北京地区2011－2014年致儿童猩红热A组链球菌emm基因型别变化特征分析

目的 了解北京地区致儿童猩红热A组链球菌(GAS)emm基因型别分布,并探讨其型别变化与猩红热病例的关系。方法 收集2011－2014年5－7月北京市36家医院临床诊断为猩红热病例咽拭子GAS分离菌株,采用PCR联合测序方法对分离菌株进行emm分型,选取中国疾病监测信息报告管理系统中北京市猩红热病例报告数据进行分析。结果 共采集咽拭子标本2 161份,分离GAS菌株762株,阳性率为35.3%(762/2 161)。检测到7个emm型别,其中emm12型占69.4%(529/762),emm1型占29.8%(227/762),其他5种emm型别(11、22、75、89、128)占0.8%(6/762)。分析各年份emm型别构成比:2011年emm12型82.2%(295/359),emm1型16.7%(60/359),其他型(11、22、89)1.1%(4/359);2012年emm12型77.3%(123/163),emm1型23.9%(39/163),emm75型0.6%(1/163);2013年emm12型50.7%(38/75),emm1型49.3%(37/75);2014年emm12型44.2%(73/165),emm1型55.2%(91/165),emm128型0.6%(1/165)。不同年份emm型别构成比变化的差异有统计学意义(P<0.001)。2011、2012年emm12为主导菌型,2014年主导型别转换为emm1型。2011－2014年报告猩红热病例分别为6 152、2 908、2 048和3 918例,以2011年报告例数最多,2014年比2013年报告病例数增加91.31%。2011年GAS分离株emm型别存在年龄差异,其中1～5岁组分离的emm12型高于>5岁组(P<0.05)。2011、2013年分离GAS菌株存在地区差异,2011年emm1型分离株为城区高于郊区(P<0.05),2013年emm1型为郊区高于城区(P<0.05)。结论 2011－2014年北京地区GAS菌株优势菌型为emm12和emm1型;不同年份emm12、emm1变换成为主导菌型;emm主导菌型变化与猩红热病例变化趋势有关。     

山东省2013年致猩红热及无症状携带者A群链球菌分子分型研究

目的 描述2013年山东省致猩红热及无症状携带者A群链球菌(GAS)分子分型特征,探讨各分型方法与emm型别的关联.方法 自猩红热、无症状携带者咽拭分离获得GAS 72株,利用emm、多位点序列分型(MLST)、超抗原(SAg)基因(speA、speC、speG、speH、speI、speJ、smeZ、ssa、speK、speM、speL)检测和脉冲场凝胶电泳(PFGE)对其进行分型检测.结果 72株GAS中,以emm1型(41.67%)和emm12型(56.94%)为主;共检出两种ST型别,其中ST28型31株(43.06%),ST36型41株(56.94%);ST28型与emm1相关(P<0.05),而ST36型与emm12相关(P<0.05);speA、speC、speG、speH、speI、speJ、smeZ、ssa的检出率分别为38.89%、95.83%、97.22%、38.89%、54.17%、41.67%、100.00%、100.00%,speK、speM、speL未检出;emm1型菌株倾向于含有speA、speJ,不含有speH、speI(P<0.05);emm12恰好相反,倾向于含有speH、speI,不含有speA、speJ(P<0.05);PFGE共检出20种型别.结论 2013年山东省致猩红热和无症状携带者中GAS型别分布较为单一,emm型别以emm1和emm12为主;ST型别主要为ST28和ST36,超抗原基因携带以speC、speG、smeZ、ssa为主.各分型方法间存在一定关联.     

