镉对离体肾小管上皮细胞内钙稳态的影响

以离体肾小管上皮细胞为研究对象，重金属镉为损伤因素，观察了镉致肾小管上皮细胞损伤时细胞内钙稳态的变化及其与肾小管上皮细胞损伤之间的关系。结果表明，用重金属镉处理后，肾小管上皮细胞内胞浆游离钙水平明显升高，且同时伴有一系列超微结构的损害；钙通道阻滞剂异丙嗪表现出明显的阻断、保护作用。本实验提示在重金属镉致肾损伤过程中钙超载机制起着很重要的作用。     

镉对大鼠肾小管上皮细胞E-cadherin影响

目的 探讨镉对体内肾小管上皮细胞E-cadherin依赖的黏附连接是否产生损伤作用。方法将大鼠分2组。实验组皮下注射含Cd 1．4mg／kg CdCl2溶液，每周3次，共4周。对照组在相应时间内皮下注射生理盐水。4周后，收集大鼠24螺样，切取肾皮质。测定尿碱性磷酸酶（LDH）活性、尿蛋白和肌酐含量、肾皮质谷胱甘肽（GSH）和丙二醛（MDA）含量，观察肾脏形态学变化及E-cadherin蛋白表达。结果CA组大鼠尿LDH活性和尿蛋白含量与对照组比较均明显升高。肾皮质GSH含量显著升高，MDA含量变化不明显。Cd组大鼠近端小管上皮细胞排列散乱，刷状缘大面积脱落。有局灶性的空泡变性。与对照组比较，Cd组中E-cadherin在肾小管上皮细胞的基底侧表达明显减少。结论在肾脏处于较低水平的氧化损伤时镉就可干扰体内肾小管上皮细胞E-cadherin依赖的黏附连接。E-cadherin是镉肾毒性的相对较早的靶部位；E-cadherin依赖黏附连接的损伤可能是镉肾毒性的一个重要机制。     

镉对肾小管上皮细胞钙黏蛋白的影响

目的 探讨镉对原代培养的肾小管上皮细胞毒作用的早期环节。方法 采用筛网分离法分离Wistar大鼠肾小管上皮细胞;分别用10、20和50μmol/L的CdCl2溶液培养细胞0、1、2和4h,测定细胞活力、细胞内ALP活性、GSH含量、细胞外液LDH活性及上皮细胞钙黏蛋白（E-cadherin）表达。结果 不同浓度的CdCl2作用培养细胞后,可造成细胞内ALP活性下降,并表现出明显的剂量-反应关系和时间-反应关系;50μmol/L CdCl2作用细胞2h时,细胞外液LDH活性已明显高于对照组;4h时细胞内GSH含量与对照组比较显著下降;而10 μmol/L的CdCl2作用细胞2h,即可使肾小管上皮细胞钙黏蛋白在胞浆表达减少。结论 在肾小管上皮细胞没有发生氧化损伤时,Cd^2＋就可干扰肾小管上皮细胞钙黏蛋白依赖的黏附连接;镉对肾小管上皮细胞钙黏蛋白依赖的黏附连接的损伤可能是镉毒性的最早表现之一。     

镉致肾小管上皮细胞损伤时蛋白激酶C活性变化及三七皂甙的影响

本文以离体肾小管上皮细胞为研究对象，重金属镉为损伤因素，从镉染毒时肾小管细胞内依赖肌醇磷脂代谢的细胞信息传递途径障碍的角度，观察镉致肾损伤时蛋白激酶Ｃ（ＰＫＣ）的活性变化及与钙超再发生的关系。结果发现，经镉染毒后，细胞浆ＰＫＣ活性无明显变化，细胞膜ＰＫＣ活性显著增加，表现为ＰＫＣ的明显激活。与此同时，胞浆游离钙离子浓度（Ｃａ＾＋＋）也明显升高，显著其与ＰＫＣ激活之间的某种联系。此外尚发现，中药三七     

肾小管上皮细胞在镉诱导的肾脏纤维化中的作用研究

目的:探究肾小管上皮细胞在镉诱导的肾脏纤维化中的作用。方法:于2018年3月,将24只C57BL/6小鼠随机分为对照组、低剂量组（100 mg/L）中剂量组（200 mg/L）和高剂量组（400 mg/L）,每组6只,每日自由饮用含不同浓度CdCl 2的饮用水,24周后处死后进行实验。通过马松（Masson...     

