寒冷气候对正常妊娠和子痫前期胎盘ACE mRNA及蛋白表达的影响

目的:探讨寒冷气候对正常妊娠和子痫前期孕妇胎盘血管紧张素转换酶(ACE) mRNA及蛋白表达的影响;方法:选取2009年9月～2010年5月在该院住院的正常孕妇40例和子痫前期孕妇80例,按照传统节气分为冬季型气候组和过渡季型气候组,各组又分别分为正常妊娠组、轻度子痫前期组和重度子痫前期组.采用半定量RT-PCR及蛋白免疫印迹(Westem-blot)法检测两组孕妇胎盘ACE mRNA及蛋白表达.结果:同季节型中各组胎盘ACE mRNA及蛋白表达量随病情加重呈上升趋势,正常妊娠组＜轻度子痫前期组＜重度子痫前期组,差异均有统计学意义(P＜0.05);冬季型正常妊娠组胎盘ACEmRNA及蛋白表达水平与过渡季型气候正常妊娠组相比,差异无统计学意义(P＞0.05);冬季型轻度子痫前期组胎盘ACE mRNA表达高于过渡季型轻度子痫前期组,差异有统计学意义(P＜0.01);冬季型轻度子痫前期组胎盘ACE蛋白表达高于过渡季型轻度子痫前期组,但差异无统计学意义(P＞0.05);冬季型重度子痫前期组胎盘ACE mRNA及蛋白表达高于过渡季型重度子痫前期组,差异有统计学意义(P＜0.01).结论:寒冷刺激会影响胎盘ACE mRNA及蛋白的表达,使胎盘肾素-血管紧张素系统(RAS)调节异常,从而进一步加重子痫前期的病情,这提示外界不良的气候条件是引发以及加重子痫前期病情的一个重要影响因素,其具体的影响机制还有待于进一步研究.     

子痫前期患者胎盘组织瘦素的表达与病情的相关性研究

目的 探讨子痫前期患者胎盘组织瘦素的表达水平与病情的关系.方法 选择妊娠期高血压疾病患者10例、子痫前期轻度患者10例、子痫前期重度患者10例,采用RT-PCR技术检测患者胎盘组织瘦素mRNA的表达水平,并与15例正常孕妇(对照者)进行比较.同时检测子痫前期患者24 h尿蛋白定量及平均动脉压.结果 胎盘组织瘦素mRNA表达水平子痫前期重度患者(0.507±0.036)及子痫前期轻度患者(0.476±0.023)均高于对照者(0.441±0.030)(P＜0.01),子痫前期重度患者高于子痫前期轻度患者(P＜0.05);妊娠期高血压疾病患者瘦素mRNA表达水平(0.463±0.024)与对照者比较,差异无统计学意义(P＞0.05).子痫前期患者胎盘组织瘦素mRNA表达水平与24 h尿蛋白定量、平均动脉压呈正相关(P＜0.05).结论 子痫前期患者胎盘组织瘦素表达水平明显升高,且表达水平与病情有关.     

胎盘组织中IL-37的表达及其与子痫前期发病的关系

目的探讨胎盘组织白细胞介素-37(IL-37)的表达及与子痫前期发病的关系。方法选取2015年1月-2016年1月在该院治疗的子痫前期患者81例,其中轻度子痫前期患者47例(轻度组),重度子痫前期患者34例(重度组);同时选取正常妊娠孕妇50例作为对照组,采用免疫组化染色和Western Blot检测各组IL-37蛋白表达,采用RT-PCR检测各组IL-37 mRNA表达。结果重度组胎盘组织IL-37蛋白表达为(0.561±0.123),明显低于轻度组和对照组(P0.05);轻度组胎盘组织IL-37蛋白表达为(0.658±0.116),明显低于对照组(P0.05);重度组胎盘组织IL-37 mRNA表达为(0.540±0.103),明显低于轻度组和对照组(P0.05);轻度组胎盘组织IL-37 mRNA表达为(0.834±0.156),明显低于对照组(P0.05);子痫前期患者IL-37 mRNA和蛋白表达与分娩孕周无相关性(P0.05)。结论子痫前期和正常妊娠孕妇胎盘组织均有IL-37表达,其中子痫前期患者IL-37蛋白和mRNA表达明显降低,可能参与了子痫前期的发病过程。     

