某印刷厂生产工人健康状况调查结果分析

目的了解深圳市某印刷厂生产工人接触的主要职业危害因素及长期接触这些因素对工人健康的影响。方法对某印刷厂进行现场职业卫生学检查并选择该厂生产工人418名为接触组,同时选择420名非生产一线工人为对照组进行健康检查,健康检查项目包括：尿常规、肝脾B超、心电图、血常规、肝功能、胸部X射线透视、内科常规（血压、心、肺、腹部、甲状腺、咽喉等）、皮肤科常规,并对体检结果进行分析。结果对照组10人尿常规异常（2．4％）、接触组44人异常（10．5％）,两组差异有统计学意义（P〈0．01）;对照组8人心电图异常（1．9％）、接触组23人异常（5．5％）,两组差异有统计学意义（P〈0．01）;对照组10人血常规异常（2．4％）、接触组69人异常（16．5％）,两组差异有统计学意义（P〈0．01）。结论该印刷厂生产工人长期接触上述职业病危害因素,导致心血管系统和血液系统产生了一定程度的损害。     

Vesalius Revised. His Annotations to the 1555 Fabrica1

The De humani corporis fabrica [The Fabric of the Human Body], Basle, 1543, of Andreas Vesalius is deservedly famous as the first modern book of anatomy. A second edition was published in Basle in 1555, but little is known of Vesalius’ activities after that date. This article discusses a recent find: Vesalius’ own copy of the 1555 edition, heavily annotated in preparation for a never published third edition. Vesalius made hundreds of changes to the second edition, the great majority being stylistic, altering the Latin words but not the overall meaning. There are also changes to the plates to give greater clarity or to correct mistakes by the original block-cutter. There is little new anatomical material, although Vesalius continued to meditate about what he had earlier discovered. He shows no sign of being acquainted with the findings of others, like Colombo or Falloppia, that were published after he had moved his residence from Brussels to Spain in summer 1559, perhaps leaving this volume behind. The number of annotations shows Vesalius’ passionate concern not only for accuracy but also for the most effective way of proclaiming his new anatomical message.     

基于3D打印的锁骨中段移位骨折微创手术与传统切开复位内固定术的病例对照研究

目的:比较基于3D打印技术的锁骨中段移位骨折微创手术与传统切开复位内固定术的临床疗效。方法:回顾性分析2016年7月至2016年12月采用3D打印微创手术与常规手术治疗的40例锁骨中段移位骨折患者的临床资料。根据手术切口不同以及是否采用3D打印技术将40例患者分为3D打印微创手术组和常规手术组。3D打印微创手术组(A组)20例,男11例,女9例;年龄19～57 (37.2±9.3)岁;骨折Robinson分型,2A2型4例,2B1型9例,2B2型7例。常规手术组(B组)20例,男13例,女7例;年龄17～54(35.1±9.5)岁;骨折Robinson分型,2A2型5例,2B1型8例,2B2型7例。观察并记录两组患者手术时间、出血量、切口长度、骨折愈合时间、并发症情况,并于术后12个月采用DASH评分及Constant评分对肩关节功能进行评价。结果:40例患者获得随访,时间12～18(15.1±2.0)个月。所有患者达到骨性愈合,A组愈合时间12～18(14.3±1.7)个月,B组11～18(14.4±1.9)个月,两组比较差异无统计学意义(P0.05)。两组患者术中出血量比较差异无统计学意义(P0.05);A组手术时间、创口长度明显小于B组(P0.05)。术后12个月随访时两组患者肩关节DASH评分及Constant评分比较差异无统计学意义(P0.05)。A组出现并发症1例,B组出现并发症6例,两组比较差异有统计学意义(P0.05)。结论:基于3D打印的锁骨中段移位骨折微创治疗可以有效解决微创手术中的一些难点,达到与传统切开复位内固定相似的骨折愈合及功能恢复,同时切口更美观,手术时间更短,手术相关并发症更少。     

Comparison of clinicopathological characteristics between patients with occupational and non‐occupational intrahepatic cholangiocarcinoma

Background

An outbreak of cholangiocarcinoma has been reported among workers of an offset color proof‐printing department at a printing company in Japan. In this study, we compared the clinicopathological findings of this type of intrahepatic cholangiocarcinoma (occupational ICC) and non‐occupational ICC.

Methods

The clinical records of 51 patients with perihilar‐type ICC who underwent liver resection, including five patients with occupational ICC were retrospectively reviewed. The clinicopathological features were compared.

