龙岩市某化肥厂682名作业人员心电图检查结果分析

目的 了解化肥厂作业人员心电图改变情况,以便监督管理,防止职业危害.方法 对龙岩市某化肥厂的作业工人682名(接触组)和不接触有害因素的职工650名(对照组)进行心电图检查.结果 心电图异常检出率,接触组为39.74%,对照组为28.76%(P<0.01).其中,窦性心律不齐、心室(左、右心室)高电压、ST-T变化显著,接触组较对照组更为明显,差异较大(P<0.01);对于组别内年龄为<30岁和30岁~39岁的心电图异常检出率接触组都比对照组高(P<0.01);对于组别内年龄为≥40岁的对照组与接触组则没有显著差别(P>0.05);工龄<5年、5年~14年的接触组心电图异常检出率高于对照组(P<0.05)、工龄≥15年的差异无显著性(P>0.05).结论 化肥厂作业人员心血管系统损害的比例较高,引起心电图的异常改变,应进一步加大监督力度,加强健康教育.     

高温和噪声混合作业对工人血压与心电图影响的研究

目的了解高温和噪声混合作业对工人血压与心电图的影响。方法将同时接触高温和噪声的作业工人138人作为复合组,单独接触高温153人作为高温组,单独接触噪声175人作为噪声组,不接触高温与噪声的作业工人156人作为对照组,进行职业健康体检。结果复合组血压及心电图异常率均高于其他组别,差异有统计学意义（P〈0.05）。复合组及高温组以窦性心律不齐为主,噪声组及对照组以T波改变为主。随着接害工龄的增长,各组间的血压异常率也增加,但只有10年~14年接害工龄段的差异有统计学意义（P〈0.05）。各组间心电图异常率在相同接害工龄段间的差异无统计学意义（P〉0.05）。结论高温和噪声混合作用对工人血压与心电图影响程度不同,但有协同加重作用。     

产程早期尿潴留69例临床分析

1　临床资料选自 2 0 0 0年 1月至 6月 ,初产、孕 38～ 4 0周单胎头位无其他合并症而在产程早期 (宫口开大 3～ 5 cm )出现尿潴留作为观察组 ,与同期分娩的 2 0 6例其余条件均等的无尿潴留的产妇进行对照分析。2　结　果2 .1　与胎头方位的关系 :(见表 1)表 1　产程早期尿潴留与胎头方位的关系组别例数 枕横位例数　　　　　 %枕后位例数　　　　　 %枕前位例数　　　　　 %观察组 6 9395 6 .5 2 2 0 2 8.9910 14 .4 9对照组 2 0 6 2 110 .1914 6 .80 17183.0 1　　 X2 =10 8.30　 P<0 .0 1　　 6 9例尿潴留患者中 ,胎头方位异常 (枕横位、…     

三越脑得生治脑梗塞疗效观察

1　一般资料　 2 0 0例为住院和门诊病人 ,随机分治疗组1 50例 ,对照组 50例 (双肓对照 ) ;男 1 36例 ,女 64例 ;2组临床症状比较见表 1 ;神经系统体征比较见表 2、3;2组血液流变学比较见表 4。表 1　 2组临床症状比较症状 治疗组对照组例数 /%例数 /% Ｐ半身不遂 15 0 10 0 5 0 10 0口舌歪斜 80 5 3 .33 40 80舌强言謇 12 0 80 .0 0 35 70不语 15 10 .0 0 816偏身麻木 10 3 6 8.6 733 6 6面色 白光白 5939.33 2 0 4 0气短乏力 73 4 9.0 0 2 958头晕 4 1 2 7.33 2 856头痛 32 2 1 .33 1 530自汗出 2 51 7.0 0 1 530心悸 2 61 7.691 3 2 6便…     

