成都市发热呼吸道症候群患者病毒感染调查

目的了解成都市发热呼吸道感染病例常见病毒的感染状况,探讨发热呼吸道症候群的病原谱构成情况。方法 2010-07/2011-03,采集成都市3家哨点医院具备发热、咳嗽以及胸部X线片提示肺部炎性改变等临床症状的呼吸道感染病例标本302份;采用多重RT-PCR方法,对302份呼吸道标本同时进行流感病毒、副流感病毒、呼吸道合胞病毒、冠状病毒、人偏肺病毒、人博卡病毒、人腺病毒、人鼻病毒和肠道病毒等常见呼吸道病毒核酸检测。结果 302份标本中检出阳性标本72份,核酸阳性率为23.84%（72/302）,其中两种病毒混合感染6份,占阳性标本的8.33%（6/72）;5岁以下儿童患者标本病毒核酸阳性检出率为39.33%（59/150）,其中偏肺病毒的检出率最高;6～18岁患者标本病毒核酸阳性检出率为15.15%（5/33）,其中呼吸道合胞病毒检出率最高;18岁以上患者标本阳性检出率为11.76%（14/119）,其中流感病毒检出率最高。3月份病毒核酸检出率最高为74.36%（29/39）,不同性别患者之间病毒核酸检出率差异无统计学意义。结论成都市发热呼吸道病毒感染病例的病原体以偏肺病毒、鼻病毒和呼吸道合胞病毒为主。     

北京地区2009年首例禽流感应急监测病原学分析

目的了解2009年1月北京地区禽流感应急监测期间人群急性呼吸道感染的病毒病原学情况,探讨应急监测措施的作用,为北京地区急性呼吸道传染病防控策略的制定提供依据。方法采用RT-PCR和实时荧光RT-PCR法,对1 936份甲型流感病毒快检阴性的咽拭子样本进行甲型流感病毒的检测,同时采用多重RT-PCR方法,对400件甲型流感病毒检测阴性的样本同时检测人偏肺病毒、腺病毒、人冠状病毒、副流感病毒、流感病毒、鼻病毒、呼吸道合胞病毒等12种常见呼吸道病毒。结果 1 936份甲型流感快检阴性样本中RT-PCR法和实时荧光RT-PCR法检出甲型流感病毒阳性样本有996份,阳性率为51.45%。400件甲型流感病毒阴性的样本中,检出其他病毒的阳性样本有60份,阳性检出率为15.00%。15岁以下患者阳性检出率最高,为18.60%,其中以呼吸道合胞病毒B（RSVB）的检出阳性率最高,为7.3%。结论 2009年1月禽流感应急监测期间选用的快检试剂敏感性较差,以此作为应急监测的初筛手段有待商榷。甲型流感病毒为调查期间北京地区人群急性呼吸道感染的主要病毒性致病原,15岁以下人群中其他病毒性病原的检出率较高,以RSVB为主。     

北京地区儿童急性上呼吸道感染病毒病原学调查

目的:了解北京地区儿童急性上呼吸道感染病毒病原学现况,探讨不同年龄组、不同月份病毒检出情况,为预防策略制定、临床诊断、治疗提供病原学依据.方法:采用多重RT-PCR法,对365份咽拭子样本同时检测腺病毒,偏肺病毒,冠状病毒229E,1、2、3型副流感病毒;甲、乙型流感病毒,甲、乙型呼吸道合胞病毒,甲型鼻病毒,冠状病毒OC43共12种常见呼吸道病毒.结果:365份样本中有阳性检出结果的有246份,阳性率为63.08%,其中有2种以上病毒混合感染65份,占17.80%;6个月以下患儿以甲型呼吸道合胞病毒检出阳性率最高;6个月以上至14岁患儿中以甲型流感病毒检出阳性率最高;2006年10月及2007年4月腺病毒检出率最高,11月份与2月份以呼吸道合胞病毒检出率最高,12月与1月份以流感病毒检出率最高;在阳性检出样本中流感病毒占52.85%、呼吸道合胞病毒占26.42%、腺病毒占18.70%.结论:流感病毒、呼吸道合胞病毒、腺病毒为北京地区儿童急性上呼吸道病毒感染主要致病原.随年龄不同、流行季节中月份不同而有一定的流行规律.     

