尘肺患者外周血T淋巴细胞亚群与肺功能的相关性研究

目的探讨尘肺患者外周血T淋巴细胞亚群与其肺功能的相关性。方法选取某矿务集团职业病防治院住院的28名尘肺壹期男性患者为尘肺组,选取徐州医学院第二附属医院体检中心的27名男性健康检查者为对照组,收集尘肺组及对照组的身高、体质量、年龄等资料,采用流式细胞仪检测T淋巴细胞CD3~+、CD4~+、CD8~+及CD4~+/CD8~+的水平;采用便携式肺功能仪测量肺功能第1秒用力呼出量(FEV1)、用力肺活量(FVC)及FEV1/FVC的值。结果尘肺组CD3~+、CD4~+、CD4~+/CD8~+较对照组降低,CD8~+较对照组增高,差异有统计学意义(P0.05);尘肺组肺功能指标FEV1、FVC、FEV1/FVC较对照组均降低,差异有统计学意义(P0.05);T淋巴细胞亚群中CD4~+/CD8~+与FVC存在正相关(r=0.361,P0.05)。结论 T淋巴细胞各个亚群参与了尘肺患者肺的免疫损伤,并与其肺功能降低相关。     

外周血T淋巴细胞亚群表达水平对恶性肿瘤病理分期的评估价值

目的探讨外周血T淋巴细胞亚群表达水平对恶性肿瘤病理分期的评估价值。方法选取该院2017年1月至2017年11月收治的恶性肿瘤患者156例,抽取研究对象外周血测定T淋巴细胞亚群指标(CD3+、CD4+、CD8+、CD4+/CD8+)水平。统计患者治疗前后及不同TNM分期患者外周血T淋巴细胞亚群指标水平,分析外周血T淋巴细胞亚群指标水平与TNM分期相关性。结果治疗后研究对象CD3+、CD4+、CD8+、CD4+/CD8+分别为(56.42±10.03)%、(29.61±10.33)%、(40.11±9.68)%、0.85±0.19,CD3+、CD4+、CD4+/CD8+水平较治疗前降低,CD8+水平较治疗前增高,差异均有统计学意义(均P0.05);由单因素方差检验可知,不同TNM分期患者CD3+、CD4+、CD8+、CD4+/CD8+水平比较,差异均有统计学意义(均P0.05);多重比较可见,随着TNM分期增高,CD3+、CD4+、CD4+/CD8+水平不断降低,CD8+水平不断增高;CD3+、CD4+、CD4+/CD8+与TNM分期负相关,CD8+与TNM分期正相关(P0.05)。结论恶性肿瘤患者外周血T淋巴细胞亚群指标水平发生异常,其表达水平与疾病分期存在密切相关性,临床可通过测定外周血T淋巴细胞亚群指标水平对患者机体功能状态予以评估,以此调整治疗方案。     

儿童支气管哮喘血液CD4~+/CD8~+T淋巴细胞亚群水平变化

目的探讨儿童支气管哮喘血液CD4~+/CD8~+T淋巴细胞亚群水平变化。方法选择2016年10月-2017年10月住院支气管哮喘急性发作患儿60例为观察对象,对血液CD4~+/CD8~+T淋巴细胞亚群水平进行检测,比较支气管哮喘急性发作不同程度和不同治疗时间血液T淋巴细胞亚群CD4~+、CD8~+和CD4~+/CD8~+水平变化。结果不同治疗时间血液T淋巴细胞亚群水平比较,随着治疗时间延长,血液CD4~+T淋巴细胞亚群下降(F=34.68,P0.01);血液CD8~+T淋巴细胞亚群水平升高(F=43.52,P0.01);CD4~+/CD8~+下降(F=28.07,P0.01);随着儿童支气管哮喘急性发作程度加重,血液CD4~+T淋巴细胞亚群水平升高(F=17.44,P0.01);而CD8~+T淋巴细胞亚群水平下降(F=6.75,P0.01);CD4~+/CD8~+升高(F=38.42,P0.01);血液CD4~+/CD8~+比值与支气管哮喘急性发作程度和治疗时间呈正相关(r值分别为0.76、0.64,P0.01)。结论支气管哮喘急性发作程度和治疗时间与血液CD4~+/CD8~+ T淋巴细胞亚群水平有关,血液CD4~+/CD8~+T淋巴细胞亚群水平可用于评估支气管哮喘急性发作程度和缓解情况。     

