平南县250名吸毒人员HIV、HCV、和梅毒感染状况分析

目的:通过对平南县社区和强制戒毒所吸毒人员抗-HIV、抗-HCV、梅毒抗体检测,了解吸毒人群HIV、HCv、和梅毒感染状况及相关危险因素,为预防控制这些疾病在该人群的流行提供科学依据.方法 :于2010年4至7月,对平南县社区和强制戒毒所吸毒人员采集血液标本进行抗-HIV、抗-HCV、梅毒抗体检测,并对结果进行统计和分析.结果 :共调查250名吸毒者,其中197名来自社区、53名来自强制戒毒所,吸毒人员的高危行为普遍,存在引起血源性疾病流行的高危行为.HIV感染率为24.4%(61/250),HCV感染率为81.2%(203/250),梅毒感染率4%(10/250).注射吸毒者与非注射吸毒者HIV感染率分别为28.1%(59/210)和5%(2/40)、HCV感染率分别为87.6%(184/210)和45%(18/40)、梅毒感染率分别为3.8%(8/210)和5%(2/40).结论 :应及早对吸毒人群开展健康宣传教育和减少危害的行为干预等综合性防制措施,以减少HIV、HCV、和梅毒在该人群中的传播和扩散.     

上海市宝山区2010—2016年吸毒人群HIV、丙肝和梅毒感染情况及影响因素分析

【目的】了解上海市宝山区吸毒人群中艾滋病病毒(HIV)、丙型病毒性肝炎(丙肝)及梅毒感染情况及其影响因素,为在该人群中开展高危干预提供参考依据。【方法】对2010—2016年新进入宝山区戒毒所和社区招募的吸毒人员进行问卷调查,采静脉血进行HIV、梅毒和丙肝抗体检测。【结果】7年间共调查吸毒人群2 803人,其中男性占76.27%,21~40岁者占51.80%。HIV、梅毒和丙肝病毒(HCV)阳性检出率分别为0.21%、11.70%和42.78%。艾滋病知识知晓率、最近1年商业性行为坚持使用安全套的比例均呈逐年上升趋势,注射吸毒比例、最近1个月有性行为的比例呈逐年下降(P值均<0.05)。多因素非条件logistic回归分析显示,女性吸毒人员相对于男性感染梅毒风险高,最近1次性行为使用安全套是吸毒人员感染梅毒的保护因素;注射吸毒是吸毒人群感染丙肝的危险因素。【结论】宝山区2010—2016年吸毒人群HIV阳性检出率保持在较低水平,丙肝和梅毒阳性检出率较高,高危行为依然存在,应继续加强宣传教育和行为干预。     

西宁市青少年强制戒毒人群艾滋病、梅毒、丙肝感染状况及影响因素研究

目的了解青海省西宁市青少年吸毒人群艾滋病、梅毒、丙肝感染状况及影响因素调查。方法采用横断面调查方法对西宁市多巴强制戒毒所内在押吸毒人员行问卷进行调查。采集调查对象血清,检测HIV抗体、梅毒抗体和HCV抗体。结果调查吸毒人员中无HIV感染,梅毒感染率为10.2%,丙肝感染率为37.9%。吸毒人员吸毒后发生过性行为的占76.4%,93.3%的吸毒人员性伴是异性,53.8%的吸毒人员的性伴是临时的,72.3%的吸毒人员有多个性伴,非注射吸毒人群吸毒后发生性行为概率大于注射人群,少数民族有10个以上的性伴的比例高于汉族。结论吸毒人员文化程度低,吸毒后发生性行为者中一半以上吸毒者存在多性伴及不安全性行为,存在疾病传播的危险行为。     

