煤矿井下作业矿工血浆醛固酮水平的变化

目的　探讨煤矿井下作业对高血压矿工血浆醛固酮 (ALD)水平的影响。方法　采用放射免疫测定法对地面与井下作业的高血压 (HP)与非高血压 (NHP)矿工进行血浆ALD水平的测定。结果　井下作业矿工血浆ALD总体水平显著高于地面作业矿工 (P <0 0 5 ) ,主要是井下HP矿工血浆ALD水平显著升高 ,不仅高于地面HP矿工 (P <0 0 5 ) ,亦高于井下NHP矿工 (P <0 0 5 ) ,且井下HP矿工中以安装维修组矿工血浆ALD水平最高。井下作业矿工平均动脉血压 (ABP)与血浆ALD水平呈显著正相关 (r =0 46 76 ,P <0 0 5 )。结论　井下特殊的作业环境和作业内容可能是引起井下HP矿工血浆ALD水平升高的原因。     

一线煤矿工人咽喉部疾患的调查

一线煤矿工人的工作环境特殊,工人长期暴露在较高浓度的粉尘里容易诱发多种咽喉部的疾患。本文旨在通过调查,了解一线煤矿工人咽喉部的健康状况及与其工作环境的相关性。     

Lung mechanics and frequency dependence of compliance in coal miners

The mechanical properties of the lungs were studied in two groups of coal miners. The first group consisted of miners with either simple or no pneumoconiosis and was divided into two subgroups (1A and 1B). The former (1A) consisted of 62 miners most of whom had simple pneumoconiosis but a few of whom had clear films. Although their spirometry was normal, all claimed to have respiratory symptoms. The other subgroup (1B) consisted of 25 working miners with definite radiographic evidence of simple pneumoconiosis but normal spirometric findings. The second major group consisted of 25 men with complicated pneumoconiosis.In subjects with simple pneumoconiosis, static compliance was mostly in the normal range, whereas it was often reduced in subjects with the complicated disease. The coefficient of retraction was normal or reduced in most subjects except those with advanced complicated disease, in several of whom it was elevated. So far as simple pneumoconiosis was concerned, abnormalities, when present, reflected "emphysema" rather than fibrosis. In severe complicated pneumoconiosis, changes suggesting fibrosis tended to predominate. In the 25 working miners (subgroup 1B) dynamic compliance was measured at different respiratory rates. 17 of the subjects in this subgroup demonstrated frequency dependence of their compliance, a finding unrelated to bronchitis and suggestive of increased resistance to flow in the smallest airways.     

煤矿工人OSAHS患者高敏C-反应蛋白观察

目的 探讨煤矿工人阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清高教C-反应蛋白(hs-CRP)浓度变化情况.方法 选取50名30～60岁经多导图确诊的中重度OSAHS煤矿工人作为试验组,50名健康查体矿工为对照组,分别测定两组对象hs-CRP水平.结果 OSAHS矿工患者与对照组相比血清hs-CRP水平明显升高(P<0.05),且OSAHS越严重,血清hs-CRP水平的升高越明显,血清hs-CRP与睡眠呼吸暂停指数呈正相关,而与夜间最低血氧饱和度呈负相关,即睡眠呼吸暂停越严重血清hs-CRP水平越高.结论 OSAHS矿工患者血清hs-CRP水平升高,且与OSAHS严重程度有关.     

Clinical and functional features of the development of myocardial infarction in miners engaged in deep coal mines

It is shown that miners engaged in deep coal mines develop myocardial infarction (MI) at a young age, the mean age being 42.8 years. The foregoing clinical picture was characterized by an atypical, painless course. In some cases (20 percent) the typical pain syndrome did not manifest itself even in the preinfarction period making the diagnosis difficult. MI develops under the conditions of relatively preserved coronary reserves (functional class I-II). The leading factors that promote IM development are intense hard physical work combined with a heating microclimate. This is evidenced by the high rate of its occurrence during work and the first 1 to 4 hours after work (74.2 percent), large zones of affection (large-focal and transmural infarctions), and by the development of disorders in cardiac rhythm and conduction. The low percentage of persons registered at the health centers before MI development, and late hospitalization indicate the necessity of improving the system of the treatment and prevention of diseases among the group of patients under consideration.     