不同性别人群免疫球蛋白G N-糖基化结构谱型比较

目的 对不同性别人群的免疫球蛋白G（IgG） N-糖基结构谱型进行分析比较。方法 采用整群抽样,以2012年1-6月在北京市宣武医院体检的669名居民为研究对象,留取空腹静脉血5 ml,对IgG N-糖基进行分离、纯化、标记后,采用超高压液相色谱串联质谱法对IgG N-糖基进行检测,最终得到24个色谱峰,每个峰代表不同的糖基结构。不同性别人群的糖基结构比较采用两独立样本t检验或非参数检验,P<0.05为差异有统计学意义。结果 669名参与者中男性235人（35.13%）,女性434人（64.87%）,平均年龄为（44.23±9.82）岁。女性核心岩藻糖基化水平Fⁿ（Z=-2.192,P=0.028）高于男性;女性半乳糖基化水平G0ⁿ（Z=-7.898,P<0.001）、G1ⁿ（Z=-2.343,P=0.019）低于男性,而G2ⁿ（Z=-8.414,P<0.001）水平高于男性;女性唾液酸化水平F^totalS1/F^totalS2（Z=-5.049,P<0.001）、FS1/FS2（Z=-3.336,P=0.001）高于男性。结论 IgG N-糖基结构水平可能与性别有关。     

脆性组氨酸三联体、甲基-CpG-结合蛋白2异常表达与宫颈癌变的关系及交互作用

目的 探讨脆性组氨酸三联体（FHIT）与甲基-CpG-结合蛋白2（MeCP2）异常表达在宫颈癌变中的交互作用。方法 选择经病理学确诊的宫颈鳞状细胞癌（SCC）患者73例,宫颈上皮内瘤样变（CIN）患者113例（CINⅠ45例;CINⅡ/Ⅲ68例）和宫颈正常（NC）妇女60人作为研究对象,分别采用荧光定量PCR和Western blot检测宫颈组织中FHIT及MeCP2 mRNA和蛋白的表达量,甲基化特异性PCR（MSP）检测FHIT基因CpG岛甲基化状态。利用SPSS 20.0软件进行相关资料的Kruskal-Wallis H检验、χ²检验、χ²趋势检验和Spearman秩相关分析,应用广义多因子降维模型（GMDR）评价交互作用。结果 随着宫颈癌变的进展,FHIT基因CpG岛甲基化率（χ²=18.64,P<0.001,趋势检验χ²=18.08,P<0.001）逐渐升高,FHIT mRNA（H=27.32,P<0.001;趋势检验χ²=12.65,P<0.001）与蛋白（H=47.10,P<0.001;趋势检验χ²=29.79,P<0.001）表达量逐渐降低,且FHIT基因CpG岛甲基化率与FHIT蛋白表达量呈负相关（r=-0.226,P<0.001）。MeCP2 mRNA（H=26.19,P<0.001;趋势检验χ²=11.81,P=0.001）与蛋白（H=69.02,P<0.001;趋势检验χ²=47.44,P<0.001）表达量均逐渐升高。MeCP2蛋白表达量与FHIT mRNA Ct比值呈正相关（r=0.254,P<0.001）,与FHIT蛋白表达量呈负相关（r=-0.213,P=0.001）。GMDR交互作用分析表明,在CINⅡ/Ⅲ组,MeCP2蛋白高表达、FHIT基因CpG岛甲基化及mRNA和蛋白低表达存在交互作用;在SCC组,MeCP2 mRNA和蛋白高表达、FHIT基因CpG岛甲基化及mRNA和蛋白低表达存在交互作用。结论 MeCP2 mRNA和蛋白高表达、FHIT基因CpG岛甲基化及mRNA和蛋白低表达,均可增加宫颈癌变的风险,且在宫颈癌变中具有协同作用。     

