高危型HPV E6/E7 mRNA与宫颈癌相关性分析

目的 探讨高危型HPV E6/E7 mRNA检出率与宫颈癌的相关性,为临床防治宫颈癌提供依据。方法 选择2015年收治的100例宫颈癌患者为A组,同期100例健康体检者为B组,采用荧光定量PCR检测入组患者高危型HPV E6/E7 mRNA和病理学检查,比较两组患者HPV E6/E7感染率和荧光定量PCR检查效率,分析HPV E6/E7感染与宫颈鳞状上皮病变的相关性。结果 A组阳性76例,阳性率为76.0%;B组阳性13例,阳性率为13.0%;A组阳性率高于B组,差异有统计学意义（χ²=24.522,P<0.001）。两组阳性预测值和阴性预测值比较,差异无统计学意义（P>0.05）。宫颈癌患者HPV E6/E7 mRNA阳性率（76.0%）高于高度宫颈鳞状上皮病变者（26.1%）、低度宫颈鳞状上皮病变者（17.6%）和非典型鳞状上皮细胞者（6.7%）,差异有统计学意义（χ²=7.615,P=0.001; χ²=9.114,P=0.001; χ²=18.241,P<0.001）。结论 宫颈癌患者HPV E6/E7mRNA检出率高,且随宫颈鳞状上皮病变加重,其HPV E6/E7 mRNA阳性率越高。     

上海地区2015－2019年急性呼吸道感染病例中腺病毒感染情况分析

目的 研究2015-2019年上海地区急性呼吸道感染病例中腺病毒感染的流行病学特征和混合感染情况,为腺病毒的防控提供科学依据。方法 收集2015-2019年上海地区3家医院内的急性呼吸道感染病例,对纳入病例进行相关信息登记和采样,进行呼吸道病原体的多重PCR检测。结果 共纳入1 543例急性呼吸道感染病例,腺病毒阳性率2.92%（45/1 543）,流感样病例（ILI）和严重急性呼吸道感染病例（SARI）中的阳性率分别为2.74%（29/1 058）和3.30%（16/485）。ILI在2019年1-5月的阳性率5.43%（7/129）高于2015-2018年同期的0.52%~4.48%（Fisher精确检验值=8.92,P=0.036）。45例腺病毒阳性病例的发病时间主要分布在第一、二季度,合计占62.22%（28/45）,各季度发病阳性率的差异有统计学意义（χ²=12.52,P=0.006）,以第二季度的阳性率最高（6.03%）,高于其他季度的1.89%~2.93%。各年龄组间差异有统计学意义（χ²=16.94,P=0.001）,且随着年龄的增加阳性率有降低的趋势（χ²=10.16,P=0.001）,13~19岁组的阳性率（9.43%）高于其他年龄组（1.48%~4.81%）;学生组阳性率（12.07%）高于其他职业（2.61%）,差异有统计学意义（χ²=11.53,P=0.001）。45例腺病毒阳性病例中混合感染占31.11%（14/45）。ILI和SARI的混合感染率分别为34.48%（10/29）和25.00%（4/16）,14例混合感染病例中,腺病毒的主要混合感染病原是甲型流感病毒和冠状病毒。结论 上海地区急性呼吸道感染病例中存在一定比例的阳性病例,需进一步加强青少年人群中的腺病毒监测,重点是关注第二季度的学生等重点人群。     

