恶性肿瘤患者肌肉减少症的诊断与营养干预

肌肉减少症是恶性肿瘤患者常见的临床综合征之一，可视为发病、死亡等不良预后的一项独立危险因素。主要评估方法为CT、MRI、PET等成像技术。肌肉减少症的发生、发展与肿瘤恶病质关系密切，且与抗肿瘤治疗相互影响。近年来，不断涌现出采取营养支持、药物和运动等综合干预手段的临床研究，其中不少取得了效果。肌肉减少症在恶性肿瘤治疗中具有不可忽视的临床价值，其发病机制复杂，疗效和安全性尚需更多高级别循证依据支持。     

锦州市社区老年人肌肉减少症现状及相关因素研究

目的了解锦州市社区老年人肌肉减少症现状及其相关因素,为老年人肌肉减少症的预防及干预提供理论支持。方法采用方便抽样的方法抽取锦州市太和区、凌河区与古塔区193名年龄≥60周岁的老年人进行问卷调查与体成分测量。结果锦州市社区老年人肌肉减少症患病率为11.4%,其中男性肌肉减少症患病率为7.6%,女性肌肉减少症的患病率为13.3%,女性的患病率高于男性;Logisitic回归分析结果显示,步速较高(OR0.001)、跌倒效能较高(OR=0.610)是社区老年人肌肉减少症的保护因素;而体脂肪率较高(OR=1.250)、运动功能较差(OR=1.154)、患有糖尿病(OR=1.089)是社区老年人肌肉减少症的危险因素。结论锦州市社区老年人肌肉减少症的患病率较高,加强老年人对肌肉减少症的认识,及时发现肌肉减少症并给与及时干预,对促进健康老龄化有着较为重要的意义。     

运动预防肌少症

肌肉减少症简称肌少症,是指随着年龄增长出现的骨骼肌量减少、肌肉力量或肌肉功能减退,是一种渐进性、全身性的骨骼肌疾病.对于老年人来说,肌少症与虚弱、跌倒、功能衰退、死亡等风险增加有关.随着全球老龄化的急速加剧,肌少症逐渐成为科学运动的关注热点.研究显示,科学的营养和运动干预对防治肌肉减少症有显著的积极作用,可不同程度地改...     

肌肉减少症——一种影响老年人生存质量及临床结局的老年综合征

肌肉减少症是一种老年综合征。随着人口的老龄化,该病的发生越来越普遍,严重影响了老人的生存质量,消耗了大量的医疗资源。本文对肌肉减少症的病因与发病机制、筛查方法与诊断、干预与治疗等方面进行综述,以期为该病的诊断、治疗提供参考。     

运动和营养干预对预防老年肌肉减少症的作用和意义

老年肌肉减少症在社区中是一种常见的与年龄相关的健康问题,运动及营养干预对预防老年肌肉减少症的发生和进展有重要作用和意义。本文通过检索MEDLINE/Pubmed数据库2015-01/2020-12发表的运动和营养干预相关文献,对老年肌少症相关的运动和营养干预的研究结果进行综述。     

2017—2021年Web of science肌肉减少症与营养研究的文献可视化分析

目的 基于Web of science数据库分析肌肉减少症与营养研究的相关文献，为后续研究提供参考。方法 检索Web of science核心数据库2017—2021年收录的肌肉减少症与营养研究领域的相关文献，应用CiteSpace.6.1.R2软件对机构、期刊、共被引及关键词等文献特征进行统计。结果 2017—2021年Web of science数据库肌肉减少症与营养研究领域发文量逐年稳定增长，美国和日本的发文量最多；发文期刊主要分布在美、英两国；研究热点集中于营养状况与肌肉减少症的流行病学研究（营养状况、体成分、患病率、死亡率等），干预研究（锻炼、饮食模式、维生素D等），疾病相关性的营养不良/肌肉减少症的评估与管理（胃癌、肝硬化、炎症性肠病等）；研究趋势为血清白蛋白、社区老年人、身体质量、重症监护室、鱼油补充剂。结论 近年来，肌肉减少症与营养研究受到了国内外学者的关注。我国还需加强该领域的国际合作与交流，本文研究热点与前沿可为我国开展相关研究提供借鉴与参考。     

肝硬化肌肉减少症的评估及临床管理

肝硬化时患者体内蛋白质及脂质氧化率高, 碳水化合物氧化率低, 这种体内供能方式发生改变使得肝硬化患者容易发生蛋白质-能量营养不良。肌肉减少症作为营养不良的重要组成部分, 在肝硬化患者中多见并且与患者预后不良相关。目前还没有肝硬化患者肌肉减少症诊断的统一标准, 关于肝硬化患者肌肉减少症的发生机制研究也较少。本文就该类患者的评估及临床管理加以阐述, 旨在为相关临床问题的研究提供参考。     

肌肉减少症与结直肠癌关系的研究进展

肌肉减少症是一种以骨骼肌质量和力量的进行性和全身性丧失为特征的综合征,导致身体残疾、生活质量降低甚至死亡。发生机制涉及炎症和氧化应激、激素水平改变、线粒体功能障碍等。结直肠癌病人肌肉减少症的发生率在12%～60%之间。有研究表明,肌肉减少症可能对CRC病人围术期产生负面影响而导致不良临床结局。本综述结合国内外最新研究进展,系统阐述CRC病人肌肉减少症的发生机制、评估方法、以及对围术期并发症、化疗毒副作用和生存预后的影响,总结并展望CRC病人肌肉减少症的干预措施。     

综合护理干预对腰椎间盘突出症患者护理质量的影响

目的:探讨综合护理干预对腰椎间盘突出症患者护理质量的影响.方法:将40例腰椎间盘突出症患者随机分为对照组和干预组各20例,对照组给予常规护理,干预组在此基础上给予综合护理干预,比较两组患者的治疗有效率、护理满意率、JOA评分及RMQ评分.结果:干预组患者的治疗有效率、护理满意率、出院时的JOA评分及RMQ评分均明显优于对照组,差异具有统计学意义(P<0.05).结论:综合护理干预可以提高腰椎间盘突出症患者的治疗效果和护理质量,值得临床推广.     

混合痔手术患者合并血小板减少症的临床疗效观察

目的:观察混合痔需手术治疗的患者合并血小板减少症的临床治疗方法及其疗效。方法:对混合痔合并血小板减少症患者采取一系列术前、术中、术后的中西医结合的止血方法,防止意外出血。结果:全部患者顺利接受手术,安全出院,无医疗事故以及医疗纠纷。结论:通过术前有效干预,血小板减少症并非患者手术禁忌。通过术前、术中、术后的合理治疗,可有效治疗混合痔合并血小板减少症患者。     

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.