西酞普兰对急性卒中后抑郁患者血清BDNF含量的影响

目的:研究西酞普兰对急性卒中后抑郁患者血清脑源性神经营养因子(BDNF)含量及抑郁状态和神经功能恢复的影响。方法:170名卒中确诊患者入院两周后进行精神状态评估,按有无抑郁症状分为急性卒中后抑郁患者组(DP,52例)及急性卒中后无抑郁患者组(NDP,118例),抑郁组给予西酞普兰每日10-40mg口服。治疗前及治疗6周后各组分别检测血清BDNF含量及评定HAMD、NIHSS和Barthel指数。结果:DP患者与NDP患者相比BDNF水平明显下降,HAMD、HINSS及Barthel指数两组具有显著差异;西酞普兰治疗能显著提高DP患者BDNF含量,但对NDP患者BDNF水平无明显影响。与NDP患者相比较,西酞普兰治疗更能显著改善DP患者HAMD,NIHSS和Barthel评分。结论:急性卒中后抑郁患者BDNF水平明显下降,西酞普兰能显著提高急性卒中患者血清BDNF含量,同时能改善抑郁状态和加速神经功能康复。     

西肽普兰对急性卒中后抑郁患者血清BDNF含量的影响

目的:研究西酞普兰对急性卒中后抑郁患者血清脑源性神经营养因子(BDNF)含量及抑郁状态和神经功能恢复的影响.方法:170名卒中确诊患者入院两周后进行精神状态评估,按有无抑郁症状分为急性卒中后抑郁患者组(DP,52例)及急性卒中后无抑郁患者组(NDP,118例),抑郁组给予西酞普兰每日10-40mg口服.治疗前及治疗6周后各组分别检测血清BDNF含量及评定HAMD、NIHSS和Barthel指数.结果:DP患者与NDP患者相比BDNF水平明显下降,HAMD、HINSS及Barthel指数两组具有显著差异;西酞普兰治疗能显著提高DP患者BDNF含量,但对NDP患者BDNF水平无明显影响.与NDP患者相比较,西酞普兰治疗更能显著改善DP患者HAMD,NIHSS和Barthel评分.结论:急性卒中后抑郁患者BDNF水平明显下降,西酞普兰能显著提高急性卒中患者血清BDNF含量,同时能改善抑郁状态和加速神经功能康复.     

艾司西酞普兰联合康复训练治疗老年脑卒中后抑郁患者的效果

目的探讨艾司西酞普兰联合康复训练治疗老年脑卒中后抑郁患者的效果。方法选取高安市人民医院2018年4月至2019年7月收治的56例老年脑卒中后抑郁患者,随机分为两组,每组28例。对照组接受艾司西酞普兰治疗,试验组则接受艾司西酞普兰联合康复训练治疗,比较两组汉密尔顿抑郁表(HAMD)评分、生命质量评分。结果治疗前,两组HAMD、生命质量评分比较,差异无统计学意义(P>0.05);治疗后4周、8周,试验组HAMD评分低于对照组,生命质量评分高于对照组,差异均有统计学意义(P<0.05)。结论艾司西酞普兰联合康复训练治疗老年脑卒中后抑郁患者,能降低患者的HAMD评分,缓解抑郁症状,促进疾病好转,提升生命质量。     

文拉法辛与西酞普兰治疗首发抑郁症对照研究

目的比较文拉法辛与西酞普兰治疗抑郁障碍的疗效、安全性及耐受性。方法将80例抑郁障碍患者随机分为文拉法辛组（40例）与西酞普兰组（40例）,疗程6周。采用汉密尔顿量表17项（HAMD）评定疗效,以症状量表（TESS）评定不良反应和安全性。结果文拉法辛组治疗1周起效,疗程结束时两组疗效和HAMD评分差异无统计学意义。结论文拉法辛与西酞普兰治疗抑郁障碍的疗效相当,文拉法辛起效早于西酞普兰。     

草酸艾司西酞普兰联合重复经颅磁刺激治疗卒中后抑郁效果探究

目的 以草酸艾司西酞普兰联合重复经颅磁刺激对脑卒中后抑郁患者进行治疗,探究实际疗效。方法 选取本院2018年3月-2022年3月收治的68例卒中后抑郁患者作为研究对象,以随机数字表法分成研究组与对照组,每组各34例。对照组以草酸艾司西酞普兰治疗,研究组联合重复经颅磁刺激治疗,对两组患者HAMD评分、治疗总有效率与不良反应发生率进行比较。结果 治疗前,两组HAMD评分比较差异无统计学意义(t=0.313,P=0.755);治疗4周后,两组HAMD评分显著下降,但研究组HAMD评分相对于对照组更低(t=5.426,P<0.001)。研究组总有效率(94.12%)要显著高于对照组(76.47%)(χ²=4.221,P=0.040)。研究组不良反应发生率(14.71%)与对照组(8.82%)对比,差异无统计学意义(χ²=0.567,P=0.452)。结论 在卒中后抑郁治疗方面,草酸艾司西酞普兰联合重复经颅磁刺激治疗可产生协同作用,获得较好的效果,不良反应较相对较少,值得推广应用。     

