妊娠与非妊娠妇女下生殖道感染比较

目的:探讨妊娠与非妊娠妇女下生殖道感染状况。方法:随机选取常规围产期保健妇女180例(早期妊娠60例、中期妊娠60例、晚期妊娠60例)采集阴道分泌物,测定pH值,检测外阴阴道假丝酵母菌病、滴虫性阴道炎、细菌性阴道病,宫颈分泌物,利用DNA杂交导流技术检测人乳头瘤病毒(HPV)及基因分型。选择60例非妊娠期健康妇女进行相同的检查作为对照。结果:阴道pH值在妊娠各期均低于非妊娠期(P<0.01)。妊娠期细菌性阴道病(BV)、外阴阴道假丝酵母菌病(VVC)及HPV感染率分别是19.4%、21.7%、28.9%,非妊娠期三项感染率分别为8.3%、10.0%、15.0%,妊娠期高于非妊娠期妇女(P<0.05)。不同妊娠期别HPV感染率及基因亚型不同,妊娠晚期HPV感染率最高,达46.7%,明显高于早、中妊娠期HPV感染率(P<0.05)。妊娠妇女高危型HPV感染率高于非妊娠妇女,以妊娠晚期明显,且部分伴有多重型感染。结论:妊娠期妇女下生殖道感染发生率高,尤应注意HPV感染,需要重复检测,加强随访。     

宫颈上皮内瘤变与生殖道感染的关系

目的探讨宫颈上皮内瘤变(CIN)与生殖道滴虫、细菌性阴道病、沙眼衣原体、解脲脲原体、人乳头瘤病毒(HPV)感染的关系。方法选择医院妇科2014年1月-2015年12月宫颈CIN患者300例为CIN组,宫颈上皮正常者300例为对照组,检测生殖道滴虫、细菌性阴道病、沙眼衣原体、解脲脲原体、HPV感染情况。结果 CIN组滴虫、细菌性阴道病、沙眼衣原体、解脲脲原体、HPV16/18感染率(25.3%、29.3%、29.0%、53.0%、75.0%)均高于对照组(13.0%、14.7%、7.3%、43.7%、4.0%)(P<0.05);CINⅠ亚组、CINⅡ亚组、CINⅢ亚组之间生殖道滴虫、细菌性阴道病、沙眼衣原体、解脲脲原体感染率比较差异无统计学意义,CINⅡ亚组、CINⅢ亚组HPV16/18感染率(83.5%、92.4%)均明显高于CINⅠ亚组(55.9%),但CINⅡ亚组和CINⅢ亚组HPV16/18感染率比较差异无统计学意义;CIN组HPV16/18感染合并滴虫感染、HPV16/18感染合并细菌性阴道病、HPV16/18感染合并沙眼衣原体、HPV16/18感染合并解脲脲原体的发生率(6.7%、11.7%、18.0%、40.3%)均高于对照组(0.3%、0.3%、1.0%、1.7%)(P<0.05);生殖道HPV16/18感染与滴虫、细菌性阴道病、沙眼衣原体感染呈正相关(r=0.013、0.020、0.027,P<0.05),和解脲脲原体感染无显著相关性。结论宫颈CIN与生殖道滴虫、细菌性阴道病、沙眼衣原体、解脲脲原体、HPV16/18感染有关,HPV16/18感染与病情进展有关,与生殖道滴虫、细菌性阴道病、沙眼衣原体感染呈正相关。     

