聚合酶链反应检测水痘带状疱疹病毒DNA

水痘带状疱疹病毒（VZV）是引起人类水痘、带状疱疹的病原体。前几年我们曾建立了VZV蚀斑减少中和试验，VZV抗体ELISA及IFA等检测方法。本文使用PCR检测VZV—DNA，取得了较好的结果，现报告如下：     

空斑减少中和试验测定血清抗乙脑病毒抗体

目的：对比空斑减少中和试验与反向被动血凝抑制试验在评价人血清抗乙脑病毒抗体时间定结果的异同。方法：对450名6－10岁儿童接种灭活乙脑疫苗前后的血清样本用两种方法进行了测定。结果：两种方法在测定免前人血清抗乙脑病毒抗体时存在显性差异，在测定免后人血清抗乙脑病毒抗体时两没有差异。结论：空斑减少中和试验比反向被动血凝抑制试验在测定人血清抗乙脑病毒抗性时灵敏。     

一起水痘爆发的病毒分离鉴定及血清学分析

目的对上海市闸北区2007年一起水痘爆发进行病原学鉴定和血清学分析。方法对采集的双份血清用酶联免疫吸附试验进行水痘-带状疱疹病毒（Varicella-zoster Virus,VZV）IgM和IgG抗体检测,采用疫苗生产用的VZV敏感细胞--人胚肺成纤维细胞（MRC-5）,对采集的疱疹液进行病毒分离以及标准血清中和鉴定,并通过特异性的引物对病毒分离株进行聚合酶链反应（Polymerase Chain Reaction,PCR）扩增。结果采集到的5例病人的双份血清中,急性期血清IgM阳性2份,IgG阳性1份,灰区2份;恢复期血清IgG均为阳性,其中4份标本IgG抗体滴度≥4倍升高。从采集的5份疱疹液标本中均分离到致细胞病变的病毒,经VZV标准血清中和鉴定,证实为VZV。PCR扩增产物电泳结果显示,在目的条带处均有单一的特异性条带。结论该次爆发是由VZV引起的,水痘减毒活疫苗（Varicella Virus Attenuated Live Vaccine,VarV）的作用已被证实,但该次水痘爆发中,47.4%的患者在出生后3年内曾接种过国产或者进口VarV,应深入研究VarV的免疫策略。     

肾综合征出血热病毒快速荧光灶抑制试验

报道一种新的HFRS病毒中和抗体检测方法──快速荧光灶抑制试验的建立。方法：病毒和细胞同时加入塑料微孔板上，37℃培养24小时后，经固定和荧光染色，即可在荧光显微镜下判定结果。结果：检验的4株病毒能在Vero－E6细胞上形成荧光灶；接种病毒的浓度与荧光灶里直线关系。用此法检测Z10单价和双价灭活疫苗免疫的20份兔及人血清的中和抗体，与空斑减少中和试验的结果相一致。结果：此法具有快速、简便、敏感、稳定的特点。     

水痘纯化疫苗候选毒株在Veto细胞上的适应传代及其免疫原性研究

目的：证实VZV1毒株粗制纯化灭活疫苗免疫效果。方法：将VZV1毒株在Vero细胞上进行适应传代，收集感染细胞后，经洗涤、破碎细胞、过柱纯化、粗制疫苗免疫家兔、采集血清测定中和抗体。结果：家兔免疫二针后血清中和抗体达1：5～1：10。结论：以VZV1为毒株粗制疫苗免疫家兔能获得保护性抗体。     

2002年福建省急性出血性结膜炎病原分离和鉴定

[目的]查明2002年我省急性出血性结膜炎(AHC)流行的病原。[方法]采集福州和漳州市临床诊断为AHC的患者眼拭子57份、双份血清7份。分别用Hep-2和Vero细胞对标本进行病原分离；用免疫血清微量中和试验对分离出的毒株进行鉴定；用诊断血清鉴定的4株病毒，对7例患者的双份血清进行中和抗体效价测定。[结果]从57份眼拭子标本中分离出47株(阳性率82．5％)；经诊断血清微量中和试验鉴定，均为柯萨奇病毒24变异株(CA24v)；7例患者双份血清经微量中和试验测定，中和抗体均呈≥4倍增长。[结论]CA24v是引起2002年我省AHC流行的病原。     

