浙江省HIV-Ⅰ流行毒株GAG基因序列测定和亚型分析

[目的]利用分子生物学方法了解浙江省境内HIV-Ⅰ流行毒株的亚型.[方法]采集14份浙江省检出的HIV-Ⅰ抗体阳性者的抗凝全血,从中提取前病毒DNA作为PCR扩增的模板,设计特异性引物对gag基因区进行扩增并测定其序列.所得序列与国际标准或参考序列进行比较,确定亚型.[结果]14份样本中有9份扩增阳性并得到相应序列,扩增率为64.3%.经过离散率计算和系统树分析后证实4份样本为A/E流行重组模式,3份样本为B亚型,1份样本为B/C流行重组模式,1份样本为G亚型.[结论]目前浙江省境内有多种亚型的HIV-Ⅰ毒株存在.迫切需要对高危人群进行宣传教育和行为干预措施以阻断HIV/AIDS的流行和传播.     

上海口岸2001—2005年HIV-1病原体变异分子流行病学研究

〔目的〕了解上海口岸2001—2005年艾滋病病毒I型感染者（HIV-1）毒株基因亚型分布、变异情况及流行特征。〔方法〕收集2001—2005年上海口岸51份HIV抗体检测确认阳性的血样标本,提取前病毒DNA,使用套式聚合酶链反应进行体外扩增,获得核心蛋白（gag）和包膜蛋白（env）区基因的核酸片段,测定其序列和进行亚型分析。〔结果〕37份标本扩增阳性,共检出8个亚型,包括B亚型11份;CRF01-AE10份;CRF02-AG5份;A亚型4份;C亚型4份;G亚型、B’,和CRF07_BC亚型各1份。上海口岸毒株亚型分布于五大洲15个国家和地区,主要流行CRF01-AE和B亚型,从2004年开始出现其它亚型逐渐增多趋势。〔结论〕上海口岸流行的HIV-1毒株复杂多样,出入境人员是我国HIV毒株输入的主要渠道,流行毒株以性接触传播为主,AE重组毒株具有较强的传播优势。     

广东国际旅行人员HIV-1基因亚型分析

〔目的〕通过对广东口岸国际旅行人员中HIV感染者的亚型分析,监测HIV毒株的流行状况及其变化。〔方法〕从22份HIV-1抗体阳性样品中提取RNA或DNA,逆转录后或直接巢式PCR扩增HIV env及gag基因,对PCR产物进行核苷酸序列测定和分析,确定基因亚型。〔结果〕22份样品中共发现8种HIV-1亚型和重组型,其中CRF-BC重组型8份,CRF01-AE重组型4份,C亚型2份,B亚型2份,A1、G、J亚型及CRF02-AG重组型各1份,2份样品分型不明确。这些不同亚型的感染者来自包括中国在内的8个不同国家。〔结论〕国际旅行人员中HIV-1亚型和重组型种类复杂多样,是我国HIV毒株输入的主要来源。监测国际旅行人员中HIV感染者基因型分布及其变异,及时发现新型毒株对于艾滋病的预防和控制十分重要。     

济宁市2例艾滋病病毒感染者HIV—1毒株包膜蛋白基因序列测定

目的 了解济宁市HIV－1毒株亚型变异情况。方法 应用套式－PCR方法对2例HIV－1感染者的外周血单核细胞样本进行扩增,对C2－V3区核苷酸序列进行测定和分析。结果 所采样本均属HIV－1B亚型,与其他国际亚型的基因离散率在15％以上,与流行于云南省的B亚型毒株基因离散率为3.49%.结论 流行于济宁市的HIV－1毒株属B亚型,与云南省流行株密切相关,流行时间约3－4年。     