北京市18～65岁居民戒烟意愿、吸烟危害认知及其对吸烟情况的影响

目的 了解北京市18～65岁居民吸烟危害认知水平及戒烟意愿,对控烟工作及相关政策措施的制定完善实施提供科学依据。方法 数据来自2017年北京市成人慢性病及其危险因素监测,以多阶段分层整群的抽样方法在北京市16个区165个村/居抽取调查对象进行调查,采用logistic回归进行多因素分析。结果 11 594例有效样本中,49.93%不想戒烟,男性不想戒烟者比例为50.39%,女性为43.01%,差异有统计学意义（χ²=14.211,P=0.002）,郊区为56.78%,城区为45.30%,差异有统计学意义（χ²=51.977,P<0.001）。吸烟者与戒烟者戒烟动机中,因所患疾病原因,戒烟者中比例（29.88%）高于吸烟者（11.50%）,差异有统计学意义（χ²=85.865,P<0.001）。吸烟危害认知较好女性的比例（34.97%）高于男性（32.63%）,差异有统计学意义（Z=5.612,P<0.001）;郊区的比例（35.44%）高于城区（33.03%）,差异有统计学意义（Z=-3.734,P<0.001）;从不吸烟者的比例（35.15%）高于吸烟者（30.06%）,差异有统计学意义（χ²=62.277,P=0.005）。多因素logistic回归结果显示,认知一般者（OR=0.61,95% CI：0.39～0.94）与认知较差者（OR=0.67,95% CI：0.50～0.90）不易产生戒烟行为,认知一般者（OR=0.64,95% CI：0.53～0.76）与认知较差者（OR=0.87,95% CI：0.78～0.98）更易产生吸烟行为。结论 北京市18～65岁吸烟者戒烟意愿较低,戒烟动机主要出于健康考虑,从不吸烟者吸烟危害认知优于吸烟者,吸烟危害认知是吸烟情况的影响因素。     

天津市2005-2017年医疗机构新报告HIV/AIDS特征分析

目的 分析天津市2005-2017年医疗机构新报告HIV/AIDS特征,为更好地在医疗机构中开展相关的艾滋病防治工作提供依据。方法 对新报告HIV/AIDS的流行病学调查及随访资料进行分析,同时回顾调查2005-2017年医疗机构新报告HIV/AIDS的科室来源及主要就诊疾病。结果 2005-2017年天津市医疗机构新报告HIV/AIDS 3 035例,医疗机构报告HIV/AIDS病例年均增长24.8%,其中49.2%（1 343/2 728）来源于住院病例,50.8%（1 385/2 728）来源于门诊病例,性病门诊就诊者检测在2011-2017年HIV阳性检出率呈现增长趋势（χ²=18.469,P=0.005）;医疗机构住院病例、门诊病例首次CD₄⁺T淋巴细胞计数（CD₄）（χ²=17.189,P=0.000）及新报告当年发生死亡比例（χ²=61.198,P=0.000）差异有统计学意义;二级医院与三级医院新报告HIV/AIDS首次CD₄值（χ²=16.751,P=0.000）及新报告当年发生死亡比例（χ²=18.926,P=0.000）差异有统计学意义;不同科室新报告HIV/AIDS首次CD₄值（χ²=37.620,P=0.000）及新报告当年发生死亡比例（χ²=95.489,P=0.000）差异有统计学意义。结论 2005-2017年天津市医疗机构门诊新报告HIV/AIDS较为及时,二级医院新报告HIV/AIDS比三级医院及时。在医疗机构重点科室门诊积极倡导医务人员中主动提供HIV检测服务,对于天津市艾滋病防治工作具有重要意义。     

中国脊髓灰质炎网络实验室人员免疫接种状况及其影响因素分析

目的 调查中国省级脊髓灰质炎网络实验室人员免疫接种状况,分析其影响因素,为国家制定脊髓灰质炎网络实验室从业人员相关免疫策略提供参考。方法 2016年10－12月选取全国省级CDC脊髓灰质炎网络实验室全部从业人员为调查对象,采用问卷调查方式,收集该人群免疫接种状况,并利用SAS软件及趋势χ²检验和确切概率法进行免疫影响因素的统计学分析,以P<0.05为差异有统计学意义。结果 共调查77人,其中完成脊髓灰质炎基础免疫60人,17人（22%）基础免疫情况不详。从事脊髓灰质炎病毒工作后明确接种疫苗者为66人（86%）,接种信息记录不完整者为11人（14%）。影响免疫接种因素包括年龄（χ²=2.48,P<0.05）、职称（χ²=2.51,P<0.05）、工作时间（确切概率法计算：P<0.000 1）、学历（χ²=0.74,P=0.46）、性别（χ²=0.46,P=0.50）。结论 目前我国省级脊髓灰质炎网络实验室人员免疫接种情况较好,其中完成≥3剂次者占41%,且接种信息记录完整,应加强新入职实验室人员免疫接种。     

