慢性苯中毒患者T淋巴细胞rDNA转录活性的研究

目的　观察慢性苯中毒患者外周血T淋巴细胞rDNA转录活性的变化 ,探讨其对慢性苯中毒人群免疫监测的意义。方法　慢性苯中毒患者 39人、恶性肿瘤患者 2 0人和健康体检者 2 2人分别取静脉血 ,通过细胞培养、银染等方法 ,并采用I CLQ细胞分析系统 ,分别测定核仁积分面积与细胞核积分面积的比值 (IA)和核仁银染积分光密度与细胞核银染积分光密度的比值 (IOD)。结果　 (1 )慢性苯中毒患者IA和IOD值分别为 7.95 %± 1 .1 3 %和 7.1 5 %± 1 .1 5 % ,较正常对照组 (IA和IOD值分别为 9.59%± 1 .2 6 %和 8.92 %± 1 .1 8% )明显降低 ,差异有显著性 (P <0 .0 1 ) ;慢性中度苯中毒组IA和IOD值分别为 6 .54 %± 0 .88%和 5 .47%± 0 .80 % ,较观察对象组 (IA和IOD值分别为 7.98%±1 .0 6 %和 7.1 3 %± 0 .96 % )和轻度中毒组 (IA和IOD值分别为 8.1 9%± 1 .0 6 %和 7.44 %± 1 .0 6 % )明显下降 ,差异有显著性 (P <0 .0 5)。 (2 )恶性肿瘤组IA和IOD值分别为 4 .1 0 %± 1 .50 %和 3 .67%±1 .42 % ,较正常对照组和慢性苯中毒组均明显下降 ,差异有显著性 (P <0 .0 1 )。结论　rDNA转录活性可作为监测慢性苯中毒患者细胞免疫功能的一项指标     

早期胃癌细胞凋亡及增殖细胞的表达

目的探讨早期胃癌中细胞凋亡、增殖在胃癌发生及形态形成中所起的作用。方法应用较敏感且特异性较强的TdT酶介导的生物素化dUTP缺口末端标记(Tunel)技术及免疫组织化学染色SP法分析研究了51例早期胃癌细胞凋亡增殖细胞核抗原(PCNA)的表达。结果(1)凋亡细胞在癌旁组织较为多见,为5.6%～29.3%,凋亡指数AI=13.19±6.68,而在早期胃癌中,凋亡细胞明显减少,为1.5%～16.0%,凋亡指数下降,AI=7.45±3.25,P<0.005,PCNA增殖指数在癌旁组织(PI=29.86±15.33)明显低于早期胃癌(PI=61.64±15.64);(2)肠型胃癌的凋亡指数(AI=7.86±3.47)明显高于弥漫型胃癌(AI=4.63±1.94),而PCNA增殖指数则相反,结果分别为59.03±10.66,68.20±14.49,P<0.05;(3)隆起型胃癌的凋亡指数(AI=9.60±3.51)明显高于凹陷型胃癌(AI=4.95±1.91),P<0.005,PCNA增殖指数则隆起型胃癌明显低于凹陷型胃癌,P<0.005。结论胃癌的发生与癌细胞过度生长及凋亡受抑有关;肠型胃癌较弥漫型胃癌净细胞增加少,所以肠型胃癌生长缓慢;早期胃癌的形态形成可能与肿瘤的增殖活动、细胞凋亡有关。     

苯作业工人淋巴细胞微核形成与骨髓单个核细胞凋亡相关性分析

目的探讨慢性职业性苯中毒病因及早期诊断指标.方法从208例苯作业工人中选取20例外周血淋巴细胞微核和淋巴细胞百分比偏高者,分为高浓度(34～582mg/m3)接触组和低浓度(8～32 mg/m3)接触组,每组各10例;另设10例对照组,用流式细胞仪法检测各组骨髓单个核细胞早期凋亡指标Annexin V及调控凋亡的细胞因子白细胞介素(IL)-2、IL-4、IL-6和干扰素(IFN)-r的水平.结果(1)低浓度、高浓度苯接触工人淋巴细胞微核率分别为0.149%、0.308%,均高于对照组(0.060%),差异均有显著性(P＜0.05,P＜0.01).(2)低浓度组骨髓单个核细胞Annexin V阳性表达水平(0.70%±0.16%)与对照组(0.68%±0.22%)相比,差异无显著性(P＞0.05),而高浓度组骨髓单个核细胞Annexin V阳性表达水平(1.16%±0.19%)则高于对照组,差异有显著性(P＜0.05).(3)淋巴细胞比例增高者IL-4表达水平增高,且与淋巴细胞比例呈相关(r=0.616),差异有显著性(P＜0.05);IL-2、IL-6、IFN-r表达水平减少,与淋巴细胞比例呈负相关(r值分别为-0.416,-0.689,-0.423),差异均有显著性(P＜0.05).结论外周血淋巴细胞微核率和骨髓单个核细胞Annexin V可作为苯作业工人和慢性苯中毒患者的监控指标.     

