用3种方法检测一起新甲型H1N1型流感病毒感染暴发流行的结果分析

目的探讨用3种方法检测2013年5月赣州市某小学暴发的一起急性上呼吸道病毒感染病原学的检测结果。方法采集患者急性期咽拭子标本进行流感病毒核酸检测(荧光PCR);咽拭子标本用MDCK细胞进行病毒分离;用患者急性期和恢复期双份血清进行新甲型H1N1型流感病毒的红细胞凝集抑制试验(HI)。结果 14份咽拭子标本中用荧光PCR扩增检测到了13份新甲型H1N1型流感病毒核酸,阳性率为92.9%。14份咽拭子标本用MDCK细胞分离到10株新甲型H1N1型流感病毒,阳性率为71.4%。14名患者中有9名患者双份血清的新甲型H1N1型流感病毒HI试验恢复期抗体比较急性期抗体有4倍或以上增长(阳性率为64.3%)。结论该次急性上呼吸道感染是由新甲型H1N1型流感病毒引起的,3种检测方法各有特点。     

一起急性呼吸道感染症暴发疫情的病原学和流行病学研究

目的：对一起急性呼吸道感染症暴发疫情进行流行病学和病原学研究，以明确诊断，控制疫情。方法：通过流行病学调查描述疫情流行特征；采用病例对照研究分析流行因素；患者的咽拭子标本中提取核酸；PCR法检测病毒特异性基因片段；组织培养法（Hep-2细胞）分离病毒；电子显微镜观察病毒形态；型特异血清及型特异引物鉴定分离毒株型别；中和实验检测患者急性期和恢复期血清抗体效价。结果：疫情报告病例871例，波及10个乡镇，主要为在校中小学及幼儿园学生（占94．37oA），具有班级聚集性。病例对照研究显示危险因素为与病人的接触、与鸡接触及家庭内共用毛巾等。35份咽拭子标本分离出15株病毒，分离阳性率42．9％。分离病毒经鉴定为腺病毒3型。PCR法检测腺病毒DNA，112份咽拭子标本中68份阳性，阳性率60．7％。18例双份血清中13例中和效价呈4倍以上增长或转阳，阳性率72．2％。对病毒进行全基因序列测定，确定为腺病毒3型。结论：本起急性呼吸道感染症暴发疫情由腺病毒3型引起，传播途径以呼吸道传播和密切接触为主。     

一起由3型腺病毒引起的咽结膜热病原学研究

目的　探讨2 0 0 4年7月上旬广州市某幼儿园暴发的一起咽结膜热的病原学。方法　采集急性咽结膜热患儿急性期眼或咽拭子标本用Hep 2细胞进行病毒分离,并对原始标本及病毒分离物使用PCR方法及序列测定进行检测鉴定。用分离鉴定的毒株作为抗原,测定7例患儿及2名健康儿童(阴性对照)双份血清中病毒的中和抗体。结果　2 2份患儿的咽拭子和眼拭子标本用PCR测定显示12份为腺病毒阳性,2 2份标本中只分离出9株毒株,经鉴定所有病毒株均为3型腺病毒,且与朝鲜分离的3型腺病毒同源性高达97%。以分离到的1株毒株与7例患儿自身急性期和恢复期血清的中和试验显示恢复期中和抗体较急性期有4倍或4倍以上增长,2例阴性对照中和抗体无增长。结论　该起急性咽结膜热暴发是由3型腺病毒引起的     

北京地区2002年秋冬儿童急性上呼吸道感染爆发的病原学调查

目的 了解2002年11～12月北京地区急性上呼吸道感染爆发的病原。方法 收集2002年11～12月北京地区80例患急性上呼吸道感染儿童咽拭子标本,应用经典病毒学方法(病毒分离和血凝试验)进行流行性感冒(流感)病毒、副流感病毒、呼吸道合胞病毒及腺病毒分离鉴定,应用巢式聚合酶链反应方法进行流感病毒、呼吸道合胞病毒、腺病毒及肺炎支原体(Mp)的检测。结果 80例标本中检测到B流感病毒18例(阳性率22.5％)、A3型流感病毒2例(阳性率2.5％)、肺炎支原体13例(阳性率16.3％),未检测到A1型流感病毒、副流感病毒、呼吸道合胞病毒及腺病毒;其中2例同时检测到B型流感病毒与Mp,1例检测到A3型流感病毒与Mp。结论 B型流感病毒是此次儿童上呼吸道感染的首要病原,Mp感染是第二位病原。     

2003年福建省流行性感冒监测结果分析

[目的]对福建省2003年流行性感冒进行病原学、流行病学监测分析。[方法]采集监测医院和疑似流感暴发点流感样病例(ILI)的咽拭子或漱口液、双份血清和一般人群血清标本；用MDCK细胞和鸡胚接种法分离病毒；血凝抑制法鉴定毒株和测定血清抗体。[结果]监测医院报告ILI7467例，占门诊病例总数的3．7％。从792份ILI呼吸道标本中分离出流感病毒97株，其中H3N2亚型90．7％，B型9．3％。75例中的31例双份血清抗体呈≥4倍升高，其中H3N2亚型20例，B型11例。150份一般人群血清的H1N1、H3N2亚型和B型流感病毒抗体阳性率分别为57．3％、90．7％和48．0％。[结论]2003年福建省同时存在H3N2亚型和B型流感病毒流行，前者为优势毒株，未发现H1N1亚型。一般人群大多具有H3N2亚型流感病毒抗体，但H1N1和B型抗体阳性率较低。     