中期因子在子痫前期患者中的定量检测及表达

目的 探讨中期因子(midkine,MK)蛋白在子痫前期患者母血、脐血和胎盘组织中的表达特点及其临床意义.方法 通过酶联免疫吸附试验(ELISA)分别检测未孕健康体检者、正常妊娠、轻度子痫前期和重度子痫前期患者母血MK的含量及正常妊娠、轻度子痫前期和重度子痫前期患者脐血MK的含量;免疫组织化学染色法检测了正常足月妊娠、轻度子痫前期和重度子痫前期患者胎盘组织MK的表达情况.结果 未孕健康体检者、正常妊娠、轻度子痫前期和重度子痫前期患者4组母血MK水平分别为0、(20.3±6.7)、(44.0±6.7)和(3.4±3.9)ng/L,轻度子痫前期组、重度子痫前期组同正常妊娠组比较,轻度子痫前期组同重度子痫前期组比较,差异均有统计学意义;正常妊娠、轻度子痫前期和重度子痫前期患者3组脐血MK水平分别(18.0±22.3)、(43.9±15.6)和(4.6±7.4)ng/L,轻度子痫前期组脐血MK水平明显高于正常足月妊娠组,重度子痫前期组脐血MK水平明显低于正常足月妊娠组,差异有统计学意义;轻度子痫前期患者胎盘组织中MK表达水平明显高于正常妊娠组,重度子痫前期患者组胎盘组织中MK表达水平明显低于正常妊娠组,差异有统计学意义.结论 MK同妊娠相关,未孕妇女血中无MK表达;正常妊娠患者血及胎盘组织中MK有表达;轻度子痫前期患者血及胎盘组织中MK表达较正常妊娠升高,重度子痫前期患者血及胎盘组织中MK表达较正常妊娠降低.此结果可期待为子痫前期的发病机制、预防预测、基因治疗及疗效评价提供一种新思路.     

子痫前期患者血清和胎盘β-hCG水平测定

目的 探讨子痫前期患者血清和胎盘组织中人绒毛膜促性腺激素水平改变与发病的相关性.方法 选择轻度、重度子痫前期患者及对照组(正常妊娠孕妇)各24例,随机选择三组产妇的胎盘各16例,利用酶联免疫分析法测定三组血清及胎盘中人绒毛膜促性腺激素水平.结果 轻度子痫前期患者组血清和胎盘中人绒毛膜促性腺激素水平分别为60.7±18.2ng/mL、5.13±1.6ng/mg,均高于对照组的27.9±16.4ng/mL、2.98±1.2ng/mg(P＜0.01);重度子痫前期患者组血清和胎盘中人绒毛膜促性腺激素水平分别为93.5±29.6ng/mL、7.82±1.5ng/mg,明显高于轻度子痫前期组的60.7±18.2ng/mL、5.13±1.6ng/mg(P＜0.01).结论 子痫前期患者血清和胎盘中人绒毛膜促性腺激素水平升高,可能通过调节细胞滋养细胞和血管内皮细胞的功能而参与了子痫前期的发病.     

白血病抑制因子在子痫前期患者胎盘组织中的表达

目的:测定白血病抑制因子(LIF)在子痫前期患者胎盘组织中的表达,探讨其在妊娠高血压发病中的作用。方法:采用免疫组化技术-链霉菌抗生物素蛋白-过氧化酶连接(SP)法对在正常妊娠(正常妊娠组)、子痫前期(轻度子痫前期组和重度子痫前期组)孕妇胎盘组织中LIF的表达进行组织学定位和半定量分析。结果:3组孕妇胎盘组织中LIF均呈现阳性表达,阳性染色主要位于滋养细胞胞质中,胞核无明显着色。轻度子痫前期组和重度子痫前期组分别与正常妊娠组比较,胎盘组织的染色强度及范围显著减弱,差异有统计学意义(P<0.01),而轻度子痫前期组和重度子痫前期组的胎盘组织染色范围和强度比较,差异无统计学意义(P>0.05)。结论:LIF对维持正常妊娠有一定的保护作用,LIF分泌或调控异常,影响了滋养细胞的浸润能力,导致病理妊娠,在胎盘组织中的低表达,参与了子痫前期发病机制。     