盐酸氟西汀治疗脑卒中后抑郁及神经功能缺损的疗效观察

目的：观察盐酸氟西汀治疗脑卒中后抑郁及神经功能缺损的疗效。方法：对86例脑卒中后抑郁状态患者,随机分为治疗组（加用盐酸氟西汀）和对照组（常规治疗）各43例进行对照观察。治疗前后行汉密尔顿抑郁量表（HAMD）、日常生活能力Barthel指数（BL）量表及神经功能缺损评分（SSS）量表进行评定其疗效和不良反应。结果：治疗组HAMD评分治疗后较治疗前显著下降（P〈0．01）,对照组治疗后与治疗前比较无显著差异（P〉0．05）。治疗组治疗后SSS评分显著降低,BI评分明显提高,与对照组比较也有显著差异（均P〈0．01）。结论：盐酸氟西汀治疗脑卒中后抑郁状态不仅对抑郁有明显效果,且可促进脑卒中后神经功能的恢复。不良反应小。     

西酞普兰联合舍曲林对产后抑郁患者认知功能和副反应量表评分的影响分析

目的探究西酞普兰联合舍曲林对产后抑郁患者认知功能(MMSE)、副反应量表(TESS)评分的影响,为产后抑郁的临床治疗提供参考。方法选取2018年4月—2020年4月绍兴市第七人民医院接诊的60例产后抑郁患者作为研究对象,按照分层抽样法分为西酞普兰组和联合治疗组各30例。西酞普兰组采用西酞普兰进行治疗,联合治疗组在其基础上联合舍曲林进行治疗。观察两组患者汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、MMSE、TESS评分及治疗效果,采用酶联免疫吸附法检测脑源性神经营养因子(BDNF)、5-羟色胺(5-HT)、P物质(SP)水平,采用放射免疫法检测雌二醇(E2)、孕酮(P)、孤啡肽(OFQ)水平。结果与西酞普兰组相比,联合治疗组HAMD、HAMA、TESS评分及BDNF、SP、P、OFQ水平较低,差异有统计学意义(P<0.05)。与西酞普兰组相比,联合治疗组5-HT、E2水平及MMSE评分、治疗总有效率较高,差异有统计学意义(P<0.05)。与西酞普兰组相比,联合治疗组不良反应发生率较高,差异无统计学意义(P>0.05)。结论西酞普兰联合舍曲林可有效改善产后抑郁患者认知功能,减少不良反应,比单用西酞普兰起效更快,疗效更优,值得在临床上广泛推广。     

盐酸度洛西汀对卒中后情感障碍及神经功能康复影响的研究

目的观察盐酸度洛西汀对卒中后抑郁焦虑及神经功能康复的影响及不良反应。方法将卒中后抑郁焦虑的92例患者随机分为治疗组和对照组,各46例,在接受脑血管病常规治疗的基础上,治疗组加用盐酸度洛西汀,分别于治疗前及治疗4、8周后进行神经功能缺损程度评分（NDS）,汉密尔顿抑郁和焦虑量表（HAMD、HAMA）评测,比较两组的疗效。结果治疗组的神经功能缺损评分减少的百分率显著高于对照组（P〈0．01）。治疗组的HAMD、HAMA评分减少的百分率显著高于对照组（P〈0．01）。结论盐酸度洛西汀治疗卒中后抑郁焦虑是有效的,而且对卒中后神经功能的恢复有一定的帮助。     

认知疗法与西酞普兰治疗产后抑郁的治疗分析

目的观察分析认知疗法与西酞普兰治疗产后抑郁的临床疗效,总结其临床治疗经验及临床应用价值。方法选取该院2009年6月—2011年6月产后抑郁的患者84例,随机分为观察组与对照组,各42例,观察组使用认知疗法与西酞普兰治疗,对照组单纯使用西酞普兰治疗,分别使用汉密顿抑郁量表（HAMD）对治疗前和治疗后1、2、4、6周末的抑郁程度进行评分,观察对比两组治疗效果。结果观察组治疗后1周末的HAMD评分与治疗前相比（P〈0.05）,差异具有统计学意义;对照组治疗后2周末的HAMD评分与治疗前相比（P〈0.05）,差异具有统计学意义,治疗后1周末的HAMD评分与治疗前相比（P〉0.05）,差异无统计学意义。两组患者在治疗后1、2、4、6周末的HAMD评分进行对比（P〈0.05）,差异具有统计学意义。结论认知疗法与西酞普兰治疗产后抑郁的临床疗效显著,明显优于单纯药物治疗,能够明显改善患者的抑郁症状,缩短治疗的疗程,对改善患者的生活质量,具有重要的临床意义。     

黛力新治疗卒中后抑郁疗效观察

目的：观察黛力新治疗卒中后抑郁的临床疗效。方法：选择92例卒中后抑郁患者,随机分为治疗组和观察组,其中治疗组46例,观察组46例,治疗前后行汉密尔顿抑郁量表（HAMD）、神经功能缺损评分量表（SSS）评定。结果：治疗组治疗后较治疗前HAMD评分显著下降,对照组治疗后与治疗前比较HAMD评分无显著性差异。治疗组治疗后SSS评分显著降低,与对照组比较差异也有显著性。结论：黛力新治疗卒中后抑郁有明显效果,也可促进神经功能恢复。     

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.