2013年度贵州省发热呼吸道症候群病毒感染状况调查

摘要:目的　了解贵州省发热呼吸道症候群病毒性疾病的感染状况。方法　调查贵州省2013年度发热呼吸道症候群病例432例,采集呼吸道标本421份,通过相应试剂盒提取核酸,进行实时荧光定量（Real-Time）PCR检测流感病毒、副流感病毒、冠状病毒、呼吸道合胞病毒、腺病毒、博卡病毒,鼻病毒及偏肺病毒。结果　从421份标本中检测出阳性标本128份,阳性率为30.41%。其中流感病毒60份,阳性率为14.25%;冠状病毒8份,阳性率为1.90%;博卡病毒3份,阳性率为0.71%;腺病毒10份,阳性率为2.38%;偏肺病毒9份,阳性率为2.14%;鼻病毒38份,阳性率为9.03%;未检出呼吸道合胞病毒和副流感病毒。检出3例流感病毒和鼻病毒混合感染。结论　呼吸道病毒是导致发热呼吸道症候群的重要病原体,其中以流感病毒最为常见,鼻病毒其次,腺病毒、偏肺病毒等检出率较低。     

台州地区2378例流感样病例呼吸道感染病毒病原学分析

目的了解台州地区流感样病例(ILI)呼吸道病毒的病原特征及流行趋势,为临床诊疗和防控策略的制订提供病原学依据。方法采用多重实时荧光定量RT-PCR法同时检测2 378份咽拭子标本人流感病毒、呼吸道合胞病毒、腺病毒、副流感病毒、鼻病毒、人偏肺病毒、人博卡病毒、人冠状病毒等常见呼吸道病毒核酸并分析。结果 2 378份标本中共检出阳性标本644份,流感病毒检出率最高,其次为鼻病毒;台州地区各年龄段患者流感病毒、鼻病毒、人偏肺病毒、副流感病毒3型、呼吸道合胞病毒以及人偏肺病毒的阳性率有显著差异,且病毒流行呈现一定的季节性。结论台州地区流感样病例呼吸道病毒感染以流感病毒和鼻病毒为主,并呈现季节性和年龄段偏好性。快速发现呼吸道感染的病原体,不仅对流感样病例的早期诊断有指导价值,同时可以为掌握疾病的流行特征提供依据。     

荧光定量PCR检测急性呼吸道感染患者常见呼吸道病毒的研究

目的分析2011年8月至2012年8月期间惠州市急性呼吸道感染病毒性病原谱的构成及流行特征,为临床诊断、治疗和呼吸道传染病的预防控制提供病原学依据。方法应用荧光定量PCR方法,对485例鼻咽拭子样本同时进行甲型流感病毒、乙型流感病毒、腺病毒、博卡病毒、副流感病毒、鼻病毒、呼吸道合胞病毒、人偏肺病毒、人冠状病毒的检测,并进行统计学分析。结果 485份样本中检出228份呼吸道病毒阳性的样本,阳性率为47.01%,其中混合感染20份,占阳性样本的8.77%。病毒病原谱构成前三位为乙型流感病毒、鼻病毒和甲型流感病毒。病毒检出阳性率的时间分布有一定规律性：1月至次年2月阳性率较高,不同月份检出的优势病毒不同。各年龄组病毒阳性率差异有统计学意义（χ2=19.414,P〈0.05）,不同年龄组病毒感染的病原谱构成也不同：0～5岁年龄组以鼻病毒为主;5岁以上各年龄组均以流感病毒为主。不同性别患者之间病毒核酸检出率差异无统计学意义（χ2=0.522,P〉0.05）。结论乙型流感病毒、鼻病毒和甲型流感病毒是惠州市急性呼吸道感染主要病原体。部分病原体的感染与年龄和季节有一定的关联;ARTI患者中部分合并感染其他呼吸道病毒,应长期监测呼吸道病毒的活动水平。     

急性呼吸道感染患者220例非细菌性病原体流行特征分析

目的了解2011年3月—2012年2月北京市丰台区急性呼吸道感染非细菌性病原谱构成及其流行特征,为该区呼吸道传染病的预防控制以及临床诊断、治疗提供实验室依据。方法随机采集哨点医院发热门诊就诊的急性呼吸道感染病例咽拭子标本220例,利用多重实时-聚合酶链反应、聚合酶链反应(RT-PCR、PCR)方法进行流行性感冒(流感)病毒、副流感病毒、呼吸道合胞病毒、肠道病毒、博卡病毒、偏肺病毒、冠状病毒、鼻病毒和腺病毒9种病毒性病原体的检测和支原体检测,并进行统计分析。结果从220份咽拭子标本中共检出125份阳性标本,阳性率为56.82%。其中有6份标本为双重感染,阳性率较高的为流感病毒(65/131,49.62%)、支原体和副流感病毒(均为26/131,19.85%)。其他病原体的检出率均小于5%。不同病原体检出在季节分布上存在差异:流感病毒冬季检出率最高,支原体秋季检出较多,而副流感病毒感染的高峰期发生在夏季,病原体检出率在季节分布上总体呈现冬季(12—2月)较高,夏季较低的特点。不同性别间病原体检出率无统计学差异。发病3 d内采集的标本流感病毒检出率高于3 d后采集的标本,而支原体相反。结论北京市丰台区急性呼吸道感染非细菌性病原体主要为流感病毒、支原体和副流感病毒。在对急性呼吸道感染病例的诊断治疗中应考虑到不同病原体的高发季节。     