2012—2015年江苏省某女子强制隔离戒毒所吸毒人群艾滋病监测结果

目的了解江苏省某女子强制隔离戒毒所吸毒人群艾滋病相关知识行为及HIV(艾滋病病毒)/HCV(丙型肝炎病毒)/梅毒感染状况。方法按照《全国艾滋病哨点监测实施方案》要求,对2012—2015年在监测期内(4-6月)的吸毒人群进行问卷调查和HIV/HCV/梅毒的检测。结果 2012—2015年共监测982名女性吸毒者,吸毒人群艾滋病知识知晓率和接受干预服务率均呈逐年上升(P值均<0.05)。注射吸毒占30.86%,逐年下降(P<0.05),其中发生性行为比例逐年上升(P<0.05)。该吸毒人群中发生商业性行为占5.20%,每次均使用安全套的占26.00%。在最近一个月中发生性行为的吸毒人员占37.17%,最近一次使用安全套比例逐年上升(P<0.05)。仅2015年发现1例HIV阳性,感染率为0.10%。梅毒阳性率为29.53%。HCV抗体阳性率为34.73%,逐年下降(P<0.05)。有注射吸毒史者HCV抗体阳性率高于无注射者(P<0.05)。结论江苏省某女子强制隔离戒毒所吸毒人群HIV感染率较低,但HCV感染率较高。     

2009年凭祥市吸毒人群艾滋病行为学和血清学监测结果分析

目的了解凭祥市吸毒人群的高危行为特征及HIV、梅毒、丙肝感染状况,为制定艾滋病预防控制策略提供科学依据。方法 2009年4—5月在凭祥市社区采用滚雪球、同伴传达等非随机抽样方法调查社区吸毒者,如完成社区调查后仍不能满足样本量要求时,再从当地戒毒所在监测期内新进入所的吸毒人群中进行补充。对调查对象进行一对一问卷调查,并采集血样进行HIV、梅毒、丙肝抗体检测。结果共调查吸毒者283人,男性占96.82%,女性占3.18%,年龄以20～44岁为主（占93.64%）。艾滋病知识知晓率为99.29%（281/283）。吸毒人群中,静脉注射毒品者占85.51%（242/283）,注射吸毒人群注射吸毒时与别人共用针具的比例为15.64%（33/211）,最近1次发生性行为时使用安全套的比例为65.67%（88/134）。检出HIV抗体阳性者15例,阳性率为5.30%;检出梅毒7例,感染率为2.47%;检出丙肝183例,感染率为64.66%;HIV、梅毒、丙肝合并三重感染率为0.35%,HIV、丙肝合并感染率为4.95%,梅毒、丙肝合并感染率为1.41%。结论凭祥市吸毒人群中不仅存在因静脉吸毒经血液传播HIV的危险,还存在经性接触传播的危险因素。今后工作重点是针对特定的高危人群采取合理的预防干预措施,同时,提高行为干预的覆盖面和覆盖率。     

2010-2013年驻马店市吸毒人群艾滋病哨点监测结果分析

目的了解驻马店市吸毒人群艾滋病病毒(HIV)、丙型肝炎病毒(HCV)及梅毒的感染状况及相关危险因素,为制订防控措施提供依据。方法根据全国哨点监测方案要求,以重复横断面调查方法对强制戒毒所内吸毒人员进行监测,对2010-2013年吸毒哨点监测数据进行分析。结果共监测检测972名吸毒者,平均年龄(32.05±2.45)岁,注射吸毒占8.23%(80/972),吸毒者通过钱或毒品交易与他人发生过性行为占13.75%(130/972)、其中每次均能够使用安全套的占25.38%(33/130);HIV抗体阳性5例,阳性率为0.51%,梅毒感染者14例、感染率为1.44%,HCV抗体阳性62例,阳性率为6.38%;注射吸毒及吸毒者通过钱或毒品交易与他人发生性行为的HIV、梅毒和HCV的感染率均高于口吸及固定性伴人群。结论驻马店市吸毒人群的HIV、梅毒和HCV的感染率较低,但存在多种危险因素,应加强综合防控,预防和控制艾滋病在该人群的传播。     

