IgG抗体亲和力指数在HCMV宫内感染中的临床评估

【目的】用孕妇外周血人巨细胞病毒(human cytomegalovirus,HCMV)IgG抗体亲和力指数(avidity in-dex,AI)判断HCMV宫内感染的发生概率。【方法】ELISA法检测中晚期孕妇HCMV特异性抗体IgM和IgG,并对463例HCMV-IgM或HCMV-IgG阳性孕妇的胎儿或新生儿脐血进行HCMV-IgM检测;采用尿素变性试验检测孕妇IgG抗体亲和力指数。【结果】孕妇HCMV-IgM抗体阳性和IgG抗体阴性132例;HCMV-IgM和IgG抗体均阳性145例;HCMV-IgM抗体阴性和IgG抗体阳性186例。胎儿或新生儿HCMV-IgM阳性80例。原发性感染宫内感染率高于继发性感染(P<0.01),活动性感染宫内感染率高于非活动性(P<0.01),AI<30%宫内感染率高于AI 30%~50%(P<0.01)及AI>50%(P<0.01)。【结论】IgG抗体亲和力指数AI<30%结合IgM阳性有助于提高判断HCMV宫内感染的发生率。     

酶联免疫法检测弓形体感染初探

目的酶联免疫法正确有效诊断弓形体急性感染。方法对4 500例无偿献血者血浆样本分别检测弓形体IgM抗体、IgG抗体,对IgM抗体阳性和IgM抗体阴性且IgG抗体阳性的样本检测其IgG抗体亲合力。结果 4 500例样本中,弓形体IgM抗体阳性率为0.51%,IgG抗体阳性率为1.53%。其中22例为IgM（＋）IgG（＋）,1例为IgM（＋）IgG（-）,47例为IgM（-）IgG（＋）,4 430例为IgM（-）IgG（-）。在对69例弓形体IgG（＋）的样本进行IgG亲合力检测时,IgM（＋）IgG（＋）的22例样本中2例为IgG中等亲合力抗体,3例为IgG高亲合力抗体,但这5例样本的IgM抗体均为可疑,可能由于IgM抗体常年保持低水平,并非正处于弓形体急性感染期;IgG（＋）IgM（-）的47例样本中,3例为IgG低亲合力抗体,可能由于其中的弓形体IgM抗体在急性感染期后期,IgM抗体滴度太低无法检测到,仍可判定为处于急性感染期。最终确定弓形体急性感染的样本为20例,感染率0.44%。结论可同时检测弓形体IgM抗体和弓形体IgG抗体亲合力来诊断弓形体感染,IgM抗体阳性或IgG抗体低亲合力的样本均可判定为弓形体急性感染。     

孕妇感染HCMV时IgG抗体亲和力与HCMV DNA联合检测的临床意义

目的：本文通过研究HCMV-IgG亲和力指数（avidity index,AI）以及HCMV-DNA的检测,对孕产妇原发性感染及继发性感染进行综合评价。旨在为防止和减少围产期感染、流产及新生儿先天畸形、听力障碍和智力障碍提供有效而准确的检测数据及临床诊断依据。方法：采用德国Virion/serion公司酶联免疫吸附试验（ELISA）定量试剂,检测孕妇血清中HCMV的IgM和IgG抗体、IgG抗体亲和力;采用中山医科大学达安公司RV核酸扩增（PCR）荧光定量检测孕妇血清中HCMV-DNA,并对其结果进行分析。结果：341例孕妇中,HCMV-IgG低亲和力样本孕产史不良孕妇组所占比例显著高于初次妊娠孕妇。孕产史不良孕妇HCMV-DNA阳性例数所占比例显著高于初次妊娠孕妇。结论：341例孕妇中存在一定比例的HCMV现症感染,建议妊娠妇女尤其是有不良孕产史者尽可能同时进行HCMV-IgG亲和力指数及HCMV-DNA检查,以便尽早采取措施,避免由于HCMV感染导致的新生儿出生缺陷的发生。     

