受血及献血者HIV-1外膜蛋白ENV基因序列分析

目的　了解在广东省受血及献血者中发现的HIV 1亚型的流行规律及其与国际参考株的同源性。方法　应用套式聚合酶链反应 (PCR)对 1 4例采自于广东省HIV 1抗体阳性的受血者或献血者淋巴细胞富集液的核酸样品进行扩增 ,并使用ABI377型测序仪对扩增产物测序后 ,对其ENV基因C2 V3段的核酸序列进行比较分析。结果　 1 4份血样中 ,7份为泰国B’亚型 ,与国际参考株RL4 2的距离最近 ,基因离散率为 (6 0 82± 2 6 0 7) % ,组内离散率为 (5 96 3± 2 383) % ;4份为AE重组亚型 ,与国际参考株TH 90 CM2 4 0最近 ,基因离散率为 (8 90 0± 1 830 ) % ,组内离散率为 (1 3 81 0± 1 31 7) % ;2份为 0 7 BC重组亚型 ,与国际参考株CN 97 C5 4A最近 ,基因离散率为 (4 1 5 5± 1 2 2 3) % ,组内基因距离为 6 36 % ;1份为 0 8 BC重组亚型 ,与国际参考株 97CNGX 9F最近 ,基因距离为 0 97%。结论　本次检测的广东省受血及献血者HIV 1以泰国B’亚型为主 ,也存在主要在性途径感染人群中流行的AE重组亚型和吸毒者中流行的 0 7 BC、0 8 BC重组亚型。     

广东省HIV-1流行株的基因亚型分析

目的　了解广东省人免疫缺陷病毒 - 1(HIV - 1)感染毒株的亚型分布情况。方法　用巢式聚合酶链反应 (nPCR)技术 ,对 1998年初至 2 0 0 2年 2月间广东省内 13例HIV - 1感染者血标本进行膜蛋白基因 (env)部分片段扩增 ,将扩增产物克隆至T载体上并进行序列分析。结果　在 11例扩增成功的血标本中 ,B亚型 6例 ,其中 3例来自献血人员 ,1例为性乱人员和 2例为吸毒人员 ;E亚型 5例 ,其中 3例为性乱人员 ,1例来自吸毒人员 ,1例来自献血人员。 5例E亚型基因离散率为 ( 6 6± 3 8) % ;6例B亚型基因基因离散率为 ( 7 6± 1 9) % ,与来自泰国和国内的B亚型代表株最接近。结论　广东省至少有HIV - 1B和E亚型毒株流行 ,且分布广泛 ,来源复杂     

深圳地区1992--2008年HIV-1分子流行病学研究

目的 了解1992-2008年深圳地区HIV-1亚型的流行特点.方法 抽取1992-2008年深圳地区HIV确认阳性患者血清489份,应用巢式PCR扩增膜蛋白基因(env基因),并对PCR产物进行序列测定和分析.结果 共有464份样本获得分型结果,主要为CRF01 AE亚型(64.4％,299/464),其次是CRF BC( 17.5％,81/464)、B'(14.7％,68/464)和B亚型(2.4％,11/464),还发现C(0.4％,2/464)、A1 (0.2％,1/464)、CRF02_AG(0.2％,1/464)和CRF06_cpx (0.2％,1/464)亚型/重组亚型.CRF01 AE和CRF BC主要流行于异性性传播、同性性传播和静脉吸毒人群,B'亚型主要经异性、同性性传播和血液传播.另外经系统进化分析发现,不同时间段的样本出现明显的时间汇聚现象,并伴随传播途径的聚集以及交叉感染现象;各亚型/重组株样本组内及与标准参考株间的基因离散率随着时间的增加有明显增大趋势.结论 CRF01 AE重组株是深圳地区HⅣ-1的主要流行株,CRF_BC、B、B'、C、A1和CRF02_AG、CRF06_cpx亚型/重组亚型也在深圳地区少量流行,各亚型在流行过程中发生较大变异.     