Nonspecific airway hyperreactivity in nonsmoking bituminous coal miners demonstrated by quantitative methacholine inhalation challenge

Because nonsmoking underground bituminous coal miners often have symptoms of chronic bronchitis and because a high proportion of patients with chronic bronchitis have nonspecific airway hyperreactivity, we hypothesized that coal miners would have a higher prevalence of nonspecific airway hyperreactivity than nonminer nonsmoking control subjects. By use of a quantitative methacholine provocative inhalation challenge test, we evaluated 22 underground bituminous coal miners and 41 nonminer age- and sex-matched control subjects from the same community. We found that a significantly higher proportion of miners had reactivity to inhalation of 100 mg/ml or less of methacholine, X2 = 6.19, p less than 0.02. The slope of phase III of the single-breath nitrogen washout test was higher in the reactive miners than in the nonreactive miners and reactive control subjects, even though the reactive miners had only been working underground 8 +/- 3 (SEM) years. Within the reactive miner subgroup, the higher the reactivity to methacholine, the more abnormal the slope of phase III of the single-breath nitrogen test, r = 0.79. Miners had more symptoms than controls; the presence of methacholine reactivity was not associated with increased symptoms. We conclude that the bituminous coal miners in our study had an increased prevalence of nonspecific airway hyperreactivity and that within the reactive miner subgroup there was evidence of early airways disease. We speculate that the nonspecific airway hyperreactivity may be related to, and also be an indicator of, lung injury in coal miners.     

煤矿工人工伤所致精神障碍赔偿行为分析

目的探讨煤矿工人工伤与非工伤精神障碍赔偿行为。方法采用自拟的煤矿工人工伤后及非工伤精神障碍待遇调查表对75例工伤和80例非工伤精神障碍矿工进行精神残疾鉴定后的赔偿行为进行对比分析。结果工伤组70.7%尚能胜任工作的患者中重返工作岗位者只有4.0%,76%长期住院或多次住院的患者中有29.3%的患者长期假出院在家;诈病率显著高于非工伤组,1～3级精神残疾率显著低于非工伤组（P〈0.01）;工伤组患者有意扩大病情的比例显著高于非工伤组,医疗费用及工资待遇显著优于非工伤组。结论煤矿工人工伤后有严重的赔偿行为;工人价值观、道德标准低,工作劳动强度大,卫生条件差,危险性大,矿区对工伤待遇优厚等是赔偿行为产生的主要原因。     

196例煤工尘肺合并肺结核死亡原因分析

目的　探讨煤工尘肺合并肺结核及其并发症的致死原因。方法　对 196例煤工尘肺合并肺结核的临床资料进行回顾性分析。结果　煤工尘肺合并肺结核后对肺功能的损害不是简单的叠加 ,而是可以相互促进 ,相互加重病情 ,使得治疗效果明显降低 ,病死率明显升高。结论　煤工尘肺合并肺结核是以肺部纤维化为主的全身性疾病 ,且病死率较高。     

Controlling Hyperthermia in the Surgical Patient

Insufficient attention is sometimes paid to the temperature of the anaesthetised or surgical patient. Ideally, normothermia should be maintained throughout anaesthesia, but this is not always possible. Although animals more commonly suffer a drop in temperature (hypothermia) whilst under general anaesthesia, this article will concentrate on hyperthermia, as this is just as important to control and which, if ignored, could result in lasting effects on the patient.     

恶性高热症的研究进展

恶性高热症 (MalignantHyperthermia ,MH)是一种罕见的常染色体显性疾患 ,此病的易感个体在接触某些麻醉药物时可发生危及生命的高代谢状态。已发现恶性高热症与ryanodine受体基因 (RYR1)缺陷相关。肌肉活检作体外氟烷和咖啡因肌肉收缩试验是诊断MH易感性的唯一可靠方法 ,非特异性肌松药丹妥宁钠是目前已知的根本治疗药物