乙肝疫苗接种无弱应答与遗传因素关系的研究

为了研究乙肝疫苗接种无弱应答的发生机制，本次研究首先对经过严格筛选的无弱应答和强应答（对照）者一级亲属（分别有８０和７９人）自然状况下的ＨＢＶ感染率进行比较。结果显示，无弱应答组ＨＢＶ的感染率为３３．８％，明显高于强应答组的１５．２％（Ｐ＝０．０１１）。在此基础上，进一步观察了无弱应答和强应答组一组亲属中乙肝三项指标全阴性和单项抗－ＨＢｓ低水平者５６人（分别为２７和２９人）接种乙肝疫苗后Ｔ７时抗－ＨＢｓ的分布情况，两组分别随访到２４人和２８人，结果无弱应答组的ＧＭＴ显著低于强应答组的ＧＭＴ。表明无弱应答具有一定的遗传易患性。     

单项乙型肝炎核心抗体（抗—HBc）阳性意义的研究

对１５名单项抗－ＨＢｃ阳性者按０、１、６方案接种３针１０μｇ血源性乙肝疫苗，１５．４％出现回忆反应，提示这部分人为过去感染已获得免疫；２６．７％产生原发性反应，这部分人可能是血清学假阳性结果；６０．０％对疫苗无、弱应答，可能代表“低水平”ＨＢｓＡｇ携带者。对经ＥＬＩＳＡ和ＲＩＡ两种方法确定的７０例单项抗－ＨＢｃ阳性者用ＰＣＲ方法检测ＨＢＶＤＮＡ，阳性率为１２．９％，说明单项抗－ＨＢｃ阳性是与ＨＢＶ携带有关的指标，单项抗－ＨＢｃ阳性者中有一部分人为ＨＢＶ携带者     

航行管制职业人群乙型肝炎病毒感染模式的研究

本文采用ＥＬＩＳＡ法检测无疫苗接种史５０２例航管人群乙型肝炎病毒（ＨＢＶ）感染标志物，其中１０２例检测ＩｇＧ、ＩｇＡ、ＩｇＭ。结果：乙肝总感染率为８０４８％，以抗－ＨＢｃ和抗－ＨＢｓ检出最高，存在１３种感染模式，注射血源乙肝疫苗二年后ＨＢｓＡｇ阳性率显著低于接种前水平。辐射组ＩｇＧ显著低于对照组。认为ＨＢＶ感染状况与长期暴露于低强度射频辐射职业环境有关系     

河南省接种与未接种乙型肝炎疫苗人群HBV感染血清抽样调查

对河南省１３个、县居民抽样调查５８９０人，接种与未接种乙型为疫苗人群中平均ＨＢＶ感染率分别为３５．４４％和６４．２１％。各年龄组ＨＢＶ感染率及ＨＢｓＡｇ、抗－ＨＢｃ和抗－ＨＣＶ阳性率均是未接种组人群高于接种组人群，而抗－ＨＢｓ则正相反。结果显示，接种乙型肝炎疫苗可以有效地降低ＨＢＶ感染。     

肝癌高发区HBV感染与肝癌关系的流行病学研究

目的：为了探讨同安县原发性肝癌高发的主要危险因素。方法：应用流行病学调查研究的方法，开展了１：２配对的ＰＨＣ危险因素病例－对照，ＥＬＩＳＡ法的高危人群筛检，ＨＢＶ感染与ＰＨＣ关系的前瞻性研究。结果：ＨＢｓＡｇ携带率病例组高于对照组，抗－ＨＢｓ阳性率病例组低于对照组；ＨＢｓＡｇ携带率病例组高对对照组，抗－ＨＢｓ阳性率病例组低于对照组；ＨＢＳａＧ，ＡＦＰ阳性率男性高于女性，抗－ＨＢｓ阳性率男性低于女性     