呼和浩特市2011年吸毒人群艾滋病、梅毒及丙肝感染现状

目的通过对呼和浩特市劳教所、戒毒所吸毒人员艾滋病、梅毒及丙肝感染状况的分析,了解吸毒人群经血液、性传播疾病的危险因素,为开展干预工作、预防控制相关疾病在该类人群中流行提供依据。方法对呼和浩特市2011年243名吸毒人员,呼市强制戒毒所226人,呼市劳教所17人,以一对一的方式进行问卷调查,收集人口学和行为学情况资料,并采集血样进行HIV、HCV、梅毒抗体检测。结果本次调查243人中,中年男性所占比例较大,口吸毒品者为138人,占吸毒人数的56.79%,注射吸毒者105人,占43.21%;确诊艾滋病患者1人,感染率为0.41%。梅毒现患病例3人,感染率为1.23%,丙肝抗体阳性52例,阳性率21.4%。注射吸毒与非注射吸毒HCV阳性(感染)率差异有统计学意义。结论吸毒人群的艾滋病、梅毒、丙肝的感染率要高于普通人群,要加强这一人群的防控工作,而禁毒,注射安全是吸毒人群的重点防护举措。     

杭州市吸毒人群艾滋病、梅毒和丙肝感染状况及影响因素分析

目的了解杭州市吸毒人群艾滋病、梅毒和丙肝的感染状况及影响因素。方法 2012—2016年通过连续采样方法对杭州市2个艾滋病监测哨点(强制戒毒所和美沙酮维持治疗门诊)的戒毒人员进行问卷调查,收集人口学、使用毒品类型、性行为等信息,并检测HIV、梅毒和丙肝抗体,采用Logistic回归模型分析梅毒和丙肝感染的影响因素。结果共纳入吸毒者4 067人,HIV、梅毒和丙肝抗体阳性率分别为0.64%(26/4 067)、7.25%(295/4 067)和22.69%(923/4 067),梅毒和丙肝合并感染率为1.70%(69/4 067)。多因素Logistic回归分析结果显示,女性(OR=4.411,95%CI:3.273~5.945)、未婚(在婚/同居:OR=0.664,95%CI:0.482~0.915;离异/丧偶:OR=0.534,95%CI:0.353~0.810)、使用新型毒品(OR=5.064,95%CI:3.287~7.803)和使用混合毒品(OR=2.663,95%CI:1.191~5.954)是感染梅毒的危险因素;高龄(OR:2.168~2.878)、外省户籍(OR=1.747,95%CI:1.398~2.184)、曾注射吸毒(OR=3.120,95%CI:2.534~3.840)、使用传统毒品(新型毒品:OR=0.348,95%CI:0.277~0.438;混合毒品:OR=0.611,95%CI:0.390~0.959)的吸毒者是感染丙肝的危险因素。结论杭州市吸毒人群HIV和梅毒感染率高于浙江省平均水平,女性、未婚、使用新型毒品和混合毒品是感染梅毒的危险因素;高龄、外省户籍、注射吸毒、使用传统毒品是感染丙肝的危险因素。     

连云港市强制戒毒人员HCV、HIV与梅毒感染状况

目的了解连云港市吸毒人群感染HCV、HIV和梅毒的行为危险因素,为预防控制HCV、HIV和梅毒在这类人群中的流行提供科学依据。方法采用中国疾病预防控制中心《艾滋病性病综合监测指南及方案》（试行）中的吸毒者监测登记表对调查对象（连云港市强制戒毒所吸毒人员）进行面对面的个人访谈和收集相关资料,输入Epidata 3.0数据库进行分析,抽取检测对象静脉血检测HCV、HIV和梅毒抗体。结果168例戒毒人员中HCV的感染率为16.67%（28/168）,注射吸毒者HCV的阳性率（32.86%）高于非注射吸毒HCV的阳性率（5.10%）;注射吸毒人员中,共用注射器或针头的吸毒者HCV的感染率（68.97%）高于非共用注射器或针头的吸毒者HCV的感染率（7.32%）。吸毒人员在20～39岁这个年龄段HCV的感染率最高。吸毒人员中HIV阳性数为0,检测出梅毒阳性者4例,阳性率为2.38%。结论连云港市强制戒毒人员HCV感染率高于一般人群,因此,应加强对吸毒人群的监测,同时开展防病知识宣传教育和行为干预,以降低HCV在该人群中的传播和扩散,控制HCV等血源性传染病的蔓延和流行。     

