河南省引起病毒性脑炎的肠道病毒分析

[目的]了解河南省2008年病毒性脑炎肠道病毒病原谱。[方法]采集2008年病毒性脑炎监测病例脑脊液标本,通过细胞培养分离病毒,RT-PCR、肠道病毒组合血清中和试验和肠道病毒VP1区基因序列分析进行鉴定。[结果]从168例病毒性脑炎病例标本中分离到24株肠道病毒,分离率为14.3%。鉴定结果显示23株为艾柯病毒,其中ECHO30占50%。[结论]2008年河南省引起病毒性脑炎的肠道病毒主要是ECHO30和ECHO6。     

一株埃可病毒25型河南分离株全基因特征分析

埃可病毒25型(Echo25)是一种常见的肠道病毒,2008年河南省从病毒性脑炎患者脑脊液中分离出4株Echo25.鉴于目前除原型株JV-4外,尚未有Echo25全基因序列的测定,为了解其基因特征,本研究对其中1株进行全基因组序列测定.     

宁夏地区1997-2011年急性弛缓性麻痹病例非脊髓灰质炎肠道病毒分型鉴定分析

目的 对1997-2011年宁夏地区急性弛缓性麻痹(AFP)病例中分离的73株非脊髓灰质炎肠道病毒(NPEV)进行分型鉴定.方法 采用简并引物RT-PCR对分离株进行VP1区基因扩增和序列测定,测序结果进行BLAST比较和基因进化分析.结果 经过基因测序分析鉴定,73株NPEV中,有4株无法定型,另69株共包括27个血清型,分别属于A组肠道病毒(HEV-A)和HEV-B组,无HEV-C和HEV-D组毒株,其中HEV-A组毒株包括8个血清型23株,HEV-B组毒株包括19个血清型46株.69株病毒中,以EV71所占比例最大(9/69),以CVA4、CVA16、Echo24、Echo6和CoxA9所占比例较高.结论 1997-2011年宁夏地区AFP病例分离的NPEV以HEV-B组为主要型别66.7％(46/69).     

开封地区病毒性脑炎病原分离株Echo30的分子流行病学分析

目的研究开封地区2008年病毒性脑炎病原分离株Echo30VP1区基因特征及其分子流行病学特点。方法对开封地区2008年病毒性脑炎监测病例脑脊液标本中分离到的8株Echo30病毒进行VP1区全基因序列测定,与GeneBank上发表的ECHO30型VP1区进行同源性比较,通过构建进化树对其进行遗传进化分析。结果所测8株Echo30VP1区基因全长均为876bp,翻译的氨基酸全长292aa。8株病毒VP1区核苷酸同源性为92.8%～99.7%,氨基酸同源性为93.0%～99.7%;与GenBank相关毒株基因组序列比对显示开封地区2008年分离株均与江苏省2003年分离株同源性较高;进化分析表明属于第7组。结论 2008年开封地区Echo30分离株与2003年江苏省分离株亲缘关系最近,可能具有相同来源。     

Echo30型病毒性脑膜炎爆发的流行病学调查

目的探讨2003年江苏省盐城市不明原因无菌性脑膜炎爆发的流行特征、影响因素和病原学病因.方法采用统一的流行病学调查表对病例进行调查,描述临床表现;采用1：1配比病例对照研究的方法分析流行因素;收集部分住院患者的脑脊液及粪便标本进行病原体的分离鉴定.结果报告病例数共计1681例,疫情波及到9个县（市、区）,3～6月为发病高峰,主要累及中小学生及学龄前儿童（占总发病数的99%）.主要临床表现为发热、头痛、呕吐,预后良好.与发热病例的接触、不洁饮食史、饭前便后不洗手等可能是本次流行的危险因素.从66份患者脑脊液中分离到18株阳性病毒,分离率为27.3%;4份患者粪便标本分离病毒全部阳性.22株分离株病毒经鉴定均为Echo30型肠道病毒.结论2003年江苏省盐城市无菌性脑膜炎爆发的病原体为Echo30型肠道病毒,不良个人卫生习惯可能是本次流行的危险因素.     

浙江省2008-2012年肠道病毒相关病毒性脑炎病原谱及分子流行病学特征分析

目的 了解2008--2012年浙汀省肠道病毒相关病毒性脑炎病原谱及分子流行病学特征。方法从监测点采集疑似病毒性脑炎患者脑脊液和粪便样本利用RD和HeP-2细胞分离病毒,采用肠道病毒标准血清定型,并对分离株VPI基因测序,进行同源性与进化分析。结果从610例患者616份样本中分离到人类肠道病毒(HEY)127株(20.6%),其中柯萨奇病毒(CV)60株,埃可病毒(ECHO：E)67株,病毒血清型分别为CVA9、CVBl、CVB3～5、E3、E4、E6、E9、E14、E25、E30。2008～2012年优势株分别为CVB3、CVB5、E6、E30和E30。各分离株VPl基因序列全长834～918个核苷酸,与相应原型株核苷酸(nt)和氨基酸(aa)的同源性分别为76.7%～85.0%和91.1%。97.9%；浙江分离株型内差异最大为E6,nt和aa差异分别为20.4%和4.8%。基于VPl基因的进化分析结果表明。浙江分离株均位于HEV-B分支上,并显示出一定地域和时问效应；E6血清型内部又分成2小分支。结论2008-2012年浙江省病毒性脑炎的主要病原为HEV-B,涉及12个血清型；不同年份优势流行株不断变化,E30为绝对优势株；浙江E6分离株存在2个亚类流行株。     

