伴有和不伴有自杀行为抑郁症遗传效应的比较研究

目的 了解伴有自杀行为的抑郁症和不伴有自杀行为的抑郁症之间是否存在遗传差异.方法 用家族史法对124例伴有自杀行为的抑郁症和115例不伴有自杀行为的抑郁症患者进行研究,用多基因阈值理论估算遗传率和标准误.结果 伴有自杀行为的抑郁症患者的一级亲属精神疾病患病率,一级亲属及一至三级亲属抑郁症患病率分别为9.64%、6.63%、1.86%,均显著高于不伴有自杀行为的抑郁症患者(均P<0.05);伴有自杀行为的抑郁症的加权平均遗传率及标准误为(44.51±1.01)%,显著高于不伴有自杀行为的抑郁症患者(u=5.46,P<0.01).结论 伴有和不伴有自杀行为的抑郁症患者的遗传效应之间存在遗传差异.     

山西省贲门癌遗传流行病学研究

目的 探讨山西省贲门癌发病因素中遗传因素的作用.方法 采用病例对照研究方法 ,对病例及对照的Ⅰ、Ⅱ、Ⅲ级亲属所有成员的姓名、性别、出生和死亡日期以及疾病诊断与治疗进行调查.用Falconer法和Li-Mentel-Gart法计算贲门癌的遗传度和分离比.结果 (1)病例组Ⅰ、Ⅱ、Ⅲ级亲属的贲门癌患病率分别是0.54%、0.04%、0.05%;病例组Ⅰ、Ⅱ、Ⅲ级亲属的上消化道癌患病率分别为2.50%、0.36%、0.13%.贲门癌与上消化道癌患病呈现Ⅰ>Ⅱ>Ⅲ级亲属的趋势,表现为家族聚集性,男女性均如此.(2)贲门癌先证者Ⅰ级亲属患贲门癌的遗传度为11.71%,其中女性为14.72%,男性为14.01%;贲门癌先证者Ⅰ级亲属患上消化道癌的遗传度为13.87%,其中女性为23.08%,男性为11.49%,均低于25%,属低遗传肿瘤.(3)病例组同胞中上消化道分离比为0.0452,其中男性为0.0441,女性为0.0507,均低于0.25,不符合单基因遗传方式,属多基因遗传方式.结论 遗传因素是贲门癌的危险因素,但不是山西省贲门癌高发的主要危险因素.     

鼻内镜下切除治疗鼻腔鼻窦内翻性乳头状瘤的临床研究

[目的]探讨鼻内镜下切除鼻腔鼻窦内翻性乳头状瘤(NIP)的治疗效果和可行性。[方法]回顾性分析2005年10月～2010年8月行手术治疗的100例NIP患者的临床资料,行鼻侧切开术治疗57例(鼻侧切开组),行鼻内窥镜手术治疗42例(鼻内镜组)。术后随访1～3年,平均(32±11)个月,观察术后复发率和并发症发生率。[结果]鼻内镜组术后肿瘤复发率为18.6%,显著低于鼻侧切开组(29.3%),差异有统计学意义(χ2=6.574,P﹤0.01);Ⅱ、Ⅲ级患者术后肿瘤复发率均显著低于鼻侧切开组,差异有统计学意义(χ2=9.150、5.648,P﹤0.01);Ⅳ级患者术后肿瘤复发率显著高于鼻侧切开组,差异有统计学意义(χ2=9.100,P﹤0.01)。鼻内镜组术后并发症发生率为9.3%,显著低于鼻侧切开组(24.6),差异有统计学意义(χ2=8.200,P﹤0.01);Ⅱ、Ⅲ级患者术后并发症发生率均显著低于鼻侧切开组,差异有统计学意义(χ2=7.721、6.102,P﹤0.01);Ⅳ级患者术后并发症发生率均显著高于鼻侧切开组,差异有统计学意义(χ2=9.019,P﹤0.01)。而两组Ⅰ级患者术后肿瘤复发率和并发症发生率比较差异无统计学意义(χ2=1.761,2.361,P﹥0.05)。[结论]鼻内镜下切除治疗NIP临床效果好,术后复发率低、并发症少,但在治疗NIP时应根据Krouse分级选择合适的术式。     

