人类巨细胞病毒潜伏-再活化感染对乙型肝炎患者疾病演变的影响研究

目的 探讨人类巨细胞病毒(HCMV)潜伏-再活化感染对乙型肝炎患者疾病演变的影响.方法 随机选取162例HBsAg呈阳性的肝病患者血清,实时荧光PCR定量法检测其HCMV-DNA和HBV-DNA含量,ELISA法检测其HCMV-IgG、IgM水平.结果 HCMV-DNA和HCMV-IgM两者的阳性率及HCMV-DNA定量均值较一致:对照者＜乙型肝炎患者＜肝硬化患者＜肝癌患者;乙型肝炎HBV-DNA阳性患者与乙型肝炎HBV-DNA阴性患者间的HCMV-DNA阳性率和HCMV-IgM阳性率比较差异均有统计学意义(P＜0.01).结论 在多重感染状态下,HCMV潜伏-再活化感染与乙型肝炎疾病演变有-定的关联.     

肝功能相关酶检测在婴儿HCMV感染中的意义

目的探讨丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、γ-谷氨酰转移酶(GGT)等生化指标在判断小儿人巨细胞病毒(HCMV)感染中有无肝细胞损伤的参考价值。方法应用荧光定量聚合酶链反应(FQ-PCR)方法检测246例临床疑诊HCMV感染住院患儿血清HCMV-DNA含量,从而将其分为实验组和对照组,并同时检测其ALT、AST、GGT等生化指标。结果巨细胞病毒感染的实验组ALT、AST、GGT均比对照组增高,差异有统计学意义(P<0.05)。结论 ALT、AST、GGT等肝功能相关酶活性升高程度对判断巨细胞病毒感染是否有肝细胞肝脏损害有一定的参考价值,提示在巨细胞病毒感染治疗中注意护肝治疗。     

聚合酶链反应技术在定量检测丙型肝炎病毒核酸中的应用

目的:研究丙型肝炎患者血清中的丙型肝炎病毒核酸(HCV-RNA)载量与抗-HCV含量以及丙氨酸氨基转移酶(ALT)水平之间的相关性.方法:应用聚合酶链反应(FQ-PCR)技术定量检测231份HCV-RNA临床标本,同时采用ELISA法检测抗-HCV,用生化分析仪测定ALT水平.结果:231份样本中有136份HCV-RNA含量高于80拷贝/ml血清,阳性率为58.9%(136/231);139份样本抗-HCV阳性,阳性率为60.2%(139/231);100份样本ALT异常,异常率为43.3%(100/231).结论:应用FQ-PCR方法检测HCV-RNA特异性强、灵敏度高,具有良好的临床应用价值.     

丙型肝炎抗体阳性患者HCV RNA与肝功能指标联合检测的意义

目的探讨丙型肝炎抗体阳性患者HCV RNA水平与肝功能主要指标的关系。方法选取235名丙型肝炎抗体阳性患者,使用实时荧光定量聚合酶链式反应(qPCR)检测HCV RNA水平,按HCV RNA检测结果 <500 IU/mL、500～10~7IU/mL和>10~7IU/mL分别划分为阴性组、低中病毒水平组、高病毒水平组。同时检测谷丙转氨酶(ALT)、谷草转氨酶(AST)、γ-谷氨酰基转移酶(GGT)、碱性磷酸酶(ALP)、总蛋白(TP)、白蛋白(ALB)、总胆红素(TBil)、直接胆红素(DBil)这8项肝功能指标。结果 HCV RNA阳性率为71.06%(167/235),不同HCV病毒水平组之间的年龄和性别分布差异无统计学意义(P>0.05)。8项肝功能指标的异常率在7.23%～48.51%,其中不同HCV病毒水平组间的ALT、AST、GGT指标的异常率差异有统计学意义(P<0.05),且ALT和AST异常率随病毒水平逐渐升高,GGT异常率在有病毒感染组明显高于阴性组。不同HCV病毒水平组间,ALT、AST、GGT、ALB水平间差异有统计学意义(P<0.05)。HCV RNA水平与ALT、AST、GGT水平正相关(r=0.505、0.407、0.284,P<0.05)。结论丙型肝炎抗体阳性患者进行HCV RNA和肝功能的检测,有助于准确诊断丙型肝炎的感染、监测病毒活动以及评估肝脏的损害,对丙型肝炎的治疗具有十分重要的意义。     

