当前盐碘水平对广东哺乳妇女及其婴幼儿碘营养的影响

[目的]了解当前盐碘水平下，广东省部分地区哺乳妇女及其婴幼儿的碘营养状况。[方法]采用一次性点状调查法，选择3个基本代表广东轻、中、重缺碘地区深圳、佛冈和乐昌的城市和农村各两个点，调查哺乳妇女及其墨幼儿的尿碘、盐碘、水碘和乳汁碘等。[结果]深圳市、佛冈县和乐昌市的婴幼儿尿碘中位数分别为281．2μg／L、237．1μg／L、286．6μg／L，大于300μg／L的比例分别占43．3％、34．9％和49．0％；哺乳妇女尿碘中位数分别为207．8μg／L、172．6μg／L和260．5μg／L，大于300μg／L的比例分别占34．4％、23．8％和41．5％；盐碘中位数分别为32．8mg／kg、27．5mg／kg和36．0mg／kg。[结论]当前的盐碘浓度完全可满足哺乳妇女及婴幼儿的碘营养需求，部分地区有偏高趋势。建议将我省重度和中度缺碘病区盐碘浓度的平均水平下调至30mg／kg，轻度缺碘地区下调至25mg／kg。     

动物性食品中抗生素及瘦肉精残留量基线调查研究

系统准确地了解动物性食品中抗生素及盐酸克伦特罗的残留现状及水平。抗生素按卫生部统一的高效液相色谱法，盐酸克伦特罗按气相／质谱法。土霉素、四环素检测283份，检出范围0．05～3．59mg／kg和0．05～0．58mg/kg，氯霉素检测80份，检出范围为0．1～36．3μg/kg，盐酸克伦特罗65份，检出范围0．01～1．36μg/kg。     

瑞芬太尼和丙泊酚在脊柱侧凸矫正术唤醒试验中的应用

目的观察瑞芬太尼和丙泊酚用于脊柱侧凸矫正术唤醒试验时血压和心率的变化及唤醒质量。方法择期行脊柱侧凸矫正术患者20例，ASA分级Ⅰ～Ⅱ级，诱导采用咪达唑仑0．1mg／kg、瑞芬太尼1μg／kg、丙泊酚2mg／kg、维库溴铵0．1mg／kg，麻醉维持用静脉持续输注丙泊酚4～6mg／（kg·h），间断注入维库溴铵和瑞芬太尼，唤醒前40min陆续停药，呼吸恢复后开始唤醒，并行唤醒时苏醒质量分级。结果唤醒前后平均动脉压和心率没有明显变化（P〉0．05）。苏醒质量Ⅰ级15例，Ⅱ级4例，Ⅲ级1例，Ⅳ级0例。所有患者无脊髓损伤。结论脊柱侧凸矫正术唤醒试验中运用瑞芬太尼和丙泊酚，在唤醒时血压和心率变化较小，唤醒时苏醒质量高，同时唤醒有可控制性。     

预输注右旋美托咪定抑制双腔支气管插管心血管反应的观察

目的评价预输注不同剂量右旋美托咪定对双腔支气管插管时心血管反应影响。方法胸外科择期手术需行双腔支气管插管患者90例，年龄18—61岁，体质量45—71kg，ASAⅠ～Ⅱ级。分为三组（n=30）：生理盐水对照组（A组）、右旋美托咪定0．25μg／kg组（B组）和右旋美托咪定0．5μg/kg组（C组）。麻醉诱导依次静注咪唑安定0．03—0．05mg／kg、舒芬太尼0．25μg/kg、依托咪酯0．2mg／kg、罗库溴铵0．8mg／kg。分别记录麻醉诱导前（T0）、插管前（T1）、插管后即刻（12）、插管后1min（T3）、3min（T4）、10min（T5）时收缩压（SBP）、舒张压（DBP）、心率（HR）。结果与A组比较，B组和C组在插管后的收缩压（SBP）、舒张压（DBP）、心率（HR）均更平稳，但C组在插管前后的显著心率过缓发生率高于B组（P〈0．05）。结论诱导前15min静脉注射DEX0．25μg／kg能安全有效的控制双腔支气管插管反应，保持血流动力学稳定。     

