广西2007－2012 年结核分枝杆菌和艾滋病病毒联合感染患者死亡特征分析

目的 了解2007－2012 年广西结核分枝杆菌（MTB）/HIV 联合感染患者死亡特征,为有效控制联合感染提供科学依据。方法 收集整理2007－2012 年广西死因登记系统（VRS）中根本死因为HIV造成MTB感染死亡的个案及死因诊断为结核病（TB）的患者,核对病例在TB专报系统的实验室检测结果、诊断时间、发病时间等信息;用统计学方法统计分析病例的三间分布、死亡平均年龄、从发病到死亡时间间隔等特征。结果 2007－2012 年广西VRS登记的HIV 死亡患者中,203 例因感染MTB死亡,MTB/HIV联合感染死亡患者占同期AIDS、TB死亡患者的平均比例为8.24%（3.94%～13.27%）和9.90%（2.56%～26.88%）。2010－2012 年,MTB/HIV 死亡患者占同期AIDS、TB死亡患者的平均比例上升到10.66%和22.17%;MTB/HIV 联合感染死亡患者男女比例为4.21 ∶ 1;平均死亡年龄为44.65（44.65±15.52）岁;从TB发病到诊断时间M为37（94.31±206.07）d;从诊断到死亡平均间隔M为46（165.22±282.19）d;54.68%的MTB/HIV患者在诊断TB2 个月内死亡;从发病到死亡时间M为131（257.68±340.79）d;16.26%的联合感染死亡患者被细菌学确诊为TB病例。结论 细菌学确诊的MTB/HIV患者比例少于HIV阴性TB患者;而MTB导致的联合感染死亡患者占同期AIDS、TB死亡比例较大,且近3 年增加明显,需要增加抗病毒治疗覆盖面;大部分联合感染患者诊断TB后很快死亡,应尽早在HIV患者中发现TB患者。     

天津市2005-2017年医疗机构新报告HIV/AIDS特征分析

目的 分析天津市2005-2017年医疗机构新报告HIV/AIDS特征,为更好地在医疗机构中开展相关的艾滋病防治工作提供依据。方法 对新报告HIV/AIDS的流行病学调查及随访资料进行分析,同时回顾调查2005-2017年医疗机构新报告HIV/AIDS的科室来源及主要就诊疾病。结果 2005-2017年天津市医疗机构新报告HIV/AIDS 3 035例,医疗机构报告HIV/AIDS病例年均增长24.8%,其中49.2%（1 343/2 728）来源于住院病例,50.8%（1 385/2 728）来源于门诊病例,性病门诊就诊者检测在2011-2017年HIV阳性检出率呈现增长趋势（χ²=18.469,P=0.005）;医疗机构住院病例、门诊病例首次CD₄⁺T淋巴细胞计数（CD₄）（χ²=17.189,P=0.000）及新报告当年发生死亡比例（χ²=61.198,P=0.000）差异有统计学意义;二级医院与三级医院新报告HIV/AIDS首次CD₄值（χ²=16.751,P=0.000）及新报告当年发生死亡比例（χ²=18.926,P=0.000）差异有统计学意义;不同科室新报告HIV/AIDS首次CD₄值（χ²=37.620,P=0.000）及新报告当年发生死亡比例（χ²=95.489,P=0.000）差异有统计学意义。结论 2005-2017年天津市医疗机构门诊新报告HIV/AIDS较为及时,二级医院新报告HIV/AIDS比三级医院及时。在医疗机构重点科室门诊积极倡导医务人员中主动提供HIV检测服务,对于天津市艾滋病防治工作具有重要意义。     

