江苏省宜兴地区丙型肝炎病毒基因分型研究

目的了解江苏省宜兴地区丙型肝炎病毒（HCV）基因型分布特征和病毒变异情况。方法对宜兴市人民医院收治的158例HCV抗体阳性患者血清进行HCV RNA检测，对阳性标本进行Simmonds分型，采用5’非编码区（5’NCR）1、2、3、1b型特异性引物进行PCR扩增，并对1b型和2型各1株的PCR产物测序验证。分析不同性别、临床类型的丙型肝炎患者基因型分布差异。结果158份血清中，有95份为HCV RNA阳性，其中1b型80份（84．2％），2型5份（5．3％），1b／2型的混合感染5份（5．3％），不能分型的5份（5．3％），1b型的序列与GenBank J-4株的同源性为99．2％，2型与GenBank J-6株的同源性为97．7％。男性和女性在基因型总体分布上存在差异（P〈0．05），并且在单一型感染和混合型感染的分布上差异亦有统计学意义，不同临床类型的丙型肝炎中HCV基因型分布未显示差异。结论江苏省宜兴地区HCV以1b型为主，男女患者HCV基因型分布差异有统计学意义，而不同临床类型的HCV基因型分布无显著差异，基本反映了本地区HCV感染的特点。     

丙型肝炎病毒窗口期感染核酸阳性血清检测和基因型别分析

目的分析丙型肝炎病毒（HCV）早期感染血液样品核酸（RNA）检测的意义，并对检出的核酸阳性血清进行基因分型。方法对8649份自然供血员及566份HCV可疑感染者血清进行核酸（TMA RNA试剂）检测，检测出的HCV RNA阳性样品利用基因分型芯片进行分型。同时利用HCV核心总抗原（HCVc Ag）和游离抗原（HCV free Ag）试剂以及抗体（Anti—HCV）试剂进行检测。并对检测数据进行比较分析。结果在所有血液样品中发现1份HCV抗体、HCVc Ag、HCV free Ag全部阴性但RNA阳性的样品，基因型别为1b型。在8649份自然供血员血清中筛出1份HCVc Ag、HCV free Ag以及HCVRNA阳性但抗体阴性血清，基因型别为1b型。在566份HCV可疑感染者血清中，筛出1份HCV free Ag和核心抗体同时阳性血清，基因型别为1b型。TMA试剂筛出5份RNA阳性血清但微粒子抗体试剂检测阴性，TMA试剂筛出6份RNA阳性的血清而酶标抗体试剂检测阴性。这6份血清，利用傲拓HCV总抗原试剂检测，其中5份HCV总抗原阳性。在澳大利亚国家血液中心进行复核，其中5份RNA阳性。在566份血清中，TMA试剂检出RNA阳性495份，阳性率87．4％。对RNA阳性血清进行型别分析，以1b、2a型为主，分别为46．5％和27％。结论由于检出了HCV RNA单独阳性的窗口期样品，认为利用HCV抗体试剂对血液进行筛查的同时，使用HCV RNA试剂做必要的补充实验，可以减少因窗口期造成的漏检。型别分析认为，窗口期感染样品基因型别也以1b，2a型为主。     

丙型肝炎病毒基因分型与肝病程度关系的研究

目的探索丙型肝炎病毒（HCV）基因型在辽宁省大连地区的分布及流行的优势型,并探讨HCV基因型与肝病程度的关系。方法采用型特异性引物逆转录巢式PCR法和限制性片段长度多态性分析（RFLP）法对85例抗-HCV阳性的慢性丙型肝炎、丙肝肝硬化、丙肝相关肝癌病人进行HCV的基因分型。结果85份抗HCV阳性标本中,HCVRNA检出率为61例,占71．76％（61／85）。在85份抗HCV阳性血清中,仅检出了61例1b和2a型感染者,其中1b型32例,占52％（32／61）;2a型29例,占48％（29／61）。结论大连地区基因型为1b型和2a型两种型,符合中国丙肝病毒基因分型,大连地区1b型和2a型基本相等。未发现1b和2a基因型因肝病严重程度而有所不同。     

广东地区丙型肝炎患者几种常见HCV基因型的快速检测

目的快速准确检测广东地区广泛分布的主要HCV基因型，为HCV的临床诊断和治疗提供依据。方法收集53例HCV—RNA阳性血清标本，选取丙型肝炎病毒（HCV）基因组保守序列为扩增靶序列，设计通用引物和特异型别探针（1，2，3，6型），通过逆转录将RNA逆转录为cDNA后，利用通用引物对cDNA进行PCR扩增，将扩增产物利用反向点杂交（RDB）技术进行基因分型。结果HCVRNA阳性血清53例，共检出标本52例，4种基因型所占的比例为1b型32例占60．38％，2a型4例占7．55％，3b型8例占15．09％，6a型8例占15．09％。结论所测患者的HCV基因型分布以1b为主，6a和3b次之，2a相对较低；反向点杂交技术能对其进行快速分型，符合率高达98．11％。     

