人乳头状瘤病毒感染及端粒酶活性与宫颈癌的关系

目的　探讨不同型别人乳头状瘤病毒 (HPV )感染和端粒酶活化与宫颈癌的关系。方法　对 83例宫颈癌、47例宫颈上皮内瘤样病变 (CIN)及 10例正常宫颈应用TRAP PCR银染定性及TRAP PCR ELISA定量法检测端粒酶活性 ,PCR法检测HPV分型。结果　 ( 1)端粒酶阳性率和HPV 16 18型阳性率 :宫颈癌 >宫颈CIN >正常宫颈 ,CINⅢ级 >CINⅠ、Ⅱ级 ;HPV 6 11型阳性率 :CINⅠ、Ⅱ级 >CINⅢ级。 ( 2 )宫颈癌中端粒酶阳性 :Ⅰ期 <Ⅱ期 <Ⅲ、Ⅳ期 ;中分化 >高分化 ;腺癌与鳞癌差异无显著性 ;HPV 16 18阳性 :Ⅰ期 <Ⅱ期 <Ⅲ、Ⅳ期 ;HPV 6 11阳性与临床分期、组织学分级及病理类型无关。 ( 3 )端粒酶阳性值 :宫颈癌 >CIN ,CINⅢ级 >CINⅠ、Ⅱ级 ;HPV 6 11拷贝数 :CIN >宫颈癌 ,CINⅠ、Ⅱ级 >CINⅢ级 ;HPV 16 18拷贝数 :宫颈癌 >CIN ,CINⅢ级 >CINⅠ、Ⅱ级。结论　HPV感染尤以 16 18型和端粒酶的激活与宫颈病变恶变关系密切     

宫颈癌患者生殖道细菌感染及人乳头瘤病毒感染情况分析

目的对宫颈癌患者生殖道细菌感染及人乳头瘤病毒(HPV)感染情况进行研究,探讨宫颈癌和生殖道细菌感染及人乳头瘤病毒感染的关系。方法选择2012年1月-2014年12月湖州市中心医院妇产科宫颈癌患者108例作为宫颈癌组,慢性宫颈炎患者108例作为宫颈炎组,对两组患者阴道分泌物进行细菌培养,并检测HPV感染情况。结果 108例宫颈癌患者检出细菌60例,检出率为55.6%,108例慢性宫颈炎患者中检出细菌53例,检出率为49.1%;宫颈癌组和宫颈炎组患者生殖道细菌培养阳性率比较差异无统计学意义;宫颈癌组和宫颈炎组患者生殖道革兰阳性菌和革兰阴性菌分布比较差异无统计学意义;108例宫颈癌患者中生殖道HPV感染65例,感染率60.2%,108例慢性宫颈炎患者生殖道HPV感染44例,感染率40.7%;宫颈癌组患者生殖道HPV阳性率高于宫颈炎组(P<0.05);宫颈癌患者中HPV阳性组和HPV阴性组生殖道细菌培养结果比较差异无统计学意义;宫颈癌组和宫颈炎组HPV阳性患者中生殖道细菌培养结果比较差异无统计学意义。结论生殖道HPV感染为宫颈癌的高危因素,生殖道细菌感染可能和宫颈癌的发生无关。     

女性生殖道人乳头瘤病毒感染率分析

目的：了解本地区女性生殖道人乳头瘤病毒（ HPV）感染情况。方法对2012年9月本地区接受妇女病普查工作中2066例女工进行二代杂交捕获技术，即HC2 HPV检测。结果2066例妇女中检测出HPV阳性244例，阳性率11．8％，不同年龄段以46-55岁最多，阳性率14．4％。结论本地区女性宫颈癌发病率高，做好HPV感染的检测，对于宫颈癌的预防具有重要意义。     

