疗1个月后血脂、hs-CRP及IL-10水平的变化.结果 ACS患者hs-CRP水平[(11.10±14.30)mg/L]明显高于SAP患者[(2.47±2.72)mg/L]和对照者[(2,34±4.22)mg/L],P均<0.05;ACS患者IL-10水平[(3.94±1.91)ng/L]明显低于SAP患者[(6.31±4.26)ng/L]和对照者[(7.76±2.82)ng/L],P均<0.05.强化治疗组与标准治疗组患者治疗后hs-CRP水平明显降低(P<0.05),IL-10水平明显升高(P<0.05),且强化治疗作用更强(P<0.05).结论 ACS患者hs-CRP水平明显升高,但IL-10水平明显降低,提示机体斑块不稳定与促炎和抗炎失衡有关.阿托伐他汀强化治疗能明显降低hs-CRP水平,升高IL-10水平,提示其稳定斑块的作用可能与改善促炎和抗炎失衡有关.     

阿托伐他汀减少冠脉介入治疗引起心肌损伤的研究

目的研究他汀类药物能否减少冠脉介入治疗(PCI)带来的心肌坏死。方法在PCI术前7 d随机给予阿托伐他汀40 mg/d或者安慰剂口服,在术前和术后8 h、24 h检测CK-MB、肌钙蛋白Ⅰ型和肌红蛋白。结果PCI术后心肌损伤的标记物升高,在阿托伐他汀组升高的人数明显低于安慰剂组,PCI术后酶学峰值升高在阿托伐他汀组比安慰剂组减低。结论在PCI术前7 d给予阿托伐他汀40 mg/d能明显减少心肌损伤。     

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.