脉络宁治疗急性病毒性心肌炎100例

1　临床资料1 .1　诊断标准根据 1 987年全国心血管病学会病毒性心肌炎诊断参考标准[1 ] 执行。1 .2　一般资料根据病人入院顺序随机分组 ,西药组 :年龄最小 8岁 ,最大 42岁 ,平均 2 3.2岁 ;男 2 8例 ,女 2 2例。脉络宁组 :年龄最小 9岁 ,最大 41岁 ,平均2 3.5岁 ;男 58例 ,女 42例。 2组一般临床表现见表 1、心电图表现见表 2、发病至入院时间见表 3。2组一般情况经统计学处理有可比性。表 1　 2组临床症状 (ｎ)组别胸闷心慌气短头晕活动能力下降脉络宁组 85 78839110 0西药组 42 40 3942 5 0表 2　 2组心电图表现 (ｎ)组别 窦性心动过速窦…     

患者腰穿音乐镇痛的观察

随着现代医学的发展 ,音乐疗法已广泛应用于临床。1999年 110月我院对 5 0例患者腰穿时采取音乐镇痛有效率达 60 % ,报告如下。1　资料与方法　　 10 0例患者随机分为观察组及对照组。观察组 5 0例 ,对照组 5 0例。观察组患者腰穿时戴上耳机 ,播放自己爱听的歌曲 ,直到做完腰穿为止。对照组腰穿时不放音乐 ,由固定医生完成。2　结果　　两组患者腰穿时的效果见表 1。表 1　两组患者腰穿时的效果 (例 )组别例数稍有疼痛乐于治疗ｎ(% )有疼痛表情能忍受治疗ｎ(% )拒绝治疗ｎ(% )观察组 50 30 (60 ) 1 6(32 ) 4 (8)对照组 50 1 0 (2 0 ) 30 (60…     

视屏显示终端作业者神经行为功能测试

目的 :了解视屏显示终端 (videodisplayterminal,VDT)作业环境对作业者神经行为功能的影响。方法 :使用WHO推荐的神经行为功能核心测试组合 (NCTB)对VDT作业者共 1 75名及不接触VDT的对照组 1 70名进行神经行为功能测试。 2组均排除神经系统疾病、视听觉及手部运动障碍和测试前 1 2h内饮酒或服用镇静剂者。 2组年龄、工龄、受教育程度具有可比性。结果 :2组作业环境仅CO2 浓度差异有统计学意义。VDT作业组的情感状态除有力 -好动项外 ,其他情感指标积分均明显高于对照组 (P <0 .0 1 ) ;各行为功能指标积分均明显低于对照组 (P <0 .0 5或P <0 .0 1 )。结论 :VDT作业对操作者的神经行为功能存在有害影响     

舒血宁注射液治疗冠心病心绞痛40例临床观察

目的观察舒血宁注射剂治疗冠心病劳力型心绞痛的疗效。方法选择冠心病劳力型心绞痛患者40例,随机分为2组,治疗组给予舒血宁2 0mg静点,对照组常规内科治疗,2周进行运动试验观察疗效。结果运动试验中心绞痛发作例数、运动前后心电图S -T变化明显改变例数,治疗组明显少于对照组,达到运动耐量例数、运动负荷量时血压峰值达标例数,治疗组明显多于对照组(P <0 .0 5 )。结论舒血宁注射液在改善病变冠状动脉血管供血和心肌对缺血的耐受性方面优于对照组。     

噪声对钢铁工人健康影响的调查

目的 :了解噪声对工人健康的影响。方法 :对 1 1 3名稳态噪声作业工人 ,1 85名脉冲噪声作业工人及 1 38名非噪声作业工人进行询问既往史和听力、神经系统、心电图及血压检查。结果 :脉冲组听力受损检出率为 4 2 .7% ,稳态组为 2 6 .5 % ,高于对照组的 6 .0 % (P<0 .0 1 )。结论 :听力受损检出率随噪声暴露水平及接触工龄的增加而增高     