不同患者群体HBsAg阳性者HBV感染特点的对比研究

目的为评价ＨＢｓＡｇ作为ＨＢＶ医院感染监测指标的价值。方法以ＰＣＲ技术检测了ＨＢｓＡｇ阳性的８０例普通住院患者和１２３例肝炎患者的ＨＢＶＤＮＡ。结果普通患者的ＨＢｅＡｇ和ＨＢＶＤＮＡ阳性率显著低于肝炎患者，抗－ＨＢｅ阳性率则升高，ＨＢＶＤＮＡ阳性率的差异仅存在于抗－ＨＢｅ阳性模式之中。提示两组患者的ＨＢＶ携带率、传染性、感染阶段和感染的分子生物学机理等方面均存在差异。ＨＢｓＡｇ可作为肝炎患者预示ＨＢＶ传染性的良好指标，但对普通患者的预示作用则大为降低。结论ＨＢｓＡｇ作为ＨＢＶ医院感染监测指标的实用性仍需作进一步的研究。     

山西省原发性肝癌丙型肝炎病毒、乙型肝炎病毒感染状况分析

目的　探讨山西地区原发性肝癌（ＰＨＣ） 中丙型肝炎病毒（ＨＣＶ） 和乙型肝炎病毒（ＨＢＶ） 感染状况。方法　选择以山西省肿瘤医院为主的省级４ 所医院ＰＨＣ患者９８ 例,检测抗－ＨＣＶ、ＨＢｓＡｇ、抗－ ＨＢｓ、ＨＢｅＡｇ、抗－ ＨＢｅ、抗－ ＨＢｃ、抗－ ＨＢｃＩｇＭ 等指标,均采用ＥＬＩＳＡ 法进行测定。结果　ＰＨＣ 组抗－ ＨＣＶ 阳性率８．１６ ％ ,ＨＢＶ 感染率６８ ．３７％ ,均显著高于对照组的阳性率（ Ｐ＜０ ．０５） 。两者的病因分值（ＡＲＰ） 分别为９４％ 和９１ ％ 。经１∶２ 条件ｌｏｇｉｓｔｉｃ 多元回归分析,抗－ ＨＣＶ、ＨＢｓＡｇ 和抗－ ＨＢｃ 均作为独立的危险因素进入了回归方程,其ＯＲ值分别为５５ ．０６、１０ ．１８ 和９．８５ 。叉生分析结果表明,抗－ ＨＣＶ和ＨＢｓＡｇ 双阳性的ＯＲ值为６１ ．３７,较两指标单一阳性的ＯＲ值明显为高,亦高于两者单独阳性的ＯＲ值之和。结论　ＨＣＶ 和ＨＢＶ 感染均是ＰＨＣ发生的主要病原学因素。ＨＣＶ感染在致肝癌作用中,是当地不可忽视的重要因素,ＨＢＶ 仍是肝癌发生的主要因素。ＨＢＶ和ＨＣＶ双重感染对肝癌的发生具有协同作用。     

不同患群体HBsAg阳性者HBV感染特点的对比研究

为评价ＨＢｓＡｇ作为ＨＢＶ医院感染监测指标的价值。方法以ＰＣＲ技术检测了ＨＢｓＡｇ阳性的８０例普通住院患者和１２３例肝炎患者的ＨＢＶＤＮＡ。结果普通患者的ＨＢｅＡｇ和ＨＢＶＤＮＡ阳性率显著低于肝炎患者，抗－ＨＢｅ阳性率则升高，ＨＢＶＤＮＡ阳性率的差异仅存在于抗－ＨＢｅ     

医学干扰对医院职工HBVm影响的观察

医学干扰前后医院职工ＨＢＶｍ检测分析，结果为抗－ＨＢｓ阳性率显著升高，感染性ＨＢＶｍ阳性率显著下降，ＨＢＶｍ类型变化为ＨＢｓＡｇ、ＨＢｅＡｇ、抗－ＨＢｅ及抗ＨＢｃ的阳性率显著下降，ＨＢｓＡｇ、ＨＢｅＡｇ、抗－ＨＢｃ的阳性率无变化，但ＨＢｓＡｇ、抗－ＨＢｅ、抗－ＨＢｃ的阳性率显著上升。分析结果提示医学干扰显著降低了ＨＢＶ感染率，同时也反映了乙肝携带者较难转阴。     

河北省某农村人群乙型和丙型肝炎病毒感染的调查

报告河北省某农村人群ＨＢＶ与ＨＣＶ感染的调查结果。该人群ＨＢＶ总感染率为５５．２％，以１０￣１９岁组最高，为６７．１％；抗－ＨＣＶ阳性率为７．１％，以４０￣４９岁组最高，为２１．１％，１０岁以下和６０岁以上组无１例抗－ＨＣＶ阳性。ＨＢＶ感染具有明显家庭聚集性，ＨＣＶ感染无家庭聚集性。父母ＨＢｓＡｇ均阳性的子女，其ＨＢｓＡｇ阳性率（３２．６％）明显高于父母均阴性者（１５．６％），但父母抗－ＨＣＶ阳性     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.     

