Headache and blood pressure among triethylamine-exposed foundry workers

This study attempted to determine whether Cold box core makersexposed to triethylamine in foundries experienced headachesor had elevated blood pressure more often than workers withoutTEA exposure, as proposed by earlier reports. Forty-one coremakers in three foundries and 82 referents were interviewedaccording to a structured questionnaire, and their blood pressurewas measured. TEA exposure was determined from breathing-zonemeasurements. The 8-h time-weighted average TEA exposure variedbetween 0.3–60 mg/m³. The core makers did not report thatthey had the general symptoms of headaches more often than thereferents. However, they had mild weekly headaches more often(44% vs. 17%). The core makers also reported headaches moreoften during the workweeks (45% vs. 19%). It seems likely thatTEA exposure provokes mild headache among persons prone to sufferfrom vascular headaches. There was no difference in the occurrenceof severe headaches or in the duration of headaches betweenthe groups. The blood pressures were similar in both groups.     

Laparoscopic extended right hepatectomy for posterior and completely caudate massive liver tumor (with videos)

<正>To the Editor: Liver tumor may occur in any hepatic segment or lobe, and thus the liver resection is individualized as per the location and size of the tumor. In addition, the resection of the posterior and caudate lobes of the liver is especially difficult amongst all types of hepatectomy. Kawaguchi et al. believed that the laparoscopic resection of right posterior liver lobe was a difficult surgical procedure [1].     

The effects of growth factors on human normal placental cytotrophoblast cell proliferation

The effects of growth factors were investigated on the proliferation of a normal placental cytotrophoblast cell line (NPC). Epidermal growth factor (EGF), transforming growth factor alpha (TGF alpha) and insulin- like growth factor-I (IGF-I) stimulated NPC cell proliferation. In contrast, TGFbeta1 was found to be a negative regulator, inhibiting EGF- induced cell proliferation. When EGF/TGF alpha receptor was analysed by radio-ligand binding, two binding sites of different affinities were revealed in the proliferating NPC cells but only the low affinity binding site was detected in the non-proliferating cytotrophoblast cells in primary cultures. The results suggest that EGF stimulates cytotrophoblast proliferation through high affinity binding sites.      

Bilateral diaphragmatic weakness: a late complication of radiotherapy

Brachial plexus neuropathy is an unfortunate complication that sometimes follows radiotherapy to the axillary and supraclavicular regions. A patient is described who, 30 years after radiotherapy for Hodgkin's disease and more than 10 years after the development of radiation-induced bilateral brachial plexus neuropathy, presented with bilateral diaphragmatic weakness secondary to bilateral phrenic nerve weakness. Previous radiotherapy was the most probable cause of the condition.


     

强啡肽A(1-17)在脊髓的致瘫作用及其与神经毒作用的相关性

在以行为学为观察指标(甩尾镇痛和斜板实验)的基础上,用组织学方法探讨大剂量强啡肽A在脊髓水平的致瘫作用与其神经毒作用的关系。结果表明,给大鼠蛛网膜下腔(it)注射强啡肽A(1-17)20nmol·L^-1,共10μl,给药后5～10min即引起大鼠后肢不可逆性瘫痪、甩尾反射被抑制长达40h以上。大鼠脊髓组织学检查发现,腰、骶段脊髓前角运动神经元大量坏死或严重变性、以腰段损伤最为显著(运动神经元减少87.2%),其次是骶段(减少69.6%),胸段损伤不明显(减少8.2%)。     

Observations on managing an outbreak of influenza A infection in an aged care facility

Influenza outbreaks in aged care facilities (ACFs) can be associated with high morbidity and mortality. National guidance includes the use of antiviral medication for residents and staff and other measures to prevent serious health outcomes. An outbreak of influenza in an ACF was reported to the Brisbane Southside Population Health Unit (BSPHU) on 10 August 2007. The BSPHU assisted the ACF and local general practitioners in the provision of oseltamivir to staff and residents on 11 August 2007. The onset of illness in the last case was 13 August 2007. Antiviral prophylaxis was ceased and the outbreak declared over on 22 August 2007. This paper describes some of the practical issues encountered in the public health response in this setting. Vaccination of ACF residents and staff remains the key preventive strategy for the future.     