西安市和咸阳市性病门诊男性就诊者HIV/STD感染及相关行为特征比较

目的 比较西安市和咸阳市的性病门诊男性就诊者的HIV/STD感染状况、行为特征及相关信息,为有效开展干预提供参考依据。方法 根据哨点监测结合横断面调查方法,选择西安市和咸阳市各1个性病门诊作为调查现场,将2016年6-7月首次到性病门诊就诊的年龄≥ 15岁男性就诊者作为调查对象。样本量估算实际约需400人,采集血样检测HIV、HCV和梅毒并收集相关行为信息。采用EpiData 3.1软件和SPSS 21.0软件整理数据和分析相关信息。结果 西安市和咸阳市分别调查了206例和221例性病门诊男性就诊者。西安市HIV阳性率为2.4%（5/206）,咸阳市为0.9%（2/221）,差异无统计学意义;梅毒阳性率分别为4.9%（10/206）和13.6%（30/221）,差异有统计学意义（χ²=9.55,P<0.01）;西安市调查对象被诊断为其他性病的比例均高于咸阳市。西安市调查对象最近3个月有异性商业性伴和临时性伴的比例分别为18.0%（37/206）、15.5%（32/206）,低于咸阳市的46.6%（103/221）和15.8%（35/221）（χ²=39.70,P<0.01;χ²=0.01,P=0.93）。西安市调查对象最近3个月与暗娼使用安全套、与临时性伴使用安全套的比例分别为37.8%（14/37）、6.3%（2/32）,均低于咸阳市的93.1%（95/102）、57.1%（20/35）（χ²=49.06,P<0.01;χ²=19.63,P<0.01）。结论 西安市和咸阳市性病门诊男性就诊者在HIV、性病感染、商业性行为及安全套使用情况等方面有不同的特征,但是均存在感染HIV和性病的高危行为。     

HBsAg阳性母亲HBV感染状况与婴儿乙肝疫苗无/弱应答的关系

目的 分析HBsAg阳性母亲HBV感染状况与婴儿乙肝疫苗无/弱应答的关系。方法 2011年6月至2013年7月采用前瞻性研究的方法选择225对HBsAg阳性母亲及其新生儿作为研究对象,新生儿按0-1-6免疫接种程序接种乙肝疫苗并随访至婴儿1周岁,采用电化学发光免疫分析法和荧光定量PCR检测母亲及婴儿外周血HBV血清学标志物和HBV DNA载量。结果 HBsAg阳性母亲共检测出6种HBV感染模式,常见模式"HBsAg（+）、HBeAg（+）、抗-HBc（+）"（模式一）与" HBsAg（+）、抗-HBe（+）、抗-HBc（+）"（模式二）所占比例最多（92.5%,208/225）;母亲HBV感染为模式一时,婴儿乙肝疫苗无/弱应答率（11.3%）低于母亲HBV感染为模式二时的婴儿无/弱应答率（23.4%）,差异有统计学意义（χ²=4.80,P=0.029）,随着母亲HBeAg水平的升高,婴儿乙肝疫苗无/弱应答率呈现下降趋势（χ²=4.86,P=0.028）;经非条件logistic回归模型控制其他因素影响后结果显示,母亲HBeAg与降低婴儿乙肝疫苗无/弱应答发生风险有关（OR=0.598,95%CI：0.378~0.947）;HBsAg阳性母亲HBV DNA阳性率为54.2%,未发现母亲HBV DNA阳性与其婴儿乙肝疫苗无/弱应答率有关（χ²=0.22,P=0.640）。结论 HBsAg阳性母亲HBV感染模式以"HBsAg（+）、HBeAg（+）、抗-HBc（+）"与"HBsAg（+）、抗-HBe（+）、抗-HBc（+）"模式为主,且该2种模式下婴儿乙肝疫苗免疫应答情况有所不同;母亲HBeAg可能是其婴儿乙肝疫苗无/弱应答的保护因素;尚未发现HBsAg阳性母亲HBV DNA与婴儿乙肝疫苗无/弱应答有关联。     

