388例HIV／AIDS患者临床特点与机会性感染发病谱

目的了解本地HW／AIDS患者的一般情况、传播途径，分析其临床特点，总结出本地艾滋病患者的机会性感染发病谱从而指导早期诊断和治疗。方法对长沙市传染病医院2003年4月-2009年8月底收治的388例HIV／AIDS患者进行回顾性分析。结果388例HIV／AIDS患者以农民、小城镇外出打工人员为主；主要传播途径为性传播；40．98％的患者胸片检查异常，绝大多数的患者CD4^＋T淋巴细胞〈200个／tA；最常见的临床症状为发热、体重减轻、咳嗽、慢性腹泻、皮肤病变及淋巴结肿大；机会性感染发生率为91．75％，最常见的机会性感染是口腔真菌感染（占54．12％），肺部感染（占45．10％）（其中包括卡氏肺孢子虫肺炎及肺结核），合并感染结核者占36．08％（包括肺结核及肺外结核）。结论本地HIV／AIDS的人群以农民、打工人员为主，传播途径主要是性传播；机会性感染以鹅口疮最为常见，其次为肺部感染，且表现为多系统、多种致病微生物并存，细菌、真菌、病毒均为常见病原，呼吸、消化系统以及皮肤软组织为常见感染部位。     

862例HIV／AIDS住院患者统计分析

目的了解1998-2006年HIV／AIDS住院患者的基本情况、感染途径以及主要的机会性感染，为广西地区防治和研究艾滋病提供基础数据和信息。方法提取1998-2006年HIV／AIDS住院患者862例归档病案进行统计分析。结果HIV／AIDS患者中男性居多，占83．76％，农民和无业者占75．52％；感染的主要途径为吸毒和性传播，夫妻感染呈现上升趋势；结核病、口腔真菌感染、丙肝和肺孢子菌病是主要的并发症。结论HIV／AIDS患者逐年增加，近2年增加幅度更大，并由高危人群向普通人群扩散。     

服务行业女性从业人员性病、艾滋病认知调查

目的了解深圳市某娱乐场所从业人员的人口学状况、行为特征及对HIV／AIDS相关知识的知晓程度。方法利用随机抽样方法，对深圳市某社区13家娱乐场所的245名女性从业人员进行性病、艾滋病知识的宣传教育；教育前后进行现场调查。结果首次性生活年龄最小13岁、最大25岁，中位数19岁；曾自愿接受HIV抗体检测占9．2％；经常使用安全套的仅占13．6％；教育前：HIV／AIDS相关知识知晓率2．0％（5／245）；HIV/AIDS经性传播相关知识知晓率22．0％（54／245）；教育后：HIV/AIDS相关知识知晓率16．7％（41／245）；HIV／AIDS经性传播相关知识知晓率35．5％（81／245）。结论娱乐场所从业人员对性病、艾滋病相关知识的了解和安全性行为的认知度低。有必要加强教育，以减少该人群性病和艾滋病的发生。遏制性病、艾滋病由高危人群向一般人群的蔓延。     

重庆市228例首诊AIDS住院患者流行病学及临床特征分析

目的通过对重庆市公共卫生医疗救治中心首诊艾滋病（acquired immunodeficiency syndrome，AIDS）患者的病例档案资料进行整理分析，探讨重庆市AIDS患者的流行病学及临床特征，为临床治疗和疾病控制的深入研究提供科学依据。方法检索重庆市公共卫生医疗救治中心（重庆市唯一一家收治AIDS的定点医院）1995年12月～2008年12月AIDS患者的病例档案，对AIDS首诊住院患者的病例档案进行归类整理，采用统计学方法对病例的年龄、性别、职业、传播途径和临床症状等分布特征进行描述。结果从1995年12月至2008年12月，重庆市公共卫生医疗救治中心首诊AIDS确诊患者共228例，其中1995年为1例，2008年为91例；病例以重庆市区及邻近的区县为主（占78．51％）；男女比例为2．30：1；30～50岁占72．81％，年龄最小为7个月，最大为92岁；异性性接触为主要传播途径（70．18％），其次为静脉吸毒（12．72％）；临床以机会感染症状为主要表现，其中结核分枝杆菌感染占60．53％（138／228），合并肺部细菌感染（包括葡萄球菌、链球菌、肺炎球菌等），占57．89％（132／228）；口腔白色念珠菌病，占46．93％（107／228）；临床检验中CD4淋巴细胞计数〈50个／μl 140例、50～200个／μl 70例、〉200个／μl 18例。结论重庆地区艾滋病疫情呈加速上升趋势，应当加大市区及邻近区县青壮年人群的AIDS控制力度，重视异性性传播的干预；患者第一次入院多因机会性感染就诊，临床医生必须提高对AIDS的警觉性。     