南京地区育龄女性TORCH感染状况调查

目的调查在南京大学医学院附属鼓楼医院进行孕前筛查和产前普查的育龄女性的TORCH感染情况,分析不同季节、不同年龄段人群TORCH感染的特征,为该地区育龄女性的预防保健提供参考依据。方法采用酶联免疫吸附试验对3 340例孕前及孕期妇女进行血清中TORCH特异性抗体IgM、IgG检测,根据季节、年龄分组比较TORCH不同病原体感染率的差异。结果 3 340例受检者中总IgM阳性率为2.6%,巨细胞病毒（CMV）的IgM阳性（近期感染）率和IgG阳性（既往感染）率分别为1.05%和65.14%;弓形虫（TOX）、风疹病毒（RV）和CMV IgM的检出率均在夏季最高,夏季TOX和RV IgM阳性率分别为1.38%和1.30%,显著高于其他3个季节（P〈0.01）;20-25岁年龄组TOX IgM检出率（1.08%）显著高于26-30岁组（0.36%）（P〈0.05）;CMV IgM的阳性率在20-25岁组最高,为1.49%,与31-45岁组（0.47%）差异有统计学意义（P〈0.05）。结论育龄女性TORCH感染以CMV最多见,相关病原体感染具有季节性和年龄差异,有必要有针对性地加强预防保健,并积极做好TORCH特异性抗体的检测和监测。     

母儿间单纯疱疹病毒感染的研究

目的 研究母儿间单纯疱疹病毒(HSV)感染及其垂直传播状况。方法 应用酶联免疫吸附试验(ELISA)筛查455例孕妇HSV特异性抗体(IgM、2型和1型IgG)，并用多聚酶链反应(PCR)检测抗体阳性孕妇的胎儿组织及其附属物中HSV2型DNA的表达。结果 孕期HSV1型和2型感染率分别为85．27％、47．69％。异常组HSV2型IgG抗体的检出率明显高于对照组。HSV宫内感染率为4．24％。羊水、胎盘及胎儿组织中均可检出HSV2型DNA。结论 妊娠期HSV感染较常见，其中HSV2型感染与流(早)产、畸形等异常孕产史关系密切。ELISA法结合PCR技术是诊断HSV宫内感染的一种行之有效的方法。     

钦州市异常孕产史妇女常见病原体检测分析

目的探讨异常孕产（自然流产、死胎和胎儿畸形）与妇女常见病原体[梅毒（TP）、弓形体（TOX）、单纯疱疹病毒（HSVⅡ）和巨细胞病毒（CMV）]的相关性。方法用酶联免疫（ELLSA）法检测异常孕产史妇女（497例）血中TP—IgM、TOX—IgM、HSVⅡ-IgM和CMV—IgM,并与正常孕产妇女（125例）比较,探讨异常孕产与4种病原体的关系。结果异常孕产史妇女中TP—IgM、TOX—IgM、HSVⅡ-IgM和CMV—IgM感染阳性率分别为1．81％、9．86％、1．61％和9．26％;正常孕产妇女仅TOX和CMV阳性病例各1例,其感染阳性率均为0．80％。在自然流产和胎儿畸形组,TOX感染阳性率分别为10．74％和7．41％;CMV感染阳性率分别为10．02％和7．41％。结论TOX和CMV感染是引起异常孕产的重要因素之一;在异常孕产中,以自然流产比率最高,胎儿畸形次之。因此,建议把TOX和CMV作为妊娠前或妊娠早期妇女常规检测项目,以便及早发现,及时防治,减少异常孕产的发生。     

