病毒性肝炎患者巨细胞病毒感染115例分析

为分析巨细胞病毒（ＣＭＶ）在病毒性肝炎病人中的流行情况及临床特点，用酶联免疫吸附试验法为６４１１例住院的肝炎病人检测血清抗ＣＭＶ－ＩｇＭ，并对比观察１１５例ＣＭＶ感染者与１９２例ＣＭＶ阴性者的临床症状、体征和肝功能等。结果ＣＭＶ感染率为１．７９％，平均发病年龄３３．６岁，男女比为２．１３∶１，ＣＭＶ与肝炎病毒呈二重、三重、四重感染，感染率分别为４４．７４％、４７．３７％和７．８９％，ＣＭＶ阳性组发热、消化道症状、肝肿大、Ｂ超胆囊改变、丙氨酸转氨酶、天门冬氨酸氨基转移酶、γ－谷酰基转移酶及住院时间均高于或长于ＣＭＶ阴性组。说明ＣＭＶ在各型肝炎中均可存在，大多呈二重或多重感染，并可加重病毒性肝炎的病情。     

5种抗生素对肺炎大鼠巨噬细胞功能的影响

本实验采用气管内注入感染法建立肺炎克雷白杆菌性大鼠肺炎模型，腹腔注射抗生素。结果显示：肺炎大鼠Ｍ∮吞噬功能显著降低；ＣＡＺ、ＩＰＭ、ＰＩＰＣ可增强Ｍ∮吞噬功能，ＡＭＫ呈抑制作用；ＣＡＺ、ＰＩＰＣ可增强ＡＤＣＣ活性，ＡＭＫ降低ＡＤＣＣ活性；ＡＲＯ能增强ＡＣＰ活性     

柯萨奇B组病毒感染与扩张型心肌病发病关系的研究

为探讨柯萨奇Ｂ组病毒（Ｃｏｘｓａｃｋｉｅｖｉｒｕｓ ｇｒｏｕｐ Ｂ，ＣＢＶ）与扩张型心肌病（ｄｉｌａｔｅｄ ｃａｒｄｉｏｍｙｏｐａｔｈｙ，ＤＣＭ）发病的关系，应用逆转录－聚合酶链反应（ＲＴ－ＰＣＲ）及酶联免疫吸附试验（ＥＬＩＳＡ）检查３９例扩张型心肌病患者（ＤＣＭ组）外周血中ＣＢＶ－ＲＮＡ、血清中ＣＢＶ－ＩｇＭ。结果表明，ＤＣＭ组中血ＣＢＶ－ＣＢＶ－ＲＮＡ、血清中ＣＢＶ－ＩｇＭ。结果表明，ＤＣＭ组     

福建省居民头发Zn、Cu、Ca、Mg、Mo、Se水平分析

福建省居民头发Ｚｎ、Ｃｕ、Ｃａ、Ｍｇ、Ｍｏ、Ｓｅ水平分析黄文光，吕华东，许希珠，陈小萍，陈巧生福建省福州环境卫生监测站（３５０００１）ＡｂｓｔｒａｃｔＡｂｏｕｔ５００ＣａｓｅｓｏｆｈｅａｌｔｈａｄｕｌｔｈａｉｒＺｎ、Ｃｕ、Ｃａ、Ｍｇ、ＭｏａｎｄＳｅｃ...     

0～16岁城乡儿童骨骼矿物质含量及影响因素的研究

使用单光子骨矿物测定仪，自１９９４年初到１９９５年底，分别在河南省扶沟县和新乡市测定了３３２名健康的０～１６岁城乡儿童右前臂１／３处桡骨和尺骨的骨矿物质含量（ＢＭＣ），采用逐步多元回归分析了多个独立变量对桡骨ＢＭＣ和测量部位骨宽度的影响。结果显示：桡骨和尺骨的ＢＭＣ、骨宽度（ＢＷ）、ＢＭＣ／ＢＷ和前臂长度均随年龄而增加，０～６岁城市儿童的ＢＭＣ高于农村儿童；桡骨ＢＭＣ与所测量部位的ＢＷ呈正相关，年龄、体重和身高对桡骨ＢＭＣ都显示出显著和独立的正影响；儿童的桡骨ＢＭＣ与年龄呈显著正相关；而桡骨ＢＭＣ与体重的比值与年龄呈显著负相关；测定部位桡骨ＢＷ和前臂长度随年龄的增加呈曲线增加。在以身高和体重调整后，性别、年龄和体重对桡骨ＢＷ的影响变得不显著，只有身高的影响显著。本研究证明儿童在０～１６岁范围，身高（而不是肥胖）是骨骼ＢＭＣ的主要决定因素。在比较儿童骨密度结果时，要参考多个变量，如ＢＭＣ、骨密度，ＢＭＣ／体重、ＢＭＣ／年龄等综合评价指标更有说明力。     