中华生存质量量表的研制

目的:在中华文化背景和中医理论指导下研制中华生存质量量表,推动国内生存质量研究的进一步发展,丰富国际生存质量研究。方法:遵照国际通用量表研制的程序化方法,在中华文化背景和中医理论指导下,结合国际生存质量概念内涵,建立中华生存质量量表的理论模型,确立了调查领域。通过设立研究组,建立条目池、编制初选量表、现场测试、文化适应和临床预调查等形成了临床初步调查表。根据研究设计,发出300份调查表,回收有效量表273份,通过对调查结果的系统统计分析进一步筛选条目。结果:应用专家重要性评分法、离散趋势法(变异系数法)、主成分分析法与因子分析法、聚类分析法、逐步回归分析法、判别分析法及克朗巴赫系数法等统计分析方法,对不同分析结果选中的条目进行综合考虑,最后形成了以3大领域、11个方面和50个条目为结构的最终中华生存质量量表。结论:基于中华文化和中医理论,按照国际量表通用的程序化方式研制的中华生存质量量表,具有国际可比性,将会得到广泛应用和同行认可。     

半侧空间忽略症状与基底核区脑卒中患者肢体功能恢复的关系

目的:观察有和无半侧中间忽略症状基底核脑卒中的患者日常生活活动能力差异。方法:①选择2002-11/2003-11吉林大学第一医院康复科住院基底核区脑卒中患者25例。均符合第四届全国脑血管病学术会议修订的急性脑梗死诊断标准,并经CT或MRI证实;均对观察目的知情同意。设有半侧空间忽略症状患者12例为阳性组,其中男4例,女8例;平均年龄(62±8)岁;全部为右基底核区脑卒中。无半侧空间忽略症状患者13例为阴性组,其中男10例,女3例;平均年龄(66±8)岁;左侧基底核区脑卒中为5例,右侧基底核区脑卒中为8例。②于患者入院、出院时采用Barthel指数分级法对日常生活活动能力进行评分,每周进行1次。该分级法有10项内容,分3级:<40分为差,依赖较明显或完全依赖;41～60分为中,有功能障碍,稍依赖;总分>60分为良。整个治疗过程中给予患者全面的康复功能训练,包括物理疗法、作业疗法和语言训练。同时对症治疗。结果:基底核区脑卒中患者25例均进入结果分析。入、出院时阳性组Barthel指数均明显低于阴性组[阳性组:(22.50±13.46),(62.83±14.72)分;阴性组:(37.62±11.98),(79.69±10.59)分,P<0.01]。出院时Barthel指数提高度差异不明显[阳性组:(40.33±19.20)分;阴性组:(42.08±11.11)分,P>0.05]。阳性组住院时间明显长于阴性组[(79.83±67.99),(34.15±18.80)d,P<0.01]。结论:①基底核脑卒中出现半侧空间忽略症状的患者日常生活活动能力差。②伴有和不伴有半侧空间忽略症状基底核脑卒中患者经过治疗日常生活活动能力改善程度相近。     

嗅鞘细胞移植修复脊髓损伤的新思考

目的:针对嗅鞘细胞移植在脊髓损伤修复中的作用进行综述,并对可能导致最佳细胞移植干预脊髓损伤效果的特定因素进行深入探讨。资料来源:应用计算机检索Medline 1994-01/2007-03期间关于嗅鞘细胞移植与脊髓损伤的文章,检索词“olfactory ensheathing cells,spinal cord injury”,并限定语言种类为English。同时计算机检索万方数据资源系统与中国期刊全文数据库1994-01/2007-03关于嗅鞘细胞移植与脊髓损伤的文章,限定文章语言种类为中文,检索词“嗅鞘细胞,脊髓损伤”。资料选择:对资料进行初审,选取包括实验组和对照组的文献,筛除非随机实验,对剩余的文献开始查找全文,进一步判断为随机对照实验。纳入标准:①随机对照实验,采用单盲,双盲或非盲法。②实验包含平行对照组。排除标准:重复性实验研究及综述类文章。资料提炼:共收集到45篇关于嗅鞘细胞干预脊髓损伤的随机实验文章,30篇符合纳入标准,排除的13篇为重复的同一研究和综述。资料综合:综述神经干细胞、胚胎干细胞移植以及基因修饰的嗅鞘细胞治疗脊髓损伤的方法,并对各方法给予评价。细胞联合移植治疗各有特色,但所有的实验结果主要以啮齿类动物-大鼠的脊髓损伤模型为基础而获得的,选择的模型包括脊髓完全横断模型、挫裂伤模型、脱髓鞘模型等,目前还不能获得完全模拟人的脊髓损伤的动物模型。如何选择适当的细胞类型联合应用,并使之实现从实验室走向应用研究是不同细胞移植策略中应重点考虑的问题。结论:尚无充分证据证明目前的嗅鞘细胞联合干预策略对人类脊髓损伤后的功能恢复有十分确切的作用,但单一、纯化的嗅鞘细胞移植可能不是干预脊髓损伤的最佳选择。