儿童难治性支原体肺炎血液T淋巴细胞亚群水平及脾氨肽冻干粉对其影响

目的探讨儿童难治性支原体肺炎血液T淋巴细胞亚群水平及脾氨肽冻干粉对其影响。方法选择2016年11月-2017年11月住院儿童难治性支原体肺炎患儿60例为RMPP组,取同期健康体检者60例为对照组,对2组血液T淋巴细胞亚群水平进行检测,并比较RMPP组脾氨肽不同治疗时间血液T淋巴细胞亚群水平。结果 RMPP组和对照组T淋巴细胞亚群CD4~+、CD8~+及CD4~+/CD8~+比较,差异有统计学意义(P0.01);随着RMPP组脾氨肽冻干粉治疗时间延长,CD4~+T淋巴细胞亚群水平显著下降(F=12.09,P0.01);CD8~+T淋巴细胞亚群水平显著升高(F=32.27,P0.01),CD4~+/CD8~+水平显著下降(F=39.15,P0.01);外周血CD4~+/CD8~+淋巴细胞水平与脾氨肽治疗时间呈负相关(r=-0.55,P0.01)。结论难治性支原体肺炎与血液T淋巴细胞亚群水平有关,动态观察外周血CD4~+/CD8~+淋巴细胞水平对RMP诊断和疗效有一定参考价值。     

宫颈高危型人乳头瘤病毒感染患者阴道微生态和外周血T淋巴细胞亚群分析

目的分析宫颈高危型人乳头瘤病毒(HPV)感染患者阴道微生态和外周血T淋巴细胞亚群。方法选取2017年8月-2019年8月宁波大学医学院附属鄞州医院妇科门诊收治的138例生殖道感染患者,分为HPV感染组(57例)和普通感染组(81例),另选取同期50例健康女性为对照组。比较3组阴道菌群和外周血T淋巴细胞亚群。结果 HPV感染组乳酸杆菌、衣原体、解脲脲原体及滴虫阳性率分别为33.33%、87.72%、84.21%及80.70%;普通感染组乳酸杆菌、衣原体、解脲脲原体及滴虫阳性率分别为55.56%、60.49%、53.09%及50.62%;对照组乳酸杆菌、衣原体、解脲脲原体及滴虫阳性率分别为78.00%、38.00%、22.00%及24.00%。3组乳酸杆菌、衣原体、解脲脲原体及滴虫阳性率比较,差异均有统计学意义(χ~2=21.487,P=0.000;χ~2=16.445,P=0.000;χ~2=20.885,P=0.000;χ~2=21.673,P=0.000)。HPV感染组乳酸杆菌阳性率显著低于普通感染组和对照组,衣原体、解脲脲原体、滴虫阳性率均显著高于普通感染组和对照组(均P0.05)。HPV感染组外周血CD3~+、CD4~+及CD8~+T淋巴细胞亚群水平,CD4~+/CD8~+比值分别为(48.45±4.45)%、(45.03±4.78)%、(32.45±4.05)%及(1.39±0.35);普通感染组外周血CD3~+、CD4~+及CD8~+T淋巴细胞亚群水平,CD4~+/CD8~+比值分别为(53.89±5.19)%、(48.02±4.08)%、(29.98±3.18)%及(1.60±0.41);对照组外周血CD3~+、CD4~+及CD8~+T淋巴细胞亚群水平,CD4~+/CD8~+比值分别为(57.70±5.09)%、(51.98±4.17)%、(27.56±3.34)%及(1.89±0.48)。3组外周血CD3~+、CD4~+及CD8~+T淋巴细胞亚群水平,CD4~+/CD8~+比值比较差异均有统计学意义(F=10.030,P=0.000; F=20.301,P=0.000; F=6.756,P=0.000; F=6.331,P=0.000)。HPV感染组外周血CD3~+、CD4~+T淋巴细胞亚群水平及CD4~+/CD8~+比值均显著低于普通感染组和对照组,CD8~+T淋巴细胞亚群水平显著高于普通感染组和对照组(均P0.05)。宫颈高危型HPV感染患者乳酸杆菌与外周血CD3~+、CD4~+T淋巴细胞亚群及CD4~+/CD8~+比值呈正相关,与CD8~+T淋巴细胞亚群呈负相关(均P0.05);宫颈高危型HPV感染患者衣原体、解脲脲原体、滴虫与CD3~+、CD4~+T淋巴细胞亚群及CD4~+/CD8~+比值呈负相关,与CD8~+T淋巴细胞亚群呈正相关(均P0.05)。结论宫颈高危型HPV感染患者存在阴道菌群紊乱和免疫功能低下,纠正宫颈高危型HPV感染患者的阴道微生态,提高患者免疫能力,对于宫颈高危型HPV感染有一定的治疗作用。     

