3种副溶血性弧菌分型方法的应用与比较

目的:用分型的方法分析副溶血性弧菌的流行优势型,溯源其亲缘关系,为追踪感染源提供依据。方法:用诊断血清进行血清学分群,用PFGE和ERIC进行基因分型。结果:607株分离于海产品的VP分出10个O血清群,有30株至今尚不能分群,分群率为94.64%,O6群和O5群为流行优势群;480株病人VP分为6个血清群,O3群为流行优势群。377株分离于海产品的VP分成29个PFGE型;480株病人VP分成12个PFGE型。261株不同来源的VP分出42个ERIC基因型。结论:3种方法均能用于VP的分型,但各有特点。由于基因分型方法敏感性高、特异性强、分型率和分辨率佳的优点,将逐渐取代传统的表型分型技术。     

宁波地区副溶血性弧菌耐药性与分型

目的:了解VP的耐药性,发现流行优势型,为追溯病原和治疗提供依据。方法:VP分离海产品采用筛检方法,病人采用GB方法;用诊断血清进行血清分型,用PFGF进行基因分型;用K-B法进行耐药性测定。结果:1040株VP分为10个血清型,分型率为94.64%,海产品VP的流行优势型为0:6群和0:5群,病人VP为0:3群;VP对氨苄西林耐药率较高,达92.64%,未检出多重耐药菌;按PFGE带型变化病人VP分为12型,海产品VP为29型,1型为流行优势型。结论:宁波地区海产品VP的血清型和PFGE型较分散,病人VP则反之,流行优势株上两者有明显差别,提示我们可用血清和PFGE分型,对其追踪与溯源;VP对青霉素类耐药性较高,是否与养殖广泛使用有关需进一步探讨。     

宁波地区副溶血弧菌分型与毒力分析

目的:了解宁波地区不同来源副溶血性弧菌的毒力及血清型、基因型,为追溯病原和防控副溶血性弧菌提供依据。方法:海产品菌株分离采用PCR+GB筛检方法,病人采用全国临床检验操作规程方法;用诊断血清进行血清学分型,用PFGE进行基因分型;用PCR检测tdh和trh毒力基因。结果:海产品流行优势血清群为O6群和O5群,病人株为O3群;海产品株PFGE分型与病人株相比较为分散;88.04%的病人株带毒力基因,海产品株带毒力基因仅有1.11%。结论:海产品株和病人株在流行优势株上存在明显差别,提示血清型分型和PFGE分型能发现菌株间的亲缘关系,可用于病原的追踪与溯源;病人株带毒率明显高于海产品株(P<0.01),认为海产品株致病性不强,建议将VP分为致病的和非致病两类,有利于鉴别和防控措施的改进。     

甬沪两地海产品中副溶血性弧菌携带与分型

目的:了解宁波和上海两地市售海产品中副溶血性弧菌污染情况以及菌株的流行优势型和毒力等.方法:用PCR快速筛检与GB法相结合方法分离海产品中副溶血性弧菌;用血清学和PFGE方法对菌株进行分群和基因分型;用PCR方法检测tdh和trh毒力基因;结果:从3 740份海产品中分离出1 507株疑似副溶血性弧菌,检出率为40.29％,其中宁波地区检出率为41.42％,上海地区检出率为21.86％;菌株的生化反应典型,560株副溶血性弧菌分出10个血清群,有30株VP未被分型,分型率为95.06％,377株副溶血性弧菌分出29个PFGE型;497株副溶血性弧菌检出7株带tdh毒力基因的副溶血性弧菌,均未检出trh毒力基因,检出率为1.41％.结论:宁波、上海海产品中副溶血性弧菌携带率较高,是诱发副溶血性弧菌疾病的原因食品.菌株的血清型和PFGE型较分散,其流行优势群与致病性副溶血性弧菌的相关性不明显;菌株带tdh和trh毒力基因较低,与病人分离株有明显差别,根据该特征,可将副溶血性弧菌分为致病的和非致病两类,便于分析和检测.     