低浓度铅对女工高血压影响探讨

目的 :高浓度铅接触对心血管的影响早已肯定 ,但低浓度 (TWA为 0 .0 34mg/ m3)铅接触对心血管 ,特别是对女性是否仍有影响报道很少 ,而女性低铅作业人数约占 75 %～ 80 %。为搞清低浓度铅对女性健康的影响 ,我们对 82名低铅接触女工进行了全面调查和研究。方法 :采用时间加权平均浓度 (TWA)表示该车间空气中铅浓度和接触者体内吸收水平 ,并测定血压 ,面询工龄、年龄、神经系统发病率等。结果 :高血压发病年龄提前 ,接触组患病率最高年龄段在 30岁～ 40岁之间 (占 6 0 % ) ,最小年龄2 0岁。对照组患病率最高年龄段在 40岁～ 5 0岁之间 ,最小年龄 2 8岁 ;高血压发病和铅接触时间有关。发病者中工龄最短为 2 a,工龄 2 0 a之内发病者占 75 % ;铅接触组高血压患者神经系统症状和非高血压组有差异 ,接触组以头痛、睡眠障碍为主 ;非高血压组以头昏发病率为最高。结论 :低铅接触对女性心血管系统仍有影响 ,应把血压作为女性铅接触的监测指标     

益智健脑颗粒联合针灸对阿尔茨海默病大鼠学习记忆的影响

目的观察益智健脑颗粒联合针灸对阿尔茨海默病（Alzheimers disease,AD）大鼠学习记忆的影响。方法将大鼠随机分为假手术组（A组）、模型组（B组）、针灸组（C组）、益智＋针灸组（D组）各10只,B、C、D 3组分别以海马CA1区注射β淀粉样蛋白25-35（Aβ25-35）造模,A组注射等量的双蒸水,各组分别治疗20 d后行Morris水迷宫试验,观察大鼠学习记忆能力变化。结果B组较A组的平均潜伏期明显延长,差异具有统计学意义（P〈0.05）;与B组比较,C组、D组的平均潜伏期明显缩短,过台次数增多,差异具有统计学意义（P〈0.05,P〈0.01）;与C组比较,D组的潜伏期缩短,过台次数增多,差异具有统计学意义（P〈0.05）。结论益智健脑颗粒联合针灸能够提高Aβ25-35介导的AD模型大鼠的学习记忆能力。     

Effects of tacrolimus and cyclosporine treatment on metabolic syndrome and cardiovascular risk factors after renal transplantation: a meta-analysis

Background The therapeutic success of renal transplantation has been largely attributable to the development of effective and balanced immunosuppressive treatment regimens.This study provides a meta-analysis of a series of randomized controlled trials that compared the effects of tacrolimus and cyclosporine on metabolic syndrome （MetS） and cardiovascular risk factors after renal transplantation.Methods We searched various electronic databases and bibliographies,including MEDLINE,the Cochrane Central Register of Controlled Trials,and EMBASE,for relevant studies published prior to October 2012.Results Our meta-analysis included five randomized controlled trials that examined a total of 923 patients.The tacrolimus group and the cyclosporine group exhibited no significant differences in MetS incidence after renal transplantation; risk ratio （RR）：1.06,95％ confidence interval （C/）：0.73-1.55,P=0.76.Cyclosporine treatment was associated with a higher incidence of hyperlipidemia （RR：0.50,95％ CI：0.39-0.64,P ＜0.01）.Although there were no statistically significant differences,cyclosporine treatment was associated with a higher incidence of hypertension （RR：0.91,95％ CI：0.83-1.00,P=0.06） after renal transplantation compared to tacrolimus treatment,and tacrolimus treatment was associated with a higher incidence of diabetes after renal transplantation （RR：1.79,95％ CI：0.98-3.27,P=0.06） compared to cyclosporine treatment.Conclusions Compared to tacrolimus treatment,cyclosporine treatment was associated with a higher incidence of hyperlipidemia.Future large-scale studies are expected to be conducted to further confirm our findings.     

喉米枯力兹（Mikulicz）病1例

米枯力兹病最早于1888年由米枯力兹（Miku-licz）描述,表现为泪腺、腮腺和颌下腺两侧性肿大,当时认为是一种慢性感染,目前一般将此病称为良性淋巴上皮性病变。此病发生于耳鼻咽喉科实属少见,而发生于喉部更为罕见。2010年1月,我们收治喉米枯力兹病患者1例,报告如下。     

May artificial sweeteners not sugar be the culprit of dramatic increase of inflammatory bowel disease in China?