武汉市2012-2015年发热呼吸道症候群监测病例病毒检测结果分析

目的 了解武汉地区发热呼吸道症候群的病原谱分布和流行特征,为防控及临床诊疗提供科学依据。方法 用实时荧光聚合酶链式反应法,对2012年3月~2015年2月间收集的576份呼吸道感染病例咽拭子标本进行病毒核酸检测。结果 576份标本中,检出阳性标本248例,阳性检出率为43.1%。男、女病例标本阳性检出率差异无统计学意义（χ2=0.371,P=0.542）。阳性标本中,单一病毒所致感染208例,混合感染40例,病原谱构成以腺病毒、鼻病毒和甲型流感病毒为主,占比分别为19.4%、17.3%和14.1%。呼吸道合胞病毒B型、腺病毒、博卡病毒和混合感染在各年龄段差异有统计学意义（均有P<0.05）,腺病毒、混合感染以2~岁人群为主,博卡病毒只在2岁以下人群中有发现。各病毒流行季节不同,具有季节差异性（χ2=17.427,P=0.001）,春季检出率最低。结论 腺病毒、鼻病毒和甲型流感病毒是武汉地区发热呼吸道症候群的主要病原体,<5岁为主要易感人群。不同流行季节病毒谱也不一致,加强对上述病毒的监测和研究,应作为本辖区呼吸道病毒的防控重点。     

2011年-2013年北京市严重急性呼吸道感染病毒病原学调查

目的了解北京地区严重急性呼吸道感染病毒病原学现况,探讨不同年龄组、不同月份病毒检出情况,为预防策略制定、临床诊断、治疗提供病原学依据。方法采用多重RT-PCR法,对270份咽拭子样本同时检测腺病毒,偏肺病毒,冠状病毒,1型、2型、3型、4型副流感病毒,甲型、乙型流感病毒,甲型、乙型呼吸道合胞病毒,甲型鼻病毒,博卡病毒和肠道病毒共14种常见呼吸道病毒。结果 270份样本中检出阳性样本103份,阳性率为38.15%。其中HBo V的检出率最高,为46.68%。15岁~25岁组呼吸道病毒检出阳性率最高,为66.67%。各病毒不同月份检出情况普遍呈10月-次年4月检出数增高,5月-9月有零星的散发。结论 HBo V和Flu为北京地区严重急性呼吸道感染主要致病原,随年龄不同、流行季节中月份不同而有一定的流行规律。     

广州地区发热呼吸道症候群病原学研究

目的探讨广州地区发热呼吸道症候群病原谱构成,为临床诊断、治疗和预防策略提供科学依据。方法采集2014年-2015年本院就诊的发热呼吸道症候群895例患者的痰液及咽拭子标本,分别进行细菌学培养和肺炎支原体、8种病毒的核酸检测。结果 895例患者中,病原学检出阳性350例,检出率为39.1%,其中439份痰液标本培养共分离64株病原菌,主要为真菌、铜绿假单胞菌和金黄色葡萄球菌;849份咽拭子中,检出肺炎支原体、病毒核酸阳性325例,主要是流感病毒、鼻病毒和呼吸道合胞病毒。细菌合并病毒感染的患者15例,病毒合并支原体感染10例,多重病毒感染15例。结论构成广州地区发热呼吸道症候群病原谱种类繁多,以病毒感染为主,且以流感病毒、鼻病毒和呼吸道合胞病毒多见,混合感染常见。     

Salmonellas in pigs and animal feeding stuffs in England and Wales and in Denmark

A comparison has been made between the incidence of salmonellas in pigs and feeding stuffs in England and Wales and in Denmark. In Denmark there is veterinary legislation requiring the sterilization of imported and home produced feed ingredients of animal origin. There is no such legislation in England and Wales. In Denmark 0·3% of resterilized imported meat and bone meal was contaminated with salmonellas. This compared with 23% of meat and bone meal in England and Wales and 20-27% of other ingredients of animal origin. In England and Wales salmonellas were isolated from 7% of caecal samples and 6% of lymph node samples, while in Denmark they were isolated from 3% of caecal samples and 4% of lymph node samples. In England and Wales 25 serotypes were found in both pigs and feeds and these included nearly all the most prevalent human pathogens. In Denmark four of the six serotypes in pigs had been found in resterilized feed. One notable difference between the two studies was the very wide range of serotypes found in pigs in England and Wales and the narrow range in Denmark. A second was that Salmonella typhimurium formed 15% of all Salmonella strains isolated from pigs in England and Wales, and 60% of those in Denmark.     

