从手足口病病例分离的两株柯萨奇病毒A组4型毒株的VP4～VP2区基因特征分析

目的研究2008年甘肃省从手足口病（Hand,Foot and Mouth Disease,HFMD）患儿分离的柯萨奇病毒A组4型（Coxsackievirus A4,CVA4）的VP4～VP2区特征。方法采集门诊就诊的两例HFMD患儿的临床标本,接种人横纹肌肉瘤细胞（Human Rhabdomyosarcoma,RD细胞）分离病毒,然后对阳性病毒分离物使用逆转录-聚合酶链反应法扩增病毒VP4～VP2区,并进行核苷酸序列测定和分析,通过生物信息学的方法进行分子定型,最后与其它16株基因数据库中登录的CVA4株构建亲缘进化树图。结果使用RD细胞成功地从两例HFMD患儿的临床标本中分离到病毒,分子定型鉴定为CVA4。2株CVA4在VP4～VP2区核苷酸同源性为94.6%,氨基酸同源性为100%;与CVA4原型株High Point/USA/1948株的核苷酸和氨基酸同源性分别为85.5%～85.8%和99.3%。在亲缘进化树图中显示,2株CVA4分离株位于独立的进化支中。结论与基因数据库中登录的在日本、蒙古分离的CVA4株相比,从甘肃省2008年HFMD病例分离的两株CVA4,在VP4～VP2区核苷酸序列上差异很大。同源进化分析结果表明,甘肃省CVA4属于独立的进化支。     

北京市2008年肠道病毒71型VP1编码区基因特征分析

目的了解北京市2008年手足口病（Hand,Foot and Mouth Disease,HFMD）流行期间,人肠道病毒71型（Human Enterovirus71,HEV71）分离株的VP1编码区基因特征。方法采集发病1～3d的咽拭子标本33份,采用人横纹肌肉瘤（Human Rhabdomyosarcoma,RD）细胞进行EV分离,用特异引物通过逆转录-聚合酶链反应扩增进行毒株鉴定。对分离到的HEV71进行VP1编码区全长扩增,并对扩增产物采用双脱氧链终止法进行序列测定,Bioedit7.0.5和Mega3.1软件进行序列比对和系统进化树分析。结果从33份咽拭子标本中共分离到16株病毒,经鉴定：HEV7114株,柯萨奇病毒（Coxsackie Virus,CV）A组16型（CVA16）2株,其中1例为HEV71和CVA16混合感染。对10株HEV71进行了VP1编码区全序列测定,10株病毒的核苷酸和氨基酸序列同源性分别为95.5%～100%和98.9%～100%;与安徽省阜阳市2008年流行株的核苷酸和氨基酸序列同源性分别为95.4%～99.1%;与C4基因型代表株的核苷酸序列同源性〉92%。基于HEV71的VP1编码区核苷酸序列构建亲缘性关系树,北京市2008年流行株与C4亚型代表株聚为一簇,属于C4基因亚型中的C4a分支;且10株病毒处于四个相对独立的进化分支。结论北京市2008年从HFMD患儿分离的HEV71均为C4亚型,且属于2004年以来我国的优势分支——C4a。亲缘性分析提示,此次流行中至少存在4个HEV71传播链。由于近年来HEV71在中国持续大规模流行,迫切需要对HEV71进行连续的分子流行病学监测,及时阐明现阶段流行毒株的基因特征,为疾病预防控制提供病毒学依据。     

北京市西城区手足口病患儿肠道病毒71型VP1区基因进化分析

目的了解北京市西城区2015年手足口病（HFMD）患儿肠道病毒71型（EV 71）分离株VP1区基因特征,分析其变异情况。方法收集北京市西城区2015年HFMD病原学检测分型鉴定为EV 71的阳性标本,对部分标本进行病毒分离、培养,并通过实时荧光PCR鉴定阳性培养物。EV 71阳性培养物提取病毒核酸,对其VP1区全长序列进行PCR扩增和测序。从Genbank中选取EV 71不同基因型别参考序列,利用生物信息学软件进行同源性和系统进化分析。结果共分离到6株EV 71（Genbank登录号为KU376383-KU376388）,其VP1区核苷酸和氨基酸序列同源性分别为93.00%~99.00%和98.00%~100.00%,与参考序列VP1区核苷酸和氨基酸序列同源性分别为81.00%~97.00%和93.00%~100.00%。进化分析显示,6株EV 71均为C4a基因亚型。结论 2015年北京市西城区EV 71流行株属于C4a亚型,未出现明显变异。     

