充血性心力衰竭患者血清Ⅲ型前胶原氨基端肽检测的临床价值

目的　测定充血性心力衰竭患者血清中的Ⅲ型前胶原氨基端肽 (PⅢP)及层粘连蛋白 (LN)水平 ,探讨其对心肌纤维化的诊断价值。方法　选择 4 4例充血性心力衰竭患者 (心功能Ⅲ级以上 )和正常健康对照者 30例 ,用放射免疫法测定其血清中的PⅢP及LN水平。结果　心力衰竭患者血清中的PⅢP水平明显高于健康对照组 (5 5± 1 1) μg/Lvs (3 8± 1 5 ) μg/L(P <0 0 1) ,心力衰竭患者血清的LN水平明显高于健康对照组 (14 8 0±32 6 ) μg/Lvs (10 2 6± 2 3 2 ) μg/L(P <0 0 1) ,心功能Ⅳ级组血清的PⅢP水平明显高于心功能Ⅲ级组 (5 7± 0 8)μg/Lvs (5 2± 0 6 ) μg/L(P <0 0 5 ) ,心功能Ⅳ级组血清的LN水平明显高于心功能Ⅲ级组 (16 8 3± 2 2 6 ) μg/Lvs(14 6 2± 18 4 ) μg/L(P <0 0 5 )。结论　PⅢP及LN水平的升高可能部分与心肌纤维化有关 ,可在充血性心力衰竭患者的血清中检测出来 ,并能反映心衰的严重程度     

幽门螺旋杆菌检查在肝硬化围手术期处理中的意义

目的　了解肝硬化病人Hp感染及其在外科围手术期处理中的意义。方法　对 32例肝硬化病人进行Hp检查以及血氨浓度的测定。结果　⑴肝硬化病人的Hp感染率为 6 2 1% ;⑵Hp阳性者与阴性者的空腹血氨浓度分别是 (186 3 6± 142 4 ) μg/L和 (16 98 4± 156 7) μg/L ,二者差异无显著性 (P >0 0 5) ;Hp阳性者抗Hp治疗后的血氨浓度 (136 7 6± 152 9) μg/L ,较治疗前 (186 3 6± 142 4 ) μg/L明显降低 (P <0 0 1)。 结论　Hp感染在肝硬化高血氨症发生过程中具有一定的作用 ;肝硬化病人围手术期处理时应常规进行Hp检查 ;抗Hp治疗应作为预防肝性脑病的治疗手段之一     

二甲基甲酰胺对大鼠肾脏线粒体和微粒体~(45)Ca转运的影响

目的　研究二甲基甲酰胺 (DMF)对大鼠肾脏线粒体和微粒体4 5Ca转运的影响 ,探讨其肾脏损害的作用机制。方法　采用超速冷冻离心技术分离大鼠肾脏线粒体及微粒体 ,应用放射性同位素技术测定DMF对线粒体和微粒体4 5Ca主动摄取及释放的影响。结果　 (1) 45Ca的摄取 :孵育 10min时 ,DMF 130、195 μmol/L组大鼠肾线粒体4 5Ca摄取量分别为 (4 .2 0± 0 .2 9)、(3.81± 0 .42 )nmol/mgpro,对照组为(5 .18± 0 .40 )nmol/mgpro;微粒体4 5Ca摄取量分别为 (2 .10± 0 .42 )、(2 .0 1± 0 .38)nmol/mgpro ,对照组为(2 .96± 0 .38)nmol/mgpro。DMF两个剂量组与对照组的差异均有显著性 (P <0 .0 5或P <0 .0 1)。 (2 ) 45Ca的释放 :孵育 2min时 ,DMF 6 5、130、195 μmol/L组大鼠肾线粒体4 5Ca残留量分别为 (5 .40± 0 .39)、(5 .0 3±0 .32 )、(4 .70± 0 .5 0 )nmol/mgpro,对照组为 (6 .0 1± 0 .40 )nmol/mgpro ;微粒体4 5Ca残留量分别为 (3.43±0 .2 6 )、(3.18± 0 .31)、(3.0 6± 0 .2 7)nmol/mgpro ,对照组为 (4 .0 6± 0 .32 )nmol/mgpro。DMF两个剂量组与对照组的差异均有显著性 (P <0 .0 1)。(3)DMF与鼠肾线粒体和微粒体4 5Ca的摄取、释放均存在剂量 -效应关系 (前者 :r=0 .918,r=0 .895 ;后者 :r=0 .886     

