红细胞分布宽度及血小板参数在急性心肌梗死诊断中的应用研究

目的观察急性心肌梗死(AMI)患者红细胞分布宽度(RDW)、血小板计数(PLT)、平均血小板体积(MPV)、血小板分布宽度(PDW)的变化,并探讨其数值变化在急性心肌梗死诊断中的应用。方法选取我院2014年1月至2015年8月期间收治的AMI患者50例(AMI组),分别检测入院时的RDW、PLT、MPV、PDW,同时选择50例健康体检者作为对照组,所有标本采用全自动血细胞分析仪进行RDW、PLT、MPV、PDW的检测。结果 AMI组的RDW、MPV、PDW水平均显著高于对照组(P<0.05),多因素Logistic回归分析显示,高RDW、MPV、PDW水平为AMI的独立危险因素。结论 RDW、MPV、PDW水平升高与AMI发病有关,监测红细胞分布宽度及血小板参数的变化有助于对怀疑急性心肌梗死患者的诊断。     

冠心病患者血小板参数的测定分析

目的 探讨血小板参数在冠心病（CHD）患者中的变化及临床意义。方法 对83例CHD患者和83例健康体检者的血小板含量（PLT）、平均血小板体积（MPV）和血小板分布宽度（PDW）进行检测比较。结果 冠心病组的PLT、MPV和PDW分别为（225±78）×109/L、9.85±1.61fl、18.78±0.72%,对照组的PLT、MPV和PDW分别为（219±72）×109 /L、8.53±0.95fl、16.57±0.53%。经统计学处理,冠心病组的MPV和PDW明显增大,与对照组比较差异具有显著性（P0.05）。结论 血小板体积变大和活化过程与冠状动脉血栓形成有关,是冠心病的危险因子。     

肺癌患者化疗后血小板参数的变化研究

目的探讨肺癌患者化疗后血小板参数的变化及其临床意义。方法用Sysmes1800i全自动血液分析仪对正常健康人、肺癌患者化疗期间血液血细胞参数白细胞(WBC)、血小板(PLT)、血小板平均体积(MPV)、血小板分布宽度(PDW)、大血小板比率(PLCR)等参数进行比较。结果患者组血小板分布宽度(PDW)化疗前后有显著变化(P<0.01),提示肺癌患者化疗后PDW减小是其特征性变化;血小板无明显变化(PLT,P>0.05),血小板平均体积减小(MPV),差异有统计学意义(P<0.05);PLCR无明显变化;正常健康组血白细(WBC,n=45,5.27±1.17),患者组白细胞(n=34,3.10±0.64)。结论血小板分布宽度(PDW)是肺癌患者化疗后骨髓抑制敏感指标。     

四项血小板参数在重症肺炎患儿中的检测及意义

目的:探讨四项血小板参数在重症肺炎患儿中的检测及意义。方法:采用日本SysmexSF23000分析仪检测65例重症肺炎患儿和60例正常对照儿童血浆血小板计数(PLT)、平均血小板体积(MPV)、血小板分布宽度(PDW)、血小板压积(PCT)水平。结果:重症肺炎组PLT、MPV、PDW、PCT明显高于对照组(P<0.05),恢复期组PLT、MPV、PDW、PCT明显低于急性期组(P<0.05)。结论:重症肺炎患儿血小板四项参数PLT、MPV、PCT、PDW水平明显升高,并且急性期明显高于恢复期,临床应密切关注血小板参数变化。     

血小板参数与急性脑梗死发病的相关性研究

目的研究急性脑梗死患者发病与血小板参数的改变之间的相关性。方法对68例急性脑梗死患者和68名健康体检者(对照组)的血小板参数进行检测,主要包括PLT(血小板计数)、IPF(未成熟血小板比率)、MPV(血小板平均体积)和PDW(血小板分布宽度),68例急性脑梗死患者按不同的发病时间分为1周组和2周组,每组34例患者,比较两亚组和对照组之间血小板参数存在的差异。结果急性脑梗死患者发病1周组与对照组比较,PLT、IPF值、MPV和PDW均存在明显差异,具有统计学意义(P<0.05)。急性脑梗死患者发病2周组与对照组比较,PDW的比较存在明显差异,具有统计学意义(P<0.05),PLT、IPF值和MPV的比较无明显差异,不具有统计学意义(P>0.05)。结论急性脑梗死患者血小板参数的改变与其病情的变化有着密切的联系,监测急性脑梗死患者血小板参数的变化,有助于急性脑梗死患者的临床治疗和预后的判断。     