人乳头状瘤病毒不同亚型在中重度宫颈上皮内瘤变与宫颈癌中的分布及临床意义

目的 了解人乳头状瘤病毒(HPV)不同亚型在中重度宫颈上皮内瘤变(CIN)与宫颈癌中的分布,探讨其临床意义.方法 对经宫颈病理组织学检查确诊的237例CINⅡ、Ⅲ和22例宫颈癌,采用PCR体外扩增和DNA反向点杂交相结合的DNA芯片技术检测宫颈脱落细胞HPV亚型.结果 259例中重度CIN及宫颈癌患者共检出HPV感染247例,总阳性率95.37％;237例CINⅡ、ⅢHPV阳性228例,阳性率96.20％;22例宫颈癌HPV阳性19例,阳性率86.36％,两者差异无统计学意义;HPV阳性的228例中重度CINⅡ、Ⅲ中,单亚型感染209例,多亚型感染19例;19例宫颈癌均为单亚型感染,两者差异无统计学意义;单亚型感染中HPV16占54.39％,为124例,HPV58占19.30％,为44例;不同亚型在CINⅡ、Ⅲ与宫颈癌中的分布差异无统计学意义.结论 宫颈CINⅡ、Ⅲ与宫颈癌多数合并有HPV感染,HPV16的持续感染对诱发CINⅡ、Ⅲ发展为宫颈癌有重要临床意义.     

甘肃省徽县妇女人乳头瘤病毒感染与宫颈癌关系的研究

目的了解我国宫颈癌高发地区妇女生殖道人乳头瘤病毒(HPV)感染现状,研究HPV感染与宫颈癌的关系。方法随机选择1000名宫颈癌高发地区已婚妇女,进行宫颈液基细胞标本采集及细胞学诊断、阴道镜检查并取活体组织做组织病理学诊断。病理学检查发现散在或成群出现的凹空细胞即诊断为HPV感染,所有检查均双盲进行。结果1000例组织活检标本中发现宫颈鳞状上皮癌(SCC)2例,宫颈上皮内瘤变Ⅲ级(CINⅢ)4例,宫颈上皮内瘤变Ⅱ级(CINⅡ)16例,宫颈上皮内瘤变Ⅰ级(CINⅠ)111例,正常867例。HPV感染603例,总阳性率60.30%(603/1000)。SCC和CINⅢ病例中HPV阳性率为100%(6/6)。SCC和宫颈上皮内瘤变(≥CINⅠ)病例中HPV阳性率为81.95%(109/133),正常者HPV阳性率为56.98%(494/867),后两者之间具有显著性差异(x2=29.02,P<0.001)。结论该地区妇女HPV感染率明显增高并且宫颈癌及宫颈上皮内瘤变Ⅲ级病例中全部感染HPV,证明HPV感染是该地区宫颈癌高发的主要危险因素。     

三种方法检测人乳头瘤病毒的比较

目的比较基因芯片分型法、PCR荧光定量法、免疫组织化学法检测人乳头瘤病毒（humanpa pillomavirus,HPV）的敏感性,为临床人乳头瘤病毒检测提供适用的方法。方法收集2002至2007年在本院就诊的宫颈癌病例200例,采用新鲜宫颈癌组织进行人乳头瘤病毒基因芯片分型检测;在上述200例患者中进取自愿接受荧光定量PCR检测的患者134例,收取宫颈癌灶分泌物,采用荧光定量PCR检测方法检测人乳头瘤病毒;对在上述134例宫颈癌患者中,选取自愿接受免疫组织化学检测的患者利用石蜡包埋宫颈癌组织,采用免疫组织化学法检测人乳头瘤病毒。结果基因芯片分型法检测人乳头瘤病毒呈阳性为188例,阳性率为94．0％（188／200）,其中HPV-16／-18阳性率为95．74％（180／188）。荧光定量PCR法检测HPV-16／18阳性率为36．57％（49／134）;免疫组化法检测HPV-16／18阳性率为46．51％（60／129）。荧光定量PCR检测和免疫组化法检测人乳头瘤病毒呈阳性者,在基因芯片分型法检测中均呈阳性。基因芯片分型法人乳头瘤病毒检出率与荧光定量PCR检测和免疫组化法比较,差异有显著意义（P〈O．05）,而后两种方法比较,差异无显著意义（P〉0．05）。结论基因芯片分型技术检测人乳头瘤病毒具有敏感性好,且同时可以分型的明显优势,适用于临床人乳头瘤病毒感染的诊断和研究。     

