镍接触性皮炎皮损趋化因子及其受体的研究

探讨趋化因子及其受体在镍接触性皮炎发病中的作用。留取镍接触性皮炎患者直接接触部位皮损和部分患者非直接接触部位皮损进行趋化因子受体CXCR3和CCR4免疫组化染色，同时采用RT-PCR分析HaCaT细胞经硫酸镍刺激后γ干扰素诱导蛋白．10（IP-10）、干扰素诱导T细胞趋化因子α（I—TAC）、胸腺活化调节的趋化因子（TARC）和巨噬细胞来源趋化因子（MDC）在mRNA水平的表达情况。     

血管趋化因子在特发性肺间质纤维化和肉芽肿性肺疾病中的发病机制研究

目的 观察影响血管生成和抑制的CXC趋化因子在特发性肺间质纤维化（IPF）和肉芽肿性肺疾病中所起的作用.方法 选择16例肉芽肿性肺疾病患者[肺部结节性病变（PN）8例和过敏性肺炎（EAA）8例,PN＋ EAA组]、16例IPF患者（IPF组）以及8例无肺部疾病患者（对照组）,从其体内的肺泡灌洗液（BALF）中提取肺泡巨噬细胞培养24h后,通过荧光珠复合技术检测培养上清液中的白细胞介素（IL）-8、IL-18、干扰素（IFN）诱导蛋白10（IP-10）、IFN-γ诱导单核因子（MIG）水平.结果 培养24h后,IPF组和PN＋ EAA组在有无LPS刺激下IL-8显著高于对照组[（17 583±3 251）,（46 830±1 371） ng/L比（2 392±192） ng/L;（32 833±9 301）,（62 839±3 942） ng/L比（16 748±1 093） ng/L],差异有统计学意义（P＜ 0.05或＜0.01）;IPF组与PN＋ EAA组在有无LPS刺激下IL-8比较差异有统计学意义（P＜0.01）.在PN和EAA患者中,MIG和IP-10与IL-18呈正相关（r=0.6566,0.565 8,P＜ 0.05）.在IPF患者中,IL-8和BALF中中性粒细胞的比例和数量存在相关性（r=0.561 5,P＜0.05;r=0.5559,P＜ 0.05）,在肉芽肿性肺疾病患者中,IP-10与淋巴细胞比例和数量存在相关性（r=0.726 6,P＜ 0.01;r=0.693 0,P＜ 0.01）.结论 CXC趋化因子和Th1细胞因子的表达差异是引起不同肺部疾病发生的免疫因素之一,同时影响患者病程和对治疗的应答.     

小鼠骨髓间充质干细胞调节T细胞亚群表达趋化因子受体的研究

目的：研究小鼠T淋巴细胞亚群受骨髓间充质干细胞（mesenchymal stem cells,MSCs）调控表达趋化因子受体的变化。方法：小鼠骨髓细胞悬液进行贴壁培养法分离出骨髓间充质干细胞,经培养扩增后按不同比例（10%及1%）与经过植物血凝素（PHA）刺激的小鼠淋巴细胞混合培养,流式细胞术检测趋化因子受体CXCR3,CCR5,CCR7在不同T细胞亚群中表达的变化。结果：在CD3＋CD8＋亚群中,添加了骨髓间充质干细胞的两个培养组均较对照组增高表达CXCR3及CCR7（P〈0.05）,而CCR5仅在10%MSC的高浓度组较对照组有增高表达。在CD3＋CD4＋亚群中,CXCR3的表达在10%MSC组、1%MSC组及对照组表达差异均无统计学意义（P〉0.05）;CCR5及CCR7在添加了骨髓间充质干细胞的两个培养组均较对照组增高表达,且在该两种骨髓间充质干细胞浓度梯度中呈剂量依赖性。结论：骨髓间充质干细胞在与淋巴细胞呈一定的细胞比例共培养时能不同程度上调T淋巴细胞及亚群表达趋化因子受体CXCR3、CCR5、CCR7,提示骨髓间充质干细胞可提高T淋巴细胞亚群的趋化能力。     

