孩尔来福甲型肝炎灭活疫苗接种乙型肝炎病毒表面抗原阳性儿童的研究

为进一步观察孩尔来福 (Healive)甲型肝炎 (甲肝 )灭活疫苗在乙型肝炎病毒表面抗原 (HBsAg)阳性儿童中接种的安全性和免疫原性 ,于 2 0 0 1年在平山县农村 ,将 4 2例HBsAg阳性儿童随机分为 4组 ,分别按照 0、1,0、3,0、6 ,0、12个月程序接种Healive甲肝灭活疫苗 ,观察初免和全程免疫后的局部和全身反应 ,检测初免及全程免疫后 1个月血清抗甲肝病毒抗体 (抗 HAV)阳转率和滴度。结果显示 :初免和全程免疫后 72h内均未见局部和全身反应 ,亦无丙氨酸氨基转移酶 (ALT)异常 ;4个组初免后 1个月 ,抗 HAV阳转率均达 10 0 0 % ,抗体几何平均滴度 (GMT)为173mIU/ml～ 318mIU/ml,其差异无显著的统计学意义 (t=1 2 0 4 ,P >0 0 5 )。全程免疫后 1个月 ,0、12 ,0、6 ,0、3,0、1个月免疫程序组GMT分别为 192 99mIU/ml、4 30 1mIU/ml、2 74 9mIU/ml、172 5mIU/ml,与同龄健康易感儿童按相同免疫程序的免疫效果规律一致。全程免疫后 1个月 ,HBsAg阳性儿童和健康儿童抗 HAVGMT的差异无显著的统计学意义 (P >0 0 5 )。表明HBsAg对Healive甲肝灭活疫苗的免疫应答无干扰 ;HBsAg阳性儿童接种Healive甲肝灭活疫苗是安全和有效的。     

孩尔来福甲型肝炎灭活疫苗单剂接种安全性与免疫效果观察

为探讨孩尔来福 (Healive○R)甲型肝炎 (甲肝 )灭活疫苗在人群中应用的安全性和免疫原性 ,选择 2 4～ 36月龄、18～ 2 5岁 2组人群 ,分别接种Healive○R甲肝灭活疫苗 2 5 0U、5 0 0U1针 ,观察免疫后的局部和全身反应 ,并检测儿童免疫后 6周抗体阳转率和抗体几何平均滴度 (GMT)。结果发现 :接种后仅个别人有轻微的一过性全身反应 ,抗体阳转率为 94 5 2 % ,抗体GMT为 2 6 0 3mIU/ml。显示Healive○R甲肝灭活疫苗在人群中接种具有良好的安全性和免疫原性。     

孩尔来福甲型肝炎灭活疫苗不同免疫程序的评价

为评价孩尔来福 (Healive○R)甲型肝炎 (甲肝 )灭活疫苗不同免疫程序的免疫原性 ,在山区农村的 5个村 ,对 16 7名 5～ 11岁甲肝易感儿童 ,分 5组以 0、1,0、3,0、6 ,0、12个月程序接种Healive○R甲肝灭活疫苗 (2 5 0U/剂 ) ,对照组以0、6个月程序接种HavrixTM72 0EIU甲肝灭活疫苗。结果显示 :Healive○R甲肝灭活疫苗初次免疫 (初免 )后 2周、4周抗甲肝病毒抗体 (抗 HAV)阳转率分别为 97 0 %和 95 5 % ,几何平均滴度 (GMT)分别为 35 5mIU/ml和 2 5 1mIU/ml;初免后 3、6、12个月的抗 HAV阳转率均为 10 0 0 % ;GMT则分别为 4 17mIU/ml、391mIU/ml和 36 1mIU/ml。各程序组全程免疫后 1个月抗 HAV阳转率均为 10 0 0 % ;GMT则分别为 14 893mIU/ml(0、12个月 ) >5 96 3mIU/ml(0、6个月 ) >32 6 5mIU/ml(0、3个月 ) >1973mIU/ml(0、1个月 ) ,差异有非常显著的统计学意义。HavrixTM 甲肝灭活疫苗初免后 4周、6个月和全程免疫后 1个月 ,抗 HAV阳转率分别为 71 0 %、71 0 %和 10 0 0 % ,GMT为 15 8mIU/ml、15 2mIU/ml和 110 4mIU/ml。免疫 1剂Healive○R甲肝灭活疫苗GMT可达有效保护水平的 12倍以上。 0、1个月程序可用于特殊人群的加速免疫 ,0、3,0、6 ,0、12个月程序可根据不同人群的需求而灵活应用 ,以 0、1     