132例艾滋病机会性感染临床特征分析

[目的]分析云南省红河州艾滋病（AIDS）机会性感染的临床特点。[方法]回顾性分析本院1998年6月～2007年6月收治的132例艾滋病病例的临床资料，总结艾滋病机会性感染的临床特点。[结果]132艾滋病病例中，机会性感染结核病84例，占63．6％，真菌感染58例，占40．9％，HIV／HCV合并感染46例，占34．8％，带状疱疹、沙门氏茵感染、致病性大肠埃希杆菌肠炎、金黄色葡萄球菌肺炎、弓形虫脑病亦有发病。[结论]艾滋病机会性感染临床表现复杂多样，结核病是最常见的机会感染，其次是真菌感染，HIV／HCV合并感染率高。     

2005-2008年兴文县HIV／AIDS流行病学分析

目的了解2005_2008兴文县年HIV／AIDS的流行病学特征。方法监测兴文县境内2005-01一01／2008．12-31HIV／AIDS高危感染人群,对兴文县疾病预防控制中心初筛后经四川省疾病预防控制中心确认的HIV／AIDS患者进行流行病学分析。结果2005m1一01／2008-12-31初筛高危人数11341人,经确认的HIV／AIDS为37例,占初筛人数的0．33％（37／11341）,占该县总人口数8．40／10万（37／44万）,TB／HIV人数为5例,占初筛的0．04％,占HIV／AIDS的13．51％;HIV／AIDS中农村人口占67．57％（25／37）,城市人口占32．43％（12／37）;发病前3位的职业分别为农民／民工48．65％（18／37）、FSW（女性商业性工作者）18．92％（7／37）、无业13．51％（5／37）。男性发病人数高于女性,分别为64．86％（24／37）和35．14％（13／37）,发病高峰期年龄段为20～50岁,占86．49％（32／37）;37例患者通过性传播途径,注射吸毒传播、母婴垂直传播及其他传播途径感染HIV／AIDS分别为25例、9例、1例和2例,患者中初中及以下文化程度占81．08％。结论兴文县HIV／AIDS患者以性传播感染为主,男性高于女性,发病人群主要集中在文化程度较低的农民／农民工和FSW,发病高峰期年龄为青壮年。     

广州地区10年入境境外人员中HIV/AIDS的流行病学调查及国内传播危险因素分析

[目的]了解广州地区入境境外人员中HIV／AIDS的感染、罹患情况，流行病学特征，评估HIV／AIDS引发国内人群传播和流行的风险性。[方法]对1996-2005年发现的HIV／AIDS资料进行回溯性流行病学调查，分析其可能引发在国内人群传播和流行的各种危险因素。[结果]10年间共发现HIV／AIDS43例，检出率为0．10％。其中HIV-1感染41例，HIV-1＋2感染2例；被诊断为艾滋病病人的4例，其中已死亡2例；HIV感染并发梅毒6例。通过性接触（同性屏性）和吸毒感染的28例（占65．12％）；手术输血感染2例（占4．65％），否认感染史或未接受流行病学调查13例（占30．23％）。他们在中国（境内）平均居留290d，承认在我国（境内）有性伴侣／不洁性接触史的有15例（占性接触感染者的53．57％），性伴侣最多的达50多个，最少的也有2个。[结论]艾滋病正通过入境境外人群不断地从境外传入国内，造成国内人群传播和流行的风险性日益增大。     

连云港市1996-2005年HIV/AIDS流行病学分析

目的探讨连云港市HIV／AIDS流行病学特征。方法收集1996-2005年发现的22例HIV／AIDS流行病学资料进行分析，HIV／AIDS诊断按GB16000—1995国家标准。结果22例HIV／AIDS感染者（病人），1例为外籍希腊船员，余均为中国本土人，其中本市籍17人（77．3％）；年龄除外籍船员52岁，中国人均在21-46岁，AIDS发病最小年龄21岁（女）；HIV携带者最长已达11a；性传播是本市HIV／AIDS的主要传播途径（86．4％），其中配偶间传播2对；HIV／AIDS发现途径有义务献血（3例），性病门诊（5例），注射吸毒者（5例），术前筛查（2例），AIDS早期症状（4例），归国体检（1例）。结论改变HIV／AIDS感染者（病人）以及具有感染HIV危险行为人群的高危险行为，是控制AIDS流行的有效措施。     

