西昌市吸毒人群HIV感染模式研究

目的：了解四川省西昌市吸毒人群吸毒方式及性行为与HIV感染的关系.方法：采用现况调查对四川省西昌市吸毒人群的社会人口学、共用注射器具静脉吸毒方式、伙伴人数和性行为情况与HIV感染的关系进行调查.同时采集血样进行HIV和梅毒抗体检测.结果：吸毒人群619人中,HIV感染率为8.6%（53/619）,其中静脉吸毒者的HIV感染率为10.1%（33/327）.在单因素分析和控制其他因素分析中,至今共用注射器具静脉吸毒的伙伴总人数与HIV感染差异均有统计学意义.趋势性检验发现随着至今共用注射器具静脉吸毒的伙伴人数的增加,吸毒人群HIV感染率也在增加.在多因素Logistic回归模型分析中,发现与HIV感染差异有统计学意义的变量是共用注射器具静脉吸毒的伙伴总人数（1～3人OR=2.47,95%CI为1.21～5.04;≥4人OR=5.13,95%CI为2.30～11.46）和彝族（OR=3.71,95%CI为2.04～6.75）.结论：吸毒人群共用注射器具静脉吸毒的社会网络大小与HIV感染有关.     

社区静脉吸毒人群人类免疫缺陷病毒感染现状

目的　了解四川省凉山彝族自治州静脉吸毒人群人类免疫缺陷病毒 (HIV)感染率及其危险因素。方法　于 2 0 0 2年 11月 8～ 2 9日 ,以社区招募方式调查凉山彝族自治州地区静脉吸毒人群的社会人口学、静脉吸毒共用注射器具和性行为方式与HIV感染的关系。采集血样进行HIV和梅毒抗体检测。结果　提供知情同意和符合纳入标准的 379人 ,HIV感染率为 11 3% (43人 )。在单因素χ2 分析中 ,民族、近 3个月共用注射器具总次数、近 3个月共用棉球和梅毒感染与HIV感染有关。在多因素logistic回归模型分析中 ,近 3个月共用注射器具总次数 (OR =2 2 8;95 %CI为 1 18～ 4 4 3)和梅毒感染 (OR =3 10 ;95 %CI为 1 4 8～ 6 4 8)与HIV感染有关。结论　近 3个月共用注射器具总次数和梅毒感染与HIV感染有关。     

直接和间接共用注射器具静脉吸毒方式与HIV感染关系的研究

目的了解四川省凉山彝族自治州地区吸毒人群直接和间接共用注射器具静脉吸毒方式与HIV感染的关系。方法于2004年5月至7月，从社区中招募吸毒人群调查其社会人口学特征、近3个月直接和间接共用注射器具静脉吸毒方式、近6个月性行为情况。采集研究对象的血样进行HIV抗体检测。结果在调查的吸毒人群中HIV感染率为15．1％（68／451），其中静脉吸毒人群HIV感染率为17．8％（66／370）。多因素Logistic分析结果显示，民族（OR为2．40；95％CI为1．39～4．13）、近3个月共用针头和注射器（OR为2．02；95％CI为1．12～3．63）、近3个月共用洗针头或注射器用水（OR，4．00；95％；CI，1．28～12．54）与HIV感染关系有统计学意义。结论四川省凉山彝族自治州吸毒人群HIV感染率高，直接和间接共用注射器具静脉吸毒行为以及高危性行为普遍，应加强对此类行为的干预。     

以社区为基础的静脉吸毒人群丙型肝炎病毒感染危险因素研究

目的　了解四川省凉山州地区静脉吸毒人群丙型肝炎病毒感染情况及其危险因素。方法　以社区为基础调查静脉吸毒人群丙型肝炎病毒感染危险因素 ,通过检测研究对象的丙型肝炎病毒抗体确定是否感染丙型肝炎病毒。结果　静脉吸毒人群丙型肝炎病毒感染率为 71.0 % (2 6 9/379)。在多因素 logistic回归模型分析中 (P<0 .0 5 ) ,共用注射器具次数的 OR值为 2 .0 5 3,其 95 %CI为 1.4 5 8～ 2 .891。在单因素χ2 分析中 (P <0 .0 5 ) ,共用注射器具次数、共用注射器具吸毒年限、近 3个月平均每天静脉吸毒频率等多个因素同丙型肝炎病毒感染有关。结论　需进一步研究阐明静脉吸毒共用注射器具方式对丙型肝炎病毒感染的影响     