宁夏回族自治区回、汉族居民烟草、酒精使用调查

目的 了解宁夏回族自治区(宁夏)回、汉族居民烟草、酒精使用情况及其分布特征,为民族地区改善戒烟、限酒措施提供参考。方法 采用多阶段系统抽样法,抽取宁夏地区≥18岁居民6 476人进行入户调查。烟草和酒精使用障碍根据国际疾病分类-10(ICD-10)标准采用复合型国际诊断交谈表3.0(CIDI 3.0)中文版评估。结果 共有5 811名受访者完成全部调查,目前吸烟率为19.15%,其中男性吸烟率高于女性(44.73% vs. 1.51%),差异有统计学意义(χ²=1 693.25,P< 0.001);男性中回族吸烟率低于汉族(33.19% vs. 51.95%),差异有统计学意义(χ²=79.99,P< 0.001)。男性烟草依赖患病率为1.75%,回、汉族男性烟草依赖患病率差异无统计学意义(χ²=0.02,P=0.958)。目前饮酒率为5.78%,其中男性饮酒率高于女性(12.48% vs. 1.16%),差异有统计学意义(χ²=329.94,P< 0.001);男性中回族饮酒率低于汉族(4.71% vs. 17.34%),差异有统计学意义(χ²=82.03,P< 0.001);男性酒精使用障碍患病率为6.03%,男性回族酒精使用障碍患病率低于汉族(3.50% vs. 7.61%),差异有统计学意义(χ²=16.68,P< 0.001)。结论 宁夏地区回族成年人烟草和酒精使用率低于同地区汉族,当地的回族文化对减少人群烟草、酒精使用可能具有积极的影响。     

2008年和2018年广州市乙型肝炎流行病学特征比较

目的 比较2008年和2018年广州市1~59岁人群乙型肝炎（乙肝）血清流行病学调查结果。方法 采用二阶段整群抽样法,于2008年和2018年在广州市随机抽取1~59岁常住人口进行乙肝血清流行病学调查。结果 2008年调查1~59岁人群4 989名,2018年3 980名。2018年1~59岁人群HBsAg阳性率为9.50%（95%CI：7.34%~11.66%）,较2008年（12.45%,95%CI：10.58%~14.33%）略有下降,差异无统计学意义（χ²=18.302,P=0.075）;下降主要为7~16岁人群,2018年HBsAg阳性率为0.88%（95%CI：0.35%~1.42%）,较2008年（4.54%,95%CI：2.71%~6.36%）下降80.62%,差异有统计学意义（χ²=34.144,P=0.000）。2018年1~59岁人群抗-HBs阳性率为72.30%（95%CI：69.56%~75.04%）,较2008年（64.93%,95%CI：61.65%~68.22%）升高11.35%,差异有统计学意义（χ²=51.618,P=0.001）;升高主要为17~59岁人群,2018年抗-HBs阳性率为71.93%（95%CI：68.90%~74.96%）,较2008年（63.77%,95%CI：60.16%~67.37%）升高12.80%,差异有统计学意义（χ²=28.422,P=0.001）。2018年1~59岁人群HBV感染率为48.10%（95%CI：43.20%~53.00%）,较2008年（62.27%,95%CI：59.11%~65.44%）下降22.76%,差异有统计学意义（χ²=167.138,P=0.000）;其中1~、7~和17~59岁人群HBV感染率分别为4.58%、5.13%和56.56%（降幅分别为81.83%、85.91%和18.47%）,高流行区域人群HBV感染率为48.87%（降幅24.70%）,有乙肝疫苗接种史人群HBV感染率为28.81%（降幅38.75%）。结论 自2008年以来,广州市乙肝防控效果显著,儿童HBV感染率达到WHO消除乙肝2020年的目标,但仍属于高流行区,降低乙肝死亡率的目标任务相当艰巨,需继续做好新生儿乙肝疫苗接种工作和成年人的监测筛查工作。     

