安徽省丙型肝炎病毒基因型分布

应用逆转录－聚合酶链反应（ＲＴ－ＰＣＲ）和限制性片段长度多态性（ＲＦＬＰ）技术分析安徽省丙肝患者丙型肝炎病毒（ＨＣＶ）基因型。结果表明ＨＣＶ基因型有Ⅰ、Ⅱ、Ⅲ、Ⅳ及Ⅱ／Ⅲ混合型，以Ⅱ型感染（７５．６６％）占优势，其次为Ⅲ型（１３．２３％）和Ⅱ／Ⅲ型（６．３５％），Ⅰ、Ⅳ型各有１例（０．５３％）。安徽省北部地区的ＨＣＶⅢ型多于南部，而Ⅱ型北部则少于南部，不同地理区域ＨＣＶ基因型分布差异有显著性（Ｐ＜０．０５）。有、无输血、血液制品史的丙肝患者间ＨＣＶ基因型分布差异无显著性     

用RT—PCR法分析合肥地区HCV基因型

应用逆转录－ＤＮＡ聚合酶链反应（ＲＴ－ＰＣＲ），对合肥地区的１９５例病人的血清进行了ＨＣＶＲＮＡ检测及基因型分析。结果显示，８０例ＨＣＶＲＮＡ阳性标本中，７０例（８７．５％）为Ⅱ／１ｂ型ＨＣＶ感染，７例（８．８％）为Ⅲ／２ａ型，３例（３．７％）为Ⅱ和Ⅲ型混合感染，未发现Ⅰ／１ａ和Ⅳ／２ｂ型ＨＣＶ感染。     

不同基因型丙型肝炎病毒混合感染者体内丙型肝炎病毒基因型和序列的分布

应用套式ＰＣＲ从一例维吾尔族丙型肝炎病毒（ＨＣＶ）感染者血清〔职业献血员，有多次献血史，无自觉肝炎症状，抗－ＨＣＶ（＋），ＰＣＲ基因分型为Ⅰ／Ⅱ／Ⅲ混合型〕中，扩增出Ｃ区部分基因片段（３５７ｂｐ），将其克隆于Ｔ载体中进行基因型分析，并对不同基因型的Ｃ区片段进行序列测定。随机挑取１５个阳性克隆，进行ＨＣＶＰＣＲ基因型分析，结果其中有１株Ⅰ型，１３株Ⅱ型，１株Ⅲ型。说明在一个Ⅰ／Ⅱ／Ⅲ混合型ＨＣＶ感染者体内，三种不同基因型的ＨＣＶ病毒滴度是不同的，存在以Ⅱ型ＨＣＶ为主的“优势基因型”。将这１５个ＨＣ…     

广西吸毒成瘾者丙型肝炎病毒的感染及其分子生物学研究

选择２８３名静脉吸毒者（ＩＶＤＡｓ）和１２１名献血员（ＢＤｓ）进行Ａｎｔｉ－ＨＣＶ、ＨＣＶ血清基因型、ＨＣＶ基因型和ＨＣＶｃＤＮＡ序列的检测。结果表明，ＩＶＤＡｓ和ＢＤｓ的Ａｎｔｉ－ＨＣＶ检出率分别为９１．１７％和０．８３％；ＩＶＤＡｓ的ＨＣＶ血清基因型为１型８１．８５％（２２１／２７０），２型１．４８％（４／２７０），ｌ＋２型０．３７％（１／２７０），不能定为１和／或２型１６．３０％（４４／２７０）；ＨＣＶ基因型为１ａ型：２８．６％（３４／１１９）；ｌｂ型：３８．７％（４６／１１９）；２ａ型１０．９％（１３／ｌ１９）；２ｂ型１４．３％（１７／ｌ１９）；３ａ型２６．９％（３２／１１９）；３ｂ型４０．３％（４８／１１９）；６ａ型８．４％（１０／１１９）；６ｂ型２６．７％（３１／１１９）；其中１４．３％的病例有４～５种不同基因亚型的混合感染现象。     

青岛地区丙型肝炎病毒基因分型

对青岛地区８６例抗ＨＣＶ阳性肝炎患者血清，采用逆转录－套式基因扩增法（ＲＴ－ＰＣＲ）检测ＨＣＶ，ＲＮＡ，并用多引物扩增进行基因分型，结果，ＨＣＶ·ＲＮＡ阳性５０例（５８．１％），其中ＨＣＶⅡ型４５例（９０．０％），Ⅲ型３例，Ⅱ／Ⅲ混合型２例。说明青岛地区ＨＣＶ基因以Ⅱ型为主，应据此设计预防和治疗措施。     

干扰素治疗丙型肝炎疗效相关因素分析

目的：探讨预测干扰素治疗慢性丙型肝炎（ＣＨＣ）疗效的临床上适用、简便、易行的指标。方法：对采用干扰素（ＩＦＮα－１ｂ）治疗３２例ＣＨＣ临床资料进行观察,包括治疗前后肝功能（ＡＬＴ、ＳＢ、ＧＧＴ）、抗－ＨＣＶＯＤ水平、ＨＣＶ基因型、ＨＣＶＲＮＡ、ＳＩＬ－２Ｒ、β２－ＭＧ等,治疗结束时有效者为肝功能复常同时ＨＣＶＲＮＡ阴转,其余反应模式均为无效者。结果：ＨＣＶ基因型为Ⅲ型患者疗效（５／１０）明显高于Ⅱ型（２／１９）（Ｐ＜０．０５）,有效者治疗前血清抗—ＨＣＶＯＤ明显低于无效者（Ｐ＜０．０５）,治疗后有效者β２－ＭＧ升高水平（３．４５±１．０８）ｍｇ／Ｌ明显高于无效者（１．３３±０．９５）ｍｇ／Ｌ（Ｐ＜０．０５）,而两者治疗前ＡＬＴ、ＳＢ、ＧＧＴ、ＩｇＭ、β２－ＭＧ患者的年龄无明显差别（Ｐ＞０．０５）。结论：感染ＨＣＶ基因型,治疗前抗—ＨＣＶＯＤ水平及治疗后β２－ＭＧ变化对预测ＩＦＮ治疗ＣＨＣ疗效有一定参考价值。     

