液相芯片技术检测有机磷中毒患者血清细胞因子及其趋势分析

目的 探讨液相芯片技术检测有机磷中毒(AOPP)患者血清细胞因子及其变化趋势。方法 选取2019年4月—2022年8月本院收治的AOPP患者80例作为AOPP组，并根据ChE活性分为中度中毒者(ChE活性30%～<50%)和重度中毒者(ChE活性<30%),另选取本院健康体检合格者共40例为对照组。采用液相芯片技术检测AOPP组和对照组基线血清细胞因子，另外对比AOPP组中中重度者血清细胞因子水平，采用Pearson相关性分析中毒程度与基线细胞因子水平间的相关性，挑选相关性强的细胞因子；利用液相芯片技术检测AOPP患者基线、中毒12 h、24 h、72 h血清细胞因子，探究血清细胞因子随时间变化趋势。结果 AOPP组基线肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-10、C-反应蛋白(CRP)、涎液化糖链抗原-6(KL-6)、转化生长因子-β(TGF-β)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白Ⅰ(cTnⅠ)水平较对照组高(P<0.05)。AOPP患者中重度中毒者TNF-α、IL-6、IL-10、CRP、KL-6、TGF-β、CK-MB、CTnⅠ水...     

辛硫磷农药中毒患者血清胆碱酯酶恢复延迟的临床研究及探讨

目的研究辛硫磷农药中毒患者病情变化与血清胆碱酯酶（ChE）恢复的关系。方法95例重度有机磷中毒（AOPP）患者,包括A组辛硫磷中毒患者45例,B组其他有机磷中毒患者50例,入院后均给予洗胃、清除毒物、解磷定、阿托品及积极的对症支持治疗。分别于入院时、治疗后1、2、3、4、5、6～8、8～11、11～13天……及出院时抽血测定血清ChE,计算阿托品用量。结果血清ChE在两组患者治疗前无统计学意义（P〉0．05）,治疗后1—3天部分有下降趋势,第1天降至最低,3天后B组血清ClE逐渐上升,而A组ChE持续低水平。6—9天后缓慢回升,部分患者出院时仍低于甚至明显低于正常,但两组预后无显著差异．A组胆碱酯酶恢复时间13—44天,较B组7—25天明显延迟。阿托品用量大,治疗时间长。结论辛硫磷中毒患者ChE恢复明显延迟．对AOPP患者合理治疗具有重要指导意义。     

子痫前期患者PON1活性和AOPP水平及对疾病严重程度的影响

目的探讨子痫前期患者对氧磷酶1 (PON1)活性和晚期氧化蛋白产物(AOPP)水平及对疾病严重程度的影响。方法选择2014年6月1日-2017年6月1日邢台市第三医院及邢台市人民医院收治的120例子痫前期患者,根据疾病严重程度分为轻度子痫前期(MPE) 60例和重度子痫前期(SPE) 60例。选择同期接受产前检查和住院的60例健康产妇为对照组。采用乙酸苯酯法检测3组血清PON1活性,采用ELISA检测血清AOPP水平,采用RT-PCR测定胎盘组织中PON1 mRNA、AOPP mRNA水平。比较3组患者血清PON1活性、AOPP水平和胎盘组织中PON1 mRNA、AOPP mRNA水平。结果 MPE组及SPE组患者血清PON1活性及胎盘组织中PON1 mRNA水平均显著低于对照组患者(均P0. 05),且SPE组患者血清PON1活性及胎盘组织中PON1 mRNA水平均显著低于MPE组患者(均P0. 05); MPE组及SPE组患者血清AOPP水平及胎盘组织中AOPP mRNA水平均显著高于对照组患者(均P0. 05),且SPE组患者血清AOPP水平及胎盘组织中AOPP mRNA水平均显著高于MPE组患者(均P0. 05)。PON1及AOPP联合检测子痫前期的准确性、灵敏度、特异度明显高于PON1或AOPP单一检测结果。结论PON1及AOPP表达水平与子痫前期患者的发病和严重程度相关,联合检测PON1和AOPP能有效提高诊断的灵敏度和特异度,对临床诊治具有明显的指导意义。     

急性有机磷农药中毒患者胱抑素C和超敏C反应蛋白的检测分析

目的：探讨急性有机磷农药中毒（AOPP）患者肾损害程度血清胱抑素C（CystatinC,CysC）和超敏C反应蛋白（hsCRP）变化及意义。方法：将48例AOPP患者分为轻、中、重度AOPP组,60例健康对照组,分别检测各组血清胆碱酯酶（CHE）,CysC,血尿素氮（Bun）,肌酐（SCr）,hsCRP。结果：轻度AOPP患者血CysC,hsCRP水平高于对照组,差异均有统计学意义（P〈0.05）;中、重度AOPP患者血CysC、hsCRP水平均明显高于对照组,差异均有统计学意义（P〈0.01）;结论：AOPP患者的肾有不同程度受损,CysC、hsCRP可作为AOPP早期肾损伤诊断及治疗的敏感指标。     

