高同型半胱氨酸血症脑梗死患者血液流变学的相关研究

目的 研究高同型半胱氨酸血症(HHe)脑梗死患者血液流变学的变化.方法 对42例同型半胱氨酸正常的脑梗死患者(对照组)和50例合并HHe的脑梗死患者(HHe组)血液流变学9项指标(血液黏度、低切黏度、高切黏度、血浆黏度、红细胞压积、血沉、纤维蛋白原、红细胞变形指数、红细胞聚集系数)进行测定,并对照比较.结果 HHe组患者血液黏度、血浆黏度、高切黏度、低切黏度、血沉、纤维蛋白原、红细胞聚集系数和红细胞变形指数明显增高,与对照组比较差异有统计学意义(P＜0.01);红细胞压积与对照组比较,差异无统计学意义(P＞0.05).结论 HHe导致血液流变学异常是脑梗死的病理机制之一,HHe致血浆纤维蛋白原增高,是造成脑梗死患者血液黏度升高的主要原因之一.     

突发性耳聋患儿血液流变学指标检测及分析

目的观察突发性耳聋患儿的血液流变学指标变化。方法对32例突发性耳聋患儿和40例正常小儿进行血液流变学检测,比较二者指标变化。结果突发耳聋患儿全血粘度30 s较对照组明显升高(P0.05);全血粘度5s、1 s,全血低切相对粘度,全血还原粘度以及血浆粘度100 s均较对照组显著升高(P0.01);红细胞变形指数(TK)相对正常患儿降低(P0.05)。血沉、红细胞压积、血沉方程K值、全血高切还原粘度及相对粘度与对照组比较差异无统计学意义。结论血液流变学指标的检测对小儿突发耳聋的诊断有一定的临床价值。     

风湿病患者的血液诊断分析

目的 :探究血液检验在风湿病患者诊断中的价值。方法 :选取我院于2015年4月至2017年1月期间收治的120例风湿病患者作为实验组,选取同时期健康体检者120名作为对照组,分别对两组患者实施血液检验,比较两组C反应蛋白、血沉、血浆粘稠度、免疫球蛋白G、免疫球蛋白M、红细胞压积、全血粘度高切、全血粘度低切情况。结果:实验组患者较对照组人员C反应蛋白含量、血沉、血浆粘稠度、全血粘度高切、全血粘度低切更高,而免疫球蛋白G、免疫球蛋白M水平较对照组更低,差异显著(P0.05);两组红细胞压积相比,差异不显著(P0.05)。结论 :对风湿病患者采用血液检验,有助于及时确诊,并对其进行相应治疗,有利于疾病的预防以及控制。     

急性脑梗死患者血浆内皮素及血液流变学指标检测分析

目的探讨血浆内皮素(endothelin,ET)水平及血液流变学指标变化在急性脑梗死发病中的作用,为急性脑梗死患者病情、预后判断提供参考依据。方法对80例急性脑梗死患者和80例健康正常人血浆内皮素及血液流变学指标进行检测和对比分析。血浆内皮素采用特异性放免分析法,血液流变学各项指标采用锥板式测量方法进行检测。结果急性脑梗死组血浆内皮素平均水平为100.83 pg/ml,明显高于健康对照组的44.52 pg/ml,差异有显著性(P0.01)。急性脑梗死组全血粘度1/s、全血粘度30/s、全血粘度200/s、血浆粘度分别为21.97±0.18、5.91±0.02、4.67±0.03、1.79±0.01 m Pa·s,均明显高于健康对照组的16.21±0.12、4.84±0.04、3.86±0.08、1.33±0.02m Pa·s,差异有显著性(P0.01);急性脑梗死组红细胞压积和纤维蛋白原分别为(49.86±1.55)%和4.38±0.06 g/L,均明显高于健康对照组的(41.37±0.78)%和2.37±0.04 g/L,差异有显著性(P0.01)。在相同性别人群中,急性脑梗死组全血粘度、血浆粘度、红细胞压积、纤维蛋白原检测值均明显高于健康对照组,差异均有显著性(P0.01)。急性脑梗死组人群中,男性全血粘度1/s、全血粘度30/s检测值明显高于女性,差异有显著性(P0.01)。结论血浆内皮素及血液流变学指标可作为急性脑梗死的临床诊断指标,是疗效观察和预后判断的敏感性指标。     

体外反搏和蝮蛇抗栓酶治疗老年缺血性心、脑血管病时血液流变学的影响

我们从1990年4月至1992年6月使用体外反搏和蝮蛇抗栓酶(以下简称抗栓酶)治疗22例老年缺血性心、脑血管病,试图从改善血液流变学的角度控制疾病的发生和发展,同时设单用抗枪酶治疗20例老年缺血性心、脑血管病为对照组,我们观察治疗前后血液流变学各项指标,(1)治疗组治疗前后纤维蛋白原、血沉、血沉K值、全血粘度低切,全血还原粘度、红细胞压积、血浆粘度有显著差异。(2)治疗组与对照组相比,红细胞压积有非常显著差异、纤维蛋白原、血浆粘度、血沉K值有显著差异。体外反搏和抗栓酶治疗老年缺血性心、脑血管病降粘作用优于单用抗栓酶。     