四川省HIV- 1 流行毒株的基因序列测定和亚型分析

使用PCR对 9份采集于 1996年中旬的四川省经血液途径感染的HIV - 1阳性感染者外周血单个核细胞 (PBMCs)样品进行扩增 ,获得HIV - 1膜蛋白 (env)基因的核酸片段 ,并对其C2-V3及邻区 350～ 4 50个核苷酸序列进行了测定和分析。结果表明 ,9份样品中存在B和C两种亚型的HIV - 1毒株序列 ,其中B亚型 5份 ,彼此间的基因离散率为 1.4 % ;C亚型 4份 ,在不包括sc3号样品的情况下彼此间的基因离散率为 2 .6% ,而sc3号样品与其它 3份样品在核苷酸序列上的差异却达 11.5%。与A～E参考亚型及部分B和C亚型代表株序列相比较 ,属四川B亚型的 5个毒株与包括泰国、缅甸及中国云南德宏在内的B亚型毒株序列十分接近 ,基因离散率在 3.6%～4 .3%的范围内 ;属四川C亚型的 4个毒株除sc3外则与代表印度毒株的C亚型共享序列及德宏C亚型毒株序列十分相似 ,其基因离散率均为 3.1% ,与非洲C亚型毒株nof的基因离散率为13.1% ,而sc3号序列与印度、中国德宏和非洲C亚型HIV - 1的基因离散率却在 10 .1%～ 17.2 %的范围内。提示 ,HIV - 1在四川的流行时间不长 ,且其B和除sc3之外的C亚型毒株的传入与流行在云南德宏州的相同亚型HIV - 1毒株密切相关 ,而由sc3所代表的C亚型毒株则存在目前还尚不了解的其它传入来源。     

东莞市HIV-1流行株pol基因序列特征和亚型分析

目的 了解东莞市人类免疫缺陷病毒Ⅰ型（human immunodeficiency virus type 1,HIV-1）感染者的流行病学特征及亚型的分布情况。方法 选取50例样本,收集流行病学资料,采用RT-PCR法扩增pol基因序列并测序,应用BioEdit、Genotyping和MEGA等生物学软件对pol基因进行序列分析。结果 收集的50例样本最终成功扩增得到32份样本的pol基因序列,其中CRF01_AE亚型12例;CRF_07BC亚型11例;B亚型7例;CRF55_01B亚型2例。各亚型基因离散率分别为CRF01_AE是（0.075±0.039）、CRF07_BC是（0.030±0.009）、B亚型是（0.073±0.022）,各亚型之间的基因离散率差异有统计学意义（F=41.055,P<0.001）,CRF01_AE亚型和B亚型内毒株间的基因离散率均大于与CRF07_BC亚型（P值均小于0.001）。结论 CRF01_AE和CRF_07BC亚型在东莞市HIV-1流行株中占优势,CRF07_BC亚型在各亚型之间的基因离散率最小。     

石家庄市男男性接触者HIV-1毒株亚型研究

[目的]了解石家庄市男男性接触者(MSM)HIV-1感染者HIV-1毒株亚型类型,为制定MSM人群干预措施提供科学依据. [方法]提取36例HIV感染阳性者外周血单个核细胞(PBMC)的核酸,利用套氏PCR方法扩增env基因部分片断,并对扩增片断进行序列测定和分析. [结果]36例阳性者中21份毒株与国际标准株B亚型聚在一起,而与其他国际标准株远离,其组内基因距离为10.3±1.0;与国际标准株的基因距离为15.7±1.6,与其他亚型国际标准株间的基因距离均在25以上,亚型分类属于B亚型.14份毒株与国际标准参考株01-AE.TH.90.CM240 ACCU54771最近,基因距离为9.6±1.9,组内距离为5.6±0.9,属于CRF01-AE亚型.1份毒株与08-BC亚型国际参考株08 BC.CN.97.97CNGx 6F ACC AY008715聚在一起,基因距离为9.7±1.2,属于CRF08-BC亚型. [结论]HIV-1在石家庄市MSM中的流行株以B亚型和重组亚型CRF01-AE最常见,也存在CRF08-BC重组亚型.     

河南省人免疫缺陷病毒1型流行现状研究

目的 了解河南省人免疫缺陷病毒1型(HIV-1)毒株的亚型状况及序列变异、流行特征,分析其传播来源和传播规律.方法 对2006-2007年在河南省采集的1287例HIV-1感染者抽取静脉血,用巢式聚合酶链反应(nest-PCR)对单个核细胞中前病毒脱氧核糖核酸的env基因和gag基因进行扩增,并测定和分析核苷酸序列.结果 1287份样本中存在B'、C亚型及BC、AE两个重组亚型,其在所有分析样本中的比例分别为95.882%(1234/1287)、0.466%(6/1287)、2.875%(37/1287)、0.777%(10/1287).与国内及国际的参考毒株RL42、C.95in21068、07-BC.CN.97.C54A、01AE.TH.90.CM240间的离散率分别为(9.327±0.245)%、(5.214±0.183)%、(6.278±0.194)%、(5.332±0.1 58)%.结论 目前河南省艾滋病感染者中有B'、C亚型及BC、AE两个重组亚型.泰国B'亚型依然占主导地位.B'亚型以既往有偿献血人员为主,BC亚型以性传播为主,AE亚型以性传播及既往献血途径为主,C亚型以性传播为主.     

