重组酵母乙型肝炎疫苗

重组酵母乙型肝炎疫苗陈宇综述赵景杰审校（卫生部北京生物制品研究所，北京，１０００２４）乙型肝炎（乙肝）是严重危害人类健康的传染病。其病原体为乙型肝炎病毒，感染乙型肝炎病毒除可能引起急性肝炎外，还可能导致慢性肝炎、肝硬化甚至肝癌。血源性乙肝疫苗的研制成...     

人血白蛋白中HCV RNA的检测分析

人血白蛋白中ＨＣＶＲＮＡ的检测分析许素菊张立孙晓燕（解放军白求恩国际和平医院，石家庄，０５００８２）丙型肝炎（丙肝）通常为肠道外传播，与乙型肝炎一样呈持续感染状态，可导致慢性肝炎、肝硬化和肝癌。其传播途径主要是通过输血及其血制品。因此，切断其传播途径...     

受血者输血前血清学检验结果分析

输血作为一种特殊的临床抢救治疗手段，同其他治疗方法一样存在一定风险，甚至会造成严重后果。输血风险主要是指输血可引起不良反应，也可引起传播输血相关疾病。输血相关疾病是指受血者通过输入含病原体的血液或血液制品而引起的疾病。一般均有明显的症状和体征。主要包括：艾滋病、梅毒、乙型肝炎、丙型肝炎、庚型肝炎、巨细胞病毒感染疾病、黄热病等。为避免受血者在输血之后发生输血相关传染病纠纷，《临床输血技术规范》中明确规定受血者输血前常规检测血清学五项指标。现对资料完整的136例受血者检测结果进行分析，报告如下：     

输血前进行输血相关传染病指标检测的临床应用研究

据统计,目前我国病毒感染者约70万人,累计报告艾滋病病例26万余例,输血后感染的人数呈逐渐增多趋势[1].近年来,由输血引起的经血传播的疾病时有报道.为杜绝因输血而引起的医疗纠纷,避免手术及交叉感染等院内感染的发生,我国政府部门先后颁布了《中华人民共和国传染病防治法》及新的《医疗事故处理条例》,其中规定经血传播的相关传染病,如乙型肝炎（HBsAg）、艾滋病（抗-HIV1＋2）、丙型肝炎（抗-HCV）及梅毒（TP）等在输血前必须进行检测.     

输血传播庚型肝炎的前瞻性观察

目的了解庚型肝炎（ＨＧ）在我国输血后肝炎中的发生率及其与输血后乙型肝炎（ＨＢ）、丙型肝炎（ＨＣ）的关系。方法检测１３８例因手术输血病人在输血前后的ＨＢｓＡｇ、抗－ＨＢｓ，ＨＢｅＡｇ、抗－ＨＢｅ、抗－ＨＢｃ、抗－ＨＣＶ、ＨＣＶＲＮＡ和ＨＧＶＲＮＡ。结果５３例发生输血后肝炎病毒感染，其中丙型肝炎病毒感染４８例；乙型肝炎病毒感染２例（含１例两型混合感染）。７例输血后可用巢式ＲＴ－ＰＣＲ法查到庚型肝炎病毒感染，３例合并丙型肝炎病毒感染者均有ＡＬＴ增高。４例单纯ＨＧＶ感染者，ＡＬＴ均正常。ＨＧＶＲＮＡ持续１个月至半年不等。５例输血后ＨＧＶ感染的病人可查到供血，其中３例病人至少有１份供血ＨＧＶＲＮＡ阳性。结论单纯ＨＧＶ感染的献血员和输血后感染者均无病毒性肝炎的临床表现和ＡＬＴ改变，与ＨＧＶ作为一种重要肝炎病毒的观点不相符。     

桂平市献血员丙型肝炎感染状况分析

丙型肝炎病毒（ＨＣＶ）主要通过输血和血液制品引起丙型肝炎。据文献报道［１］，输血后肝炎９０％以上是由于ＨＣＶ感染引起，因此在献血、献浆者中进行抗－ＨＣＶ检测是预防和减少输血后肝炎必不可少的手段。为了解桂平市献血员ＨＣＶ感染状况，本文对桂平市的２４５４...     

病毒性肝炎会引起肝癌吗

七十年代后期,从事流行病学研究的国外学者发现,除了甲型肝炎和乙型肝炎之外,还有非甲非乙型肝炎。迄今为止,医学界将病毒性肝炎分为甲、乙、丙、丁、戊等五型。过去所指的非甲非乙型肝炎,实际上包括丙型肝炎和戊型肝炎。戊型肝炎通过粪——口途径传播,其临床表现与甲型肝炎相似,只引起一次性感染,无慢性化病例。而丙型肝炎通过输血等肠道外途径传播。其临床过程与乙型肝炎相似,但更易慢性化,除引起一次性感染外,还可导致慢性肝炎、肝硬化和肝癌。近些年来,肿瘤流行病学调查资料证明,甲型和戊型肝炎与肝癌关系甚小;乙型肝炎病毒     

海盐县食品和公共场所从业人员丙肝和戊肝感染的现状调查

丙型肝炎（丙肝）是由丙型肝炎病毒（HCV）引起的一种传染病,可以通过血液、性接触和母婴等3种途径传播[1];戊型肝炎（戊肝）是由戊型肝炎病毒（HEV）感染的经粪-口途径传播的急性病毒性肝炎[2]。到目前为止许多医疗机构没有     

戊型病毒性肝炎诊疗规范

戊型病毒性肝炎（hepatitis E,以下简称“戊型肝炎”）是由戊型肝炎病毒（hepatitis Evirus,HEV）感染导致的急性传染病,主要经消化道传播,是我国乙类法定传染病之一,常引起暴发流行,近年来散发病例持续上升。戊型肝炎既往曾被称为“肠道传播的非甲非乙型肝炎”,1989年起被命名为戊型肝炎。     

输血后感染δ肝炎病毒的危险

δ肝炎病毒是一种缺损病毒,只有在乙型肝炎病毒存在的条件下才能复制。为搞清流行情况、传播环境以及感染δ肝炎病毒的临床重要性,作者从262例乙型肝炎表面抗原(HBsAg)阳性的输血后肝炎患者获取资料,同时还研究了94例乙型肝炎表面抗原携带者(他们因其他疾病曾接受过反复输血),以及103例携带乙型肝炎表面抗原的血友病患者(这些患者曾接受过各种凝血因子的输注)。患有输血后肝炎的262例患者中的9例(3.5%)发现了抗-δ肝炎病毒的抗体,     

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.