As we know, inflammatory bowel disease （IBD） is ,typically used as a general term for ulcerative colitis （UC） and Crohn＇s disease （CD）, two highly related debilitating diseases of the digestive tract with similar clinical, pathological, and epidemiological features. Both UC and CD are most prevalent in young adults and still incurable. The patients usually depend on constant heavy medication and frequently need multiple devastating surgeries such as bowel resection, proctocolectomy, ileostomy, and ileal pouch-anal anastomosis.     

High prevalence of obstructive sleep apnea in Marfan’s syndrome

Objective To review the current evidence about the prevalence of obstructive sleep apnea in patients with Marfan＇s syndrome,and discuss some proposed potential mechanisms for this relationship.Data sources The data in this review were mainly from Medline and PubMed articles published in English from 1990 to 2013.The search term was ＂Marfan＇s syndrome and sleep apnea＂.Study selection Clinical evidence about the epidemiology of obstructive sleep apnea in patients with Marfan＇s syndrome; the mechanism that causes obstructive sleep apnea; interventional therapy for patients with Marfan＇s syndrome,and coexisting obstructive sleep apnea.Results A high prevalence of obstructive sleep apnea exists in patients with Marfan＇s syndrome.The potential reasons are craniofacial abnormalities and lax upper airway muscles,which lead to high nasal airway resistance and upper airway collapse.Obstructive sleep apnea mechanically deteriorates aortic dilatation and accelerates progression of aortic aneurysms.The condition is reversible and rapid maxillary expansion and adequate continuous positive airway pressure therapy are possible effective therapies to delay the expansion of aortic diameter in patients with Marfan＇s syndrome.Conclusions Obstructive sleep apnea is strongly associated with Marfan＇s syndrome.Craniofacial abnormalities and lax upper airway are the main mechanisms.Untreated obstructive sleep apnea accelerates progression of aortic dissection and rupture.Effective therapies for obstructive sleep apnea could postpone the aortic dilatation in patients with Marfan＇s syndrome.     

Electrical response grading versus House-Brackmann scale for evaluation of facial nerve injury after Bell＇s palsy： a comparative study

OBJECTIVE： There are no convenient techniques to evaluate the degree of facial nerve injury during a course of acupuncture treatment for Bell＇s palsy. Our previous studies found that observing the electrical response of specific facial muscles provided reasonable correlation with the prognosis of electroacupuncture treatment. Hence, we used the new method to evaluate the degree of facial nerve injury in patients with Bell＇s palsy in comparison with the House-Brackmann scale. The relationship between therapeutic effects and prognosis was analyzed to explore an objective method for evaluating Bell＇s palsy. METHODS： The facial nerve function of 68 patients with Bell＇s palsy was assessed with both electrical response grading and the House-Brackmann scale before treatment. Then differences in evaluation results of the two methods were compared. All enrolled patients received electroacupuncture treatment with disperse-dense wave at 1/100 Hz for 4 weeks. After treatment, correlation analysis was conducted to find the relationship between electrical response and therapeutic effects or prognosis. RESULTS： Checking consistency between electrical response grading and House-Brackmann scale： Kappa value 0.028 （P = 0.578）. Correlation analysis： the two methods were correlated with the prognosis, and electrical response grading （rER = 0.789） was better than the House-Brackmann scale （rHB = 0.423）. CONCLUSION： Electrical response grading is superior to the House-Brackmann scale in efficacy and reliability, and can conveniently assess the degree of facial nerve injury. The House-Brackmann scale is suitable for the patients with mild facial nerve injury, but its evaluation quality for severe facial nerve injury is poor.     

成人先天性髋内翻一例

先天性髋内翻为一种少见发育性畸形，首先由Fiorani于1891年描述。我们遇到一例中年女性先天性髋内翻患者，影像形态呈“牧羊杖”状（Shepherd’scrookdeformity），国内文献尚未见类似病例，兹报告如下。     

Liuwei Dihuang,a traditional Chinese herbal formula,suppresses chronic inflammation and oxidative stress in obese rats