婴儿黄疸患儿尿中及母乳中人巨细胞病毒感染的研究

目的:了解婴儿黄疸患儿尿中人巨细胞病毒(HCMV)感染情况及HCMV通过母乳对婴儿的传播情况。方法:应用荧光定量PCR方法对858例患黄疸的婴儿尿及配对的316例母乳进行HCMV-DNA检测。结果:黄疸患儿尿中的HCMV-DNA阳性率为29.02%,母乳中的阳性率为59.18%;母乳HCMV-DNA阳性配对的患儿尿的HCMV-DNA阳性率为40.11%,母乳HCMV-DNA阴性配对患儿尿HCMV-DNA阳性率为18.60%,两组之间具有显著性差异(P<0.01)。结论:婴儿黄疸与HCMV感染有一定关系,HCMV感染母乳是婴儿获得性感染引起黄疸的主要途径之一。     

病毒性肝炎肝脏血清铁代谢指标与炎症活动的关系研究

目的探讨血清铁代谢指标与病毒性肝炎患者肝脏炎症活动的关系及临床意义。方法选择2012年6月—2014年6月天水市第三人民医院收治的病毒性肝炎患者200例,其中乙型肝炎114例(乙肝组),丙型肝炎86例(丙肝组)。采集患者静脉血,测定血清铁(SI)、血清铁蛋白(SF)、转铁蛋白(TRF)和总铁结合力(TIBC)并计算转铁蛋白饱和度(TS),分析其与丙氨酸氨基转移(ALT)、白蛋白(ALB)、天冬氨酸转氨酶(AST)和总胆红素(TBIL)等肝功能指标的相关性,比较两组患者以上各指标的差异。结果两组患者ALT、AST、TBIL、ALB、SI和TS比较,差异无统计学意义(P0.05),丙肝组患者SF水平明显高于乙肝组(P0.01),TRF、TIBC水平低于乙肝组(P0.05)。SF、SI、TS与ALT、AST呈正相关,ALB与SF、TS呈负相关,AST、ALT、TBIL与TRF呈负相关(P0.01),TRF与ALB呈正相关(P0.01),AST、ALT、TBIL与TIBC呈负相关(P0.01),TIBC与ALB呈正相关(P0.01)。结论铁代谢指标与肝脏炎症活动具有良好的相关性,慢性丙型肝炎患者铁超载现象突出。     

新生儿黄疸尿液与母乳人巨细胞病毒-DNA配对检测结果分析

目的 了解新生儿病理性黄疸人巨细胞病毒(HCMV)的感染状况,为制定合理喂养方案提供可靠依据.方法 应用荧光PCR法对368例病理性黄疸患儿的尿液及其母亲的乳汁进行配对检测HCMV-DNA,并进行分析;另选100名健康新生儿作为对照组,进行尿液HCMV-DNA的检测.结果 368例患儿组尿液HCMV-DNA阳性16例,阳性率为4.35％,100名健康对照组尿液HCMV-DNA阳性1名,阳性率为1.00％,两者比较,差异有统计学意义(P＜0.01);另与患儿配对检测的其母亲乳汁HCMV-DNA阳性225例,阳性率为61.1％,乳汁与尿液配对同时阳性的有14例.结论 新生儿病理性黄疸与HCMV感染有密切关系;母乳中HCMV感染率较高,对患有黄疸的新生儿应先进行必要的检测,再进行合理喂养.     

