VitE降低重度妊高征发生频率的临床流行病学研究

目的 :探讨 Vit E在预防重度妊高征发生中的作用。方法 :采用临床流行病学的队列研究方法。实验组人群口服 Vit E30 0 mg/ d,并设对照组。结果 :口服 Vit E组重度妊高征的发生率为 6 .1% ,明显低于对照组 4 5 .5 % ,其未服 Vit E孕妇发展成重度妊高征的 RR为 7.5 ( P<0 .0 0 1) ,AR%为 86 .7%。口服 Vit E可使 86 .7%的孕妇避免发展成为重度妊高征患者 ;以妊高征为指征的剖宫产率口服 Vit E组为 6 .1% ,显著低于对照组 36 .4 % ( P<0 .0 1)。结论 :口服 Vit E对阻止轻度妊高征患者发展成为重度妊高征有着重要的预防价值 ,并从临床的角度间接提示妊高征发生与Vit E的抗氧化作用有重要联系     

妊高征患者血尿酸值变化与新生儿体重的关系

目的: 探讨孕晚期孕产妇血清尿酸值在妊高征中的变化和孕产妇血清尿酸值变化与新生儿体重的关系。方法:检测131例孕晚期妊高征孕产妇的血清尿酸值, 与70例孕晚期正常妊娠孕产妇的血清尿酸值进行比较。结果: 妊高征组血清尿酸值显著高于正常妊娠组(P<0 .01), 妊高征各组血清尿酸值随妊高征程度的加深而升高(P<0. 01)。正常妊娠组血尿酸值变化与新生儿体重关系不大(P>0 .05), 妊高征组随血尿酸值升高, 妊高征程度加深, 新生儿体重下降(P<0 .05)。低体重儿易发生在血尿酸值较高的中、重度妊高征。结论: 血清尿酸值测定对了解妊高征的严重程度有重要意义, 并能间接预测新生儿体重。     

胎儿生长受限与重度妊高征的关系

目的 :探讨 FGR的发生、预后与重度妊高征的关系。方法 :以回顾性分析方法收集 2 0 0 0～ 2 0 0 3年住我院治疗、分娩的单胎重度妊高征病例 83例 ,比较重度妊高征的相关因素对 FGR发生率的影响和重度妊高征合并 FGR的情况下对围产儿预后的影响。结果 :妊高征的发生孕周、重度妊高征终止妊娠的孕周及有无合并症直接影响到 FGR的发生率 ,重度妊高征在合并FGR时 ,新生儿窒息率和围产儿死亡率明显升高 ( P<0 .0 5 )。结论 :重度妊高征与 FGR关系密切 ,加强孕期宣教、管理、积极防治妊高征能减少 FGR的发生     

瘦素与新生儿体重的关系

目的探讨妊娠高血压综合征(妊高征)患者和正常孕妇血清中的瘦素浓度与胎儿体重的关系。方法采用放射免疫分析法,分别检测177例孕妇血清中的瘦素水平,并对其结果进行t检验。结果妊高征患者血清中的瘦素水平〔(31.2±10.4)ng/ml〕明显高于正常孕妇〔(18.2±7.3)ng/ml〕,P<0.01;重度妊高征组血清中的瘦素水平〔(39.6±10.1)ng/ml〕明显高于轻度妊高征组〔(24.4±8.6)ng/ml〕,P<0.01,亦高于中度妊高征组〔(33.8±8.5)ng/ml〕,P<0.05;妊高征组的新生儿体重〔(3088±364)g〕明显低于正常孕妇组〔(3437±649)g〕,P<0.01,重度妊高征组的新生儿体重〔(2478±353)g〕明显低于轻度妊高征组〔(3434±342)g〕,P<0.01,亦低于中度妊高征组〔(3058±378)g〕,P<0.01。结论检测孕妇血清中的瘦素水平对于评估胎儿的发育和体重具有重要意义,对妊高征的治疗和预后评估也有指导价值。     

57例早产病因与新生儿结局分析

目的:探讨早产发生的高危因素及对新生儿的影响。方法:回顾分析57例早产的病因及新生儿结局,将早产分娩不同孕龄分为28~33+6周,34~36+6周两组,与同期足月分娩50例对照。结果:胎膜早破、妊娠胆汁淤积症、双胎、臀位、妊高征占早产病因前5位,不同孕龄组母亲年龄及人流史无显著差异;而新生儿死亡、窒息及新生儿低体重发生率有显著差别(P<0·01)。结论:早产是新生儿发病和死亡的主要原因,胎龄越小,新生儿体重越低,其窒息死亡发生率越高。提高对早产高危因素的预防及治疗对防治早产、改善新生儿结局有着十分重要的意义。     

