江苏省艾滋病病毒感染的分子流行病学研究

目的 了解江苏省不同人群中艾滋病病毒(HIV)各亚型毒株的流行情况和传播规律。方法 收集HIV感染者及患者的流行病学资料；无菌采集HIV感染者或艾滋病(AIDS)患者抗凝全血标本5ml，提取前病毒DNA，用巢式聚合酶链反应(nested—PCR)扩增膜蛋白基因的C2～V3区，进行序列测定，鉴定病毒亚型。用威斯康星GCG软件进行共享序列、基因离散率的计算和毒株的聚类分析。结果 截止2001年底，江苏省已发现HIV-1中的A、B、C、D、E五种亚型和一个B亚型变种(B^ )流行，C(占40．48％)和B^ (38．10％)亚型为主要流行株；静脉吸毒感染人群中86．67％为C亚型，采供血和受血感染人群中91．67％为B^ 亚型，在性途径传播人群中所有六种亚型均有，且分布较为均一。结论有偿献血人群中B^ 亚型毒株由邻省传人，吸毒人群中C亚型毒株的传人主要与新疆籍流动人口的介入有关；多种亚型的并存说明江苏省存在着适宜AIDS流行的各种危险因素；提示今后在药物治疗、疫苗研制以及其他防制工作上将面临更大的困难。     

江苏省艾滋病病毒流行毒株的基因序列测定和亚型分析

目的 :了解江苏省不同人群中HIV各亚型毒株的流行情况和传播规律。方法 :收集感染者及病人的流行病学资料 ;无菌采集HIV感染者或AIDS病人抗凝全血标本 5ml,提取前病毒DNA ,用套式聚合酶链反应扩增膜蛋白基因的C2 -V3区 ,进行序列测定 ,鉴定病毒亚型。用威斯康星GCG软件进行共享序列、基因离散率的计算和毒株的聚类分析。结果 :截止 2 0 0 1年 6月底 ,江苏省已发现HIV - 1中的A、B、B′、C、D、E 6种亚型 ,B′亚型 (占 4 1.6 7% )和C亚型 (占 2 5 % )为主要流行株 ;静脉吸毒感染人群中10 0 %为C亚型 ,采供血和受血感染人群中 87.5 %为B′亚型 ,在性途径传播人群中所有 6种亚型均有 ,且分布较为均一。结论 :多种亚型的并存说明江苏存在着适宜艾滋病流行的各种危险因素 ,提示今后在药物治疗、疫苗研制以及其它防制工作上将面临着更大的困难。因此在今后相当长的一段时间内 ,对高危人群进行行为干预将是江苏省艾滋病防制工作的重中之重。     

宜宾市1 998～2001年HIV感染监测结果分析

目的：了解宜宾市HIV感染情况，感染途径，感染人群特征，为控制本市艾滋病的流行提供依据。方法：从1998年起对高危人群（吸毒者，献血者，性门诊病人等）进行监测，采用酶联免疫吸附（ELISA）试验初筛，初筛试验阳性者送四川省HIV检测中心确认。结果：检测出22人HIV抗体阳性，阳性率1．38％，其中21例有吸毒史，8例为外地人员。结论：我市HIV传播方式以吸毒为主，HIV感染者中外地流入者占有很大比例，应加强以吸毒人群，性乱人群及流动人群的监测和管理。     

艾滋病流行因素研究的重要结论

中国疾控中心性病艾滋病预防控制中心首席专家邵一鸣教授等近日完成一项国家“十五”科技攻关课题研究,确定了影响我国艾滋病病毒传播的几个主要生物学因素,得出5个方面重要结论,并提出改进我国艾滋病防治策略的重要建议。第一,全国调查显示,我国艾滋病流行的主要HIV毒株已从B′亚型演变为B′/C重组亚型,B′/C亚型HIV-1毒株还扩散到性传播人群,成为由高危人群向一般人群扩散的重要毒株。第二,我国四川凉山地区静脉吸毒人群死因调查结果显示,导致静脉吸毒人群近期死亡的主要原因并非HIV感染引起的艾滋病,而是吸毒过量和注射事故相关的…     

河北省某市艾滋病流行特征分析

目的分析某市艾滋病病毒／艾滋病（HIV/AIDS）流行现状、特征及趋势。方法依据该市1989—2006年AIDS常规监测、高危人群哨点监测，流行病学调查及实验室资料，建立数据库并进行综合分析。结果自1989年发现首例HIV感染者至2006年底，累计发现HIV抗体阳性者240例，其中AIDS病人60例，死亡82例。HIV感染者／AIDS病例主要分布在沙河市。从市外既往有偿供血者传人为主转向境内蔓延扩散，经可疑受血感染是该市HIV传播的主要途径，青壮年女性感染率较高。HIV～1型B’亚型、CRF—BC重组株是该市主要流行株。结论该市艾滋病呈低流行状态，局部地区呈聚集性升高，经可疑受血传播HIV已被阻断。     

