唐山地区人体内有机氯农药蓄积水平调查

目的探讨唐山地区女性体内有机氯农药的蓄积水平。方法选择2006年4月～2007年6月在唐山市各大医院就诊,且在唐山地区居住10年以上的女性居民,收集其血清样品1ml,用气相色谱法测定血清中有机氯农药滴滴涕(DDT)和六六六(HCH)的残留量。结果唐山地区女性血清中HCH和DDT检出率均在80%以上,检出水平较高,各种HCH异构体的含量顺序为β-HCH﹥δ-HCH﹥α-HCH﹥γ-HCH,DDT异构体中以p,p’-DDT和p,p’-DDE为主;血清中p,p’-DDE、p,p’-DDT、γ-HCH、β-HCH及δ-HCH残留水平在不同年龄组差异有统计学意义;不同居住地区血清中有机氯农药残留水平比较差异无统计学意义;唐山震后农药不同暴露地区血清中p,p’-DDE及δ-HCH残留水平差异有统计学意义,高暴露地区高于低暴露地区。结论唐山地区女性血液中有机氯农药DDT及HCH有一定的蓄积。     

唐山震后有机氯农药暴露与乳腺癌关系的病例对照研究

目的探讨唐山震后有机氯农药暴露与乳腺癌发生的关系。方法收集2006年4月—2007年6月在唐山市3家医院就诊的经病理学确诊的新发女性乳腺癌患者150例,以同期住院的非肿瘤、非生殖内分泌系统疾病的女性患者为对照,进行1∶1配比的病例对照研究。在进行流行病学调查的同时用气相色谱法测定血清中有机氯农药滴滴涕(DDT)和六六六(HCH)的含量。应用条件Logistic回归模型分析有机氯农药残留与乳腺癌发病的关系。结果 p,p’-DDD及o,p’-DDT两组检出率比较差异有统计学意义,病例组高于对照组;血清中p,p’-DDE、α-HCH及δ-HCH残留水平在乳腺癌病例组和对照组差异有统计学意义,病例组高于对照组,唐山震后农药不同暴露地区血清中δ-HCH、p,p’-DDE及o,p’-DDT残留水平差异有统计学意义,高暴露地区高于低暴露地区;多因素条件Logistic回归分析显示震后农药高暴露、p,p’-DDE和p,p’-DDT均与乳腺癌的发生有关联,OR值分别为6.592(95%CI:1.402～31.002)、2.405(95%CI:1.033～5.600)和1.845(95%CI:1.028～3.353)。结论环境有机氯农药暴露可能是乳腺癌发生的危险因素;唐山震后农药的高暴露可能增加当地乳腺癌的发病危险。     

产妇体内有机氯农药残留对血中4种生殖激素水平的影响

[目的]探讨有机氯农药污染区产妇静脉血中有机氯农药目前的残留水平及其对血中生殖激素的影响。[方法]抽取2004年1月1日至4月30日在湖北省天门市妇幼保健院住院分娩的产妇71名，分别采集产妇静脉血和脐带血样各1份，采用磁性分离酶联免疫法检测其中的促卵泡激素（FSH）、黄体生成激素（LH）、雌二醇（E2）、孕酮（P）水平。同时，采用气相色谱附电子捕获器（GC—ECD）方法检测产妇静脉血中有机氯农药的残留水平。[结果]①有机氯农药污染区产妇静脉血中六六六和DDT的8种主要代谢产物在低、中、高残留组均有不同程度检出，总六六六的检出量明显高于总DDT，低残留组为4.1与0.0μg/L，中残留组为13．2与5．5μg/L，高残留组为50.0与41．8μg/L；各组总有机氯的检出量均数分别为〈0．005、4．95、24.10、98．70μg/L，经统计学检验差异有显著性（P〈0.05）。（参产妇血中总有机氯残留水平与产妇血和脐带血中FSH、LH、E2和P的改变有关，并呈现剂量-效应关系（P〈0．05）。③相关分析表明，产妇血和脐带血中FSH、LH、E2和P水平呈现明显的相关关系；产妇血中总有机氯残留水平与产妇血中E2和P呈现负相关（r=-0．5158，P=0．0238；r=-0．6491，P=0.0026）。[结论]人体内有机氯农药残留可能与血中生殖激素水平的改变有密切关系。     