OBJECTIVE： To investigate the anti-inflammatory, anti-oxidative stress, and adipokine-ameliorating effects of Liuwei Dihuang （LWDH）, a traditional Chinese herbal formula, in obese rats. METHODS： After 2 weeks of acclimation with free access to regular rodent chow and water, obese-prone-caesarean-derived （OP-CD） rats were fed a modified AIN-93G diet containing 60% energy from fat. Treatment was performed twice daily by gavage feeding with 500, 1 500, or 3 500 mg/kg body weight LWDH suspended in water （n=12 rats per group）. Twelve obese-resistant-CD （OR-CD） rats were fed the atherogenic diet and gavaged with water, and served as the normal control. Blood biomarkers of inflammation, oxidative stress and adiponectin were measured post-sacrifice and used to determine the treatment effect of LWDH and assess the suitability of OR/OP-CD rats for studying these parameters. RESULTS： After 9 weeks of treatment, LWDH lowered serum C-reactive protein （CRP） and tumour necrosis factor-α （TNF-α） levels. Serum interleukin-6 （IL-6） levels showed a tendency towards reduction, but were not significantly different from the OP-CD control. Liver superoxide dismutase （SOD） activity was increased in response to all three doses of LWDH, while the levels of reduced （GSH） and oxidized glutathione （GSSG） and thiobarbituric acid reactive substances （TBARS） were unchanged. Serum adiponectin levels were increased in response to oral administration of LWDH at the dose of either 500 or 1 500 mg/kg body weight. In addition, comparisons between OR-CD and OP-CD rats revealed differential, and for some biomarkers, conflicting characteristics of high-fat diet-fed OP-CD rats in reference to obese human subjects in terms of inflammatory and oxidative stress biomarkers and circulating adiponectin levels. CONCLUSION： The results show, for the first time, the anti-inflammatory, anti-oxidative stress and adiponectin-ameliorating effects of LWDH in obese rats. The suitability of the OP-JOP-CD rat model as     

表皮生长因子受体酪氨酸激酶抑制剂在非小细胞肺癌应用的瓶颈——获得性耐药

以表皮生长因子受体酪氨酸激酶抑制剂（epidermal growth factor receptor-tyrosine kinase inhibitor,EGFR-TKI）分子靶向治疗研究为肇始,转化性研究使基础实验和临床实践间的鸿沟迅速填平,改变着人们认识治疗肺癌的视角。无可否认,EGFR-TKI上市后极大地延伸了肿瘤学家治疗肺癌的手段,但不管从临床经验、临床研究数据、分子生物学层面还是文献计量学的角度,     

Application of immunosuppressant facilitates the therapy of optic neuritis combined with Sj（o）gren＇s syndrome

Background Optic neuritis （ON） is often the first symptom of multiple sclerosis （MS） and neuromyelitis optica （NMO） while there has been very little research reported on ON combined with Sj（o）gren＇s syndrome （SS）.The aim of this study is to provide different treatments and services for and NMO patients combined with SS.Methods Twenty-seven patients with ON combined SS were divided into two groups：corticosteroid group （C group,methylprednisolone sodium succinate,14 patients） and corticosteroid＋ immunosuppressant group （C＋I group,leflunomide,13 patients）.ON relapse times in 1 year after treatment,number of patients who relapsed to NMO/MS in 1 years,visual acuity and retina nerve fiber layer （RNFL） thickness were measured.Mann Whitney-Wilcoxon test was used to compare continuous variables and Chi-square test or Fisher＇s exact test was to compare proportions.Results ON combined with SS patients had higher incidence rates in middle-aged women who have binocular damage and heavier visual function damage or when there is an easy relapse,and the patients are often hormone dependent.The patients are more likely anti-aquaporin-4 IgG seropositive （70.4％）.They are liable to form a centrocecal scotoma and tubular vision.The times of relapse decreased in patients who used immunosuppressant,and a significant difference was found between immunosuppressant and non-immunosuppressant groups in visual acuity recovery during 6-month followup period （P ＜0.05）; however,the RNFL thickness at the four quadrants was not significantly different.Conclusions The effect of immunosuppressant plus corticosteroid on the early onset of ON combined with SS was to provide ON remedy and to prevent recurrence in clinics.This study provides a significant reference for the prevention and treatment of ON on the basis of immunosuppressant and corticosteroid.