孕妇TORCH感染及血清中白细胞介素-6、肿瘤坏死因子-α水平的变化

目的了解孕妇弓形虫（TOX）、风疹病毒（RV）、巨细胞病毒（cMv）及单纯疱疹病毒（HSV）感染（TORCH感染）情况及其血清IL-6、TNF—α的变化。方法采用ELISA法进行血清TORCH-IgM检测，同时采用双抗体夹心ELISA法测定孕妇血清IL-6及TNF—α。结果853例早期孕妇中TORCH-IgM阳性78例，占9．14％，其中CMV—IgM阳性31例，占3．63％，TOX-IgM阳性21例，占2．46％，RV-IgM阳性14例，占1．64％，HSV—IgM阳性12例，占1．41％。TORCH—IgM阳性孕妇血清IL-6和TNF—α分别为（67．25±13．24）ndL和（278．13±81．03）ng/L，对照孕妇分别为（28．62±10．23）ng／L和（173．21±41．17）ng/L，TORCH—IgM阳性孕妇血清IL-6和TNF—α均较对照孕妇明显升高（P〈0．01）。结论孕妇TORCH感染以CMV为主；TORCH感染后，孕妇血清中免疫细胞因子失衡，提示免疫调节失衡是TORCH感染后各脏器进一步损伤的重要因素之一，在临床上TORCH感染治疗中，除抗病原体治疗外，还应重视免疫调节治疗。     

汕尾地区妊娠妇女TORCH感染调查分析

目的了解汕尾地区妊娠妇女TORCH感染状况。为预防TORCH感染、降低新生儿出生缺陷发生率提供参考资料。方法采用酶联免疫吸附试验（ELISA）对476例妊娠妇女进行TORCH-IgM及IgG抗体检测。结果TORCH的10项检测结果包括Tox、RV、CMV、HSV-I和HSV-Ⅱ的IgM阳性率分别为3．36％、0．84％、2．73％、1．26％和1．68％,Tox、RV、CMV、HSV-I和HSV-Ⅱ的kG阳性率分别为11．10％、86．10％、81．90％、38．40％和15．30％。结论汕尾地区妊娠妇女弓形虫感染率最高．其次是巨细胞病毒。为减少因TORCH感染而导致新生儿出生缺陷,建议妊娠妇女尽可能进行TORCH筛查;孕期TORCH感染者应采取一定的干预治疗措施．必要时终止妊娠．促进优生优育．提高人口素质。     

南京地区育龄女性TORCH感染状况调查

目的调查在南京大学医学院附属鼓楼医院进行孕前筛查和产前普查的育龄女性的TORCH感染情况,分析不同季节、不同年龄段人群TORCH感染的特征,为该地区育龄女性的预防保健提供参考依据。方法采用酶联免疫吸附试验对3 340例孕前及孕期妇女进行血清中TORCH特异性抗体IgM、IgG检测,根据季节、年龄分组比较TORCH不同病原体感染率的差异。结果 3 340例受检者中总IgM阳性率为2.6%,巨细胞病毒（CMV）的IgM阳性（近期感染）率和IgG阳性（既往感染）率分别为1.05%和65.14%;弓形虫（TOX）、风疹病毒（RV）和CMV IgM的检出率均在夏季最高,夏季TOX和RV IgM阳性率分别为1.38%和1.30%,显著高于其他3个季节（P〈0.01）;20-25岁年龄组TOX IgM检出率（1.08%）显著高于26-30岁组（0.36%）（P〈0.05）;CMV IgM的阳性率在20-25岁组最高,为1.49%,与31-45岁组（0.47%）差异有统计学意义（P〈0.05）。结论育龄女性TORCH感染以CMV最多见,相关病原体感染具有季节性和年龄差异,有必要有针对性地加强预防保健,并积极做好TORCH特异性抗体的检测和监测。     

TORCH感染与习惯性流产的关系

目的：探讨TORCH感染与习惯性流产的关系。方法：用ELISA方法检测68例习惯性流产妇女与TORCH感染的关系(观察组)，并与同期正常妊娠的孕妇60例对照(对照组)。结果：68例习惯性流产妇女检测弓形体，风疹病毒，巨细胞病毒，单纯疱疹Ⅰ、Ⅱ型病毒(优生5项)的IgM阳性检出率分别为11．76％(8／68)、1．46％(1／68)、5．58％(4／68)、5．58％(4／68)、5．58％(4／68)，总检出率30．88％；60例对照组相应5项病毒检出率分别为0％、0％、3．33％(2／60)、1．67％(1／60)、0％，总检出率5．00％。结论；TORCH感染是习惯性流产的病因之一，习惯性流产患者有必要检测优生5项指标，并予以相应治疗后再妊娠为佳。     

476对不良孕产史夫妇相关因素探讨

目的 探讨不良孕产史的原因，以对不良孕产史夫妇今后的生育进行指导。方法 对曾在我院就诊的476对有不良孕产史的夫妇进行职业调查，了解有害物质接触史情况，并行TORCH感染筛查、染色体分析、高危病例进行梅毒感染筛查及糖尿病筛查等。结果 TORCH感染率46．2％(220／476)，染色体异常率5．7％(54／952)，有害物质接触史占12．2％(58／476)，梅毒感染占被检者的14．3％(12／84)；妊娠合并糖尿病占被检者的52．7％(29／55)。结论 TORCH感染、染色体异常、有害物质接触史是不良孕产史的主要原因，梅毒感染、妊娠合并糖尿病等也是不容忽视的因素。     