19份手足口病临床标本的病原学分离与鉴定

目的：为探索手足口病的病原并为该病的防治提供科学依据,对本省徐州地区采集的19份手足口病临床标本进行病原学分离与鉴定。方法：采集的患者咽拭子（6份）和肛拭子（13份）标本,接种Hep-2细胞进行病毒分离,经培养3代,对有明显致细胞病变效应并能连续传代的毒株,用肠道病毒通用引物real-time-RT-PCR方法鉴定确认为肠道病毒后,用肠道病毒分子分型引物（E187/E222）对肠道病毒VP1区进行扩增,将扩增产物测序获得的序列与GeneBank中肠道病毒核苷酸序列进行比对,确定毒株血清型别。结果：19份标本中分离到9株病毒,均为肠道病毒。对其VP1区部分核苷酸序列测定和比较分析后,鉴定出其中有6株为CoxB5,1株为CoxB3,2株为Echo6。结论：虽然肠道病毒71型（EV71）和柯萨奇病毒A16（CoxA16）是引起手足口病暴发流行的主要病原,但引起手足口病的肠道病毒存在多种血清型,CoxB5、CoxB3和Echo6等均能引起手足口病。因此,对手足口病的病原学检测,除EV71和CoxA16外,不能忽视对其他肠道病毒的病原学检测和鉴定。     

河北省2013-2017年其他肠道病毒手足口病重症和死亡病例流行病学和病原特征分析

目的 掌握2013-2017年河北省其他肠道病毒感染所致手足口病重症和死亡病例的流行病学特征;分析柯萨奇病毒A组6型（CoxA6）的基因特征,进一步阐明其遗传进化特点及规律。方法 利用描述性流行病学方法对2013-2017年河北省其他肠道病毒感染所致手足口病重症和死亡病例的三间分布特征进行分析。运用Mega 5.2软件对CoxA6的VP1区序列进行系统进化树分析。结果 2013-2017年河北省累计报告其他肠道病毒手足口病重症和死亡病例86例（重症84例,死亡2例）,占其他肠道病毒手足口病报告病例的1.12%（86/7 698）。每年4月份发病人数逐渐上升,5-7月达到最高峰。人群分布上,1～岁年龄组儿童的5年累计占比65.12%（56/86）。男女性别比为1.39：1（50/36）。职业分布上,散居儿童占总发病人数的93.02%（80/86）。标本经病毒分离获得阳性毒株39份,阳性分离率为45.35%（39/86）。亲缘进化树显示,CoxA6分离株与D3a和D3b这2种亚型代表株处于同一分支。结论 2013-2017年河北省其他肠道病毒手足口病重症和死亡病例在发病时间上呈现季节性,与手足口病流行的整体趋势一致。CoxA6属于D3基因型,且未出现新的进化分支。     

2008—2009年广东省手足口病病毒分离和鉴定

目的了解广东省手足口病病原特征,为科学防治手足口病提供依据。方法采集2008—2009年广东省疑似手足口病患者的粪便、肛拭子、咽拭子、疱疹液、脑脊液等标本,对其中肠道病毒通用引物阳性的标本进行病毒分离;分离株用肠道病毒通用引物、EV71引物、CoxA16引物进行RT-PCR鉴定。结果对892份肠道病毒通用引物阳性的标本进行病毒分离,共分离出毒株484株,分离率为54.26%;其中EV71型302株,占62.40%;CoxA16型143株,占29.55%。2008年和2009年不同类型标本的病毒分离率差异均有统计学意义(均P0.01),2年均以粪便标本的分离率最高,分别为70.79%(126/178)和73.89%(232/314);不同类型病例的病毒分离率之间差异无统计学意义(P0.05),2年死亡和重症病例均以EV71型为主。结论 2008—2009年广东省手足口病疫情主要由EV71和CoxA16引起,今后应加强对多种病原及其变异情况的监测。     

2008--2009年广东省手足口病病毒分离和鉴定

目的了解广东省手足口病病原特征,为科学防治手足口病提供依据。方法采集2008-2009年广东省疑似手足口病患者的粪便、肛拭子、咽拭子、疱疹液、脑脊液等标本,对其中肠道病毒通用引物阳性的标本进行病毒分离;分离株用肠道病毒通用引物、EV71引物、CoxAl6引物进行RT—PCR鉴定。结果对892份肠道病毒通用引物阳性的标本进行病毒分离,共分离出毒株484株,分离率为54．26％;其中EV71型302株,占62．40％;CoxAl6型143株,占29．55％。2008年和2009年不同类型标本的病毒分离率差异均有统计学意义（均P〈0．01）,2年均以粪便标本的分离率最高,分别为70．79％（126／178）和73．89％（232／314）;不同类型病例的病毒分离率之间差异无统计学意义（P〉0．05）,2年死亡和重症病例均以EV71型为主。结论2008—2009年广东省手足口病疫情主要由EV71和CoxAl6引起,今后应加强对多种病原及其变异情况的监测。     

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.