51例早期胃癌及癌旁组织p53、PCNA、bcl-2检测及临床意义

目的 研究p53、bcl-2的表达与细胞凋亡的关系,探讨凋亡及凋亡相关基因与胃癌发生的关系及临床意义.方法 采用原位末端标记法(Tunel)及免疫组化技术检测51例胃癌及癌旁组织胃黏膜上皮细胞凋亡及增殖和p53、bcl-2的表达情况.结果 (1)凋亡细胞在癌旁和早期胃癌组织中的凋亡指数(AI)分别为13.19±6.68,6.54±3.25,差异有统计学意义(P＜0.05);而增殖细胞核抗原(PCNA)增殖指数(PI)则相反,在癌旁和早期胃癌组织中分别为29.86±15.33,61.64±15.64,差异有统计学意义(P＜0.05).(2)p53在早期胃癌组织中表达率明显高于癌旁组织,在肠型及弥漫型胃癌组织中表达率明显高于癌旁组织;bcl-2在早期胃癌组织中表达率略高于癌旁组织(P＞0.05);在肠型胃癌组织中表达率明显高于癌旁组织;在弥漫型胃癌组织中表达率与癌旁组织差异无统计学意义(P＞0.05).(3)p53阳性病例AI明显低于p53阴性病例,差异有统计学意义(P＜0.05).bcl-2阳性病例AI明显高于bcl-2阴性病例,差异有统计学意义(P＜0.05).结论 细胞凋亡及p53、bcl-2在胃癌的发生过程中起重要作用.     

不同营养状态对口腔粘膜细胞凋亡和增殖的影响

目的研究不同营养状态对口腔粘膜细胞凋亡和增殖的影响。方法选取营养不良患者17名,健康志愿者15名。用亚G1峰法和增殖抗原Ki-67标记法分别检测口腔粘膜细胞的凋亡率和增殖率;非配对t检验分析不同营养状态受试者口腔粘膜细胞凋亡率和增殖率的差异。结果营养不良患者与健康志愿者在年龄、性别上无显著差异,营养不良患者组与健康组口腔粘膜细胞的凋亡率分别为19·90%±4·14%和33·87%±6·28%(P=0·001);营养不良患者与健康组口腔粘膜细胞的增殖率分别为6·66%±5·83%和12·18%±7·97%(P=0·043)。结论在不同营养状态的人群中,口腔粘膜细胞凋亡率和增殖率存在显著差异,营养不良患者的口腔粘膜细胞凋亡率和增殖率明显低于正常人。     

氟对体外培养的血管内皮细胞增殖的影响

目的 观察不同浓度的氟对体外培养的人脐静脉血管内皮细胞增殖的影响.方法 利用二甲基噻唑二苯基四唑溴(MTT)比色法、流式细胞仪及免疫组织化学法观察不同浓度的(120、240、360、480、600、720、840、960 μmol/L)氟化钠染毒24 h对体外培养的人脐静脉血管内皮细胞增殖活性的影响.结果 氟化钠的浓度在120～240 μmol/L时,增殖细胞核抗原表达阳性率高于正常对照组(P＜0.01),240 μmol/L时的阳性率最高约为80%;吸光度(A)值和细胞分裂增殖指数(PI)值也高于正常对照组(P＜0.05,P＜0.01);360～480 μmol/L氟化钠染毒组上述指标与正常对照组差异无统计学意义(P＞0.05);当氟化钠的浓度增加到600 μmol/L以上时,增殖细胞核抗原的表达、A值及PI值均低于正常对照组(P＜0.05,P＜0.01),以960μmol/L时增殖抗原表达阳性率最低(约为20%),并且随着浓度增高上述指标呈下降趋势.结论 低浓度的氟化钠能促进脐静脉血管内皮细胞增殖活性,高浓度时抑制脐静脉血管内皮细胞的增殖活性,且随着氟浓度的增加,抑制作用逐渐增强.     

