血小板参数变化与新生儿缺氧缺血性脑病关系探讨

目的:探讨血小板参数的动态变化与新生儿缺氧缺血性脑病(HIE)病情程度的关系。方法:对确诊为HIE的68例患儿进行临床分度,观察患儿急性期及恢复期血小板数(PLT)、平均血小板体积(MPV)及血小板分布宽度(PDW)的变化,并与50例正常足月新生儿作对照。结果:HIE患儿急性期PLT明显降低,MPV及PDW明显升高,与对照组比较差异有显著性意义(P<0.01),HIE恢复期PLT、MPV及PDW与对照组比较差异无显著性意义(P>0.05),HIE患儿PLT随HIE病情加重而降低,而MPV、PDW则随病情加重而增大,组间比较差异有显著性意义(P<0.01)。结论:临床动态观察HIE患儿的血小板参数,可作为判断HIE的严重程度及监测病情变化的指标之一。     

肝硬化患者血小板参数变化分析

目的 研究肝硬化患者血小板参数的变化，并探讨其临床意义。方法 采用日本SF－3000型血细胞分析仪检测62例肝硬化患者血小板计数（PLT），血小板平均体积（MPV），血小板分布宽度（PDW）并与肝功能分级（Child-Pugh积分法）比较。结果 肝硬化组PLT、MPV较对照组显著降低（P＜0．05），而PDW升高（P＜0．05），肝硬化A级组PLT，B级、C级组PLT、MPV显著降低，B级、C级组PDW显著升高。结论 血小板参数可间接反映血小板功能，肝功能损害可能是血小板功能异常的主要原因。     

肝硬化患者血小板4项参数的检测及临床意义

目的：分析肝炎肝硬化患者血小板参数测定的临床意义。方法：采用SysmexKX-21型血细胞分析仪测定94例肝炎肝硬化患者的血小板4项参数,并将健康体检者血小板参数作为对照组。结果：与对照组比较,肝硬化患者的血小板计数（PLT）、平均血小板体积（MPV）、血小板体积分布宽度（PDW）均明显下降（P〈0．05或〈0．01）,血小板压积（PCT）则明显升高（P〈0．01）,且随着Child-Pugh积分的增加,血小板4项参数异常程度逐渐加重。结论：血小板参数测定值有助于肝硬化患者的诊断及预后观察。     

慢性阻塞性肺疾病患者血小板参数变化及临床意义

目的探讨血小板参数在慢性阻塞性肺疾病（COPD）中的变化及临床意义。方法对确诊为COPD的患者128例,分别测定急性加重期及治疗后缓解期的85例的血小板计数（PLT）、血小板平均体积（MPV）、血小板分布宽度（PDW）及大血小板比率（P—LCR）,并与136例健康老年人血小板参数结果进行比较。结果COPD急性加重期PLT、P—LCR明显低于正常对照组（P〈0．05）,MPV明显低于缓解期组（P〈0．01）;缓解期组各项参数与正常对照组无明显差异（P〉0．05）。结论监测血小板参数对COPD患者病情判断及指导治疗具有一定的意义。     

新生儿缺氧缺血性脑病血小板参数的临床意义

目的了解足月新生儿缺氧缺血性脑病（HIE）血小板参数的变化及临床意义。方法选择2001年1月-2008年7月间,在株洲市人民医院治疗的足月新生儿缺氧缺血性脑病90例,其中轻度34例,中度30例,重度26例,同时与足月正常新生儿45例作对比,检测缺氧缺血性脑病急性期、恢复期血小板数（PLT）、血小板平均容积（MPV）、血小板分布宽度（PDW）的变化,并对照。结果足月新生儿缺氧缺血性脑病急性期PLT较对照组明显下降（P〈0.01）,MPV、PDW则明显升高（P〈0.05）,随病情加重,前者愈低,后两者愈高,而恢复期,检测结果与对照组间则差异无统计学意义。结论血小板参数可作为判断该病严重与否的参数指标,并监测病情变化。     

