新疆阿克苏地区HIV-1抗病毒治疗失败患者基因型耐药特征分析

目的 分析新疆阿克苏地区HIV-1抗病毒治疗失败患者基因型耐药特征。方法 选取新疆阿克苏地区2020年5月—2021年3月期间病毒载量>1 000拷贝/ml的HIV感染者664例的血样本,通过套式PCR扩增pol基因,对HIV-1抗病毒治疗失败患者进行耐药检测,将获得的pol基因序列与美国斯坦福大学网络HIV耐药数据库比对,分析耐药因素,确定耐药突变位点及耐药程度。结果 664例抗病毒治疗失败患者的耐药率为55.9%,对蛋白酶抑制剂（PIs）、核苷类逆转录酶抑制剂（NRTIs）及非核苷类逆转录酶抑制剂（NNRTIs）的耐药率分别为7.1%、18.2%和50.9%。在PIs、NRTIs和NNRTIs中最常见的突变位点及突变频率依次分别为Q58(83.0%)、M184(87.6%)、K103(71.3%)。结论新疆阿克苏地区需加强服药督导、开展服药依从性教育和宣传引导,同时加强对抗病毒治疗失败患者耐药监测并及时调整抗病毒治疗方案。     

云南省男男性行为人群HIV/AIDS病例抗病毒治疗失败基因型耐药分析

目的了解云南省男男性行为人群艾滋病病毒感染者和艾滋病患者(HIV/AIDS)抗病毒治疗失败的基因型耐药情况,为提高艾滋病抗病毒治疗效果提供依据。方法选择2014—2019年云南省确证艾滋病病毒1型阳性、经男男性行为感染且抗病毒治疗失败的HIV/AIDS病例为研究对象,采集血浆样本,采用套式反转录聚合酶链反应(RTnPCR)扩增并测序,采用Contig Express软件拼接测序片段,整理后序列提交至美国斯坦福大学HIV耐药数据网站比对耐药突变位点,获得序列对8种蛋白酶抑制剂(PIs)、7种核苷类反转录酶抑制剂(NRTIs)和5种非核苷类反转录酶抑制剂(NNRTIs)的耐药程度。结果共纳入HIV/AIDS病例205例,血浆样本扩增阳性169例,耐药112例,耐药率为66.27%;不同年龄病例中,30～50岁的耐药率较高,为76.09%;不同基因亚型中,CRF01_AE的耐药率较高,为76.34%;不同用药方案中,采用"齐多夫定+拉米夫定+奈韦拉平"的病例耐药率较高,为77.08%。NNRTIs、NRTIs和PIs耐药率分别为62.72%、49.70%和2.96%;NNRTIs中的奈韦拉平和依非韦仑耐药率较高,分别为62.72%和61.54%。与NNRTIs相关的主要突变位点为K103,37例占21.89%;与NRTIs相关的主要突变位点为M184,67例占39.64%;与PIs相关的主要突变位点为M46L/K,5例占2.96%,且导致奈非那韦高度耐药。结论云南省男男性行为人群HIV/AIDS病例抗病毒治疗失败的耐药率相对较高,耐药的基因亚型以CRF01_AE为主,NNRTIs类药物耐药率较高,奈韦拉平和依非韦仑尤其需谨慎使用。     

