河北省2004～2008年乙型流行性感冒病毒监测与血凝素蛋白基因序列分析

目的了解河北省2004～2008年乙型流行性感冒（流感）病毒抗原性的变异及种系分布。方法采用狗肾传代细胞分离流感病毒,经血清学鉴定后提取病毒核糖核酸,经逆转录一聚合酶链反应扩增目的基因后,进行乙型流感病毒的血凝素重链（Heamagglutiningl HA1）基因片段的核苷酸序列测定。结果2004年10月～2008年3月,共分离到乙型流感病毒131株,其中48株为维多利亚（Victoria）系,83株为山形（Yamagata）系。2004～2005年流行期为Yamagata系毒株,2005～2006年流行期为Victoria系毒株,2006～2008年2个流行期都有Yamagata和Victoria系的毒株出现。HA2基因片段核苷酸序列测定结果显示,两个系列的毒株都有小的变异,但Yamagata系毒株变异更明显。2008年分离到的Yamagata系乙型流感病毒与2005年毒株相比已经有8个氨基酸被替代,同源性只有97．4％～98．0％。结论2004～2008年Victoria系乙型流感病毒的抗原性未发生明显的变异,但Yamagata系乙型流感病毒的基因发生变异,使抗原性发生漂移,是2007～2008年流行期引起乙型流感爆发的主要因素。     

宁波市2003年以来乙型流感病毒监测结果与HA1序列分析

目的：了解近年来宁波市乙型流行性感冒病毒流行和抗原性的变异情况及种系分布。方法：采用狗肾传代细胞（MDCK）培养分离流感病毒，经血清学鉴定后提取病毒RNA，经聚合酶链式反应扩增目的基因后进行乙型流感病毒的HA1区域基因片段的核苷酸序列测定。结果：2003～2005年6月共分离到乙型流感病毒22株，血清学鉴定结果除2株为Victoria系的毒株以外，其余20株均为Yamagata种系。在时间的分布上2003及2004年都有Yamagata和Victoria系的毒株出现。血凝素基因重链区（HA1）基因片段的核苷酸序列测定结果，两个系列的毒株都有一些小的变异，但Yamagata系的毒株变异更明显些。2005年分离到的Yamagata系乙型流感与Shanghai／01／2000株相比已经有7个氨基酸被替代，它们的同源性只有97．6％。结论：宁波市乙型流感病毒大多以散发存在为主，抗原性有一定的漂移。     

2006年无锡地区春季暴发流感疫情监测分析

目的了解无锡市流感流行动态,探索暴发和流行规律,为流感防治提供科学依据。方法开展流感监测和疫情流行病学调查,网络实验室用MDCK细胞进行流感病毒分离,用血凝抑制实验对病毒株进行分型鉴定。结果2006年春季本市共报告局部暴发流感疫情11起,流感样病例193例,对7起疫情采集鼻咽拭子标本43份,分离流感病毒26份,分离阳性率为60.47%(26/43),均为乙型流感病毒株(Victoria系)。结论无锡市2006年春季流感暴发主要发生在中小学校,暴发时间集中在2006年的2月中旬至4月中旬,引起流感暴发的毒株为Victoria系乙型流感病毒。     