宁波地区海产品中副溶血性弧菌分布与研究

目的了解宁波地区海产品中副溶血性弧菌的分布,菌株血清型、PFGE型别及产毒基因等特征,为防控副溶血性弧菌引起的食源性疾病提供依据。方法用PCR筛检与GB法相结合方法分离细菌;用标准血清和PFGE对菌株进行分群和基因分型;用PCR方法检测tdh和trh毒力基因;用K-B法进行耐药性测定。结果从3 525份海产品中检出1460株副溶血性弧菌,检出率为41.42%;象山、宁海检出率分别为73.72%和70.69%,与其他县(市)区差异有统计学意义(χ2=42.694,P<0.01);560株副溶血性弧菌分出10个血清群,0∶6群和0∶5群为流行优势血清群;菌株对氨苄西林耐药率达92.64%,但对常用抗生素均敏感;450株副溶血性弧菌检出5株带tdh的,阳性率为1.11%,未检出trh毒力基因。依据PGFE带型差异将330株副溶血性弧菌分为29个型。结论在海产品中副溶血性弧菌带菌率较高,是引发疾病的高危食品;菌株的流行优势群型较分散;可用常用抗生素治疗;菌株带tdh和trh毒力基因较低,根据该特征可将副溶血性弧菌分为致病的和非致病两类。     

三亚地区副溶血性弧菌血清分型、毒力基因及药敏分析

目的 了解三亚地区副溶血性弧菌食物中毒分离株和海产品分离株的血清分型、毒力基因及药敏情况。 方法 依照 GB47897-2008方法进行血清分型、采用荧光定量PCR法检测毒力基因、K-B琼脂纸片扩散法进行药敏实验。 结果 100菌株分属10个群14个血清型,以O4群为主,占32%,其次O2群(19%)。40株中毒患者分离株以O4 群(62.5%)为主,主要血清型是O4:K8;60株海产品分离株以 O2群(31.7%)为主。100株VP均携带tlh,未携带trh。40株食物中毒患者分离株中,38株携带tdh,携带率为95.0%,海产品VP株均未携带tdh。均对青霉素G、苯唑西林、氨苄青霉素耐药。 结论 三亚地区食物中毒的主要优势血清型为O4:K8,病人和海产品的分离株携带毒力基因不一致;药敏试验均对喹诺酮类和大部份氨基糖苷类抗生素高度敏感。     

宁波地区致泻性病原菌检测与主要流行株的分子分型研究

目的了解宁波地区致泻性病原菌组成和主要流行株的基因分型,探讨菌株的同源性,为追踪传染源提供依据。方法病原菌检测采用直接与增菌分离相结合的方法;细菌鉴定采用生化筛检和API等法;细菌分型采用诊断血清和PFGE分型。结果本组9 256份样本检出8类16种3 473株致泻性病原菌,检出率为37.52%,以副溶血性弧菌最高,与其他病原菌比差异有统计学意义(P<0.05);血清分型发现副溶血性弧菌的O3群、沙门菌的甲型副伤寒、志贺菌的褔氏志贺菌、致病性大肠埃希菌O119为各病原菌的优势菌;PFGE分型副溶血性弧菌分出19个,伤寒沙门菌分出3个,甲型副伤寒沙门菌分出12个。结论副溶血性弧菌是引起宁波地区感染性腹泻最主要的流行株,PFGE分型能显示菌株间的亲缘关系,PFGE分子分型可分析菌株的来源,为流行病学追踪传染源提供依据。     

脉冲场凝胶电泳用于霍乱弧菌分子流行病学研究

目的：从分子生物学基础上了解同一次流行、不同来源的霍乱弧菌之间的遗传相关性，为有效控制传染源提供依据。方法：采用PCR技术对2005年分离的70株霍乱弧菌检测CT基因后，进行PFGE分型研究。结果：分离自患者01、0139群霍乱弧菌均有CT基因，而分离自外环境1株01群稻叶菌株及1株0139菌株CT基因为阴性。所试菌株PFGE分型共呈3大亚类8种带型。结论：霍乱流行期间分离于患者的霍乱弧菌PFGE图谱基本一致，与外环境分离的非流行株在分化关系上较远。     

福建省志贺菌PFGE分型研究

目的了解福建省志贺菌脉冲场凝胶电泳(PFGE)分子分型情况,描述基因群的流行及分布特征,探讨优势血清群的变迁规律。方法收集2005-2010年志贺菌96株,分离自临床患者。选择NotⅠ进行酶切,H9812作为脉冲场凝胶分子量标准。采用脉冲场凝胶电泳技术分析电泳酶切指纹图谱,运用BioNumer-ics软件进行聚类分析。结果按照100%的相似度可将34株福氏志贺菌酶切图谱分为27种PFGE型别;将62株宋内志贺菌酶切图谱分为43种PFGE型别。根据TENOVER原则,福氏志贺菌有2个优势基因群G1-G2,宋内志贺菌有4个优势基因群GI-GIV。优势基因群集中分布于7～10月,其他PFGE型别分布比较分散,无明显时间和地区的聚集性。结论福建省志贺菌分子分型呈现多样性,宋内和F4c的某些基因群可能逐渐演变为福建省优势且稳定的志贺菌流行菌株。     