河南省2002-2019年抗病毒治疗15岁及以上HIV/AIDS死亡状况分析

目的 分析河南省抗病毒治疗（ART）≥ 15岁HIV/AIDS的死亡状况,为降低HIV/AIDS病死率提供参考依据。方法 资料来源于艾滋病综合防治信息系统2002-2019年河南省开始ART ≥ 15岁HIV/AIDS,采用回顾性队列研究方法,应用Cox比例风险回归模型分析HIV/AIDS死亡的相关因素。采用SPSS 23.0软件进行统计学分析。结果 研究对象共72 986例HIV/AIDS,死亡16 634例,死亡病例以年龄≥ 40岁（68.5%,11 393/16 634）、男性（62.6%,10 419/16 634）、血液传播感染（71.7%,11 927/16 634）、农民/农民工（91.7%,15 249/16 634）为主。以因艾滋病相关疾病死亡为主（73.7%,12 261/16 634）,病死率为16.8%（12 261/72 986）。34.6%（4 237/12 261）的HIV/AIDS在开始ART第1年因艾滋病相关疾病死亡,开始ART第10年和第18年的累积生存率分别为78.3%和71.8%。≥ 15岁HIV/AIDS开始ART的基线CD4⁺T淋巴细胞计数（CD4）<200个/μl的比例为45.5%（30 432/66 898）。Cox比例风险回归模型分析结果显示,研究对象基线CD4<200个/μl组和200~个/μl组的死亡风险分别是≥ 350个/μl组的1.78倍（95% CI：1.64~1.94）和1.24倍（95% CI：1.13~1.36）;基线有症状的死亡风险是无症状的1.25倍（95% CI：1.16~1.35）;最近1次病毒载量值≥ 1 000拷贝数/ml的死亡风险是<1 000拷贝数/ml的7.09倍（95% CI：6.65~7.54）。结论 2002-2019年河南省ART ≥ 15岁HIV/AIDS的死亡病例以血液传播感染和农民/农民工为主,艾滋病相关疾病是导致HIV/AIDS死亡的主要原因。随着河南省逐步推行ART策略,HIV/AIDS能长时间保持较高的生存率。应继续加强CD4检测工作,尽早纳入符合条件的HIV/AIDS进行规范化ART,以降低病死率、提高生存质量。     

浙江省台州市1998-2022年HIV/AIDS死因分析

目的 了解台州市1998-2022年HIV/AIDS的死亡情况和死因。方法 资料来源于中国疾病预防控制信息系统的艾滋病综合防治信息系统和台州市慢性病信息管理系统,以1998-2022年现住址为台州市的5 126例HIV/AIDS为研究对象,用SAS 9.4软件进行秩和检验、χ²检验及趋势分析。结果 1998-2022年HIV/AIDS死亡796例,病死率为15.53%（796/5 126）,病例在确证后1年内死亡占52.26%（416/796）。年初尚存活病例在年内死亡的构成比呈下降趋势（趋势χ²=5.60,P<0.001）。在死因构成上,艾滋病140例（17.59%）、恶性肿瘤237例（29.77%）、心血管病99例（12.44%）、伤害58例（7.29%）、其他160例（20.10%）和不详102例（12.81%）。恶性肿瘤、心血管病和其他死因的死亡病例构成比随时间变化均呈上升趋势（趋势χ²=1.92,P=0.028;趋势χ²=2.81,P=0.003;趋势χ²=2.07,P=0.020）。在HIV/AIDS不同死因中,确证年龄、职业、婚姻状况、民族、文化程度和感染途径的差异有统计学意义（均P<0.05）。死因为心血管病者死亡年龄最大,死因为艾滋病的死亡距确证间隔时间最短且首次检测CD4⁺T淋巴细胞计数最低,死因不详者的确证至抗病毒治疗的时间间隔最长（均P<0.05）。结论 1998-2022年台州市HIV/AIDS的非艾滋病相关死亡的构成比较高,随时间变化呈上升趋势,要进一步加强HIV/AIDS慢性非传染性疾病的早期筛查、干预和治疗。     

天津市2004-2014年HIV/AIDS生存时间及影响因素

目的 了解天津市HIV/AIDS生存时间及影响因素。方法 统计2004-2014年全国艾滋病防治信息系统中天津市报告的全部HIV/AIDS,运用寿命表法和Kaplan-Meier方法计算生存时间及各年生存率,运用单因素及多因素Cox回归方法对生存时间的影响因素进行相关分析。结果 2 775例HIV/AIDS病例1年、3年、5年、10年、11年累计生存率分别为91%、88%、86%、79%和79%;AIDS患者的死亡风险高于HIV感染者（χ²=107.622,P<0.001）;多因素Cox比例风险回归分析发现,感染途径、病例来源、抗病毒治疗和首次CD₄⁺T淋巴细胞（CD₄）计数均是影响AIDS患者生存时间的因素。结论 早发现和早治疗能够明显降低HIV/AIDS的死亡风险,提高生存时间,应加强HIV/AIDS早发现和早治疗工作。     