β-arrestin2基因多态性与湖南省汉族海洛因成瘾者美沙酮维持治疗反应的关联分析

目的 研究β-arrestin2(ARRB2)基因的3个单核苷酸多态性(SNP)位点rs3786047、rs1045280、rs2036657在湖南省汉族海洛因成瘾者中的分布及其与美沙酮维持治疗反应的相关性。方法 从湖南省美沙酮维持治疗门诊中随机抽取4个门诊,以汉族美沙酮维持治疗者作为研究对象,收集研究对象的一般社会经济学特征、相关吸毒史和美沙酮治疗史资料,测定ARRB2基因多态性位点的基因型以分析SNP位点与治疗反应的关系。结果 ARRB2基因rs3786047、rs1045280、rs2036657 SNP位点在不同治疗反应组基因型分布频率符合Hardy-Weinberg遗传平衡。在治疗反应好与差两组间,rs3786047(χ²=0.4862,P=0.784)、rs1045280(χ²=1.5919,P=0.451)、rs2036657(χ²=1.0615,P=0.588)的基因型频率分布和等位基因频率分布差异无统计学意义。结论 湖南省汉族美沙酮维持治疗人群中尚未发现ARRB2基因单核苷酸多态位点rs3786047、rs1045280、rs2036657与治疗反应有关联关系。     

肿瘤转移抑制基因KISS-1蛋白、基质金属蛋白酶-2和血管内皮生长因子在结肠癌组织中的表达及临床意义

目的 检测结肠癌组织中肿瘤转移抑制基因KISS-1蛋白(KISS-1)、基质金属蛋白酶-2(MMP-2)和血管内皮生长因子(VEGF)的表达,分析其与结肠癌病理特征的相关性。方法 收集2009年1月至2010年6月在潍坊市人民医院60例行结肠癌切除术患者的癌组织标本作为观察组,60例良性结肠疾病手术患者的切除组织作为对照组。采用免疫组织化学法检测KISS-1、MMP-2和VEGF的表达。结果 观察组KISS-1、MMP-2和VEGF阳性表达率分别为31.7%、58.3%和78.3%,对照组分别为73.3%、16.7%和33.3%;观察组KISS-1阳性表达率明显低于对照组,差异有统计学意义(χ²=23.489,P<0.001);观察组MMP-2和VEGF的阳性表达率明显高于对照组,差异有统计学意义(χ²=27.469,P<0.001; χ²=25.817,P<0.001)。KISS-1、MMP-2和VEGF的表达与结肠癌组织学分型和TNM分期均有明显关系,差异有统计学意义(χ²=8.997,P=0.011; χ²=6.163,P=0.013; χ²=8.519,P=0.014; χ²=9.160,P=0.002; χ²=16.577,P<0.001; χ²=10.523,P=0.001)。结论 KISS-1、MMP-2和VEGF检测有助于了解结肠癌分化程度和临床分期,并为判断预后和个体化治疗提供参考依据。     

北京市18~65岁慢性病患者吸烟状态、戒烟态度及危险因素分析

目的 了解北京市18~65岁高血压、糖尿病、血脂异常、COPD、哮喘患者的吸烟状态、戒烟态度及危险因素。方法 数据来源于2014年北京市成人慢性病与危险因素监测,即在北京市16个区/县采用多阶段分层整群抽样方法抽取180个社区共19 815名调查对象,以其中18~65岁人群作为研究对象。结果 18 405例有效样本中,男性高血压、血脂异常患者现在吸烟比例均高于非患者（分别χ²=17.695,P<0.001;χ²=39.292,P<0.001）;女性高血压、COPD、哮喘患者现在吸烟者比例均高于非患者（分别χ²=6.649,P=0.010;χ²=6.276,P=0.012;χ²=8.245,P=0.004）。吸烟者中,高血压患者1年内想戒烟比例低于非高血压患者（χ²=20.487,P<0.001）,COPD患者1年内想戒烟比例高于非COPD患者（χ²=6.085,P=0.048）。男性中糖尿病（χ²=9.219,P=0.010）、血脂异常（χ²=13.513,P=0.001）患者中已戒烟者控制情况好于现在吸烟者。多因素logistic回归结果显示,吸烟是高血压（OR=1.17）、血脂异常（OR=1.25）、COPD（OR=1.78）、哮喘（OR=1.57）的影响因素。结论 北京市18~65岁居民中部分慢性病患者现在吸烟比例高且戒烟意愿低;吸烟是高血压、血脂异常、COPD、哮喘的危险因素。     