重组人生长激素对肝硬化大鼠肝脏蛋白质代谢的影响

目的探讨重组人生长激素(recombinantgrowthhormone,rHGH)对肝硬化大鼠肝脏蛋白质代谢的影响。方法100只清洁级雄性SD大鼠,皮下注射3%硫代乙酰胺(TAA)溶液,制备大鼠药物损伤性肝硬化模型,从中随机抽取60只大鼠分为肝硬化组(n=30)和肝硬化+rHGH组(n=30)。正常组以生理盐水同法处理(n=30)。rHGH用法为1U·kg-1·d-1皮下注射,连续14天。注射后第14天取门静脉血测定胰岛素样生长因子-1(insulin-likegrowthfactor-1,IGF-1)、白蛋白、前白蛋白、转铁蛋白浓度,取肝脏做白蛋白mRNA定量测定。结果正常对照组血清白蛋白、前白蛋白、转铁蛋白浓度分别为(32.07±2.15)(1.84±0.11)和(2.85±0.45)g/L,肝硬化+rHGH组分、别为(27.68±2.31)(2.49±0.41)和(2.56±0.27)g/L,均高于肝硬化组的(21.98±1.86)(1.12±0.5)和(1.37±0.32)、、g/L(P<0.01)正常对照组和肝硬化+rHGH组IGF-1浓度比肝硬化组高,差异有显著性(P<0.01)。肝硬化+rHGH;组白蛋白mRNA表达量明显高于肝硬化组。结论rHGH具有刺激产生IGF-1和增加白蛋白mRNA表达量的作用,进而可促进肝细胞蛋白质合成,明显改善肝硬化引起的低蛋白血症。     

硒与氟对人肝细胞凋亡和脂质过氧化的影响

目的　研究硒、氟对离体培养的人肝细胞凋亡和脂质过氧化的影响。方法　体外培养的人肝细胞分别接触一定剂量的氟和 /或硒 1 2h后 ,检测肝细胞凋亡小体百分率、细胞周期构成比、还原型谷胱甘肽 (GSH)含量和脂质过氧化物 (LPO)的水平以及培养液中LPO和乳酸脱氢酶 (LDH)、丙氨酸转氨酶 (ALT)和天冬氨酸转氨酶 (AST)的活性。结果　加氟组肝细胞凋亡小体百分率 (1 5 557±2 0 56) % ,S期细胞数 (4 82 3± 0 454) % ,肝组织和培养液中LPO水平 [分别为 (2 884± 0 589)和 (3 547± 0 561 )nmol/LMDA/mg prot) ,培养液中AST和LDH含量 (分别为 91 1± 36 4和 1 4 0 4± 7 6U/L) ,均明显高于对照组 [分别为 (1 0 31 3± 1 0 2 3) % ,(3 2 53± 0 743) % ,(1 473± 0 40 1 )nmol/LMDA/mg ,(1 694± 0 443)nmol/LMDA/mg,(54 5± 3 2 )U/L和 (1 2 6 4± 2 6)U/L] ,而氟组肝组织GSH含量则明显低于对照组 [分别为 (4 2 2 5± 0 781 ) μg/mg和 (7 595± 1 0 4 2 ) μg/mg) ;硒可通过升高GSH含量 ,降低LPO、AST、LDH水平和凋亡小体百分率而拮抗氟产生的毒性作用。结论　一定剂量的硒可拮抗氟所诱导的肝细胞凋亡和脂质过氧化     

阿托伐他丁对心脏X综合征患者hs-CRP水平的影响

目的　观察心脏X综合征病人血循环中高敏C反应蛋白的变化以及阿托伐他丁的可能影响。方法　选取 2 5例心脏X综合征病人和 10例健康人。⑴比较心脏X综合征病人和健康人血清hs -CRP水平 ;⑵比较胸痛频率每周≥ 5次 (n =14 )和 <5次 (n =11)两组心脏X综合征病人血清hs -CRP的水平 ;⑶比较胸痛持续时间≥ 15min(n =13 )和 <15min(n =12 )两组血清hs -CRP的水平 ;⑷ 2 5例病人分为对照组 (n =12 ,予以消心痛 10mgTid和地尔硫卓 3 0mgTid)和治疗组 (n =13 ,在前者基础上加阿托伐他丁 2 0mgQD) ,持续 12周 ,比较两组胸痛症状和hs -CRP的变化。结果　⑴心脏X综合征病人血清hs -CRP显著高于健康人[( 3 7± 3 2mg/Lvs 0 9± 0 5mg/L ,P <0 0 1) ] ;⑵胸痛频率每周≥ 5次组血清hs -CRP高于 <5次组 [( 3 8± 2 4mg/Lvs 2 6± 2 6mg/L ,P <0 0 5 ) ] ;⑶胸痛持续时间≥ 15min组血清hs -CRP高于 <15min组 [( 3 9± 3 0mg/Lvs 2 7± 1 7mg/L ,P <0 0 1) ] ;⑷阿托伐他丁治疗组血清hs -CRP下降较对照组显著 [( 1 3± 1 6mg/Lvs 2 8± 3 1mg/L ,P <0 0 1) ] ,胸痛症状缓解更明显。结论　⑴hs -CRP可能与心脏X综合征的发病相关 ;⑵阿托伐他丁有助于降低心脏X综合征病人的hs -CRP水平并缓解症状     