缺血性脑梗死与血小板参数相关性的研究

目的 通过对沈阳市第一人民医院缺血性脑梗死患者外周血的血小板计数（PLT）、血小板平均体积（MPV）、血小板分布宽度（PDW）、血小板比积（PCT）的检验结果进行分析,研究缺血性脑梗死与血小板相关参数与的相关性.方法 检测血小板四项参数即PLT、MPV、PDW和PCT,采用t检验比较脑梗组与正常对照组之间的差异显著性.结果 脑梗组和对照组相比较PLT显著降低,MPV、PDW显著升高,差异显著（P＜0.01）,两组PCT比较无明显差异（P＞0.05）.结论 脑梗死患者的PLT降低,MPV、PDW升高,动态观察血小板参数的变化对脑梗死的诊断及治疗有一定的临床意义.     

血小板、纤维蛋白原水平与缺血性脑卒中关系的临床研究

目的探讨缺血性脑卒中与血小板、血浆纤维蛋白原之间关系。方法选取缺血性脑卒中患者235例和健康者156例,进行血小板（PLT）、平均血小板体积（MPV）、血小板分布宽度（PDW）及纤维蛋白原（FIB）水平检测。在入院时和出院后6个月分别评价脑卒中组患者的血小板和纤维蛋白原水平,并给予为期2年的随访。结果缺血性脑卒中组与健康组比较,MPV、PDW、FIB明显升高（P〈0．05）,PLT明显降低（P〈0．05）;患者的纤维蛋白原水平和神经功能损伤之间具有明显的相关性（r=0．761,P〈0．05）。结论观察PLT、MPV、PDW及FIB水平变化对病情诊断和病情判断具有重要的指导意义。     

作者修稿注意事项

目的：了解血小板四项参数在肾综合征出血热疾病中的意义。方法：采用美国库尔特全自动血细胞分析仪对32例肾综合征出血热患者进行血小板计数（PLT）、血小板体积（MPV）、血小板压积（PCT）、血小板宽度（PDW）4项参数测定。结果-肾综合征出血热患者初期PLT、PCT明显降低，发热期、低血压休克期、少尿期PLT、PCT均显著低于对照组、恢复组（P〈O．01）；同时MPV、PDW高于对照组、恢复组（P〈O．01）。低血压休克期最明显，其改变与骨髓及血小板损伤程度呈正相关，结论：血小板4项参数动态监测对判断疾病状态可提供可靠依据。     

脑梗死患者血浆凝血功能和血小板参数的变化

目的 探讨脑梗死患者血浆凝血及血小板参数的变化及其临床意义。方法 选自2005年6月—2007年6月在我院神经内科收治的258例脑梗死患者，进行凝血酶原时间（PT）、部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原含量（Fbg）、血小板计数（PLT）、平均血小板体积（MPV）、血小板分布宽度（PDW）、血小板压积（PCT）的检测，同时选取180例健康人进行对照。结果 脑梗死患者血浆PT、APTT、TT、PLT计数显著低于对照组（P〈0．01），患者Fbg、MPV、PDW显著高于对照组（P〈0．01），PCT2组之间差异无统计学意义（P〉0．05）。结论 凝血功能及血小板参数的异常对诊断脑梗死有重要意义。     

53例慢性心衰患者血小板参数的结果分析

目的探讨慢性心衰对血小板参数的影响。方法抽取53例慢性心衰患者和33例非心衰患者的静脉血标本，测定其血小板参数并进行比较。结果慢性心衰患者的血小板（PLT）计数与非心衰患者差异无显著性意义（P〉0．05），慢性心衰患者血小板体积分布宽度（PDW）显著高于非心衰患者（P〈0．05），慢性心衰患者平均血小板体积（MPV）、血小板比率（P—LCR）显著高于非心衰患者（P〈0．01）。结论P—LCR增大是慢性心衰出现早期心源性肝硬化的重要指标之一，并且可作为心衰治疗的一个指标。     

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 human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

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.     

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.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.