2009-2012年江西省外环境霍乱弧菌致病力及药敏检测

目的掌握江西省外环境中霍乱弧菌菌型分布、毒力基因、耐药现状,为霍乱防治提供科学依据。方法采用血清学分型法对外环境中分离的霍乱弧菌进行分型,同时以主要毒力基因ctx为引物对检索的霍乱弧菌进行PCR扩增,并应用K-B纸片法对部分菌株进行10种抗生素的药物敏感试验。结果 2009-2012年期间,共从外环境中分离到霍乱菌株156株。毒力实验结果显示37株O139群中15株扩增出与阳性对照一致的毒力基因(ctx)条带,而119株O1群除2株小川型外,其余均未扩增出毒力基因(ctx)条带,与阴性对照一致。药敏结果显示:O139群和O1群对丁胺卡那霉素、诺氟沙星、环丙沙星、头孢噻肟90%以上敏感。结论江西省2009-2012年间外环境中分离到的霍乱弧菌中,O139群与O1群并存,O1群为优势菌;水产品中O139群菌株绝大多数为产毒株,而O1群菌株绝大多数为非产毒株。应重点加强水产品的霍乱监测。药敏结果供霍乱治疗和必要时的预防药物选择提供依据。     

江西省2006-2008年人间霍乱弧菌致病力及药敏检测

目的掌握江西省人群中霍乱弧菌菌型变迁、毒力基因、耐药情况,为霍乱防治提供科学依据。方法采用血清学分型法对人群分离的霍乱弧菌进行分型,同时以主要毒力基因ctx为引物对分离的霍乱弧菌进行PCR扩增,并采用改良K-B纸片法对部分菌株进行10种抗生素的药物敏感试验。结果 2006-2008年期间,共从人群中分离到霍乱菌株139株(O139群136株,O1群小川型3株),其中从患者中分离到O139群41株、O1群小川型1株;从密切接触者中分离到O139群95株、O1群小川型2株。毒力实验结果显示O139群中除1株外,其余的均扩增出与阳性对照一致的毒力基因(ctx)条带,而O1群小川型均未扩增出毒力基因(ctx)条带,与阴性对照一致。药敏结果显示:O139群和O1群小川型霍乱弧菌均对利福平、丁胺卡那、氟哌酸、环丙沙星、头孢噻肟100%敏感,耐药性在90%以上的药物是四环素、强力霉素。结论江西省2006-2008年间人群中分离到的霍乱弧菌中,O139群与O1群小川型并存,O139群为优势菌;O139群菌株绝大多数为产毒株,小川型均为非产毒株。药敏结果供霍乱治疗和必要时的预防药物选择提供依据。     

2008年衡阳市水产品霍乱弧菌监测及药敏结果报告

目的 对水产品中霍乱弧菌进行实验室鉴定、毒力基因(ctxA和TcpA)检测及药敏分析. 方法 细菌的分离、鉴定和药敏试验按照卫生部疾病控制司<霍乱防治手册>(第5版)1999提供的方法进行;用PCR方法对霍乱弧菌的ctxA和TcpA 2种毒力基因进行检测. 结果 从277份水产品中检出1株小川型霍乱弧菌、1株稻叶型霍乱弧菌和7株O139血清群霍乱弧菌,阳性率3.25%;1株O139血清群霍乱弧菌毒力基因ctx A阳性,TcpA阴性,其它菌株的毒力基因ctxA和TcpA均为阴性;9株霍乱弧菌菌株对15种药物的敏感度完全一致,其中耐药的抗菌药物有复方新诺明、四环素、链霉素等3种,敏感的抗菌药物有诺氟沙星、环丙沙星、丁胺卡那霉素、庆大霉素等8种,中敏的抗菌药物有强力霉素、红霉素等4种. 结论 在霍乱防治工作中应密切监测水产品中霍乱弧菌的药物敏感性以及携带毒力基因的情况;诺氟沙星、环丙沙星、丁胺卡那霉素等抗菌药物可作为抗菌治疗和预防性服药的首选药物,而复方新诺明、四环素和链霉素则不应被选用.     

