静脉药瘾者多病毒感染与T细胞亚群关系

目的 研究静脉药瘾者(IDU)血源性病毒感染及重叠感染状况、T细胞亚群变化与多重病毒感染的关系.方法 以406名元肝炎病史的静脉药瘾者为研究对象,用酶联免疫吸附法、免疫层析法和多聚酶链反应检测血源传播的常见病毒的感染标志物,用免疫荧光法检测T细胞;用ELISA和放射免疫法检测诱生的细胞因子和血清的细胞因子.选取同一地区102名健康体检者作对照.结果 在406例静脉药瘾者中,乙肝病毒(HBV)、丙肝病毒(HCV)、人类免疫缺陷病毒(HIV)、丁肝病毒(HDV)、戊肝病毒(HGV)和血源传染病毒(HCMV)感染率分别为36.45%,69.7%,47.3%,2.22%,1.97%和3.45%,均明显高于对照组,静脉药瘾者(61.81%)存在2种以上病毒感染.HIV易重叠HCV和HBV等病毒感染,重叠感染率为83.85%.对照组仅存在HBV感染17.65%(18/102).静脉药瘾者的CD3+和CD4+细胞比例减少,CD8+细胞比例无明显变化,单个核细胞诱生的IL-4、IFN-γ以及血清IL-2减少,血清IL-4增高(P<0.01).发生HIV感染或HIV重叠HCV/HBV病毒感染时,诱生的IFN-γ和CD4+细胞比例进一步降低.HIV合并HBV感染的静脉药瘾者,51.72%表现HBV-DNA阳性和37.93%的HBeAg阳性;但无HIV感染时,HBV-DNA阳性率仅为1.68%.结论 静脉药瘾者易出现多种病毒感染,主要是HIV、HCV和HBV的感染.静脉药瘾者Th1细胞功能减弱,出现HIV感染或重叠感染使Th1/Th2细胞平衡紊乱,进一步证实了HIV可能通过减弱Th1细胞功能,促进HBV的复制.     

少数民族地区静脉药瘾者多病毒感染及与T细胞亚群变化的研究

[目的]研究云南少数民族地区静脉药瘾者(IDU)血源性病毒感染、重叠感染状况以及T细胞亚群变化与多重病毒感染的关系。[方法]以406名无肝炎病史的云南少数民族地区IDU为研究对象,用酶联免疫吸附法、免疫层析法和多聚酶链反应检测血源传播的常见病毒(HBV等)的感染标志物,用免疫荧光法检测CD3、CD4和CD8T细胞;用ELISA和放射免疫法检测诱生的细胞因子和血清的细胞因子。同时选取同一地区102名健康体检者作对照。[结果]在406例IDU中,HBV、HCV、HIV、HDV、HGV和HCMV感染率分别为36.45%,69.7%,47.3%,2.22%,1.97%和3.45%,均明显高于对照组,大多数IDU 62.81%,存在两种以上病毒感染。HIV易重叠HCV和HBV等病毒感染,重叠感染率为83.85%。对照组仅存在HBV感染17.65%。IDU的CD3+和CD4+细胞比例减少,CD8+细胞比例无明显变化,单个核细胞诱生的IL-4、IFN-γ以及血清IL-2减少,血清IL-4增高(P﹤0.01)。发生HIV感染或HIV重叠HCV/HBV病毒感染时,诱生的IFN-γ和CD4细胞比例进一步降低。当HIV合并HBV感染的IDU,51.72%表现HBV-DNA阳性和37.93%的HBeAg阳性;但无HIV感染时,HBV-DNA阳性率仅为1.68%。[结论]IDU易出现多种病毒感染,主要是HIV、HCV和HBV的感染。IDUTh1细胞功能减弱,出现HIV感染或重叠感染使Th1/Th2细胞平衡紊乱,进一步证实了HIV可能通过减弱Th1细胞功能,促进HBV的复制。     