高频彩色多普勒超声在甲状腺良恶性结节诊断中的应用价值

[目的]探讨高频彩色多普勒超声检查在甲状腺良恶性结节诊断中的临床应用价值。[方法]对87例甲状腺结节患者于术前行超声检查,比较良恶性结节的二维超声声像图与彩色多普勒(CDFI)特征。[结果]34例甲状腺癌组中Adler分级Ⅱ级与III级者25例,约占73.5%,明显高于良性甲状腺结节组(P﹤0.05);恶性结节分支型和穿入型血管的检出率分别为33.3%与45.1%,显著高于良性结节(P﹤0.01),而两组点线型与团状型比较差异无统计学意义(P﹥0.05);恶性结节的阻力指数(RI)明显高于良性结节(P﹤0.05),而两者收缩期峰值流速(Vmax)比较差异无统计学意义(P﹥0.05)。[结论]彩色多普勒超声检查对甲状腺良恶性结节具有较高的诊断价值。     

血清VEGF、CEA、NSE在非小细胞肺癌诊断中应用价值研究

[目的]探讨血清血管内皮生长因子(VEGF)、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)在非小细胞肺癌(NSCLC)诊断中的应用价值,旨在为肺癌的诊治提供理论参考。[方法]采用ELISA方法测定100例NSCLC患者和50例健康查体者血清VEGF、CEA、NSE水平,并分析其与病理分型和临床分期的关系。[结果]肺癌组血清CEA、NSE、VEGF水平均显著高于对照组,相比较差异有统计学意义(P﹤0.05);鳞癌患者血清CEA和NSE水平显著高于腺癌,相比较差异有统计学意义(P﹤0.05);而血清VEGF水平在鳞癌和腺癌患者中差异无统计学意义(P﹥0.05);血清VEGF、CEA、NSE水平随着临床分期的递增而显著上升,其血清水平为Ⅳ期﹥Ⅲ期﹥I～Ⅱ期,3组之间比较差异有统计学意义(P﹤0.05)。[结论]联合检测肺癌患者血清中VEGF、CEA、NSE水平的变化,对NSCLC的早期诊断和鉴别具有重要的临床价值。     

郑州地区儿童单纯性肥胖症流行病学研究

[目的]了解郑州地区肥胖儿童发生情况,探讨郑州市儿童肥胖的流行病学特征,分析肥胖对儿童健康的影响因素。[方法]采用分层及随机抽样方法对该市中小学生进行现场调查。按WHO推荐,采用身高标准体重法。[结果](1)城区2880名中小学生超重发生率16.53%,肥胖发生率28.97%,小学生、初中、高中各阶段超重和肥胖发生率差异无统计学意义(χ2=12.31,P﹥0.25);而男生肥胖发生率明显高于女生(χ2=44.46,P﹤0.001);(2)郊区2880名中小学生超重发生率17.39%,肥胖发生率13.65%,小学生、初中、高中各阶段肥胖发生率分别为12.15%、14.17%、16.11%,差异有统计学意义(χ2=353.42,P﹤0.005);郊区男女儿童肥胖发生率及肥胖度差异无统计学意义(χ2=0.66,P﹥0.25);(3)城区中小学生肥胖发生率明显高于郊区(χ2=201,P﹤0.005)。[结论]郑州地区儿童肥胖发生率急剧上升,该市应采取有效措施防治儿童肥胖是当务之急。     