广东省2011—2013年腹泻病例非O1/O139群霍乱弧菌耐药性及分子特征

目的分析2011—2013年广东省腹泻病例非O1/O139群霍乱弧菌的耐药性及分子特征,为霍乱防控提供依据。方法选取2011—2013年广东省腹泻病例非O1/O139群霍乱弧菌分离株20株,以及同时期海水产品分离株4株,采用抗菌药物敏感试验、毒力基因PCR检测和脉冲场凝胶电泳(PFGE)分子分型方法,分析其耐药性及分子特征。结果抗菌药物敏感性试验结果显示,分离株对复方新诺明、萘啶酸和四环素的耐药率分别为70.8%(17/24),37.5%(9/24)和20.8%(5/24);对头孢曲松和阿米卡星则完全敏感。毒力基因PCR检测结果显示,所有的菌株均携带hly A和toxR基因,而所有菌株均未检出ctxA、tcp A、ace、zot、st等5种毒力基因。菌株经NotⅠ酶切后的PFGE型别表现出明显的多样性,病例菌株与海水产品分离株的带型差别较大。结论广东省非O1/O139群霍乱弧菌毒力基因和遗传特征复杂多样,菌株对多种抗菌药物高度耐药,耐药率较高,需加强腹泻病例中非O1/O139群霍乱弧菌的菌株型别变异及耐药监测。     

海宁市霍乱病原学调查检测

目的:为了查清我市水体等外环境及患者中霍乱弧菌的菌型分布特征、毒力基因、药敏等,为霍乱防控提供科学依据。方法:采用GB15984-1995附录A、C及《霍乱防治手册》第五版中有关要求进行调查检测。结果:从外环境标本和患者中共检出霍乱弧菌83株,经血清学鉴定分型,其中:O1群埃尔托霍乱弧菌(Vibriocholerae serotypeO1,b iotype E ltor,EVC)稻叶型38株,占45.78%,O1群EVC小川型16株,占19.28%,O139群霍乱弧菌29株,占34.94%。23株霍乱弧菌噬菌体生物分型以O1群EVC稻叶型1 f居多,占86.96%(20/23);14株霍乱弧菌毒力基因检测结果均为阳性(携带ctx,ace,zot 3种毒力基因);药敏试验O1群、O139群霍乱弧菌对抗菌药物均有不同程度的耐药,其中对磺胺的耐药率高达100%;对头孢噻肟、诺氟沙星、丁胺卡那霉素敏感率高达100%。结论:河水中菌型复杂,O139群、小川、稻叶三型并存,但以O139群为主,占48.94%;井水中检出4株埃尔托霍乱弧菌均为稻叶型;甲鱼塘水中O139群与O1群小川型并存;患者中以O1群EVC稻叶型为主,占88.24%(15/17)。经噬菌体生物分型,以不常见流行株为主,毒力基因检测均为产毒株。     

非O1/非O139群霍乱弧菌感染病例分离株分子流行病学分析

目的 分析安徽省马鞍山市连续2个月内监测到的6例具有霍乱疑似症状、感染非O1/非O139群霍乱弧菌的病例,判断疫情的聚集性.方法 对病例分离株进行生化和血清型别鉴定以及溶血试验,药敏试验检测抗生素耐药谱,应用荧光PCR和常规PCR进行霍乱弧菌特异基因、毒力及其相关基因的检测,包括ompW、ctx 、tcpA、toxR、hlyA 、zot、ace、rstR和gⅢCTX,应用脉冲场凝胶电泳(PFGE)分析其分子型别.结果 生化鉴定和血清学试验鉴别腹泻病例6株菌株为非O1/非O139霍乱弧菌,均产生β溶血;14种药物中有12种属于全部敏感;荧光PCR检测霍乱弧菌特异性基因ompW均为阳性,ctx、tcpA 、zot、ace、rstR和gⅢCTX基因均为阴性,toxR 、hlyA基因有5株菌扩增阳性,1株菌(1001434446)为阴性;PFGE显示6株菌带型均不相同,但有2株非常相似,分离株与霍乱弧菌产毒株相似性很低.结论 6例感染非产毒的非O1/非O139群霍乱弧菌病例发病虽相对集中,但属于散发病例,在局部地区频繁出现,提示其公共卫生意义不可忽视.     