湖南省艾滋病患者抗病毒治疗后耐药性分析

目的了解湖南省艾滋病患者接受免费抗病毒治疗的效果以及人免疫缺陷病毒(HIV)的耐药情况,为改善该省的高效抗逆转录病毒治疗效果,指导临床医生用药提供科学的依据。方法收集湖南省衡阳市抗病毒治疗6个月以上的252例HIV感染者的血标本,进行病毒载量检测,其中32例病毒载量10~3拷贝/mL,对此32份样本进行进一步的HIV基因型耐药检测。结果测得的31个序列中,发生突变的样本18份,其中13份(5.16%,13/252)对蛋白酶抑制剂(PIs)、核苷类逆转录酶抑制剂(NRTIs)以及非核苷类逆转录酶抑制剂(NNRTIs)这3类抗逆转录病毒药物有耐药突变;对PIs、NRTIs和NNRTIs均耐药者1例(0.40%),对NRTIs和NNRTIs均耐药者9例(3.57%),对NNRTIs耐药者3例(1.19%)。同时发现M184V、K103N、Y181CG、G190A引起NRTIs和NNRTIs高水平耐药的重要突变位点。结论湖南省艾滋病治疗者中,PIs耐药发生率极低,NRTIs和NNRTIs的耐药发生率相对较高;已出现NNRTIs高水平的多药耐药。但总体耐药的发生仍处于较低水平。     

徐州地区292例抗病毒治疗失败HIV/AIDS患者耐药情况分析

目的 了解近年来徐州地区人类免疫缺陷病毒(HIV-1)感染者对抗反转录病毒药物的耐药情况和基因突变位点。方法 收集2018—2020年292例抗病毒治疗(antiretroviral therapy, ART)失败HIV/AIDS患者血浆样本,检测病毒毒株亚型耐药突变特点。结果 292例治疗失败患者中,有129例(占44.18%)发生耐药突变,其中126例(占43.15%)非核苷逆转录酶抑制剂(NNRTIs)耐药,主要突变位点为K103N(占22.26%);核苷逆转录酶抑制剂(NRTIs)耐药88例(占30.14%),主要的突变位点为M184V/I(占57.36%);蛋白酶抑制剂耐药位点突变率为1.37%。NNRTIs类药物中奈韦拉平(NVP)和依非韦伦(EFV)出现耐药程度最高,分别为42.12%和41.78%;其次是NRTIs类药物中的阿巴卡韦(ABC)和拉米夫定(3TC),分别为30.14%和29.79%。耐药毒株常见的基因亚型为CRF01＿AE亚型。结论 徐州地区ART治疗失败HIV/AIDS患者以NNRTIs耐药为主,应加强相关监测,合理选用抗病毒治疗药物,减少耐药的发生与传...     

2016—2019年深圳市龙岗区16～25岁HIV感染者病毒亚型及耐药特征分析

目的 了解深圳市龙岗区抗病毒治疗前HIV - 1感染者基因亚型和耐药株流行现况。方法 HIV/AIDS流行病学数据来源于全国艾滋病综合防治数据信息管理系统。采用描述性研究方法,对HIV感染者的流行特征进行统计分析,率和构成比的比较采用χ2检验或Fisher精确检验。收集2016—2019年新报告的16～25岁的HIV感染者血清样品,扩增HIV pol区全部蛋白酶基因和部分逆转录酶基因区域,测序后进行HIV - 1基因分型和耐药突变位点分析。结果 173份血清样品成功获得pol序列片段,男性占93.64%(162/173),单身占95.95%(166/173),外省户籍者占65.32%(112/173),同性性传播占67.63%(117/173)。HIV - 1亚型以CRF07_BC(43.35%)和CRF01_AE(32.95%)为主,其次为CRF55_01B(13.87%)、B(5.78%)和其他亚型(4.05%)。不同年份HIV - 1亚型分布差异有统计学意义(H = 9.456,P = 0.042)。总传播耐药率为5.78%（10/173）,非核苷类反转录酶抑制剂（NNRTIs）耐药率为4.62%(8/173),核苷类反转录酶抑制剂(NRTIs)为2.31%(4/173)。同性性传播的耐药率为7.69%(9/117),异性性传播为1.79%(1/56)。突变发生率为21.97%(38/173),未检测出PIs突变,主要耐药突变位点中5个针对NNRTIs和4个针对NRTIs。次要突变V179D/E高达17.34%(30/173),主要发生在CRF55_01B亚型,不同HIV - 1亚型检测出V179D/E突变差异有统计学意义(χ2 = 91.733,P＜0.001)。5例病例对一线治疗药物NNRTIs耐药,1例对NNRTIs和NRTIs双重耐药。结论 2016—2019年深圳市龙岗区HIV - 1亚型分布表现为以CRF07_BC和CRF01_AE为主,多个亚型共存的特点。HIV - 1感染者原发耐药率已达到中度水平,MSM人群中NNRTIs类药物的耐药需引起重视。应加强年轻的MSM人群的耐药监测。     

