女性泌尿生殖道感染解脲脲支原体的耐药现状

目的 探讨女性泌尿生殖道感染解脲脲支原体(Uu)的耐药现状,为临床医师抗感染治疗提供用药依据.方法 采用珠海迪尔生物工程有限公司生产的支原体培养药敏试剂盒对833例女性泌尿生殖道感染患者进行Uu培养和药敏试验.结果 Uu检测阳性率为52.9％;对Uu敏感率＞70.0％的抗菌药物有四环素、交沙霉素、多西环素、米诺环素、克拉霉素;面对氟喹诺酮类抗菌药物环丙沙星、氧氟沙星敏感率最低,分别为9.3％和15.6％.结论 临床医师应加强对Uu的耐药性监测,按照药敏试验结果合理选用抗菌药物,以提高Uu感染的临床治愈率.     

解脲脲原体和人型支原体感染的性别差异及耐药分析

目的探讨解脲脲原体(Uu)、人型支原体(Mh)感染的性别差异、耐药情况,为药物的合理使用提供依据。方法对1366人份的泌尿生殖道标本进行Uu、Mh培养及药敏试验。结果支原体的感染率存在性别差异,女性高于男性。在Uu、Mh体外药物敏感试验中美满霉素、强力霉素和交沙霉素的抑制效果均较好且敏感率接近,而喹诺酮类和大环内酯类中的其他4种药物分别对Uu和Mh的敏感性较差。结论交沙霉素对支原体的抑制效果最好且副作用少,美满霉素、强力霉素次之。     

不同女性人群解脲脲原体检测结果分析

目的:对广州地区解脲脲原体(Uu)在不同女性人群的检测结果及其对抗生素的敏感性进行分析,为临床合理应用抗生素治疗其感染提供依据。方法:采集生殖道炎症患者及健康体检女性两组人群的生殖道分泌物标本,用法国生物梅里埃公司IST2试剂盒进行Uu培养、鉴定和药敏试验,结合临床资料,对两组人群的Uu检测结果进行分析。结果:Uu阳性率生殖道炎症组为38.7%,健康体检组为33.5%,两组阳性率差异无统计学意义(P>0.05),且Uu在各年龄段女性定植无差异;生殖道炎症组Uu≥104 CFU/ml的例数明显高于健康体检组,两组Uu≥104 CFU/ml检出率比较差异有统计学意义(P<0.01);药敏结果显示除环丙沙星和氧氟沙星外,其余抗生素对Uu均有较好的抗菌活性(敏感性均>70%)。结论:Uu为女性生殖道常见寄生物,应慎重判断其致病性,合理应用抗生素治疗其感染。     

泌尿生殖道解脲脲支原体感染及药敏结果分析

目的分析无锡市人民医院近3年来皮肤性病科、妇产科及泌尿科门诊患者,泌尿生殖道解脲脲支原体(Uu)感染和耐药性,为临床治疗提供依据。方法统计2008年1月-2010年12月Uu培养及药敏结果,并进行回顾性分析。结果 8042份标本培养阳性1366份,阳性率17.0%,最敏感的抗菌药物依次是普那霉素、多西环素、四环素、交沙霉素。结论多西环素和交沙霉素目前可作为无锡地区临床治疗Uu感染的首选药物。     

解脲脲支原体多带抗原基因分型鉴定及其临床应用研究

目的应用PCR技术对解脲脲支原体(Uu)多带抗原进行分型鉴定,探讨Uu各种基因型与临床病原学之间的关系. 方法 根据解脲脲支原体多带抗原基因(MBA)与16S rRNA基因和尿素酶基因结构设计10对引物,采用PCR基因扩增技术,对 384例非淋菌性尿道炎和其他泌尿生殖道感染患者的临床标本,进行解脲脲支原体生物变种和基因型分型鉴定,并与Uu培养法作比较. 结果 384例性病门诊患者临床标本中,检测Uu培养阳性 218例,阳性率56.8%;PCR基因扩增检测Uu-DNA阳性 208例,总阳性率为54.2%:其中生物变种1(biovar 1) 143例,占37.2%, 生物变种2 (biovar 2) 65例,占16.9%;基因分型结果:生物变种1血清变种1 (serovar 1) 50例,占13.0%,血清变种3/14 (serovars 3/14) 64例, 占16.7%, 血清变种6 (serovar 6) 29例,占7.6%;生物变种2 亚型1 (subtype 1) 25例,占6.5%, 亚型2 (subtype 2) 30例,占7.8%, 亚型3 (subtype 3) 10例,占2.6%. 结论 Uu是性病的重要病原体,MBA多带抗原PCR基因分型鉴定具有简便、快速、敏感、特异之优点.     