静脉药瘾者HIV重叠HBV/HCV感染研究

目的探讨人类免疫缺陷病毒（HIV）重叠乙型肝炎病毒（HBV）/丙型肝炎病毒（HCV）感染时,HIV对机体T辅助细胞亚群的影响及HBV/HCV核酸载量的变化.方法以静脉药瘾者（IVDUs）为研究对象,采用ELISA、免疫层析法和PCR法检测病毒感染指标,用ELISA法和间接免疫荧光法检测T细胞亚群.结果 IVDUs的CD3、CD4细胞、干扰素（IFN）-γ和白细胞介素（IL）-4产生减少,IVDUs存在HIV感染时CD3、CD4细胞和IFN-γ产生进一步降低,HIV感染与HBV-DNA和HBeAg表达相关.结论 IVDUsT细胞亚群功能减弱,HIV促进HBV复制,重叠感染可进一步干扰辅助性T细胞（TH）1/T2细胞平衡,降低机体细胞免疫功能.     

48例静脉药瘾者多重病毒感染临床分析

目的探讨静脉药瘾病毒性肝炎患者多重病毒感染率及转归。方法对48例静脉药瘾病毒性肝炎患者进行乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）、人免疫缺陷病毒（HIV）血清标志物及核酸测定,并进行临床分析。结果48例静脉药瘾病毒性肝炎患者中,HBV、HCV双重感染率为31.25%,HBV、HIV双重感染率为4.17%,HBV、HCV、HIV三重感染率为62.50%;重型肝炎者占70.83%。重型肝炎患者住院时间为（48.67±19.25）d,与同期住院的非药瘾重型肝炎患者住院时间（65.32±31.49）d相比,明显缩短（U=4.25,P＜0.01）。结论静脉药瘾者病毒重叠感染率高,且重型肝炎患者多,但相对非药瘾重型肝炎患者恢复较快。     

静脉药瘾者血源性病毒感染调查分析

目的　调查静脉药瘾者主要血源传播病毒HBV、HCV、HGV、巨细胞病毒 (CMV)和单纯疱疹病毒 (HSV)的感染率。方法　采用酶联免疫吸附法、放射免疫法、RT -PCR和荧光定量PCR法 ,检测 40 6例静脉药瘾者血清 ,其中共用注射器者 49 0 1% ,同时设立 10 2例正常健康体检者作为对照。结果　静脉药瘾者HBV、HCV、HGV、CMV和HSV的感染率分别是 3 6 45% ,69 7% ,1 97% ,2 71%和 3 45% ,其中总感染人数 3 2 1人 (79 0 6% )和重叠感染人数12 8人 (3 1 53 % ) ,有共用注射器者单项感染率及重叠感染率均高于未共用者 ,2者有显著性差异 (P <0 0 5)。对照组检测仅发现存在HBV感染 (17 6% ) ,其余病毒感染指标均为阴性。结论　静脉药瘾者血源传播病毒感染率明显增高 ,其中以HCV感染最为突出 ,并且共用注射器是导致感染危险增大的要素     

乙型肝炎病毒及丙型肝炎病毒重叠感染患者生化免疫指标变化与临床意义

目的探讨分析乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)重叠感染患者血清白细胞介素-6(IL-6)、干扰素-γ(IFN-γ)的变化,为重叠感染患者的诊疗提供理论依据。方法随机选取2012年6月-2014年6月100例肝炎患者作为研究对象,其中37例患者为HBV、HCV重叠感染;HBV、HCV单纯感染患者分别为35、28例;测定3类患者血清IL-6,IFN-γ水平以及肝功指标进行比较分析,探讨各项指标与重叠感染的关系。结果重叠感染患者血清IL-6水平为(90.24±43.18)ng/L,高于HBV、HCV单纯感染患者的(52.37±24.27)、(56.28±25.41)ng/L,差异有统计学意义;重叠感染的患者血清IFN-γ水平为(51.39±29.91)ng/L,高于HBV、HCV单纯感染患者的(49.87±27.62)(52.57±22.97)ng/L,差异无统计学意义;重叠感染患者的总胆红素(TBil)、丙氨酸转移酶(ALT)水平高于HBV、HCV单纯感染的患者,差异有统计学意义。结论 HBV、HCV重叠感染与患者体内IL-6,IFN-γ水平有关。     

