肺炎支原体感染合并呼吸道哮喘患者血清免疫球蛋白和炎性因子及维生素D联合检测的临床意义

目的拟探讨肺炎支原体感染合并呼吸道哮喘患者血清免疫球蛋白、炎性因子及维生素D联合检测的临床意义。方法选择2016年4月-2018年6月遵义市第一人民医院收治的肺炎支原体感染患者80例,按照是否合并支气管哮喘分为:合并支气管哮喘组与非合并支气管哮喘组,每组40例。选择同期到医院体检的健康人40名为对照组,检测各组血清25-羟基维生素D[25-hydroxyvitamin D,25(OH)D]、免疫球蛋白与炎性因子水平,分析其相关性。结果合并支气管哮喘组的免疫球蛋白E(Immunoglobulin E,IgE)、免疫球蛋白M(Immunoglobulin M,IgM)、免疫球蛋白G(Immunoglobulin G,IgG)水平高于非合并支气管哮喘组与对照组;非合并支气管哮喘组的IgE、IgM、IgG水平高于对照组,差异有统计学意义(P<0.05)。合并支气管哮喘组的血清炎性因子水平高于非合并支气管哮喘组与对照组,非合并支气管哮喘组的血清炎性因子水平高于对照组,差异均有统计学意义(P<0.05)。合并支气管哮喘组、非合并支气管哮喘组、对照组的25(OH)D水平分别为(13.24±5.12)ng/ml、(25.36±4.02)ng/ml、(30.11±4.21)ng/ml,合并支气管哮喘组低于非合并支气管哮喘组与对照组,非合并支气管哮喘组低于对照组,差异均有统计学意义(P<0.05)。经Logistic多因素回归分析,血清IgG、25(OH)D、IL-5水平与肺炎支原体感染合并支气管哮喘具有明显相关性。结论肺炎支原体感染合并呼吸道哮喘患者存在维生素D缺乏症状,其血清球蛋白及炎性因子水平高于正常人群,联合检测上述指标可为临床早期诊治肺炎支原体感染合并呼吸道哮喘提供依据。     

支气管哮喘与肺炎支原体感染的临床相关性探讨

目的：研究分析小儿支气管哮喘与肺炎支原体（MP）感染的临床相关性,为小儿支气管哮喘的治疗提供科学可靠的依据。方法：将2010年1月-2012年3月入住笔者所在医院治疗的80例呼吸道感染患儿和72例呼吸道感染并伴有支气管哮喘患儿作为研究对象,分别为对照组和哮喘组。两组患者进行血清学检查,运用ELISA测定MP-IgM,检测患者肺炎支原体感染状况。根据结果,对照组患者使用抗生素、激素及支气管扩张剂进行治疗,哮喘组患者在此基础上加用阿奇霉素序贯治疗。半年内回访,调查治疗效果和复发率。结果：对照组和哮喘组患者MP-IgM阳性率分别为21.3%和44.4%,两组比较差异具有统计学意义（P〈0.05）。两组相比较,哮喘组患者经相应治疗后预后更好。结论：小儿支气管哮喘与肺炎支原体关系密切,肺炎支原体可能是引发小儿支气管哮喘的重要病原体。     

盆腔炎合并支原体感染60例临床治疗分析

目的 对盆腔炎合并支原体感染的临床治疗进行分析,总结其治疗经验。方法 选取我院2013年2月至2014年2月收治入院的盆腔炎合并支原体感染患者60例,将患者随机分为观察组和对照组,分别采用综合治疗法和传统单纯西医治疗法,观察对比两组患者的临床疗效。结果 观察组治疗总有效率为93.3%,UU转阴率45.7%,均显著高于对照组的80.0%和18.5%,组间比较差异有统计学意义,P0.05。结论 中西医结合的综合治疗法可显著提高临床疗效,不良反应少,并复发率低,患者经济负担小。     