HBsAg阳性母亲HBeAg和新生儿调节性T淋巴细胞关系及对HBV宫内传播的影响

目的 探讨HBsAg阳性母亲的HBeAg与新生儿CD₄⁺CD₂₅⁺Foxp3⁺调节性T淋巴细胞（Treg）含量的关系以及对增加新生儿HBV宫内传播发生风险的影响。方法 选择太原市第三人民医院妇产科分娩的270对HBsAg阳性母亲及其新生儿,收集一般人口学特征及分娩情况等资料,采用荧光定量聚合酶链式反应（FQ-PCR）和化学发光免疫试验（CLIA）检测母婴外周血HBV DNA及HBV血清学标志物;流式细胞术（FCM）检测新生儿外周血Treg等免疫细胞含量。结果 母亲HBeAg阳性是HBV宫内传播的危险因素（OR=4.08,95% CI：1.89~8.82）;母亲HBeAg阳性者新生儿Treg含量高于阴性者（Z=2.29,P=0.022）;按母亲HBeAg滴度分为5组,各组间新生儿Treg、HBeAg及母亲HBV DNA随母亲HBeAg滴度增高呈上升趋势,差异均有统计学意义（χ²=18.73,P<0.001;χ²=181.60,P<0.001;χ²=183.09,P<0.001）。偏相关分析中控制母亲HBV DNA以及新生儿HBeAg后,母亲HBeAg与新生儿Treg呈正相关（r_s=0.19,P=0.039）。新生儿Treg与浆细胞样树突状细胞（pDC）、CD₄⁺T淋巴细胞含量为负相关（r_s=-0.21,P=0.017;r_s=-0.23,P=0.009）。结论 HBsAg阳性母亲的HBeAg可能通过上调新生儿Treg含量,影响树突状细胞和效应T淋巴细胞的功能及其对HBV的免疫应答,从而增加新生儿发生HBV宫内传播的风险。     

Water,sanitation, and hygiene in schools: Status and implications of low coverage in Ethiopia,Kenya, Mozambique,Rwanda, Uganda,and Zambia

Adequate access to water, sanitation, and hygiene (WaSH) in schools impacts health, educational outcomes, and gender disparities. Little multi-country research has been published on WaSH in rural schools in Sub-Saharan Africa. In this multi-national cross-sectional WaSH study, we document WaSH access, continuity, quality, quantity, and reliability in 2270 schools that were randomly sampled in rural regions of six Sub-Saharan African countries: Ethiopia, Kenya, Mozambique, Rwanda, Uganda, and Zambia. Data collection included: school WaSH surveys containing internationally established WaSH indicators, direct observation, and field- and laboratory-based microbiological water quality testing. We found 1% of rural schools in Ethiopia and Mozambique to 23% of rural schools in Rwanda had improved water sources on premises, improved sanitation, and water and soap for handwashing. Fewer than 23% of rural schools in the six countries studied met the World Health Organization’s recommended student-to-latrine ratios for boys and for girls. Fewer than 20% were observed to have at least four of five recommended menstrual hygiene services (separate-sex latrines with doors and locks, water for use, waste bin). The low access to safe and adequate WaSH services in rural schools suggest opportunities for WaSH interventions that could have substantive impact on health, education, and gender disparities.     

济南市区蔬菜、水果、粮食和鲜肉中铜、锰、锌、硒含量调查

目的 调查济南居民日常消费的蔬菜、水果、粮食和鲜肉中铜、锰、锌、硒的含量.方法 于2008年采集济南居民日常消费的蔬菜、水果、粮食和鲜肉进行消化处理,采用火焰原子吸收分光光度法检测铜和锌,以石墨炉原子吸收分光光度法检测锰,以氢化物发生-原子吸收分光光度法检测硒.结果 所调查的4种元素中锰和锌的含量比较高,硒最低;粮食和...     

Reference intervals of cadmium,lead, and mercury in blood,urine, hair,and nails among residents in Mansoura city,Nile delta,Egypt

A random sample of 68 males and 25 females who reside in Mansoura city, Egypt, was examined for concentrations of cadmium, lead, and mercury in blood, urine, hair, and nails. The effect of gender and smoking on such levels was studied. The influence of dental amalgam on the levels of mercury in these biological samples was also examined. The results obtained show that only blood lead, which increased among males, was affected by gender. Blood levels of cadmium and lead as well as hair lead appeared to increase with smoking habit. Mercury levels in blood and urine were related to the presence of dental amalgam fillings. International comparisons between our results and the corresponding levels in other localities in the world showed that there were environmentally related variations in terms of cadmium levels in hair, lead levels in blood, urine, hair, and nails, and mercury levels in blood, hair, and nails. In conclusion, reference intervals of cadmium, lead, and mercury in the biological samples are environmentally related parameters. Some factors, such as gender, smoking habit, and the presence of dental amalgam fillings, may affect such levels and therefore should be considered.     