肠道病毒71型宁波分离株全基因组特征研究

目的:研究2010年肠道病毒71型宁波分离株的全基因组序列特征。方法:收集宁波市手足口病患者的粪便标本进行特异性荧光定量RT-PCR鉴定,EV71阳性标本进行病毒分离和全基因组序列的测定。结果:2010NB65株全长7406 bp,与参考株EV71相比编码区没有核苷酸的缺失和插入。2010NB65株与2008年-2010年中国大陆EV71流行株的各区段核苷酸和氨基酸同源性均较高,分别为94.1%～98.8%和97.6%～100%;与A型和CoxA16核苷酸同源性较低,分别为75.0%～82.4%和63.0%～85.4%。VP1和全基因组亲缘进化分析表明,2010NB65株属于C4基因亚型的C4a进化分支,与浙江株、阜阳株、北京株亲缘关系近。2010NB65株P2、P3区与CoxA16的进化途径相近。结论:宁波市HFMD患者粪便中分离得到EV71属于C4基因亚型的C4a进化分支,与我国其他地区的EV71存在共同进化趋势,全基因组序列提供了完整的分子生物学背景,为EV71病毒性疾病的防控提供参考价值。     

手足口病患儿柯萨奇病毒A4的鉴定及其5’UTR—VP4一VP2区序列分析

目的分析2009年北京市西城区手足口病患儿柯萨奇病毒A4（CoxA4）5’UTR-VP4-VP2区进化特征,探讨其与国内外其他地区CoxA4分离株的关系。方法提取病毒RNA,进行半巢式RT-PCR扩增肠道病毒（EV）5’UTR-VP4-VP2区。通过测序和Blast比对确定EV型别;并对其进行序列和进化分析。结果共鉴定出两株CoxA4,Genbank登录号为JQ429434和JQ429435。进化分析表明,CoxA4包括3个进化树分支：原型株AY421762位于独立的分支,其余CoxA4构成两个基因型（I型和II型）,每个基因型包括两个亚型（A和B）。在5’UTR-VP4-VP2区．两株CoxA4核苷酸序列同源性为96．00％;它们与原型株、基因Ⅰ型及Ⅱ型毒株序列同源性分别为87．00％～88．00％,85．00％～87．00％,92．00％～98．OO％。两株CoxA4与其他中国株均位于基因Ⅱ型分支上。结论北京市西城区CoxA4株与我国近年CoxA4流行株在5’UTR—VP4一VP2区具有较高的同源性,且进化关系密切。     

2014年龙岩市手足口病患者CVA10病毒基因特征分析

目的了解2014年龙岩市手足口病病例中分离到的CVA10病毒VP1区基因特征。方法 2014年共收集221份采用实时荧光RT-PCR法判定为其他EV的HFMD患者样本,经RD细胞分离培养后,再次进行特异性核酸检测。通过引物486-489进行肠道病毒A组完整的VP1序列分段扩增,采用ClustalX2、Mega6.0进行核苷酸及氨基酸序列同源性分析和构建进化树。结果通过测序获得3株CVA10完整的VP1区基因序列,通过分析计算,LY2014116与LY2014163氨基酸相似性为100%,3株分离株与原型株Kowalik(AF081300)的核苷酸(nt)同源性均为76%,氨基酸(aa)同源性为89%-90%。结论 3株分离株均位于进化树D亚型的同一分支上,与国内其他地方分离的D亚型流行株亲缘关系较近,与俄罗斯、法国等地分离的病毒差异较大。     

