育龄妇女孕前TORCH感染的筛查

ＴＯＲＣＨ是一组微生物,ＴＯ为弓形虫（ＴＯＸ）,Ｒ为风疹病毒（ＲＶ）,Ｃ为巨细胞病毒（ＣＭＶ）,Ｈ为单纯疱疹病毒,Ⅰ型和Ⅱ型（ＨＳＶⅠ和ＨＳＶⅡ）。这组病原体是引起先天性感染最常见的病原微生物。孕妇如果受到此组病原体中任何一种感染,都可能导致流产,死...     

TORCH及HBV、HCV的母婴传播

ＴＯＲＣＨ及ＨＢＶ、ＨＣＶ的母婴传播乐祥东，陆志檬ＴＯＲＣＨ是能通过母婴传播引起胎儿感染并造成先天性畸形或发育异常的传染源首字母的组合，它包括弓形体（Ｔｏｘｐｌａｓｍ）、风疹病毒（Ｒｕｂｅｕａｖｉｒｕｓ）、巨细胞病毒（Ｃｙｔｏｍｅｇａｌｏｖｉｒｕｓ）...     

TORCH母婴传播的研究进展

ＴＯＲＣＨ母婴传播的研究进展何友雄１吕元聪２综述ＴＯＲＣＨ感染是一组围产期慢性非细菌性感染。Ｔ是指弓形虫（Ｔｏｘｏｐｌａｓｍａ），Ｒ代表风疹病毒（ＲｕｂｅｌａＶｉｒｕｓ），Ｃ指巨细胞病毒（Ｃｙｔｏｍｅｇａｌｏｖｉｒｕｓ），Ｈ代表单纯疱疹病毒（Ｈｅｒｐ...     

HBV感染孕妇血清HBVM与TORCH抗体检测

目的了解ＨＢＶ感染孕妇血清ＨＢＶＭ与ＴＯＲＣＨ抗体阳性率。方法应用ＥＬＩＳＡ法筛查出９３例ＨＢＶ感染孕妇,并用ＰＣＲ检测ＨＢＶ－ＤＮＡ。分娩时取脐血测弓形体（Ｔｏｘ）、风疹病毒（ＲＶ）、巨细胞病毒（ＣＭＶ）、单纯疱疹病毒Ⅱ型（ＨＳＶ－Ⅱ）四种病原血清特异性ＩｇＭ和风疹病毒ＩｇＧ抗体。结果９３例ＨＢＶ感染孕妇中ＴＯＲＣＨ总感染率４７．３１％。单项抗体阳性率２５．８１％,７例为２项抗体阳性,２例３项抗体阳性。原发宫内感染以Ｔｏｘ最高（１２．９０％）,ＣＭＶ次之（６．４５％）,随后ＨＳＶ－Ⅱ（５．３８％）,ＲＶ最低（３．２３％）。孕妇ＨＢｓＡｇ阳性组,ＰＣＲＨＢＶ－ＤＮＡ阳性率７６．９２％,ＴＯＲＣＨ感染率６１．５４％。ＨＢｓＡｇ阴性组,ＰＣＲＨＢＶ－ＤＮＡ阳性率３８．８９％,ＴＯＲＣＨ感染率３７．０４％。结论脐血ＴＯＲＣＨ感染率与母血ＨＢｓＡｇ、ＨＢｅＡｇ、ＨＢＶ－ＤＮＡ相关（相关系数分别为０．１４、０．２９、０．１５）。乙肝感染孕妇ＴＯＲＣＨ的抗体筛查对优生优育是非常有用的指标。     