HIV-1 gp41基因片段亚型多样性研究

〔目的〕应用HIV-1 env gp41基因分型技术进行出入境HIV感染者HIV-1亚型多样性研究。〔方法〕采用套式逆转录PCR方法对env gp41和gp120(C2-V3区)进行基因扩增、测序、亚型对比分析,以及应用威斯康星GCG公司软件进行系统树分析和用美国Los Alamos国家实验室的HIV-Blast软件进行序列的亚型鉴定。〔结果〕对22份样本的gp41和gp120(C2-V3区)的基因亚型进行对比分析,结果表明gp41和gp120(C2-V3区)在亚型上具有一致性。对65例来自中国、非洲、欧洲、美洲和东南亚的出入境HIV-1阳性者进行gp41扩增基因亚型分析,发现有A、B、C、D、F1、G亚型和重组亚型AC、01_AE、02_AG、07_BC、08_BC、06_cpx、18_cpx共计13种亚型,其中重组株占33.8%(22/65)。中国籍出入境感染者包括了A、B、C、D、F1、G亚型和重组亚型01_AE、02_AG、07_BC、08_BC在内的10种亚型,其中重组株占25%(7/28)。〔结论〕用gp41替代gp120(C2-V3区)进行HIV-1亚型分析较为理想。出入境人群中HIV感染者感染的HIV毒株几乎包括了全球流行的所有亚型,多种国内少见的亚型已经通过国际旅行者传入国内。     

陕西省HIV-Ⅰ流行毒株亚型分析

目的了解陕西省近年来发现的人类免疫缺陷病毒（HIV）感染者所携带毒株的基因序列特征、亚型种类和毒株来源以及在各高危人群中的分布,推断其传播来源和流行趋势,为本省艾滋病防治工作提供技术资料。方法对HIV感染者进行流行病学相关因素调查,无菌采集HIV感染者抗凝全血,提取前病毒DNA,应用套式聚合酶链式反应（nested-PCR）扩增其膜蛋白基因env,对其C2～V3区及邻区的核苷酸序列进行测定,用GCG软件（Wisconsin公司）进行亚型分析。结果35份样本PCR扩增阳性并得到相应序列。经基因离散率计算和系统树分析,共发现4种HIV-1基因亚型和重组毒株,即HIV-1 B’、C、CRF01-AE和CRF-BC重组型。其中泰国B’亚型为主要流行株,占82.35%（28/34）,主要来源于既往采供血者及其配偶;其次是CRF-BC重组型,占11.77%（4/34）,主要来源于吸毒人群：CRF01-AE和C亚型各1份,分别占2.94%,均来自劳务输出的归国人员。该组样本B’亚型内的基因离散率为5.2%（n=23）;而CRF-BC亚型内的基因离散率为0.9%（n=3）,彼此间显示出较近的传播关系。结论陕西省HIV-1流行株以泰国B’亚型为主,发生在与既往有偿采供血相关的地区和人群,已有6～7年的流行史;首次在当地吸毒人群中发现HIV-1 CRF-BC重组型,并且显示近期高度流行的趋势。加强对既往有偿献血人群和吸毒人群的行为干预,控制HIV病毒在家庭内和吸毒人群中的传播,将是今后本省艾滋病防治工作重点之一。     

四川省HIV- 1 流行毒株的基因序列测定和亚型分析

使用PCR对 9份采集于 1996年中旬的四川省经血液途径感染的HIV - 1阳性感染者外周血单个核细胞 (PBMCs)样品进行扩增 ,获得HIV - 1膜蛋白 (env)基因的核酸片段 ,并对其C2-V3及邻区 350～ 4 50个核苷酸序列进行了测定和分析。结果表明 ,9份样品中存在B和C两种亚型的HIV - 1毒株序列 ,其中B亚型 5份 ,彼此间的基因离散率为 1.4 % ;C亚型 4份 ,在不包括sc3号样品的情况下彼此间的基因离散率为 2 .6% ,而sc3号样品与其它 3份样品在核苷酸序列上的差异却达 11.5%。与A～E参考亚型及部分B和C亚型代表株序列相比较 ,属四川B亚型的 5个毒株与包括泰国、缅甸及中国云南德宏在内的B亚型毒株序列十分接近 ,基因离散率在 3.6%～4 .3%的范围内 ;属四川C亚型的 4个毒株除sc3外则与代表印度毒株的C亚型共享序列及德宏C亚型毒株序列十分相似 ,其基因离散率均为 3.1% ,与非洲C亚型毒株nof的基因离散率为13.1% ,而sc3号序列与印度、中国德宏和非洲C亚型HIV - 1的基因离散率却在 10 .1%～ 17.2 %的范围内。提示 ,HIV - 1在四川的流行时间不长 ,且其B和除sc3之外的C亚型毒株的传入与流行在云南德宏州的相同亚型HIV - 1毒株密切相关 ,而由sc3所代表的C亚型毒株则存在目前还尚不了解的其它传入来源。     

