徐州市442例艾滋病患者抗病毒治疗效果评价

目的了解徐州市2005—2013年艾滋病患者接受抗病毒治疗的效果。方法利用艾滋病抗病毒治疗系统收集2005—2013年所有抗病毒治疗患者监测数据,分析其治疗前后CD4+T淋巴细胞计数、病毒载量变化、治疗维持时间,对徐州市艾滋病抗病毒治疗效果进行综合评价。结果截止到调查结束,442例接受免费抗病毒治疗患者中有79例死亡;治疗12、24、36月后CD4+T淋巴细胞计数均值均有不同程度的增长(P值均0.05),随治疗时间延长,病毒抑制率逐渐上升(P0.05)。结论目前徐州市艾滋病抗病毒治疗效果明显,艾滋病抗病毒治疗应在CD4+T淋巴细胞计数较高或者症状较轻时开始,同时也要注意患者的服药依从性。     

艾滋病患者抗病毒治疗前后CD4~+T淋巴细胞计数变化

目的分析艾滋病患者抗病毒治疗前后CD4~+T淋巴细胞计数变化,为艾滋病免费抗病毒治疗工作提供依据。方法利用国家"艾滋病综合防治信息"系统收集宁波市鄞州区304例艾滋病患者资料,分析抗病毒治疗前后CD4~+T淋巴细胞计数变化。结果鄞州区304例艾滋病患者基线与治疗3、6、12、24和36个月后的CD4~+T淋巴细胞计数比较,均有不同程度增加(P0.05);在治疗前3个月增幅最大,随着治疗时间延长增幅趋缓。秩相关分析显示,治疗36个月后CD4~+T淋巴细胞计数与基线水平相关(r=0.471,P0.01)。结论高效抗反转录病毒治疗效果明显,早期治疗效果较好,应全面推进早检测、早诊断、早治疗工作。     

晋江市艾滋病患者抗病毒治疗效果评价

目的艾滋病抗病毒治疗可以有效抑制病毒的复制,使人体被破坏的免疫功能逐步恢复,从而延缓病程进展,延长患者生命时间,提高生活质量。本研究旨在了解晋江市艾滋病患者抗病毒治疗现状,评价治疗效果。方法资料来源于泉州市疾病预防控制中心和晋江市医院以及艾滋病防治基本信息系统,从2005-06-01-2017-12-31晋江市陆续有530例艾滋病患者开始抗病毒治疗,按治疗开始日期分成4组,调查随访日期至2018-12-31。随访期间监测CD4~+T淋巴细胞和病毒载量等变化情况,将各组2018年CD4~+T淋巴细胞计数与治疗前基线CD4~+T淋巴细胞计数进行比较分析,记录死亡和退出治疗情况。结果晋江市艾滋病患者接受抗病毒治疗最长时间13年,最短治疗6d,随访过程中死亡43例,退出治疗36例。变更治疗方案124例,主要原因为不良反应104例,占比83.9%。2005-2009年新治疗23例,CD4~+T淋巴细胞平均水平由99.96个/μL上升至575.89个/μL,t=8.509,P0.05;2010-2013年新治疗107例,CD4~+T淋巴细胞平均水平由198.56个/μL上升至496.09个/μL,t=10.532,P0.05;2014-2015年新治疗151例,CD4~+T淋巴细胞平均水平由258.83个/μL上升至486.57个/μL,t=8.556,P0.05;2016-2017年新治疗249例,CD4~+T淋巴细胞平均水平由301.85个/μL上升至476.63个/μL,t=7.452,P0.05;各治疗组2018年CD4~+T淋巴细胞水平比治疗前均有明显上升,差异有统计学意义。2016-2018年病毒抑制率分别为80.70%、68.67%和58.51%。1、3、5和9年生存率为别为91.89%、89.32%、87.69%和86.96%。结论晋江市艾滋病患者抗病毒治疗效果良好。     

