载脂蛋白E基因多态性对血脂的影响

[目的]探讨载脂蛋白E（ApoE）基因多态性对血脂的影响。[方法]采用聚合酶链式反应-限制性片段长度多态性分析方法（PCR-RFLP），测定252名河南省汉族研究对象的血脂及ApoE基因型。[结果]ApoE基因型以E3／3型常见为77．0％，等位基因频率ε2、ε3和ε4分别为5．7％、87．1％和7．5％。在不同基因型组间，总胆固醇（TC）和低密度脂蛋白胆固酵（LDL-C）水平均按E3／4＋E4／4〉E3／3〉E2／2＋E2／3顺序递减（P〈0．05），甘油三脂（TG）、高密度脂蛋白胆固醇（HDL-C）水平在各组间比较无差异（P〉0．05）。[结论]ApoE基因多态性影响血脂水平，ε4等位基因携带者有较高的TC，LDL-C水平（P〈0．05），ApoE基因多态性是个体间血脂水平差异的独立遗传因素。     

载脂蛋白E基因型与脂类代谢、脑梗死的关系

目的探讨载脂蛋白E（ApoE）基因型对脂类代谢、脑梗死的影响。方法应用聚合酶链式反应——限制性片断长度多态性（PCR—RFLP）技术检测脑血管病患者和健康对照的ApoE基因型分布特征。应用酶比色法检测血脂水平。结果不同ApoE基因型之间总胆固醇TC和低密度脂蛋白胆固醇（LDL—C）水平差异有统计学意义（P〈0．05）。结论ApoE。等位基因是脑梗死发病的遗传易患因子,而ApoE3等位基因则对脑梗死具有保护作用。ApoE基因型影响血脂水平。     

非典型冠状动脉痉挛患者血脂谱的变化

目的探讨非典型冠状动脉痉挛患者的血脂谱变化情况。方法选择有胸痛、胸闷且无明显冠脉狭窄、符合非创伤性诊断冠脉痉挛条件的患者76例（痉挛组），分析其各项血脂指标，并与显著冠脉狭窄患者（冠心病组）及非冠脉病变患者（对照组）进行比较。结果痉挛组和冠心病组的TC和LDL-C水平均显著高于对照组（P〈0．05，P〈0．01），而HDL-C显著低于对照组（P〈0．05）；痉挛组患者的HDL-C和ApoAI显著高于冠心病组（P〈0．05），冠心病组患者的TG水平显著高于痉挛组和对照组（P〈0．05）。3组的ApoB差异无统计学意义（P〉0．05）。结论非典型冠脉痉挛患者与冠脉狭窄患者均存在明显的血脂代谢紊乱。     

急性脑梗死患者脂蛋白a的测定

目的研究急性脑梗死患者与脂蛋白a水平的关系。方法选择本院2010年8月～12月急性脑梗死住院患者65例为病例组和健康体检者53例为对照组，并检测两组患者血压、血糖、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、脂蛋白a（LPa），两组结果进行统计学分析。结果急性脑梗死组与对照组年龄、TG、TC、HDL、LDL之间的差异无统计学意义（P〉0．05）。收缩压、舒张压、血糖、LPa之间的差异有统计学意义（p〈0．05）。急性脑梗死组LPa阳性检出率明显高于对照组，经卡方检验（P〈0．05），差异有统计学意义。结论LPa与急性脑梗死密切相关，可作为急性脑梗死的危险因素。监测LPa能为临床预防和治疗脑梗死提供依据。     

同型半胱氨酸水平与老年冠心病的关系

目的探讨同型半胱氨酸（Hey）水平与老年冠心病的关系。方法检测141例老年冠心病患者（老年冠心病组）、82例非老年冠心病患者（非老年冠心病组）和65例老年健康体检者（健康老年对照组）的Hcy、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白一胆固醇（HDL-C）、低密度脂蛋白-胆固醇（LDL-C）水平，对老年冠心病组Hcy的分布特征及相关因素进行统计分析。结果老年冠心病组和非老年冠心病组Hcy水平显著高于健康老年对照组，差异有统计学意义（P〈0．01），老年冠心病组Hcy水平高于非老年冠心病组，但差异无统计学意义（P〉0．05）；老年冠心病组中男性患者Hcy水平高于女性（t=16．790，P〈0．05）；将所有女性患者以50岁为界分为两组，两组间Hcy水平比较差异有统计学意义（t=2．740，P〈0．05），显示绝经期后Hcy水平显著升高；老年冠心病组Hcy水平与年龄呈正相关。结论老年冠心病患者Hcy水平显著增高，男性高于女性，且Hcy水平与年龄呈正相关，与TC、TG、LDL-C、HDL-C无相关性，高Hcy血症是老年冠心病的独立危险因素之一。     

