宁波市人群中非O1群霍乱弧菌携带及其毒性研究

目的：非O1群霍乱弧菌是我市感染性腹泻的常见病原菌，通过研究其在人群中携带频度和产生毒素的种类，有利于对该疾病采取针对性措施。方法：用筛检方法分离菌株，经系统生化血清分型确定型别，K-B法测定菌株的耐药性，用PCR、ELISA和动物等试验测定细菌的毒性。结果：从18416份标本中检出O1群霍乱弧菌236株，检出率为1．28％，其中腹泻病人检出率为8．3％，健康人群为0．3％，分属于25个血清型、9个噬菌体，除对青霉素有较高的耐药性外，其他常用抗生素敏感在67．6％-100．0％之间，发现有15．3％的菌株对弧菌抑制剂O／129抗性。92．0％的非O1群霍乱弧菌对小鼠有毒性，CT毒素检出率为1．3％；ST毒素检出率为78．8％；溶血素血平板法阳性率为94．4％、试管法阳性率为88．9％；未检出耐热性溶血素、Vero毒素等多种。结论：宁波市人群中携带一定数量的非O1群霍乱弧菌，腹泻病人中检出率较高，健康人群携带率稍低，与报道一致。7-10月份为检出高峰，与疾病流行规律相符。菌株的生化和药敏特征未发现变异，但抗弧菌抑制剂O／129现象较严重，在鉴定、鉴别时应加以关注。从细菌中检出多种致病毒素，并对小鼠的有较强的致病作用。说明该菌的综合毒力较强。结果提示我们，非O1群霍乱弧菌的致病因子复杂程度高于O1群霍乱弧菌，应引起我们的重视。     

2006年鸭绿江水及水产品中检出霍乱弧菌报告

〔目的〕通过对鸭绿江水及水产品中O1群和O139群霍乱弧菌检测,了解霍乱弧菌在其中的存活及菌型分布情况,为制定防治措施提供依据。〔方法〕采集鸭绿江水及水产品进行霍乱弧菌分离培养,血清学诊断符合O1群和O139群霍乱弧菌者,按国标法进行系统菌株鉴定。〔结果〕从216份(江水189份、水产品27份)标本中检出9株O1群霍乱弧菌,全部为江水中检出,总检出率为4.17%。其中稻叶型2株,占22.2%;小川型7株,占77.8%。〔结论〕检出的9株O1群霍乱弧菌均属非流行株,江水中霍乱弧菌的检出率高于水产品的检出率。总检出率较高,提示在今后霍乱监测中,鸭绿江水应继续作为重点。     

7株产色素非O1群霍乱弧菌的生物学性状及毒素原性检测

目的：了解佛山市产色素非O1群霍乱弧菌的生物学性状、血清学分型和致病性。方法：1998－2000年在珠江水系佛山段沿岸的25个采水点每月采样1次，采用水样吸附沉淀集菌法分离非O1群霍乱弧菌。使用PCR检测待测菌是否带有霍乱肠毒素（CT）基因；用ELISA法检测耐热肠毒素（ST）和不耐热肠毒素（LT）。结果：3年共检测1644份水样，共分离到478株非O1群霍乱弧菌，其中分离到7株分属7个不同血清型的产褐色色素的非O1群霍乱弧菌，并发现其中3株带有毒素。结论：首次在佛山市外环境水体中分离出产色素非O1群霍乱弧菌，通过检测发现部分菌株具有一定的致病性，提示在感染性腹泻和霍乱的监测工作中，应注意对产色素非O1群霍乱弧菌的观察和研究。     

实时荧光RT-PCR方法检测水及水产品中霍乱弧菌

〔目的〕探索实时荧光RT-PCR方法在霍乱弧菌检验方面是否比传统方法有优势。〔方法〕用深圳太太基因工程有限公司提供的霍乱弧菌实时荧光RT-PCR试剂盒方法进行检验。〔结果〕用实时荧光RT-PCR方法从样品的2次增菌液中检出2个样品为霍乱弧菌通用型阳性。用传统的微生物生理、生化培养法,从上述2个样品中分离出3株菌株。根据血清分型、API鉴定和荧光RT-PCR,确认所分离的菌株有2株是国际检疫传染病的病原—O1群霍乱弧菌;1株是非O1/非O139群霍乱弧菌。〔结论〕实时荧光RT-PCR方法在霍乱弧菌的检验方面具有快速、灵敏、特异性强等优势,有利于提高霍乱弧菌的检出率。     

佛山市外环境水体非O1群霍乱弧菌生物学特性和流行病学研究

目的　了解佛山市外环境水体中非O1群霍乱弧菌的菌型分布及毒素携带情况。方法收集外环境水样 ,用常规的细菌培养方法分离非O1群霍乱弧菌。采用分子生物学PCR技术检测霍乱肠毒素 (CT)基因 ,用ELISA检测耐热肠毒素 (ST)和不耐热肠毒素 (LT)。结果　共检测水样 16 4 4份 ,分离到非O1群霍乱弧菌 4 78株 ,分离率为 2 9 0 7% ;血清学分型显示近年佛山市外环境水体中非O1群霍乱弧菌的主要菌型为VBO7。霍乱肠毒素基因检测阳性率为 1 91% ;耐热肠毒素、不耐热肠毒素的检出率分别为 13 14 %和 12 17%。结论　个别非O1群霍乱弧菌可同时带有多种毒力因子 ,提示佛山市外环境水体中存在的非O1群霍乱弧菌具有潜在的致病性 ,加强监测对做好感染性腹泻的防治工作实属必要。     