重度妊高征终止妊娠时机及方式的研究

目的　研究重度妊高征患者不同孕周、不同方式终止妊娠对母婴的影响。方法　回顾性分析5 1例重度妊高征患者及其围生儿,比较不同孕周、两种分娩方式与母婴预后的关系。结果　重度妊高征患者在32～37孕周终止妊娠者,其胎盘早剥、胎儿宫内窘迫的发生率明显低于≥37孕周终止妊娠组(P <0 . 0 5 ) ,而两组新生儿窒息、新生儿肺透明膜病的发生率无显著性差异(P >0 . 0 5 )。而剖宫产分娩组并发产后出血、产时产后子痫明显低于阴道分娩组(P <0 . 0 5 )。结论　重度妊高征患者如病情需要,可将妊娠终止提前至32～37孕周之间,剖宫产指征应适当放宽。     

酚妥拉明治疗中重度妊高征50例临床分析

我院从 1996年 12月至 1999年 12月住院分娩人数 82 72例 ,其中妊高征 50 0例 ,发生率为 6.0 4 % ,其中轻度妊高征有 10 5例 ,中、重度妊高征为 395例。在临床中 ,我院使用两种不同药物 (酚妥拉明、硫酸镁 )治疗中、重度妊高征 50例 ,结果如下。1　资料与方法1.1　一般资料 :两组妊高征分度依据全国标准 ,患者年龄为 2 3～ 36岁 ,均为初产妇 ,孕周为 33～ 4 0 w,均具备阴道分娩条件而无紧急终止妊娠者 ,既往无高血压病史 ,从未应用其他降压药物。 A组中度妊高征 2 3例 ,重度妊高征 2 7例 ;B组中、重度妊高征例数与 A组相同。治疗前平均血…     

重度妊高征118例分娩方式的分析

目的探讨重度妊高征患者分娩方式的选择。方法选取我院2008年7月~2011年8月收治的118例重度妊高征患者的临床资料,分析不同分娩对母婴的影响,为临床最佳分娩方式的选择提供依据。结果通过自然分娩42例,母婴并发症16例,发生率38.10%;剖宫产76例,母婴并发症5例,发生率6.58%,两组分娩方式母婴并发症比较差异有统计学意义(P<0.05)。结论剖宫产是重度妊高征患者终止妊娠的最佳方式,并能有效预防母婴并发症。     

妊娠高血压综合征尿蛋白的丢失对新生儿出生体重的影响

目的: 几乎没有研究报道妊娠高血压综合征 (妊高征 ) 患者尿蛋白对新生儿出生体重的影响, 该研究欲探讨妊高征患者不同水平尿蛋白对新生儿出生体重的影响关系。方法: 1997年 1月 ~2004年 6月期间, 住院分娩患中、重度妊高征产妇 136例, 对新生儿出生体重与各种因素进行回归分析及t检验分析。结果: 单变量回归分析尿蛋白、孕龄分别与新生儿出生体重有高度显著性关系 (P<0. 01); 尿蛋白和孕龄一起进入多元回归分析, 校正影响因素, 尿蛋白和孕龄仍然是影响新生儿出生体重显著性因素 (P<0 .01); 与妊高征尿蛋白 ( +) 比较, 尿蛋白 无显著性影响新生儿出生体重 (P>0. 05), 尿蛋白 有显著性影响新生儿出生体重 (P<0. 01)。结论: 新生儿出生体重与妊高征患者尿蛋白丢失有关, 尿蛋白 丢失将严重影响新生儿出生体重。     

妊娠高血压综合征患者胎儿生长发育与白细胞介素-6的关系

目的:了解妊高征患者胎儿生长发育与白细胞介素-6(IL-6)水平的关系。方法:对2002年9月2004年9月50例妊娠高血压综合征患者(妊高征组)及30例正常孕妇(对照组)胎儿生长情况进行评价。采用酶联免疫吸附试验(ELISA法)检测两组母血清及羊水中IL-6的含量。结果:①中、重度妊高征患者低体重儿发生率显著高于正常妊娠组(P<0.01);②妊高征组母血清IL-6含量随病情加重呈升高趋势,中、重度妊高征组母血清IL-6含量显著高于正常妊娠组(P<0.01),羊水IL-6含量随妊高征病情加重呈下降趋势,中、重度妊高征组羊水IL-6含量显著低于正常妊娠组(P<0.01),母血清IL-6与羊水IL-6无显著相关关系(r=-0.21,r=-0.29,P>0.05);③妊高征组中24例新生儿出生体重低于2 500 g,其羊水IL-6含量显著低于新生儿出生体重达到2 500 g以上者,羊水IL-6水平与新生儿体重在妊高征组未发现明显相关性(r=0.232,P>0.05)。结论:妊高征患者的免疫活性细胞释放过多的IL-6,参与了妊高征的免疫损伤过程;妊高征患者胎盘产生并转运IL-6至羊水的能力下降,致羊水IL-6含量下降,对妊高征发病及其胎儿生长发育可能有重要影响。     

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.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.     

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.     

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.     

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.