孩尔来福甲型肝炎灭活疫苗用于加强免疫的研究

为了观察孩尔来福 (Healive○R)甲型肝炎 (甲肝 )灭活疫苗用于加强免疫的效果 ,对 1～ 10岁 1年内曾接种过甲肝减毒活疫苗而血清学检测 [酶联免疫吸附试验 (ELISA) ]抗甲肝病毒抗体 (抗 HAV)阴性的 70名农村儿童 ,加强免疫 1剂Healive○R甲肝灭活疫苗 ,并于加强接种后 1个月采血检测 (ELISA)甲肝抗 HAV。结果显示 :所有加强免疫的儿童抗 HAV阳转率为 10 0 0 % ,几何平均滴度 (GMT)为 30 13mIU/ml;并且与接种甲肝减毒活疫苗的时间间隔不同抗 HAVGMT也不同 ,间隔时间长者高于间隔时间短者 ,与不同免疫程序接种 2剂Healive○R甲肝灭活疫苗的免疫效果规律一致 ,但显著低于 2剂Healive○R的抗 HAVGMT。Healive○R甲肝灭活疫苗对有甲肝减毒活疫苗接种史的儿童进行加强免疫 ,可使其产生较高的抗 HAVGMT。     

孩尔来福甲型肝炎灭活疫苗小剂量免疫效果研究

为制定孩尔来福 (Healive)甲型肝炎 (甲肝 )灭活疫苗在儿童中免疫的最佳剂量和最佳程序 ,在河北省某山区农村筛选 5～ 15岁的甲肝易感儿童 2 0 6人 ,随机分为 6组 ,分别接种 5 0 0U/剂和 2 5 0U/剂 ( 0、1个月 ,0、3个月和 0、6个月程序 )甲肝灭活疫苗 ,观察初免和加强免疫后局部和全身反应 ;检测免疫后 2周、3周、4周及 3、4、6、7个月的甲肝抗体 (抗 HAV)阳转率和抗体水平。结果显示 :Healive甲肝灭活疫苗副反应呈轻微的一过性局部和全身反应 ;5 0 0U/剂和 2 5 0U/剂初免后 2周 ,抗 HAV阳转率分别为 97 4%和 97 0 %,抗体几何平均滴度 (GMT)分别为371mlU/ml和 35 5mlU/ml;全程免疫后各剂量 /程序组抗 HAV阳转率均为 10 0 0 %,2 5 0U/剂 0、1个月 ,0、3个月和0、6个月程序组抗 HAV滴度分别为 1973mlU/ml、3 2 6 5mlU/ml和 5 96 3mlU/ml,以 0、6个月程序组最高 ,差异有显著的统计学意义。表明Healive甲肝灭活疫苗安全、高效 ;0、1个月程序可对特殊人群进行免疫预防 ;2 5 0U/剂 0、6个月程序是儿童的适宜剂量和免疫程序。     

国产甲型肝炎灭活疫苗在低龄儿童中应用的安全性和免疫原性研究

目的 探讨国产甲型肝炎灭活疫苗在低龄儿童（1－4岁）中应用的安全性和免疫原性。方法 选1－4岁易感健康儿童63名，随机分为两组，按0，3和0，6程序接种国产甲肝灭活疫苗500U／剂，观察免疫后的局部和全身反应，并检测初免后及全程免疫后的抗－HAV阳转率和抗体GMT。结果 初免和加强免疫后有轻微的过性局部和全身反应，未见肝功异常。初免后1、3、6个月抗体阳转率分别为85.7%、88.5%和83.8%；抗体GMT玢别为182mU/ml、225mU/ml和252mU/ml；0，3和0，6程序全程免疫后1个月抗体阳转率均为100％；抗体GMT分别为2718mU/ml和4683mU/ml。结论 国产甲肝灭活疫苗在低龄儿童中应用具有良好的安全性和免疫原性；接种两剂可获高滴度甲肝抗体；0，6程序优于0，3程序。     

孩尔来福甲型肝炎灭活疫苗0,12个月免疫程序研究

目的　对孩尔来福 (HealiveR○)甲型肝炎 (甲肝 )灭活疫苗的安全性、免疫原性及适宜儿童的剂量进行研究。方法　在某山区两个农村筛选 4～ 10岁甲肝病毒抗体 (抗 HAV)阴性的 85名易感儿童。以自然村随机分为两组 ,按 0 ,12个月免疫程序分别接种北京科兴生物制品有限公司生产的每剂 2 50U 0 .5ml和 50 0U 1ml甲肝灭活疫苗 ,观察免疫后局部反应和全身反应 ,检测初次免疫 (初免 )后 2 1天、12个月及全程免疫后 1个月抗 HAV阳转率和抗体几何平均滴度 (GMT )。结果　两组均未见严重局部反应和全身反应 ;2 50U 0 .5ml组和 50 0U 1ml组初免后 2 1天 ,抗 HAV阳转率分别为94.4%和 10 0 .0 % ,GMT分别为 195mIU ml和 3 70mIU ml ;初免后 12个月抗 HAV全部阳转 ,GMT分别达 3 61mIU ml和 456mIU ml(P >0 .0 5) ;全程免疫后 1个月 ,GMT分别达 14 893mIU ml和2 1696mIU ml。结论　孩尔来福甲肝灭活疫苗的安全性和免疫原性好 ;每剂 2 50U 0 .5ml适宜儿童 ;0 ,12个月免疫程序更适宜中国儿童     