罗哌卡因联合利多卡因应用于腰丛-坐骨神经阻滞的临床研究

[目的]将利多卡因与罗哌卡因联合应用于腰丛-坐骨神经阻滞,拟获得可加快阻滞起效时间、增强运动阻滞效果、但不影响运动功能恢复的利多卡因浓度。[方法]ASAⅠ～Ⅱ级择期下肢手术患者115例,随机分I组(0.22%罗哌卡因)、II组(0.22%罗哌卡因+0.17%利多卡因)、III组(0.22%罗哌卡因+0.25%利多卡因)、IV组(0.22%罗哌卡因+0.33%利多卡因)及V组(0.3%罗哌卡因)。腰丛-坐骨神经阻滞,注入试验药物60ml,阻滞后30min内间断行感觉、运动功能评分,记录术中麻醉药物用量、肌松满意度、不良反应发生率、感觉及运动恢复时间。[结果]2～15minIII、IV组股神经感觉VAS评分明显低于I、II、V组(P﹤0.05),2～10minIII-V组股神经感觉完全阻滞率明显高于I、II组(P﹤0.05),25min时5组均为100%;坐骨神经感觉VAS评分及完全阻滞率5组各时点比较差异均无统计学意义(P﹥0.05);10～15minII～IV组运动完全阻滞率明显高于I、V组(P﹤0.05);术中肌松满意度、感觉与运动恢复时间5组比较差异无统计学意义(P﹥0.05)。[结论]0.22%罗哌卡因行腰丛和坐骨神经阻滞可达到与0.3%罗哌卡因相同的阻滞效果,联合利多卡因可加快感觉与运动阻滞起效时间,但并不能改变其阻滞效果和延长阻滞时间。     

TPH2基因单核苷酸多态性与情感性精神障碍及其自杀行为的关系

[目的]探讨色氨酸羟化酶2(TPH2)基因rs7305115单核苷酸多态性与情感障碍及自杀行为的关系。[方法]提取402例情感障碍患者和225名健康对照者基因组DNA,采用聚合酶链反应(polymerase chain reactionPCR)扩增含TPH2基因rs7305115位点的312bp基因组DNA片段,并将PCR产物直接测序。[结果]在第7外显子周围未发现其他的单核苷酸多态性。情感障碍患者和健康对照者TPH2rs7305115基因型和等位基因频率差异无统计学意义(P﹥0.05),但患者组内有自杀行为的个体携带基因型AA的频率及等位基因A的频率均较低,差异有统计学意义(P﹤0.01)。[结论]TPH2基因rs7305115单核苷酸多态性与情感障碍无明显关联,与自杀行为有关联,其可能与情感障碍自杀行为易感性相关。     

原发性肝癌家族单位监测的研究

108例原发性肝癌先证者“家族单位”成员,血缘与肝癌,环境与肝癌发生的关系监测结果表明,有血缘关系的发生率为6.19％(21/3393),无血缘关系的发生率为1.19％(211684),P<0.025,显示遗传基础所决定的家族易患性的作用;因环境居住的发生率为9.01‰(12/1332),不同环境居住的发生率为2.94％(11/3745),P<0.005,显示环境条件所决定的家族易患性的作用。应用FaIconer回归法计算遗传度:1级亲属为52.40±15.56％,2级亲属为64.52±34.12％,3级亲属为88.43±57.15％,1、2、3级亲属(联合计算)为58.38±13.74％。     

203例哮喘患儿家族史关系调查

[目的]通过支气管哮喘的患儿进行家属病史调查,为诊断提供参考。[方法]对门诊就诊并确诊为哮喘的患儿203例和非支气管哮喘的呼吸道疾病患儿205例的亲属做家族过敏性疾病史问卷调查。[结果]在203例哮喘患儿中,Ⅰ级亲属456名,患各种过敏性疾病者214例(46.9%);Ⅱ级亲属2086人中,有156例患病(7.5%)。Ⅰ、Ⅱ级亲属中均以哮喘、过敏性鼻炎和荨麻疹患病率较高。对照组患儿Ⅰ级亲属559人中,患各种过敏性疾病者47例(8.4%);Ⅱ级亲属2152人中,有26例患病(1.2%)。Ⅰ、Ⅱ级亲属中均以湿疹和荨麻疹患病率较高。两组对照以哮喘组亲属过敏性疾病患病率较高(P＜0.05)。[结论]家属过敏性疾病史在哮喘诊断上有重要参考意义。     

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.     

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.