孕妇TORCH感染及血清中白细胞介素-6、肿瘤坏死因子-α水平的变化

目的了解孕妇弓形虫（TOX）、风疹病毒（RV）、巨细胞病毒（cMv）及单纯疱疹病毒（HSV）感染（TORCH感染）情况及其血清IL-6、TNF—α的变化。方法采用ELISA法进行血清TORCH-IgM检测，同时采用双抗体夹心ELISA法测定孕妇血清IL-6及TNF—α。结果853例早期孕妇中TORCH-IgM阳性78例，占9．14％，其中CMV—IgM阳性31例，占3．63％，TOX-IgM阳性21例，占2．46％，RV-IgM阳性14例，占1．64％，HSV—IgM阳性12例，占1．41％。TORCH—IgM阳性孕妇血清IL-6和TNF—α分别为（67．25±13．24）ndL和（278．13±81．03）ng/L，对照孕妇分别为（28．62±10．23）ng／L和（173．21±41．17）ng/L，TORCH—IgM阳性孕妇血清IL-6和TNF—α均较对照孕妇明显升高（P〈0．01）。结论孕妇TORCH感染以CMV为主；TORCH感染后，孕妇血清中免疫细胞因子失衡，提示免疫调节失衡是TORCH感染后各脏器进一步损伤的重要因素之一，在临床上TORCH感染治疗中，除抗病原体治疗外，还应重视免疫调节治疗。     

妊娠期弓形体感染的母婴传播观察

采用聚合酶链技术（ＰＣＲ）分别检测母婴血弓形体ＤＮＡ（Ｔｏｘｏ－ＤＮＡ）及羊水Ｔｏｘｏ－ＤＮＡ。结果：（１）对３０例孕晚期孕妇检测羊水Ｔｏｘｏ－ＤＮＡ与其新生儿血Ｔｏｘｏ－ＤＮＡ，检测结果无显著差异，Ｐ＞００５。。（２）孕中晚期组孕妇感染弓形体后，其胎儿感染率明显高于孕早期组，Ｐ＜００５。说明孕中晚期孕妇感染弓形体后，易于传染给胎儿且感染弓形体的孕妇维持到足月分娩者，出生的胎儿多为无临床症状的先天性弓形体病（隐性先天性弓形体病，实验室诊断为阳性）；由于羊水易于在孕中晚期获取，故检测羊水Ｔｏｘｏ－ＤＮＡ将有利于先天性弓形体病的早期诊断及早期治疗，从而控制先天性弓形体病儿的出生。     

分娩期孕妇TORCH感染的血清学检测及临床分析

目的 分析分娩期孕妇TORCH感染的影响因素。并探讨其对病理产科的影响。方法 应用酶联免疫吸附法（ELISA）筛查119例分娩期孕妇特异性抗体（IgM,IgG)，同时检测孕母，胎儿肝肾功能。结果 孕母血清中CMV的特异性IgM抗体阳性率和RV的特异性IgG抗体阳性率分别是7.6%和66.1%；TORCH感染与患者的民族，职业，产次及是否感染乙肝密切相关；并且CMV感染与妊高征，胎膜砷破及胎儿宫内窘迫的发生有关。结论 及时发现高危因素，并进行TORCH筛查，有利于优生优育。     

贫困山区妊娠妇女HCMV感染与血清IL-8的关系

目的 研究贫困山区孕期人巨细胞病毒感染状况,探讨苓与白细胞介素8 (Interleukin-8,IL-8)的关系.方法 用ELISA和PCR方法 检测贫困山区323例正常孕妇外周血特异性 HCMV IgM、IgG抗体及HCMV DNA,对其中27例孕期HCMV 活动性感染者及48例孕期无HCMV活动性感染者进行随访,检测产后乳汁及新生儿尿液HCMV DNA;并采用双抗体夹心ELISA法检测孕妇及乳母外周血中IL-8水平.结果 孕妇HCMV活动性感染率为8.36%,宫内传播率为25.93%,孕期CMV活动性感染者及宫内传播者其外周血IL-8水平显著高于未感染者(P<0.05),乳汁排毒者和未排毒者间血清IL-8水平没有明显变化.结论 近年来贫困山区孕期HCMV活动性感染率有所下降,但较国内外报道仍高;IL-8在孕期活动性HCMV感染及宫内感染中可能起着重要的免疫调节作用.     

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.     

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.     

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.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.     

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.