2010年全国新报告HIV/AIDS病例接受规范化随访及效果分析

目的 分析2010年全国新报告HIV/AIDS病例（HIV/AIDS）接受规范化随访的效果。方法 使用艾滋病综合防治数据信息系统截至2015年12月31日的病例报告历史卡片和随访定时数据库，筛选出2010年新报告的病例，对其在2010-2015年期间接受规范化随访的情况进行分析，通过安全性行为比例、成功转介抗病毒治疗比例以及死亡情况等指标的变化评估随访效果。结果 2010年新报告、年龄≥14周岁的HIV/AIDS共40 335例，其中，男性占70.4%，汉族占72.0%，25～44岁年龄组占56.7%，小学及以下文化程度者占62.3%，未婚者占53.9%；异性传播、注射吸毒和同性传播分别占65.8%、15.0%和11.7%。40 335例HIV/AIDS每年接受规范化随访的比例逐年上升，趋势 χ²检验结果差异有统计学意义（χ²=3 749.77，P<0.01）；接受随访干预后，发生危险性行为的比例明显下降，2011-2015年安全性行为比例均>90%（趋势 χ²=16 971.98，P<0.01），但从同一病例角度，其接受全程规范化随访期间安全性行为比例为86.1%；符合抗病毒治疗标准的病例当年成功转介治疗的比例从2010年的56.5%上升到2015年的83.2%，呈现明显的上升趋势（趋势 χ²=2 504.86，P<0.01），注射毒品感染的HIV/AIDS接受抗病毒治疗的比例较低（2015年为64.7%）；HIV/AIDS病死率从2010年新报告时的12.4%下降到2015年的2.4%（趋势 χ²=4 935.89，P<0.01）。结论 实施规范化随访后，HIV/AIDS采取安全性行为的比例和及时转介接受抗病毒治疗的比例逐年上升，病死率有所降低。     

山东省抗病毒治疗HIV/AIDS生存状况及影响因素分析

目的 了解山东省抗病毒治疗HIV/AIDS的生存状况及影响因素。方法 运用Kaplan-Meier（K-M）法及累积发生函数（CIF）估算2003-2015年山东省抗病毒治疗HIV/AIDS的艾滋病相关死亡发生率、部分分布比例风险回归模型（F-G模型）分析生存状况及影响因素。结果 竞争风险存在时,K-M法计算艾滋病相关死亡累积发生率高于CIF。CIF估算5 593例治疗HIV/AIDS随访1、3、5、10年艾滋病相关死亡累积发生率分别为3.08%、4.21%、5.37%和7.59%。大专及以上文化程度（HR=0.40,95% CI：0.24~0.65）HIV/AIDS的艾滋病相关死亡发生危险较低,现住址在鲁西地区（HR=1.33,95% CI：1.01~1.89）、医疗机构检测发现（HR=1.39,95% CI：1.06~1.80）、治疗基线方案含NVP（HR=1.36,95% CI：1.03~1.88）、治疗基线临床症状Ⅲ/Ⅳ期（HR=2.61,95% CI：1.94~3.53）、诊断1年后接受随访（HR=2.02,95% CI：1.30~3.15）、诊断基线CD₄⁺T淋巴细胞计数（CD₄）≤ 200个/μl（HR=3.41,95% CI：2.59~4.59）、治疗基线CD₄ ≤ 350个/μl（HR=5.48,95% CI：2.32~12.72）的HIV/AIDS发生艾滋病相关死亡风险高。结论 竞争风险存在时,K-M法高估艾滋病相关死亡累积发生率,优选竞争风险模型进行生存分析;早诊断、及时随访、早治疗可降低HIV/AIDS艾滋病相关死亡。     