河南省2008－2013年男男性行为人群艾滋病流行趋势分析

目的 分析河南省MSM人群HIV感染流行趋势,为河南省艾滋病防治政策与策略制定提供科学依据。方法 分析2008-2013年艾滋病病例报告系统中同性性传播HIV/AIDS病例的变化趋势,利用MSM人群艾滋病综合防治专项调查数据分析该人群HIV感染率及危险行为变化。结果 2008-2013年河南省同性性传播病例构成从1.3%上升到17.1%,呈现快速增长趋势;专项调查数据显示,MSM人群HIV感染率呈现快速上升趋势,从2008年的4.69%增至2013年的8.33%(趋势χ²=39.24,P<0.001).单因素分析结果显示,年龄(χ²=21.03,P<0.001)、文化程度(χ²=31.66,P<0.001)、职业(χ²=14.59,P=0.01)、最近1次肛交行为安全套使用情况(χ²=134.97,P<0.001)、最近6个月同性性行为安全套使用情况(χ²=97.15,P<0.001)、最近1年性病症状(χ²=67.21,P<0.001)以及梅毒感染(χ²=163.60,P<0.001)均为感染HIV的影响因素。多因素分析结果显示,年龄、性病症状史、感染梅毒与艾滋病防治知识不知晓为感染HIV的危险因素。结论 河南省MSM人群中HIV感染呈不断上升趋势,男男同性性传播已经成为主要感染途径,该人群不安全性行为普遍存在,亟需采取有效措施控制HIV在该人群中的传播。     

叶酸与甲基-CpG-结合蛋白2基因表达在宫颈癌变中的关系及交互作用

目的 探讨叶酸和甲基-CpG-结合蛋白2（MeCP2）表达在宫颈癌变中的交互作用。方法 选择经病理学确诊的宫颈鳞状细胞癌（SCC）患者41例,宫颈上皮内瘤样变（CIN）患者71例（34例CIN1和37例CIN2+）及61名宫颈正常（NC）妇女为研究对象。采用微生物法检测血清叶酸和红细胞叶酸水平,Western blot法和荧光定量PCR法检测宫颈组织中MeCP2蛋白和mRNA的表达量。利用SPSS 20.0软件进行相关资料的Kruskal-Wallis H检验、χ²检验、χ²趋势检验和Spearman秩相关分析,应用广义多因子降维模型（GMDR）评价交互作用。结果 随着宫颈病变程度的加重,血清叶酸（H=44.71,P<0.001;趋势检验 χ²=24.48,P<0.001）和红细胞叶酸（H=5.28,P<0.001;趋势检验 χ²=3.83,P<0.05）水平均呈逐渐降低趋势,且血清叶酸和红细胞叶酸水平呈正相关（r=0.270,P<0.001）;MeCP2蛋白（H=33.72,P<0.001;趋势检验χ²=14.74,P<0.001）和mRNA （H=19.50,P<0.001;趋势检验χ²=10.74,P<0.001）表达量随着宫颈病变的进展均呈逐渐升高趋势;叶酸水平与MeCP2蛋白表达量呈负相关（血清叶酸：r=-0.226,P=0.003;红细胞叶酸：r=-0.164,P=0.004）。GMDR交互作用分析表明,在SCC组和CIN2+组,血清叶酸和红细胞叶酸缺乏,MeCP2蛋白高表达与MeCP2mRNA高表达呈现交互作用。结论 叶酸缺乏和MeCP2基因异常高表达可增加宫颈癌及其癌前病变的风险,血清叶酸缺乏、红细胞叶酸缺乏、MeCP2蛋白高表达和MeCP2mRNA高表达在宫颈癌变的发展过程中具有协同作用。     

