广州市人群SARS血清IgG抗体检测结果分析

目的 了解广州市非典型肺炎人群血清中严重急性呼吸综合征(SARS)冠状病毒(CoV)IgG抗体的基本特征及有关影响因素。方法 采集恢复期SARS、非SARS肺炎患者及SARS患者家庭密切接触者、野生动物、蔬菜销售者、社区对照人群的血清标本,用ELISA方法检测血清中SARS-CoV IgG抗体,并对SARS患者进行流行病学调查。结果 上述人群中,临床诊断为SARS患者SARS-CoV IgG抗体检出率最高,为53.7％,野生动物销售人员次之,为16.7％,社区普通人群为0.9％。在临床诊断的SARS患者中,可溯源病例抗体阳性率为90.4％,高于不可溯源病例的抗体阳性率为19.6％;且可溯源病例中低年龄组和高年龄组抗体阳性率低于中青年组,而不可溯源病例中不同年龄组患者抗体阳性率无差异;不同性别SARS患者的IgG抗体检出率也无差异;SARS抗体检出率呈逐月降低的趋势。结论 SARS临床诊断病例的血清SARS-CoV IgG抗体检出率只有53.7％,剔除患者年龄、使用激素、试剂盒等因素外,主要原因在于存在临床误诊的可能;实验室检测与流行病学调查相结合可明显提高SARS患者诊断的准确性;SARS-CoV存在隐性感染的可能,其在病毒传播过程中的作用有待进一步研究。     

太原市不同人群SARS血清流行病学调查

目的 分析山西省太原市严重急性呼吸系统综合征(SARS)患者及其密切接触者和社区人群中血清SARS抗体水平。方法 采用ELISA方法检测3组人群的SARS特异性抗体，并进行分析比较。结果 SARS患者、密切接触者和社区健康人群的SARS冠状病毒(SARS-CoV)抗体阳性率分别为52．08％，4．63％和1．88％．3组人群比较差异有统计学意义；3组人群中不同年龄组及性别间抗体阳性率差异无统计学意义。在密切接触者既往各类接触史中，除“接触时有无洗手”与血清SARS-CoV抗体阳性有关外，未发现其它有关因素。结论 太原SARS病例存在过度诊断现象，密切接触和普通人群中可能存在SARS的隐性感染。     

上海浦东新区人群SARS-GoV血清抗体分析

目的 了解上海市浦东新区不同人群SARS-CoV血沮抗体水平及隐性感染情况。方法 对发热病人、饲养和宰杀动物职业人群及一般人群进行流行病学调查，采集血清标本，用酶联免疫法检测血清中SARS-CoV抗体。结果 浦东新区不同人群SARS-CoV抗体检出阳性率1．46％（1．19％～1．66％），不同年龄、不同人群的SARS-CoV抗体检出阳性率差异无统计学意义。结论 浦东新区人群SARS抗体阳性的现象尚需进一步研究。     

发热患者SARS冠状病毒抗体分析

目的了解临床发热患者中是否存在严重急性呼吸综合征（SARS）冠状病毒（SARS-CoV）隐性感染或亚临床感染。方法对2003年5月～7月，SARS流行期间湖北地区临床发热患者373例血清进行SARS冠状病毒（SARS-CoV）抗体（IgG、IgM、N蛋白抗体）酶联免疫吸附法（ELISA）检测和分子生物学（RT—PCR）检测。结果373例发热患者中，检出冠状病毒抗体阳性者24例，阳性率6．43％（24／373），其中SARSIgG抗体、IgM抗体、N蛋白抗体阳性率分别为0．54％，1．34％和5．09％，但SARS-CoVRT—PCR检测均为阴性。结论临床发热患者可能存在SARS-CoV隐性或亚临床感染，患者体内产生针对SARS-CoV的保护性抗体，应具有免疫力和抵抗力。     

惠州市人群SARS冠状病毒抗体血清学调查分析

目的分析惠州市各类人群SARS-CoV抗体水平情况。方法抽取惠州市某门诊健康体检人群、医务工作人员、学生、学龄前儿童、野生动物从业人员血清标本共2397人份,采用酶联免疫方法进行SARS病毒IgG抗体检测。结果2397份样本,SARS病毒IgG抗体阳性率为1.1%(26/2397),0～6岁阳性率为4.0%(20/501)。7～14岁、医务工作人员阳性率分别为0.95%(5/527),0.32%(1/311)。健康体检人群样本1028人份,其中厨师样本54人份,野生动物从业人员样本30人份,抗体均为阴性。结论惠州地区人群SARS-CoV抗体水平低下,不能形成免疫屏障,人群普遍易感,作为预警信号,提示应当适时作好相关预防工作。     

医务人员SARS抗体研究初探

目的 探讨SARS感染者抗体产生的规律。方法 采用酶联免疫吸附法(ELISA)对某院20名患SARS的医务人员及445名未患SARS的医务人员的505份血清标本进行SARS抗体检测，并设75名社区健康成人为对照。结果20名临床确诊感染SARS的医务人员，IgM抗体阳性率35％(7／20)，起病后3～4周阳性4／5例，5～8周阳性3／9例，9周后全部转阴性；IgG抗体阳性率95％(19／20)，起病后3～5周阳性5／5例，6～9周阳性10／10例，18周阳性19／20例，且抗体滴度较高。未患SARS的医务人员，IgM抗体阳性率为0，IgG抗体阳性率为2．25％(10／445)；75例对照者IgM抗体阳性率为0，IgG抗体阳性率1．33％。结论 患SARS的医务人员IgG抗体阳性率较高；未患SARS的医务人员SARS抗体阳性率与社区人员相比无差异(P=0．611)；SARS在健康人群中存在隐性感染的可能。     