山东省50岁及以上HIV感染者和艾滋病患者抗病毒治疗效果分析

目的 分析山东省50岁及以上首次接受艾滋病免费抗病毒治疗的HIV感染者和艾滋病患者抗病毒治疗情况。方法 收集2003-2014年底在山东省内接受艾滋病抗病毒治疗的50岁及以上HIV感染者和艾滋病患者基线和治疗后的相关资料,分析抗病毒治疗效果。结果 共纳入研究对象322例,其中男性占76.7%,女性占23.3%;平均年龄为（56.9±6.4）岁;以已婚或同居者为主,占63.4%;感染途径以异性性传播为主,占54.3%;基线时CD4+T淋巴细胞计数中位数是194.0（83.5～301.0）个/mm3,基线时仅不同感染途径者CD4+T淋巴细胞计数差异有统计学意义（H=14.200,P=0.003）。治疗后不同时间段与基线时CD4+T淋巴细胞计数进行比较,显示差异均有统计学意义（均有P<0.001）,多因素分析结果显示性别和治疗前机会性感染情况是影响治疗效果的因素（均有P<0.05）。治疗后不同时间段病毒完全抑制的比例差异无统计学意义（χ2=2.093,P=0.719）。结论 山东省50岁以上的HIV感染者和艾滋病患者接受艾滋病抗病毒治疗能有效提高机体免疫力,降低病毒载量。     

2009-2011年河南省部分未治疗艾滋病病毒感染者/艾滋病患者的CD4和病毒载量情况分析

目的了解2009-2011年河南省未治疗艾滋病病毒感染者/艾滋病患者的CD4+T淋巴细胞计数和病毒载量状况。方法通过"河南省艾滋病检测实验室数据应用平台"收集2009-2011年河南省部分未治疗艾滋病病毒感染者/艾滋病患者的相关信息以及CD4+T淋巴细胞计数和病毒载量信息,分析比较该人群CD4+T淋巴细胞和病毒载量的中位数和构成比。结果 2009-2011年3年间河南省未接受抗病毒治疗人群的病毒载量变化差异无统计学意义(χ2=3.345,P=0.188),病毒载量在103拷贝/ml和105拷贝/ml两个区间的患者构成比均有所增加(分别为:χ2=7.965,P=0.019和χ2=22.869,P=0.000)。2009-2011年3年间河南省未治疗艾滋病感染者人群的CD4有所升高(χ2=16.567,P=0.000),CD4在200~349个/μl区间的构成比有所减少(χ2=12.236,P=0.002),而在350~499个/μl区间的构成比则有所增加(χ2=10.412,P=0.005)。结论 2009-2011年河南省未治疗艾滋病病毒感染者/艾滋病患者的机体状况有所好转,目前河南省的抗病毒治疗工作要以应治尽治的为基础同时加强关注高病毒载量的患者。     

性传播感染的HIV/AIDS抗病毒治疗CD4~+T淋巴细胞计数和HIV病毒载量结果分析

目的探讨性传播感染的人类免疫缺陷病毒(感染者)/艾滋病(患者)(HIV/AIDS)抗病毒治疗CD4+T淋巴细胞计数和HIV载量变化。方法选取2012年1月—2015年1月凉山彝族自治州第一人民医院就诊的通过性传播途径感染HIV/AIDS 160例,分别使用流式细胞仪和依赖核酸序列的扩增技术(NASBA)方法检测抗病毒治疗前及6个月后CD4+T淋巴细胞计数和病毒载量。结果 1治疗前患者CD4+T淋巴细胞计数为(262.7±21.8)个/μl,治疗后为(316.4±208.9)个/μl,治疗前患者病毒载量为(4.55±0.91)log/ml,治疗后病毒载量为(1.48±0.47)log/ml,治疗前后差异有统计学意义(P0.01);2不同性别、年龄分组研究对象CD4+T淋巴细胞计数和病毒载量治疗前后均有不同;3CD4+T淋巴细胞计数与病毒载量之间呈显著负相关(r=-0.486,P0.01)。结论性传播感染HIV/AIDS抗病毒治疗后CD4+T淋巴细胞计数上升,病毒载量下降,应结合指标变化制定合理方案开展抗病毒治疗。     