老年体检者血液流变学检测结果分析

目的:分析老年体检者血液流变学检测结果的特征,为老年性疾病的防治提供依据。方法:选取100例老年体检者进行血流变检测,与中青年体检者组成的对照组进行对照分析。结果:观察组全血粘度、血沉、红细胞聚集指数、总胆固醇、甘油三酯显著高于对照组(P0.05),红细胞变形指数显著低于对照组(P0.05);两组血浆粘度、红细胞刚性指数差异无统计学意义(P0.05)。观察组,全血粘度增高42例(42.0%)、红细胞聚集指数增高46例(46.0%),红细胞变形指数降低42例(42.0%);对照组,全血粘度增高16例(16.0%)、红细胞聚集指数增高23例(23.0%),红细胞变形指数降低21例(21.0%)。结论:与中青年体检患者相比,老年体检患者血液流变学指标异常率相对较高。     

2型糖尿病患者血液流变学指标检测及意义

目的探讨2型糖尿病患者血液流变学指标变化及检测意义。方法选择2011年3月—2012年5月就诊的2型糖尿病患者114例作为糖尿病组,选择30例同期进行健康体检的年龄、性别匹配者作为对照组。待检者采血前1 d禁食高脂饮食,妇女应尽量避开月经期。于清晨空腹采肘静脉血5 ml存放于肝素抗凝试管,2 h内送检。采用北京众驰伟业ZS-9200型全自动血流变分析仪测定全血粘度、血浆粘度、纤维蛋白原等血液流变学指标,红细胞压积采用温氏法测定。HbA1c检测采用微柱法。计量资料采用t检验,P0.05为差异有统计学意义。结果糖尿病组全血高切、中切、低切粘度、血浆粘度、纤维蛋白原、红细胞沉降率[(5.01±0.52)、(5.13±0.73)、(5.13±0.73)、(1.64±0.23)mPa·s、(19.48±8.28)mm/h]均明显高于对照组(均P0.05)。而红细胞压积差异无统计学意义(P0.05)。全血高切、中切、低切粘度、血浆粘度随HbA1c水平升高而增加,比较差异均有统计学意义(均P0.05),而红细胞沉降率和红细胞压积比较差异均无统计学意义(均P0.05)。结论 2型糖尿病患者存在血液流变学的异常改变,且与血糖水平密切相关。     

硝酸甘油对妊高征患者血流变学、血小板聚集的影响

目的拟用硝酸甘油(Ng)治疗妊高征(PIH),评价其对PIH患者血流变学、血小板聚集的影响.方法选取晚期正常妊娠妇女(正常组Ⅰ组11例),中、重度妊高征患者34例[PIH组,其中单用硫酸镁(Mg)治疗Ⅱ组11例;单用硝酸甘油(Ng)治疗Ⅲ组11例;联合用药(Mg+Ng)治疗Ⅳ组12例].采用血液粘度仪在高、低切变率下测血流变学,硫酸铵沉淀法测纤维蛋白原(Fn),魏式法测血沉(ESR),常规法测红细胞压积(Hct),血小板聚集仪测血小板聚集(PAg).结果①血流变学产前PIH组较Ⅰ组全血粘度(BV),红细胞聚集指数(RE)、血浆粘度(PV)、Hct、ESR、血沉方程K值(Kesr)、Fn均增高(P＜0.05)差异显著;产后各组无明显差别,Ⅲ、Ⅳ组治疗后BV、ESR、Kesr、Fn下降,差异显著(P＜0.05),余下指标及Ⅱ组各指标改变不明显.②血小板聚集产前PIH组较Ⅰ组增高,差异显著(P＜0.05),产后各组无明显差别;Ⅲ、Ⅳ组治疗后较用前降低,差异显著(P＜0.01),Ⅱ组改变不明显.结论硝酸甘油作为NO供体治疗妊高征时,能改变血流变,抑制血小板聚集.     

急性心肌梗死患者cTn I与血流变指标的相关性分析

目的探讨急性心肌梗死(AMI)患者心肌肌钙蛋白Ⅰ(cTn I)与血流变指标的相关性。方法选取2017年07月—2019年01月收治的AMI患者50例,作为AMI组,选取同期于体检的50例健康体检者作为对照组。两组均于入院当日检测血清cTn I水平及血液流变学指标,包括纤维蛋白原、血浆粘度、全血粘度、红细胞压积率、红细胞聚集指数。经Pearson线性相关分析血清cTn I与各血流变指标间的相关性。结果 AMI组的血清cTn I、全血粘度、纤维蛋白原、血浆粘度、红细胞压积率、红细胞聚集指数显著高于对照组,差异有统计学意义(P <0. 05)。经Pearson线性相关分析提示血清cTn I与全血粘度、纤维蛋白原、血浆粘度、红细胞聚集指数呈正相关(P <0. 05),而与红细胞压积率无明显相关性(P> 0. 05)。结论 AMI患者血清cTn I与全血粘度、纤维蛋白原、血浆粘度、红细胞聚集指数存在密切关联,临床需对此引起重视。     

30例矽肺患者血液流变指标初探

对３０例已确诊为矽肺的患者进行了血液流变学指标探讨，并与对照组比较，发现矽肺病人在全血比粘度、全血还原粘度、血浆比粘度、红细胞比积及纤维蛋白原与对照组比较均有较大改变，血液呈高粘度状态。因此，对矽肺患者做血液流变学指标检查有一定意义。     

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.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.