胎盘蛋白13在子痫前期孕妇血清中的表达和意义

目的探讨子痫前期孕妇血清中胎盘蛋白13的表达水平与妊娠孕周长短的关系。方法选取2012年1月~2013年12月间该院收治的子痫前期孕妇52例,根据病情严重程度分为轻度子痫前期组(20例)和重度子痫前期组(32例);选取同期来本院健康体检的健康孕妇33例为对照组。分别于妊娠中期(孕33~36周)和妊娠晚期(孕33~36周)收集3组孕妇的肘静脉血5ml,采用ELISA法检测血清样本中胎盘蛋白13的含量。结果轻度子痫前期组、重度子痫前期组血清胎盘蛋白13含量均明显高于对照组孕妇,差异有统计学意义(P0.05);重度子痫前期组血清胎盘蛋白13含量明显高于轻度子痫前期组,差异有统计学意义(P0.05)。3组孕妇妊娠晚期胎盘蛋白13含量均高于妊娠中期,其中对照组妊娠晚期胎盘蛋白13含量与妊娠中期之间差异无统计学意义(P0.05);轻度子痫前期组和重度子痫前期组妊娠晚期胎盘蛋白13含量均明显高于妊娠中期,差异有统计学意义(P0.05)。对照组胎盘蛋白13含量与孕周之间无明显相关性(P0.05);轻度子痫前期组和重度子痫前期组胎盘蛋白13含量与孕周之间有明显相关性(P0.05)。结论子痫前期孕妇外周血清中胎盘蛋白13含量明显增加,可能参与了子痫前期病情的进展;随着孕周的延长,子痫前期孕妇血清中胎盘蛋白13表达水平明显升高,与病情严重程度呈正相关,可作为预测病情进展的指标。     

子痫前期孕妇血清和胎盘组织脂联素的表达及意义

目的 分析子痫前期孕妇血清和胎盘组织脂联素的表达及意义.方法 采用酶联免疫吸附法检测52例无妊娠并发症孕妇（对照组）、58例轻度子痫前期孕妇（轻度子痫前期组）、55例重度子痫前期孕妇（重度子痫前期组）血清脂联素,并计算稳态模型评估法胰岛素抵抗指数（HOMA-IR）;采用免疫组织化学SP法检测三组孕妇胎盘组织脂联素表达情况.结果 重度子痫前期组空腹血糖明显高于对照组和轻度子痫前期组[（5.56±1.37） mmol/L比（4.55±0.51）,（4.68±0.66） mmol/L],轻度子痫前期组、重度子痫前期组空腹胰岛素及HOMA-IR均高于对照组[（14.19±3.42）,（14.90±6.64） mU/L比（9.87±1.75） mU/L,1.04±0.37,1.18±0.56比0.67±0.21],重度子痫前期组血清脂联素明显高于对照组和轻度子痫前期组[（15.79±4.86） mg/L比（11.47± 3.50）,（11.92±2.96） mg/L],差异均有统计学意义（P＜0.05）.三组胎盘组织脂联素水平比较差异均无统计学意义（P＞0.05）.血清脂联素水平与HOMA-IR及胎盘组织脂联素表达无相关性（P＞0.05）.结论 重度子痫前期孕妇血清脂联素、HOMA-IR明显增高,血清脂联素升高可能是子痫前期孕妇的一种适当的反馈性调节.     

胎盘组织KiSS-1及metastin表达在早发重度子痫前期发病中的作用及其与围生结局的相关研究

目的:探讨胎盘组织中KiSS-1及其蛋白肽metastin表达在早发重度子痫前期发病中的作用及其与围生结局的相关性。方法:采用RT-PCR、westernblot、免疫组化方法检测57例子痫前期患者(轻度15例和重度42例,其中早发重度12例,晚发重度30例)和30例正常晚期妊娠者胎盘组织中KiSS-1及其蛋白的表达水平和定位,并与围生结局进行相关性分析。结果:子痫前期胎盘组织中KiSS-1及蛋白肽metastin的表达定位与正常晚期胎盘组织相似,主要表达在绒毛的合体滋养细胞和细胞滋养细胞。子痫前期组胎盘组织中KiSS-1mRNA及其蛋白表达分别为(1.73±0.24)和(78.41±7.96)μg/100μg总蛋白,显著高于正常晚期妊娠组(P<0.01、P<0.01),以重度子痫前期组尤为显著,早发重度子痫前期组显著高于晚发重度子痫前期组。与正常晚期妊娠组相比,子痫前期组metastin平均光密度(0.64±0.02)显著增高(P<0.01),随着病情的加重而逐渐增高,早发重度子痫前期组显著高于晚发重度子痫前期组(P<0.01)。随着新生儿窒息程度的加重,KiSS-1mRNA及其蛋白表达水平呈升高趋势(P<0.05、P<0.05),且与窒息程度呈明显正相关,r分别为0.463(P=0.016)和0.587(P=0.027)。KiSS-1mRNA及其蛋白表达水平与新生儿体重呈显著负相关,r分别为-0.764(P=0.000)和-0.899(P=0.000)。结论:子痫前期存在KiSS-1基因及其表达增强,且早发重度子痫前期组表达显著高于晚发重度子痫前期组,与滋养细胞侵润能力下降和新生儿预后密切相关,其异常表达可能是早发重度子痫前期发病的主要原因之一且与围生结局密切相关。     