不同剂量甲型肝炎减毒活疫苗免疫原性与免疫持久性观察

目的：观察不同剂量的甲型肝炎（甲肝）减毒活疫苗免疫原性与免疫持久性。方法：对河北省正定县4个村166名6－8岁事先经血清检测抗－HAV阴性的易感儿童,按村分成4组,分别给予0.5、1、2及2剂经60℃3h灭活处理的甲肝减毒活疫苗（滴度为10^6.52TCID50）。并于接种后3、12、24、36及48个月采集观察对象血清,采用Abbott-IMx mEIA试剂检测血清抗－HAV。并对接种1剂、2剂活疫苗组免后4年部分血清检测中和抗体。结果：免后3个月抗体阳转率、抗体几何平均滴度（GMT）同疫苗滴度呈剂量效应关系。免疫各组抗体水平于免疫后3个月达高峰后逐年下降,12个月内下降较明显,12个月后下降缓慢。免疫后4年接种2剂活疫苗组抗体阳性率与GMT均高于接种0.5剂及1剂组。接种1、2剂活疫苗组部分经Abbott-IMx mEIA试剂检测抗－HAV阴性的血清检测中和抗体,其阳性率为60％及83％。结论：甲型肝炎减毒活疫苗的免疫原性与免疫持久性同疫苗的滴度有关,滴度为10^6.83TCID50的减毒活凤苗具有较理想的免疫原性及免疫持久性。减毒活疫苗接种后近期内不必予以加强免疫。     

贵州省成人流行性乙型脑炎病毒中和抗体水平调查

  目的  调查贵州省成人流行性乙型脑炎（乙脑）病毒中和抗体水平。  方法  采用多阶段随机抽样的方法,在2017年5~6月采集3个市（州）6个年龄组健康成人血清共360份,应用蚀斑减少中和试验法检测乙脑病毒中和抗体。  结果  360名调查对象中乙脑病毒中和抗体阳性率为55.28%,几何平均滴度（GMT）为1 ∶17.52。不同性别（χ2=10.798,P=0.001）、不同发病率地区（χ2=6.090,P=0.048）成人乙脑病毒中和抗体阳性率差异具有统计学意义（均有P<0.05）;不同年龄成人乙脑病毒中和抗体阳性率在45.00%~60.00%之间（χ2=4.236,P=0.516）;不同民族中,布依族成人乙脑病毒中和抗体阳性率最高（79.17%）。  结论  贵州省成人乙脑病毒中和抗体水平较低,存在成人乙脑流行风险。     

口服脊髓灰质炎疫苗免疫儿童对四川Ⅰ型脊髓灰质炎病毒的抗体水平

目的：为了解我国口服脊髓灰质炎（以下简称脊灰）疫苗（OPV）按现行免疫程序接种后，被免疫儿童对四川1型脊灰病毒的免疫水平，以指导预防、控制乃至消灭脊灰策略的制定。方法：应用微量中和试验方法检测血清中对三种毒株的中和抗体滴度。结果：儿童基础兔疫后对三种毒株Sabinl、Mahoney、四川株的阳性率为100％，免后GMT分别为1196．8、317．9、62．9。结论：免疫儿童对四川Ⅰ型脊灰病毒抗体的GMT较SabinⅠ型和Mahoney低．但OPV能诱生抗四川株的抗体，OPV对四川Ⅰ型脊灰病毒是有效的。     

双价肾综合征出血热灭活疫苗加强免疫后中和抗体反应

目的：双价肾综合征出血热（ＨＦＲＳ）灭活疫苗基础全程３针免后１年半加强１针免疫,观察两型的中和抗体反应水平。方法：对免疫志愿者加强免疫前和免疫后２０d采血,以空斑减少中和试验（ＰＲＮＴ）检测血清中ＨＦＲＳⅠ型（７６－１１８）和Ⅱ型（ＳＥＯＶ）中和抗体。结果：血学检测加强免疫后Ⅰ型中和抗体滴度ＧＭＴ１：２８．２９,Ⅱ型中和抗体滴度为１：３２．４９,比加强免疫前两型中和抗体滴度高３－１０倍。结论：加强免疫实属必要。     

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.