乙型肝炎病毒基因分型研究新进展

目的综述HBV的基因型研究新进展。方法参阅近年来国内外公开发表的文献，对HBV基因型研究新进展进行综述。结果迄今为止，已经发现HBV有A、B、C、D、E、F、G、H8个基因型．根据不同的病毒学和传染病学特质，一些基因型再分成24个基因亚型。HBV累计的点突变形成不同的基因型，HBV的自然变异对于疾病的临床转归影响成为国际研究的热点。结论基因型的提出为肝炎病毒的研究开辟了新的领域。     

乙型肝炎病毒基因型及其临床意义的研究进展

慢性乙型肝炎病毒（HBV）感染是全球性公共卫生问题,慢性HBV感染可导致不同类型的肝病,包括慢性肝炎、肝硬化和肝细胞癌。大量的研究表明,HBV基因组易发生变异,形成不同的基因型,HBV基因型具有明显的地理分布和种族分布特点,它与疾病进展和临床转归有关,不同的基因型对抗病毒治疗的应答也不完全相同,近年来国内外学者从流行病学、分子生物学、临床医学开展了大量的研究,本文就国内外乙型肝炎病毒基因型及其临床意义的研究进展进行了综述。     

乙型肝炎病毒基因型研究进展

乙型病毒性肝炎是全球严重的公共卫生问题之一,每年大约有65万患者死于乙肝相关的疾病,如慢性乙肝、肝硬化和肝细胞癌等。许多研究表明,不同的HBV基因型及亚型由于其基因结构的差异可以造成致病性的差异,从而影响乙肝患者的临床表现、治疗及预后等。目前为止,HBV已经发现了10种基因型和40多种亚型,不同的基因型别地区分布不同。了解HBV基因型及其特征,有利于进一步对HBV的流行病学进行研究,利于预测疾病的严重性,从而更好地制定防治策略。     

乙型肝炎病毒基因型研究现状

乙型肝炎病毒（HBV）是嗜肝的DNA病毒,可引起不同程度的肝脏疾病。本文就1988年Okamoto等首次发现HBV存在基因组的差异以来HBV基因型研究现状作一综述。着重对现有的HBV基因分型方法、基因型别与地理分布、与基因突变、致病性及抗病毒治疗的关系进行介绍,并对未来HBV基因型研究目前存在的不足与发展进行讨论与展望。     

乙型肝炎病毒基因结构、基因型及病毒变异

乙型肝炎病毒(HBV)基因结构复杂,易于变异,根据HBVDNA核苷酸序列异质性≥8%为一种基因型的规定,HBV目前分为A～H8个基因型。有研究显示,HBV变异给疾病的预防、诊断、治疗和预后带来了新问题,不同基因型的基因变异、临床表现及对抗病毒、肝移植等的治疗反应存在差异。本文对HBV基因组结构与功能及其变异的研究进展,基因型与变异及临床的相关性研究作了综述。     

全球乙型肝炎病毒基因型的分布现状

乙型肝炎病毒(hepatitis B virus, HBV)感染是全球范围内一个重要的公共卫生问题, 是慢性肝炎、肝硬化及肝癌发生的主要原因。许多研究表明, HBV不同的基因型及其亚型, 其致病性存在差异, 从而影响感染者的疾病进程和治疗预后。迄今为止, 全球已经报道了10种HBV基因型及40多种HBV亚型, 这些亚型有其各自的分布特征, 本文对全球乙型肝炎病毒基因型的分布现状进行综述。     

病毒基因型对联合抗病毒治疗慢性乙型肝炎患者的HBV DNA、HBeAg变化的影响

目的:分析慢性乙型肝炎患者在拉米夫定和阿德福韦酯联合治疗过程中不同基因型对HBV DNA、HBeAg及ALT变化的影响。方法:对2009年9月-2011年3月在我院就诊的51例服用拉米夫定和阿德福韦酯慢性乙型肝炎患者进行基因分型、HBV DNA及肝功能指标的测定。结果:51例患者的HBV病毒基因型主要为B和C型,C型32例,占62.7%,B型19例,为37.3%,以C型基因型为主;B、C不同基因型组在治疗48周后,除12周时的HBV DNA、HBeAg有统计学意义,其余均无显著性差异。结论:拉米夫定和阿德福韦酯联合治疗的慢性乙型肝炎患者在治疗12周时,B和C基因型对患者的HBV DNA、HBeAg的变化有影响;但随着治疗时间的延长,基因型对HBV DNA、HBeAg及ALT的变化均无显著影响。     