宫颈高危型人乳头瘤病毒感染者外周血淋巴细胞亚群 变化的意义

目的探讨宫颈高危型人乳头瘤病毒(HPV)感染者外周血淋巴细胞亚群变化的意义。方法选取2014年8月—2016年8月中核四○四医院收治的HPV基因分型检测为阳性的373例患者为研究组,HPV基因分型检测为阴性的85例患者为对照组。流式细胞检测法检测各组外周血中淋巴细胞亚群(CD3+、CD4+和CD8+)数量,计算CD4+/CD8+比值。比较研究组中,不同CIN分型、宫颈癌分期、组织分化及淋巴结转移患者T细胞亚群的检测结果。结果研究组外周血中CD3+、CD4+淋巴细胞亚群数量较对照组有不同程度降低,CD8+淋巴细胞亚群数量较对照组有不同程度升高,CD4+/CD8+比值较对照组有不同程度降低,经比较差异有统计学意义(P0.05)。随着CIN分级、宫颈癌分期的增加,外周血中CD3+、CD4+淋巴细胞亚群数量逐渐降低,CD8+淋巴细胞亚群数量逐渐增加,CD4+/CD8+比值逐渐降低,组间比较差异有统计学意义(P0.05)。分化程度越低、淋巴结转移阳性的患者外周血CD4+淋巴细胞亚群数量越低,CD8+淋巴细胞亚群数量越高,CD4+/CD8+比值越低,组间比较差异有统计学意义(P0.05)。结论宫颈高危型人乳头瘤病毒(HPV)感染者存在细胞免疫功能低下,淋巴细胞亚群及CD4+/CD8+比值的检测有助于预测HPV感染的转归。     

COPD患者外周血淋巴细胞亚群及其表面受体CXCR3的表达及相关分析

目的探讨外周血中淋巴细胞亚群及趋化因子受体3(CXCR3)在慢性阻塞性肺疾病(COPD)各期中的表达及其相互关系。方法选择COPD急性加重期、稳定期患者67例和健康体检者40例,采用流式细胞术检测外周血淋巴细胞亚群及CXCR3的表达水平。结果 COPD急性加重期、稳定期患者与健康对照组人群比较,外周血CD3+、CD4+、CD4+/CD8+、NK细胞、B细胞水平明显降低,差异具有统计学意义(P0.05);COPD急性加重期组与稳定期组外周血中CD4+、CD8+T淋巴细胞表面的CXCR3水平均高于对照组,差异具有统计学意义(P0.05),且COPD急性加重期组高于稳定期组,差异均具有统计学意义(P0.05)。结论 COPD患者存在免疫功能紊乱,细胞免疫和体液免疫能力下降,淋巴细胞亚群及CXCR3参与COPD的发生与发展过程。     