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。     

Absorption,metabolism and elimination of N,N-dimethylformamide in humans

Summary Excretion of N,N-dimethylformamide (DMF) and DMF metabolites N-hydroxymethyl-N-methylformamide (MF), N-hydroxymethyl-formamide (F) and N-acetyl-S-(N-methylcarbamoyl)cysteine (AMCC) has been monitored in the urine of volunteers during and after their 8-h exposure to DMF vapour at a concentration of 10, 30 and 60 mg · m^–3. The pulmonary ventilation in these experiments was typically about 101 · min^–1 and the retention in the respiratory tract was 90%. After exposure to 30 mg DMF · m^–3, the yield of compound determined in the urine represented 0.3% (DMF), 22.3% (MF), 13.2% (F) and 13.4% (AMCC) of the dose absorbed via the respiratory tract. The excretion curves of the particular compounds attained their maximum 6–8h (DMF), 6–8h (MF), 8–14h (F) and 24–34h (AMCC) after the start of the exposure. The half-times of excretion were approximately 2, 4, 7 and 23 h respectively. In contrast to slow elimination of AMCC after exposure to DMF, AMCC was eliminated rapidly after AMCC intake. This discrepancy could be explained by rate-limiting reversible protein binding of a reactive metabolic intermediate of DMF, possibly methylisocyanate.     

Screening of the municipal water system of La Plata, Argentina, for human intestinal parasites

The La Plata River, though severely contaminated by intestinal parasites through the discharge of tons of crude fecal material from a main sewage channel, nevertheless provides drinking water to two-thirds of La Plata, Argentina, after conventional purification at a processing plant. With intestinal parasitosis being endemic here, we investigated the importance of this water in transmitting such pathogens to the city's populace by means of standard methodology for sample acquisition and processing involving filter-concentration of waterborne particulates. Of 14 tap-water samples collected from the distribution network, 12 pertained to four zones (A-D) within the city center; while the remaining 2 were obtained near the processing plant, 15 kilometers outside the city. Although parasites were found within the samples derived from the four urban zones, none were detected in the specimens obtained near the plant. The four downtown areas differed from each other as to the quantity and nature of the parasites present in their water: whereas zones A and B registered similar lower levels of contaminants, C and D exhibited higher values significantly different from the former two and from each other. Given an average parasite count/l citywide of 0.38 and a probability of encountering a parasite within 11 of water of 0.32, the municipal network is seen to contribute to the transmission of intestinal parasites. A routine system of water-quality control is therefore needed throughout the city along with the establishment of infrastructures for locating and eliminating peripheral sources of contamination.     

DNA relatedness,karyotyping and gene probing of Candida tropicalis,Candida albicans and its synonyms Candida stellatoidea and Candida Claussenii

Isolates of Candida albicans with varied phenotypes, including sucrose-negative variants (C. stellatoidea, serotypes A and B) and avirulent germ tube-negative forms (C. claussenii) showed significant (> 90%) DNA relatedness to classical C. albicans, but insignificant relatedness to C. tropicalis and sucrose-negative C. tropicalis. A transverse alternating-field gel electrophoresis procedure (TAFE) showed discrete karyotype patterns among the phenotypic variants of C. albicans including the sucrose-negative C. stellatoidea. The number of chromosome-sized DNA bands for C. tropicalis (7 bands) were within the range of bands observed for C. albicans (5 to 10 bands). The general DNA-migration pattern for C. albicans appeared distinct from that of C. tropicalis. An aspartyl proteinase (PrA) gene probe from C. albicans hybridized with chromosomal DNA from C. albicans, C. claussenii and C. stellatoidea but not with that from C. tropicalis.     