基因重组HPV16L1蛋白的血清学实验在人乳头瘤病毒16感染诊断中的应用价值

目的探讨基因重组人乳头瘤病毒16L1蛋白(HPV16L1)在诊断HPV16感染中的临床应用价值。方法对718例因宫颈病变到该院进行HPV检查的患者采用聚合酶链反应(PCR)法和基因重组HPV16 L1蛋白采用ELISA法检测HPV16 L1抗体,并按照宫颈癌组、尖锐湿疣组、宫颈糜烂组对HPV16 L1抗体阳性及HPV16 DNA阳性进行统计分析。结果宫颈癌组的HPV16 L1抗体水平、HPV16 DNA水平均显著高于尖锐湿疣组、宫颈糜烂组,差异均具有统计学意义(P0.05);根据阳性临界值判定法则,ELISAHPV16 L1抗体检测法及PCR检查法宫颈癌组的HPV16阳性率分别为45.68%、48.15%均显著高于尖锐湿疣组的11.29%、12.90%及宫颈糜烂组的1.75%、1.95%(P0.05)。尖锐湿疣组的HPV16 L1抗体水平、HPV16 DNA水平、HPV16阳性检出率显著高于宫颈糜烂组,差异均具有统计学意义(P0.05)。采用ELISA HPV16 L1抗体检查方法与PCR检测的HPV16阳性率符合率为89.23%(58/65),两种方法检测的一致性检验Kappa值=0.921,两种检测方法具有较高的一致性。结论基因重组人乳头瘤病毒16L1蛋白在诊断HPV16感染具有一定的准确性,对宫颈癌HPV16感染的临床筛查具有一定的推广价值。     

应用液相基因芯片技术筛查山东地区高危人群人乳头瘤病毒基因型

目的 评价Luminex XMAP系统的液相芯片技术在女性生殖道人乳头状瘤病毒（HPV）感染检测中的临床价值,调查山东地区女性生殖道HPV感染情况及最常见的基因型。方法 取妇科门诊就诊者宫颈脱落细胞2925例,采用液相芯片技术进行HPV基因型检测,96孔板操作,26种亚型1次呈现。639例患者同时做病理诊断,按组织病理学分为细胞学正常组、炎症组、宫颈上皮内瘤变（CIN）Ⅰ组、CINⅠ-Ⅱ组、CINⅡ组、CINⅢ组和宫颈癌组。通过HPV DNA亚型分布结合病理诊断,分析山东地区HPV感染基因型与宫颈病变程度的关系。结果 HPV总感染率36．0% （1054/2925）,26种基因型检出23种,按感染率从高到低依次为HPV-16（26．75%）,HPV-52 （25．75%）,HPV-58（10．47%）,HPV-18（8．87%）和HPV-11（6．94%）。其中高危型感染占87．32%,低危型13．68%;单一型感染698例（66．22%）,多重感染356例（33．78%）,低危亚型11、6多与高危型多重感染。1054例HPV阳性患者中,261例（24．8%）为21～25岁女性,随年龄增大阳性例数减少, 52例（4．9％）为51～67岁女性。各病理组HPV阳性率及多重感染率依次为正常组23．37％、4．89％，炎症组33．08％、7．14％，CINI组54．54％、18．18％，CINⅠ-Ⅱ组57．14％、28．57％，CIN Ⅱ组82．61％、41．30％，CINⅢ组91．30％、43．37％，宫颈癌组100％、38．46％。以组织病理学为确诊标准，液相芯片HPVDNA检测CINⅡ、Ⅲ和宫颈癌的灵敏度、特异度、阳性预测值、阴性预测值依次为88．57％、76．63％、68.89％和92．16％。结论 所选山东地区高危人群HPV感染的常见基因型是16、52、58、18、11、6、56、31。随宫颈病变程度加重，HPV感染率及多重感染有增加趋势，HPV阳性以年轻女性多见。液相芯片HPVDNA检测在宫颈病变临床诊断及大规模筛查中有重要价值。     