2005年-2010年武汉市霍乱弧菌监测分析

目的:对2005年-2010年霍乱弧菌监测中分离的25株疑似菌株进行系统鉴定。方法:分离培养、血清学试验、系统生化鉴定(VITEK32)、PCR检测其分型及毒素基因、药敏试验。结果:25株菌鉴定为霍乱弧菌的有21株,与霍乱弧菌发生交叉凝集4株;病例监测主要为O139霍乱弧菌、外环境监测主要为O1群霍乱弧菌;病例监测菌株携带霍乱弧菌毒素基因(ctxAB)、其他菌株均不携带霍乱弧菌毒素基因(ctxAB)。药敏实验结果对诺氟沙星和环丙沙星敏感,对其他抗生素有不同程度的耐药。结论:武汉市霍乱弧菌在病例监测中主要为O139群霍乱弧菌产毒株、外环境监测中主要为O1群霍乱弧菌非产毒株,不同型别菌株存在不同程度耐药性。     

滕州市185株弧菌及肠毒素检测分析

目的探讨滕州市弧菌种类、分布、构成特征和毒力因子。方法对就诊的急性腹泻病人采集腹泻便,按《卫生防疫细菌检验》提供的方法进行弧菌分离鉴定及肠毒素检测。结果1992～201i年共检测急性腹泻病人粪便4847份,检出各类弧菌185株,检出率为3．82％。其中以非O1群霍乱弧菌为主126株占68．i1％,其次是河弧菌16株占8．65％、梅契尼柯夫弧菌和弗尼斯弧菌各12株各占6．49％、溶藻弧菌9株占4．86％、副溶血弧菌8株占4．32％、霍乱弧菌2株占1．08％。结论在检出的弧菌中,以非O。群霍乱弧菌为主要菌群,另外还有霍乱弧菌、河弧菌、弗尼斯弧菌、溶藻弧菌、梅契尼柯夫弧菌和副溶血弧菌。非0。群霍乱弧菌能产生CT,与其致病性密切相关;NAG-ST是非0。群霍乱弧菌一种主要毒力因子。     

从鸭绿江水产品中检出非流行株埃尔托型霍乱弧菌

〔目的〕对丹东口岸中朝界河鸭绿江中的水产品进行霍乱监测,从而了解鸭绿江中水产品被霍乱弧菌污染的情况。〔方法〕对可疑菌落做霍乱弧菌O1群、O139群血清玻片凝集试验,对凝集菌落作进一步的生化试验和噬菌体-生物分型。〔结果〕从水产品中检出非流行株O1群稻叶型霍乱弧菌。〔结论〕鸭绿江中水产品对健康人群存在感染风险,应注意水产品的饮食卫生和安全。     

浙江省检出首例带stx2 O157∶H7病人的报告

目前大多数学者认为肠出血性大肠杆菌O157∶H7之所以能对人类致病,其致病因子为志贺毒素,并认为该毒素为肠出血性大肠杆菌(EHEC)所特有〔1〕。浙江省于1997年首次在杭州人和动物中检出肠出血性大肠杆菌O157∶H7后〔2,3〕,又相继在宁波等地从动物中检出〔4〕,但是都不带志贺毒素1(stx1)和志贺毒素2(stx2)。本次检出的病人为浙江省首次发现带有stx2毒素的肠出血性大肠杆菌O157∶H7菌株。现报告如下。1病人发病和治疗情况患者,男性,15个月龄,杭州市人。2005年6月2日上午9时在家中开始腹泻,起初腹泻为黄色水样便,后转为黏液样便,腹泻2d共12~…     

多重PCR检测霍乱弧菌的毒素相关基因

目的 探索建立一种快速、敏感地检测霍乱弧菌O1群、O139群、非O1／非O139群的毒素相关基因的方法。方法 针对霍乱弧菌霍乱肠毒素A亚单位基因(ctxA)、小带联结毒素基因(zot)、辅助霍乱肠毒素基因(oce)、霍乱弧菌毒素共调菌毛A基因(tcpA)、毒素表达调控蛋白基因(toxR)分别设计引物，建立多基因PCR方法；通过一次扩增反应之产物经琼脂糖凝胶电泳，可检测出菌株的毒素相关基因的携带情况。结果 阳性对照菌株：MO45(霍乱弧菌O139群)检出5种毒素相关基因，结果符合设计要求；其他不同来源的霍乱弧菌(O1群、O139群、非O1／非O139群)检出1—5种不等的毒素相关基因；根据毒素相关基因携带情况，可将菌株分为5个基因型，并可区分为产毒株和非产毒株；多重PCR敏感度可达10^2cfu／ml。结论 该方法快速、特异、敏感，具有较大的应用价值。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

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.     

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.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

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.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.