山东省HIV-1B亚型毒株分子流行病学研究

目的　了解人类免疫缺陷病毒 1型 (HIV -1B)亚型毒株在山东省的流行分布情况和传播规律。方法　采集 17份HIV -1感染者的外周静脉防凝血 ,提取前病毒DNA进行体外扩增 ,获得包膜蛋白 (env)基因的核酸片段 ,并对其C2 -V3及邻区的核苷酸进行测定和分析。结果　系统树和基因离散率分析发现这 17份血样均为HIV -1B亚型感染 ,且感染毒株距离泰国B亚型代表株RL42最近 ,离散率为 9 16± 3 3 4 ,17毒株之间的离散率为 11 69±4 19。氨基酸序列分析发现 ,V3环顶端 4肽基序呈多态性 ,有 6种形式。结论　HIV -1B亚型在山东省地理分布广 ,并涉及 3类人群两种传播途径 ,且毒株出现较大变异 ,具有广泛传播的潜在危险     

浙江省HIV-1 CRF01_AE流行株的分子特征分析

目的 分析艾滋病病毒1型(HIV-1)CRF01_AE重组毒株在浙江省的分子流行特征.方法 提取234例HIV-1感染者基因组DNA用巢式聚合酶链反应(nPCR)方法扩增gag部分基因片段,测定序列以后分析核苷酸和氨基酸序列.结果 在扩增阳性并成功测序的192个序列中HIV-1CRF01 AE有81个,占42%,是浙江省HIV主要的流行毒株之一.系统进化树中存在3个bootstrap值＞60的分支簇,其中MIX组包括47个序列,内部基因离散率为2.4%±0.7%,与参考株CM240的基因离散率为3.4%±0.5%;SEX组包括7个样本,组内基因离散率为3.0%±1.2%,与参考株的基因离散率为3.9%±1.0%;MSM组包括12个样本,组内基因离散率为2.8%±1.1%,与参考株的基因离散率为4.9%±0.6%,三者差别有统计学意义.特征性氨基酸分析表明MIX组、SEX组、MSN组共享序列与国际参考株共享序列之间分别存在2个、4个和8个位点的差异.结论 浙江省内HIV-1 CRF01 AE流行株中主要存在三个进化簇,其中两个簇与广西来源株密切相关.CRF01_AE毒株在浙江省内主要以异性性途径和注射吸毒形式传播.     

陕西省HIV-Ⅰ流行毒株亚型分析

目的 了解陕西省近年来发现的人类免疫缺陷病毒(HIV)感染者所携带毒株的基因序列特征、亚型种类和毒株来源以及在各高危人群中的分布,推断其传播来源和流行趋势,为本省艾滋病防治工作提供技术资料.方法 对HIV感染者进行流行病学相关因素调查,无菌采集HIV感染者抗凝全血,提取前病毒DNA,应用套式聚合酶链式反应(nested-PCR)扩增其膜蛋白基因env,对其C2～V3区及邻区的核苷酸序列进行测定,用GCG软件(Wisconsin 公司)进行亚型分析.结果 35份样本PCR扩增阳性并得到相应序列.经基因离散率计算和系统树分析,共发现4种HIV-1基因亚型和重组毒株,即HIV-1 B'、C、CRF01-AE和CRF-BC重组型.其中泰国B'亚型为主要流行株,占82.35%(28/34),主要来源于既往采供血者及其配偶;其次是CRF-BC重组型,占11.77%(4/34),主要来源于吸毒人群:CRF01-AE和C亚型各1份,分别占2.94%,均来自劳务输出的归国人员.该组样本B'亚型内的基因离散率为5.2%(n=23);而CRF-BC亚型内的基因离散率为0.9%(n=3),彼此间显示出较近的传播关系.结论 陕西省HIV-1流行株以泰国B'亚型为主,发生在与既往有偿采供血相关的地区和人群,已有6～7年的流行史;首次在当地吸毒人群中发现HIV-1 CRF-BC重组型,并且显示近期高度流行的趋势.加强对既往有偿献血人群和吸毒人群的行为干预,控制HIV病毒在家庭内和吸毒人群中的传播,将是今后本省艾滋病防治工作重点之一.     

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.     

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.     

Psychopathological features of a patient population of targets of workplace bullying

BACKGROUND: A strong association between workplace bullying and subsequent anxiety and depression, indicated by empirical research, suggests that bullying is an aetiological factor for mental health problems. AIMS: To evaluate levels of stress and anxiety-depression disorder developed by targets of workplace bullying together with outcome at 12 months and to characterize this population in terms of psychopathology and sociodemographic features. METHODS: Forty-eight patients (36 women and 12 men) meeting Leymann Inventory of Psychological Terror criteria for bullying were included in a prospective study. Evaluations were performed at first consultation and at 12 months using a standard clinical interview, a visual analogue scale of stress, the Hospital Anxiety and Depression (HAD) scale, the Beech scale of stress in the workplace and a projective test (Picture-Frustration Study). RESULTS: At first consultation, 81% of patients showed high levels of perceived stress at work and 83 and 52% presented with anxiety or depression, respectively. At 12 months, only 19% of working patients expressed a feeling of stress at work. There was a significant change in symptoms of anxiety while there was no change in symptoms of depression. Stress at work and depression influenced significatively capacity to go back to work. At 12-month assessments, workers showed a significantly better score on the HAD scale than non-workers. Over half the targets presented a neuroticism-related predominant personality trait. CONCLUSION: Workplace bullying can have severe mental health repercussions, triggering serious and persistent underlying disorders.     