新疆维吾尔族宫颈癌新辅助化疗前后Ki-67、凋亡指数的表达及意义

目的:探讨维吾尔族(维族)宫颈鳞癌组织细胞增殖和凋亡与新辅助化疗疗效的关系。方法:选取20例维族正常宫颈组织,22例维族宫颈鳞癌患者新辅助化疗前后的宫颈组织,分别应用免疫组化SP法和脱氧核糖核苷酸末端转移酶介导dUTP缺口末端标记法(TUNEL)检测组织中的Ki-67核抗原指数(PI)和凋亡指数(AI)。结果:化疗临床有效率为81.8%;化疗前后宫颈鳞癌组织Ki-67增殖指数表达分别为(66.45±16.31)和(38.41±7.46),差异有统计学意义(t=7.33,P<0.05);凋亡指数分别为(6.95±1.50)和(15.73±2.75),经比较差异有统计学意义(t=-13.195,P<0.05);化疗前后有效组和无效组宫颈鳞癌组织Ki-67变化值分别为(30.78±15.56)和(15.75±17.75),经比较差异无统计学意义(t=1.71,P>0.05);凋亡指数变化值分别为(9.16±3.04)和(6.70±1.16),经比较差异无统计学意义(t=1.57,P>0.05)。结论:新辅助化疗能抑制维族宫颈鳞癌细胞增殖,诱导凋亡;化疗后宫颈鳞癌细胞凋亡指数明显上调者可能与良好预后有关。     

苯中毒性再生障碍性贫血患者外周血网织血小板水平观察

目的探讨苯中毒性再生障碍性贫血(BPAA)患者外周血网织血小板(RPs)的变化规律.方法采用流式细胞仪技术测定47例BPAA患者外周血RPs的比例和绝对值,观察RPs在BPAA中的变化规律,并与30例健康对照组进行比较.结果苯中毒性急性再生障碍性贫血(ABPAA)患者外周血中RPs百分率及绝对计数均低于正常对照组(P＜0.05);苯中毒性慢性再生障碍性贫血(CBPAA)患者外周血中RPs百分率与正常对照组差异无显著性(P＞0.05),而RPs绝对计数低于正常对照组,差异有显著意义(P＜0.05).CBPAA和ABPAA组之间RPs百分率及绝对计数差异有显著性(P＜0.05).RPs绝对计数与BPC计数间呈正相关(r＝0.74).治疗有效的患者在外周血象开始好转前,首先出现RPs%上升.22例ABPAA患者按疗效分成治疗有效组和治疗无效组,治疗有效组患者的RPs%及RPs绝对计数均明显高于治疗无效组,差异有显著意义(P＜0.05).结论在BPAA患者中,RPs%及RPs绝对计数的水平间接地反映了苯对骨髓的损害程度,并可作为预测其疗效的有用指标.     

苯接触者及苯中毒者血小板参数变化研究

目的 分析苯职业接触进程中血小板参数变化规律.方法 对正常人群组(74人)、苯接触组(33人)、慢性苯中毒组(14人)进行血小板参数和其他周围血细胞计数分析.结果 血小板计数慢性苯中毒组、苯接触组分别和正常人群组比较,差异均有统计学意义(P＜0.05);苯接触组和正常人群组比较,差异无统计学意义(P＞0.05).血小板分布宽度慢性苯中毒组、苯接触组分别和正常人群组比较,差异均有统计学意义(P＜0.05);苯接触组和慢性苯中毒组比较,差异有统计学意义(P＜0.05).血小板平均体积慢性苯中毒组、苯接触组分别和正常人群组比较,差异均有统计学意义(P＜0.05);苯接触组和慢性苯中毒组比较,差异有统计学意义(P＜0.05).大血小板比率慢性苯中毒组、苯接触组分别与正常人群组比较,差异均有统计学意义(P＜0.05);慢性苯中毒组与苯接触组比较,差异无统计学意义(P＞0.05).结论 血小板参数在苯接触监测中具有潜在应用价值.     

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.     

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.