我国部分产生志贺毒素肠出血性大肠埃希菌O157∶H7脉冲电场凝胶电泳分型

目的　探讨我国部分地区产生志贺毒素的肠出血性大肠埃希菌 (EHEC)O15 7∶H7菌株的分布、流行以及分型情况。方法　用脉冲电场凝胶电泳 (PFGE)方法进行分型 ,辅以药物敏感性试验对 5 1株产生志贺毒素的EHECO15 7∶H7菌株进行研究。结果　根据细菌染色体DNA的XbaI酶切图谱 ,可将从江苏省徐州市等地分离的 5 1株产生志贺毒素的EHECO15 7∶H7菌株分成 8个PFGE型别 (PFGE1～PFGE8) ,宁夏菌株为PFGE1型和 2型 ,徐州菌株有 6个PFGE型。 1986～ 1988年的分离菌株属于PFGE7型 ,1999、2 0 0 0年病人分离株的优势型别分别是PFGE5型与 3型。 1999年爆发性流行期间从患者分离的 5株菌属于PFGE 5型 ,从家畜家禽的粪便、食品、蔬菜等标本分离的 19株菌 ,可以分为PFGE3～ 6等 4个型别 ,其中 ,PFGE5型占优势 (10株菌 )。结论　爆发性流行的发生与携带病原菌的家畜家禽粪便污染的食品、蔬菜等有关 ,从我国部分地区分离的EHECO15 7∶H7菌株的PFGE型别有地区性差异     

企业职工高尿酸血症与血压、血脂、血糖的相关性研究

目的探讨企业职工高尿酸血症（HUA）与血压、血脂、血糖的相关性,为企业进行健康管理提供依据。方法以中国石油长庆油田公司各下属企业为抽样单位,整群随机抽取2个单位,每个单位中所有的HUA者作为HUA组,共720人;同时在尿酸水平正常者中随机选取620人为正常组。通过Logistic回归分析HUA与年龄、性别、血压、血脂、血糖的关系。结果HUA合并高血压、高血脂、空腹m糖受损任意一项、两项、三项的比例均远高于正常组（OR值分别为：4．036,2．562,4．174）。多因素Logistic回归发现：男性、收缩压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇是HUA的危险因素（OR值分别为7．736,2．309,1．721,2．761,1．411）;高密度脂蛋白胆固醇为HUA的保护因素（OR值为0．211）。结论HUA存在性别差异,且与血压、血脂密切相关。企业对职工的健康管理应充分考虑多危险因素的综合作用,全面的进行健康教育及干预。     

癌缺氧病因及预防和治疗

目的 探讨癌及安阳林州市食管癌高发原因及癌病因预防和治疗措施.方法 对林州市食管癌等疾病现场进行调查,在进行10余年统计分析基础上,综合分析了全国156篇文献成果.结果 提出癌缺氧病因学说,使用制氧机、按摩器、饮用纯净水治疗恶性肿瘤,取得良好效果,改水能够大幅降低林州市居民食管癌发病率、死亡率.结论 癌可能是由于机体长...     

Recruitment and retention challenges and successes

Objective: Addressing health disparities requires well designed, culturally adapted research. However, recruiting/retaining minority participants has often been challenging. We present strategies used to successfully recruit and retain rural Hispanic women during a breastfeeding education intervention.

Design: This study involved a two-group repeated measures quasi-experimental design with assessments at seven intervals between enrollment and 6 months postpartum. Participants (Hispanic women?≥?15 years old) were recruited through a regional hospital.

Results: We successfully met our recruitment goals, most women contacted were enrolled (46 of 58), and 100% completed the study.

Discussion: Research staff with ties within the community helped establish trust. Using bilingual study materials, simple language, and an interpreter addressed language/literacy concerns. Phone assessments facilitated participation as transportation was an issue. Accommodating requests to deliver or mail study materials and providing incentives were important. Extra effort was needed to maintain contact when phone service was disrupted or participants moved. Keys to success were persistence, flexibility, and alleviating barriers to participation.     

Continuity and change in neighborhood disadvantage and adolescent depression and anxiety

We used data from the Fragile Families and Child Wellbeing Study which includes a sample of adolescents of age 15 at the most recent wave (between 2014 and 2017) from mainly low-income urban families in the United States, to examine the association between neighborhood poverty entries and exits and adolescent depression and anxiety. In addition, we examined whether these associations differed by gender. Adolescents who consistently lived in disadvantaged neighborhoods had the highest level of depression and anxiety. Those who entered poor neighborhoods were more depressed than those who never lived in poor neighborhoods. Those who exited poor neighborhoods showed no significant difference in depression and anxiety compared to those never lived in poor neighborhoods. Furthermore, these associations applied to adolescent girls only and were not statistically significant for boys. The results suggest that neighborhood poverty has cumulative negative impacts on adolescent mental health and disproportionally affects adolescent girls. Reducing neighborhood poverty would substantially improve the health of adolescents, especially girls, which would reduce health disparities.     