锌缺乏对大鼠骨骼矿化的影响

目的　探讨缺锌对大鼠骨骼矿化的影响。方法　将 30只Wistar大鼠按体重随机分为缺锌组、对照组和对喂组 ,每组 10只。缺锌组饲料锌含量为 3 9mg/kg ,对照组饲料锌含量为 2 4 7mg/kg,对喂组饲对照组饲料 ,饲料摄入量与缺锌组相同。运用骨组织形态计量学方法测量骨骼矿化相关指标、测定股骨矿物质含量、骨密度、骨中锌、钙、磷、镁、锰、铜元素和骨骼羟脯氨酸含量及血中甲状旁腺激素、降钙素和骨钙素含量。结果　缺锌组大鼠与对照组和对喂组相比 ,骨矿化沉积速率、股骨磷、锌、骨羟脯氨酸及血清降钙素、骨钙素含量显著降低 ,缺锌组相应指标分别为 :( 3 2 6± 0 34) μm/d、( 6 4 5 4± 2 34)g/kg、( 5 4 4± 9 5 )mg/kg、( 9 2 8± 1 6 2 )g/kg、( 41 2± 13 5 ) μg/L、( 82± 30 ) μg/L ;对照组分别为 :( 5 37± 0 5 3) μm/d、( 6 9 0 1± 4 0 5 )g/kg、( 117 4± 8 0 )mg/kg、( 11 31± 1 30 )g/kg、( 6 8 3± 14 4)μg/L、( 131± 46 ) μg/L ;对喂组分别为 :( 5 45± 0 30 ) μm/d、( 6 7 81± 3 5 6 )g/kg、( 10 6 7± 8 4)mg/kg、( 10 88± 1 47)g/kg、( 6 3 7± 12 0 ) μg/L、( 12 0± 5 2 ) μg/L。骨矿化延迟时间和骨基质成熟时间显著增加 ,缺锌组相应指标分别为 :( 1 0 8± 0 19)     

肝性脑病患者血清神经元特异性烯醇化酶测定及意义

目的 :研究神经元特异性烯醇化酶 (neuron -specificenolase ,NSE)在肝性脑病时的意义。方法 :以ELISA法对46例肝性脑病患者的血清NSE水平进行了检测 ,并对不同肝病组、不同昏迷程度组的NSE进行比较分析。结果 :肝性脑病组NSE(46 .0 38± 2 4.2 6 0 ) μg/L显著高于慢性肝炎组 (12 .12 7± 5 .6 73) μg/L及对照组 (10 .196± 3.2 37)μg/L ;肝硬化、亚急性重肝、急性重肝引起的肝性脑病患者血清NSE水平依次增高 (P <0 .0 5 ) ;肝性脑病四期患者NSE水平显著高于一、二期患者。结论 :肝性脑病患者血清NSE水平显著升高 ,肝硬化、亚重肝、急性重肝引起的肝性脑病患者NSE依次增高 :昏迷程度重者 ,NSE水平较高。     

血清硒浓度对冠心病的影响

目的 :调查研究血清硒浓度对冠心病的影响。方法 :对 186名冠心病病人和 186名对照组病人 ,应用多道光谱扫描仪进行了血清硒测定和统计分析。结果 :冠心病人组平均血清硒浓度为 (10 3.95± 19.14) μg/ L,对照组病人平均血清硒浓度为 (12 7.10± 2 2 .0 4) μg/ L。冠心病人组平均血清硒浓度明显低于对照组 ,两组统计学上差异非常显著 (P<0 .0 1)。结论 :低血清硒将会增加冠心病发生的危险性。     

溴氰菊酯对大鼠神经细胞胞内游离钙浓度及凋亡的影响

目的　观察溴氰菊酯 (DM )对神经细胞游离钙浓度 ([Ca2 + ]i)及凋亡的影响。方法　Wistar大鼠随机分为对照组与 3个染毒组 ,染毒组腹腔注射 1 2 .5mg/kg的DM ;以Fura 2 /AM为荧光指示剂 ,RF 530 1PC荧光分光光度计测定染毒后 5、2 4、48h后大鼠神经细胞 [Ca2 + ]i浓度的变化 ;FACS42 0型流式细胞仪测定细胞凋亡率。结果　PM染毒 5、2 4、48h组大鼠海马及皮层细胞 [Ca2 + ]i分别为 :5h组海马 :(389.94± 43 .64)nmol/L、皮层 :(449.33± 2 3 .2 3)nmol/L ;2 4h组海马 :(340 .47±32 .36)nmol/L、皮层 :(31 1 .62± 2 5 .48)nmol/L ;48h组海马 (2 87.1 3± 2 4 .2 9)nmol/L、皮层 :(346 .55±36 .87)nmol/L ,均高于对照组 [海马 :(2 0 3 .2 4± 1 8.53)nmol/L、皮层 :(2 2 6 .85± 1 4 .81 )nmol/L] ,差异有显著性 (P <0 .0 1 )。染毒 48h组大鼠此二项指标值较 5h组明显下降 ,差异有显著性 (P <0 .0 5)。染毒 2 4、48h组大鼠神经细胞凋亡率 [海马 :(8.45± 1 .0 2 ) %、(9.44± 1 .1 4 ) % ,皮层 :(7.90± 0 .49) %、(8.0 1± 0 .87) % ]均明显高于对照组 [海马 :(2 .97± 0 .36) %、皮层 :(3 .50± 0 .48) % ] ,差异有显著性 (P<0 .0 1 ) ,且有时间 反应关系 (r=0 .940、0 .893)。结论　DM可影响大鼠神     

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.