基因型检测对诊断乙型肝炎病毒感染患者感染程度的临床价值研究

目的探讨基因型检测在乙型肝炎病毒(HBV)感染患者感染程度诊断中的临床价值。方法选取2014年1-12月医院所收治的HBV感染患者256例,并分别对HBV DNA载量,HBV DNA基因分型,HBV e抗原进行检测和分析。结果与B基因型相比,BC混合基因型和C基因型患者所占比例、HBV e抗原阴性比例以及慢性乙型肝炎的比例均显著降低,HBV DNA表达载量均显著提高;BC混合基因型患者中肝硬化的比例显著提高;C基因型患者中原发性肝癌的比例显著提高(P<0.05);与BC混合基因型相比,C基因型患者所占比例和HBV DNA表达载量显著提高,HBV e抗原阴性比例、肝硬化的比例以及原发性肝癌的比例均显著降低(P<0.05),不同基因型患者之间男女比例及平均年龄比较,差异均无统计学意义。结论基因型检测对HBV感染患者感染程度的诊断具有重要意义,可作为临床治疗的参考依据。     

江苏地区乙型肝炎病毒基因分型及其临床意义

目前乙型肝炎病毒 (hepatitisBvirus,HBV)基因型分型的方法有 :全基因或S基因序列测定、聚合酶链反应限制性片段长度多态性 (PCR RFLP)、单克隆抗体酶联免疫吸附法、特异性线型探针法等。迄今为止 ,已发现A到H 8种HBV基因型。国内外众多学者研究表明 ,HBV基因型存在区域性分布特征 ,并与临床疾病谱、疾病的进展以及抗HBV治疗反应不同等方面可能相关[1] 。本研究采用HBVS区直接测序法对江苏地区 12 8例不同类型HBV感染者进行基因分型 ,并分析基因型与临床疾病谱之间的关系。1　材料与方法1.1　研究对象　 12 8例HBV感染者来自…     

重庆地区乙型肝炎病毒B/adw2和C/adrq+亚型PreS/S基因参照序列的初步建立

目的 建立重庆地区不同亚型乙型肝炎病毒(HBV)流行株PreS/S基因参照序列。方法 扩增18例HBV慢性无症状携带者的PreS/S基因，应用同源性分析和对齐比较等方法确定基因型／血清型，并选同HBV亚型的PreS/S拟定参照序列。结果 9株基因型B/血清型adw2、6株基因型C／血清型adrq 、3株基因型B/血清型aywl；建立的重庆地区基因型B/血清型adw2、基因型C／血清型adrq HBV流行株PreS/S参照序列，与华东华南、东北华南地区同亚型的参照序列比较分别有6个、13个核苷酸差异，均可引起4个氨基酸差异。结论 初步建立了重庆地区HBV基因型吲血清型adw2、基因型C/血清型adrq HBV流行株PreS/S基因参照序列。     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.     

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.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Hydrazine inhalation hepatotoxicity

Abstract Hydrazine is a hazardous chemical commonly used as a reactant in rocket and jet fuel cells. Animal studies have demonstrated hepatic changes after hydrazine inhalation. Human case reports of hydrazine inhalation hepatotoxicity are rare. We report a case of mild hepatotoxicity following brief hydrazine vapour inhalation in a healthy young man, which resolved completely on expectant management.     

Fitness standards in airline staff

Employers have a legal duty to manage safety and to meet this duty it is necessary to control risks arising from pre-existing medical conditions. Such conditions can be identified at the time of job placement, but there is little published information about the approach to fitness standards by most airlines. This review is therefore limited to the practice of one major airline. It is illustrated by reference to various occupations within the airline, with the associated rationale.