体内有机氯农药残留水平与CYP1A1、GSTMl、GSTT1基因多态性的交互作用对女性乳腺癌发病的影响

[目的]探讨体内有机氯农药残留水平与CYP1A1、GSTM1、GSTT1基因多态性的交互作用对女性乳腺癌发病的影响. [方法]用1:1配比的病例对照研究方法,自2006年9月～2007年10月收集女性乳腺癌病例及对照共70对.采用气相色谱法(GB/TS009.19-2003)检测血清中有机氯农药残留水平,用聚合酶链反应(PCR)检测细胞色素P4501A1 Msp Ⅰ(CYP1A1 Msp Ⅰ)、谷胱甘肽S-转移酶M1(GSTM1)和谷胱甘肽S-转移酶T1(GSTT1)3个位点的基因多态性.[结果]携带CYP1A1 MspⅠ突变等位基因与有机氧农药(HCH/DDT)高残留存在交互作用,交互作用系数γ分别为1.558和8.491;携带GSTT1缺失型基因与DDT高残留存在交互作用,交互作用系数γ为1.726. [结论]CYP1A1 MapⅠ突变基因型、GSTT1缺失基因型对有机氯农药的残留效应有放大作用.     

体内有机氯农药残留水平与CYP1A1、GSTM1、GSTT1基因多态性的交互作用对女性乳腺癌发病的影响

[目的]探讨体内有机氯农药残留水平与CYP1A1、GSTM1、GSTT1基因多态性的交互作用对女性乳腺癌发病的影响。[方法]用1︰1配比的病例对照研究方法,自2006年9月～2007年10月收集女性乳腺癌病例及对照共70对。采用气相色谱法(GB/T5009.19-2003)检测血清中有机氯农药残留水平,用聚合酶链反应(PCR)检测细胞色素P4501A1Msp I(CYP1A1Msp I)、谷胱甘肽S-转移酶M1(GSTM1)和谷胱甘肽S-转移酶T1(GSTT1)3个位点的基因多态性。[结果]携带CYP1A1Msp I突变等位基因与有机氯农药(HCH/DDT)高残留存在交互作用,交互作用系数γ分别为1.558和8.491;携带GSTT1缺失型基因与DDT高残留存在交互作用,交互作用系数γ为1.726。[结论]CYP1A1Msp I突变基因型、GSTT1缺失基因型对有机氯农药的残留效应有放大作用。     

有机氯农药残留及GSTM1基因与女性乳腺癌关系

目的研究血清中有机氯农药残留及谷胱甘肽转移酶M1(GSTM1)基因多态性与女性乳腺癌患病风险的关系。方法运用1∶1配比病例对照研究方法,自2006年9月-2007年10月收集女性乳腺癌病例及对照共70对,采用气相色谱法检测血清中有机氯农药残留,用聚合酶链反应(PCR)检测GSTM1基因多态性。结果2型交互作用模型分析结果显示,单独暴露于滴滴涕(DDT)高残留的OR值为3.859,95%CI=1.195～12.466,单独GSTM1缺失基因型的OR值为1.343,95%CI=0.355～5.075,两因素共同作用的OR值为5.557,95%CI=1.633～18.903,r值为1.237,提示GSTM1缺失基因型对血清DDT残留效应有放大作用;单独暴露于六六六(HCH)高残留的OR值为2.731,95%CI=0.841～8.869,单独GSTM1缺失基因型的OR值为1.483,95%CI=0.478～4.603,两因素共同作用的OR值为3.866,95%CI=1.178～12.682,r值为1.379,提示GSTM1缺失基因型对血清HCH残留效应有放大作用。结论GSTM1基因多态性与环境危险因素DDT、HCH暴露在乳腺癌发生中存在一定的交互作用。     