肺炎支原体感染与儿童哮喘关系的探讨

目的探讨肺炎支原体感染与儿童支气管哮喘的相关性。方法选取96例儿童支气管哮喘患儿作为观察组,87例健康体检者作为对照组,对两组患儿血清MP-IgM进行检测;将观察组分为MP-IgM阳性组与阴性组,对两组患儿血清总IgE水平和外周血嗜酸性粒细胞计数进行比较。结果观察组MP-IgM阳性率为44.8%,显著高于对照组的19.5%,差异有统计学意义(P<0.05);MP-IgM阳性组血清总IgE水平和外周血嗜酸性粒细胞计数显著高于MP-IgM阴性组,差异有统计学意义(P<0.05)。结论肺炎支原体感染与儿童支气管哮喘密切相关。     

孟鲁司特钠与特布他林联合治疗儿童咳嗽变异性哮喘临床疗效分析

目的探讨孟鲁司特钠联合特布他林对儿童咳嗽变异性哮喘伴肺炎支原体感染的临床治疗效果,并观察其安全性,为临床治疗提供依据。方法选择2012年3月-2014年3月医院收治的咳嗽变异性哮喘伴肺炎支原体感染患儿112例,根据治疗方法将患儿分为对照组和观察组,各56例,两组患儿均给予阿奇霉素治疗,对照组给予特布他林雾化吸入;观察组给予口服孟鲁司特联合特布他林雾化吸入治疗;主要评估两组治疗效果、评估治疗前后患儿咳嗽和睡眠评分、评估治疗期间患儿肺功能指标及不良反应。结果治疗显效率观察组为73.21%,高于对照组58.93%,差异有统计学意义(P<0.05);观察组患儿咳嗽消失和喘憋消失时间均低于对照组,差异有统计学意义(P<0.05);观察组患儿治疗期间FEV1、PEF和FEV1/FVC分别为(2.97±0.62)L、(96.61±4.17)%和(71.84±2.76)%均高于对照组,差异有统计学意义(P<0.05);观察组患儿治疗后咳嗽和睡眠评分均低于对照组,且两者治疗后均低于治疗前,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义。结论孟鲁司特钠联合特布他林治疗儿童咳嗽变异性哮喘伴肺炎支原体感染临床疗效较好,能够显著改善患儿的临床症状或体征,并具有安全性,值得临床推广。     

临床护理路径在支气管哮喘治疗过程中的应用

目的探讨临床护理路径在支气管哮喘治疗过程中的临床应用价值。方法将2009年10月—2012年11月治疗的144例支气管哮喘患者随机分为观察组与对照组各72例,所有患者均接受支气管哮喘常规治疗,观察组患者接受临床护理路径模式,对照组患者接受常规护理模式。结果观察组护理依从率(90.28%)显著高于对照组(58.33%),护理服务满意度(93.06%)显著优于对照组(81.94%),比较差异均有统计学意义(均P<0.05)。观察组住院天数(8.4±1.9)d显著短于对照组(12.5±2.3)d,哮喘知识掌握得分(86.9±12.7)分显著高于对照组(63.0±10.4)分比较差异有统计学意义(P<0.05)。观察组总有效率(98.61%)显著优于对照组(90.28%),比较差异有统计学意义(P<0.05)。结论临床护理路径在支气管哮喘治疗过程中的临床应用价值确切,可以显著改善支气管哮喘患者多个住院指标。     

支原体属抗体及血清白介素-4、γ-干扰素对支气管哮喘患儿肺炎的诊断

目的探讨支原体抗体以及血清中白介素-4(IL-4)、γ-干扰素(IFN-γ)的检测对支气管哮喘患儿肺炎的诊断意义,为临床资料提供参考依据。方法选择医院2011年2月-2012年2月医院进行治疗的支气管哮喘患儿84例,经MP-IgM检测后分为观察组36例、对照组48例,另选择40名健康儿童作为正常健康组,分别检测3组血清IL-4、IFN-γ浓度,并进行比较分析,数据采用SPSS 16.0软件进行分析。结果观察组血清中IL-4的浓度显著高于对照组(P<0.05)与正常健康组(P<0.05),同时对照组的IL-4浓度显著高于正常健康组(P<0.05);观察组血清中IFN-γ的浓度显著低于对照组(P<0.05)与正常健康组(P<0.05),同时对照组的IFN-γ浓度显著低于正常健康组(P<0.05);IL-4与IFN-γ之间logistic回归分析结果显示,血清中的IL-4与IFN-γ为支气管哮喘患儿肺炎的主要的危险因素。结论在临床中支原体抗体、血清IL-4、IFN-γ的检测对支气管哮喘患儿肺炎的诊断具有重要意义。     