HBV与HCV重叠感染患者生化免疫指标检验分析

目的分析乙型肝炎病毒(HBV)与丙型肝炎病毒(HCV)重叠感染患者的生化免疫检验指标。方法选择2017年1月至2018年10月我院收治的150例HBV与HCV重叠感染患者(HBV与HCV重叠感染组)、 150例HBV感染患者(HBV感染组)、 150例HCV感染患者(HCV感染组)为研究对象,比较各组的ALT、 AST、 IL-6、 IFN-γ水平以及肝储备功能评分。结果 HBV与HCV重叠感染组的ALT、 AST水平显著高于HBV感染组、 HCV感染组,差异有统计学意义(P <0.05)。HBV与HCV重叠感染组的IL-6水平显著高于HBV感染组、 HCV感染组,差异有统计学意义(P <0.05);三组患者的IFN-γ水平无统计学差异(P>0.05)。HBV与HCV重叠感染组的肝储备功能评分显著高于HBV感染组、 HCV感染组,差异有统计学意义(P <0.05)。结论 HBV与HCV重叠感染会影响患者的肝功能、 IL-6水平及肝储备功能。     

血液透析患者病毒性肝炎感染的情况调查

目的 调查血液透析患乙型、丙型和庚型肝炎病毒感染有其多重感染的情况，探讨其感染的危险因素。方法 对1478例血透患的血清进行HBsAg、HBsAb、HBeAb、HBcAb、HBV－DNA、anti－HCV、anti－HGV的检测。并随机抽取100例anti－HGV和anti－HGV阳性轿清RT－PCR方法检测HCV－RNA和HGV－RNA。结果 1478例轿清中HBV感染率为43．9％，HBV－DNA感染率为7．9％；HCV感染率42．6％；HGV感染率为46．4％。随机抽取100例anti-HCV和anti－HGV阳性血清；HCV－RNA和HGVRRNA的感染率分别为73％和77％。HBV合并HCV天津25．4％，HCV合并HGV感染21．0％，HCV、HBV、HGV3合并感染10．4％。结论 血透透析患存在着经血行感染乙型、丙型和庚型肝炎病毒的高危因素。     

老年人病毒性肝炎血清学感染模式分析

选择年龄在60岁以上的临床诊断为病毒性肝炎的住院患者152例作为研究对象,采用血清学方法对各型肝炎病毒感染标本进行检测,结果表明,感染甲型肝炎病毒（HAV）者4例（2．63％）,乙型肝炎病毒（HBV）107型（739％）,丙型肝炎病毒（HCV）4例（63％）,戊型肝炎病毒（HEV）5例（3．28％）,重叠或混合感染23例（15．13％）,庚型肝炎病毒（HGV）2例（1．31％）,未能分型7例（4．60％）,以HBV的感染率最高,老年HBV感染共有11种血清学模式。     

肝炎患者血清中抗庚型肝炎病毒抗体的检测

目的：了解各型病毒性肝炎患庚型肝炎病毒（HGV）的感染状况及感染后的临床经过及转归。方法：用HGV重组蛋白为抗原建立的酶联免疫吸附试验法（ELISA）检测病毒性肝炎患血清中抗庚型肝炎病毒抗体。结果：各型肝炎患的抗－HGV阳性率分别为甲肝3．8％，乙肝16．7％，丙肝25．3％，丁肝26．7％，戊肝2．0％，甲、戊型肝炎患中HGV的感染率小于乙、丙、丁型肝炎患。结论：HGV可与HAV、HBV、HCV、HDV、HEV合并感染，病毒性肝炎患应检测抗庚型肝炎病毒抗体。     

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.     

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.