126例输卵管积水患者病原体感染状况分析

为了研究慢性盆腔炎输卵管积水的病原体 ,对 12 6例输卵管积水患者在做输卵管通液或输卵管造影以及电视腹腔镜下做输卵管伞部成形术时分别采集宫颈分泌物和输卵管积液 ,进行细菌培养和解脲支原体及沙眼衣原体培养。结果 :12 6例中在宫颈分泌物和输卵管积液中培养出沙眼衣原体和厌氧菌相同病原体 67例 ,占 5 3 % ;解脲支原体、沙眼衣原体及白色念珠菌等混合感染 2 4例 ,占 19% ;沙眼衣原体混合金黄色葡萄球菌感染 2 2例 ,占 17% ;沙眼衣原体混合白色念珠菌感染 9例 ,占 7% ;解脲支原体混合淋球菌感染 4例 ,占 3 % ;17例未检出沙眼衣原体。提示 :输卵管积水的不孕患者的病原体感染多为混合性 ;一半以上宫颈分泌物与输卵管积液培养出相同的病原体 ,术前、术后的治疗应引起注意。     

输卵管妊娠患者生殖道解脲脲原体和衣原体的感染情况分析

目的分析输卵管妊娠患者血清、宫颈分泌物、输卵管组织中解脲脲原体和沙眼衣原体的感染情况,探讨输卵管妊娠与生殖道解脲脲原体和沙眼衣原体的相关性。方法选取2014年1月-2015年12月医院妇产科输卵管妊娠行腹腔镜下输卵管切除术患者70例为输卵管妊娠组,另选妇科良性病变行腹腔镜下附件切除术或者输卵管切除术患者70例为对照组,检测血清解脲脲原体和沙眼衣原体抗体、宫颈分泌物和输卵管组织中解脲脲原体和沙眼衣原体DNA;比较两组患者血清、宫颈分泌物和标本中沙眼衣原体、解脲脲原体、解脲脲原体+沙眼衣原体的阳性率。结果输卵管妊娠组血清、宫颈分泌物和标本中沙眼衣原体阳性率(31.4%、37.1%、24.3%)均高于对照组(4.3%、5.7%、2.9%),两组比较差异有统计学意义(P<0.05);输卵管妊娠组血清、宫颈分泌物和标本中解脲脲原体阳性率(41.4%、40.4%、31.4%)均高于对照组(11.4%、8.6%、2.9%),两组比较差异有统计学意义(P<0.05);输卵管妊娠组血清、宫颈分泌物和标本中解脲脲原体+沙眼衣原体阳性率(20.0%、12.9%、18.6%)均高于对照组(4.3%、1.4%、1.4%),两组比较差异有统计学意义(P<0.05)。结论输卵管妊娠患者血清、宫颈分泌物、输卵管组织中解脲脲原体和沙眼衣原体阳性率升高,输卵管妊娠和生殖道解脲脲原体和沙眼衣原体感染关系密切。     

输卵管妊娠患者生殖道解脲脲原体和衣原体的感染情况分析

目的观察输卵管妊娠患者宫颈分泌物及输卵管组织中解脲脲原体和衣原体的感染情况及宫颈分泌物解脲脲原体的药敏结果,探讨生殖道解脲脲原体和衣原体感染与输卵管妊娠的关系。方法选择医院2010-2015年输卵管妊娠腹腔镜下行输卵管切除患者160例为输卵管妊娠组、妇科良性疾病腹腔镜下行输卵管切除者160例为对照组,聚合酶链反应测定输卵管组织中解脲脲原体和沙眼衣原体DNA以及宫颈分泌物中衣原体DNA,液体培养法测定宫颈分泌物解脲脲原体及药敏情况。结果输卵管妊娠组患者宫颈分泌物解脲脲原体、衣原体和解脲脲原体+衣原体检出率均高于对照组(P<0.05);41例解脲脲原体感染中,解脲脲原体对交沙霉素、阿奇霉素、克拉霉素、罗红霉素的敏感率比较高,均>90.0%。结论输卵管妊娠和宫颈分泌物及输卵管组织中解脲脲原体和衣原体感染关系密切,解脲脲原体对交沙霉素、阿奇霉素、克拉霉素、罗红霉素敏感率高,对环丙沙星耐药率高。     

