乙酰肝素酶在人类自然流产过程中的作用研究

目的:研究乙酰肝素酶(HPSE)与人类自然流产的关系以及在妊娠中的作用。方法:采用反转录PCR和Western Blot检测正常妊娠者和早期自然流产者流产绒毛组织中HPSE mRNA和蛋白的表达。结果:反转录PCR实验结果显示,正常妊娠组的HPSE mRNA阳性表达比例(12/15)高于自然流产组(9/20),(χ2=4.375,P=0.036);Western Blot正常妊娠组的HPSE蛋白的阳性表达比例(11/15)高于自然流产组(7/20),(χ2=5.042,P=0.025)。结论:HPSE参与正常妊娠过程,自然流产的发生可能与HPSE的低表达有关。     

乙酰肝素酶在人类妊娠过程中的作用研究

目的:探讨乙酰肝素酶(heparanase,HPSE)与人类自然流产的关系及在正常妊娠和自然流产过程中所起的作用。方法:采用免疫荧光法和Western blot检测非意愿性正常妊娠者流产绒毛组织和早期自然流产者流产绒毛中HPSE的表达情况。结果:正常妊娠组的HPSE表达率明显高于自然流产组,差异有统计学意义(P<0.05)。结论:HPSE参与正常妊娠的胚胎植入过程,自然流产的发生可能与HPSE的低表达、胚胎的低植入率有关。     

HLA-G mRNA在原因不明复发性流产患者绒毛中的表达

目的 探讨人类白细胞抗原G mRNA在原因不明复发性流产患者绒毛中的表达和临床意义.方法 采用实时荧光定量聚合酶链技术分别检测30例正常妊娠人工流产患者、24例单次自然流产患者、28例原因不明复发性流产患者绒毛中人类白细胞抗原G mRNA的表达水平,用聚合酶链反应循环阈值(Ct值)表示其表达水平.结果 3组人类白细胞抗原G mRNA的表达水平由高到低依次为:正常妊娠人工流产组、单次自然流产组、原因不明复发性流产组.原因不明复发性流产组、单次自然流产组分别与正常妊娠人工流产组人类白细胞抗原G mRNA表达水平比较,差异均有统计学意义(原因不明复发性流产组:t=9.681,P<0.001;单次自然流产组:t=8.890,P<0.001).结论 人类白细胞抗原G mRNA的表达水平与维持妊娠有一定的关联.     

血红素氧合酶和细胞凋亡在流产绒毛中的表达

目的 探讨血红素氧合酶-1和血红素氧合酶-2在早期自然流产绒毛组织中的表达及其与滋养细胞凋亡的关系.方法 应用原位杂交及免疫组织化学法分别检测正常早孕组30例和早期自然流产组40例(其中先兆流产组20例,难免流产组20例)绒毛组织中滋养细胞血红素氧合酶-1和血红素氧合酶-2的mRNA和蛋白的表达;用脱氧核糖核苷酸末端转移酶介导的缺口末端标记法检测两组滋养细胞的凋亡.结果 ①早期自然流产组血红素氧合酶-1和血红素氧合酶-2的表达低于正常早孕组(P＜0.05),早期自然流产组中难免流产组血红素氧合酶-1和血红素氧合酶-2的表达低于先兆流产组(P＜0.05);②早期自然流产组滋养细胞凋亡明显高于正常早孕组(P＜0.001),难免流产组明显高于先兆流产组(P＜0.001);③各组间绒毛组织中血红素氧合酶-1的表达与滋养细胞凋亡均呈负相关(均P＜0.001),该研究中尚未发现血红素氧合酶-2与各组数据的关系.结论 绒毛滋养细胞血红素氧合酶-1和血红素氧合酶-2以及凋亡的表达在早期自然流产的发病中起着重要作用,滋养细胞的异常凋亡与血红素氧合酶-1表达下降有关.     

