大肠癌外周血及淋巴结癌胚抗原mRNA表达

目的 了解大肠癌患者不同临床分期外周血及淋巴结中癌胚抗原信使核糖核酸(CEA mRNA)相对表达量,为大肠癌术前诊断及分期提供依据.方法 采用实时荧光定量RT-PCR技术检测40例大肠癌患者和10名健康对照者外周血及淋巴结中CEA mRNA的相对表达量.结果 40例大肠癌患者手术前外周血CEA mRNA表达阳性率为87.5%,与正常对照组(10人元1例阳性)比较,差异有统计学意义(P<0.01);淋巴结A+B期阳性率15.8%,C+D期阳性率53.3%,差异有统计学意义(X2=5.4,P<0.05).C+D期大肠癌患者外周血中CEA mRNA阳性率较A+B期为高,但差异无统计学意义(X2=0.75,P>0.05).结论 大肠癌患者外周血中CEA mRNA相对表达量高于正常健康者,检测结果有助于大肠癌患者术前辅助诊断;淋巴结CEA mRNA阳性表达与不同临床分期密切相关,可作为大肠癌患者临床分期的参考.     

RT-PCR检测胃癌患者外周血中细胞角蛋白20 mRNA及其意义

目的检测胃癌患者外周血中细胞角蛋白20(CK20)mRNA的表达情况,并探讨其存在的临床意义。方法应用逆转录-聚合酶链反应(RT-PCR)检测56例胃癌(胃癌组)、18例良性胃病(良性胃病组)、20例正常献血者(对照组)外周血中CK20mRNA的表达情况。结果对照组及良性胃病组外周血中CK20mRNA均为阴性表达,胃癌组外周血中阳性表达率为35.7%。胃癌组外周血中CK20mRNA的阳性表达率在不同肿瘤组织学类型、TNM分期之间差异有统计学意义(P<0.05),在不同肿瘤部位及患者性别之间差异无统计学意义(P均>0.05)。结论胃癌患者外周血中CK20mRNA的阳性表达可作为肿瘤细胞血行播散的标志,有助于胃癌预后的判断。     

RT—PCR检测胃癌患者外周血中细胞角蛋白20mRNA及其意义

目的检测胃癌患者外周血中细胞角蛋白20（CK20）mRNA的表达情况，并探讨其存在的临床意义。方法应用逆转录-聚合酶链反应（RT—PCR）检测56例胃癌（胃癌组）、18例良性胃病（良性胃病组）、20例正常献血者（对照组）外周血中CK20 mRNA的表达情况。结果对照组及良性胃病组外周血中CK20 mRNA均为阴性表达，胃癌组外周血中阳性表达率为35．7％。胃癌组外周血中CK20 mRNA的阳性表达率在不同肿瘤组织学类型、TNM分期之间差异有统计学意义（P〈0．05），在不同肿瘤部位及患者性别之间差异无统计学意义（P均〉0．05）。结论胃癌患者外周血中CK20 mRNA的阳性表达可作为肿瘤细胞血行播散的标志，有助于胃癌预后的判断。     

食管癌患者外周静脉血细胞角蛋白7 mRNA与癌胚抗原mRNA表达的检测及临床价值

目的通过检测食管癌患者外周静脉血细胞角蛋白7(CK7)mRNA、癌胚抗原(CEA)mRNA表达,探讨CK7、CEA mRNA能否作为检测食管癌外周静脉血微转移的标志物。方法用随机表的方法选择和收集食管癌患者40例,门诊健康体检者40例的外周静脉血,用逆转录-聚合酶链反应(RT-PCR)测定CK7mRNA、CEA mRNA含量,分析其与临床病理特征的关系。结果门诊健康体检者组有3例CEA mRNA表达阳性,CK7mRNA均为阴性;食管癌组,CK7阳性表达率为50.00%(20/40);CEA阳性表达率为60.00%(24/40),二者同时阳性者占37.50%(15/40);二者至少1项阳性者占72.50%(29/40)。结合临床资料分析,食管癌患者外周静脉血CK7mRNA或CEA mRNA单基因表达阳性率与肿瘤患者的性别、年龄及浸润深度无相关性;与肿瘤临床分期相关(P0.05)。二者同时表达则与浸润深度、临床分期均有相关性(P0.05)。二者至少1项阳性表达与肿瘤临床分期相关(P0.05)。结论CK7、CEA mRNA可作为检测食管癌外周静脉血微转移的标志物,两者联合检测可提高检出率。     

