WBC计数和血清C-反应蛋白在阑尾炎的诊断及病情评估中的价值

目的探讨白细胞计数(WBC)、血清C-反应蛋白(CRP)水平在急性阑尾炎的诊断及病情评估中的价值。方法 178例急性阑尾炎患者,经手术和病理结果诊断为65例坏疽性阑尾炎及穿孔、73例化脓性阑尾炎和40例单纯性阑尾炎;58例疑似阑尾炎腹痛患者为对照组。回顾性分析3组患者手术前或术后第5 d WBC和CRP检测结果,与对照组比较,并进行统计学分析。结果从对照组、单纯性阑尾炎组、化脓性阑尾炎组、坏疽性阑尾炎及穿孔组术前CRP检测结果逐步升高,且各组间比较差异均有统计学意义(P0.05),坏疽性阑尾炎及穿孔组与化脓性阑尾炎组术前WBC与单纯性阑尾炎组和对照组比差异均有统计学意义(P0.05)。各组患者术后第5 d WBC和CRP与术前比较差异均有统计学意义(P0.05)。诊断急性阑尾炎WBC灵敏度明显高于CRP,而特异度则是血清CRP明显高于WBC。结论 WBC和血清CRP检测对于急性阑尾炎的诊断及病情评估有重要意义。     

36例广州管圆线虫病实验室分析

目的 通过对广州管圆线虫病患者实验室检验结果的分析.探讨临床早期诊断的指标.方法 对大理地区36例疑似或临床诊断为广州管圆线虫病患者进行血液、脑脊液的ELISA检测,结果与正常对照组进行回顾性比较分析.结果 广州管圆线虫病患者WBC总数轻度升高,血液和脑脊液嗜酸性细胞明显增多,脑脊液细胞计数和蛋白质含量中度升高,可检测出广州管圆线虫抗体,与正常对照组相比差异有统计学意义(P＜0.05).结论 广州管圆线虫病患者的实验室检查对该病的早期诊断及鉴别诊断有重要意义.     

联合检测血清PCT、CRP水平变化对脓毒症患者的诊断价值

目的:观察血清降钙素原(PCT)、C反应蛋白(CRP)联合检测对脓毒症患者的诊断价值,为临床合理用药和控制院感提供科学依据。方法:采用回顾性分析方法,选择104例ICU患者,根据脓毒症诊断标准分轻度脓毒症组45例,严重脓毒症组29例,非脓毒症组30例,另选40例健康人群为对照组;采用免疫层析法检测PCT水平;7060型全自动生化分析仪检测CRP水平,观察各指标诊断脓毒症患者的敏感性、特异性、阳性预测值、阴性预测值、Youden指数;绘制ROC曲线并加以分析,明确检测最佳阈值。结果:轻度脓毒症组、严重脓毒症组血清PCT、CRP水平较对照组、非脓毒症组明显升高;非脓毒症组血清CRP水平较对照组明显升高,差异均有统计学意义(P<0.01);PCT指标敏感性、特异性、阳性预测值、阴性预测值、Youden指数与ROC曲线下的面积值均好于CRP;联合检测血清PCT、CRP的敏感性及准确率好于各指标独立诊断。结论:血清PCT指标对脓毒症患者有较好的临床诊断价值,联合检测血清PCT、CRP水平变化对脓毒症患者可以提高其诊断的敏感性及准确率。     

CRP血常规联合用于儿科临床检验的意义分析

目的:分析CRP(C反应蛋白)、血常规联合在儿科临床检验的应用意义。方法:选取我院儿科2019年5月～2020年5月收治的80例患儿做为研究对象,根据检查结果将有病毒感染的40例患儿分为观察组、有细菌感染的患儿40例分为对照组,两组患儿均实施CRP血常规联合检验,比较检验结果。结果:对照组CRP以及WBC指标均处于正常范围内,而观察组CRP以及WBC指标均高出正常范围,且观察组CRP以及WBC指标均高于对照组,对比差异具有统计学意义(P0.05);观察组中病毒性感染患儿CRP水平为(7.29±2.51)mg/L,细菌性感染患儿CRP水平为(19.69±4.46)mg/L,对比差异具有统计学意义(P0.05)。结论:在儿科疾病诊断中使用CRP血常规联合检验,对小儿疾病感染类型诊断的准确率有明显的提升作用,有利于根据诊断结果及时、有效的对患者开展治疗。     

磷脂酶A2、C-反应蛋白和白细胞计数在急性阑尾炎中的诊断价值探讨

目的为了解血清磷脂酶A2(PLA2)、CRP以及WBC计数在急性阑尾炎中的诊断价值。方法收集了2004年6月-2006年8月间在本院被诊断为急性阑尾炎并进行了阑尾切除术的147例病人的样本,对患者的血样作了WBC计数、血清CRP和PLA2检测。结果男性患者WBC计数、血清CRP和PLA2与非阑尾炎患者有显著差异。而女性患者除阑尾炎穿孔或阑尾炎脓肿患者的血清CRP和PLA2高于上限值外均在正常范围之内。结论对男性患者血清CRP、PLA2和WBC计数的增高可作为男性患者阑尾炎的诊断指标,而血清CRP和PLA2显著增高则提示男性患者阑尾炎穿孔或脓肿。而WBC计数、血清CRP和PLA2对女性患者不敏感,其浓度正常也不能排除急性阑尾炎。     