长沙市2010年手足口病EV71型VP1区基因序列分析

目的了解2010年长沙市手足口病（hand-foot-mouth disease,HFMD）重症和普通病例肠道病毒71型（human Enterovirus 71,EV71）VP1区基因特征。方法收集12例HFMD重症和普通病例的咽拭子或肛拭子标本进行VP1区基因RT-PCR扩增和核苷酸序列测定,测序结果利用sequin软件提交至GenBank,Lasergene和Mega5软件对测序结果进行氨基酸比对分析和构建进化树。结果 12株EV71 VP1区基因序列在进化树上与C基因型中的C4a亚型代表株属同一分支,在核苷酸同源性分析中,12株EV71与C4a亚型代表株（3254-TAI-98）的同源性达到92.6%-93.3%,高于与A、B、C1、C2、C3、CVA16型或亚型代表株的同源性（分别为79.9%-80.7%、83.1%-84.0%、87.9%-88.7%、89.1%-89.8%8、7.8%-88.2%和57.3%-58.4%）;12株EV71病毒VP1之间的核苷酸有高度的同源性：同源性为98.1%-100.0%,高于与C4亚型代表株的同源性（92.6%-93.3%和91.8%-92.7%）。2010年分离自长沙的重症和普通病例与2008年分离自北京、深圳和阜阳的EV71病毒VP1基因序列之间的氨基酸变异位点少。结论 2010年长沙市流行的EV71型病毒属于C基因型中的C4亚型;12例HFMD重症和普通病例的EV71 VP1区基因序列差异较小;不同时间、不同地区和不同病例来源的EV71 VP1区氨基酸变异位点无关联。     

柯萨奇病毒A24型变异株VP1基因变异分析

目的:从分子水平探讨2002年-2008年柯萨奇病毒A24型变异株(Coxsackie virus type A24 vari-ant,CoxA 24v)VP1基因变异情况。方法:在GenBank基因库上下载26株2002年-2008年引起AHC的CoxA 24v病毒株VP1基因核苷酸和氨基酸全序列,分析各株之间核苷酸和氨基酸序列差异;并与CoxA24原型株Joseph株核苷酸和氨基酸序列进行比较。结果:各株之间VP1基因核苷酸全序列的同源性为94.3%～100%,氨基酸全序列的同源性为97.7%～100%;与Joseph株比较,核苷酸全序列的同源性为76.4%～77.9%,氨基酸全序列的同源性为90.5%～91.8%。结论:2002年-2008年CoxA 24v病毒株VP1基因在核苷酸水平上存在着一定的变异,在氨基酸层面上也存在变异,但变异幅度相对较小。     

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.     

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.     

Stress in the Norwegian police service

BACKGROUND: High levels of stress have been attributed to the conditions of police work, but there is little empirical evidence for this. AIMS: To develop a new instrument to measure job stress in the police; to assess the most severe and frequent police stressors; to compare levels of stress according to the demographic and organizational factors; and to study stress in relation to personality traits, work locus of control and coping strategies. METHODS: A comprehensive nationwide questionnaire survey of 3272 Norwegian police at all hierarchical levels, including the Norwegian Police Stress Survey (NPSS), the Job Stress Survey, the Basic Character Inventory, the Work Locus of Control Scale, and the Coping Strategies Scale. RESULTS: Work injuries were appraised as the most stressful but least frequent stressor and job pressure was reported the least severe but most frequent stressor. Females experienced job stressors less frequently, but appraised them as more severe than men did. Older police officers reported more job pressure severity and fewer work injuries. The police in districts where peer support was planned but not implemented, and who worked in districts with more than 50,000 inhabitants, perceived the lack of support more severely than others. The correlations between stress and personality traits, work locus of control, and coping were moderate. CONCLUSIONS: The NPSS captures police-specific stressors that are not adequately measured by global stress instruments. The study of stress in police work should preferably involve a nationwide use of police-specific stress instruments.