北京市1995-2015年艾滋病病例诊断后生存时间与影响因素分析

目的 分析1995-2015年北京市HIV感染者/AIDS患者（HIV/AIDS）诊断后生存时间及影响因素。方法 运用回顾性队列研究方法,对1995-2015年中国艾滋病综合防治信息系统中报告的12 874例HIV/AIDS的数据资料进行分析,应用寿命表法计算生存率,采用Cox比例风险模型分析生存时间的相关因素。结果 12 874例HIV/AIDS中,303例（2.4%）死于艾滋病及相关疾病,接受抗病毒治疗9 346例（72.6%）。平均生存时间为226.5个月（95% CI：223.0~230.1）,1、5、10、15年生存率分别为98.2%、96.4%、93.2%、91.9%。Cox比例风险模型分析结果显示,艾滋病死亡风险较高的因素包括诊断时为艾滋病患者（比HIV感染者,HR=1.439,95% CI：1.041~1.989）;异性传播（比同性传播,HR=1.646,95% CI：1.184~2.289）;现有或曾有配偶（比未婚,HR=2.186,95% CI：1.510~3.164）;诊断时年龄≥ 60岁（比≤ 30岁,HR=6.608,95% CI：3.546~12.316）;诊断后首次CD₄⁺T淋巴细胞计数（CD₄）<350个/μl（比≥ 350个/μl,HR=8.711,95% CI：5.757~13.181）;未抗病毒治疗（比抗病毒治疗,HR=18.223,95% CI：13.317~24.937）。结论 1995-2015年北京市HIV/AIDS诊断后的平均生存时间为226.5个月。诊断为HIV感染、同性传播、未婚、≤ 30岁、首次CD₄ ≥ 350个/μl、接受抗病毒治疗的HIV/AIDS生存时间较长。相反,诊断为AIDS、异性传播、现有或曾有配偶、年龄≥ 60岁、CD₄<350个/μl、未抗病毒治疗的死亡风险较高。     

贵州省1996－2015年注射吸毒人群HIV/AIDS死亡率及其影响因素分析

目的 了解贵州省注射吸毒人群中HIV/AIDS死亡情况及其影响因素,为降低HIV/AIDS死亡率提供参考依据。方法 采用回顾性队列研究方法,以我国艾滋病防治基本信息系统中1996－2015年贵州省注射吸毒人群HIV/AIDS为研究对象,应用Cox比例风险回归模型分析其死亡的影响因素。结果 共有3 958例注射吸毒HIV/AIDS纳入分析,全死因的死亡比例为44.01%（1 742/3 958）,总死亡率为7.80/100人年,生存时间M=8.08年;抗病毒治疗（ART）组死亡率为3.57/100人年,美沙酮维持治疗（MMT）组死亡率为4.08/100人年。多因素Cox回归分析结果显示,研究对象的死亡与性别、民族、确认HIV阳性时年龄、确认HIV阳性后首次CD₄⁺T淋巴细胞计数（CD₄）、ART和MMT有关;女性的死亡风险是男性的0.82倍（95% CI：0.69～0.98）;少数民族的死亡风险是汉族的1.39倍（95% CI：1.21～1.60）;确认HIV阳性时年龄≥50岁的死亡风险是<20岁的2.44倍（95% CI：1.07～5.56）;确认HIV阳性后首次CD₄≥500个/μl组的死亡风险是CD₄<200个/μl组的0.27倍（95% CI：0.22～0.32）;未参加ART的死亡风险是参加者的2.83倍（95% CI：2.45～3.26）;未参加MMT的死亡风险是参加者的1.35倍（95% CI：1.15～1.59）。结论 1996－2015年贵州省注射吸毒人群HIV/AIDS中,男性、确认HIV阳性时年龄较大者、确认HIV阳性后首次CD₄较低、未参加ART和MMT的病例,死亡风险较高。     

中国2011－2015年跨省流动HIV/AIDS免费抗病毒治疗现状及影响因素分析

目的 分析我国跨省流动艾滋病病毒感染者/艾滋病患者（HIV/AIDS）免费抗病毒治疗现状及其影响因素。方法 利用2011－2015年全国艾滋病综合防治信息系统工作数据,采用描述性和趋势检验分析跨省流动HIV/AIDS抗病毒治疗历年变化趋势和主要特征,logistic回归分析探讨影响该人群抗病毒治疗覆盖面的主要因素。结果 跨省流动HIV/AIDS占比从2011年的7.1%（17 784/250 645）提高到2015年的10.3%（54 596/528 226）（Z=51.38,P<0.000 1）,跨省流动HIV/AIDS抗病毒治疗比例由2011年的37.3%（6 641/17 784）逐步上升到2015年的71.0%（38 783/54 596）（Z=96.23,P<0.000 1）,已与2015年非跨省流动HIV/AIDS抗病毒治疗比例接近（71.5%,338 654/473 630）。多因素logistic回归分析显示,跨省流动HIV/AIDS中,女性、≥50岁年龄组、汉族、已婚/有配偶、高中/中专及以上文化程度、男男性行为感染、首次随访CD₄⁺T淋巴细胞计数≤500个/μl、通过医疗机构检测或重点人群检测发现HIV感染者、现住址在城市者抗病毒治疗比例较高。结论 不同特征的跨省流动HIV/AIDS抗病毒治疗比例不同,需采取有效措施进一步扩大抗病毒治疗覆盖面,尽早将跨省流动HIV/AIDS纳入抗病毒治疗规范化管理系统。     