巨细胞病毒对孕产妇造成异常妊娠结局的研究

采用ＰＣＲ技术和ＥＬＩＳＡ法对５１７６例孕产妇及新生儿进行巨细胞病毒（ＣＭＶ）检测。结果表明：有异常妊娠史妇女ＣＭＶ平均感染率为１５．６％，前３位依次为畸胎史（２９．２％）、习惯性流产史（１９．２％）、先兆流产史（１５．６％）；早孕至中孕期，孕妇ＣＭＶ感染率为１９．２％；孕前妇女ＣＭＶ－ＩｇＭ阳性率为８．７％；对１５５例新生儿进行ＣＭＶ检测，得知ＣＭＶ感染患儿以合并肺炎最为常见，其次为黄疸、溶血性贫血、先心病等；对４６５０份新生儿脐血检测ＣＭＶ，结果表明先天性ＣＭＶ感染率为１．７％。     

苦丁茶的微量元素测定及其保健功能初探

用原子吸收分光光度计测定苦丁茶中Ｚｎ、Ｃｕ、Ｍｎ、Ｆｅ、Ｃａ、Ｍｇ、Ｓｒ、Ｃｏ、Ｌｉ、Ｒｂ、Ｋ、Ｎｉ的含量，发现其中Ｚｎ、Ｍｎ、Ｃａ、Ｍｇ、Ｋ、Ｒｂ、Ｆｅ、Ｃｏ的含量要比其他茶的含量高得多，并根据测定结果，初步讨论苦丁茶的保健价值。     

胃癌患者血清Mn,Zn,Cu含量变化的观察

用Ｗｙｘ４０２Ｂ型原子吸收分光光度计测定了５８名不同类型胃癌患者和５６名正常对照者血清Ｍｎ、Ｚｎ、Ｃｕ含量并对其Ｃｕ／Ｚｎ、Ｃｕ／Ｍｎ比值进行了分析。结果表明：胃癌患者血清Ｃｕ含量升高，血清Ｍｎ、Ｚｎ含量低于对照组（Ｐ＜０．０１）；Ｃｕ／Ｚｎ、Ｃｕ／Ｍｎ比值明显高于正常组（Ｐ＜０．０１），并呈正相关关系。不同类型胃癌患者血清Ｍｎ、Ｚｎ、Ｃｕ含量及其Ｃｕ／Ｚｎ、Ｃｕ／Ｍｎ比值均有所不同，尤以高分化腺癌更甚，但均无统计学意义（Ｐ＞０．０５）。测定胃癌患者血清Ｍｎ、Ｚｎ、Ｃｕ含量，可以估价体内这些元素的总的状态，为观察病情的变化、估计预后及对胃部良性疾病的鉴别有一定的参考价值     

柠檬酸—苹果酸钙盐在大鼠体内吸收利用的实验研究

选用４０只Ｗｉｓｔａｒ雄性初断乳大鼠，按体重随机分为本底组、实验组（ＣＣＭⅠ组、ＣＣＭⅡ组）和正对照组（ＣａＣＯ３Ⅰ组、ＣａＣＯ３Ⅱ组）。本底组在实验开始前处死，其它各组均饲以按ＡＯＡＣ配方配制的纯合金饲料，仅其中的钙分别来自Ｃａ－ＣＯ３ｔ ＣＣＭ。ＣａＣＯ３Ⅰ组和ＣＣＭⅠ组的饲料含钙２００ｍｇ／１００ｇ，ＣａＣＯ３Ⅱ组和ＣＣＭⅡ组的饲料含钙４００ｍｇ／１００ｇ，分别达到大鼠推荐量的５０％和１００     