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 reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

Function of the protein RPE65 in the visual cycle

A protein called RPE65 performs a key role in the trans-cis isomerization of retinol in the retinal pigment epithelium of the eye. The palmitoylation of RPE65 serves to switch off the visual cycle in darkness and to switch it on in the light.     

Acute symptoms following work with pesticides

BACKGROUND: Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms. AIM: To explore the frequency, nature and determinants of acute symptoms following work with pesticides. METHODS: A postal survey of men in three rural areas of England and Wales provided data on occupational use of five categories of pesticide, occurrence of 12 specified symptoms within 48 h of using pesticides and tendency to somatize. Risk factors for pesticide-related symptoms were assessed by modified Cox regression. RESULTS: Of 10 765 responders (response rate = 31%), 4108 had at some time used pesticides occupationally, including 935 (23%) who reported symptoms following such work on at least one occasion. In two areas, acute symptoms were most frequent following use of sheep dip (29 and 32% of users), but in the third area the rate was significantly lower (13% of users). The relative frequency of symptoms was similar for all five categories of pesticide, and flu-like symptoms did not cluster unusually among users of sheep dip. Risk of pesticide-related symptoms increased with somatizing tendency (prevalence ratio for highest versus lowest category 2.4, 95% confidence interval 2.0-3.0) and was higher in men who had used pesticides most often or handled concentrate. CONCLUSION: Acute symptoms are common following work with pesticides, but in many cases the illness may arise through psychological rather than toxic mechanisms.     

The Life Events Inventory: re-scaling based on an occupational sample.

The objective of this study was to compare the validity of the original weightings used by the Life Events Inventory (LEI) with those obtained from a contemporary occupational sample. Fifty male and 62 female manufacturing employees (age range 16-55 years) assigned scores to each item on a slightly modified version of the LEI scale. The current sample consistently assigned higher weights to events/items than did the original sample, but there was high agreement in terms of item ranking. Some distinct age and gender differences in scoring were apparent, and are discussed further. It was concluded that when separate weightings are employed for age and gender groups, the LEI remains a useful tool for quantifying background levels of stress in both workplace stress audits and epidemiological studies where statistical control for non-occupational sources of stress is required.     

Maxillofacial injuries related to work accidents: a new concept of a hospital-based full electronic occupational trauma surveillance system

The objective of this study was to investigate the occurrence of occupational maxillofacial injuries using a newly installed relational database. Twenty-six injuries were identified out of 28,624 patients admitted to the emergency unit during a 12 month period. Falls from height or being struck by moving objects were common causes of these injuries. Two-thirds of those identified were construction workers. This paper demonstrates the power of modern databases to identify specific occurrences that may provide the basis for prevention in the future.     

Rôles physiologiques des endocannabinoïdes dans le contrôle de l’homéostasie énergétique

Endocannabinoids are endogenous lipids which modulate the release of neurotransmitters and activate different signaling pathways, through the binding to cannabinoïd receptors, CB1 and CB2. Endocannabinoids are involved in the control of a variety of behavioural and neuroendocrine functions, including feeding behaviour. In the central nervous system, they essentially modulate the expression of orexigen or anorexigen neuropeptides thus resulting in the stimulation of food intake. Their peripheral targets are mainly the liver and the white adipose tissue where they stimulate lipogenesis, through the modulation of several enzymes and proteins expressions. Cannabinoïd receptor agonists are nowadays prescribed to improve appetite of people suffering from cancer or AIDS. In the same way, CB1 antagonist, such as Rimonabant, could provide efficient treatment of obesity.