湖南省未接受抗病毒治疗的HIV-1毒株耐药基因变异研究

目的研究湖南省HIV感染者/AIDS患者的耐药情况。为开展大规模抗病毒药物治疗制定计划和方案时提供科学依据。方法对51名HIV感染者/AIDS患者进行CD4绝对计数、血浆病毒载量测定、基因型耐药性检测,并进行分析。结果发现1份样品存在蛋白酶抑制剂(PIs)主要耐药相关突变V32L,N88D(2.13%),3份存在次要耐药相关突变,分别为A71T(4.26%)、A71V(2.13%),3份对核苷类逆转录酶抑制剂(NRTIs)耐药突变L210M(2.13%)、L210F(4.26%),4份对非核苷类逆转录酶抑制剂(NNRTIs)耐药突变V179D(6.38%)、V108A(2.13%)。结论湖南省未接受抗病毒药物治疗的HIV感染者/AIDS患者中对现行的抗病毒治疗方案药物耐药水平仍然很低,但是应该加强对HIV感染者/AIDS患者体内HIV-1变异的监测。     

四川省达州市HIV-1感染者抗病毒治疗耐药性及耐药株亚型分析

目的了解四川省达州市接受艾滋病抗病毒治疗的I型艾滋病病毒(HIV-1)感染者的耐药现状及耐药株亚型特征,为预防耐药株的发生和流行提供依据。方法采集2013年全市范围内接受12个月以上抗病毒治疗的938名HIV-1感染者抗凝全血,检测病毒载量,对1 000 cps/ml的标本进行PCR和pol基因测序,所得序列构建系统进化树分析亚型;并利用Stanford HIV Drug Resistance Database在线分析确定耐药突变情况。结果 938例接受抗病毒治疗感染者中,140例(14.93%)病毒载量1 000 cps/ml,92例扩增阳性,44例出现不同程度耐药,经换算后耐药率为7.14%,比2011年高出3.15个百分点;44例耐药样本中,28例(63.64%)对核苷类逆转录酶抑制剂(NRTIs)类药物耐药,42例(34.09%)对非核苷类逆转录酶抑制剂(NNRTIs)类药物耐药,27例(61.36%)对NRTIs和NNRTIs两种药物同时耐药,1例(2.27%)对蛋白酶抑制剂(PIs)耐药。对耐药感染者标本进行基因型分析,以CRF01_AE重组亚型为主。结论 2013年达州市HIV-1耐药总体程度较2011年有所上升;对NNRTIs的高度耐药和交叉耐药较为严重,且首次出现了对PIs耐药的毒株。随着达州市抗病毒治疗工作开展时间延长,耐药株会逐渐增加,有必要加强耐药监测工作。     

应用基因检测法分析艾滋病毒的耐药性

目的:分析当地艾滋病患者体内艾滋病毒耐药性情况。方法:运用RT-PCR扩增HIV pol区基因片段,并对扩增的目的片段进行测序,将测序结果提交http://hivdb.stanford.edu网站,通过比对,分析艾滋病毒的耐药性。结果:基因型耐药性检测结果表明:93例病毒载量>1000 cp/ml的艾滋病患者中共有46例通过PCR扩增出了目的基因片段,并做了耐药基因型分析,耐药性基因检测阳性包括10例未治疗样本和36例治疗样本。耐药发生率为60.86%。Q58E、M184V、Y181C、K103N等等这些耐药突变能够不同程度地引起蛋白酶类抑制剂(PIs)、核苷类逆转录酶抑制剂(NRTIs)和非核苷类逆转录酶抑制剂(NNRTIs)治疗效果降低或失效。HIV-1亚型在46例患者中的分布为:4例CRF01-AE亚型和42例B亚型,病毒亚型间存在耐药突变的特异性。结论:要及时监测HIV的耐药性,改良治疗方案,降低耐药毒株的传播。     