Results

In the occupational group, the patients were significantly younger (P < 0.01), while serum γ‐glutamyl transpeptidase activity and the proportions of patients with regional dilatation of the bile ducts without tumor‐induced obstruction were significantly higher (P = 0.041 and P < 0.01, respectively); the indocyanine green retention rate at 15 min was significantly lower (P = 0.020). On pathological examinations, precancerous or early cancerous lesions, such as biliary intraepithelial neoplasia and intraductal papillary neoplasm of the bile duct, were observed at various sites of the bile ducts in all occupational ICC patients; such lesions were observed in only six patients in the control group (P < 0.01).

Conclusions

The clinicopathological findings including age, liver function test results, diagnostic imaging findings, and pathological findings differed between the occupational and control groups.     

3D打印技术辅助诊断和指导室间隔缺损手术

目的 探讨运用3D打印技术构建三维心脏模型对结构性心脏病诊断及治疗的可行性与临床价值。方法 基于1例室间隔缺损患儿的心脏CT影像数据,采用Mimics 17.0图形分割软件,以阈值法进行心肌分割,以动态区域生长法进行血池分割获得数字化三维心脏模型;采用PolyJet材料,以Objet500 Connex3聚合物喷射成型3D打印机打印软质的实体心脏模型,并对心脏模型进行评估。结果 3D模型可清晰显示心脏内部解剖结构、空间关系以及室间隔缺损的三维形态。在打印出的实体心脏模型上测量室间隔缺损的轴位长度为4.85 mm,与3D数字模型和CT图像中测量结果（轴位长度分别为4.86 mm和4.84 mm,矢状位长度分别为6.66 mm和6.65 mm）基本一致。结论 将3D打印技术用于结构性心脏病有助于诊断和制定适当的手术方案;通过规范化的图像处理技术获取精确的心脏模型,使个性化精准诊疗结构性心脏病成为可能。     

印刷作业女工外周血淋巴细胞微核观察

本文采用微量全血培养法对某印刷厂装订车间４０名女工外周血淋巴细胞微核进行了分析。结果表明,印刷作业女工的微核阳性检出率,微核细胞率和微核率均非常显著地高于对照组（Ｐ〈０．０１,而且随着作业工龄的延长,微核细胞率和微核率有极显著意义的增高趋势（Ｐ〈０．０１）。对印刷作业女工微核增高的原因进行了讨论。     

Printed paper and board food contact materials as a potential source of food contamination

Food contact materials (FCM) are estimated to be the largest source of food contamination. Apart from plastics, the most commonly used FCM are made of printed paper and board. Unlike their plastic counterparts, these are not covered by a specific European regulation. Several contamination issues have raised concerns towards potential adverse health effects caused by exposure to substances migrating from printed paper and board FCM. In the current study, an inventory combining the substances which may be used in printed paper and board FCM, was created. More than 6000 unique compounds were identified, the majority (77%) considered non-evaluated in terms of potential toxicity. Based on a preliminary study of their physicochemical properties, it is estimated that most of the non-evaluated single substances have the potential to migrate into the food and become bioavailable after oral intake. Almost all are included in the FACET tool, indicating that their use in primary food packaging has been confirmed by industry. Importantly, 19 substances are also present in one of the lists with substances of concern compiled by the European Chemicals Agency (ECHA). To ensure consumer safety, the actual use of these substances in printed paper and board FCM should be investigated urgently.     

Subjective image quality of digital panoramic radiographs displayed on monitor and printed on various hardcopy media

The subjective image quality of panoramic radiographs shown on a diagnostic computer monitor were compared with professional direct thermal prints and with common inkjet prints on different paper qualities. Indirect digital panoramic radiographs were obtained from 15 patients. The images were printed with a direct thermal printer in their original format. Afterwards, these were loaded in an imaging software programme (Microsoft Photo Editor) and assessed both on computer monitor and inkjet prints on transparency, glossy, satin and regular paper. Five observers assessed subjective image quality for different regions and anatomical landmarks on a 5-point rating scale. Data were statistically analysed and inter- and intra-observer performances were calculated. Best image quality was obtained with direct thermal prints, followed in descending order by panoramic images viewed on the monitor, inkjet prints on transparencies, glossy paper, satin paper and finally regular paper. The differences were significant except for monitor images versus direct thermal prints, inkjet-transparencies and inkjet-glossy images and inkjet-satin versus inkjet-glossy images. The subjective image quality of indirect digital panoramic images is different for images shown on the computer monitor and for printed images depending on both the printer and paper type used.The research was carried out at the Oral Imaging Centre, Katholieke Universiteit Leuven, Kapucijnenvoer 7, B-3000 Leuven, Belgium