Arsenic, Cadmium, and Mercury in Cocoyam (Xanthosoma sagititolium) and Watercocoyam (Colocasia esculenta) in Tarkwa a Mining Community

Cocoyam (Xanthosoma sagititolium) and Watercocoyam (Colocasia esculenta) have gained increased importance in the diets of majority of people in developing countries such as Ghana. The concentration levels of arsenic, cadmium, and mercury in Cocoyam (X. sagititolium) and Watercocoyam (C. esculenta) in Tarkwa and its surrounding villages a mining community in Ghana were measured in this study. From the results of the study, the levels of arsenic, cadmium and mercury in X. sagititolium and C. esculenta were higher than the WHO recommended levels. These root tubers absorb or uptake toxic chemicals from the soil as a result of the mining operations. This means that, the consumption of X. sagititolium and C. esculenta by humans from such environments may pose a serious health risk. There is therefore the need for a concerted effort by all to minimize the negative impact of gold mining in the study area.     

Vapor-Phase Toxicity of Butylbenzyl Phthalate to Three Plant Species: White Mustard,Chinese Cabbage,and White Clover

During the manufacture of products containing butylbenzyl phthalate (BBP), low emissions to the air may occur. Due to potential exposure of terrestrial communities to BBP vapors, phytotoxicity tests were conducted using Chinese cabbage, white mustard, and white clover. No significant effects on shoot growth were observed at the higher BBP vapor-phase concentration tested, which measured 5.7 microg/m(3). The overall practicality of vapor-phase testing of chemicals with very low vapor pressures is reviewed. These study results suggest that environmental risk from exposure to BBP vapor is negligible for plants.     

Monitoring of Cryptosporidium and Giardia in the Vantaa river basin, southern Finland

We compared two sampling methods to assess the contamination of the Vantaa river basin by Giardia cysts and Cryptosporidium oocysts: 10-1 grab samples, the common river mussel Anadonta piscinalis, were analysed for concentration of (oo)cysts from river water. The samples were collected 2-5 times in autumn 2001 from four wastewater treatment plants and four river water sites located downstream of the plants, and six times from raw water of a drinking water plant using the river as water source. The presence of Giardia and Cryptosporidium was analysed by IF microscopy and PCR. Both cysts and oocysts were detected at all sampling sites, but oocysts were more common than cysts in river water samples. In contrast, cysts were more common in A. piscinalis. Most Cryptosporidium-positive samples were of genotype 2 and Giardia were assemblage B. In river water, MPN of Escherichia coli did not correlate to the presence of (oo)cysts. In conclusion, low (oo)cyst counts were regularly identified in the Vantaa river basin which is contaminated by discharges of treated wastewater of human origin. In general, both methods to appropriate to detect (oo)cysts, but grab samples yielded more positive results. Grab sampling is also more practical and less expensive than analysis of A. piscinalis.     

Percutaneous absorption of N,N-dimethylformamide in humans

Summary Skin penetration fo N,N-dimethylformamide (DMF) liquid or vapour was studied in volunteers. Exposure to liquid DMF was performed in two ways: in a dipping experiment, one hand was dipped up to the wrist in DMF for 2–20 min, while in a patch experiment, 2 mmol DMF was applied to the skin and allowed to be absorbed completely. The period of exposure to DMF vapour (50 mg · m^–3) was 4 h. The DMF metabolites N-hydroxymethyl-N-methylformamide (MF), N-hydroxymethylformamide (F), and N-acetyl-S-(N-methylcarbamoyl)cysteine (AMCC) were monitored in the urine. Liquid DMF was absorbed through the skin at a rate of 9.4 mg · cm^–2 · h^–1. Percutaneous absorption of DMF vapour depended strongly on ambient temperature and humidity and accounted for 13%–36% of totally excreted MF. The results suggest that skin absorption of liquid DMF is likely to contribute to occupational exposure substantially more than penetration of DMF vapour. The yield of metabolites after transdermal DMF absorption was only half of that seen after pulmonary absorption. Elimination of MF and F but not that of AMCC was delayed, which supports the contention that AMCC should be used instead of MF as the most suitable biomarker of DMF in cases where percutaneous intake can occur.     