浙江省乙型流感病毒HA1基因分析

目的：了解浙江省近几年乙型流感病毒的基因变异情况和WHO推荐流感疫苗株对浙江省人体的保护情况。方法：采集浙江省类流感样本进行流感病毒的分离和鉴定，并对分离到的乙型流感病毒进行核酸的提取，采用逆转录-聚合酶链反应（RT-PCR）扩增病毒基因后进行病毒血凝素HA1基因核苷酸序列测定，用DNAMAN和BioEdit生物软件对测序结果进行分析处理，并与WHO推荐疫苗株基因进行比对。结果：分离到Yamagata系和Victoria系两个进化系的乙型流感病毒，两系毒株均未发现核苷酸的丢失和插入，糖基化位点没有太大改变。毒株之间核苷酸的同源性为95.25%，氨基酸的同源性为95.28%。Yamagata系毒株HA1区域核苷酸序列长度为1038 bp，推导的氨基酸序列长度为346个，氨基酸变异替换数在6-8之间；Victoria系毒株HA1区域的核苷酸序列长度为1041 bp，推导的氨基酸序列长度为347个，氨基酸变异替换数在2-8之间，相比Yamagata系毒株在163位上都多1个天冬酰胺（N）。基因进化树上可见明显的Yamagata系和Victoria系两个分支。结论：浙江省人群交替流行着Yamagata系和Victoria系两个抗原性不同的进化系的乙型流感病毒，病毒的基因发生了变异，抗原已发生漂移。2001、2006两年WHO推荐乙型流感疫苗株与我省当年流行株为不同谱系毒株，预防保护效果不够理想，其余年份为同一谱系毒株，预防保护效果较好。     

江苏省一起乙型流感暴发疫情的流行病学分析

目的 了解2006年春季江苏省一起流感疫情的流行病学和毒株的变异情况。方法对一起流感暴发疫情进行流行病学调查，使用荧光定量RT-PCR快速检测病原体，采用MDCK细胞分离流感病毒，用血凝抑制实验对病毒株分型鉴定，对该起疫情的流感毒株进行种系发生分析，并与同一时间的其他地区乙型流感毒株的HAl基因序列进行比较。结果 此起疫情发病人数为357人，发病率为13．2％，23份咽拭子标本中分离出16份毒株，病原为B型Victoria株型流感病毒。基因种系发生树分析证明了它们的HAl基因不同于B／HongKong／330／2001和B／zhejiang／2／2001病毒。结论 2006年春季江苏省人群中流行的乙型流感病毒维多利亚毒株系已发生变异，因此加强流感病毒病原学监测，对于防止流感疫情暴发具有重要意义。     

2006年～2010年无锡地区乙型流感病毒HA基因特性分析

目的：了解无锡地区2006年～2010年流行的乙型流感病毒HA基因变异特点及种系进化分布。方法：取哨点医院送检的疑似流感标本,经MDCK细胞培养、血清鉴定为乙型流感病毒,提取病毒RNA,经逆转录聚合酶链式反应扩增,产物经纯化后,进行血凝素基因HA区核苷酸序列测定并推导出其氨基酸序列,用Bioedit和MEGA version 4.0分析软件进行基因种系进化特性分析。结果：2006年Victoria系毒株为主要优势流行株,2007～2010年Yamagata系和Victoria系同时流行。2010年Victoria系在第163位、174位、203位、269位氨基酸分别转换为Y-C、G-E、Y-G、P-L;2010年Yamagata系在第84位、133位、182位、357位、363位、369位有氨基酸的转换,分别位于G-D、T-D、G-E、L-P、N-Y、K-P。结论：2010年无锡地区人群中流行的乙型流感病毒Yamagata系和Victoria系基因位点有一定的替换,抗原已发生漂移,但不会引起大的流行。     

嘉兴市2011—2012年乙型流感监测与HA1序列分析

[目的]了解2011—2012年嘉兴市乙型流感的流行状况及病毒序列特性、变异特点和WHO推荐流感疫苗株对人体的保护情况。[方法]将采集的流感样病例的咽拭子标本用MDCK细胞培养分离流感病毒,用标准血清及荧光定量RT-PCR方法鉴定。随机选取6株乙型流感病毒株进行HA1基因核苷酸序列测定,并进行特性分析。[结果]2011—2012年嘉兴市乙型流感病毒Victoria系和Yamagata系同时存在。随机抽取4株Victoria系和2株Yamagata系毒株,在糖基化位点上没有变化。4株Victoria系毒株核苷酸同源性为98.6%～99.7%,氨基酸同源性为98.8%～100.0%,其中2株与2009—2012年疫苗株相比,在L58P、N129S、I146V、N171D发生了氨基酸的替换。2株Yamagata系毒株核苷酸和氨基酸同源性为99.4%,与2012—2013年疫苗株极为接近。[结论]嘉兴市流行的Victoria系乙型流感病毒与2009—2012年疫苗代表株同源性较高,当年度的流感疫苗株对本市Victoria系乙型流感病毒流行的防治有一定保护作用。但本地同时也还活跃着Yamagata系的乙型流感病毒,当年度的流感疫苗株对Yamagata系乙型流感病毒不能提供最佳保护。     