孕前TORCH筛查8395例分析

目的了解准父母孕前微生物感染状况,为制定出生缺陷干预措施提供依据。方法对8395名孕前准父母采血进行TORCH综合征的筛查,结果进行回顾性统计分析。结果常规4项筛查（CMV、RV、HBV、Tox）IgM阳性1008人,阳性率12．00％;单项阳性735人,阳性率8．76％;合并阳性273人,阳性率3．25％。结论孕前TORCH感染阳性率较低,且父系传给子代的机会极少,母亲感染并不意味胎儿感染,故对准父母进行TORCH筛查的必要性需慎重考虑。     

X、γ射线作业人员血液中T细胞酯酶及免疫球蛋白的检测

目的检测T细胞酯酶及3种免疫球蛋白（IgA、IgG、IgM）指标，旨在观察接触X、γ射线对作业人员机体免疫系统的影响。方法T细胞酯酶测定采用α-醋酸萘酯酶（ANAE）染色法；免疫球蛋白测定采用半自动生化分析仪免疫比浊法。检测接触X、γ射线各100人，并各分2个年龄组，比较组间检测结果的差异。结果医用X射线19～30和31～58岁2组人员T细胞酯酶均值为（57．76±6．79）％和（57．64±5．77）％。IgA、IgG、IgM均值19～30岁组分别为（1．78±0．56）、（1．76±0．51）和（10．04±2．26）g／L；31～58岁组分别为（9．89±1．79）、（1．16±0．25）和（1．06±0．20）g／L；仅IgM2年龄组相比，差异有统计学意义（P〈0．05）。γ射线20～30和31～58岁2组人员T细胞酯酶均值分别为（54．20±6．38）％和（55．30±6．18）％。IgA、IgG、IgM均值20～30岁组分别为（1．82±0．45）、（1．78±0．47）和（9．20±2．15）g／L；31～58岁组分别为（10．37±2．61）、（1．11±0．23）和（1．04±0．21）g／L。仅IgG2年龄组比较，差异有统计学意义（P〈0．05）。结论受检人员，不论年龄大小（接触射线时间长短），以上免疫指标检测结果均值均在正常参考值范围。个别人某个指标检出结果偏低提示，有关单位仍不可忽视对射线的防护和对接触者的健康监护，以防免疫系统受到危害。     

钦州市异常孕产史妇女常见病原体检测分析

目的探讨异常孕产（自然流产、死胎和胎儿畸形）与妇女常见病原体[梅毒（TP）、弓形体（TOX）、单纯疱疹病毒（HSVⅡ）和巨细胞病毒（CMV）]的相关性。方法用酶联免疫（ELLSA）法检测异常孕产史妇女（497例）血中TP—IgM、TOX—IgM、HSVⅡ-IgM和CMV—IgM,并与正常孕产妇女（125例）比较,探讨异常孕产与4种病原体的关系。结果异常孕产史妇女中TP—IgM、TOX—IgM、HSVⅡ-IgM和CMV—IgM感染阳性率分别为1．81％、9．86％、1．61％和9．26％;正常孕产妇女仅TOX和CMV阳性病例各1例,其感染阳性率均为0．80％。在自然流产和胎儿畸形组,TOX感染阳性率分别为10．74％和7．41％;CMV感染阳性率分别为10．02％和7．41％。结论TOX和CMV感染是引起异常孕产的重要因素之一;在异常孕产中,以自然流产比率最高,胎儿畸形次之。因此,建议把TOX和CMV作为妊娠前或妊娠早期妇女常规检测项目,以便及早发现,及时防治,减少异常孕产的发生。     

鄂西南地区居民并殖吸虫病血清流行病学调查

目的了解鄂西南并殖吸虫病流行区人群并殖吸虫感染现状。方法对鄂西南4个山区县中12个自然村长住居民采静脉血1．5～2ml，用酶联免疫吸附实验（ELISA），检测血清中并殖吸虫特异性抗体（IgM）。结果ELISA检测血清5255人（份），IgM阳性81人（份），阳性检出率为1．54％；其中男性阳性率为1．62％（38／2350）、女性阳性率为1．48％（43／2905），12岁以下儿童阳性率最高为2．16％（28／1298），中学生和农民阳性率分别为1．82％和1．35％。对检出的全部阳性血清和部分阴性血清进行了复测，复合率为97．21％。结论鄂西南4个县（区）居民并殖吸虫隐性感染依然存在；不能排除并殖吸虫对当地居民的潜在危害。     

嘉兴市儿童肺炎支原体IgM抗体结果分析

目的分析嘉兴市儿童肺炎支原体（MP）感染规律,为临床早期诊断、早期治疗提供依据。。方法采用酶联免疫吸附测定法（ELISA）法,对2011年12月至2012年11月间在嘉兴市第二医院就诊的0～12岁吸道感染患儿2275例进行肺炎支原体免疫球蛋白M抗体（MP—IgM抗体）检测,并分析〈1岁、l～6岁和～12岁年龄组及全年4个季度患儿MP—IgM抗体的阳性检出率。结果2275例呼吸道感染患儿,栓出MP—IgM抗体阳性295例,阳性率为12．97％,其中〈1岁、1～6岁和一12岁年龄组患儿MP—IgM抗体阳性检出率分别为8．88％（30／338）、13．67％（205／1500）和13．73％（60／437）;1岁以内患儿MP—IgM抗体阳性率均低于其它两个年龄组,差异具有统计学意义（∥值分别为5．673和4．371,均P〈0．05）,1～6岁和～12岁两组比较差异无统计学意义（／=0．001,P〉0．05）。4个季度阳性检出率分别为14．44％（65／450）、12．36％（83／671）、9．82％（40／407）和14．20％（107／747）,差异均有统计学意义（,=10．462,P〈0．05）。结论MP感染的患儿以学龄前儿童及学龄期儿童为主,一年四季均可发病,第3季度最低,第一、第4季度较高。     

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.