急性有机磷农药中毒患者血清脂蛋白(a)的变化

目的探讨急性有机磷农药中毒（AOPP）患者血清脂蛋白（a）[LP（a）]的变化及临床意义。方法用ELISA法检测71例AOPP患者血清LP（a）含量，并与45例对照比较。结果71例AOPP患者血清LP（a）含量在中毒第1、3、5、7天的中位数分别为160、208、310、220mg／L，中毒第3、5、7天血清LP（a）明显高于对照，差异有统计学意义（P〈0．01或P〈0．05），中毒第3天患者血清LP（a）开始升高，第5天达高峰；中度及重度中毒患者血清LP（a）含量明显高于轻度中毒患者，差异有统计学意义（P〈0．05或P〈0．01）。结论血清LP（a）可作为AOPP患者组织细胞损伤及炎症的一种标志物。     

急性有机磷农药中毒患者尿微量白蛋白水平的变化

目的 探讨急性有机磷农药中毒（AOPP）患者尿微量白蛋白水平的变化及意义.方法 用速率散射比浊法检测71例AOPP患者尿微量白蛋白含量,并与正常对照组（45例）比较.结果 71例AOPP患者中,20例中毒后尿微量白蛋白水平逐渐增高,且随着病情的发展尿蛋白呈阳性;51例尿蛋白阴性患者尿微量白蛋白含量增高16例,在中毒后第1、3、5天,其尿微量白蛋白含量中位数分别为2.12、2.31、1.70g/mol Cr,均高于正常对照组（1.25g/mol Cr）,差异有统计学意义（P＜0.05）,且中毒愈重,尿微量白蛋白增高愈明显.结论 尿微量白蛋白对AOPP患者肾损害的早期诊断有参考价值.     

急性有机磷农药中毒患者血清中性粒细胞明胶酶相关脂质运载蛋白的改变及临床意义

[目的]探讨急性有机磷农药中毒(AOPP)患者血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)的改变及临床价值。[方法]采用ELISA法检测100例AOPP患者入院时、中毒后12h、48h、72h时的血清NGAL水平和100例健康体检者血清NGAL水平。[结果]AOPP组入院时、中毒后12h、48h、72h时的血清NGAL水平显著高于对照组,两者相比较差异有统计学意义(P﹤0.05);血清NGAL水平随着中毒程度加重而升高,NGAL与不同中毒程度分级呈正相关(r=0.548,P﹤0.01)。[结论]监测AOPP患者血清NGAL水平有助于判断中毒程度,AOPP患者血清NGAL水平的升高对早期急性肾损伤具有重要的诊断价值。     

同型半胱氨酸和超敏C反应蛋白检测对急性脑梗死诊断的价值

目的：探讨同型半胱氨酸（H cy）和超敏C反应蛋白（H s-CRP）的检测对急性脑梗死（AC I）诊断的价值。方法：将157例AC I患者（AC I组）根据临床神经功能缺损程度（NDS）评分分为轻、中、重型三组,分别采用酶循环法及免疫透射比浊法检测其血清H cy和H s—CRP,同时与正常对照组比较。结果：与正常对照组比较,AC I组血清H cy和H s—CRP均明显升高,且轻、中、重型患者两两比较均有统计学差异（P均〈0.05）。结论：血清H cy和H s—CRP是AC I的独立危险因素,二者联合检测与ACI患者的NDS有直接关系，可作为判断ACI患者病情严重程度及预后的检测指标。     

小儿急性有机磷农药中毒院前系统救治的研究

目的 探讨小儿急性有机磷农药中毒（AOPP）现场系统救治的可行性,比较长托宁与阿托品院前急救小儿AOPP的疗效.方法 39例小儿AOPP病例,其中长托宁治疗组19例,阿托品对照组20例,两组均联合使用氯磷定.观察两组生存率;存活儿童ChE恢复时间、平均用药次数、平均住院日、中毒症状消失时间及药物不良反应.结果 治疗组及对照组生存率分别为947%、90%;两组存活儿童出汗、流涎、肺部啰音、瞳孔缩小等症状消失时间,口干、高热发生率比较差异无统计学意义（P〉005）,但治疗组ChE恢复时间、平均用药次数、平均住院日、昏迷持续时间、心动过速及躁动发生率与对照组比较,差异有统计学意义（P〈005）.结论 院前救治AOPP切实可行,长托宁是抢救小儿AOPP较理想的抗胆碱药物.     

血液灌流串联血液透析抢救重度有机磷农药中毒21例临床观察

目的观察血液灌流（HP）串联血液透析（HD）抢救重度有机磷农药中毒（AOPP）的疗效。方法将42例重度AOPP患者分为治疗组（21例）和对照组（21例）。对照组给予常规治疗;治疗组在常规治疗基础上加用血液灌流组串联血液透析治疗。观察两组患者胆碱酯酶活力恢复情况、阿托品及解磷定用量、治愈率及住院时间等的差异。结果治疗组胆碱酯酶（ChE）活性恢复时间、阿托品及解磷定用量、住院时间等方面均明显少于对照组,治愈率高于对照组（P〈0．01）。结论HP＋HD治疗可以明显提高重度有机磷农药中毒患者的治愈率、缩短住院时间、减少阿托品和解磷定用量,是基层医院抢救治疗重度AOPP的最佳选择方案之一。     

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.     

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.     

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.     

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.     

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.