腔镜检查前HIV感染筛查结果分析

目的 了解腔镜检查前患者人类免疫缺陷病毒抗体1型与2型(抗-HIV1/2)阳性率及其流行病学特征.方法 在23 182例腔镜检查前患者中,筛选人类免疫缺陷病毒(HIV)感染与艾滋病(AIDS)患者.用抗-HIV1/2快速胶体硒初筛,可疑者再用抗-HIV1/2酶联免疫法证实;两者均阳性者,按初筛阳性报送确认实验室进行HIV感染确认试验;对抗-HIV1/2阳性患者的年龄、性别、传播途径、就诊科室和首发病症等进行分析.结果 23 182例腔镜检查前患者,检出抗-HIV1/2阳性35例,阳性率为0.15%,其中男、女性比例为3:2;年龄以20～49岁为主.其中HIV/HBsAg双阳者5例,占14.3%;HIV/HCV双阳者6例,占17.1%;HIV/HBsAg/HCV均阳性者1例,占2.9%.35例HIV感染者中,经血液传播占74.3%;职业为农民者占57.2%.就诊时症状缺乏特异性,多以消化道及肺部真菌感染等接受胃镜、肠镜和气管镜等检查,其中肠镜和气管镜检查各占总例数的34.2%和31.4%.结论 腔镜检查前进行抗-HIV检测,有助于及时发现HIV感染者,避免腔镜检查传播HIV而引起医源性交叉感染.     

艾滋病感染特征与预防对策

目的 分析艾滋病感染特征及预防对策.方法 选择医院2006年2月-2011年8月接受治疗的66例艾滋病患者,所有患者的诊断均采用酶联免疫吸附法检测人类免疫缺陷病毒(HIV)病毒进行初筛,对初筛的阳性样本重新取样进行双孔复试,复试阳性者按《全国HIV检测管理规范》进行确认；对患者的感染原因以及人口学特征、并发感染情况进行分析.结果 在66例确诊的艾滋病患者中,男39例,女27例,年龄6～56岁,平均38.14岁,其中青壮年(20～45岁)占59.1％；职业分布主要为农民,占68.2％,其次为娱乐服务人员,占13.6％；艾滋病患者人类免疫缺陷病毒的感染途径主要为血液,占60.6％,其次为性接触,占27.3％；66例艾滋病患者中,28例并发肺部感染,感染率为42.4％；24例并发感染乙型肝炎,感染率为36.4％.结论 为预防艾滋病感染,需要加强输血的管理,提倡避孕套的正确使用,拒绝毒品.     

昆明铁路看守所2010-2014年羁押人员艾滋病感染状况调查

目的 为了解监管场所内羁押人员的艾滋病(AIDS)感染状况和人口学特点,制定针对相关羁押人群艾滋病防控政策和制度提供依据,以进一步控制艾滋病在该人群及普通人群中流行和蔓延.方法 依据《全国劳教场所艾滋病预防与控制实施办法(试行)》,定期到昆明铁路看守所,抽取新入所的目标人群的血液标本,进行初筛HIV抗体,初筛阳性者,送昆明市疾病预防控制中心进行确认.再用昆明市统一的个案调查随访表,对确证HIV抗体阳性者进行艾滋病感染状况和人口学调查.结果 2010-2014年,共HIV抗体筛查1 726人,检出HIV阳性者52人,阳性率3.01％.检出的阳性者中,通过静脉注射吸毒途径感染的人数占71.2％,男性占78.8％.且以30～40岁年龄组为主占51.1％.户籍所在地以四川为主占67.3％(P=0.000),文化程度较低,小学及以下占88.5％(P=0.000).民族以彝族为主占65.4％(P-0.000).职业以无业为主占98.1％.结论 昆明铁路看守所羁押人群HIV阳性检出率较高,静脉吸毒为主要传播途径.少数民族、文化程度低、无业、有明显的地域特点等为其主要特点.应坚持定期对新入所的羁押人员进行HIV抗体的检测.今后应进一步加强对针具交换的宣传力度,同时加强对外来流动人口的管理及艾滋病宣传教育和筛查力度.     

术前、产前及腔镜检查前进行四项指标检测的意义

目的探讨术前、产前及腔镜检查前患者四项指标检测的意义。方法随机收集3年来笔者所在医院就医的术前、产前及腔镜检查前患者4230例,并对其检测的HBsAg、抗HCV、抗HIV、TP—Ab结果进行分析。结果4230例患者中,总阳性率高达19．67％,其中HBsAg阳性率达10．78％,抗HCV阳性率达1．11％,抗HIV（1＋2）型阳性率达0．64％。以双抗原夹心法和胶体金法进行HIV抗体初筛试验,所有检测程序严格按照《全国艾滋病检测技术规范》进行,阳性及可疑血清标本经复试仍为阳性者,送省疾病预防控制中心（CDC）确证实验室进行确认,TP—Ab阳性率达7．14％。结论在术前、产前及腔镜检查前检测HBsAg、抗HCV、抗HIV、TP—Ab对避免医务人员的职业感染和预防患者医院内感染,以及防止医疗纠纷具有重要意义。     