已婚育龄妇女阴道宫颈感染病原体分析

目的 了解已婚育龄妇女阴道宫颈感染病原体分布情况以及不同病原体与不孕症的关系.方法 对延安市中医医院妇科门诊检查的3 685例已婚育龄妇女阴道、宫颈感染病原体检测结果进行分析,并比较86例不孕症妇女和86例对照组妇女病原体的异同.结果 阴道或宫颈分泌物感染者1 124例,感染率为30.23%.其中解脲支原体感染率为8.60%(317/3 685);衣原体感染率为12.02%(443/3 685);假丝酵母菌感染感染率为8.09%(298/3 685).两种及两种以上混合感染率14.82%(546/3 685).不孕症妇女阴道或宫颈分泌物感染率(52.33%)高于对照组(30.23%),有显著性差异(χ2=8.66,P<0.05).与对照组妇女比较,病原体分布特点不同,沙眼衣原体、阴道毛滴虫和淋球菌感染率较高.结论 已婚育龄妇女阴道宫颈感染以沙眼衣原体、假丝酵母菌和解脲支原体感染为主,不孕症妇女沙眼衣原体、阴道毛滴虫和淋球菌感染率高于年龄和婚龄相近的已婚已生育妇女.     

平湖地区妇女阴道炎病原学分析

目的:探讨平湖地区妇女阴道炎感染情况及其病原菌分布状况。方法:采集受检女性阴道分泌物,采用直接涂片和培养等方法检测细菌、支原体和念珠菌,沙眼衣原体采用胶体金法。结果:1 366例阴道炎患者中念珠菌、支原体、细菌的感染率较高,分别为47.0%、46.0%和31.4%,混合感染率为29.2%。各年龄组间细菌(除淋球菌)的感染率差异无统计学意义(P>0.05),各年龄组间念珠菌、支原体、衣原体、淋病奈瑟菌和滴虫的感染率差异有统计学意义(P<0.05)。21～45岁年龄段妇女支原体和衣原体感染率显著高于其他年龄段,45岁以上组滴虫和淋球菌的感染率明显高于<45岁年龄组。结论:平湖地区妇女阴道炎混合感染率较高,临床对阴道炎患者应进行病原菌的联合检测,对合理对症用药有重要意义。     

社区妇女生殖道沙眼衣原体感染的调查分析

[目的]了解厦门市社区已婚妇女生殖道沙眼衣原体感染情况。[方法]对200名妇女做分层随机抽样调查。[结果]生殖道沙眼衣原体的感染率达10%，高于其它阴道疾病。[结论]在妇科病检查中，对有生殖道炎症，尤其是宫颈糜烂、盆腔炎、不孕症、不良妊娠，应将沙眼衣原体列为常规检查项目；在社区中开展生殖健康教育，定期妇科病检查是保持社区妇女生殖健康的有效方法。     

妇女阴道炎常见病原体分析

目的 了解引起妇女阴道炎的主要病原体及其感染情况.方法 对720例患阴道炎的妇女采集阴道分泌物检查进行检查、分析.结果 引起阴道炎的常见病原体的感染率为白色念珠菌(CA)21.3％、沙眼衣原体(CT)20.7％、阴道加德纳菌(GD)19.6％、阴道毛滴虫(TVD)13.6％、淋病奈瑟菌(NG)11.0％,其它14.6％,单纯一种病原体感染占38.6％,混合感染占61.4％.结论 白色念珠菌、沙眼衣原体是引起妇女阴道炎的主要病原体,几种病原体混合感染在妇女阴道炎中占很大比例.     

人乳头瘤病毒与女性生殖道病原体感染相关性分析

目的探讨妇女生殖道人乳头瘤病毒(HPV)感染与生殖道其他病原体感染的相互关系及危险因素分析。方法共计950名伴有各种生殖道感染症状与体征的妇女,病原体的检测包括阴道滴虫、白色念珠菌、沙眼衣原体、解脲支原体、淋病奈瑟菌、HPV和梅毒。用单因素Logistic回归分析HPV感染与其他生殖道病原体感染的相关性。结果生殖道HPV6、11感染合并解脲支原体阳性检出率较高,HPV6、11感染与解脲支原体感染有明显相关性(P=0.01),HPV6、11、16、18感染与解脲支原体(P=0.02),沙眼衣原体(P=0.04),梅毒(P=0.01)感染有一定的相关危险性。结论妇女生殖道HPV感染与解脲支原体、沙眼衣原体、梅毒的感染有关。HPV与生殖道病原体感染相互作用的机制值得进一步探讨。     