淮安市HIV/AIDS抗病毒治疗效果分析

目的评估淮安市人类免疫缺陷病毒(感染者)/艾滋病(患者)(HIV/AIDS)实施免费抗病毒治疗的效果。方法收集2005—2013年在淮安市接受抗病毒治疗的HIV/AIDS的资料,分析治疗前后不同时间的CD4+T淋巴细胞计数以及治疗后病毒抑制率。结果共214例HIV/AIDS接受抗病毒治疗,在治194例,死亡20例。治疗前CD4+T淋巴细胞平均值为(170.1±117.3)个/μl,治疗后3、6个月和1、2、3、4、5年与治疗前相比,CD4+T淋巴细胞计数均有增加(P0.05)。治疗1年后,CD4+T淋巴细胞计数较基线平均增加146.7个/μl,病毒抑制率为81.48%。有94例更换过抗病毒治疗药物,换药原因主要为药物不良。结论淮安市HIV/AIDS抗病毒治疗效果较好,可以有效抑制病毒复制,重建免疫功能,提高患者生存质量。     

111例艾滋病抗病毒治疗近期疗效观察

目的观察艾滋病抗病毒治疗近期效果,探论ART工作经验。方法对2011-01-01/2013-12-30初始抗病毒治疗艾滋病患者111例的临床资料进行回顾性描述,对其CD4+T淋巴细胞、病毒载量的变化进行统计分析,评价治疗效果。结果111例AIDS/HIV坚持治疗96例(86.48%),终止治疗15例(13.50%)、其中死亡8例(7.20%)、药物副反应7例(6.30%);111例AIDS/HIV在抗病毒治疗后CD4+T淋巴细胞计数值上升与基线CD4+T淋巴细胞计数值对比差异有统计学意义(P0.001);在抗病毒治疗6月时有效治疗率为80.95%,免疫、病毒失败率为19.05%;在抗病毒治疗12 h有效治疗率为75.41%,免疫、病毒失败率为24.59%;在抗病毒治疗24月时有效治疗率为73.81%,免疫、病毒失败率为26.19%。结论规范性抗病毒治疗病人终止治疗率死亡率     

69例HIV感染者/艾滋病患者抗病毒治疗效果分析

目的 评价HIV感染者/艾滋病患者(HIV/AIDS)抗病毒治疗效果,为抗病毒治疗提供依据.方法 采用回顾性队列研究方法,对江都区2006年3月-2012年12月加入治疗的69例HIV/AIDS进行随访观察,观察截止于2013年12月.记录随访期间患者CD4+T细胞计数和病毒载量检测数据,及死亡、退出治疗等情况.结果 治疗1年后病毒抑制比例为68.85％;随着治疗时间的延长,CD4+T细胞计数逐渐增长,治疗3年较治疗前平均增长266/mm3;治疗前后CD4+T细胞计数变化差异均有统计学意义(P值均＜0.01);治疗3年生存率为92.74％.结论 HIV/AIDS抗病毒治疗效果较理想,早发现早治疗、扩大治疗覆盖面、提高患者服药依从性可提高治疗效果.     

艾滋病患者抗病毒治疗生存时间分析

目的 了解内江市艾滋病患者抗病毒治疗后生存时间现状,探讨不同治疗方案及基线CD4 +T淋巴细胞计数对生存时间的影响.方法 利用国家艾滋病综合防治信息系统抗病毒治疗内江市治疗数据信息,使用SPSS 17.0进行相关分析.结果 本研究纳入227例患者,截止到2011-12-31,共有40例研究对象死亡,其中92.5％ (37/40)死于艾滋病相关疾病.含AZT方案/d4T方案患者生存率差异无统计学意义,基线CD4+T淋巴细胞计数不同,患者的生存期差异有统计学意义(x2=10.631,P＜0.01).结论 定期监测艾滋病感染人群的CD+ 4T淋巴细胞计数,定期随访观察他们的临床症状,早期对患者开展抗病毒治疗更有利于延长病人的生存时间.     

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.