不同麻醉诱导注药顺序对芬太尼咳嗽反应的影响

目的研究在全身麻醉诱导时不同的肌松药与芬太尼注药顺序对芬太尼引起咳嗽反应的影响。方法选择ASA分级Ⅰ-Ⅱ级行气管插管全身麻醉的患者120例,随机分为芬太尼肌松药组（Fen—Vec组）和肌松药芬太尼组（Vec-Fen组）,每组60例。全部患者在右上肢远端建立静脉通道。两组均先分别静脉注射咪达唑仑0．1mg/kg、异丙酚1．0mg／kg开始诱导,然后Fen-Vec组先后静脉注射芬太尼5μg／kg、维库溴铵0．1mg／kg;Vec-Fen组先静脉注射维库溴铵0．1mg／kg,60s后静脉注射芬太尼5μg／kg。两组芬太尼均于5s内静脉注射完毕,静脉注射维库溴铵后2．5min气管插管。观察并记录静脉注射芬太尼后15s内咳嗽的发生情况,记录麻醉诱导前即刻（T0）、静脉注射芬太尼前（T1）、插管前即刻（T2）、插管后1min（T3）、插管后3min（T4）患者的血压和心率变化。结果Vec-Fen组的咳嗽发生率（10．0％,6／60）低于Fen-Vec组（43．3％,26／60）,差异有统计学意义（P〈0．01）。两组各时间点血压和心率变化比较差异无统计学意义（P〉0．05）。结论全身麻醉诱导时采用先肌松药后芬太尼的注药顺序可预防芬太尼引起的咳嗽反应。     

反相离子对HPLC法测定中药材中苯并咪唑类农药残留的研究

目的：研究建立一种用反相离子对HPLC测定中药材中苯并咪唑农药残留量的分析方法。方法：样品经乙腈萃取后盐析，PSA净化，癸烷磺酸钠离子对试剂处理后，用HPLC-DAD分离测定，外标法定量。结果：对于5g试样，进样量为40μl，本方法的最低检出质量浓度为：多菌灵：0．07mg／kg；甲基硫菌灵：0．09mg／kg；噻菌灵：0．05mg／kg；2-氨基苯并咪唑：0．10mg／kg。样品回收率〉80％，精密度〈13％。结论：本方法能够满足残留分析的要求。     

福建省部分食品中N—亚硝胺含量调查结果分析

应用气相色谱-热能分析仪检测啤酒、鱼露、鱼、肉制品中N-亚硝胺，啤酒中检出N-业硝基二甲胺含量范围0．9～9．5μg／L；鱼露中检出N-亚硝基二甲胺含量范围0。1~0．43μg／L；肉制品100％检出N-亚硝胺，其中N-亚硝基二甲胺（NDMA）0.08～2.6μg／kg。N-亚硝基二乙胺（NDEA）0．13～1．7μg／kg．N--亚硝基二丙胺（NDPA）0.18～8．78μg／kg，N-亚硝基吡咯（NPYR）0．21～27．34μg／kg。咸鱼和风干海产品100％检出亚硝基二甲胺、含量在0.12～0.18μg／kg。1材料与方法：1．1材料：啤酒样品采自福建省各啤酒厂．鱼露采自福州、长…     