戒毒所吸毒人员艾滋病、梅毒和丙肝感染情况

目的了解吸毒人群经血液、性传播疾病的危险因素,为开展干预工作提供依据。方法以强制隔离戒毒的吸毒人员为调查对象,收集人口学和行为学资料,采集血样进行艾滋病病毒(HIV)、梅毒、抗丙型肝炎病毒(HCV)抗体检测。结果共调查916人,单纯口鼻吸毒者536人,占58.51%;注射吸毒380人,占41.49%。确诊梅毒现患病例82例,感染率为8.95%,HCV抗体阳性262例,阳性率28.60%,无艾滋病确证病例。注射吸毒与非注射吸毒HCV抗体阳性率差异有统计学意义(χ2=17.65,P0.01),初中及以下学历人群HCV感染率高于初中以上学历吸毒者(χ2=7.70,P0.01)。结论吸毒人群梅毒、丙肝感染率高于普通人群,应采取有效干预。     

Rapid SPME/LC/MS/MS Analysis of N-Methylcarbamate Pesticides in Water

Solid-phase microextraction combined with fast short-column liquid chromatography/electrospray ionization tandem mass spectrometry (SPME/LC/MS/MS) was used for isolating and analyzing nine N-methylcarbamate pesticides from water samples. Several SPME parameters, such as polarity of fibers, extraction time, and effect of ionic strength, were investigated and their impact on the SPME/LC/MS/MS technique was studied. The method was shown to be sensitive with detection limits between 0.3 and 1.9 μg/L and reproducible with precision between 4.5 and 12.7% RSD. The versatility of the method was exhibited by its excellent linearity in the concentration range of 2–2,000 μg/L in drinking water. A comparison of the SPME/LC/MS/MS method with LC/MS/MS methods utilizing traditional sample preparation techniques shows that the former offers similar performance in terms of precision and linearity, but is clearly easier to use and faster to perform. Received: 26 September 1997/Accepted: 14 November 1997     

Cost/volume/profit analysis in the hospital industry

Although the concepts and techniques of cost/volume/profit analysis as currently discussed and used in general industry can be adapted to the cost-reimbursed hospital industry, they cannot be employed with any degree of reliability.     

Molecular assessment of dhfr/dhps mutations among Plasmodium vivax clinical isolates after introduction of sulfadoxine/pyrimethamine in combination with artesunate in Iran

The increasing use of sulfadoxine/pyrimethamine (SP) for treatment of chloroquine-resistant Plasmodium falciparum has resulted in increased exposure of Plasmodium vivax parasites in areas where both species co-exist. In this study, the extent of mutations/haplotypes in pvdhfr and pvdhps was examined using PCR-RFLP methods in 427 P. vivax isolates in Iran after 4 years of introducing SP as the first-line anti-malarial drug in Iran. Mutations were detected in three codons of pvdhfr (F57L, S58R and S117N) and in one of pvdhps (A383G) and the majority of isolates had double mutations (58R/117N, 45.4%). In addition, the frequency of 57L mutation was detected in 8.2% of P. vivax isolates. This frequency was significantly increased when compared with a similar study on P. vivax isolates in 2005 (X² test, P < 0.0001). Moreover, there was an increase in the frequency of single nucleotide polymorphisms at position 383G in pvdhps (0-2.6%) was found. Furthermore, the number of haplotypes increased from 6 to 12 in the study areas during 2006-2010. Interestingly, when combining the two loci, the frequency of parasites carrying pvdhfr/pvdhps pure mutations (L₅₇R₅₈/G₃₈₃, R₅₈N₁₁₇/G₃₈₃) increased from 0% in 2006 to 2.1% in 2010. In conclusion, the present results suggest that SP could be effective in treatment against the erythrocytic stages of vivax malaria in Iran; however, the increased frequency of mutant haplotypes in Iran since 2006 is worrying and indicates the emergence of drug-tolerant/resistant P. vivax isolates in Iran in near future.     