Trends in predictors of death due to HIV-related causes among persons living with AIDS in New York City: 1993–2001

To examine trends in predictors of HIV-related mortality among cohorts of persons living with AIDS (PLWA) in New York City (NYC), nine calendar year-specific cohorts of PLWA were created from 1993 to 2001. Cohorts were defined as persons who had been alive at any time during that year and had been diagnosed with AIDS before the end of that year. Predictors of death because of HIV-related causes of death were assessed by examinnng year-specific, stratified death rates per 1,000 PLWA and adjusted relative risks (RRs) from proportional hazards models. We conducted an analysis of AIDS surveillance data PLWA in NYC between 1993 and 2001. Univariate and multivariate Cox proportional hazards models were constructed for each calendar year cohort to evaluate trends in the RR of HIV-related death over the subsequent 5 years, adjusting for sex, reace/ethnicity, age, transmission risk borough of residence, category of AIDS diagnosis [opportunistic illness (OI) or CD4 count <200 cells/μL], time since AIDS diagnosis, and CD4 count at time of AIDS diagnosis. Death rates due to all causes and HIV-related causes declined substantially during 1993–1997 and then stabilized in all subgroups of PLWA between 1998 and 2001. Beginning in 1995, differences in survival emerged in some subgroups, such that by 2001 (1) injecting drug users (IDUs) had poorer survival compared with men who have sex with men (MSM) [RR₂₀₀₁=2.1, 95% confidence intervals (95% CI)=1.8–2.4]; (2) black and Hispanic PLWA had a significantly higher risk of death than white PLWA (RR₂₀₀₁=1.4, 95% CI=1.2–1.6, RR₂₀₀₁=1.2, 95% CI=1.1–1.4, respectively, and (3) PLWA aged 60 and above had poorer survival compared with younger persons (RR₂₀₀₁=2.4, 95% CI=1.9–3.0), after adjustment for other factors. The observed disparities that began to emerge in 1995 may be attributable to differential effects of, access to, or usage of highly active antiretroviral therapy (HAART). More targeted studies are needed to determine why such disparities have emerged.     

A vulnerable population in a time of crisis: Drug users and the attacks on the World Trade Center

In this article, we present preliminary findings from a qualitative study focused on the impact of the World Trade Center attacks on New York City residents who are current or former users of heroin, crack, and other forms of cocaine. In it, we present data describing their responses to and feelings about the attacks, changes in drug use after the attacks, and factors affecting changes in use. Our analysis is based on 57 open-ended interviews conducted between October 2001 and February 2002. The majority of study participants reported that the attacks had a significant emotional impact on them, causing anxiety, sadness, and anger. Several described practical impacts as well, including significant reductions in income. On September 11th and the weeks and months that followed, several participants who had been actively using did increase their use of heroin, crack, and/or other forms of cocaine. Reductions in use were, however, as common over time as were increases. There was some relapse among former users, but this was limited to those who had stopped using drugs within the 6 months immediately preceding the attacks. A diverse set of factors interacted to control use. For some participants, these factors were internal, relating to their individual motivations and drug use experiences. Other participants were essentially forced to limit use by marked reductions in income. For others, access to health and social service professionals, as well as drug treatment, proved to be key. Department of Family Medicine and Community Health at Montefiore Medical Center     

Computer and internet use among urban African Americans with type 2 diabetes

Previous studies have identified a “digital divide” between African Americans and whites, with African Americans having substantially lower rates of Internet use. However, use of the Internet to access health information has not been sufficiently evaluated in this population. Therefore, we conducted a telephone survey to determine the prevalence of computer and Internet use among 457 African American adults with type 2 diabetes. Participants were 78% female, with a mean age of 57±11 years, and about one-third had a yearly income ≦$7,500. Forty percent of the participants reported having a computer at home and 46% reported knowing how to use a computer. Most participants (58%) reported that they had, at some point, used a computer, and of those, 40% reported that they used the computer to find health information. In a stratified analysis, participants with lower education levels (<high school) were less likely to have a computer; older participants, men, and individuals with lower education levels were less likely to know how to use a computer and to use it to search for health information (all P<.05). Nonetheless, of the participants who did not know how to use a computer, 66% reported that they would be willing to learn. In addition, 82% reported that they had friends or family in the neighborhood who would let them use a computer. Furthermore, 89% of participants reported that they would use a computer program to manage their diabetes if it were offered free of charge. These data show promise for the willingness of this under-served population to use computers and access health information using the Internet. New programs are needed to explore Internet-based interventions to improve self-management and diabetes care among African Americans.     