继发不孕与生殖道感染的临床相关性分析

目的探讨继发不孕妇女生殖道感染的情况及与输卵管炎症的相关性。方法对985例继发不孕妇女的临床资料进行回顾性分析,采用碘海醇注射液进行子宫输卵管造影,根据输卵管通畅情况分为3组,即输卵管完全阻塞组（A组）、部分阻塞组（B组）和通畅组（C组）,取宫颈分泌物进行生殖道病原体（解脲支原体、沙眼衣原体、人型支原体）检测,并进行临床分析。结果在继发不孕的985例患者中,感染率依次为解脲支原体25．48％（251／985）、沙眼衣原体5．89％（58／985）、人型支原体2．44％（24／985）。其中解脲支原体感染者输卵管通畅组与完全阻塞组及部分阻塞组均有统计学差异（Pearsonχ2=40．629,P〈0．05;沙眼衣原体感染者输卵管通畅组与完全阻塞组有统计学差异（Pearsonχ2=6．898,P〈0．05）;人型支原体感染者输卵管通畅与否均无统计学意义（eearsonχ2=2．897,P〉0．05）。结论在继发不孕妇女中,应重视对解脲支原体、沙眼衣原体的检测,从而降低输卵管性生不孕的发生率。     

输卵管妊娠患者生殖道解脲脲原体和衣原体的感染情况分析北大核心CSCD

目的观察输卵管妊娠患者宫颈分泌物及输卵管组织中解脲脲原体和衣原体的感染情况及宫颈分泌物解脲脲原体的药敏结果,探讨生殖道解脲脲原体和衣原体感染与输卵管妊娠的关系。方法选择医院2010-2015年输卵管妊娠腹腔镜下行输卵管切除患者160例为输卵管妊娠组、妇科良性疾病腹腔镜下行输卵管切除者160例为对照组,聚合酶链反应测定输卵管组织中解脲脲原体和沙眼衣原体DNA以及宫颈分泌物中衣原体DNA,液体培养法测定宫颈分泌物解脲脲原体及药敏情况。结果输卵管妊娠组患者宫颈分泌物解脲脲原体、衣原体和解脲脲原体+衣原体检出率均高于对照组(P<0.05);41例解脲脲原体感染中,解脲脲原体对交沙霉素、阿奇霉素、克拉霉素、罗红霉素的敏感率比较高,均>90.0%。结论输卵管妊娠和宫颈分泌物及输卵管组织中解脲脲原体和衣原体感染关系密切,解脲脲原体对交沙霉素、阿奇霉素、克拉霉素、罗红霉素敏感率高,对环丙沙星耐药率高。     

检测不孕症妇女宫颈分泌物、盆腔液解脲支原体和沙眼衣原体的临床意义

目的:探讨检测不孕症妇女体内解脲支原体和沙眼衣原体的临床意义。方法:选择近期在不孕症门诊收治的不孕症妇女90例,另收集120例正常妇女临床文献资料作为对照组。检测两组妇女宫颈分泌物、盆腔液中解脲支原体和沙眼衣原体情况,比较两组妇女UU与CT感染率差异,并分析原发性不孕与继发性不孕感染率差异。结果:90例不孕症妇女宫颈分泌物UU感染检出率为28.9%,显著高于健康对照组的8.3%(P<0.05);继发性不孕妇女宫颈分泌物UU、CT病原体检出率分别为37.7%(23/61)、9.8%(6/61),比原发不孕组显著增高,且继发性不孕妇女盆腔液UU检出率也较原发不孕组明显增高。结论:解脲支原体和沙眼衣原体是导致不孕症发生的重要因素,定期检测解脲支原体和沙眼衣原体具有重要的临床意义。     