反高效液相色谱法研究芹菜素在大鼠体内的药代动力学及组织分布

目的建立一个检测大鼠血浆及组织中芹菜素的RP—HPLC分析方法,并对其大鼠体内过程特性进行分析研究。方法生物样品经甲醇沉淀蛋白质,采用RP—HPLC法,色谱柱为Phenomenex C18柱（250×4．6mm,4μm）,流动相为甲醇-0．1％磷酸水溶液-乙腈（25：40：35）,流速1．0ml／min,柱温为30℃,检测波长为339nm。结果测得芹菜素在血浆和组织中的线性范围分别为：0．10～2．00μg／ml（r〉0．999）和0．05～2．00μg／g（r〉0．999）,最低检出限分别为0．03μg／ml和0．02μg／g,日内和日间精密度（RSD）均小于8％。大鼠一次性灌胃给予芹菜素后血芹菜素浓度-时间曲线呈一室模型,半衰期t1／2（116．53±22．55）min。在主要组织脏器分布特点是C肝〉C肾〉C肺〉C卵〉C脂肪〉C脾〉C脑〉C心〉C睾。结论本法准确、灵敏度较高,可用于芹菜素在大鼠体内代谢过程的研究。     

依托咪酯对老年患者非心脏手术后早期认知功能的影响

目的观察依托咪酯乳剂全麻诱导对老年患者非心脏手术后早期认知功能的影响。方法选择全麻下行择期非心脏手术且年龄≥60岁的老年患者60例（男36例,女24例）,随机分为依托咪酯组和对照组。全身麻醉诱导均采用静注咪唑安定0．06mg／kg、芬太尼3μg/g、维库溴铵0．1mg／kg,在此基础上观察组和对照组分别加用依托咪酯0．15mg,／kg、异丙酚1mg／kg。术中持续静脉微泵丙泊酚2～5mg．kg^-1·h^-1和吸入七氟醚0．5％～1．5％,并适时间断追加芬太尼和维库溴铵,维持麻醉深度。结果两组患者年龄、体量、性别等一般资料及手术时间、麻醉时间和麻醉药物总量差异无统计学意义（P〉0．05）。两组间术前MMSE评分的差异均无统计学意义（P〉0．05）,术后1、4hMMSE评分均较术前显著下降（P〈0．05）,12h后两组患者MMSE评分与术前差异无统计学差异（P〉0．05）。结论依托咪酯乳剂用于老年患者,与异丙酚全身麻醉类似,术后均会出现短暂性认知功能减退。     

突发性耳聋患者内脂素和RBP4含量变化的研究

目的探讨突发性耳聋患者血清内脂素（visfatin）和视黄醇结合蛋白4（RBP4）的含量变化,及其在突发性耳聋发生过程中的作用和意义。方法采用酶联免疫（ELISA）法检测血清内脂素和RBP4含量;检测102例突发性耳聋患者、35例其他疾病对照组和30例正常健康对照组的血清内脂素和RBP4含量,并比较治疗前后血清内脂素和RBP4的测定结果。结果突发性耳聋患者治疗后血清内脂素[（24．26±2．17）μg／L]和RBP4含量[（46．65±5．26）mg／L]显著高于其它疾病对照组[内脂素：（20．67±2．14）μg／L;RBP4：（34．37±5．73）mg／L]和健康对照组[内脂素：（17．61±2．45）μg／L;RBP4：（24．82±5．24）mg,／L]（t=10．38,10．41,12．16,15．06,P〈0．01）,较治疗前明显降低[内脂素：（32．24±2．37）μg／L;RBP4：（57．43±6．19）mg／L]（t=17．25,15．12,P〈0．01）。同时重度组突发性耳聋患者血清内脂素[（36．52±2．46）μg／L]和RBP4[（67．17±5．92）mg,／L]浓度明显高于中度组[内脂素：（28．92±2．26）μg／L;RBP4：（55．34±5．95）mg／L]（t=11．21,11．17,P〈0．01）,中度组患者明显高于轻度组[内脂素：（25．31±2．32）μg／L;RBP4：（47．48±5．82）ms／L],且差异有统计学意义（t=10。43,10．49,P〈0．01）。突发性耳聋患者血清内脂素和RBP4含量之间呈正相关（r=0．68,P〈0．01）。结论血清内脂素和RBP4水平的变化与突发性耳聋病情严重程度密切相关。     

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.