宁波市鲜活水产品有机氯农药残留现状及对策分析

目的了解宁波市市售鲜活水产品中有机氯农药的残留现状。方法随机选择35个采样点，共采集230份样品，采用气相色谱方法进行农药含量检测。结果“六六六”检出范围为ND～0．402mg／kg，超标率5．2％；“滴滴涕”检出范围为ND～0．370mg/kg，未超标。“六六六”除鲫鱼外，其他各种类都有超标，超标率最高的是鳊鱼（9．5％），“六六六”超标率在海水产品和淡水产品中差异无统计学意义；“滴滴涕”检出率最高的是黄鱼（67．7％）。结论宁波市鲜活水产品中主要的有机氯农药残留污染物是“六六六”，需要加强水产品养殖、销售中有机氯农药残留的监测和管理。     

中国居民膳食中农药残留的研究

目的 探讨中国居民膳食中农药残留的变化趋势。方法 采用总膳食研究，通过对全国四个区域代表性混合食物样品的调查，了解各类食物样品中农药残留量；根据食物消费量，获得我国居民膳食农药残留摄入量，并与允许摄入量比较；对于污染的食物样品进一步溯源性分析。结果 我国居民2000年每人每天膳食有机氯农药六六六(HCH)总摄入量为3．11μg，滴滴涕(DDT)总摄入量不足FAO／WHO农药残留联席会议(2000)提出的每日摄入耐受量(PTDI)(0．01mg／kg bw)的1％。与1990年相比，2000年我国居民从动物性食品中摄入的HCH有所增加，主要来自北方一区和南方二区水产类样品中林丹的污染。2000年中国总膳食研究在谷类、蔬菜和水果三类食物的混合样品中均未检出有机磷农药残留。结论 我国居民2000年膳食农药残留摄入处于低水平，且有机磷农药的滥用现象得到了明显的改善。     

闽北山区茶叶中农药残留状况及评价

[目的]调查分析南平市茶叶主产区的农药使用状况及茶叶中的农药残留水平。[方法]调查各产茶区的农药使用情况；运用气相色谱仪，按国标方法，测定随机抽取的164份样品的农药残留量。[结果]茶叶中检出的农药残留品种有：有机氯类(六六六、DDT、艾氏剂、三氯杀螨醇)、有机磷类(敌敌畏、乐果、氧化乐果)、拟除虫菊酯类(联苯菊酯、功夫菊酯、氯氰菊酯、氰戊菊酯、甲氰菊酯、二氯苯醚菊酯)。残留量超出国标的品种有六六六；超出欧盟标准的有联苯菊酯、功夫菊酯、氯氰菊酯和氰戊菊酯。有机磷类农药残留水平均在国标之内。[结论]南平市茶叶中农药残留整体偏低。但产茶区间呈现不平衡，个别茶叶品种农药残留水平相对较高些，政和、松溪、浦城和建阳相对残留水平较低。     

松花江肇源段水和沿岸土壤及作物中六六六和DDT的残留水平

目的了解松花江上游肇源江段水和沿岸农田土壤、粮食中有机氯农药的残留状况。方法于2008年6月,在松花江上游肇源江段10个断面采集水、沿岸土壤(稻田、菜地、绿化带)、粮食样本,分别测定六六六类和DDT类农药及其各种异构体残留量。结果松花江上游肇源江段水、土壤、粮食(玉米、大米、高粱、小米、黄豆、绿豆)中六六六类、DDT类农药均被检出。水中六六六类农药浓度水平有高至低依次为δ-六六六β-六六六α-六六六γ-六六六,DDT类农药浓度水平由高至低依次为p,p’-DDEp,p’-DDTo,p’-DDT。松花江沿岸农田土壤中六六六类农药残留量由高至低依次为菜地稻田绿化带。与菜地土壤比较,绿化带和稻田土壤中DDTs类农药残留水平均较低,差异有统计学意义(P0.05)。松花江沿岸粮食样品中六六六类和DDT类农药的同分异构体含量依次为δ-六六六α-六六六β-六六六,p,p’-DDEp,p’-DDTp,p’-DDD。无论是松花江沿岸水、土壤还是粮食中DDT类农药的残留量都高于六六六残留量,差异有统计学意义(P0.05)。结论松花江上游肇源江段水体、不同土壤、粮食中仍有六六六类和DDT类农药残留,虽未超过国家标准,但对人体健康的潜在威胁仍不能忽视。     

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.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.     

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.     

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.     

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.