Monitoring of Nutrients, Pesticides, and Metals in Waters, Sediments, and Fish of a Wetland

Wetland areas are of extraordinary importance for the conservation of wildlife. The Aiguamolls de l’Empordà Natural Park, located in Girona (northeast Spain), is one of the few areas in Europe acting as a way station for migratory birds. The natural park is made up of a brackish water reserve and a fresh water reserve. Agriculture and tourism, which are concentrated especially around coastal population centers, are the main activities in this area and result in the release into the environment of nutrients, pesticides, and heavy metals. This article aims to investigate the presence of nutrients, selected pesticides (organochlorine compounds, permethrin and triazines) and metals (Cr, Cu, Cd, Ni and Pb) in water, sediments, and fish samples. In the case of water, seasonal variations in levels of contamination were also monitored. Comparison was made of the fresh and brackish water reserves and concentration factors for metals and pesticides in sediment were determined. We conclude that the most significant sources of contamination in the natural park are from the entry of pesticides and nutrients into surface waters and sediments as a result of the intensive farming activity of the surrounding areas. The pesticides with the greatest presence were found to be lindane, heptachlor epoxide, permethrin, and atrazine. Among the metals analyzed, Cu and Cr presented the highest concentrations in surface waters and sediments.     

Levels of As, Cd, Pb, Cu, Se and Zn in bovine kidneys and livers in Jamaica

Paired liver and kidney samples from 100 free-range cattle in different parts of Jamaica were analyzed for essential and non-essential trace elements. We found significant enrichment of elements in the kidney (K) compared to the liver (L) with the K/L concentration ratios being 5.2 for Cd, 4.1 for Pb, 3.5 for Se and 2.1 for As, but the Cu contents of the kidney were significantly higher with the K/L ratio of 0.45. A large number of kidney and liver samples showed Cu concentrations in the ranges that were associated with deficiency effects in mammals. About 15% of the hepatic samples had Zn concentrations below 20 microg/g, suggesting that there might be zinc insufficiency in some of the animals. Positive associations were found between the metals in both the kidney and liver. On average, the intake of Cd from consumption of both bovine kidney and liver from the island was estimated to be 5.2 microg/day, equivalent to about 7% of the provisional tolerable daily intake (PTDI), although anyone who habitually consumed the few kidneys or livers with >40 microg/g cadmium may be at some risk of exceeding the PTDI. The consumption of offal from local animals did not appear to be an important dietary source of any of the essential microelements.     

Homocysteine, folate, vitamin B12, and cardiovascular risk in Indians, Malays, and Chinese in Singapore

OBJECTIVE: To examine the hypothesis that the higher rates of coronary heart disease (CHD) in Indians (South Asians) compared with Malays and Chinese is partly attributable to differences in blood concentrations of homocysteine, and related blood concentrations of folate and vitamin B12. DESIGN: Cross sectional study of the general population. SETTING: Singapore. PARTICIPANTS: Random sample of 726 fasting subjects aged 30 to 69 years. MAIN RESULTS: Mean plasma total homocysteine concentrations did not show significant ethnic differences; values were Indians (men 16.2 and women 11.5 mumol/l), Malays (men 15.0 and women 12.5 mumol/l), and Chinese (men 15.3 and women 12.2 mumol/l). Similarly, the proportions with high plasma homocysteine (> 14.0 mumol/l) showed no important ethnic differences being, Indians (men 60.0 and women 21.9%), Malays (men 53.9 and women 37.8%), and Chinese (men 56.6 and women 30.6%). Mean plasma folate concentrations were lower in Indians (men 8.7 and women 10.9 nmol/l) and Malays (men 8.5 and women 10.8 nmol/l), than Chinese (men 9.7 and women 13.8 nmol/l). Similarly, the proportions with low plasma folate (< 6.8 nmol/l) were higher in Indians (men 44.9 and women 36.6%) and Malays (men 45.3 and women 24.5%) than Chinese (men 31.4 and women 12.6%). Mean plasma vitamin B12 concentrations were lowest in Indians (men 352.5 and women 350.7 pmol/l), then Chinese (men 371.1 and women 373.7 pmol/l), and then Malays (men 430.5 and women 486.0 pmol/l). CONCLUSION: While there were ethnic differences for plasma folate and vitamin B12 (in particular lower levels in Indians), there was no evidence that homocysteine plays any part in the differential ethnic risk from CHD in Singapore and in particular the increased susceptibility of Indians to the disease.