贵州省结核病人中艾滋病病毒筛查情况调查

[目的]了解贵州省结核病人中艾滋病病毒感染情况。[方法]在县级结防机构门诊对新登记的结核病患者进行HIV抗体初筛,阳性者由省疾控中心进行确认试验。[结果]从2006～2008年,共筛查结核病患者41453例,检出HIV抗体阳性70例,HIV感染率0.17%。安顺市、毕节地区、贵阳市发现的HIV阳性患者数占全省在结核病人中发现的HIV阳性患者的68.6%。[结论]贵州省在结核病人中筛查HIV的感染率较1995～1997年的水平有所上升。     

扬州市2005—2007年监管场所羁押人员HIV监测分析

目的了解扬州市监管场所中羁押人员HIV感染状况，以防止艾滋病在监管场所中传播与蔓延。方法定期对扬州市所有监管场所羁押人员进行调查，按照统一调查表填写，录入Excel并统计分析；采集静脉血5ml，用酶联免疫试剂初筛，初筛阳性标本用蛋白印记法（WB）进行确证。结果8414名羁押人员中，检出20例HIV阳性者，其中男性18人，女性2人，总检出率为0．24％。HIV感染者经吸毒感染8人（占总阳性数的40．00％），有注射吸毒史者阳性率5．26％；经性途径感染4人（占总阳性数的20．00％），有性乱史者阳性率1．12％；经血液感染1人，7人感染途径不详。结论扬州市监管场所中羁押人员HIV感染率较高，感染者主要为吸毒和性乱人员。     

汕头市综合医院艾滋病毒抗体检测分析

了解我市综合医院患者中HIV感染的现状,为艾滋病的预防与控制提供依据。方法以2005年1月至2010年12月在本院就诊的99 010例患者为对象,采用双抗原夹心ELISA和免疫层析快速诊断试剂测定对患者血清中的HIV抗体进行初筛、复检及确诊实验。结果99 010例患者中,共检出HIV抗体阳性40例,总阳性率为0.04％...     

贵州省结核病和艾滋病双向筛查4年监测结果分析

目的进一步了解贵州省结核病/艾滋病双重感染流行情况。方法在县级结核病防治机构门诊对新登记的结核病患者进行HIV抗体初筛,对初筛阳性结果进行确认。在艾滋病防治机构对HIV/AIDS筛查结核病。结果 2010年-2013年4年间,共筛查结核病患者125 365例,检出HIV抗体阳性225例,结核病中HIV感染率为0.18%;在6 071例HIV/AIDS中,发现697例结核病患者,艾滋病中结核病患病率为11.48%;结核病中HIV感染率和艾滋病中结核病患病率之间差异具有统计学意义(P0.01)。9个市州中,黔东南州发现的结核病/艾滋病双重感染患者最多,占全省发现病例数的17.03%。结论贵州省结核病人中HIV感染率维持在较低水平,但艾滋病中结核病患病率呈上升趋势,结核病对艾滋病的影响不容忽视。要切实降低HIV/AIDS的结核病负担,控制好2种疾病的流行和传播。     

上海市浦东新区2012年结核病人HIV感染检测结果分析

目的了解上海市浦东新区结核病人中艾滋病病毒(HIV)感染现状及流行病学特征,为制定TB/HIV双重感染防治对策提供依据。方法对2012年上海市浦东新区7家定点医院送检的756例结核病人,采取自愿的原则进行HIV抗体初筛检测,对HIV初筛阳性标本做免疫印迹(WB)确证实验。结果 756例结核病人进行了HIV检测,其中HIV阳性者4例,阳性率为0.53%,4例阳性者中已知HIV阳性者1例,占25.00%,新发现3例占75.00%。4例TB/HIV双感病人均为因症就诊,无固定职业,年龄以青壮年男性为主。结论对结核病人进行HIV检测是发现HIV感染者的方法之一,对控制结核病疫情均有现实意义。     

2010-2013年基层综合医院HIV检测分析

目的了解基层综合性医院就诊患者中HIV感染现状,分析感染者相关特征,为艾滋病相关防治策略及措施的制定提供依据。方法采用酶联免疫吸附试验对患者血清进行初筛,初筛阳性者再进行复检,其检测结果为一阴一阳或者双阳者送成都市疾病预防控制中心采用免疫印迹法(WB)确诊。结果 2010-2013年共检测血清样本59 027例,确诊HIV阳性126例,阳性率为0.213 5%。感染者以汉族(91.27%)、男性(79.37%)、40岁以下青壮年(76.19%)、高中及以下文化程度(95.24%)和有婚姻经历者(74.60%)为主;阳性样本主要来自其他就诊者检测、术前检测及性病门诊(92.86%);传播途径以异性传播为主(91.27%)。结论对入院患者进行HIV检测,是发现感染者、控制艾滋病蔓延的有效途径之一,同时也是降低医源性感染风险的有效手段。     

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.