龙泉市首例O139群霍乱弧菌耐药性及毒力基因携带情况研究

目的：研究龙泉市首例O139群霍乱弧菌耐药性及毒力基因携带情况。方法：运用药敏试验及PCR方法．分要该霍乱弧菌的耐药性以及携带ctxA、tcpA毒力基因的情况。结果：该O139群霍乱弧菌对庆大霉素等9种抗生素多重耐药：仅对丁胺卡那、诺氟沙星和环丙沙星敏感；该O139群霍乱弧菌携带ctxA、tcpA毒力基因。结论：在对O139群霍乱弧菌引起霍乱的防治工作中应密切监测其耐药性以及携带毒力基因的情况。     

2005年上海市霍乱弧菌菌株表型及ctxA毒力基因分析

目的：分析本市2005年不同来源01群和0139群霍乱弧菌菌株表型和ctxA毒力基因特征。方法：以PCR方法，对所有菌株进行ctxA毒力基因检测。采用WHO推荐的改良K—B纸片法，对所有菌株均进行了12种抗菌药物的药敏试验。结果：从病人和外环境中分离出的0139群霍乱弧菌均为产毒株；从病人中分离出的01群霍乱弧菌流行株均产毒，外环境中分离出的非流行株少数也产毒。0139群霍乱弧菌菌株耐药谱较01群霍乱弧菌菌株广；两者对氨苄青霉素、强力霉素、庆大霉素、复方新诺明、利福平耐药率有显著差异。结论：本市2005年霍乱的流行株都是产毒株，但产毒株不一定是流行株。药敏结果显示，对01群和0139群霍乱弧菌应采取不同抗菌治疗，0139群霍乱弧菌多重耐药应引起重视。     

四川省2005年霍乱分子流行病学特征

目的：分析四川省2005年霍乱弧菌分子特征,以及霍乱暴发疫情分离的菌株与菌株之间,疫情分离的菌株与海、水产品监测分离的霍乱弧菌之间的遗传相关性,查找霍乱传染来源,为预测疫情和制定防治措施提供依据.方法：利用聚合酶链反应（PCR）检测O139群霍乱弧菌特异性编码脂多糖基因（LPS）和霍乱毒力基因（ctxAB）;脉冲场凝胶电泳对菌株进行分子分型,所得结果以BioNumerics V4.0软件UPGMA方法进行聚类分析.结果：所试16株霍乱弧菌14株LPS阳性,为O139群霍乱弧菌;另2株为O1群稻叶型霍乱弧菌.2株稻叶型霍乱弧菌和1株O139群霍乱弧菌ctxAB阴性,其余13株菌均具有ctxAB,为产毒株.对16株菌以NotⅠ酶切后PFGE可分为5个型别.O139群霍乱弧菌优势流行株与从甲鱼分离的O139群霍乱弧菌PFGE型别一致,且同为产毒株.结论：甲鱼等海、水产品被O139群霍乱弧菌污染情况严重,甲鱼中分离的O139群霍乱弧菌与霍乱疫情分离菌株之间高度同源,被污染的甲鱼可能是本年度食源性霍乱暴发的主要传染来源之一,海、水产品的监测是近期霍乱防控的重点.     

5株O139群霍乱弧菌生物学性状研究

目的研究从病人和水产品中分离到的5株O139群霍乱弧菌的生物学性状。方法参照《霍乱防治手册》对5株菌的生长特征、生化特征、血清学反应及药物敏感性进行鉴定；应用多重PCR方法对所试菌株进行毒力相关基因检测，用Vero细胞测定方法检测ctxA阳性菌株霍乱肠毒素的表达。结果5株O139群霍乱弧菌生物学性状和血清学反应与阳性对照菌体O139群霍乱弧菌MO45基本相同；2株来自重型病人和1株来自水产品的菌株ctxA、zot、ace、tcpA、tcpI、hlyA、rtxA、rtxC、ompU、tarR 11种毒力相关基因全部阳性。经Vero细胞测定，其霍乱肠毒素效价达到1：160；在2株来自轻型病人的菌株中仅hlyA、rtxA、rtxC、toxR 4种毒力相关基因为阳性。结论O139群霍乱弧菌致病(泻)的决定基因簇并非仅为ctxA、zot、ace、cep等毒力相关基因。     

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.     

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.