Coding and non-coding polymorphisms in VDR gene and susceptibility to pulmonary tuberculosis in tribes, castes and Muslims of Central India

Vitamin D receptor (VDR) plays an important role in activating immune response against various infectious agents. This study was aimed to investigate the association between VDR gene polymorphisms and different clinical forms of pulmonary tuberculosis (TB) in different population groups. Four common polymorphisms (TaqI, ApaI, BsmI and FokI) of VDR gene were studied in clinically diagnosed TB patients and healthy controls from Sahariya tribe (n = 377), Bhil tribe (n = 95), Chhattisgarh tribe (n = 33), general population from North-Central (NC) (n = 1021) and South-Eastern (SE) region (n = 646) and Muslims (n = 217). Genotyping was carried out using PCR-RFLP method and re-confirmed by direct sequencing. The haplotype analysis was performed on Haploview 4.1 and statistical analysis was done using SPSS 13.0 software. We found that bb genotype of BsmI polymorphism conferred significant risk to smear positive and multiple drug resistant (MDR) TB in tribes [OR (CI) = 3.7 (1.5–9.2), p = 0.002], SE population [OR (CI) = 2.1 (1.4–3.3), p = 0.0004] and Muslims [OR (CI) = 6.7 (1.1–39), p = 0.01]. The subjects with FF genotype of FokI polymorphism appeared less likely (p = 0.004) to develop MDR TB in NC population, whereas, those with Ff [OR (CI) = 2.5 (1.3–5.0), p = 0.004] and ff [OR (CI) = 3.4 (1.2–9.3), p = 0.01] genotypes were at high risk of MDR and smear positive disease, respectively. Similarly, tt genotype of TaqI polymorphism was found associated with high risk of smear positive TB in NC [OR (CI) = 3.6 (0.9–14.2), p = 0.05] as well as in SE [OR (CI) = 4.7 (1.8–12.3), p = 0.00003] population. Interestingly, tt genotype appeared strongly associated [OR (CI) = 8.9 (2.7–29), p = 0.00001] with high bacillary load outcome. In conclusion, genetic polymorphisms in VDR gene, alone or in combination (haplotypes) are associated with different clinical outcomes in pulmonary TB.     

应用聚合酶链反应对淋球菌、沙眼衣原体和解脲支原体感染现状的调查

采用聚合酶链反应对北京、汕头、武汉三地区ＳＴＤ门诊共３５５例患者，进行了淋球菌、沙眼衣原体和解脲支原的检测，在三地区ＳＴＤ门诊患者中，淋球菌检出率的居首位，男性患者检出率高于女性患者；沙眼衣原体和解脲支原体的检出率及在ＳＴＤ门诊患者中的构成比，三地区间存在较大区别。聚合酶链反应适用于三种病原体的临床检测和流行病学调查。     

Effects of increasing syringe availability on syringe-exchange use and HIV risk: Connecticut, 1990–2001

Syringe-exchange programs (SEPs) in Connecticut operate with caps on the number of syringes exchanged per visit. We investigated the effects of legislation increasing the cap on drug injectors' access to clean syringes through the SEPs in New Haven and Hartford. The mixed design of this study included longitudinal and crosssectional data from individuals and ecological data from program operations. Five parameters—syringe return rate, syringes per visit to the SEP, syringe reuse rate, syringe human immunodeficiency virus (HIV) prevalence, and syringe sharing—were monitored through syringe tracking and testing of SEP syringes and by interviewing injectors. Two increases in the cap—from 5 to 10 and then from 10 to 30—had little effect on the five parameters that measured injectors' access to clean syringes. In contrast, access to clean syringes increased when the New Haven SEP first began operations, when syringes first became available at pharmacies in Hartford, and when the agency running the Hartford SEP changed. Legislation providing piecemeal increases in the cap may not, by themselves, be sufficient to increase injectors' access to clean syringes and decrease the risk of human immunodeficiency virus transmission in this population.