青岛地区丙型肝炎病毒基因型分布情况调查

为了解青岛地区丙型肝炎病毒（HCV）基因型分布情况，采用逆转录－套式聚合酶链反应和限制性片段长度的多态性分析方法。对154份HCV－RNA阳性血清进行了HCV－5’末端非编码区酶切分型，结果：HCVⅡ型占82．5％，HCVⅢ型占16．9％，Ⅱ/Ⅲ混合型占0．6％，在各临床类型中，HCVⅡ型的感染率随着肝病的进展而逐渐增加，提示：HCV Ⅱ型为青岛地区HCV感染的优势株，并且与肝病的进展密切相关，今后在丙肝的诊断，治疗及疫苗开发等研究方面，应将HCVⅡ型作为重点。     

北京地区不同人群HCV感染状况及其基因调查

为了解北京地区不同人群HCV感染状况及其基因型．对来自北京地区不同人群1072份血清分别进行了抗HCVELISA和HCVRNA基因型检测。结果显示．该地区自然人群、急性肝炎、慢性迁延性肝炎、慢性活动性肝炎、肝硬化和肝细胞癌患者中抗-HCV阳性率分别为1．7％、8．3％、12．4％、27．6％、38．1％及20．7％，HCV感染者中有56．4％具有输血、献血及使用血制品史．提示经血传播是该地区HCV的主要感染途径.该地区人群HCV基因型分布以Ⅱ型为主（77．4％）．其次为Ⅲ型（17．8％）．并有少量ⅡⅢ混合型（4．8％）。     

维汉族儿童青少年HBV／HCV重叠感染的实验研究

采用PCR等多种实验诊断方法，探讨了维汉族儿童青少年HBV／HCV重叠感染的血清学模式及临床特点。研究结果表明，两民族均以抗HBs／抗HCV双阳性感染模式最常见，其比率分别为45．16％（14／31）和47．69％（31／65），且该感染模式HCVRNA阳性检出率和ALT异常率亦较高。提示若单项抗HBS阳性伴ALT轻中度升高，应进一步检测抗HCV和HCVRNA，以确证是否为HBV／HCV重叠感染。     

丙型肝炎病毒3''非编码区准种研究

目的获得中国大陆1b型丙型肝炎病毒（HCV）3’非编码区（3’UTR）全长序列，探讨在丙型肝炎病毒3’非编码区（高变区）是否存在复杂的准种特性。方法利用逆转录套式聚合酶链反应（RT—PCR）限制性内切酶长度多态性分析（RFLP）初步筛选出6例1b型HCV感染者，采用半套式RT—PCR法扩增出约400bp的cDNA片段，每例选择12-15个克隆测序。结果每例获得了5～8株全长1b型HCV3’非编码区克隆，由高变区，Poly（u）区，Poly（u／c）区及98碱基区四部分组成；各克隆中序列变异位点主要分布于高变区，Poly（u／c）区，核苷酸同源性0．2％～2．1％，呈现明显的准种分布特征。结论在丙型肝炎病毒3’非编码区（高变区）存在复杂的准种特性。     

江苏省宜兴地区丙型肝炎病毒F蛋白抗体检测

目的检测江苏省宜兴地区丙型肝炎（丙肝）患者血清丙肝病毒（HCV）-F抗体及其分布。方法利用基因重组获得的HCV—F／GST蛋白作为抗原，包被酶联反应板，ELISA间接法检测120例丙肝患者、15例乙肝患者、3例戊肝患者及10份正常人血清HCV—F抗体，结合丙肝患者的临床资料及疾病特征，统计分析HCV—F抗体的分布情况及与HCV感染的关系。结果120例丙肝患者血清HCV—F抗体阳性82例，阳性率68％，而15例乙肝、3例戊肝患者及10份正常人血清标本均未检出阳性；资料分析显示HCV—F抗体阳性率与HCV患者年龄、临床类型之间差异有统计学意义，51岁以上年龄组的HCV—F抗体阳性率是20～50岁组的6．675倍（95％CI：2．407～19．071），并且随着病程进展，阳性率也随之增高（OR=2．749，95％CI：1．470～5．141）。结论江苏省宜兴地区HCV感染者血清中存在HCV—F抗体，并可能与病程相关。     

苏州市丙型肝炎病毒基因型分析

目的了解苏州市丙型肝炎病毒(HCV)基因型的分布特征,为丙型肝炎防控提供参考。方法收集112份HCV抗体阳性血清样本,通过核酸液相芯片法进行基因分型,分析HCV基因型的组成及其与性别、年龄和地域的关系。结果苏州市HCV基因型有1a、1b、2a、3a、3b、6a和1b+2a混合感染,1b型占32.20%,其次为2a型占25.00%,未见4型和5型;男性明显高于女性组,差异有统计学意义(P0.01)。结论苏州地区HCV基因型呈多样性,以1b型为主。     

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.