温州地区不孕妇女生殖道感染的检测结果分析

目的:了解温州地区不孕妇女生殖道感染的情况及常见病原体分布,探讨生殖道感染与宫颈柱状上皮异位程度、抗精子抗体(AsAb)、抗子宫内膜抗体(EmAb)之间的关系。方法:对227例不孕妇女通过常规妇科检查、病原体分离培养、核酸鉴定,统计生殖道感染率及其主要病原体的感染率,分析生殖道感染与宫颈柱状上皮异位程度、抗精子抗体和抗子宫内膜抗体之间的关系。结果:①227例不孕症妇女共检出生殖道感染116例,感染率为51.1%。解脲支原体感染率为42.2%,念珠菌感染率为23.3%,沙眼衣原体感染率为17.2%,滴虫感染率为8.6%,淋球菌感染率为6.0%,梅毒患病率为1.7%,淋病患病率为0.9%。②宫颈柱状上皮异位中重度妇女解脲支原体、念珠菌和沙眼衣原体感染检测阳性率明显高于轻度宫颈柱状上皮异位,且重度宫颈柱状上皮异位感染检出率高于中度宫颈柱状上皮异位(P<0.05)。③生殖道感染妇女血清AsAb、EmAb阳性率分别为31.9%(37/116)和26.7%(31/116),其中解脲支原体感染组AsAb、EmAb阳性率显著高于沙眼衣原体感染组(P<0.05)。结论:温州地区不孕妇女生殖道感染率较高,特别是解脲支原体、念珠菌和沙眼衣原体感染率高,并与宫颈柱状上皮异位的发生、AsAb和EmAb的高表达有关。     

正常妇女宫颈沙眼衣原体筛查及其临床意义

目的:了解北京地区正常妇女宫颈沙眼衣原体的感染情况,探讨其发病的高危因素,为制定预防及诊治策略提供依据。方法:在2005年3月~2006年9月间,对北京地区870例健康体检妇女进行了阴道感染性疾病的筛查。对衣原体感染的发生率及高危因素进行了分析。结果:沙眼衣原体的总感染发生率为13.4%(117/870)。高教育程度(高中及以上,OR=1.793,95%CI1.106~2.906,P=0.017)、阴道清洁度异常(OR=1.701,95%CI1.147~2.521,P=0.008)和pH值异常(OR=1.675,95%CI1.053~2.666,P=0.028)是衣原体感染的高危因素。结论:对于阴道清洁度和pH值异常的患者应警惕宫颈沙眼衣原体感染的可能,尤其是教育程度较高者。对高危妇女应进行沙眼衣原体筛查,以便早发现衣原体感染并采取适当干预措施预防妇产科并发症的发生。     

宜昌三峡移民妇女生殖道感染及宫颈糜烂的调查

目的:了解宜昌三峡移民生殖道白色念珠菌、沙眼衣原体感染率以及宫颈糜烂发生情况,分析其相关关系,为进一步改善该人群生殖健康提供依据。方法:通过常规妇科检查、病原体分离培养、核酸鉴定分析了解白色念珠菌、沙眼衣原体的感染率与宫颈糜烂的发生率。结果:该地区妇女生殖道白色念珠菌、沙眼衣原体感染率分别为23.7%、16.9%,宫颈糜烂发生率为58.0%,明显高于卫生部基层卫生与妇幼保健司在全国部分城市抽查的结果以及在浙江、山东农民中调查的结果,该地区宫颈糜烂的发生与沙眼衣原体感染有一定关系。结论:三峡坝区妇女生殖道感染及宫颈糜烂发病率较高与其经济发展水平、特殊的不稳定生活状态、较大劳动强度和受教育程度有关,防治妇女生殖道感染应为该地区妇女保健的重要内容之一,有关部门需采取综合措施重点干预。     

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.     

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.     

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.     

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.