鼻咽癌患者外周血T细胞亚群及活化T淋巴细胞的检测及放疗后对其变化的影响

目的:探讨用流式细胞仪检测鼻咽癌(NPC)患者外周血T细胞亚群及活化T淋巴细胞的检测及放疗后对其变化的影响。方法:用双色直标的免疫荧光试剂,采用流式细胞术检测30例正常人,128例NPC患者外周血在细胞膜受体上的表达。结果:126例NPC患者外周血T细胞亚群中的CD3+、CD4+、CD4+/CD8+比值明显下降,CD8+升高,导致NPC患者免疫功能紊乱,特别是细胞免疫功能明显低下,放疗后肿瘤有复发或转移者CD4+、CD4+/CD8+也有明显的下降。NPC患者的活化淋巴细胞CD3+/HLA—DR、CD8+/HLA—DR的含量明显高于正常对照组活化T淋巴细胞的含量(P<0.01)。结论:用流式细胞术检测T细胞亚群及活化T淋巴细胞,对NPC患者的免疫功能状况,放疗对免疫功能的影响,对NPC放疗后复发及转移的可能性判断有一定的临床意义。     

复发性口腔溃疡患者外周血T淋巴细胞亚群的变化及卡介菌多糖核酸注射液的干预作用

目的 探讨复发性口腔溃疡(RAU)患者外周血T淋巴细胞亚群的变化及卡介菌多糖核酸注射液(斯奇康)的干预作用.方法 选择RAU患者40例(治疗组)予以斯奇康1 mg肌肉注射,隔日1次,连续治疗8周;后改为5 mg肌肉注射,每周1次,连续治疗8周,总疗程为16周.观察治疗前后外周血T淋巴细胞亚群的变化,并进行疗效评定.并以30例健康体检者作为对照组.结果 与对照组比较,治疗组患者外周血CD3+、CD4+明显减少,CD8+明显增加,CD4+/CD8+比值明显下降(P＜0.05或＜0.01).治疗组治疗后外周血CD3+、CD4+明显增加,CD8+明显减少,CD4+/CD8+比值明显升高,临床总有效率95.0%(38/40).结论 RAU患者存在外周血T淋巴细胞亚群失衡,斯奇康治疗RAU的临床疗效确切,其作用机制可能是改善RAU患者外周血T淋巴细胞亚群失衡.     

HIV/AIDS患者T淋巴细胞HLA-DR抗原表达分析

目的:研究HIV/AIDS患者外周血T淋巴细胞HLA-DR抗原的表达,探讨其临床意义。方法:用流式细胞仪检测71例HIV/AIDS患者和40例健康体检者外周血T淋巴细胞亚群及各亚群HLA-DR抗原百分比(HLA-DR+CD3+/CD3+、HLA-DR+CD4+/CD4+、HLA-DR+CD8+/CD8+)。结果:①与对照组相比,HIV组和AIDS组的CD3细胞、CD4细胞、CD8细胞HLA-DR抗原百分比均显著高于对照组;AIDS组的CD3细胞、CD4细胞HLA-DR抗原百分比均显著高于HIV组。②HIV/AIDS患者CD3细胞、CD4细胞HLA-DR抗原百分比均与CD4细胞数负相关,相关系数分别为r=-0.392(P<0.01)、r=-0.619(P<0.01)。结论:HIV/AIDS患者T淋巴细胞持续紊乱,测定T淋巴细胞HLA-DR抗原表达有助于评价HIV/AIDS患者的免疫状况以及疾病的进程。     

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.     

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.