甲、乙型肝炎联合疫苗在儿童中0、6月程序接种的安全性和免疫原性研究

目的 观察和评价在儿童中接种2剂倍尔来福~(TM)甲、乙型肝炎(分别简称为甲肝、乙肝)联合疫苗的安全性及免疫原性.方法 本研究以江苏省常州市116名1～10岁完成乙肝疫苗全程免疫同时无甲肝疫苗接种史的抗甲肝病毒抗体(anti-hepatitis A virus,抗-HAV)阴性儿童为研究对象,按0、6个月程序接种甲、乙肝联合疫苗(倍尔来福~(TM)).每剂疫苗0.5 ml,含HAV抗原250 U和乙肝表面抗原5μg.观察接种疫苗后72 h内局部反应和全身反应,检测免疫后1、6、7个月的血清抗-HAV阳转率、乙肝病毒表面抗体(抗-HBs)保护率及抗体滴度.结果 倍尔来福~(TM)接种后局部和全身不良反应发生率分别为12.1%(14/116)和6.0%(7/116),其中局部不良反应以注射部位红、肿、硬结为主,占6.9%(8/116)～11.2%(13/116),全身不良反应发生率为6.0%(7/116),以发热为主.免疫后1、6、7个月,抗.HAV阳转率为92.9%(92/99)～100.0%(101/101),抗体几何平均滴度(GMT)为47.0～2762.3 mIU/ml;疫苗免疫前抗-HBs阳性保护率为86.1%(87/101),免疫后1个月达到100.0%(101/101),免疫后1、6、7个月抗-HBs GMT为894.3～3314.3 mlU/ml.结论 倍尔来福~(TM)甲、乙肝联合疫苗2剂接种程序在乙肝基础免疫儿童中应用具有良好的安全性和免疫原性.     

国产甲型肝炎灭活疫苗低剂量的免疫原性研究

为了观察国产甲型肝炎(甲肝)灭活疫苗低剂量多针次的免疫效果,在平山县2个农村筛选4～10岁甲肝病毒抗体(抗-HAV)阴性的65名易感儿童,以自然村随机分为2组,分别接种125U/剂(0、1、6个月)和250U/剂(0、6个月)唐山怡安生物工程有限公司研制的甲肝灭活疫苗,观察免疫后局部反应和全身反应;检测免疫后1、6、7个月的血清抗-HAV阳转率和滴度.结果显示两种剂量疫苗免疫后无严重的局部和全身副反应.125U/剂和250U/剂初免后,抗-HAV阳转率分别为62.5%和93.9%,几何平均滴度(GMT)分别为342mIU/ml和382mIU/ml;6个月阳转率均为100.0%,GMT分别为531mIU/ml和391mIU/ml;全程免疫后1个月GMT分别为3170mIU/ml和5963mIU/ml.表明国产甲肝灭活疫苗125U适于儿童使用,并可作为研究甲、乙肝联合疫苗的参考剂量.     

倍尔来福TM甲乙型肝炎联合疫苗在成人中应用的安全性和免疫原性研究

为评价倍尔来福TM甲、乙型肝炎联合疫苗在成人中应用的安全性和免疫原性 ,在广西壮族自治区和河北省以16～ 2 0岁中学生为研究对象 ,按抗甲型肝炎 (甲肝 )病毒抗体 (抗 HAV )和乙型肝炎 (乙肝 )病毒 (HBV)感染 5项指标均阴性 ,抗 HAV阴性和HBV感染 5项指标阴性或阳性 ,HBV感染 5项指标阴性、抗 HAV阴性或阳性 ,分为AB组、A组和B组 ,按 0、1、6个月程序分别接种甲、乙型肝炎联合疫苗 ,甲肝灭活疫苗和重组 (酵母 )乙肝疫苗。疫苗剂量为每剂含HAV抗原 5 0 0U和乙肝病毒表面抗原 10 μg。观察接种疫苗后 72h内局部反应和全身反应 ,检测免疫后 2个月和7个月的血清抗 HAV阳转率、乙肝病毒表面抗体 (抗 HBs)保护率及抗体滴度。结果表明 :AB组局部副反应主要为—过性疼痛 ,全身副反应以低热为主 ,并在 72h内自行恢复。免疫后 7个月 ,AB组与A组抗 HAV阳转率均为 10 0 % ;几何平均滴度 (GMT)分别为 2 2 6 6 3mIU/ml和 2 3311mIU/ml;抗 HBs保护率AB组和B组分别为 97 71%和 96 89% ;GMT分别为 10 7mIU/ml和 97mIU/ml,两组阳转率、保护率及GMT差异均无显著的统计学意义。因此 ,在成人中应用甲、乙型肝炎联合疫苗与单价甲肝灭活疫苗和单价重组 (酵母 )乙肝疫苗具有相同的安全性和免疫原性。     

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.     

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.