安徽农民膳食中无机元素全年摄入量调查

对歙县、庐江、凤阳、利辛四县部分农户的Ｋ、Ｎａ、Ｃａ、Ｍｇ、Ｐ、Ｆｅ、Ｚｎ、Ｃｕ、Ｍｎ９种无机元素摄入量进行为期一年的调查，显示Ｋ、Ｃａ、Ｍｇ、Ｚｎ摄入量不足，Ｃａ尤为明显。Ｃａ、Ｚｎ、Ｃｕ、Ｆｅ、Ｍｎ的食物来源以植物性食物为主，吸收率低，应适当增加Ｃａ及微量元素含量高且易吸收的动物性食物的摄取量。江淮地区钠摄入量过高，应降低食盐的摄取量。     

疫苗相关麻痹型脊髓灰质炎对IPV疫苗选择的影响

摘要:在全球消除脊髓灰质炎（脊灰）的进程稳步推进的大背景下,随着口服脊髓灰质炎减毒活疫苗（Oral Polio Vaccine,OPV）的继续使用,疫苗相关麻痹型脊髓灰质炎（Vaccine-associated Paralytic Poliomyelitis,VAPP）越来越受到人们的关注,VAPP在国内外的发病情况不容忽视。WHO估计全球每年约有250～500例VAPP发生,国内的估算数字是76～161例,其中首剂次疫苗VAPP发生率较高。在疫苗选择上,灭活的脊髓灰质炎疫苗（IPV）最大的优点是能够避免VAPP的发生,但成本效益分析结果并不支持引入IPV。尽管如此,为了消除VAPP的危害,一些发达国家已率先使用IPV疫苗,同时一些发展中国家采用IPV/OPV序贯程序。因此,基于当前我国维持无脊灰的现状,VAPP所带来的公共卫生问题是决定选择IPV疫苗的重要因素,在可承担的价格空间上,IPV疫苗可作为首选疫苗推荐,也可先行引入IPV/OPV序贯程序。     

北京市大气污染对学龄儿童呼吸系统疾病和症状的影响

目的了解北京市大气污染对儿童呼吸系统疾病和症状的影响,为保护儿童健康和治理空气污染提出依据。方法根据北京环境监测的结果,选择污染程度和类型不同的A、B、C3个区。在每区选择3所小学,按照整群抽样的方法,选取1～5年级的5749名小学生进行呼吸系统健康问卷调查。结果在大气质量较好的A区,儿童各呼吸系统疾病和症状的发生率均小于污染严重的B、C区,差异具有显著性(P<0.05)。而在污染类型不同的B、C区,儿童各呼吸系统疾病和症状的发生率相当(P>0.05)。经多因素Logistic回归分析发现,咳嗽、感冒时咳嗽、咯痰、感冒时咯痰以及咳嗽、咯痰等症状在B、C区儿童发生的危险性高于A区儿童。居室附近有交通要道的儿童中各呼吸系统疾病和症状的发生率高于居室附近没有交通要道的儿童。结论学龄儿童中一些呼吸系统症状的增加与北京市城区大气污染有关。     

怀化市某区不同人群艾滋病基本知识调查及分析

目的了解怀化市某区不同人群有关艾滋病的知识知晓及知识来源情况.方法抽取怀化市某区18岁以上不同人群进行无记名问卷调查.结果怀化市某区不同人群对艾滋病知识的掌握程度有差异.人们获得艾滋病相关信息的主要途径均为电视、报纸等大众媒体. 结论怀化市某区在实施健康教育的过程中要针对不同的人群采用不同的传播策略.     

居室空气中挥发性有机物与氨的联合毒性

目的探讨居室装修后几种主要的挥发性有机物与氨的联合毒性。方法根据现场45间新装修居室检测所得甲醛、苯、甲苯、二甲苯、乙苯、氨浓度的中位数换算成平均质量百分比,再用分析纯品配制成混合物。分别以3.93、8.47、18.24、39.35g/m3混合物剂量进行昆明种小鼠急性毒性实验,分别以高剂量:3.935g/m3、中剂量:1.970g/m3、低剂量:0.393g/m3进行昆明种小鼠亚急性毒性实验。结果混合物小鼠LC50为26.84g/m3。亚急性毒性实验中,雌性小鼠染毒各剂量组网织红细胞计数,中剂量组红细胞比积(HCT),雌、雄性小鼠高剂量组血清血小板计数(PLT)显著低于对照组(P<0.05)。雌性小鼠高剂量组血清丙氨酸转氨酶(ALT)显著高于对照组。病理学检查发现混合物染毒各剂量组小鼠均可见心内膜下浅层不同程度脂肪变性,肺组织有不同程度淤血,随剂量增加,病变加重;高剂量组小鼠可见肝细胞轻度脂肪变性。结论该混合物对小鼠血液系统、肝脏、心脏以及肺脏有损害作用,雌性小鼠较为敏感,网织红细胞计数可以作为其机体毒性的敏感性损伤变化指标。     

