替米沙坦对高血压病患者血管内皮功能的影响

目的 探讨替米沙坦对高血压病患者血管内皮功能的影响。方法 46例轻、中度原发性高血压患者，给予替米沙坦80mg／d，共6周。观察治疗前后的血浆内皮素-1(ET-1)和-氧化氮(NO)水平的变化。另设40例为健康对照组。结果 高血压病患者治疗前与对照组比较，其血浆ET-1水平明显升高，NO水平显著降低；经替米沙坦治疗后其ET-1明显下降，NO水平显著升高，与治疗前差别有显著性。结论 替米沙坦能改善高血压病患者的血管内皮功能。     

老年高血压病患者血浆sICAM-1及ET和NO水平变化与培哚普利对其影响

目的　探讨老年高血压病 (EH)患者血浆可溶性细胞间粘附分子 -1(sICAM -1)、内皮素 (ET)和一氧化氮 (NO)浓度的变化及培哚普利对其的影响。方法　采用酶联免疫吸附法 (ELISA)、放射免疫分析法和硝酸还原酶法分别对 63例轻至中度老年高血压患者应用培哚普利治疗前后和正常老年对照组者血浆sICAM -1、ET和NO水平进行检测。结果　老年EH患者血浆sICAM -1和ET水平明显高于正常对照组 (P <0 0 1) ,经培哚普利治疗 8周后其浓度明显下降 (P <0 0 1) ;而其血浆NO水平显著低于对照组 ,经培哚普利治疗后浓度上升 (P <0 0 5 )。结论　老年EH病人血浆sICAM -1和ET水平较正常老年人明显升高而NO水平明显降低 .培哚普利在降血压的同时能降低老年EH患者血sICAM -1和ET浓度并升高NO浓度 ,减少高血压并发症发生。     

肝硬化患者血浆维生素C水平与血管内皮功能的关系

目的　探讨肝硬化患者血浆维生素C水平的变化及其与血管内皮释放的一氧化氮 (NO)和内皮素 - 1 (ET - 1 )之间的关系。方法　对 38例肝硬化患者和 30例健康人进行血清维生素C和血浆NO、ET - 1水平进行测定 ,测定血浆维生素C水平采用高效液相色谱分析法 ,测定NO采用化学比色法 ,测定ET - 1水平采用放射免疫法。结果　线性相关分析表明血浆患者血浆维生素C水平与NO水平、ET - 1水平呈显著负相关 (r =- 0 .5 8,- 0 .6 1 ,P <0 .0 1 )。结论　肝硬化患者存在血浆维生素C水平降低 ,NO、ET - 1水平升高 ,且随肝功能损伤加重血浆维生素C水平降低 ,血管内皮功能损伤加重     

恶性肿瘤患者治疗前后血浆一氧化氮与内皮素-1的变化及意义

目的探讨恶性肿瘤患者治疗前后血浆一氧化氮(NO)与内皮素-1(ET-1)的变化。方法采用比色法和放射免疫法分别检测了治疗前恶性肿瘤患者59例、治疗后恶性肿瘤患者48例的血浆NO和ET-1水平,并设24例健康成人作为对照。结果恶性肿瘤患者治疗前血浆NO与ET-1水平与治疗后恶性肿瘤患者比较,差异有统计学意义,治疗前后恶性肿瘤患者血浆NO与ET-1水平与对照组比较,差异有统计学意义(P均<0.01),血浆NO与ET-1水平差异有统计学意义(r=0.565,P<0.05)。结论血浆NO与ET-1水平的变化可能与恶性肿瘤的发生、发展有关,检测其水平的变化有助于疗效观察和预后评估,亦可作为恶性肿瘤的辅助诊断。     

恶性肿瘤患者治疗前后血浆一氧化氮与内皮素-1的变化及意义

目的 探讨恶性肿瘤患者治疗前后血浆一氧化氮（NO）与内皮素-1（ET-1）的变化。方法采用比色法和放射免疫法分别检测了治疗前恶性肿瘤患者59例、治疗后恶性肿瘤患者48例的血浆NO和ET-1水平，并设24例健康成人作为对照。结果恶性肿瘤患者治疗前血浆NO与ET-1水平与治疗后恶性肿瘤患者比较，差异有统计学意义，治疗前后恶性肿瘤患者血浆NO与ET-1水平与对照组比较，差异有统计学意义（P均〈0．01），血浆NO与ET-1水平差异有统计学意义（r=0．565，P〈0．05）。结论血浆NO与ET-1水平的变化可能与恶性肿瘤的发生、发展有关，检测其水平的变化有助于疗效观察和预后评估，亦可作为恶性肿瘤的辅助诊断。     