血清高迁移率族蛋白B1检测在重症急性胰腺炎鉴别诊断中的应用研究

目的调查急性胰腺炎患者高迁移率族蛋白B1(HMGB1)、C反应蛋白(CRP)、钙(Ca)、白细胞(WBC)、血清淀粉酶(AMY)水平的变化及其临床意义。方法检测30例健康对照者、45例轻症急性胰腺炎(MAP)患者和32例重症急性胰腺炎(SAP)患者的血清HMGB1水平及血清CRP、WBC;分析血清HMGB1水平与血清CRP、WBC等与胰腺炎的关系。结果 SAP、MAP患者血清HMGB1、CRP、WBC水平显著性高于健康对照组,差异有统计学意义(P<0.01);SAP患者血清HMGB1水平(16.2±11.28)ng/ml,显著性高于MAP患者(5.96±3.83)ng/ml;SAP、MAP患者血清CRP、WBC水平比较,差异有统计学意义(P<0.05);以SAP与MAP组作ROC曲线,AMY、HMGB1、CRP、WBC、Ca曲线下面积分别为0.536、0.857、0.727、0.488、0.275;检测灵敏度达到50.0%时AMY、HMGB1、CRP、WBC、Ca对应的特异性分别为44.8%、93.1%、75.9%、37.9%、14.8%,HMGB1的诊断效率最高,其次为CRP。结论胰腺炎患者血清HMGB1水平明显升高,血清HMGB1水平测定可作为评价胰腺炎病变和炎症反应程度的有效指标。     

胎膜早破孕妇血清C-反应蛋白和白细胞介素-1与胎膜早破关系研究

目的:探讨胎膜早破孕妇血清C-反应蛋白(CRP)和白细胞介素-1(IL-1)与胎膜早破的关系,为临床诊断治疗提供参考。方法:纳入研究的112例足月胎膜早破患者,其中足月胎膜早破未感染患者(A组)和胎膜早破合并绒毛膜羊膜炎患者(B组),各56例;选择同期在该院收诊的正常足月孕妇50例作为对照组。对比分析三组孕妇血清CRP、IL-1含量,破膜时间与血清CRP和IL-1水平变化及IL-1和CRP预测绒毛膜羊膜炎的价值。结果:B组血清CRP和IL-1含量明显高于A组和对照组,且差异具有统计学意义(P<0.05);而A组和对照组比较差异无统计学意义(P>0.05);破膜时间>12 h血清CRP和IL-1水平明显高于破膜时间≤12 h,且差异具有统计学意义(P<0.05);当血清IL-1取326 pg/ml时,敏感性为78%,特异性为86%;当血清CRP取10 mg/ml时,敏感性为73%,特异性为63%。结论:血清CRP和IL-1是诊断足月胎膜早破孕妇出现绒毛膜羊膜炎的特异、敏感指标,具有重要临床价值,值得临床进一步研究。     

216例糖尿病患者血清微量元素的含量及与胰岛素和血糖的关系

目的 :探讨非胰岛素依赖性糖尿病 (NIDDM )患者血清锌、铬、铜、铁的变化及与胰岛素和血糖的关系。方法 :对 2 16例NIDDM患者血清微量元素、胰岛素、血糖水平进行了观察 ,并与正常对照组做比较 ,各指标间做相关分析。结果 :糖尿病组血清Zn、Cr显著下降 ,Cu显著升高 ,Fe无明显改变。结论 :血清微量元素含量变化与糖尿病关系密切 ,动态检测Zn、Cr、Cu、Fe对防治糖尿病并发症的发生及判断预后有着特殊的诊断价值。     

c-反应蛋白与血沉在老年肺部感染中的临床应用价值研究

目的:探讨c-反应蛋白(C-reactiveprotein,CRP)与血沉(erythrocyte sedimentation rate,ESR)在老年肺部感染中的临床应用价值。方法:老年肺部感染100例,所有病例均在第1天、第3天、第7天、第14天凌晨采静脉血测定CRP、ESR和白细胞计数。结果:①经有效治疗后各数值较治疗前均明显下降(P<0.01)。②2血清CRP较ESR下降迅速(P<0.01)。③CRP阳性率明显高于ESR和WBC(P<0.01)。结论:血清CRP与ESR均为临床老年肺部感染诊断和治疗评价的有效指标。CRP有助于老年肺部感染的早期识别及感染严重程度的判定,并且能迅速准确的反应抗生素的疗效,是明显优于ESR、WBC的有效炎症指标,为临床老年肺部感染诊断和治疗评价的有效指标。     

产褥期发热患者CRP检测对预防产褥感染意义分析

目的:探讨产褥期发热患者检查血清C-反应蛋白(CRP)对预防产褥感染的意义。方法:回顾性分析该院妇产科2012年9月~2014年5月收治的48例(研究组)产后发热产妇的临床资料,并选择同期分娩后未发热产妇50例作为对照组,比较两组产妇产前与产后48h内的CRP、白细胞介素-6(IL-6)、白细胞(WBC)水平的差异,分析产后研究组血清CRP水平与WBC、IL-6的相关性,同时根据CRP不同水平进行分组,比较最终临床确诊感染患者数量差异。结果:产后研究组和对照组的CRP、WBC及IL-6较产前均显著升高(P<0.05);产后研究组CRP、WBC及IL-6较对照组升高更加显著(P<0.05);研究组48例产妇产后的CRP水平与WBC、IL-6进行相关性分析,结果 CRP水平与WBC、IL-6均呈显著的正相关〔(r=0.457,P=0.001),(r=0.541,P=0.000)〕;CRP>5 mg/L组并发产褥感染28.57%显著高于CRP≤5 mg/L组的3.70%。结论:产后检测产妇的CRP水平,对于判断产妇并发产褥感染并采取及时治疗具有一定的价值。     

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.