舟山海岛地区孕早期妇女ＴＯＲＣＨ 感染情况调查研究

摘要：目的　了解舟山海岛地区孕早期妇女ＴＯＲＣＨ 感染状况,为有效预防ＴＯＲＣＨ 感染提供参考。方法 　以２０１３年６月至２０１６年３月于舟山医院进行孕期检查的１９７２例孕早期妇女为试验对象。采用酶联免疫 吸附试验（ＥＬＩＳＡ）检测血清ＴＯＲＣＨ ＩｇＭ 与ＴＯＲＣＨ ＩｇＧ 抗体水平。结果　舟山海岛地区ＴＯＲＣＨ ＩｇＭ 总阳性率为０．６６％。９９．９５％的研究对象至少检出１项ＩｇＧ 抗体阳性,以单纯疱疹病毒（ｈｅｒｐｅｓｓｉｍｐｌｅｘｖｉ ｒｕｓ,ＨＳＶ）Ⅰ 型和巨细胞病毒（ｃｙｔｏｍｅｇａｌｏｖｉｒｕｓ,ＣＭＶ） 阳性率最高, 均为９４．５２％。ＩｇＧ 抗体分布以 ＨＳＶⅠ＋ＣＭＶ＋ＲＶ 模式最多见。ＲＶ ＩｇＧ、ＴＯＸ ＩｇＧ 抗体阳性率在各年龄段间差异无统计学意义（χ ２＝ ０．３５５、０．４９７,犘＝０．５５１、０．４８１）;ＨＳＶⅠ ＩｇＧ、ＨＳＶⅡ ＩｇＧ、ＣＭＶ ＩｇＧ 这三种病原体阳性率随着年龄增 大而上升,差异有统计学意义（χ ２ 趋势＝７．８０９、３５．３４３、１１．７２６,犘＝０．００５、０．０００、０．００１）。结论　舟山 海岛地区孕早期妇女ＴＯＲＣＨ 感染情况不容忽视, 应加强孕妇对ＴＯＲＣＨ 危害认知的宣传工作, 将 ＴＯＲＣＨ 筛查作为孕前和孕早期常规检查项目,ＩｇＭ 抗体和ＩｇＧ 抗体同时检测很有必要,高龄孕妇更应加 以关注。 关键词：ＴＯＲＣＨ;感染;免疫球蛋白Ｍ;免疫球蛋白Ｇ;抗体;孕早期 中图分类号：Ｒ１７３　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１７）０９ ０７０３ ０４     

TORCH宫内感染的诊断与处理

ＴＯＲＣＨ宫内感染的诊断与处理曹武军马树凤（合肥市妇幼保健院２３０００１）ＴＯＲＣＨ一词是Ｎａｈａｍｉａｓ等于１９７１年将孕妇患病能够引起宫内胎儿感染，甚至致其先天性缺陷或发育异常的数种病原体的英文名词的第一个字母组合而成。ＴＯＲＣＨ包括弓形虫（Ｔｏ...     

山西省原发性肝癌丙型肝炎病毒、乙型肝炎病毒感染状况分析

目的　探讨山西地区原发性肝癌（ＰＨＣ） 中丙型肝炎病毒（ＨＣＶ） 和乙型肝炎病毒（ＨＢＶ） 感染状况。方法　选择以山西省肿瘤医院为主的省级４ 所医院ＰＨＣ患者９８ 例,检测抗－ＨＣＶ、ＨＢｓＡｇ、抗－ ＨＢｓ、ＨＢｅＡｇ、抗－ ＨＢｅ、抗－ ＨＢｃ、抗－ ＨＢｃＩｇＭ 等指标,均采用ＥＬＩＳＡ 法进行测定。结果　ＰＨＣ 组抗－ ＨＣＶ 阳性率８．１６ ％ ,ＨＢＶ 感染率６８ ．３７％ ,均显著高于对照组的阳性率（ Ｐ＜０ ．０５） 。两者的病因分值（ＡＲＰ） 分别为９４％ 和９１ ％ 。经１∶２ 条件ｌｏｇｉｓｔｉｃ 多元回归分析,抗－ ＨＣＶ、ＨＢｓＡｇ 和抗－ ＨＢｃ 均作为独立的危险因素进入了回归方程,其ＯＲ值分别为５５ ．０６、１０ ．１８ 和９．８５ 。叉生分析结果表明,抗－ ＨＣＶ和ＨＢｓＡｇ 双阳性的ＯＲ值为６１ ．３７,较两指标单一阳性的ＯＲ值明显为高,亦高于两者单独阳性的ＯＲ值之和。结论　ＨＣＶ 和ＨＢＶ 感染均是ＰＨＣ发生的主要病原学因素。ＨＣＶ感染在致肝癌作用中,是当地不可忽视的重要因素,ＨＢＶ 仍是肝癌发生的主要因素。ＨＢＶ和ＨＣＶ双重感染对肝癌的发生具有协同作用。     