Lunasin is prevalent in barley and is bioavailable and bioactive in in vivo and in vitro studies

Lunasin, a unique 43-amino acid peptide found in a number of seeds, has been shown to be chemopreventive in mammalian cells and in a skin cancer mouse model. To elucidate the role of cereals in cancer prevention, we report here the prevalence, bioavailability, and bioactivity of lunasin from barley. Lunasin is present in all cultivars of barley analyzed. The liver and kidney of rats fed with lunasin-enriched barley (LEB) show the presence of lunasin in Western blot. Lunasin extracted from the kidney and liver inhibits the activities of HATs (histone acetyl transferases), yGCN5 by 20% and 18% at 100 nM, and PCAF activity by 25% and 24% at 100 nM, confirming that the peptide is intact and bioactive. Purified barley lunasin localizes in the nuclei of NIH 3T3 cells. Barley lunasin added to NIH 3T3 cells in the presence of the chemical carcinogen MCA activates the expression of tumor suppressors p21 and p15 by 45% and 47%, decreases cyclin D1 by 98%, and inhibits Rb hyperphosphorylation by 45% compared with the MCA treatment alone. We conclude that lunasin is prevalent in barley, bioavailable, and bioactive and that consumption of barley could play an important role of cancer prevention in barley-consuming populations.     

Management of pregnancy and childbirth in England and Wales and in France

This paper reviews national data on obstetric and neonatal practices in England and Wales, and in France between 1970 and 1980. The data have been derived from national statistics and surveys on national samples of births in 1970, 1975 and 1980 in England and Wales, and 1972, 1976 and 1981 in France. The analysis shows that there was no major difference in pregnancy outcome, but wide variations in medical practices, and their trend over time. The main differences were: in England and Wales a higher number of antenatal visits, a higher percentage of inpatient admissions during pregnancy, a higher rate of induction, more episiotomies, a higher rate of resuscitation at birth, and admission to neonatal special care units; in France, a higher rate of caesarean sections before and during labour, some evidence of a more active management of labour, and a longer hospital post-natal stay. These differences in practice reflect differences in objectives and assessment of the effectiveness of care between the two countries: they point out the need for better monitoring and evaluation of obstetric and neonatal practices.     

Research and teaching in social and preventive medicine and in public health

Summary Both public health and social and preventive medicine are characterised by the common goal of promoting, maintaining and improving health and preventing disease, and both are concerned with a population-related, preventive and environmental perspective. But whereas public health is interdisciplinary and goes far beyond the medical focus, social and preventive medicine is medically based and forms a bridge between public health and medical practice. Research in a department of social and preventive medicine serves to support preventive and medico-social activities in medical practice as well as in public health. This is illustrated by results from research conducted at the author's department during the last twenty years. Examples are research in support of smoking cessation activities, and research used for the planning of care for the elderly. Both the research and the teaching activities of the department take into account the population focus of public health as well as the focus on individual medicine in clinical practice.

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Forschung und Lehre in Sozial-und Präventivmedizin und öffentlicher Gesundheit

Zusammenfassung Sowohl das Gebiet der öffentlichen Gesundheit als auch dasjenige der Sozial-und Präventivmedizin sind durch das Ziel der Förderung, Erhaltung und Verbesserung der Gesundheit sowie der Krankheitsvorbeugung gekennzeichnet, und beide beschäftigen sich mit einer bevölkerungsbezogenen, präventiven und umweltbezogenen Perspektive. Aber während die öffentliche Gesundheit stark interdisziplinär ist und weit über den medizinischen Fokus hinausreicht, ist die Sozial-und Präventivmedizin ein medizinisches Fach und stellt eine Brücke zwischen der öffentlichen Gesundheit und der ärztlichen Praxis dar. Die Forschung in einem Institut für Sozial-und Präventivmedizin dient der Förderung präventiver und sozialmedizinischer Tätigkeiten in der ärztlichen Praxis wie auch in der öffentlichen Gesundheit. Dies wird durch die Forschungstätigkeit des Instituts des Autors aus den letzten 20 Jahren illustriert, wobei Beispiele aus den Gebieten der Förderung der Raucherentwöhnung und der Betreuung behinderter Betagter dargestellt werden. Sowohl in den Forschungs-als auch in den Lehrtätigkeiten des Instituts finden der Bevölkerungsbezug der öffentlichen Gesundheit wie auch der individualmedizinische Ansatz der ärztlichen Praxis ihren Ausdruck.