高血压病人血脂和脂蛋白水平变化与肾损害的关系

目的探讨高血压病人血脂、脂蛋白水平变化与肾损害的关系。方法将106例高血压患者分为高血压未发生肾损害组（n=44）、高血压早期肾损害组（n=40）、高血压肾损害组（n=22），以104例血压正常者作为对照组，检测血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白A1及B（apoA1、apoB）、脂蛋白（a）[LP（a）]，进行比较分析。结果高血压病人血清TC、TG、HDL—C、LDL-C、apoB、LP（a）水平明显高于正常对照组，差异有显著性意义（P均〈O．01），HDL-C水平明显高于正常对照组p〈0．05）。TC、LDL—C、apoB水平随高血压早期肾损害的加重呈现升高的趋势，高血压肾损害组病人血清LP（a）水平及异常率明显高于高血压早期肾损害组和未发生肾损害组，差异有显著性意义（p〈0．05，p〈0．01），其余各指标异常率均无显著性意义。结论高血压病人存在着明显的脂质异常，高血压肾损害与脂质代谢紊乱相关联，肾损害加重脂质代谢紊乱。     

载脂蛋白B基因3''''-VNTR多态与长沙地区脑血管病的关系研究

目的探讨载脂蛋白B基因(apolipoproteinB,apoB)3'端可变数目串联重复序列(variablenumble of tandem repeats,3'-VNTR)多态与长沙地区脑血管病的关系.方法采用聚合酶链式反应(PCR)结合聚丙烯酰胺凝胶电泳分析130例脑梗死患者、130例脑出血患者、100例对照组人群apoB基因3'-VNTR多态;并采用氧化酶法测定血清甘油三脂(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL),运用酶联免疫吸附法测定LP(a)浓度,免疫比浊法测定apoB-100及apoAI浓度.结果脑梗死组的apoB基因3'-VNTR的B等位基因频率(0.150)高于对照组(0.080)(P<0.05);脑出血组apoB基因3'-VNTR的B等位基因频率(0.077)与对照组无显著差别.脑梗死组中,B/S或B/B基因型亚组的TC、TG、LDL-C水平明显高于S/S基因型(P<0.05);脑出血组中,B/S或B/B基因型亚组的各项血脂水平与S/S基因型无显著差别.结论1、长沙地区脑梗死可能与apoB基因3'-VNTR多态有关,而脑出血与之无关.2、apoB基因3'-VNTR多态B等位基因可能通过影响血脂水平增加脑梗死易感性.     

2型糖尿病与超敏C-反应蛋白和血脂的关系

目的观察2型糖尿病与超敏C-反应蛋白（hs—CRP）和血脂的关系。方法选取40例2型糖尿病患者（观察组）,同时选取40例健康志愿者（对照组）,均于清晨空腹采集静脉血,分离血清,利用全自动生化分析仪检测血清中hs—CRP、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）和高密度脂蛋白胆固醇（HDL—C）的含量,比较两组各生化指标的差别。结果观察组hs—CRP、TG、TC、LDL—C均明显高于对照组,差异有统计学意义（P〈0．05）;观察组HDL—C明显低于对照组,差异亦有统计学意义（P〈0．05）。结论hs—CRP和血脂与2型糖尿病有密切的关系,糖尿病患者应定期检测血脂,有效地控制血脂水平,以对糖尿病及并发心血管等疾病的诊断、治疗和预防提供依据。     

2型糖尿病血脂改变与脑梗死的临床研究

目的探讨2型糖尿病患者血脂改变与脑梗死的关系,为脑梗死患者早期治疗提供依据。方法将2型糖尿病合并脑梗死患者40例为观察组,同期精尿病无脑梗死患者38例为对照组,检测两组血清胆固醇（TC）、甘油三酯（TG）、LDL-C（低密度脂蛋白）、HDL—C（高密度脂蛋白）、载脂蛋白A（APOA）、载脂蛋白B（APOB）进行研究。结果两组间TC差异无统计学意义（P〉0．05）,TG、LDL—C、HDL—C、APOA、APOB差异有统计学意义（P〈0．01）。结论2型糖尿病患者的血脂改变与脑梗死有密切关系。     

脑血管病患者血脂、脂蛋白及载脂蛋白AI、B100测定的临床意义

目的 研究脑血管病患血脂，脂蛋白及载脂蛋白AI（apo AI），载脂蛋白B100（apoB100)测定的临床意义。方法 脑血管病人及健康人均晨起空腹静脉抽血，血清TC，TG及HDL－C采用酶法试剂盒及生化仪测定；apoAI,B100和免疫周围扩散法；LDL－C用Friedewald公式计算，即LDL-C=TC-(1/5TC＋HDL－C）。结果 脑动脉硬化组及脑梗死组与健康对照组的血脂，脂蛋白及apoAI,B100含量的比较，经过统计学处理，均有显差异至极显差异（P＜0．05－0．001）。脑出血组除TG有显差异（P＜0．05）外，其余均无显差异（P＞0．05）。结论 载脂蛋白测定对脑血管疾病预测的敏感度远比血脂及脂蛋白高。     

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.