Enabling positive change: Progress and setbacks in HIV and sexual and reproductive health and rights

At a point in history when the future of sexual and reproductive health including HIV looks particularly uncertain, it is helpful to recognise that many of the challenges currently faced are neither new nor insurmountable. Reflecting on past achievements and lessons learned helps us to have confidence that positive change is feasible. This paper reflects on some of the changes observed in countries like India and Mozambique and identifies a range of factors which need to coalesce to enable these developments, along with specific contextual factors. It is the combination of these influences rather than any one of them alone that brought about the change in the three instances described – fostering a positive political response to HIV in its early years in India; bringing about policy reform on abortion in Mozambique; and increasing contraceptive prevalence and age at marriage in some districts in Bihar, India. Change is always fragile and susceptible to setbacks, but change-seekers can learn in the process and gain renewed hope that progress can and often does take place if they persevere.     

儿童青少年超重肥胖评价方法及SPSS和SAS实现

超重肥胖已成为世界各国儿童青少年面临的重大公共卫生问题之一。现行的儿童青少年超重肥胖筛查标准不统一,逐条评价或自行编写程序容易出错且效率较低。本研究以中国学龄儿童青少年超重与肥胖筛查标准为例,详细介绍了国际和中国共四种评价儿童青少年超重肥胖的方法和步骤,结合具体案例详细介绍其应用方法,同时编制SPSS和SAS程序包和解...     

初产妇与经产妇焦虑抑郁状态分析及干预

目的：分析初产妇、经产妇心理状态特点,以便采取更有效的干预措施。方法筛选2014年6月至2015年1月在咸阳市旬邑县妇幼保健院产科门诊产前检查的健康初产和经产妇各60名,孕周为28~40周。入组时用焦虑自评量表( SAS)、抑郁自评量表(SDS)对两组孕妇进行心理评定,并给1次支持性心理干预(40~60分钟),1周后再次用SAS、SDS对两组孕妇进行评定分析。结果经产妇干预前SAS(50.73±3.45)、SDS(49.13±3.86)评分明显高于初产妇SAS(42.45±2.08)、SDS(41.77±2.21),差异均有统计学意义(t值分别为-15.921、-12.817,均P<0.01);干预后两组SAS、SDS评分均比干预前明显降低,差异均有统计学意义(t值分别为14.999、15.413;15.724、15.832,均P<0.01);干预后经产妇 SAS(38.61±5.02)、SDS(39.10±3.03)评分明显高于初产妇SAS(34.88±3.31)、SDS(32.01±4.27),差异均有统计学意义(t值分别为-4.805、-10.489,均P<0.01)。结论初产妇和经产妇均伴有焦虑、抑郁情绪,干预前后经产妇抑郁、焦虑情绪均较初产妇明显,支持性心理干预能有效改善孕妇的不良情绪。     

Car ownership and the association between fruit and vegetable availability and diet

Objective

Nearly all research on the food environment and diet has not accounted for car ownership — a potential key modifying factor. This study examined the modifying effect of car ownership on the relationship between neighborhood fruit and vegetable availability and intake.

Methods

Data on respondents' (n = 760) fruit and vegetable intake, car ownership, and demographics came from the 2008 New Orleans Behavioral Risk Factor Surveillance System. Shelf space data on fresh, frozen, and canned fruits and vegetables were collected in 2008 from a random sample of New Orleans stores (n = 114). Availability measures were constructed by summing the amount of fruit and vegetable shelf space in all stores within defined distances from respondent households. Regression analyses controlled for demographics and were run separately for respondents with and without a car.

Results

Fruit and vegetable availability was positively associated with intake among non-car owners. An additional 100 m of shelf space within 2 km of a residence was predictive of a half-serving/day increase in fruit and vegetable intake. Availability was not associated with intake among car owners.

Conclusions

Future research and interventions to increase neighborhood healthy food options should consider car ownership rates in their target areas as an important modifying factor.     

医用电子仪器中干扰与噪声的防止与抑制(上)

介绍了医用电子仪器中的干扰与噪声的产生、危害、抑制及其应用，其中有的干扰与噪声是首次提出的。