Antimicrobial antibodies in Danish slaughterhouse workers and greenhouse workers

Summary As a consequence of contact with animals and animal products slaughterhouse workers might be at risk of infection with pathogenic microorganisms. This hypothesis has been supported by some earlier studies. In this study 217 slaughtermen and a control group of 113 greenhouse workers were investigated for the prevalence of serum antibodies to Toxoplasma gondii, Campylobacter jejuni (IgA and IgG), Yersinia enterocolitica types 3 and 9, Yersinia pseudotuberculosis types I, II, III, IV, and V, Salmonella typhi, Salmonella paratyphi, Salmonella enteritidis, Salmonella typhimurium, and Borrelia burgdorferi. No significant differences were found concerning either frequency of positive tests or magnitude of titers. The prevalence of toxoplasma antibodies was remarkably high in both groups.     

成人灰色小克银汉霉侵袭性毛霉菌病1例并文献复习

目的 探讨灰色小克银汉霉感染导致成人毛霉菌病患者的临床特点及诊治方案。方法 总结某院血液内科收治的1例灰色小克银汉霉感染致成人侵袭性毛霉菌病患者的临床诊疗过程,并检索数据库相关文献进行复习。结果 患者男性,54岁,因“反复乏力1年余,加重伴发热1周”入院,肺组织病理检查可见宽大、不规则、无分隔的菌丝,形态学鉴定为毛霉菌,肺泡灌洗液及外周血宏基因组二代测序(mNGS)检测示灰色小克银汉霉,诊断为灰色小克银汉霉感染致侵袭性毛霉菌病,给予脂质体两性霉素B联合泊沙康唑、卡泊芬净治疗后感染获得控制。检索出符合条件的文献37篇,加上本病例,共纳入44例患者,其中男性26例,女性18例,中位年龄52.5(18～79)岁;基础疾病主要为血液系统疾病(65.9%,29例),进行造血干细胞或实体器官移植者14例;最常见的侵犯部位为肺、脑及皮肤,分别为36、9、9例;组织病理学、真菌培养、直接镜检及分子学检测阳性者分别为28、37、29、17例。41例患者接受了抗真菌治疗,其中8例联合手术治疗;30例死亡,病死率为68.2%,抗真菌治疗联合手术者生存率(62.5%,5/8)高于单独抗真菌治疗者(24.2%,...     

Clinical and laboratory evidence of the importance of the tick D. marginatus as a vector of B. burgdorferi in some areas of sporadic Lyme disease in Bulgaria

56 adult ticks D. marginatus and 38 adult ticks H. punctata were sampled by the flagging method, transferred to the laboratory, dissected and tested for infection with Lyme disease spirochetes. 3 (7.9%) of the adult H. punctata and 2 (3.57%) of the adult D. marginatus were infected with B. burgdorferi (Bb). This report also presents the case of a patient, who developed Lyme disease symptoms after he had been bitten by a D. marginatus tick. The clinical diagnosis was confirmed by serological testing and by a biopsy, taken from the patient's skin lesion. The skin biopsy was examined under an electron microscope and Bb was found in the sections of the deeper strata of the dermis in two structural forms: (a) cylindrical bodies (protoplasm cylinder) with circular ends covered with a three-layered membrane; (b) granules, situated among the collagenous fibres either closely adhered to them or covered with a membrane. The result of the study demonstrates that in single cases in some ecosystems, ticks D. marginatus might be implicated in Bb transmission to humans as secondary vectors.     