东莞市2005年健康人群流脑监测结果分析

目的：了解东莞市健康人群脑膜炎双球菌带菌率及抗体水平。方法：按流脑监测方案采集市内两个地方0～、5～、10～、15～、25～、35～及45岁以上共7个年龄组人群的咽拭子及静脉血．分别进行健康人群带菌调查及人群流脑A群和C群抗体IgC水平检测。结果：226份健康人群流脑的带菌率为0％；175份血清中流脑A群IgG抗体的阳性率为74．3％，GMT为4．40；C群IgC抗体的阳性率为19．4％，GNT为1．47。结论：东莞市健康人群中流脑A群IgG抗体阳性率维持在中等水平，C群IgG抗体处于较低水平；健康人群流脑的带菌率很低。     

广东省不同人群SARS病毒抗体水平调查

目的对不同人群进行SARS-IgG抗体水平检测，分析SARS流行规模和特征，评价暴露的危险性，了解人数中是否存在SARS病毒隐性感染，为寻找SARS病毒传染源提供线索。方法抽取7708份不同人群标本，按临床症状和暴露因素分为临床确诊SARS病人、病人或污染物的接触者、普通健康人群和动物销售人员4类，采用酶联免疫方法(ELISA)进行SARS-IgG抗体检测，用免疫荧光法(IFA)复核，并结合流行病学资料进行分析。结果127例临床确诊SARS病人抗体阳性率为66．9％；密切接触者中女性发病率高于男性；SARS病人或其污染物的密切接触者抗体阳性率为0．88％；动物销售人员为13．4％；野生哺乳动物销售者的抗体阳性率显著高于其他动物销售者，普通健康人群未检出抗体阳性。低年龄健康人群ELISA检测阳性率为2．06％，高于总体水平。结论人群总体抗体水平很低，普通健康人群无SARS冠状病毒抗体，但可能存在某种可与SARS冠状病毒起交叉反应的抗体；有无接触史是影响抗体阳性率的重要因素；密切接触者可能存在隐性感染；野生动物可能是本次SARS的传染源。     

不同地区人群SARS血清流行病学调查

目的分析严重急性呼吸综合征(Severe Acute Respiratory Syndrome，SARS)流行期间不同地区人群及SARS临床诊断病例血清特异性抗体(SARS-CoV IgG)变化规律以及健康人群是否存在隐性感染。方法采用酶联免疫方法(ELISA)及间接免疫荧光法(IFA)，对香港、澳门、北京、广州地区1453名健康人及广州和北京地区257例SARS临床诊断病例进行血清SARS—CoV IgG抗体检测，并跟踪检测患者病后不同时间(发病3～270d)血清抗体变化情况。结果4个地区健康人群(包括160名密切接触者)中，用ELISA法检出2例SARS—CoV IgG抗体阳性，阳性者进一步用IFA检测则为阴性；广州地区200名健康体检者同时采用ELISA和IFA检测，结果均为阴性。ELISA和IFA同时检测257例临床诊断病例发病20d后的血清SARS—CoV IgG抗体，2种方法检出的阳性率均为90％。ELISA法跟踪检测257例临床诊断病例发病后3～270d血清IgG抗体，抗体滴度在发病后4～6个月内随时间延长逐渐升高，多数病人抗体在第4～6个月达到高峰，并持续到第8个月，部分病人抗体达高峰后开始下降，但至第9个月仍阳性。结论健康人群中隐性感染率极低，血清SARS—CoV IgG抗体在病程后期有诊断价值，血清特异性抗体可持续9个月以上。     

广东省野生动物销售人员SARS冠状病毒抗体血清学研究

目的　比较野生动物销售人员和健康人群感染SARS冠状病毒的情况 ,为探索验证SARS冠状病毒源于动物的假设提供依据。方法　于 2 0 0 3年 5月选择广州市 3个野生动物市场销售人员、2家医院的医务人员、某疾病预防控制中心工作人员及某门诊健康体检人员等无SARS临床症状的健康人群为调查对象 ,采集调查对象的血清 ,用间接ELISA法检测SARS冠状病毒IgG抗体。结果　共检测销售野生动物人员血清 5 0 8份 ,SARS冠状病毒抗体阳性率为1 3 0 2 % (6 6 / 5 0 8) ,其中以主要销售果子狸人员的阳性率最高 ,为 72 7% (1 6 / 2 2 ) ,其次销售山猪人员为 5 7 1 % (1 6 / 2 8) ,销售黄犭京人员为 5 6 3% (9/ 1 6 ) ,销售兔人员为 4 6 2 % (6 / 1 3) ,销售山鸡人员为 33 3% (3/ 9) ,另在猫、鸟和蛇等其他 1 2种野生动物的销售人员中均不同程度检出SARS冠状病毒抗体。其他健康人群SARS冠状病毒抗体阳性率为 2 1 1 %(6 / 2 84 ) ,其中医院医务人员为 2 92 % (4 / 1 37) ,疾病控制人员为 1 5 9% (1 / 6 3) ,社区健康人员为 1 1 9% (1 / 84 )。销售野生动物人员SARS冠状病毒抗体阳性率与其他健康人群比较差异有显著性 (χ2 =2 6 0 89,P <0 0 1 )。结论　野生动物销售人员的SARS冠状病毒抗体阳性率显著高于其他健康人群     

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.