HPV感染及其与宫颈上皮内瘤变的关系

一、关于HPV感染 生殖道人乳头瘤病毒（HPV）感染主要是通过性传播，但也可以通过其他途径传播。有报道称，如果对女性进行密切的HPV检测和宫颈刮片，可以发现开始性生活两年内有50％女性生殖道HPV感染。女性一生中生殖道HPV感染的几率为80％，其中5％发生生殖道疣，35％宫颈刮片异常，25％发生宫颈内瘤样病变（CIN），小于1％发生宫颈癌。HPV感染具很强的地域性，而且因检测方法及受检人群不同而显示不同感染率和感染类型。亚临床感染和潜伏感染率至少是临床HPV感染的3倍，如果重复检测数次，阳性率上升至3-5倍。     

高危型人乳头瘤病毒感染与宫颈病变的相关性研究

目的 探讨高危型人乳头瘤病毒( HR-HPV)感染与宫颈病变的相关性.方法 对32例宫颈上皮内瘤变(CIN)Ⅰ、45例CINⅡ、53例CIN Ⅲ及68例浸润性宫颈癌患者的HR-HPV进行检测,并应用多因素条件Logistic回归分析HR-HPV各亚型与宫颈病变的相关性.结果 CIN Ⅰ患者HR-HPV阳性率为75.00％(24/32),CIN Ⅱ患者HR-HPV阳性率为80.00％(36/45),CIN Ⅲ患者HR-HPV阳性率为84.91％(45/53),浸润性宫颈癌患者HR-HPV阳性率为89.71％(61/68).不同级别CIN患者与浸润性宫颈癌患者HR-HPV阳性率比较差异无统计学意义(P＞0.05).人乳头瘤病毒(HPV) 16分布频率按CIN Ⅰ、CINⅡ、CIN Ⅲ的顺序递增[15.6％ (5/32)、22.2％(10/45)、28.3％( 15/53)],OR值也呈递增趋势(3.23、5.34、6.23).结论 HPV16感染与宫颈病变的严重程度密切相关.     

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.     

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.     

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.     

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.     

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.     

The rise and fall in incidence of malignant mesothelioma from a British Naval Dockyard, 1979-1999

BACKGROUND: The incidence of malignant mesothelioma in Britain is predicted to rise over the next 15-25 years because of past failure to protect the workforce against inhalation of asbestos. In British Naval dockyards, alternative insulation materials and respiratory protection were introduced from the mid-1960s. Aims This study was carried out to investigate the effects of these control measures on mesothelioma deaths in dockyard workers. METHODS: Cases of mesothelioma of the pleura and peritoneum between 1979 and 1999 in workers from the Devonport Naval Dockyard, south-west England, were sought from coroners' and medico-legal records. RESULTS: Three hundred and one cases were identified, 7% peritoneal. The peak incidence occurred in 1991 with 25 cases per annum (quadratic model fit R(2) = 74.2%, P < 0.001) and we predict that by 2003 the incidence will fall to fewer than five cases per annum. The mean time between first exposure and presentation was 48.5 years [95% confidence interval (CI) = 47.3-49.8], but this was significantly shorter in the more heavily exposed trades, when compared with the less heavily exposed (42 years, 95% CI = 39.0-45.0, versus 49.5 years, 95% CI = 48.2-50.9). Those with higher exposure were also at significantly greater risk of peritoneal disease (P < 0.023, Fisher's exact test). CONCLUSION: The reduction in incidence of mesothelioma is greater than can be accounted for by reduction in numbers of dockyard workers over the last 50 years. Changes in insulation materials and improved industrial hygiene measures introduced into the Devonport Dockyard from the mid-1960s have resulted in an earlier decline in the incidence of malignant mesothelioma than that predicted for the British workforce as a whole.