对北京护理人员HIV／AIDS的知识、态度调查和HIV／AIDS医源性暴露风险评估

目的：了解北京护理人员对HIV／AIDS的知识、态度以及评价医源性HIV／AIDS暴露的风险。方法：以分层随机抽样的方法，对北京市6所医院的1300名护理人员进行问卷调查，了解其对HIV／AIDS的知识、态度及医院对侵袭性医疗器械的使用、收集、消毒情况；对北京地坛医院艾滋病病房的全体护理人员（22人）进行问卷调查，做HIV／AIDS医源性暴露情况的10年回顾性研究。结果：90．3％以上的护士对HIV／AIDS有很全面的认识，但仅31．8％的护士愿意给艾滋病患提供全护理，好们掌握HIV／AIDS知识的程度与愿意接纳艾滋病患的态度之间不呈正相关（P＜0．05）；从事HIV／AIDS工作的护理人员“侵袭性医疗操作”误伤率31．8％；北京市各级医院中侵袭性医疗器械重复使用率1．3％－27．1％。收集用过的侵袭性医疗器械的容器，不符合安全标准的占33．3％，消毒用过侵袭性医疗器械的程序不正确的占17．2％。结论：北京护士掌握HIV／AIDS知识较好，但对HIV感染／AIDS患仍有相当的排斥。进行侵袭性医疗操作及使用、收集、消毒侵袭性医疗器械的过程中也存在HIV／AIDS医源性暴露的风险。制定有关的医疗防护政策是必要的。     

2006-2011年河南省新蔡县HIV／AIDS流行病学特征与趋势分析

目的了解和掌握河南省新蔡县新发现HIV／AIDS流行病学特征和流行趋势,为制定艾滋病防治策略提供科学依据。方法对2006-2011年发现的HIV／AIDS监测、检测资料进行统计分析。结果2006-2011年全县发现HIV感染者及AIDS病人531例,其中HIV感染者118例,AIDS病人413例。传播途径以输入血液／血制品为主,占43．13％;其次为异性性传播（其中婚内性传播131例,婚外性传播38例）,占31．83％;有偿采供血传播占12．24％;母婴传播占5．08％;同性传播占0．75％;静脉吸毒占0．38％;其他及不详占6．59％。结论当前新蔡县预防与控制艾滋病的重点是应加强对1995年以前输入血液／血制品人群的专题调查,及时发现病例,并加强对单阳配偶、阳性育龄妇女、丧偶阳性者的干预管理,预防婚内性传播,同时积极开展高危行为干预措施,减少经性传播的发生。     

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.     

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.     

Stress in police officers: a study of the origins,prevalence and severity of stress-related symptoms within a county police force

BACKGROUND: High levels of stress-related illness are causing concern across industry. Against a background of impending legislative moves to try to improve this situation, there is a need to identify key work-related stressors. Police work tends to be regarded as inherently stressful because of the personal risk of exposure to confrontation and violence and the day-to-day involvement in a variety of traumatic incidents. As a result, high levels of stress-related symptoms might be expected in this population. OBJECTIVE: To examine the sources of stress-related symptoms within police officers and measure the prevalence of significant associated mental ill-health. METHOD: A cross-sectional questionnaire survey of a population of 1206 police officers was performed to assess levels of strain associated with a series of potential home and work related stressors. Participants were then split into low and high scoring groups on the basis of a General Health Questionnaire (GHQ) threshold score in order to identify those stressors most associated with mental ill-health effects. RESULTS: Occupational stressors ranking most highly within the population were not specific to policing, but to organizational issues such as the demands of work impinging upon home life, lack of consultation and communication, lack of control over workload, inadequate support and excess workload in general. The high scoring group constituted 41% of the population and differed significantly from those with low scores in perception of all stressors, ranking both personal and occupational stressors more highly, and from personality constraints appeared significantly more 'stress-prone'. A significant association between gender and mental ill-health was found, with females more likely to score more highly on the GHQ than males. CONCLUSION: This study confirms previous findings of organizational culture and workload as the key issues in officer stress. Given that the degree of symptomatology appears to be worsening, management action is required. Further research is indicated within the police population into a possible increased susceptibility in female officers.