巢式PCR检测新生儿先天畸形心脏组织中的B19—DNA的研究

为探讨人微小病毒Ｂ１９感染与先天性心脏病病因学的关系。用巢式聚合酶链反应技术，检测１１例新生儿先天性心脏病心脏心肌标本中的Ｂ１９病毒ＤＮＡ，并取曲同期１１例先天畸形死亡患儿的心肌组织作对照，同时作ＣＭＶ，ＨＳＶ，ＴＯＸ的ＰＣＲ检测。结果：病例组中Ｂ１９ ＤＮＡ阳性２例，ＣＭＶ－ＤＮＡ阳性１例，ＴＯＸ，ＨＳＶ均阴性，对照组中，１例ＣＭＶ－ＤＮＡ阳性，其余各病原体均阴性。     

肝炎病毒在朝鲜族原发性肝癌发生中相互作用的分析

采用酶联免疫吸附法（ＥＬＩＳＡ）对１１２例延边地区朝鲜族原发性肝癌（ＰＨＣ）患者血清进行了乙型、丙型和丁型肝炎病毒（ＨＢＶ、ＨＣＶ和ＨＤＶ）的检测。结果,ＰＨＣ组ＨＢＶ、ＨＣＶ感染率显著高于对照组,ＯＲ值分别为２２．３３和６．２０;合并ＨＢＶ、ＨＣＶ混合感染的ＯＲ值为８５．８７,其相对超额危险度为３６．３１。其中６１例ＨＢｓＡｇ阳性肝癌的ＨＤＶ血清标志检出率２６．２２％,明显高于６５例ＨＢｓＡｇ阳性的肝炎对照组。提示ＨＢＶ、ＨＣＶ感染在朝鲜族ＰＨＣ的发生中有显著的病因协同作用;且ＨＢＶ、ＨＤＶ的混合感染可能促进肝脏疾病的恶化     

HBV与HCV在HCC高危人群中的病因学作用

本文对在在启东、泰兴原发性肝细胞癌（ＨＣＣ）高发区随机抽取的１４０份ＨＣＣ病例和２４７份对照资料，进行了乙型肝炎病毒（ＨＢＶ）、丙型肝炎病毒（ＨＣＶ）感染与ＨＣＣ关系的病因学研究。结果显示：病例ＨＢＶ总感染指标和抗－ＨＣＶ的ＯＲ值为４．６７，多元非条件Ｌｏｇｉｓｔｉｃ回归分析显示：在ＨＢＶ感染指标中，以ＨＢｓＡｇ，抗－ＨＢｃ和前Ｓ２蛋白３指标的意义较大，均入选多元模型，抗－ＨＣＶ也作为ＨＣＶ感染的唯一指标入选多元模型Ａ，且两模型的拟合较满意，说明两者的感染均对ＨＣＣ的发生有一定的病因学作用，ＨＢＶ和ＨＣＶ混合感染的ＯＲ值为７．８４２，约等于两者分别感染的ＯＲ值之积，说明两者之间有一定的协同作用。ＰＡＲ指标的分析表明，ＨＢＶ和ＨＣＶ的综合ＰＡＲ值在７３．６４％～７５．１１％之间，抗－ＨＣＶ的ＰＡＲ值为１１．４６％，即如能有效控制人群ＨＢＶ和ＨＣＶ的感染率，将使该地ＨＣＣ的发病数减少７５％左右，其中由ＨＣＶ感染引起的ＨＣＣ病例约占１１．４６％，说明该地ＨＢＶ的感染仍为ＨＣＣ的主要病因因素，ＨＣＶ感染的病因作用次之。     

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.