Stephen Abrahamson,PhD, ScD,educationist: a stranger in a kind of paradise

This profile of Stephen Abrahamson, Ph.D., Sc.D., is the first of six profiles to appear as part of the Exemplar project focused of six retired medical educators who transformed the field of medical education. The exemplars, all graduate degree recipients in education were interviewed by six senior present-day medical educators using a common protocol designed to elicit career chronology and the significant contributions of educationists to medical education of Dr. Abrahamson's profile was based on an in-depth two-day interview, examination of a comprehensive list of his publications, the history of the Society of the Directors of Research in Medical Education, and unsolicited conversations with several of his colleagues. Dr. Abrahamson began his career teaching high school, later receiving a masters and doctorate degrees, in preparation for a career as a teacher-educator. Through collaboration with Dr. George Miller, Dr. Abrahamson began his career as an educationist in medicine - one who studies the education process and prepares others to become teachers - by teaching medical school faculty about the science of education. Dr. Abrahamson's career was devoted to applying his evidence-based education approach to the newly emerging profession of medical education. An examination of his career shows that he made four vital contributions to medical education - defining the educationist role, serving as a teaching/mentor/network builder/friend to medical educators, curriculum change agent and innovator at USC, and demonstrating and articulating the value of offices of medical education and research in medical education. More broadly, Dr. Abrahamson identified three major contributions made by educationists to the field of medical education: the application of education principles to instructional/assessment innovations (e.g., programmed patients), an evidence-based approach to assessing education, and faculty development/teacher training. Based on his half-century of experience in medical education, Dr. Abrahamson outlined seven lessons for success as an educationist in medicine. This revised version was published online in June 2006 with corrections to the Cover Date.     

Introducing professional educators into academic medicine: stories of exemplars

This article describes an oral history project aimed at documenting the history and contributions of the innovation of hiring professional educators in medical schools to improve the education of medical students, residents, and fellows. Six professional educators who spent their careers in medical schools were chosen as Exemplars: Stephen Abrahamson, Ph.D.; Charles Dohner, Ph.D.; Arthur Elstein, Ph.D.; Hilliard Jason, M.D., Ph.D.; Christine McGuire, M.A.; and Frank Stritter, Ph.D. Pairs of senior professional educators currently working in medical schools interviewed the six Exemplars using a standardized protocol. Articles describing each Exemplar appear consecutively in this and subsequent issues of Advances in Health Professions Education. The series culminates with an article that presents the consensus conclusions of the series authors, based on the five study questions that guided the study and interview protocol. This revised version was published online in June 2006 with corrections to the Cover Date.     

Assessment of the enhancement of PLGA nanoparticle uptake by dendritic cells through the addition of natural receptor ligands and monoclonal antibody

Targeting of specific receptors on antigen-presenting cells is an appealing prospect in the production of novel nanoparticulate vaccines. In particular, the targeting of vaccines to dendritic cell (DC) subsets has been shown in models to significantly improve the induction of immune responses. This paper describes the evaluation of natural ligands, mannan and chitosan, and monoclonal antibodies as targeting motifs to enhance uptake of PLGA nanoparticle carriers by bovine DCs. To assess enhancement of uptake after the addition of natural ligands a bovine monocyte derived DC (MoDC) model was used. For the assessment of monoclonal antibody targeting, the model was expanded to include afferent lymph DCs (ALDCs) in a competitive uptake assay. Mannan, proved unsuccessful at enhancing uptake or targeting by MoDCs. Chitosan coated particle uptake could be impeded by the addition of mannan suggesting uptake may be mediated through sugar receptors. Inclusion of monoclonal antibodies specific for the DEC-205 (CD205) receptor increased the number of receptor expressing DCs associated with particles as well as the number of particles taken up by individual cells. These results support the further evaluation of active targeting of nanovaccines to DCs to enhance their immunogenicity in cattle and other large mammalian species including humans.     