2015年乐山市HIV-1抗体阳性病例抗病毒治疗效果及耐药分析

目的分析乐山市接受抗病毒治疗的HIV-1抗体阳性病例治疗效果及毒株耐药、突变情况。方法选取乐山市2015年接受抗病毒治疗时间>6个月的HIV-1抗体阳性病例共计620例,采集其抗凝全血进行病毒载量检测,对病毒载量>1 000copy/mL的样本采用自建基因型耐药检测进行耐药检测及分析。结果 620例患者中,419例病毒载量<200copy/mL,抗病毒治疗有效率为67.58%;175例病毒载量>1 000copy/mL,均值1.85×105copy/mL,病毒抑制失败率28.22%;其中93例样本核酸扩增阳性,主要为CRF07-BC亚型(占68.82%)和CRF01-AE亚型(占19.35%)。总耐药率6.13%(33/538),其中对核苷类反转录酶抑制剂(NRTIs)、非核苷类反转录酶抑制剂(NNRTIs)和蛋白酶抑制剂(PIs)的耐药率分别为57.58%、84.85%和18.18%;耐药毒株对NRTI主要突变位点为M184V、K65R,对NNRTI主要突变位点为K103N、K101E、Y181C、G190A,对PI未发现主要位点突变,次要突变位点主要是Q58E、A71V。结论乐山地区部分HIV-1抗体阳性患者抗病毒治疗效果较差。与2014年相比,总耐药率及对NRTIs、NNRTIs耐药率均有所下降,但对PI耐药率上升。应加强对接受HAART的HIV-1抗体阳性病例的病毒载量及耐药检测,及时评估治疗效果及耐药情况。     

Trends in meningococcal disease in Italy in 1988

Meningococcal disease in Italy decreased 15% in 1988 from the previous year (290 vs. 342 cases). The decline was particularly evident in military cases (1.7/100,000 in 1988 vs. 5/100,000 in 1987) reflecting the full coverage of bivalent serogroup (A + C) meningococcal polysaccaride vaccine in army recruits, achieved since January 1988. The highest proportion of cases was seen in people older than 25 years of age (25%). Serogroup C constituted 60% of the isolates, while 19% belonged to serogroup B. The proportion of strains resistant to sulphonamides was 45%, while 15% were resistant to Minocycline and none to Rifampin. Out of the five military cases, only one (due to serogroup C) was attributable to the vaccine failure. A single coprimary case, but no secondary cases occurred among civilians. These findings are consistent with the trends reported in Italy in the previous years.     

Benzene in blood and phenol in urine in monitoring benzene exposure in industry

Determinations of benzene concentration in blood and of phenol in urine were made by head-space gas chromatography techniques on samples taken near the end of the work day from two groups of workers potentially exposed to low levels of benzene in the work-place atmosphere. Preliminary results suggest that benzene in blood is more reliable than phenol tests for assessing both exposure and uptake of benzene. Normal values of phenol in urine (10 mg/liter or less) were found in nearly all those cases in which benzene was detected in the blood.     