2005～2006年宁波市流行性感冒病毒的流行与优势株转换分析

目的：分析2005—2006年宁波市流行性感冒病毒的流行与流感病毒优势株的转换情况。方法：常年监测宁波市流感病毒的流行情况，选取不同时间的各种型别流感毒株进行血凝素基因HA1区核苷酸序列测定，并推导出其氨基酸序列进行基因进化特性分析。结果：2005年1—9月份宁波市的甲型流感以H3N2亚型为流行优势株，而乙型流感在2005年初以Yamagata系占优势。到2005年9月份以后至2006年底甲型流感的H1N1亚型替代了H3N2亚型占据优势株地位，乙型流感也以Victoria系成了优势株。结论：在2005年流感病毒甲、乙型的流行株均发生了亚型或种系的优势转换。流行株的基因特征及抗原性发生了明显的变异，并造成了一定规模的暴发流行。     

1999-2012年浙江省乙型流行性感冒病毒血凝素与三个内部基因的变异分析

目的 探讨乙型流行性感冒病毒(简称乙型流感病毒)分离株血凝素(hemagglutinin,HA)、核蛋白(nucleoprotein,NP)、基质蛋白(matrix protein,M)和非结构蛋白(nonstructural protein,NS)基因的分子变异特征.方法 选取浙江省1999-2012年乙型流感病毒分离代表株31株,进行HA重链区(HA1)、NP、M和NS基因测序,并构建基因进化树,估算此4个基因的核苷酸进化速率并分析其氨基酸变异位点.结果 31株乙型流感病毒分离株在HA1基因进化树上分别处于Victoria系和Yamagata系两大分支,分别以B/Victoria/2/87和B/Yamagata/16/88为代表.2010年之后Victoria系分离株的NP基因与Yamagata系毒株高度同源,处于同一进化分支.估算HA1 、NP、M和NS基因的核苷酸年进化速率分别为2.29×10-3、1.39×10-3、1.78×10-3、1.30×10-3/位点.Victoria系分离株HA1氨基酸重要变异位点主要包括K48E、L58P 、N75K 、K80R、K129N/S、N165K、S172P、S197N/D和A202V,Yamagata系分离株HA1的变异位点包括R48K、S150I、N166Y、N203S、G230D和D233N.2010年之后的Victoria系分离株NP氨基酸序列与Yamagata系毒株类似,与之前的毒株存在4个特征性氨基酸位点的变异,分别为A60D、L233V、N513S和V534I.结论 1999-2012年浙江省乙型流感病毒分离株发生明显变异,表面抗原基因HA1进化速度快于内部基因,基因重配和基因突变是病毒发生变异的主要机制.     

2016年泰州市2起流感疫情的病原学检测及血凝素基因特征分析

目的 对泰州市连续发生的2起呼吸道疫情进行病原学检测和血凝素基因特征分析。方法 采集样本进行PCR快速检测,选取PCR阳性样本进行病毒分离鉴定,从中选取典型病毒培养物进行HA基因序列测定,并进行相关生物信息学分析。结果 样本核酸检测17例B型流感病毒核酸阳性,阳性率70.8％,阳性样品经病原学鉴定为B型Victoria系流感病毒,流感毒株HA基因与该市近期常规监测的Victoria 系毒株、北半球乙型流感疫苗株和来自美国的南半球代表株同源性高,而与该市2007年代表性分离株相比发生很大程度变异。结论 这2起流感疫情均由B型Vicoria系流感病毒引起,泰州市B型流感病毒HA基因暂处于稳态,应加强动态监测。     

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.