趋化因子受体CCR5和CXCR3在甲亢患者中的表达

目的研究G raves(GD)患者外周血趋化因子受体表达的规律,探讨其在GD发病机制中的作用。方法采用流式细胞术分析趋化因子受体CXCR3、CCR5的表达,用化学发光法和手工放免法检测GD患者甲状腺功能和甲状腺自身抗体。结果GD患者趋化因子受体CCR5明显降低(P<0.01),并与TPO-Ab负相关。结论趋化因子受体CCR5参与了GD的免疫病理过程,并在GD发病机制中发挥重要作用。     

甲状腺相关性眼病血清细胞因子水平及免疫机制的临床关系研究

目的 研究甲状腺相关性眼病患者血清IL-2、IL-6和TNF-α的水平及其与免疫的关系.方法 采用RIA法分析25例GD、25例GO患者及20例对照组血清中IL-2、IL-6、TNF-α、TRAb值;化学发光法测定TGAb、TPOAb、FT3、FT4、TSH.结果 在GO、GD组,IL-6、TNF-α水平均高于对照组（P〈0.01,P〈0.05）;GO组高于GD组（P〈0.01,P〈0.05）;两组患者TGAb、TPOAb值均高于对照组（P〈0.05）;TRAb值在三组间两两比较差异有统计学意义（P〈0.01）、GO组明显高于另两组（P〈0.01）;TRAb与TNF-α、IL-6及甲状腺功能呈正相关（r=0.608,0.827,P〈0.05）.结论 GDGO患者IL-6、TNF-α增高,Th1、Th2细胞因子表达增强,TRAb与GO细胞因子相关,细胞介导和体液免疫在发病机制中起重要作用.     

系统性红斑狼疮患者血清中IP-10测定及其临床意义

目的 探讨血清γ干扰素诱导蛋白10（interferon-gamma-inducible protein of 10kD,IP-10）水平与系统性红斑狼疮（SLE）疾病活动的关系及意义.方法 采用双抗体夹心ELISA法检测32例SLE患者和30例正常对照者血清中IP-10水平,分析其与SLE病情活动指数（SLEDAI）、抗dsDNA抗体滴度、补体C3、肾损害的相关性.结果 （1）患者血清IP-10水平[（303±187）pg/ml]明显高于正常对照组[（72±50）pg/ml],活动期患者（512±347）pg/ml]高于非活动期患者[（128±115）pg/ml];患者血清IP-10水平与疾病活动指数呈正相关（r=0.54,P＜0.01）;血清IP-10水平与抗dsDNA抗体呈正相关（r=0.51,P＜0.01）,而与补体C3呈负相关（r=-0.41,P＜0.05）.（2）肾损害组血清IP-10水平[（532±307）pg/ml]明显高于非肾损害组（241±108）pg/ml].结论 IP-10水平可作为监测SLE疾病活动程度和肾脏损害的指标之一.     

HIV感染者第二受体CCR5和CXCR4表达与机会性感染的相关性

目的分析HIV感染者第二受体表达与机会性感染的相关性,为临床监测提供依据。方法45例HIV-1阳性者作为研究组,其中发生机会性感染16例,无机会性感染29例。正常对照11例。比较机会性感染与无机会性感染HIV各期第二受体CCR5、CXCR4在CD4^＋T、CD8^＋T细胞上的表达,并分析其与CD4^＋／CD8^＋比值的相关性。结果与对照组比较,机会性感染组CD4^＋／CCR5、CD8^＋／CCR5、CD8^＋T细胞明显升高（P〈0．05或P〈0．01）,而CD4^＋／CXCR4、CD4^＋T细胞明显下降（P〈0．01）。机会性感染组CD8^＋／CCR5[（43．4±22．4）％]明显地高于无机会性感染组[（29．9±20．8）％,（P〈0．05）],CD8^＋T细胞[（1095．6±476．7）×100／L]明显高于无机会性感染组[（773．3±464．0）×10^6／L,（P〈0．05）]。CD4^＋／CXCR4表达与CD4^＋／CD8^＋比值呈正相关（r=0．306,P〈0．05）,CD8^＋／CCR5与CD8^＋呈正相关（r=0．432,P〈0．01）。结论HIV感染者第二受体CCR5表达增高,CD4^＋／CXCR4表达下降,机会性感染者第二受体CD8^＋／CCR5表达增高更为明显。检测第二受体CCR5、CXCR4有一定的临床价值,但第二受体检测仍需要结合CD4^＋T细胞动态检验,以提高监测价值。     

