青海省三江源地区鼠疫病原学分析

目的 研究青海省三江源地区鼠疫菌株生物学特性并确定疫源地空间结构及性质.方法 对1954-2007年青海省三江源地区分离的鼠疫菌株进行生物学表型鉴定及分子生物学研究.结果 411株代表性菌株中,12株脱氮(-)阿胶糖(-)甘油(+)属田鼠型,399株为脱氮(+)阿胶糖(+)甘油(+)属古典型.411株均能产生F1和Pst I;vw+菌株占95.13%(391/411),VW-菌株占4.87%(20/411);Pgm+菌株占80.78%(332/411)、Pgm+菌株占9%(37/411)、Pgm-菌株占10.22%(42/411).220株代表株中96.82%(213/220)的菌株对小白鼠表现为强毒株,3.18%(7,220)为中等毒力,说明绝大多数具高致病性,其毒力很强.90.02%(307/341)菌株携带6×106 45×106 x65×106质粒.80株代表株包括8个基因组型,其中6个基因型与原分型相同,另有2个新的基因组型.结论 三江源地区鼠疫菌株具备青藏高原鼠疫病原体特性,人类一旦感染可导致发病急、病情重、传染性强、病死率高等特点.     

一起肺鼠疫暴发流行的病原学研究及流行病学分析

[目的]研究一起人间肺鼠疫暴发流行的鼠疫菌分离株其生物学特性、基因特征等。拟从分子流行病学的角度分析传染源和传播关系。[方法]对8株于鼠疫患者(尸体)分离的鼠疫菌进行糖醇类酵解试验;检测其毒力、毒力因子、质粒、生物型、基因型;运用分子流行病学方法分析本次流行的传染源。[结果]8株鼠疫菌全部为甘油+、阿胶糖+、脱氮+,生物型为古典型。具备强毒鼠疫菌的4个毒力决定因子,为FraI+、VW+、PstI+、Pgm+;对小白鼠的最小致死量介于50～1000个菌,为强毒株;具备我国多数鼠疫菌所携带的6、45和65Mdal质粒;基因组型全部为10型。[结论]根据分子流行病学和现场流行病学调查结果证实,此次肺鼠疫暴发流行来自同一个传染源。     

我国鼠疫耶尔森菌Pgm特征的研究

目的　对从我国不同类型疫源地分离的鼠疫菌进行色素沉着因子 (Pgm )表型的分析。方法　用氯化血红素培养基或刚果红培养基培养鼠疫菌 ,对不同颜色的菌落进行计数 ,计算鼠疫菌Pgm的阳性率。 结果　我国 10个疫源地的 16个生态型和新发现的四川青海田鼠型 ,除昆仑山A、B型外 ,其他各型的菌株均含有Pgm+ 菌 ,以青海田鼠型、锡林郭勒高原型、北天山东段型、北天山西段A型、北天山西段B型菌株的Pgm+ 率为高 ,Pgm+ 菌株 >90 %。结论　青海田鼠型、锡林郭勒高原型、北天山东段型、北天山西段A型、北天山西段B型菌株的Pgm+ 表型稳定。     

广西鼠疫自然疫源地研究概述

鼠疫在广西有865年的流行史,经过53年的静息期后于2000年重新暴发,并首次分离到鼠疫杆菌,该菌株属滇闽居民区型,携带有4、6、45和65MD 4种质粒,具有明显的地理区域分布特征。广西目前共发现鼠疫染疫动物5种,有3个黄胸鼠鼠疫疫源县,鼠形动物有2目10科50种,室内优势鼠为褐家鼠,野外优势鼠为板齿鼠;媒介蚤有5科15属20种,以印鼠客蚤为优势蚤种。广西鼠疫疫情由暴发→扩散→初步遏制,控制效果显著,但形势依然严峻;具有广西特色的鼠疫疫区后期处理工作是广西鼠疫防治工作的特点和亮点,补充并完善后可推广应用。     

青藏铁路沿线鼠疫菌表型性状及对抗生素敏感性的研究

目的检测青藏铁路沿线鼠疫菌表型性状、质粒组成、外膜蛋白种类及对抗生素的敏感性。方法采用常规糖醇发酵管法检测生化等表型性状;采用反向血凝试验、用假结核菌为复盖种子层法、用草酸镁培养基和刚果红色素培养基检测FraI、Pstl、Vwa和Pgm4种毒力因子;用Lawton最小培养基测定营养型;采用常规的动物接种试验测定毒力;采用碱裂解、酚一氯仿抽提法提取鼠疫菌质粒;鼠疫菌经破碎后采取超高速离心法提取外膜蛋白;采用纸片法进行抗生素敏感性试验。结果实验用的青藏铁路沿线鼠疫菌株生化性状表现为甘油＋、鼠李糖一、阿胶糖＋、密二糖一、麦芽糖＋、脱氮＋的特征;具有鼠疫菌荚膜抗原（FraI＋）、毒力抗原（Vwa＋）、鼠疫菌素I（PstI＋）、色素沉着因子（Pgm＋）4种毒力因子;营养型表现为对Trp、Thr、Leu、Arg不依赖,而对Phe、Met、Cys依赖,对Ile和Glu表现出低营养;对小白鼠的LD100在10^2～10^3个菌,LDs。为7．94-31．62个菌,对豚鼠的LD100在10^5～10^7个菌,LD50为68．14-685．49个菌;携带Mr为6×10^6、45×10^6、52×10^6、65×10^6、92×10^6]质粒;在10％的SDS-PAGE上37℃条件下的培养物可表达26条外膜蛋白带,28℃培养物可表达36条外膜蛋白;部分头孢类和喹诺酮类药物对实验菌株的敏感性效果较好,20种抗生素均较链霉素为佳。结论青藏铁路沿线的鼠疫菌属于典型的青藏高原型菌株,都是强毒力鼠疫菌,临床治疗除常规的链霉素外可选用头孢类和喹诺酮类药物,该项研究可为青藏铁路沿线的鼠疫防治提供科学的依据。     