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La recherche et l'ensignement en médecine sociale et préventive et en santé publique

Résumé La santé publique aussi bien que la médecine sociale et préventive sont caractérisées par le but commun de promouvoir, maintenir et améliorer l'état de santé et de prévenir les maladies, et elles s'orientent vers une perspective de population, de prévention et environnementale. Mais la santé publique est interdisciplinaire et va loin au-delà de la médecine, tandis que la médecine sociale et préventive est basée sur la médecine et représente le lien entre la santé publique et la pratique médicale. La recherche d'un institut de médecine sociale et préventive sert à appuyer les activités préventives et médico-sociales au cabinet médical aussi bien qu'en santé publique. Cela est illustré par des résultats de recherches conduites dans les vingt années passées à l'institut de l'auteur, et les exemples sont tirés de la recherche en appui de la promotion de la cessation de fumée et de la planification de la prise en charge des personnes âgées et handicapées. Les activités de recherche et de l'enseignement de l'institut tiennent compte de la perspective de population cacactéristique de la santé publique, aussi bien que de la dimension de médecine individuelle caractéristique de la pratique clinique.

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Paper presented at a symposium on The Public Health Perspective of Social and Preventive Medicine, in celebration of the 20th anniversary of the Department of Social and Preventive Medicine, University of Berne, 25 June 1992 in Berne.     

Eggs enriched in omega-3 fatty acids and alterations in lipid concentrations in plasma and lipoproteins and in blood pressure

Effects of dietary eggs enriched with omega-3 fatty acids on lipid concentrations in plasma and lipoproteins and blood pressure were determined in 11 men and women in two groups. Group 1 consumed four omega-3 eggs per day during the first 4-wk period and four control eggs for the second 4-wk period. Group 2 ate the same number of eggs in the reverse order. Mean plasma cholesterol concentration was significantly increased by control eggs (P less than 0.01) but unchanged by omega-3 eggs. Mean plasma triglyceride concentration was decreased by omega-3 eggs but increased by control eggs. Both systolic and diastolic blood pressures were significantly lowered by omega-3 eggs in group 1 whereas only systolic pressure was significantly decreased on omega-3 eggs in group 2. The control eggs did not change blood pressure. In conclusion, the omega-3 eggs may be more healthful than the control eggs.     

Bacteriology and constitutional health--genomics and proteomics: concepts in medicine and concepts in health insurance in the past and future

Future discussions on health issues on the individual or society level will be fundamentally linked to genetic dispositions. This genetic world will become reality in the same way the world of hygiene and bacteriology has become real for everyone. Approaches of molecular medicine for public health issues have not yet been created so far. The secret dreams of molecular eugenics must be made public and critically discussed. Up to now only a few monogenetically recessive hereditary diseases can be detected by screening. This kind of screening should be carefully considered. However, for the sciences, for medicine and thus for the physicians in practice, for health care sciences as well as for public health care, new tasks will emerge from genetics and molecular medicine. In individual as well as public health these new tasks will at first mainly turn in on the sphere of diagnosis and specific screening as well as health education and consultation. With regard to the considerable social implications the public health care sector should be aware of the coming issues of molecular medicine in time.     

Prevalence and Trends in Overweight in Mexican-American Adults and Children

Overweight and obesity have been increasing in many countries. Our objective is to describe the trends in overweight and obesity occurring in the Mexican-American population in the United States. Data on measured height and weight for Mexican Americans come from the following surveys: the Hispanic Health and Nutrition Examination Survey (HHANES, 1982–84), the Third National Health and Nutrition Examination Survey (NHANES III, 1988–94), and NHANES 1999–2002. In 1999–2002, 73% of Mexican-American adults were overweight and 33% were obese. Obesity increased between NHANES III and NHANES 1999–2002, from 24% to 27% for men and from 35% to 38% for women. Increases were also seen for children and adolescents. The Mexican-American population in the United States, both children and adults, is showing trends in overweight and obesity over time that are similar to those seen in other segments of the U.S. population and indeed in many countries