2015年郑州市饮用水放射性水平状况调查

目的了解郑州市不同地区、不同季节、不同水源类型的放射性水平。方法分别于丰水期和枯水期采集郑州市区黄河水源水、井水源水、丹江口水源水、出厂水和末梢水各一份;以县为单位,每单位采集出厂水、末梢水、水库水、河水、井水各1份,按《生活饮用水生活标准检验方法》(GB/T 5750.13-2006)检测饮用水中总α和总β放射性水平,依据《生活饮用水卫生标准》(GB 5749-2006)进行判定。结果丰水期、枯水期水体总α、总β放射性水平均低于国家标准限值。结论郑州市不同水源类型均处于正常的天然放射性本底水平。     

Occupational stress in nurses in psychiatric institutions in Taiwan

Nurses are known to be exposed to occupational stress. However, occupational stress is not well documented for nurses in psychiatric institutions in Taiwan. A cross-sectional study was conducted to explore the work-related stress and risk factors of nurses in psychiatric institutions in Taiwan. A structured questionnaire was distributed to nurses at five state-owned psychiatric hospitals in Taiwan in 2001. Demographic information, working environment, and personal health status were inquired. Occupational stress was assessed based on the Chinese version of Job Content Questionnaire (JCQ). General health status and mental health were evaluated by the International Quality of Life Assessment Short Form-36 (IQOLA SF-36). A total of 573 questionnaires were disseminated to nurses and 518 (90.4%) were satisfactorily completed by nurses, including 408 female full-time nurses who had been in their current work for more than 6 months. In the past one month, 17.2% of nurses reported being under significant stress often or always. Assault episodes were reported by 45.1% of nurses in the past 6 months. Among the nurses, 16.9%, 25.2%, 50.0%, and 7.8% belong to the "High strain", "Low strain", "Active", and "Passive" groups, respectively. Perceived occupational stress was associated with young age, widowed/divorced/separated marital status, high psychological demand, low workplace support, and threat of assault at work. Lower general health score was associated with low job control, high psychological demand, and perceived occupational stress. A lower mental health score was associated with low job control, high psychological demand, low workplace support, and perceived occupational stress. We concluded that nurses in psychiatric institutions are under significant stress related to work factors.     

Changes in nursing administration in supporting transplantation in Brazil

This historical and bibliographic study aimed to understand how Nursing was organized to support care in transplantation. The HISA, LILACS, BDENF, PERIENF and DEDALUS databases were consulted, and thirteen references were found, ten of which were scientific articles, two were master's dissertations and one was a doctoral thesis. The span of time chosen for study ranges from the date of the first kidney transplant in Brazil (1965), to the date of publication of the last scientific article found in the databases mentioned above (2003). After reading these articles, the ones that were similar in topic were grouped together, thus creating the thematic axis for the presentation of the results. The results showed that the Nursing profession has played an important and active role in transplants ever since the first procedure in 1965.     

2019年中国肿瘤流行病学研究进展

恶性肿瘤已成为中国居民的主要死因之一。近些年来,中国政府积极推进肿瘤预防和控制领域的研究工作,取得了很大的进步。本文简要汇总中国在肿瘤流行病学领域的研究进展,具体包括2019年的肿瘤负担、癌症危险因素及其干预、筛查和早期发现、癌症防治专项行动(2019-2022年)方案等方面,以期为我国肿瘤防治工作的有效开展提供技术支撑和理论依据。     

2012年绵阳市蔬菜中农药残留状况

目的 了解绵阳市2012年市售蔬菜中农药残留情况,为食用蔬菜监管提供依据.方法 全部样品均按照GB/T 5009-2003的方法进行农药的残留检测.依据GB 2763-2005《食品中农药最大残留限量》进行判定.结果 2012年共检测蔬菜165份,农药检出率和超标率分别为72.12％和23.64％.豆类、根茎类、叶菜类、瓜果菜类和食用菌类蔬菜检测农药残留超标率分别为8.00％、23.53％、36.00％、5.26％和27.03％,差异有统计学意义(x2=11.41,P＜0.01).不同种类农药超标率差异有统计学意义(x2 =62.42,P＜0.01).夏季和冬季蔬菜农药超标率差异无统计学意义(x2=3.44,P＞0.05).结论 绵阳市叶菜类蔬菜中农药残留情况较为严重,应采取有效措施,加强蔬菜的监督管理,从源头禁止高毒农药的使用,加大蔬菜种植、销售环节的监测,确保市民食用蔬菜的安全.