The rise and fall in incidence of malignant mesothelioma from a British Naval Dockyard, 1979-1999

BACKGROUND: The incidence of malignant mesothelioma in Britain is predicted to rise over the next 15-25 years because of past failure to protect the workforce against inhalation of asbestos. In British Naval dockyards, alternative insulation materials and respiratory protection were introduced from the mid-1960s. Aims This study was carried out to investigate the effects of these control measures on mesothelioma deaths in dockyard workers. METHODS: Cases of mesothelioma of the pleura and peritoneum between 1979 and 1999 in workers from the Devonport Naval Dockyard, south-west England, were sought from coroners' and medico-legal records. RESULTS: Three hundred and one cases were identified, 7% peritoneal. The peak incidence occurred in 1991 with 25 cases per annum (quadratic model fit R(2) = 74.2%, P < 0.001) and we predict that by 2003 the incidence will fall to fewer than five cases per annum. The mean time between first exposure and presentation was 48.5 years [95% confidence interval (CI) = 47.3-49.8], but this was significantly shorter in the more heavily exposed trades, when compared with the less heavily exposed (42 years, 95% CI = 39.0-45.0, versus 49.5 years, 95% CI = 48.2-50.9). Those with higher exposure were also at significantly greater risk of peritoneal disease (P < 0.023, Fisher's exact test). CONCLUSION: The reduction in incidence of mesothelioma is greater than can be accounted for by reduction in numbers of dockyard workers over the last 50 years. Changes in insulation materials and improved industrial hygiene measures introduced into the Devonport Dockyard from the mid-1960s have resulted in an earlier decline in the incidence of malignant mesothelioma than that predicted for the British workforce as a whole.     

Organophosphate toxicity and occupational exposure

The ubiquitous organophosphates present a continuing health hazard in agriculture, public health eradication programmes and as chemical warfare agents. Despite significant progress in understanding the potential mechanisms of toxicity far beyond the commonly accepted mechanism of cholinesterase inhibition in intentional exposures, the precise health effects following occupational exposures are yet to be completely defined. A much greater understanding exists of the clinical features of organophosphate poisoning. These are characterized by a triphasic response involving an initial acute cholinergic phase, an intermediate syndrome (both associated with high mortality) and a disabling but non-lethal delayed polyneuropathy. The delayed polyneuropathy may occur in the absence of the cholinergic or intermediate phases. However, progress is still required in order to improve the quantification and assessment of occupational exposures and the implementation of appropriate preventive measures. Finally, evidence-based guidelines for appropriate or optimal therapeutic interventions following poisoning are required urgently and collaborative work with colleagues in developing countries, where the occurrence of organophosphate exposures is more frequent, may provide the answers.     

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.     

Miliaria rubra of the lower limbs in underground miners

This report documents a case series of miliaria rubra of the lower limbs in miners at a deep underground metalliferous mine in tropical arid Australia. During the summer months of February and March 1999, all cases of miliaria rubra of the lower limbs in underground miners seen at the mine's medical centre were clinically examined and administered a questionnaire. Twenty-five patients were seen, an incidence of 56.4 cases per million man-hours. Miliaria rubra was most often located between the ankle and knee (88% of cases). Twenty-four percent had concurrent folliculitis and 20% had concurrent tinea. Thirty-two percent had a personal history of asthma. Walking through ground-water and splashing of the legs was common. Three to 4 weeks of sedentary duties in air conditioning was generally required to achieve resolution of miliaria rubra. The incidence of miliaria rubra of the lower limbs is 38% of the incidence of heat exhaustion at the same mine. The length of disablement is greater, however. Atopics may be at increased risk of miliaria rubra. Control measures are discussed.     

Planning research

The starting point for any research project should be a question.Once this has been defined and the relevant scientific literaturereviewed, a protocol should be drawn up. This will be used notonly as a guide to the conduct of the study and in the preparationof the final report, but also in seeking any financial supportand approvals that are required for the investigation. A protocolis normally arranged in sections covering the background tothe study, the question(s) that it will address, the methodsthat will be used for the collection and analysis of data, thestatistical power of the investigation (where relevant), anyethical considerations, and the financial input that will beneeded. A pilot study is often helpful where aspects of thestudy method are untried or of uncertainvalidity.