湖州市不同感染人群HIV-1流行毒株亚型分析

目的了解湖州市HIV-1型流行毒株的基因型分布情况,为艾滋病防治工作提供科学依据。方法采集204份HIV-1型抗体阳性的全血标本,从样本中提取病毒RNA,采用巢式PCR方法扩增病毒gag基因,对PCR产物进行核苷酸序列测定。应用Clustal W软件对测序结果和HIV分型参考株序列进行多序列比对和分析;使用MEGA 4.0软件进行系统进化分析。结果 204份标本有138份样品扩增出HIV-1的gag基因片段,共存在4种HIV-1亚型和重组型。其中CRF07_BC重组亚型74株(53.62%)、CRF01_AE重组亚型40株(28.99%)、B亚型12株(8.69%)、CRF08_BC重组亚型12株(8.69%)。异性、同性性传播以CRF07_BC和CRF01_AE为主;注射吸毒传播以CRF07_BC为主。结论湖州市不同感染人群中主要存在4种基因亚型,CRF07_BC已成为湖州市不同感染人群中HIV主要流行亚型,重组型毒株占优势,应加强对HIV-1流行毒株亚型变异的监测,及时调整防控策略。     

HIV-1重组毒株gag区快速基因分型方法

目的建立一种简便、快速基因分型方法,对广西人类免疫缺陷病毒（HIV-1）重组毒株gag基因区进行亚型鉴定。方法从HIV阳性样本中提取核酸,使用HIV-1 M组通用引物对gag区进行第1轮扩增,第2轮使用分别检测C亚型和CRF01-AE重组型的二套特异性引物放入同一反应管中进行扩增,根据不同亚型扩增的目的带位置不同判断亚型。另外设计了一套引物,专门用于检测B’/C重组毒株。扩增出的所有样本均进行基因测序和系统树分析以验证结果。结果54份样本中,经基因测序和系统树分析证实CRF08-BC样本4份（7.41%）,CRF01-AE样本46份（85.18%）,4份（7.41）无法确定亚型。经亚型特异性引物PCR法检测出4份（100%）B’/C重组毒株,45份（97.83%）CRF01-AE重组毒株,灵敏度为98%,特异性为100%。2种方法检测结果经差异性检验显示,P〉0.05,差异无统计学意义,结果一致性高达98.15%。与基因分析结果吻合。重复实验显示,B’/C的平均重复性为100%（20/20）,CRF01-AE为98.3%（59/60）。结论该方法具有简便、快速,高度灵敏度和特异性的特点,可直接对广西HIV-1重组毒株CRFO 1-AE gag基因区进行分型。     

湖北省HIV-1 B′亚型核心蛋白基因序列分析

目的 分析湖北省人类免疫缺陷病毒(HIV-1)主要流行株核心蛋白(gag)基因P17/24区序列特征,了解其流行特点和变异规律.方法 对湖北省HIV-1主要流行区域进行流行病学调查,应用巢式聚合酶链反应对102例HIV-1感染者的gag基因P17/24区进行扩增,对阳性扩增样本进行基因测序和序列分析.结果 湖北省共发现4种HIV亚型和重组亚型,B'亚型占82.69%,B'/C重组毒株、CRF01-AE重组毒株各占7.69%,C亚型占1.92%;基因序列分析显示,湖北省HIV-1 B'亚型与我国河南和云南省等地的毒株有较高的同源性;氨基酸序列变异分析显示,HIV-1 B'亚型毒株gag基因P17/24区发生不同程度的变异,P17突变位点较多,P24较为保守.结论 B'亚型依然是湖北省HIV优势流行株,HIV-1在湖北省有加快流行和进一步复杂化的趋势.     

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.     

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.     

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.