尿激酶溶栓治疗急性脑梗死患者血浆NO、ET和D-二聚体含量变化及临床意义

目的探讨急性脑梗死患者尿激酶溶栓治疗前后血浆一氧化氮(NO)、内皮素(ET)和D-二聚体含量动态变化及临床意义。方法测定38例急性脑梗死患者溶栓前及溶栓后2 h、4 h2、4 h4、8 h血标本NO、ET和D-二聚体含量,并与正常对照组33例进行比较。结果脑梗死患者NO含量明显低于正常对照组(P<0.01),血浆ET和D-二聚体含量显著高于对照组(P<0.01和P<0.05)。溶栓后有效组24 h后NO明显升高,与溶栓前差异有统计学意义,而无效组无显著变化。有效组4 h后ET明显下降,以后降幅较小,但明显低于无效组。结论血浆NO、ET和D-二聚体含量可以作为急性脑梗死的诊断指标,溶栓治疗后NO、ET与D-二聚体水平变化对判断疗效有一定指导意义。     

普伐他汀治疗肾移植术后血脂异常的临床研究

目的探讨他汀类药物对肾移植术后血脂异常患者的疗效。方法21例肾移植术后高胆固醇血症患者(血浆总胆固醇水平>6.2mmol/L),每日口服普伐他汀10mg,每晚1次,疗程8周。治疗前后测定本组及30例健康人(对照组)血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、血浆内皮素(ET)、一氧化氮(NO)的变化。并采用高分辨血管外超声技术测定所有个体肱动脉血流介导的舒张功能及硝酸甘油介导的舒张功能。结果血浆ET在肾移植组显著高于对照组,而NO显著低于对照组;降脂治疗8周后,ET明显下降(P<0.01),NO明显升高(P<0.01),血TC、LDL-C、TG水平明显降低(P<0.01,P<0.05),HDL-C亦升高,但无统计学意义。治疗组肱动脉血流介导的舒张低于对照组,治疗后较治疗前明显好转。结论肾移植患者应用普伐他汀调脂治疗,可显著改善血管内皮细胞功能。     

尿激酶溶栓治疗急性脑梗死患者血浆NO、ET和D-二聚体含量变化及临床意义

目的 探讨急性脑梗死患者尿激酶溶栓治疗前后血浆一氧化氮（NO）、内皮素（ET）和D-二聚体含量动态变化及临床意义。方法 测定38例急性脑梗死患者溶栓前及溶栓后2h、4h、24h、48h血标本NO、ET和D-二聚体含量，并与正常对照组33例进行比较。结果 脑梗死患者NO含量明显低于正常对照组（P〈0．01），血浆ET和D-二聚体含量显著高于对照组（P〈001和P〈0．05）。溶栓后有效组24h后NO明显升高，与溶栓前差异有统计学意义，而无效组无显著变化。有效组4h后ET明显下降，以后降幅较小，但明显低于无效组。结论 血浆NO、ET和D-二聚体含量可以作为急性脑梗死的诊断指标，溶栓治疗后NO、ET与D-二聚体水平变化对判断疗效有一定指导意义。     

伊贝沙坦对老年性高血压病和左室重塑的影响

目的　观察血管紧张素Ⅱ受体拮抗剂伊贝沙坦对老年性高血压患者的长期降压疗效及对左室重塑的影响。方法　老年性高血压病患者 38例 ,服伊贝沙坦 1 50～ 30 0mg/d ,共 1 0个月 ,观察血压和治疗前后超声心动图变化。结果　服药后高血压组血压显著降低 (- 1 6 .5/8.8mmHg) ,左室质量指数减小 (- 2 5g/m2 ) ,P均 <0 .0 5。结论　伊贝沙坦能有效降低老年高血压患者的血压水平 ,同时具有抗左室重塑的作用     

普伐他汀治疗肾移植术后血脂异常的临床研究

目的探讨他汀类药物对肾移植术后血脂异常患者的疗效。方法21例肾移植术后高胆固醇血症患者（血浆总胆固醇水平〉6．2mmol／L），每日口服普伐他汀10mg，每晚1次，疗程8周。治疗前后测定本组及30例健康人（对照组）血清总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）、高密度脂蛋白胆固醇（HDL—C）、甘油三酯（TG）、血浆内皮素（ET）、一氧化氮（NO）的变化。并采用高分辨血管外超声技术测定所有个体肱动脉血流介导的舒张功能及硝酸甘油介导的舒张功能。结果血浆ET在肾移植组显著高于对照组，而NO显著低于对照组；降脂治疗8周后，ET明显下降（P〈0．01），NO明显升高（P〈0．01），血TE、LDL—C、TG水平明显降低（P〈0．01，P〈0．05），HDL—C亦升高，但无统计学意义。治疗组肱动脉血流介导的舒张低于对照组，治疗后较治疗前明显好转。结论肾移植患者应用普伐他汀调脂治疗，可显著改善血管内皮细胞功能。     

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.