脂联素与慢性病毒性肝炎的相关性

目的探讨血清脂联素水平与慢性乙型肝炎、慢性丙型肝炎的相关性。方法选取98例乙型肝炎、丙型肝炎患者及病毒携带者作为观察组,根据每ml血清病毒含量分为:低病毒含量组(<1.0×104copies/ml)和高病毒含量组(≥1.0×104copies/ml)。选取50例肝功能正常者作为对照组,用ELISA方法测定两组的血清脂联素水平,并用全自动生化分析义对患者的AST和ALT进行检测,观察两组脂联素水平的差异,以及脂联素水平与AST/ALT比值的关系。结果对照组血清脂联素平均水平为5.12 g/ml,且女性的脂联素水平比男性高(p<0.01)。观察组慢性乙肝患者的脂联素水平比对照组低,但是统计结果无明显差异;慢性丙肝患者的脂联素水平与对照组也无统计学差异。乙型与丙型肝炎病毒携带者的脂联素水平比对照组高(p<0.01),同时观察组的女性脂联素水平也比男性高(p<0.01),观察组中慢性肝患者的AST和ALT比值与脂联素水平呈负相关。结论脂联素可以由损伤的肝细胞分泌,脂联素的水平与慢性病毒性肝炎患者的肝功能损伤程度有关。     

丙型肝炎患者血清IL-17与ALT等指标相关性分析

目的了解慢性丙型肝炎患者和对照组血清ALT、AST、TBil、IL-17水平以及在丙型肝炎的不同发展阶段的变化特点,探讨病毒载量与IL-17、ALT、AST、TBil的相关性。方法 85例丙型肝炎患者其中包括24例丙型肝炎肝硬化患者和61例慢性丙型肝炎患者,30名健康人作为对照。所有丙型肝炎患者抗-HCV抗体检测S/CO〉3.8（排除抗-HCV假阳性患者）,研究对象分为4组。采用全自动生化分析仪检测所有研究对象的ALT、AST、TBil的水平,采用酶联免疫吸附实验-双抗体夹心法（ELISA）检测所有研究对象血清中抗-HCV抗体和细胞因子IL-17水平。采用荧光定量聚合酶链反应（RT-PCR）检测HCV-RNA的病毒载量。结果（1）通过各组间多重比较,丙型肝炎患者各组IL-17水平显著高于健康对照组（P〈0.05）,差异有统计学意义,在病毒载量〉1×10^3组IL-17水平与ALT、AST水平变化有很好的相关性。（2）按照病毒载量HCV-RNA高低分组,病毒载量与IL-17水平呈正相关,随着病毒载量的升高IL-17水平也随之升高。结论患者组IL-17、ALT、AST、TBil的检测水平升高可能与患者肝细胞的炎性损伤有关,并且IL-17在一定程度上能够反映肝脏的损伤程度。在病毒检测阳性的患者中病毒载量与IL-17水平呈正相关。     

HCV-RNA及ALT、AST联合检测在丙肝患者诊断治疗中的应用研究

目的研究HCV-RNA及ALT、AST联合检测在丙肝患者诊断治疗中的应用价值。方法选择我院2012年1月至2014年12月收治的104例丙肝患者作为研究对象,并选择70例同期健康体检者作为对照组,检测HCV-RNA病毒含量和AST、ALT活性。采用SPSS 11.0软件对结果进行统计学分析。结果HCV-RNA病毒含量和抗-HCV的阳性率呈正相关(r=0.78,P<0.05),丙肝患者AST水平、ALT水平和AST/ALT比值均高于正常人群,并且AST/ALT比值和病毒含量成正相关(r=0.528,P<0.01)。结论 HCV-RNA含量反映病毒复制情况,ALT、AST水平反映丙肝患者肝脏损伤情况,两组指标间存在一定相关性。HCV-RNA及ALT、AST联合检测有助于病情分析、疗效观察及预后评估,在丙肝患者的诊治中发挥作用。     

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 human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

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.     

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.     

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.     

The risk of heat exhaustion at a deep underground metalliferous mine in relation to surface temperatures

The risk of heat exhaustion at a deep underground metalliferous mine was assessed in relation to thermal conditions prevailing on the surface. For each day of a 1-year prospective case series of heat exhaustion, surface 24-h mean wet and dry bulb temperatures were recorded. From this data, 24-h mean wet bulb globe temperatures were derived using certain assumptions. The three surface temperature variables were significantly higher on those days on which heat exhaustion occurred, compared to those days on which it did not occur (P < 0.001). The relative risk of heat exhaustion on days when the 24-h mean wet bulb globe temperature was in the range 26.0-28.0 degrees C was 4.82 (95% confidence interval 2.12-10.96). Surface temperature data could be used at this mine to warn miners about the risk of heat exhaustion.