2002年福建省急性出血性结膜炎病原分离和鉴定

[目的]查明2002年我省急性出血性结膜炎(AHC)流行的病原。[方法]采集福州和漳州市临床诊断为AHC的患者眼拭子57份、双份血清7份。分别用Hep-2和Vero细胞对标本进行病原分离；用免疫血清微量中和试验对分离出的毒株进行鉴定；用诊断血清鉴定的4株病毒，对7例患者的双份血清进行中和抗体效价测定。[结果]从57份眼拭子标本中分离出47株(阳性率82．5％)；经诊断血清微量中和试验鉴定，均为柯萨奇病毒24变异株(CA24v)；7例患者双份血清经微量中和试验测定，中和抗体均呈≥4倍增长。[结论]CA24v是引起2002年我省AHC流行的病原。     

吉林省2010年7-12月上呼吸道感染病毒病原学检测结果分析

目的了解2010年吉林省地区急性上呼吸道感染患者5种呼吸道病毒感染情况,为以后的急性呼吸道感染监测做出指导。方法采集门诊就诊的456例患者咽拭子标本,对其进行核酸提取后,采用(RT)-PCR方法检测甲型流感病毒(IVA)、呼吸道合胞病毒(RSV)A/B、副流感病毒(PIV)1-4型、腺病毒(ADV)以及博卡病毒(HBoV)等5种常见呼吸道病毒。结果检测出阳性标本92例,阳性率20.18%,以流感病毒感染阳性率(8.11%)最高。结论 2010年7-12月吉林省地区上呼吸道感染主要以流感病毒、呼吸道合胞病毒、腺病毒为主。其中流感病毒感染居首位。     

湛江市1998～2001年流行性感冒监测分析

[目的 ]及时掌握湛江市流行性感冒流行规律和毒株变异动态 ,为及早发现和控制疫情提供科学依据。 [方法 ]1998～ 2 0 0 1年用鸡胚双腔法对湛江市流感样病人咽拭子和鸡咽拭子进行病毒分离 ,用血凝抑制试验进行病毒鉴定 ;用微量半加敏血凝抑制试验测定一般人血清流感抗体。 [结果 ]合计采集病人咽拭子 180 5份 ,分离出 7株H1N1和 4株B型流感病毒 ;鸡咽拭子 96份 ,分离出 4株H9N2 禽流感病毒 ;1名职业密切接触者血清H5N1亚型抗体阳性 ;一般人群甲3型流感抗体阳性率各年龄组均在 75 %以上 ;0～ 4岁组儿童甲1型流感抗体阳性率和B型流感抗体阳性率 ,分别为 2 1 7%和 3 0 4% ,均较其他年龄组低。 [结论 ]湛江市近几年流感流行株是甲3 型流感病毒 ,甲1、B型流感病毒近年流行呈上升趋势 ,要对容易感染H9N2 亚型流感病毒的重点人群加强预防与检测。     

流感样病例暴发流行的病原学研究与方法比较

目的 对 2007 年 5 月下旬至 6 月上旬深圳市龙岗区某鞋厂流感暴发流行情况进行病原学研究.方法 采集发热患者的鼻咽拭子 27 份,急性期患者血清标本 17 份和恢复期患者血清标本 12 份.27 份鼻咽拭子标本,采用荧光定量 RT-PCR 方法 、胶体金法、MDCK 细胞培养、鸡胚分离培养方法 进行病原学检测;血清标本采用血清学和血凝抑制试验检测.结果 27 份鼻咽拭子标本中荧光定量 RT-PCR 检测阳性 17 份,阳性率为 62.96%(17/27);胶体金法检测阳性 12 份,阳性率 44.44%(12/27);MDCK 细胞分离培养,其中 2 份鼻咽拭子标本中分离出 2 株 H3N2 亚型流感病毒,阳性率 7.41%(2/27);鸡胚分离培养未分离出流感病毒.6 例病人的双份血清学检测结果 显示:恢复期抗体比较急性期抗体有 4 倍或以上增长. 结论 该起流感样病例暴发流行由 H3N2 亚型流感病毒引起.荧光定量 PCR 法的特异性高、灵敏度好,可用于流感病毒的快速检测.     

湛江市1998—2001年流行性感冒监测分析

[目的]及时掌握湛江市流行性感冒流行规律和毒株变异动态，为及早发现和控制疫情提供科学依据。[方法]1998—2001年用鸡胚双腔法对湛江市流感样病人咽拭子和鸡咽拭子进行病毒分离，用血凝抑制试验进行病毒鉴定；用微量半加敏血凝抑制试验圈定一般人血清流感抗体。[结果]合计采集病人咽拭子1805份，分离出7株H1N1和4株B型流感病毒；鸡咽拭子96份，分离出4株H5N2禽流感病毒，1名职业密切接触者血清H5N1亚型抗体阳性；一般人群甲3型流感抗体阳性率各年龄组均在75％以上；0-4岁组儿童甲1型流感抗体阳性率和B型流感抗体阳性率，分别为21．7％和30．4％，均较其他年龄组低。[结论]湛江市近几年流感流行株是甲3型流感病毒，甲1、B型流感病毒近年流行呈上升趋势，要对容易感染H9N2亚型流感病毒的重点人群加强预防与检测。     

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.