血清CA724、CEA、TNF-α联合检测对进展期胃癌诊疗的临床价值

目的 探讨血清糖链抗原724(CA724)、癌胚抗原(CEA)、肿瘤坏死因子-α(TNF-α)联合检测在进展期胃癌(AGC)诊断、疗效判定及病情监测中的临床价值.方法 采用化学发光法检测20例AGC患者(A组)、20例良性胃病患者(B组)、20例正常人(C组)血清CA724、CEA、TNF-α的含量,比较A、B、C组受试者血清CA724、CEA、TNF-α含量的差异;检测并比较A组患者手术治疗前后外周静脉血、门静脉血中CA724、CEA、TNF-α含量的差异.结果 A组患者血清CA724、CEA、TNF-α的含量明显高于B、C组,差异有统计学意义(P＜0.05);A组患者手术治疗后CA724、CEA、TNF-α含量较手术治疗前明显下降,术后1个月CA724、CEA、TNF-α含量略有上升,各时间点差异有统计学意义(P＜0.05).结论 多数AGC患者血清CA724、CEA、TNF-α含量明显升高,血清CA724、CEA、TNF-α的联合检测有助于AGC的诊断、疗效判定及病情监测.     

大肠癌腹腔灌洗液CK 20及CEA mRNA的表达及意义

目的 探讨大肠癌腹腔灌洗液细胞角蛋白20(CK 20)及癌胚抗原(CEA)mRNA的表达及意义.方法 收集44例大肠肿瘤患者的术中腹腔灌洗液,其中大肠癌36例(大肠癌组),大肠良性病变8例(对照组),用逆转录聚合酶链反应(RT-PCR)方法测定腹腔灌洗液中游离细胞的CK 20 mRNA和CEA mRNA的表达.结果 大肠癌组腹腔灌洗液CK 20 mRNA和CEA mRNA表达阳性率分别为52.8%(19/36)、63.9%(23/36);总阳性率为80.6%(29/36);对照组CK 20mRNA及CEA mRNA结果均为阴性.CK 20 mRNA和CEA mRNA的阳性率与有无淋巴结转移、有无浆膜侵犯、肿瘤分化程度和Dukes分期有关(P＜0.05),与患者年龄、性别无关(P＞0.05).结论 随着Dukes分期的进展,大肠癌患者发生腹腔微转移的几率增加;CK 20与CEA一样,可作为检测大肠癌患者腹腔微转移的指标;二者联合应用,可提高大肠癌腹腔微转移的检出率.     

靛胭脂染色内镜在检测大肠微小息肉和腺瘤中的应用价值

目的 探讨靛胭脂染色内镜在大肠微小息肉和腺瘤中的检测价值.方法 将109例患者分为常规结肠镜阴性组(A组)、常规结肠镜阳性组(B组)、染色结肠镜阴性组(C组)、染色结肠镜阳性组(D组),分别行普通内镜及靛胭脂染色内镜诊断,并与组织学结果比较.比较2种内镜诊断方法对大肠微小息肉和腺瘤的诊断准确率.结果 靛胭脂染色内镜对微...     

逆转录聚合酶链反应检测大肠癌患者外周血CK—20mRNA

目的 检测大肠癌患者外周血CK－20mRNA并评价其临床意义。方法 应用逆转录聚合酶链反应（RT－PCR）检测肿瘤细胞株及大肠癌患者外周血CK－20mRNA。结果 大肠癌细胞株CK－20mRNA阳性；肺癌、肝癌、乳腺癌等肿瘤细胞株及20例健康志愿者外周血中未见CK－20mRNA的表达。51例大肠癌患者外周血中25例CK－20mRNA表达阳性，阳性率为49．0％。大肠癌患者外周血CK－20mRNA的表达与临床分期关系为：A期14．3％（1／7）、B期25．0％（3／12）、C期55．0％（11／20）、D期83．3（10／12）；其中C、D期与A、B期相比有显著性差异（P＜0．01）。结论 CK－20mRNA可以作为对大肠癌血行转移进行早期诊断的生物学标志物，并能监测大肠癌的疗效。     

乙型肝炎病毒基因型的研究

目的 研究常德市乙型肝炎病毒(HBV)基因型。方法 随机选择HBsAg阳性携带者65例，慢性乙型肝炎患者5例。应用FQ-PCR方法检测血清HBVDNA含量。采用微板核酸杂交-ELISA技术进行血清HBVA-F6种基因分型。结果 43例HBVDNA定量阳性血中B、D混合型占51．2％(22例)，B型占27．9％(12例)，C型占9．3％(4例)，C、D混合型占4．7％(2例)，B、C混合型占2．3％(1例)，未分型者2例，未发现A型、单纯D型、E型和F型。结论 常德市HBV基因型以B、D混合型为主，次为B型、C型，C、D混合型及B、C混合型。     

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.