解脲支原体和沙眼衣原体感染与输卵管妊娠的关系

目的　探讨解脲支原体和沙眼衣原体感染与输卵管妊娠的关系。方法　应用聚合酶链反应技术 ,检测 12 8例输卵管妊娠患者 (观察组 )和 5 0例行附件切除术、无输卵管妊娠史的卵巢囊肿患者 (对照组 )的宫颈分泌物和输卵管组织中解脲支原体和沙眼衣原体DNA。结果　⑴观察组 5 6例宫颈分泌物检测出解脲支原体DNA ,阳性率为 43 8% ,对照组 10例阳性 ;48例输卵管组织检测出解脲支原体DNA ,阳性率为 3 7 5 % ,对照组 5例阳性 ;两组比较差异有非常显著性 (P <0 0 1) ;⑵观察组 3 5例宫颈分泌物检测出沙眼衣原体DNA ,阳性率为 2 7 3 % ,对照组 5例阳性 ;3 4例输卵管组织检测出解脲支原体DNA ,阳性率为 2 6 6% ,对照组 3例阳性 ;两组比较差异有显著性 (P <0 0 5 ) ;⑶解脲支原体DNA阳性者盆腔粘连发生率为 70 6% ,沙眼衣原体阳性者盆腔粘连发生率为77 3 % ,两种病原体均阴性者盆腔粘连发生率为 13 3 %。结论　解脲支原体和沙眼衣原体感染与输卵管妊娠的发生有关。     

输卵管妊娠与沙眼衣原体和解脲脲原体感染的关系

目的:探讨解脲脲原体(ureaplasma urealyticum,UU)和沙眼衣原体(chlamydia trchomatis,CT)感染与输卵管妊娠的关系,以降低输卵管妊娠发生率。方法:应用聚合酶链反应(PCR-CT-DNA)技术和液体培养+固体培养的方法检测50例输卵管妊娠患者(观察组)和40例行附件切除术、无输卵管妊娠史的卵巢囊肿患者(对照组)的宫颈分泌物中沙眼衣原体和解脲脲原体DNA。结果:①观察组20例宫颈分泌物检测出解脲脲原体DNA,阳性率为40.0%,对照组4例阳性,阳性率为10.0%,两组比较有极显著性差异(P<0.01);②观察组16例宫颈分泌物检测出沙眼衣原体DNA,阳性率为32.0%,对照组3例阳性,阳性率为7.5%,两组比较有极显著性差异(P<0.01);③解脲脲原体阳性者盆腔粘连发生率为70.8%,沙眼衣原体阳性者盆腔粘连发生率为78.9%,两种病原体均阳性者盆腔粘连发生率为100%。结论:解脲脲原体和沙眼衣原体感染与输卵管妊娠的发生有关。早发现、早治疗女性生殖道解脲脲原体、沙眼衣原体感染可以减少输卵管妊娠的发生。     

成都地区育龄男性泌尿生殖道衣原体检测及支原体培养、药敏分析

目的了解成都地区育龄男性支原体、沙眼衣原体感染情况,并对支原体感染的药敏情况进行分析。方法采用胶体金法检测沙眼衣原体(CT)抗原,采用培养法检测解脲脲原体(UU)和人型支原体(Mh),并对阳性标本进行药物敏感性试验。结果 672例受试者衣原体感染者8例,占1.19%,支原体感染者296例,占44.05%,其中支原体与衣原体混合感染者6例,支原体感染中主要以解脲脲原体感染为主;感染支原体对交沙霉素、美满霉素及强力霉素的敏感率最高,分别为98.53%、96.70%及95.97%。结论有必要对育龄男性进行支原体、衣原体感染的筛检,并根据支原体药敏试验选用适宜的抗生素治疗。     

支原体衣原体感染及染色体畸变与自然流产的关系

目的:了解解脲支原体、人型支原体和沙眼衣原体感染及染色体畸变与自然流产的关系,为临床治疗提供理论基础。方法:取43例自然流产和40例人工流产患者的宫颈分泌物,进行解脲支原体、人型支原体和沙眼衣原体分离培养鉴定,同时对两组患者夫妇双方抽取外周血进行染色体核型分析。结果:实验组病原体总感染率41·8%,染色体畸变5例,对照组分别为15%和0例,两组间差异均有显著性意义(P<0·01)。在病原体感染中解脲支原体的感染率与人型支原体和沙眼衣原体的感染率之间存在显著差异(P<0·05),病原体复合感染率高。经Logistic回归分析结果显示,解脲支原体、人型支原体和沙眼衣原体感染及染色体畸变与自然流产密切相关(P<0·01)。本资料还发现,病原体感染与染色体畸变间无显著差异(P>0·05)。结论:解脲支原体、人型支原体和沙眼衣原体感染与自然流产有密切相关关系,提示病原体感染是引起本地区自然流产的重要原因。但感染所占比例有所不同,解脲支原体感染占主要位置。染色体畸变对自然流产产生的影响也不容忽视,因此对自然流产孕妇进行病原体培养和染色体检查在防止不良妊娠结局再次发生中具有重要意义。     

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.     

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.