高同型半胱氨酸血症患者血小板参数检测的临床意义

目的观察高同型半胱氨酸血症(HHcy)患者血小板参数的变化,并对其临床价值做初步评价。方法检测65例HHcy患者,50例健康体检者(正常对照组)的血小板计数(PLT)、平均血小板体积(MPV)、血小板压积(PCT)、血小板分布宽度(PDW)及大血小板比率(P-LCR)水平,分析Hcy与PLT、MPV、PCT、PDW及P-LCR的相关性。结果HHcy患者PLT、MPV、PDW及P-LCR水平与对照比较,均明显增高,差异均具有统计学意义(P0.05),PCT水平与对照组比较,差异无统计学意义(P0.05)。HHcy患者血清Hcy水平与MPV、PDW及P-LCR呈明显正相关(P0.05)。结论 HHcy患者血小板参数变化明显,提示Hcy可以通过增加血小板活性,在血栓性疾病发生、发展中起重要的作用。     

血小板参数对川崎病诊断的临床意义

目的探讨小儿川崎病发病第1周、第2~3周血小板参数的变化和临床意义。方法对78例川崎病患儿(病例组)及78例同期体检健康儿童(对照组)取静脉全血用ADVIA2120全自动血液细胞分析仪测定血小板数(PLT)、血小板压积(PCT)、血小板平均体积(MPV)、血小板体积分布宽度(PDW)。对疾病组和对照组血小板参数分别进行比较,并对血小板各参数进行相关性分析。结果川崎病患儿发病第1周PLT、PCT明显高于对照组(P0.05),PDW低于对照组(P0.05),MPV与对照组比较差异无统计学意义;川崎病患儿发病第2~3周PLT、PCT明显高于对照组(P0.05),MPV、PDW均低于对照组(P0.05);川崎病发病第2~3周PLT、PCT高于川崎病发病第1周,川崎病发病第2~3周MPV、PDW低于川崎病发病第1周。川崎病患儿PLT与MPV、PDW呈负相关(r=-0.391;r=-0.362);PLT与PCT呈正相关(r=0.969);PCT与PDW呈负相关(r=-0.356);MPV与PCT、PDW无相关性(r=-0.207;r=0.226)。结论血小板参数变化对川崎病诊断有非常重要意义,并可作为判断患儿病情及指导临床治疗用药的指标。     

血小板参数的变化在急性脑梗死患者中的临床意义

目的 检测外周血血小板参数的变化在急性脑梗死(CI)患者诊疗中应用价值.方法 应用全自动血细胞分析仪,对82例急性脑梗死患者及50例健康体检者(对照组)进行血小板参数[主要指血小板计数(PLT)、未成熟血小板比率(IPF)、血小板平均体积(MPV)、血小板分布宽度(PDW)]的检测,82例患者按不同发病时间段分为1～7d及8～14d两个检测组各41例,分别与对照组进行血小板参数的比较.结果 CI发病1～7d组与健康对照组比较,IPF值两组比较差异有显著统计学意义(P＜0.01),PLT、MPV、PDW两组对比差异有统计学意义(P ＜0.05); CI发病8～14d组与健康对照组比较,PDW两组比较差异有统计学意义(P＜0.05),PLT、MPV、IPF两组比较差异无统计学意义(P＞0.05).结论 监测急性脑梗死患者外周血血小板参数不同时间段的变化,有助于临床观察脑梗死患者病情的疗效及预防、预后的判断.     

急性心肌梗死患者血小板相关参数与血清同型半胱氨酸测定的临床意义

目的:观察急性心肌梗死(AMI)患者的血小板相关参数、血清同型半胱氨酸的变化,探讨其检测在急性心肌梗死中的意义。方法:测定对照组与急性心肌梗死组治疗前后的血小板计数(PLT)、平均血小板体积(MPV)、血小板分布宽度(PDW)及血清同型半胱氨酸(Hcy)并对检验结果进行分析。结果:与对照组相比,AMI组治疗前MPV与PDW水平明显升高(P<0.01),Hcy水平升高(P<0.05),PLT水平明显降低(P<0.01),两组差别具有统计学意义,AMI组治疗后PLT水平上升,MPV、PDW、Hcy水平下降,与对照组相比差别无统计学意义。结论:监测血小板参数和Hcy的变化,有助于对急性心肌梗死的治疗和预后。     

脑梗死患者血小板参数检测30例分析

目的:探讨血小板参数血小板计数PLT,血小板压积PCT,平均血小板体积MPV,血小板体积分布宽度PDW在脑梗死疾病中的变化。方法:全自动血液细胞分析仪检测30例脑梗死患者血小板4项参数,并与对照组正常人50例进行比较。结果:脑梗死患者的血小板计数PLT和血小板压积PCT明显减少,存在显著性差异(P<0.05),血小板体积分布宽度PDW、平均血小板体积MPV明显升高,存在显著性差异(P<0.05)。结论:血小板参数检测对脑梗死患者有重要意义。     

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.