子痫前期患者血清及胎盘激活素A水平变化的研究

目的 研究子痫前期患者血清及胎盘激活素A水平的变化及其与病情的关系.方法 采用ELISA检测40例子痫前期患者(子痫前期组,包括20例轻度,20例重度)和40例健康晚孕期妇女(正常妊娠组)的血清激活素A的水平;采用免疫组化方法检测胎盘激活素A的水平.结果 子痫前期组血清、胎盘激活素A水平分别为(32.23±6.11)μg/L、(516.14±5.46)μg/L,明显高于正常妊娠组的(8.04±2.19)μg/L、(275.38±18.12)μg/L(P＜0.01);其中重度子痫前期患者血清、胎盘激活素A水平较轻度子痫前期患者升高(P＜0.01);子痫前期组血清、胎盘激活素A水平与24 h尿蛋白含量之间呈显著正相关;重度子痫前期伴胎儿生长受限(FGR)者血清胎盘激活素A水平较不伴FGR者差异均无统计学意义(P＞0.05).结论 子痫前期患者血清、胎盘激活素A水平较健康晚孕期妇女显著升高,且与子痫前期病情进展关系密切.     

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.     

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.     

Assessing occupational and environmental exposure

Exposure assessment is a poorly understood component of the science of epidemiology. The relationship between exposure to chemicals and ill-health outcomes is often calculated using crude exposure measures such as ever/never exposed or duration. When investigating subtle effects, exposures need to be characterized much more fully in terms of intensity, frequency, duration and route. While occupational exposures tend to be much greater than those experienced from the wider environment there is a need to remember that, for many chemicals, exposure can occur occupationally, environmentally and through consumer use of products containing the material of interest. Inhalation exposure has generally been the traditional focus for most epidemiological investigations but there is now growing awareness of the importance of the dermal and ingested routes of contact and internalization. Quantification of the exposure also needs to be related to a biological mechanism of action and exposure metrics need to be selected accordingly. Occupational exposures can generally be measured using simple well-validated techniques. Environmental exposures require much more sensitive instruments and are more difficult to assess. Exposure modelling, particularly for the environmental fate of chemicals has undergone many recent developments and Monte Carlo techniques can be used to characterize model uncertainty and variability. This approach to exposure assessment can now be used in the setting of the wider environment and will enable a far better understanding of the relationship between exposure and disease.     

Mercury toxicity due to the smelting of placer gold recovered by mercury amalgam

A 19-year-old man developed tremor in both hands and fatigue after starting work at a placer gold mine where he was exposed to mercury-gold amalgam. Examination revealed an intention tremor, dysdiadochokinesis and mild rigidity. The 24-h urinary mercury concentration reached a peak of 715 nmol/l (143 ug/l) shortly before the clinical examination, after which he was removed from working in the gold room [Mercury No. Adverse Effect Level: 250 nmol/l (50 ug/l)]. On review 7 weeks later his tremor had almost resolved and the dysdiadochokinesis and rigidity had gone. The 24-h urinary mercury concentration had fallen to 160 nmol/l (32 ug/l). The principal exposure to mercury was considered to be the smelting of retorted gold with previously unrecognized residual mercury in it. The peak air concentration of mercury vapour during gold smelting was 0.533 mg/m3 (Mercury Vapour ACGIH TLV: 0.05 mg/m3 TWA). Several engineering and procedural controls were instituted. This episode occurred at another mine site, unrelated to Mount Isa Mines Limited.     

How Adults with Acquired Brain Damage Perceive Computer Training as a Rehabilitation Tool: A Focus-group Study

The aim of this study was to explore and describe how adult outpatients with acquired brain damage and referred to occupational therapy perceive computer training with the RehaCom programs, in order to evaluate the method of treatment as a tool in the rehabilitation of persons with cognitive disorders. By using focus-group discussions as a qualitative method of research when analysing the result, five themes with corresponding categories emerged, describing a development of understanding and learning about capacities. Themes describing how the participants could apply strategies to overcome shortcomings in daily occupations and the therapeutic role of the occupational therapist were identified as well. The result shows that a computer training program such as RehaCom can be used as an educational tool, for example, to guide a person who is trying to adopt compensatory strategies to avoid overload by taking pauses. It was found that anything the participants learned was also applicable to occupational performance in daily life.