静脉吸毒共用注射器具方式和性行为与丙型肝炎病毒感染关系的研究

目的 了解四川省凉山州某地区静脉吸毒人群共用注射器具方式及性行为与丙型肝炎病毒(HCV)感染的关系。方法 以社区为基础使用标准化问卷调查静脉吸毒人群人口学特征和静脉吸毒共用注射器具方式、性行为情况;通过检测研究对象的HCV抗体确定是否感染HCV。结果 在静脉吸毒379人中,静脉吸毒人群HCV感染率为对71.0％(269/379)。单因素分析结果显示近3个月共用针头或注射器和既往感染梅毒在HCV感染方面差异有统计学意义。趋势性检验发现随着共用针头或注射器、共用洗针头或注射器水的频率以及共用注射器具伙伴数的增加HCV的感染率也在增加。多因素分析结果显示,近3个月共用针头或注射器。既往感染梅毒是HCV感染的危险因素,其OR值分别为1.468(95％CI:1.045～2.061)和2.914(95％CI:1.327～6.398)。未见性行为对HCV感染的影响。结论 需考虑采用定群血清流行病学研究来进一步阐明静脉吸毒共用注射器具方式及性行为同HCV感染的关系及其联系强度。     

钦州市吸毒人群性传播疾病感染状况及HIV感染影响因素分析

目的了解钦州市吸毒人群人类免疫缺陷病毒(HIV)、丙型肝炎病毒(HCV)和梅毒(TP)的感染状况,探讨HIV感染的影响因素,为制定疾病防控策略提供科学依据。方法选取2014年4月～2016年7月在钦州市辖区内活动的吸毒人员作为研究对象,通过问卷调查收集相关信息,并采集5.0 mL静脉血进行HIV、HCV及梅毒抗体检测。结果 3 148例研究对象中,男女性别比为37.9:1;平均(32.66±7.59)岁;HIV、HCV和梅毒感染率分别为4.7%、59.5%和3.6%;女性HCV和梅毒感染率高于男性(P0.05),采用注射方式吸毒者HIV和HCV感染率则明显高于非注射方式吸毒者(P0.05);多因素Logistic回归分析结果显示,年龄≥41岁(OR=9.50, 95%CI:1.25～72.38)、离异或丧偶(OR=1.83, 95%CI:1.06～3.17)、曾经共用针具(OR=2.95, 95%CI:2.06～4.22)和感染HCV(OR=6.43, 95%CI:3.32～12.46)是吸毒人群感染HIV的危险因素;在婚(OR=0.64, 95%CI:0.42～0.97)和知晓艾滋病相关知识(OR=0.55 95%CI:0.34～0.87)是吸毒人群感染HIV的保护因素。结论钦州市吸毒人群HIV、HCV和梅毒的感染率较高,感染HIV的影响因素较多,应针对各个因素制定综合干预措施,控制相关疾病的传播蔓延。     

2009—2015年乌鲁木齐市女性吸毒者艾滋病哨点监测结果

目的了解乌鲁木齐市女性吸毒者的人类免疫缺陷病毒(HIV)感染状况及其影响因素,为吸毒人群艾滋病预防和控制及效果评价提供科学依据。方法 2009—2015年,调查乌鲁木齐市739名女性吸毒者的HIV感染率及行为学特征,采用多因素logistic回归分析其影响因素。结果 2009—2015年乌鲁木齐市女性吸毒者HIV感染率为20.0%,历年的感染率依次为34.3%、21.1%、20.8%、17.1%、16.8%、16.4%和16.4%。多因素logistic回归分析显示,乌鲁木齐市女性吸毒人群感染HIV的主要影响因素包括民族、吸毒方式、是否共用针具、和最近1年内做过HIV检测等;少数民族感染HIV的危险性高于汉族(OR=0.269,95%CI=0.152~0.475),注射吸毒者高于非注射吸毒者(OR=11.973,95%CI=4.212~34.040),共用针具者高于未共用针具者(OR=8.107,95%CI=4.987~13.180),最近1年内做过HIV检测者感染HIV的危险性低于未检测者(OR=0.503,95%CI=0.334~0.758)。结论乌鲁木齐市女性吸毒人群高危行为较普遍,HIV感染率较高,应进一步制定针对性的高危行为干预等防治措施。     