调节趋化因子CXCL12、CCL2、RANTES及其受体表达对自然流产模型小鼠妊娠结局的影响

目的:观察选择性改变母胎界面趋化因子CXCL12、CCL2、RANTES及其受体CXCR4、CCR2、CCR5的表达对自然流产模型小鼠妊娠结局的影响,探讨免疫学改造在不明原因复发性流产(URSA)治疗中的可行性.方法:选择经典模型动物建立正常妊娠与URSA小鼠模型,正常妊娠小鼠为对照组(10例),URSA小鼠随机分为5组:未干预组(10例)、CXCL12干预组(10例)、CCR2拮抗剂干预组(10例)、CCR5拮抗剂干预组(10例)和CXCL12+CCR2拮抗剂+CCR5拮抗剂联合干预组(10例).Western Blot方法检测各组小鼠绒毛和蜕膜组织中趋化因子及其受体CXCL12/CXCR4、CCL2/CCR2、RANTES/CCR5蛋白的表达;同时观察各组小鼠胚胎丢失的情况,计算胚胎丢失率.结果:①URSA小鼠未干预组绒毛和蜕膜组织中CXCL12/CXCR4蛋白的表达显著低于正常妊娠对照组,而CCL2/CCR2和RAN]ES/CCR5蛋白的表达均显著高于正常妊娠对照组,差异有统计学意义(P均＜0.05).URSA小鼠CXCL12干预组绒毛和蜕膜组织中CXCL12/CXCR4蛋白的表达显著高于未干预组(P＜o.05);但仍低于正常妊娠对照组(P＜0.05).URSA小鼠CCR2拮抗剂干预组绒毛和蜕膜组织中CCL2/CCR2蛋白的表达显著低于未干预组(P＜0.05),但仍高于正常妊娠对照组(P＜0.05).URSA小鼠CCR5拮抗剂干预组绒毛和蜕膜组织中RANTES/CCR5蛋白的表达显著低于未干预组(P＜0.05),但仍高于正常妊娠对照组(P＜0.05).URSA小鼠CXCL12+CCR2拮抗剂+CCR5拮抗剂联合干预组绒毛和蜕膜组织中CXCL12/CXCR4蛋白的表达显著高于未干预组(P＜0.05);但仍低于正常妊娠对照组(P＜0.05);CCL2/CCR2和RANTES/CCR5蛋白的表达均显著低于未干预组(P＜0.05),但仍高于正常妊娠对照组(P＜0.05).②UR-SA小鼠未干预组的胚胎吸收率显著高于正常妊娠对照组,差异有统计学意义(P＜0.01).URSA小鼠CXCL12干预组、CCR2拮抗剂干预组、CCR5拮抗剂干预组和CXCL12+ CCR2拮抗剂+CCR5拮抗剂联合干预组的胚胎吸收率均低于未干预组(P均＜0.05),其中联合干预组下降更为显著(P＜0.05),但仍高于正常妊娠对照组(P＜0.05).结论:可以通过选择性诱导母胎界面CXCL12/CXCR4蛋白高表达、CCL2/CCR2和RANTES/CCR5蛋白低表达改善URSA小鼠妊娠结局.     

炎症相关因子在不明原因早期自然流产患者绒毛及蜕膜组织中的表达

目的:探讨炎症相关因子诱导型-氧化氮合酶(iNOS)和缺氧诱导因子-1(HIF-1)在早期不明原因自然流产患者绒毛和蜕膜组织中的表达状况.方法:选择60例不明原因早期自然流产患者(不明原因流产组)和60例要求人工流产的正常早期妊娠妇女(对照组)为研究对象,分别收集其绒毛及蜕膜组织.采用免疫组织化学SP法检测两组绒毛和蜕膜组织中iNOS和HIF-1的表达.结果:iNOS在不明原因流产组绒毛及蜕膜组织中的表达强度高于对照组,差异有统计学意义(P＜0.05)而HIF-1在不明原因流产组绒毛及蜕膜组织中的表达强度低于对照组,差异有统计学意义(P＜0.05).结论:不明原因早期自然流产的发生可能与绒毛及蜕膜局部微炎症状态加剧有关.     

