尖锐湿疣患者人乳头瘤病毒的亚型分布比较

目的:探讨人乳头瘤病毒亚型的地区分布差异。方法:采用GP-PCR和基于序列分析的基因分型方法进行HPV的检测与分型,宜春、阳城、沈阳、广州为4个研究现场。将其划分成农村和城市、北方与南方分别进行比较。结果:农村和城市分别检出单一型感染39例、163例,复合型感染2例、5例,HPV亚型分别为3种、5种;北方与南方分别检出单一型感染100例、163例,复合型感染4例、5例,HPV亚型分别为5种、3种;农村与城市、北方与南方高危型与低危型分布有差异。结论:HPV11和HPV6两低危型为尖锐湿疣患者的优势亚型;农村地区和北方地区均以单一型感染为主。     

反向寡核苷酸探针杂交技术检测人乳头状瘤病毒基因型的临床应用

目的探讨反向寡核苷酸探针杂交技术(PCR-RDB)在人乳头状瘤病毒(HPV)分型检测中的临床应用。方法采用PCR-RDB对524例HPV感染的女性生殖道标本进行HPV分型检测,分析各型的感染率以及感染病毒与年龄段关系。结果 524例HPV感染者共检出5种低危型和18种高危型,其中单一型感染者304例,占58.02%,2种混合感染79例,占15.07%,3种混合感染51例,占9.73%,4种混合感染45例,占8.59%,5种混合感染35例,占6.68%,>5种混合感染10例,占1.91%,低危型感染以HPV-6、11为主,高危型感染以HPV-16、18、58、52、33型为主,不同年龄段感染各型也存在差异,15~25岁感染者以低危感染为主,多重感染主要发生在该年龄段;46~55岁年龄段感染高危型较多,随着宫颈糜烂程度的增加多重感染数量也增加。结论 PCR-RDB法可检测HPV多种亚型,对HPV感染早期诊断及预防宫颈病变和治疗具有较好的临床应用价值。     

解脲支原体及合并人型支原体感染对12种抗生素敏感性的比较

目的了解非淋菌性尿道炎(NCU)患者解脲支原体(UU),人型支原体(MH)混合感染对12种抗生素的敏感性及其与解脲支原体单一感染的差异。方法用珠海浪峰试剂对UU、MH培养阳性的223例患者进行了12种抗生素的体外药物敏感性测定。结果UU感染组与uu MH混合感染组对12种抗生素有不同程度的耐药,UU组和UU MH组中耐药率最高的分别为红霉素(77．1％)和阿奇霉素(91．7％)。结论支原体感染具有较高耐药性,不同类型支原体感染表现的耐药性不一致,MH UU混合感染比单纯UU感染对多种抗生素有较高耐药性,通过药敏试验指导临床合理用药,才能减少耐药株产生。     

育龄妇女性病病原体感染分析

目的了解有生殖道感染症状与体征的已婚育龄妇女中5种性病病原体的感染情况。方法用PCR法对浙江省950例有生殖道感染症状与体征已婚育龄妇女的宫颈分泌物进行人乳头瘤病毒(HPV)16.18、HPV6.11、沙眼衣原体(CT)、解脲支原体(UU)、淋病奈瑟菌(NG)检测。结果该组人群的5种性病病原体总阳性率为69.05%(656/950),其中HPV6.11阳性率最高(45.47%),UU阳性率次之(42.95%),CT阳性率为8.50%,HPV16.18阳性率为2.20%,NG阳性率最低(0.32%),单一病原体感染率42%,混合感染率26.94%,性病病原体感染与受教育程度呈正相关(P<0.05),年龄差异与性病病原体感染无统计学意义(P>0.05)。结论本地区已婚育龄妇女存在不同程度5种性病病原体感染,应高度重视感染的控制问题。     

医院文化建设对医院感染管理的作用

目的探讨医院感染文化建设对医院感染管理的作用,寻找加强医院感染管理的有效途径与方法。方法调动全院各部门职工积极参与医院感染控制,举办了医院感染控制宣传周这一活动。结果宣传周活动加强了医院领导和医务人员对预防控制医院感染重要性的认识,提升了职工对“预防院感,你我行动”的责任意识,促进了医院感染管理处与其他各部门在医院感染管理工作上的合作与协调。结论医院感染文化建设对医院感染管理有着积极的促进作用,提高了医院感染控制工作在医务人员当中的影响力,是加强医院感染管理的一种有效方法。     

白色假丝酵母菌与细菌混合生物膜的研究

生物膜(BF)是微生物生长过程中为适应生存坏境而吸附于惰性或活性材料表面形成的一种与浮游细胞(planktonic cell)相对应的生长方式,由微生物和自身分泌的胞外基质组成[1].研究表明,人体中80％的感染涉及到BF的形成[3];根据美国国家卫生协会和疾病控制中心的调查显示,有＞60％的感染与BF的形成有关[2].临床常见的BF相关感染有两种,一种是医疗材料相关性感染,即病原菌黏附于医疗材料表面如导尿管、中心静脉插管和人工心脏瓣膜等表面,形成BF而导致感染;另一种是慢性感染,微生物在人体腔道表面吸附生长而引起的感染.     

邛崃县人体寄生虫分布的调查研究

本文报告了邛崃县首次人体寄生虫分布调查研究的结果。人群肠道寄生虫总感染率为85.51％,检出虫种12种,其中6种为我县首次发现;1人感染寄生虫多为1-3种,最高感染5种。感染率女性高于男性,农村高于城市。职业以农民、学生为高,各年龄感染有显著性差异。并初步探讨了寄生虫感染与自然环境、生产劳动、经济状况、卫生习惯等     

导管室医院感染的危险因素与干预对策

介入治疗是一种有创性操作,导管室的工作质量与医院感染密切相关,感染的预防和控制是护理人员关注的重点.     

清上治下法治疗慢性肾小球肾炎98例疗效观察

慢性肾小球肾炎（CGN）是一种与感染有关的免疫反应性疾病,以双侧肾症的肾小球病变为主要表现,其形成与机体内感染灶对肾脏的长期影响有关。扁桃体炎、咽炎是常见的咽喉感染疾病,与CGN的发生、复发和恶化有重要的相关性。咽喉感染灶控制与否直接关系到CGN的治疗效果。     

结核病与寄生虫病的关联

结核病和寄生虫病均为全球重大的公共卫生问题,世界各地已报道了多个结核菌和寄生虫双重感染以及结核病与寄生虫病误诊的案例,两种疾病之间的关联不容忽视.结核菌不仅可与单一寄生虫发生双重感染,而且在一些特殊情况下也可能与多种寄生虫发生多重感染.在亚洲和东非部分国家开展的流行病学研究显示,结核病患者中约有2.6％～77％感染了不同的寄生虫,呈现出虫种和地区的差异.多项研究表明,与被单一病原体感染相比,结核菌和寄生虫的双重感染能够降低宿主机体免疫机能,使结核病患者的临床症状加重、病程延长、治疗预后差.某些寄生虫病,尤其是肺部寄生虫病,与结核病具有相似的临床表现及肺部影像学特征,易被误诊为结核病,从而导致治疗延误.     

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.     

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.     

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.