我国鼠疫耶尔森菌最大质粒的研究

目的　研究我国鼠疫菌最大质粒的特性及地理分布特征。方法　采用Kado和Liu法提取我国各鼠疫自然疫源地 2 0 2 6株鼠疫菌的质粒 ,经琼脂糖凝胶电泳进行检测分析。结果　我国鼠疫菌具有分类属性的最大质粒有 3种 ,其相对分子质量分别为 5 2× 10 6、65× 10 6和 90× 10 6,有明显的地理分布特征。 5 2× 10 6质粒分布在祁连山南、北麓和青海湖环湖地区 ,90× 10 6质粒仅分布在藏北高原的那曲地区和青海青南高原的玉树、曲麻莱、格尔木的部分地区 ,其余各鼠疫疫源地的鼠疫菌其最大质粒均为 65× 10 6。结论　我国鼠疫菌最大质粒的特点及地理分布对研究鼠疫自然疫源地空间结构和鼠疫菌的遗传学特性具有重要意义。     

河北省鼠疫自然疫源地鼠疫菌生物学特征的研究概述

为进一步研究河北省鼠疫疫源地的结构和性质,通过查阅大量资料,对该疫源地分离的鼠疫菌株的生物学特征做了总结,分别从生化特征、营养需求、质粒特征、毒力因子、毒力和毒素几方面进行介绍,发现河北省分离的鼠疫菌属于B群鄂尔多斯高原型,营养需求表现为对甘氨酸的半依赖和对色氨酸的营养依赖,含有4种质粒,其中13×106质粒是内蒙古长爪沙鼠疫源地所特有,有的菌株缺失45×106质粒,全部菌株表现为F1抗原和鼠疫菌素（PstⅠ）阳性,而鼠疫菌色素沉着（Pgm）和VW抗原阳性仅占一定比例,表现为遗传的不稳定性,中等毒力。     

青藏高原鼠疫耶尔森菌基因型分布

目的研究青藏高原鼠疫耶尔森菌（鼠疫菌）基因组型分布特征.方法对分离到的青藏高原鼠疫菌297株,根据已经证实的22个差异区段设计引物,每株鼠疫菌的每个基因差异区段都采用PCR技术进行验证.结果在喜马拉雅旱獭鼠疫自然疫源地中,鼠疫菌基因组型有9种,分别为1、5、6、7、8、10、11、新基因组型和Ype-ancestor型,其中以5、8和10型为主,3种基因组型合计所占比例为80.6%（204/253）,而且不同地区鼠疫菌基因组型的分布也不一致.青藏高原青海田鼠鼠疫疫源地鼠疫菌基因组型全部为14型.结论青藏高原鼠疫菌基因组型分布具有明显的地理特征.根据基因组型的分布状况推测出了鼠疫菌在青藏高原的传播路径.     

青藏铁路沿线鼠疫菌毒力因子检测

目的 检测青藏铁路沿线鼠疫菌是否具有公认的毒力因子.方法 采用反向间接血凝试验检测Fral;利用假结核菌对PstI敏感可产生抑菌环的复盖种子层法检测PstI;采用乏Ca2+时37℃鼠疫菌不能生长观察Vwa,利用色素培养基观察Pgm.结果 所检测青藏铁路沿线菌株都具有PstI+、Vwa+、FraI+、Pgnn+4种毒力因子.结论 根据其地理位置和宿主判断所检测菌株属于强毒力菌株.     

鼠疫亚单位疫苗的免疫学效果评价

9.10,P<0.01),而豚鼠和兔产生的F1 IgG抗体滴度的差异无统计学意义(q=0.06,P=0.81).亚单位疫苗免疫的小鼠、豚鼠和兔免疫保护率分别为100%(10/10)、86%(12/14)和100%(5/5);EV76疫苗免疫的小鼠、豚鼠和兔免疫保护率分别为100%(6/6)、93%(13/14)和100%(6/6).结论 BALB/c小鼠是较好的评价鼠疫亚单位疫苗的小型动物;豚鼠评价鼠疫亚单位疫苗存在较大个体差异;兔也可用作评价鼠疫亚单位疫苗的动物.     

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.