自然流产小鼠绒毛滋养细胞PCNA和OPN的表达与相关研究

目的 比较正常妊娠和自然流产小鼠绒毛滋养细胞增殖细胞核抗原(Proliferating Cell Nuclear Antigen,PCNA)和骨桥蛋白(Osteopontin,OPN)的表达,探讨自然流产的发病机制.方法 建立正常妊娠模型CBA×BALB/c 和自然流产模型CBA×DBA/2.采用免疫组化SP法测定两组孕13 d绒毛滋养细胞PCNA和OPN的表达.结果 与正常妊娠相比,自然流产绒毛滋养细胞PCNA和OPN的表达均明显降低(P＜0.01,P＜0.05).结论 绒毛滋养细胞PCNA和OPN的表达低下与自然流产的发生有关.     

基于KaryoLite~(TM) BoBs~(TM)的复发性流产物染色体研究

目的利用KaryoLite~(TM) BoBs~(TM)技术对自然流产物的DNA进行检测,分析偶发性及复发性自然流产染色体异常情况。方法选取2015年3月-2017年1月在嘉兴市妇幼保健院就诊自然流产1次及以上且此次妊娠又发生不明原因自然流产的50例患者为复发性流产组,偶发性1次自然流产患者32例为对照组,分析两组流产物染色体异常的差异情况。结果复发性流产组绒毛染色体异常检出率为52. 0%(26/50),染色体数目异常率为76. 9%(20/26),其中大部分为染色体三体。对照组绒毛染色体异常检出率为43. 8%(14/32),染色体数目异常率为28. 6%(4/14)。复发性流产和偶发性1次自然流产胚胎染色体异常发生率比较,差异无统计学意义(P0. 05)。结论复发性流产染色体异常概率和偶发性自然流产概率无明显差异,但是胚胎染色体异常是复发性流产的主要原因,主要为染色体三体异常。     

应用高通量测序技术检测74例早期自然流产绒毛染色体结果分析

目的 应用高通量测序技术检测早期自然流产绒毛组织染色体,探讨早期自然流产的遗传学病因。方法 高通量测序检测74例早期自然流产孕妇(孕40～77 d)的绒毛组织,统计染色体异常的类型及所占比率。根据患者是否通过辅助生殖技术(ART)受孕将其分为ART组24例和自然妊娠组50例。结果 74例早期自然流产患者绒毛组织中,染色体异常46例(62.16%);染色体数目异常41例,其中三体型占44.59%(33/74),X单体占6.76%(5/74),嵌合体占4.05%(3/74)。染色体结构异常5例占6.76%(5/74),其中3例重复(1例致病性,2例临床意义不明),2例缺失(1例致病性,1例临床意义不明)。孕妇年龄≥35岁组和<35岁组的绒毛染色体异常率分别为64.71%(11/17)和61.40%(35/57),两组比较差异无统计学意义(P>0.05)。复发性流产(RSA)组42例,其中绒毛染色体异常24例(57.14%),偶发流产组32例,其中绒毛染色体异常22例(68.75%),两组比较差异无统计学意义(P>0.05)。ART组绒毛染色体异常14例,自然妊娠组绒毛染色...     

母胎界面维生素D受体表达与复发性自然流产相关及可能的机制

目的 探讨母胎界面维生素D受体(VDR)表达与复发性自然流产及胎盘激素的关系.方法 2014年7月至2014年9月在西安交通大学第一附属医院妇产科门诊收集复发性流产患者和正常早孕妇女绒毛和蜕膜组织,采用荧光实时定量聚合酶链式反应(FQ-PCR)检测两组绒毛组织和蜕膜组织中VDR及绒毛膜促性腺激素受体、雌激素受体和孕激素受体mRNA的含量,比较两组表达的差异.结果 复发性流产组绒毛组织中VDR、绒毛膜促性腺激素受体、雌激素受体mRNA相对水平低于对照组(t值分别为4.86、6.16、2.39,均P<0.05);绒毛膜促性腺激素受体和雌激素受体mRNA的表达水平与VDR表达水平明显正相关(F=10.21,P=0.01;F=14.52,P=0.00).复发性流产组蜕膜组织中VDR、绒毛膜促性腺激素受体、雌激素受体mRNA相对水平也低于对照组(t值分别为5.28、2.34、2.60,均P<0.05).结论 母胎界面VDR mRNA表达水平与早期自然流产相关,绒毛组织绒毛膜促性腺激素受体和雌激素受体mRNA的表达水平与VDR表达水平有一定的相关性.但是VDR导致自然流产的机制仍需进一步研究.     

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.