血清趋化因子受体CCR5和CXCR3与胎膜早破并发绒毛膜羊膜炎的关系

目的探讨孕妇血清中趋化因子（CK）受体CCR5和CXCR3与胎膜早破并发绒毛膜羊膜炎（PROM-CAM）的之间关系。方法选取足月妊娠PROM孕妇72例（实验组）,采用双抗体夹心酶联免疫吸附法（ELISA）检测血清中CCR5和CXCR3的表达水平,分娩后均取胎盘及胎膜进行病理检查确诊CAM,并与同期正常足月孕妇40例（对照组）比较,再按不同破膜时间分为0-6、6-12、12-24 h组进行比较。结果 PROM-CAM组CCR5、CXCR3的表达水平明显高于PROM无CAM组及对照组,差异均具有统计学意义（P〈0.05）,PROM无CAM组CCR5、CXCR3水平与对照组比较差异无统计学意义（P〉0.05）,破膜时间〉12 h血清中CCR5、CXCR3水平高于破膜时间不足12h的两组,差异具有统计学意义（P〈0.05）。结论孕妇CCR5、CXCR3与PROM-CAM之间密切相关,CCR5、CXCR3表达水平的检测可做为一种指标用于PROM-CAM的早期诊断。     

CXCR3／CXCL10在乳腺癌中的表达及临床意义

目的探讨趋化因子受体3（CXCR3）及趋化因子配体10（CXCL10）在乳腺癌中的表达及临床意义。方法采用免疫组织化学SP法及二步法对60例乳腺癌组织、20例乳腺纤维瘤组织及20例乳腺腺病组织分别进行CXCR3、CXCL10检测。结果乳腺癌中CXCR3（40／60,66．7％）、CXCL10（45／60,75％）的表达高于乳腺腺病[CXCR3（8／20,40％）X^2=4．44,P=0．035;CXCL10（10／20,50％）x。=4．36,P=0．037）],乳腺癌中CXCR3的表达与有无腋窝淋巴结转移、临床分期、HER-2的表达有关（X^2=4．15,P=0．042;X^2=7．74,P：0．021;X^2=4．27,P=0．039）,且CXCR3的表达强度与腋窝淋巴结转移数及临床分期目呈正相关（-=0．375,P=0．003;t=0．451,P=0．000）。结论CXCR3可能与乳腺癌的进展及早期转移有关,CXCR3可能作为乳腺癌的一个预后指标。     

CXCR4和CCR7趋化因子受体在宫颈癌中的表达

目的:探讨CXC族趋化因子受体4(CXCR4)和CC族趋化因子受体7(CCR7)在宫颈癌中的表达及意义。方法:选择2006年1月～2007年1月淮北市矿工总医院69例宫颈癌组织标本作为病例组,以20例正常宫颈组织作为观察组,应用免疫组织化学技术检测两组CXCR4和CCR7的表达,并分析不同临床病理特征中表达的差异。结果:观察组中CXCR4和CCR7的表达阳性率均明显高于对照组,差异均有统计学意义(P<0.01),CXCR4表达与宫颈癌患者的淋巴结转移密切相关,CXCR4表达与宫颈癌患者的FIGO分期、肿瘤大小、肌层浸润深度、组织病理类型、阴道浸润、子宫旁浸润无关。CCR7的表达与宫颈癌患者的FIGO分期、肿瘤大小、肌层浸润深度、淋巴结转移密切相关(P<0.01)。结论:宫颈癌中CXCR4和CCR7异常表达,二者在宫颈癌淋巴转移中发挥重要作用。     

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.