镉致肾小管上皮细胞损伤时胞内肌动蛋白与ATP的改变及意义

从细胞功能与结构入手，着重观察镉染毒后细胞内能量代谢变化及其与细胞骨架、细胞形态学改变之间的关系。方法：采用离体肾灌注镉染毒模型，以免疫荧光及超微病理技术对肾小管细胞内肌动蛋白结构行时效分析。结果：染毒早期，肌动蛋白结构可迅速改变，且随着镉染毒时间的延长而愈趋明显；肌动蛋白结构的改变先于形态学变化；在肌动蛋白改变的同时伴有细胞内ＡＴＰ水平的降低，随着染毒时间延长而逐渐加重。当镉被洗脱后，细胞内ＡＴＰ水平开始上升，而肌动蛋白分布并未出现明显回复现象。结论：镉染毒可导致细胞内能量代谢抑制，肌动蛋白结构改变，从而导致细胞结构及功能异常。肌动蛋白结构改变在重金属镉所致的细胞形态、极性及功能损伤中起着重要的作用     

铅镉联合作用对大鼠肾小管上皮细胞脂质过氧化的影响

为观察铅镉联合作用对大鼠肾小管上皮细胞脂质过氧化的影响 ,对原代大鼠肾小管上皮细胞提取、纯化、鉴定、培养后 ,采用 3× 3析因设计方法进行染毒实验 ,A组 :醋酸铅 0 0 2mmol L ;B组 :醋酸铅 0 1mmol L ;C组 :氯化镉 0 0 0 1mmol L ;D组 :氯化镉 0 0 0 4mmol L ;E组 :醋酸铅 0 0 2mmol L +氯化镉 0 0 0 1mmol L ;F组 :醋酸铅 0 0 2mmol L +氯化镉 0 0 0 4mmol L ;G组 :醋酸铅 0 1mmol L +氯化镉 0 0 0 1mmol L ;H组 :醋酸铅0 1mmol L +氯化镉 0 0 0 4mmol L。染毒时间为 6小时。经超声波粉碎细胞后 ,测定细胞内谷胱甘肽 (GSH)和丙二醛 (MDA)的含量 ,以及谷胱甘肽过氧化物酶 (GSH Px)和超氧化物歧化酶 (SOD)的活性。与对照组比较 ,联合染毒组GSH、GSH Px、SOD水平显著降低 ,MDA水平显著升高 ,析因分析表明 ,铅镉联合作用在对大鼠肾小管上皮细胞GSH、SOD、MDA改变方面有交互作用 (P <0 0 5 ) ,即铅镉联合作用呈现增毒作用 ;在对GSH Px改变方面未见交互作用     

环境镉接触人群肾小管功能损害的研究

目的：探讨镉污染若干年后，镉接触人群的。肾小管功能损害。方法：测定居住在镉污染区20年以上的161名居民和非污染区42名居民的尿镉（UCa）、尿N-乙酰-β—D-氨基葡萄糖苷酶（UNAG）、尿β2-微球蛋白（LIB—MG）及尿视黄醇结合蛋白（URBP）水平。上述指标均用尿肌酐校正，并用几何均数进行比较。结果：镉污染区居民UCA、UNAG、UBMG、URBP水平及UNAG的异常率均显著高于对照组；UNAG、UBMG、URBP水平和异常率均与尿镉水平呈现出较强的一致性，尤以尿镉水平达10μg／gCr以上明显；各指标的变化以UNAG最明显。结论：镉能引起。肾小管的不可逆损伤：UNAG可作为镉接触人群肾小管功能损害的敏感指标：尿镉水平可反映体内镉负荷及肾功能损害程度。     