Coxsackievirus B3 induces autophagy in HeLa cells via the AMPK/MEK/ERK and Ras/Raf/MEK/ERK signaling pathways

In a previous study, the number of autophagosomes increased after coxsackievirus B3 (CVB3) infection. However, the exact mechanism by which CVB3 regulates the number of autophagosomes is unclear. Earlier studies have found that infection with CVB3 activates extracellular signal-regulated kinase (ERK). ERK is essential for CVB3 replication and can increase the number of autophagosomes. In the current study, extracellular signal-regulated kinase 1/2 was activated in HeLa cells after CVB3 infection. The ERK kinase inhibitor, U0126, was then used to inhibit the activity of ERK. Treatment with U0126 led to a significant reduction in the number of autophagosomes indicating that the CVB3-induced autophagosome accumulation may have occurred via the ERK pathway. The relationship between CVB3 infection and ERK pathway activation was also investigated. The results showed that the RasGAP protein could be further cleaved, leading to the activation of the Ras/Raf/MEK (mitogen/extracellular signal-regulated kinase)/ERK pathway and that CVB3 infection could result in an increase in the concentration of calcium in the cytoplasm, resulting in mitochondrial damage, a decrease in the concentration of ATP and activation of the AMPK (AMP-activated protein kinase)/MEK/ERK pathway. In summary, CVB3 might directly or indirectly induce autophagy via AMPK/MEK/ERK and Ras/Raf/MEK/ERK signaling pathways in the host cells, representing a pivotal mechanism for CVB3 pathogenesis.     

The Efficacy of the A2/Aichi/68 Strain in Inhaled Influenza Immunisation Against the A/England/42/72 Variant

Sickness absence attributed to influenza has recently been assessedin 1007 male manual workers immunised with inhaled inactivatedvaccine and 1007 unimmunised male manual workers in the sameestablishment. The vaccine contained strains of B/Mass/66 andA2/Aichi/68 whereas the circulating virus was exclusively A/England/42/72.The protection rate in this trial was 47% as opposed to approximately60% in two previous trials using the same vaccine but in whichno variant was known to have been encountered. The results tendedto confirm the findings of a laboratory study that protectionagainst the variant was likely to be higher than had originallybeen thought. The trial also provided further evidence of the acceptabilityand efficacy of the inhaled vaccine, which may be particularlyconvenient for large-scale usage in industry.     

肺炎克雷伯菌、类肺炎克雷伯菌和变栖克雷伯菌的研究进展

肺炎克雷伯菌临床分离株是一种有荚膜的革兰阴性粗短杆菌,是临床上重要的机会致病菌。肺炎克雷伯菌临床分离株基因间存在差异,依据系统发育树可分为肺炎克雷伯菌(Klebsiella pneumoniae, KpⅠ)、类肺炎克雷伯菌(Klebsiella quasipneumoniae, KpⅡ)和变栖克雷伯菌(Klebsiella variicola, KpⅢ),三者生态分布、基因型、耐药性、毒力特征以及致病性存在显著差异,为感染性疾病精准治疗带来新的挑战。本文对KpⅠ、KpⅡ、KpⅢ的鉴定、流行特点及致病特点的最新研究进展进行综述。