口服二巯丁二酸治疗铅中毒的临床研究

本文观察口服DMSA治疗铅中毒70例,铅吸收47例,铅接触者20例,共137例的疗效:驱铅作用明显,排铅量可达治疗前18倍。血铅下降,δ-ALAD活性恢复正常,ZPP有下降趋势,副作用轻微,使用方便。     

口服二巯丁二酸胶囊驱汞效果观察

对39例汞作业人员口服二巯丁二酸(DMSA)胶囊驱汞治疗前后尿汞水平进行统计分析比较。结果显示,口服DMSA后尿汞水平高于治疗前,差异有统计学意义(P<0.05);16例口服DMSA后第1天、第2天、第3天和第三疗程第3天24 h尿总汞水平相近,两两比较差异均无统计学意义(P>0.05);肌注二巯丙磺钠(Na-DMPS)后尿汞水平明显增高,平均增加排汞量可达口服DMSA的20倍以上。口服DMSA虽可促进尿汞排出,但驱汞效果明显不及Na-DMPS。     

不同治疗方案儿童驱铅效果与血微量元素变化分析

目的通过驱铅治疗前后儿童血微量元素水平的变化,评价不同治疗方案的安全性及有效性。方法对2008—2013年59例诊断为中度以上铅中毒的患儿随机分成3组,采用3种不同疗法,并于驱铅前后检测铁、锌、钙、铜、镁、铅6种元素,进行纵横向比较。结果单纯二巯基丁二酸（DMSA）组服药19d驱铅63%,但造成血铁、镁、钙、锌下降8.2%～14.8%,经1个月自然饮食后微量元素损失可恢复;DMSA＋碳酸钙、多维元素片组驱铅效果与DMSA组相同,但微量元素流失减少;单纯祀枣口服液组效果不如DMSA组,其安全性类似。结论 DMSA快速安全有效,驱铅有高度选择性,对血中微量元素铁、锌、钙、镁的驱出量在可接受范围,总体效果优于祀枣口服液,结合补充微量元素,能减少相关微量元素驱出,适用于中度以上儿童铅中毒的治疗。     

儿童铅中毒防治的新进展

本文从儿童铅中毒诊断标准、我国儿童铅中毒现状、国内外降低儿童血铅水平的综合措施等 3方面 ,对儿童铅中毒初级预防和驱铅治疗的最新进展进行了综述。重点介绍了控制环境铅污染、开展健康教育对降低儿童血铅水平的重要意义 ;口服二巯基丁二酸 (DMSA)及增加膳食钙摄入对中度铅中毒儿童的治疗作用     

劳动卫生

961439铅作业者口服二疏基丁二酸的排铅效果/张幼辰…刀中国预防医学杂志一1995,29(2)一110 研究对象为上海冶炼厂脱岗疗养的21名铅作业工人(非铅中毒者),经口服二琉基丁二酸(DM sA)o·59,每日3次,共6d的治疗,尿铅排出量为用药前的1.61倍;改用减半量的DMsA并加适量的维生素C时,排铅效果高达4.88倍。DMsA口服胶囊使用方便,易吸收,排铅效果显著,又无副作用,不仅可用于治疗铅中毒和铅吸收,而且对低铅负荷者也同样具有排铅作用。本调查结果提示,口服DMSA时,加用适量的维生素c有促进排铅作用。 (赵阳)子代x线骨摄片发现9例胫排骨干髓端有铅…     

口服二巯丁二酸驱汞效果临床观察

二巯丁二酸(DMSA)是广谱金属解毒剂,具有疗效高、无毒性的特点 [1].多年来一直受到人们关注,20世纪80年代我国合成了口服制剂,并证实它对铅、铜、锑、锶、铊和钷具促排作用[2].但DMSA驱汞效果报道较少,为此本文报告口服DMSA 40例汞作业工人排汞的疗效观察,试图为汞的中毒防治提供有益线索.     

口服二巯丁二酸治疗慢性铅中毒临床观察

分析螯合剂二巯丁二酸对42例慢性铅中毒患者进行3个疗程的驱铅治疗结果,并与CaNa2-EDTA进行比较,发现两者排铅效果、临床症状体征改善、Hb的提高等差异无显著性（P〉0．05）,但副作用二巯丁二酸较CaNa2-EDTA轻,对铅性肾损害有一定保护作用;建议对慢性铅中毒患者采用二巯丁二酸代替CaNa2-EDTA进行驱铅治疗,特别对肾等软组织性慢性铅中毒患者更有好处。     

88例职业性慢性铅中毒的临床分析

目的分析88例职业性慢性铅中毒病例,探讨铅中毒的临床表现和驱铅治疗效果。方法分析88例职业性慢性铅中毒患者的临床特点,并给予驱铅治疗,检查尿铅变化等。结果其中84例为轻度铅中毒,3例为中度铅中毒,1例重度铅中毒。经2～8个疗程驱铅治疗后以上病例的相关临床表现均明显好转。结论职业性铅中毒的症状是多方面的,驱铅治疗效果好,一般预后良好。     

口服二巯丁二酸驱铅试验效果的探讨

目的探讨二巯丁二酸(DMSA)驱铅试验在铅中毒诊断上的可行性。方法197名受检者随机分配成DMSA驱铅试验组和依地酸二钠钙(CaNa2-EDTA)驱铅试验组;用石墨炉原子吸收光谱测定个体尿铅含量。结果两组驱铅效果非常接近,两组24h驱铅量差异无显著性(P>0.05);两组铅中毒观察对象、铅中毒检出率差异均无显著性(P>0.05)。结论本研究表明现行驱铅试验诊断标准的限值同样适用于DMSA进行驱铅试验。     

儿童重度铅中毒的临床诊治疗效分析

目的探讨儿童重度铅中毒的临床特点和治疗疗效。方法回顾分析本院收治9例铅中毒患儿的临床资料,按照《儿童高铅血症和铅中毒预防指南》和《儿童高铅血症和铅中毒分级和处理原则（试行）》进行诊治,对各项结果进行综合分析。结果重度铅中毒的患儿贫血7例（77.8%）、纳差5例（55.6%）、多动4例（44.4%）、爱哭闹4例（44.4%）、脾气暴躁3例（33.3%）、有攻击性行为2例（22.2%）、经常便秘2例（22.2%）、腹痛1例（11.1%）、明显发育落后1例（11.1%）。经过3次驱铅治疗后,血铅下降明显（0.01〉P〈0.05）。结论环境污染、生活接触是儿童铅中毒的主要原因,重度铅中毒需要多个疗程的驱铅治疗,血铅水平才能稳定降至250 mg/L以下。     

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.