自贡市HIV/AIDS流行现状及趋势分析

目的：了解自贡市艾滋病病毒（HIV）感染流行状况及影响因素，为制定控制措施提供依据。方法：对全市1994-2004年HIV哨点监测资料、全市各地区、县监测报表、自贡市艾滋病初筛监测中心的常规监测和血清流行病学调查资料进行分析。结果：1997年发现首例HIV抗体阳性者，至2003年底累计报告确诊HIV感染者111例，死亡3例，经血传播为主要传播途径，以静脉吸毒感染为主；经性途径感染呈逐年上升趋势。结论：自贡市HIV感染已进入快速增长阶段，应立即采取有效的防治措施。     

山东省HIV/AIDS流行状况分析及预测

目的分析山东省艾滋病流行状况,为政府制定艾滋病控制策略提供依据.方法依据全省的艾滋病病例报告、各类监测报表、专项流行病学调查等资料;用SPSS软件进行分析;用工作簿（WORKBOOK）对全省高危人群基数和艾滋病疫情进行预测;采集HIV感染阳性者外周静脉防凝血,提取核酸,进行基因序列测定和亚型分析.结果截止2004年底,山东省累计报告艾滋病病毒感染者436例,艾滋病病人152例,死亡65例;预测全省现有感染者7000余人.17个省辖市有16个市的68个县（市区）有疫情报告;感染方式仍以血液途径传播为主,但性传播呈明显上升趋势,HIV感染人数呈快速增长趋势,近2年检出数占13年总数的68.2%.全省存在多种HIV病毒株亚型,已检出B、B′C等3种亚型以及CRF07-BC、CRF08-BC、CRF01-AG和CRFD1-AE等4种重组毒株.结论山东省HIV感染已进入快速增长阶段,艾滋病在我省人群、地域分布广泛,同时具有明显的地区和人群聚集性;艾滋病发病和死亡人数将持续增加;艾滋病流行由吸毒、献血员、卖淫嫖娼等高危人群向一般人群传播;女性感染者所占比例有较大幅度增加,母婴传播危险性增大.     

福建省70例HIV抗体阳性者流行病学分析

为了及时掌握福建省HIV感染的流行状况及发展动态，自1987年以来，全省逐步建立、完善HIV／AIDS监测网络，加强对各高危人群的监测。截止至1997年底，全省共发现HIV抗体阳性者70例，其中艾滋病病人23例（包括8例从无症状HIV感染者临床进展为艾滋病，已死亡ZI例）。现将70例HIV抗体阳性者流行病学调查情况分析讨论如下：1材料与方法1．IHIV抗体检测全部病例的HIV抗体检测均按卫生部统一制定的HIV实验室检测规程进行。首先采用PA、ELISA法进行初筛试验，当出现HIV抗体可疑阳性时，重复试验，如仍为阳性，再用蛋白印迹法（WB…     

衡阳市HIV/AIDS流行现状及趋势分析

目的了解和掌握衡阳市HIV感染和发病情况,为进一步开展艾滋病防制工作提供科学依据。方法对1992~2004年衡阳市艾滋病的常规监测、哨点监测和专项监测结果及流行病学个案调查等资料进行综合分析。结果1992~2004年共监测高危人群5 263人,发现HIV感染者486例,HIV阳性检出率为9.23%,其中45例发病,29例死亡。感染途径以血液传播为主,占84.77%,其中静脉吸毒占血液传播中99.51%,其次为性途径传播。感染者以青壮年男性为主,职业大多为无业,其次为农民。结论目前,衡阳市处于艾滋病流行快速增长期,HIV感染途径以静脉吸毒为主,性途径传播有上升趋势。因此,开展宣传教育、行为干预,提高高危人群和一般人群自我防范意识,对遏制艾滋病在全市传播和流行具有十分重要意义。     

江门地区吸毒人群与无偿献血人群HIV抗体检测结果分析

目的了解江门地区2000～2003年艾滋病病毒(HIV)通过血液传播感染情况,为艾滋病的预防控制工作提供依据.方法对江门地区吸毒人群和无偿献血人群进行HIV抗体检测和分析.结果吸毒人群检测共1 726例,抗-HIV阳性130例,阳性率7.53%;无偿献血人群检测141 130例,抗-HIV阳性19例,阳性率0.013%.结论吸毒共用针具静脉注射导致血液传播HIV是江门市艾滋病流行的主要途径,无偿献血人群中也有HIV感染者,提示艾滋病已从高危人群向一般人群扩散.吸毒人群是艾滋病防治的重点对象,要采取有效措施加强防治.同时要加强对采供血部门的血液监测,防止HIV经血液传播.     

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.