非淋病性尿道炎患者的解脲脲支原体检测及其药敏分析

目的 了解非淋病性尿道炎(NGU)患者解脲脲支原体(Uu)感染情况与耐药性,为临床医师合理用药提供依据.方法 632例疑似NGU患者,分别采集男性尿道分泌物与女性的宫颈分泌物,对标本进行Uu培养与药敏试验,考察标本的Uu阳性率与Uu药敏性.结果 632例疑似NGU患者的标本中,男265例,女367例；共检测Uu阳性标本369株,Uu阳性率58.39％;其中,男性Uu 123株,阳性率46.42％,女性Uu 246株,阳性率67.03％；女性Uu阳性率显著高于男性,差异有统计学意义(P＜0.01)；Uu对9种常见抗菌药物敏感性由高到低分别为普那霉素、交沙霉素、多西环素、阿奇霉素、克拉霉素、红霉素、四环素、氧氟沙星、环丙沙星.结论 Uu是造成NGU的主要病原体,Uu感染存在性别差异,临床检验人员应对Uu感染进行动态监测与药敏试验,提高NGU的治愈率,减少耐药菌株的出现.     

泌尿生殖道解脲脲支原体的药物敏感性分析

目的了解泌尿生殖道解脲脲支原体(Uu)感染状况及对抗菌药物的敏感性,为临床提供抗感染治疗的科学依据。方法回顾性调查2006年1月~2008年12月送检的泌尿生殖道分泌物标本解脲脲支原体培养的阳性结果。结果Uu检测总阳性率49.9%,其中女性阳性率60.5%,男性阳性率24.9%;Uu的耐药性特点为对喹诺酮类抗菌药物敏感率最低,对环丙沙星和氧氟沙星敏感率分别为15.0%和20.2%;对普那霉素、多西环素、交沙霉素、四环素敏感率最高,分别为99.8%、98.6%、92.8%、91.9%。结论Uu对常用抗菌药物已产生了不同程度的耐药性,泌尿生殖道Uu感染必须参照药敏试验结果,选用敏感率高的抗菌药物进行治疗。     

女性泌尿生殖道解脲脲支原体感染现状及耐药性调查

目的了解女性泌尿生殖道解脲脲支原体(Uu)感染状况及耐药性,为临床合理用药提供试验依据。方法对601例泌尿生殖道感染标本采用珠海迪尔生物有限公司生产的试剂盒进行支原体属培养和药敏试验。结果 Uu培养阳性率为31.1%,Uu对12种抗菌药物的药敏试验结果表明,Uu对氟喹诺酮类抗菌药物环丙沙星和氧氟沙星敏感率最低为9.1%、15.0%,对四环素、交沙霉素、多西环素、克拉霉素、米诺环素敏感率均>70.0%。结论 Uu对常用抗菌药物已产生了不同程度的耐药性,因此,将支原体属培养和药敏试验纳入常规检测项目,对临床医师正确诊断疾病和针对性抗感染治疗非常必要。     

解脲支原体致非淋菌性尿道炎的研究

目的：探讨解脲支原体（Uu）的感染率、分群与致非淋菌性尿道炎（NGU）的关系。方法：1．试验人群分组：1）试验组：选择来本院妇科门诊诊断NGU患者，取宫颈分泌物培养Uu阳性的标本；2）健康对照组：选择来本院体检女性人群，取宫颈分泌物培养Uu阳性的标本。2．Uu分群：将每个标本提取DNA作为模板，分别加入Uu群寡核苷酸引物进行PCR扩增。结果：1．试验组共调查了109例，PCR检测Uu阳性68例（62．4％）；健康对照组共调查了68例，PCR检测Uu阳性37例（54．4％）。2．对试验组68例液体培养和PCR检测Uu阳性的标本进行PCR分群，结果生物1群感染54例（79．4％），生物2群感染13例（19．1％），生物1群和生物2群混合感染1例（1．5％）；健康对照组37例液体培养和PCR检测Uu阳性的标本进行PCR分群，结果生物1群感染29例（78．4％），生物2群感染8例（21．6％）。结论：在正常人群中单纯从宫颈分离出Uu并不意味着致病性；Uu感染与携带均以生物1群为主。     

320例非淋菌性尿道炎患者沙眼衣原体和解脲脲支原体检测结果分析

目的了解非淋菌性尿道炎(NGU)患者沙眼衣原体(CT)和解脲脲支原体(Uu)感染情况。方法沙眼衣原体采用抗原抗体快速免疫测定法检测,解脲脲支原体由液体培养基培养。结果320例NGU患者CT阳性率为36.25%,Uu阳性率为43.75%,混合感染阳性率为20.00%;不同性别CT、Uu检出率差异均有显著性(P<0.005),CT感染率男性多于女性(χ2=10.421,P<0.005),Uu感染率女性多于男性(χ2=13.545,P<0.001)。结论NGU患者CT、Uu感染率较高,临床考虑NGU应同时检测CT和Uu。     

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.     

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.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

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.     

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.     

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.