A novel vaccinological evaluation of intranasal vaccine and adjuvant safety for preclinical tests

Vaccines are administered to healthy humans, including infants, so the safety and efficacy must be very high. Therefore, evaluating vaccine safety in preclinical and clinical studies, according to World Health Organization guidelines, is crucial for vaccine development and clinical use. A change in the route of administration is considered to alter a vaccine’s immunogenicity. Several adjuvants have also been developed and approved for use in vaccines. However, the addition of adjuvants to vaccines may cause unwanted immune responses, including facial nerve paralysis and narcolepsy. Therefore, a more accurate and comprehensive strategy must be used to develope next-generation vaccines for ensuring vaccine safety. Previously, we have developed a system with which to evaluate vaccine safety in rats using a systematic vaccinological approach and 20 marker genes. In this study, we developed a safety evaluation system for nasally administered influenza vaccines and adjuvanted influenza vaccines using these marker genes. Expression of these genes increased dose-dependent manner when mice were intranasally administered the toxicity reference vaccine. When the adjuvant CpG K3 or a CpG-K3-combined influenza vaccine was administered intranasally, marker gene expression increased in a CpG-K3-dose-dependent way. A histopathological analysis indicated that marker gene expression correlated with vaccine- or adjuvant-induced phenotypic changes in the lung and nasal mucosa. We believe that the marker genes expression analyses will be useful in preclinical testing, adjuvant development, and selecting the appropriate dose of adjuvant in nasal administration vaccines.     

The short-term impact of each primary dose of pneumococcal conjugate vaccine on nasopharyngeal carriage: Systematic review and meta-analyses of randomised controlled trials

BackgroundEarly onset of persistent otitis media is a priority issue for Australian Indigenous populations. The objective is to determine the direct and short-term impact of one, two and three doses of any pneumococcal conjugate vaccine (PCV) formulation on nasopharyngeal (NP) carriage of Streptococcus pneumoniae (Spn) and non-typeable Haemophilus influenzae (NTHi), the otopathogens targeted by current PCVs.MethodsWe searched MEDLINE (PubMed) and CENTRAL (Cochrane Library) to 29 September 2015. We also scanned reference lists of recent reviews and contacted authors. We included randomised controlled trials (RCTs) with a PCV schedule commencing ≤3 months of age that reported controlled non-cumulative group-specific prevalence data for carriage of Spn or NTHi at age < 12 months. We performed a standard risk of bias assessment. We estimated the pooled relative risk (RR) and 95% confidence interval (95%CI) for each vaccine dose on NP carriage by meta-analysis.ResultsWe included 16 RCTs involving 14,776 participants. The PCVs were conjugated to diphtheria toxin CRM₁₉₇, diphtheria toxoid, tetanus toxoid or NTHi protein D and varied in valency (4–13). Controls were non-PCVs, placebo or no vaccine. The earliest carriage outcome was from 2 to 9 months of age. Compared to controls, there were no significant differences between one or two doses of PCV on vaccine-type (VT) pneumococcal carriage at ∼4 and ∼6 months respectively. However, VT carriage was significantly lower at ∼7 months RR 0.67 95%CI 0.56–0.81 from 9 studies and 7613 infants and non-vaccine type (NVT) carriage was higher RR 1.23 95%CI 1.09–1.40 from 8 studies and 5861 infants. No impact on overall pneumococcal or NTHi carriage was found.ConclusionsThe primary PCV schedule had no significant short-term impact on overall pneumococcal or NTHi NP carriage and a limited impact on VT pneumococcal carriage before the third dose.     

National transparency assessment of Kuwait's pharmaceutical sector

ObjectivesCorruption is one of several factors that may hinder the access to pharmaceuticals. Since Kuwait has the highest per-capita spending on pharmaceuticals in the region, we wanted to evaluate the level of transparency in its pharmaceutical sector using an established assessment tool adapted by the World Health Organization.MethodsStandardized questionnaires were conducted via semi-structured interviews with key informants to measure the level of transparency in eight functions of the public pharmaceutical sector.ResultsThe scores for the degree of vulnerability to corruption reflected marginal to moderate venerability to corruption for most pharmaceutical sectors. The perceived strengths included availability of appropriate laws, the presence of clear standard operating procedures, and the use of an efficient registration/distribution system. Weaknesses included lack of conflict of interest guidelines and written terms of reference, absence of pharmacoeconomic studies, and inconsistencies in law enforcement.ConclusionsFindings reveal that few functions of Kuwait pharmaceutical sector remain fairly vulnerable to corruption. However, the willingness of Kuwait Ministry of Health to adopt the assessment study and the acknowledgement of the weaknesses of current processes of the pharmaceutical sector may assist to achieve a transparent pharmaceutical system in the near future.