Absorption,metabolism and elimination of N,N-dimethylformamide in humans

Summary Excretion of N,N-dimethylformamide (DMF) and DMF metabolites N-hydroxymethyl-N-methylformamide (MF), N-hydroxymethyl-formamide (F) and N-acetyl-S-(N-methylcarbamoyl)cysteine (AMCC) has been monitored in the urine of volunteers during and after their 8-h exposure to DMF vapour at a concentration of 10, 30 and 60 mg · m^–3. The pulmonary ventilation in these experiments was typically about 101 · min^–1 and the retention in the respiratory tract was 90%. After exposure to 30 mg DMF · m^–3, the yield of compound determined in the urine represented 0.3% (DMF), 22.3% (MF), 13.2% (F) and 13.4% (AMCC) of the dose absorbed via the respiratory tract. The excretion curves of the particular compounds attained their maximum 6–8h (DMF), 6–8h (MF), 8–14h (F) and 24–34h (AMCC) after the start of the exposure. The half-times of excretion were approximately 2, 4, 7 and 23 h respectively. In contrast to slow elimination of AMCC after exposure to DMF, AMCC was eliminated rapidly after AMCC intake. This discrepancy could be explained by rate-limiting reversible protein binding of a reactive metabolic intermediate of DMF, possibly methylisocyanate.     

Biological monitoring of workers exposed to<Emphasis Type="Italic"> N</Emphasis>,<Emphasis Type="Italic">N</Emphasis>-dimethylformamide in synthetic leather manufacturing factories in Korea

Objectives To investigate the relationship between N,N-dimethylformamide (DMF) exposure and excretion of urinary N-acetyl-S-(N-methylcarbamoyl)cysteine (AMCC) and N-methylformamide (NMF) in workers at synthetic leather manufacturing factories in Korea, for the first time.Methods One-hundred forty-four male workers at nine synthetic leather manufacturing factories were surveyed. Exposure to DMF was evaluated through breathing zone air sampling followed by analysis via a gas chromatograph equipped with a flame ionization detector (GC-FID). The levels of NMF and AMCC were determined by a GC with a flame thermionic detector (GC-FTD). Urine samples were collected at the end of the workshift.Results and Conclusions Geometric mean of workplace air DMF and urinary NMF was 8.8 ppm and 47.5 mg/l, respectively, and the level of DMF and NMF was significantly correlated. The biological exposure limit for NMF (15 mg/ml) was exceeded in 89.5% of urine samples, and 37.9% of air samples exceeded the environmental DMF exposure limit (10 ppm), indicating a serious health risk to the employees of the synthetic leather industry in Korea. Exposure to 10 ppm DMF in the workplace air corresponded to a urinary NMF concentration of 53.4 mg/l. Alcohol intake the day before urine was sampled influenced NMF excretion into urine (40.5 mg/l NMF for the no-alcohol group and 94.6 mg/l for the group consuming more than 63.0 g alcohol/day). We could not find a significant relationship between air DMF and urinary AMCC concentration. Exposure to 10 ppm DMF corresponded to an AMCC concentration of 8.0 mg/l in the urine samples collected on the same day as the air was sampled.     

我国几种非嗜肺军团菌感染的血清流行病学研究

本文报告了1986年对我国五个地区994名健康成人、373名儿童和100例肺炎病人进行三种军团菌抗体检测的结果。健康成人抗体阳性率(≥1:16)Lm为9.26%,Ld为9.05%,Lg为3.32%。儿童Lm为5.36%,Ld为2.14%,Lg为3.75%。肺炎病人抗体阳性率以Ld最高(44%),Lm次之(23%),Lg均阴性。提示我国南方和北方地区人群中均存在这三种军团菌感染的可能性,应予以注意。     

Percutaneous absorption of N,N-dimethylformamide in humans

Summary Skin penetration fo N,N-dimethylformamide (DMF) liquid or vapour was studied in volunteers. Exposure to liquid DMF was performed in two ways: in a dipping experiment, one hand was dipped up to the wrist in DMF for 2–20 min, while in a patch experiment, 2 mmol DMF was applied to the skin and allowed to be absorbed completely. The period of exposure to DMF vapour (50 mg · m^–3) was 4 h. The DMF metabolites N-hydroxymethyl-N-methylformamide (MF), N-hydroxymethylformamide (F), and N-acetyl-S-(N-methylcarbamoyl)cysteine (AMCC) were monitored in the urine. Liquid DMF was absorbed through the skin at a rate of 9.4 mg · cm^–2 · h^–1. Percutaneous absorption of DMF vapour depended strongly on ambient temperature and humidity and accounted for 13%–36% of totally excreted MF. The results suggest that skin absorption of liquid DMF is likely to contribute to occupational exposure substantially more than penetration of DMF vapour. The yield of metabolites after transdermal DMF absorption was only half of that seen after pulmonary absorption. Elimination of MF and F but not that of AMCC was delayed, which supports the contention that AMCC should be used instead of MF as the most suitable biomarker of DMF in cases where percutaneous intake can occur.