北京市社区吸毒人群艾滋病病毒感染相关因素分析

目的了解北京市社区吸毒人群艾滋病病毒(HIV)感染率及其相关因素,为在该人群中开展监测和行为干预提供依据。方法 2007年9~12月采用滚雪球的方法对北京市社区吸毒者进行专题调查,调查采用结构式问卷,内容包括人口学信息、吸毒行为、性行为的情况等,同时采集静脉血进行HIV抗体检测(WB阳性即判定为阳性)。结果共调查529名社区吸毒者,其中62.8%为京籍,社区吸毒者HIV感染率为2.7%(14/525),社区吸毒者HIV感染的相关因素有维族(OR=21.622,95%CI=3.879~120.521)和共用针头/注射器(OR=8.074,95%CI=1.832~35.589)。结论 应适当调整北京市吸毒人群监测网络,加强社区吸毒人群的监测力度;社区吸毒者的干预重点是美沙酮维持治疗和清洁针具交换。     

乌鲁木齐市1516名吸毒人员HIV、HCV和梅毒感染率和高危行为特征调查

目的了解2010年乌鲁木齐市吸毒人群人类免疫缺陷病毒(HIV)感染率及相关行为特征。方法查询公安部门资料结合滚雪球办法招募吸毒人员,进行面对面的问卷调查,采集血样进行HIV、丙型肝炎病毒(HCV)和梅毒抗体检测。结果本组共调查和采样吸毒人员1 516名,检出HIV、HCV和梅毒的感染者分别占20.38%(309/1 516)、36.02%(546/1 516)和2.24%(34/1 516)。高危行为分析吸毒者中男性(OR:0.62;95%CI:0.40～0.96)、维吾尔族(OR:0.45;95%CI:0.34～0.60)、未接受过预防艾滋病服务者(OR:2.32;95%CI:1.65～3.26)共用注射器的比例高;安全套的使用上维吾尔族(χ2=11.98,P=0.0005),艾滋病基本知识得分低者(χ2=4.85,P=0.0275)安全套的使用率低。结论乌鲁木齐市吸毒人群HIV流行形势严峻,如何采取行之有效的干预措施降低高危行为势在必行。     

新疆吸毒人群艾滋病感染现状及其影响因素分析

目的 为了解新疆吸毒人群艾滋病病毒(HIV)感染现状及其影响因素,为艾滋病防治工作效果评价提供科学依据.方法 于2010年8-12月对新疆乌鲁木齐市及伊犁州4 493名吸毒者进行问卷调查和血清学检测.结果 新疆吸毒人群艾滋病感染率为21.4％ (963/4 493),其中男性感染率为20.7％ (864/4 175),女性感染率为31.1％(99/318);维吾尔族感染率为30.1％(800/2 660),汉族感染率为7.0％(74/1 050),回族感染率为11.3％ (64/566);≤30岁者感染率为10.0％(174/1 739),＞30岁者为28.6％(789/2 754);多因素logistic回归分析结果表明,吸毒者感染HIV的风险女性高于男性(OR=2.12,95％CI=1.56～2.88),维吾尔族、回族均高于汉族(OR=7.66、2.06,95％ CI=5.79～10.13、1.41 ～ 3.01),注射吸毒者高于非注射吸毒者(OR=11.95,95％ CI=9.26 ～ 15.42),共用针具者高于非共用针具者(OR =4.02,95％ CI=3.35～4.83).结论 与其他吸毒人群聚集区比较,新疆吸毒人群HIV感染率处于中等水平,吸毒人群感染HIV的主要影响因素包括性别、民族、吸毒方式和是否共用针具等,据此应制定针对性的防治措施.     

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.