镉染毒后肾小管上皮细胞内氧自由基代谢与损伤之间关系的研究

本文以离体肾小管上皮细胞为研究对象，观察了镉致肾小管上皮细胞损伤时细胞内氧自由基反应及其与细胞超微结构改变之间的关系。结果表明，镉可诱发离体肾小管上皮细胞脂质过氧化反应增强，脂质过氧化产物明显增加，超氧化物歧化酶及过氧化氢酶活性显著受抑，与此同时肾小管细胞出现一系列超微结构改变；抗氧化剂ＶｉｔＥ可使脂质过氧化作用明显减弱。提示镉臻肾小管上皮细胞损伤与氧自由基对细胞膜结构及功能的损伤有关，氧自由基在     

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.     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.     

The reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

Function of the protein RPE65 in the visual cycle

A protein called RPE65 performs a key role in the trans-cis isomerization of retinol in the retinal pigment epithelium of the eye. The palmitoylation of RPE65 serves to switch off the visual cycle in darkness and to switch it on in the light.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

Acute symptoms following work with pesticides

BACKGROUND: Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms. AIM: To explore the frequency, nature and determinants of acute symptoms following work with pesticides. METHODS: A postal survey of men in three rural areas of England and Wales provided data on occupational use of five categories of pesticide, occurrence of 12 specified symptoms within 48 h of using pesticides and tendency to somatize. Risk factors for pesticide-related symptoms were assessed by modified Cox regression. RESULTS: Of 10 765 responders (response rate = 31%), 4108 had at some time used pesticides occupationally, including 935 (23%) who reported symptoms following such work on at least one occasion. In two areas, acute symptoms were most frequent following use of sheep dip (29 and 32% of users), but in the third area the rate was significantly lower (13% of users). The relative frequency of symptoms was similar for all five categories of pesticide, and flu-like symptoms did not cluster unusually among users of sheep dip. Risk of pesticide-related symptoms increased with somatizing tendency (prevalence ratio for highest versus lowest category 2.4, 95% confidence interval 2.0-3.0) and was higher in men who had used pesticides most often or handled concentrate. CONCLUSION: Acute symptoms are common following work with pesticides, but in many cases the illness may arise through psychological rather than toxic mechanisms.     

Hydrazine inhalation hepatotoxicity

Abstract Hydrazine is a hazardous chemical commonly used as a reactant in rocket and jet fuel cells. Animal studies have demonstrated hepatic changes after hydrazine inhalation. Human case reports of hydrazine inhalation hepatotoxicity are rare. We report a case of mild hepatotoxicity following brief hydrazine vapour inhalation in a healthy young man, which resolved completely on expectant management.     

The management of influenza in people of working age

Influenza is common, causing considerable morbidity and sickness absence from work in most winters. Influenza vaccines have been available for >40 years, but are not extensively used in the workforce (in the UK). Amantadine has been available for 25 years as a treatment and prophylactic against influenza A infection, but has scarcely been used. In the last 3 years, two neuraminidase inhibitor antivirals, zanamivir and oseltamivir, have been introduced to the market for the treatment and prophylaxis of influenza A and B infections. This review focuses on aspects of prevention and treatment of influenza appropriate to people of working age. Decisions based on the cost-effectiveness of prevention and treatment options differ when viewed from the perspective of the healthcare provider, the employer or the employee. Options currently available need to be directed to a wider range of people than those conventionally regarded as the target risk group.     

Fitness standards in airline staff

Employers have a legal duty to manage safety and to meet this duty it is necessary to control risks arising from pre-existing medical conditions. Such conditions can be identified at the time of job placement, but there is little published information about the approach to fitness standards by most airlines. This review is therefore limited to the practice of one major airline. It is illustrated by reference to various occupations within the airline, with the associated rationale.