支气管肺泡灌洗术治疗儿童肺炎支原体肺炎的疗效分析

目的分析采用支气管肺泡灌洗术治疗儿童肺炎支原体肺炎的效果。方法选取我院2016年1月至2016年12月收治的82例肺炎支原体肺炎患儿,随机分为观察组和对照组,各41例。对照组采用大环内酯类抗生素、止咳化痰药物等治疗,观察组在对照组基础上采用纤维支气管镜下支气管肺泡灌洗术治疗。对比两组患儿治疗后的症状、体征情况和临床效果。结果观察组的咳嗽、发热、肺部体征持续时间均明显短于对照组,差异有统计学意义(P<0.05)。观察组的肺部X线提示阴影吸收时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。观察组的总有效率为92.68%,明显高于对照组的75.61%,差异有统计学意义(P<0.05)。结论采用纤维支气管镜下支气管肺泡灌洗术治疗儿童肺炎支原体肺炎效果显著,能够有效改善患儿的症状体征,值得临床推广应用。     

儿童支气管哮喘与肺炎支原体感染的关系

目的探讨儿童支气管哮喘病与肺炎支原体感染的关系。方法选取该院在2011—2012年收治的支气管哮喘患儿152例,将这152例患儿选为观察组,另选同一时期该院收治的上呼吸道感染患儿100例,选为对照组,对两组患儿进行MP-Ab阳性检测,比较两组患儿的MP-Ab阳性率,同时对检测为MP-Ab阳性患儿进行分组治疗,分为常规组和治疗组,常规组采用一般常规治疗,治疗组加用阿奇霉素进行治疗,比较两组疗效。结果①对观察组和对照组MP-Ab阳性率的比较,观察组(44.7%)明显高于对照组(7.0%),且差异具有统计学意义P<0.05;②对常规组和治疗组治疗效果的比较,治疗组有效率(85.3%)明显高于对照组(44.1%),且差异具有统计学意义P<0.05。结论儿童支气管哮喘与肺炎支原体感染关系密切,且应用大环内酯类抗生素对治疗小儿支气管哮喘确有疗效。     

支气管哮喘合并肺结核患者脑源性神经营养因子和神经激肽A表达对预后的影响分析

目的探究支气管哮喘合并肺结核患者脑源性神经营养因子(BDNF)和神经激肽A(NKA)表达对预后的影响,以便于更好地监测患者病情进展,改善患者预后,提高患者生活质量。方法随机选取2014年1月-2015年12月医院收治55例支气管哮喘合并肺结核患者为观察组对象,另选取30名在医院体检的健康成人为对照组,观察并记录两组受试者治疗前后BDNF、NKA、第一秒用力呼吸量(FEV1)和呼气峰值(PEF)变化情况,分析比较。结果哮喘急性期患者BDNF水平显著高于哮喘缓解期患者和对照组,治疗后,缓解期和急性期支气管哮喘患者BDNF均下降,与治疗前比较差异有统计学意义(P<0.05);支气管哮喘缓解期患者NKA显著高于对照组,而哮喘急性期患者显著高于缓解期患者,两组比较差异有统计学意义(P<0.05),治疗后,均有明显降低,较治疗前差异有统计学意义(P<0.05);治疗后,两组患者FEV1和PEF等肺功能指标明显改善,较治疗前差异有统计学意义(P<0.05)。结论支气管哮喘患者体内NKA和BDNF含量较正常人显著升高,有利于疾病早期诊断和监测,便于控制病情发展,预后较好。     

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.