60例丙型肝炎患者血清丙型肝炎病毒RNA的基因分析

丙型肝炎 (丙肝 )病毒 (ＨＣＶ)全基因或片段基因克隆的序列分析 ,据国内外报道证实至少存在 12种基因型 ,不同国家地区核苷酸有很大差异。目前日本和美国已分离出 4种基因型 ,美国以Ⅰ型为主 ,日本以Ⅱ型为主 ,中国是Ⅱ、Ⅲ型 ,其次是Ⅱ Ⅲ混合型。不同基因型的ＨＣＶ致病性及对干扰素治疗反应不同。我们对克拉玛依地区慢性丙肝患者血清ＨＣＶＲＮＡ进行基因分型的检测 ,了解该地区ＨＣＶ基因型分布情况 ,指导治疗及判断预后。研究对象与方法 :1996年 3月至 2 0 0 0年 9月 ,我院门诊及住院患者的ＨＣＶＲＮＡ阳性血清标本 6 0份 ,其中抗 Ｈ…     

新疆地区维吾尔族人群HCV感染状况及HCV基因型分布调查

对采自新疆地区维吾尔族自然人群、职业献血员、肝硬化、肝细胞癌患者血清分别进行了抗－ＨＣＶＥＬＩＳＡ和ＨＣＶＲＮＡ基因型检测。结果显示：该地区自然人群、职业献血员、肝硬化、肝细胞癌患者抗－ＨＣＶ阳性率分别为２．０％、３５．７％、４２．５％、２０．８％，ＨＣＶ感染者中多数具有输血及献血史，职业献血员、肝硬化和肝细胞癌患者ＨＣＶ感染比例较高。该人群ＨＣＶ基因型以混合型感染（占４９．７％）为主，单一基因型感染以Ⅱ型（占２６．２％）为主，提示当地可能存在严重的不同基因型ＨＣＶ的混合感染。     

广西肝病患者及献血员的HCV Serotype和Genotype的分子生物学研究

选择广西不同地市的肝病患者１０３例（ＡＨ８、ＣＡＨ３６、ＣＰＨ３６、ＬＣ７、ＨＣＣ１６）和献血员３５５例进行Ａｎｔｉ－ＨＣＶ阳性率、ＨＣＶＳｅｒｏｔｙｐｅ和Ｇｅｎｏｔｙｐｅ的分子生物学研究。结果表明：肝病患者Ａｎｔｉ－ＨＣＶ阳性１２例（ＡＨ１／８。ＣＡＨ２／３６。ＣＰＨ９／３６。ＬＣＯ／７、ＨＣＣ０／１６），阳性率为１１．６５％，明显高于同室检测兰州和南京肝病患者的Ａｎｔｉ－ＨＣＶ阳性率４．３％和４．２％（Ｐ＜０．０１）；２４０例献血员中检出Ａｎｔｉ－ＨＣＶ阳性１１例（４．５８％），明显低于同室检测兰州献血员的Ａｎｔｉ－ＨＣＶ阳性率３５．００％（Ｐ＜０．０１）；本文两组的Ａｎｔｉ－ＨＣＶ阳性率也存在显著性差异（Ｐ＜０．０１）。肝病患者组的ＨＣＶＳｅｒｏｔｐｙｅ１型、２型、１＋２型和无法定为１和／或２型者分别为３３．３３％、０、０和６６．６７％；而献血员组的ＨＣＶＳｅｒｏｔｙｐｅ分别为６５．９５％、１．１０％、２．２０％和３０．７７％。此外，肝病患者组的ＨＣＶＧｅｎｏｔｙｐｅ均属ｌｂ型（５０．００％）和ｌｂ混合型（５０．００％）；献血员组的ＨＣＶＧｅｎｏｔｙｐｅ中ｌａ型、ｌｂ型、ｌｂ混合型和无法定为１和／或２     

肝癌高发区丙型肝炎与肝癌关系的流行病学研究

用病例－对照研究方法，探讨肝癌高发区广西隆安县丙型肝炎病毒（ＨＣＶ）与原发性肝癌（ＰＬＣ）的关系。结果显示，丙肝病毒感染标志抗－ＨＣＶ阳性率在肝癌病例组显著于对照组，分别为１１．５％（１０／８７）和１．３％（１／８０）（Ｐ〈０．０１）。抗－ＨＣＶ阳性者的肝癌患者均检出ＨＢｓＡｇ和抗－ＨＢｃ阳性，占ＨＢｓＡｇ阳性肝癌病例的１３．７％（１０／７２）。抗－ＨＣＶ阳性的ＨＢｓＡｇ携带者发生肝癌的相对危险性     

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.     

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.     

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.     

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.     

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.     

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.