安徽省2株人感染H9N2流感病毒基因特征

目的 分析2015年安徽省2株人感染H9N2禽流感病毒分离株全基因组特征。方法 对安徽省2015年4月和9月流感监测网络实验室先后发现并确诊的2例H9N2禽流感病毒感染病例及其病毒分离株全基因组序列进行分析,使用Mega 6.0等软件解析2株H9N2毒株全基因组特征。结果 安徽省首次报道人感染H9N2禽流感病毒病例,对病毒分离株分析显示,其HA和NA基因与中国2013年禽间流行的H9N2病毒高度同源,属于A/Chicken/Shanghai/F/98(H9N2)支系;而PB2和MP基因属于A/quail/Hong Kong/G1/97支系,与H7N9、H10N8和H6N2具有较高的相似度。氨基酸序列比对发现该2株病毒出现多个人易感倾向位点分子特征:HA蛋白发生Q226L、H183N和E190T突变,且HA裂解位点为PSRSSR\GL排列,NA蛋白茎部发生63~65位氨基酸缺失,M2蛋白S31N突变,以及PA-100A、PA-356R和PA-409N。结论 安徽省首次报道的人感染禽源H9N2流感病毒为H9N2系间重配病毒,存在多个人易感位点。     

浙江省人感染H7N9禽流感病毒的基因组序列分析

目的分析浙江省2013年4月初一例人感染甲型H7N9禽流感患者的病原学和基因组序列特征.方法提取患者标本的病毒RNA并用荧光定量RT-PCR方法检测,一步法RT-PCR扩增H7N9禽流感病毒基因组的8个片段,测序并拼接出基因组序列.下载目前已经公布的H7N9禽流感病毒和其他H7、N9亚型的病毒的HA和NA序列,采用Mega 5.1软件对其进行序列比对并构建进化树.根据测序的结果分析该例H7N9禽流感病毒的序列变异情况.结果该患者标本甲型流感、H7亚型和N9亚型均为阳性,通过扩增基因组各片段并进行测序.对血凝素和神经氨酸酶基因进行比对和进化树构建,结果显示该H7N9病毒HA基因与A/duck/Zhejiang/12/2011(H7N3)的亲缘关系最近,NA基因与A/wild bird/Korea/A14/2011 (H7N9)的亲缘关系最近.编码内部蛋白的6个基因均与中国大陆近两年的H9N2毒株最为相似.该标本的病毒HA蛋白发生了Q226L突变,而与已经公布的人感染H7N9禽流感毒株均不一致的是PB2未发生E627K突变.结论从该份临床标本完成了检测和基因组各片段的扩增与测序.该病毒与已报道的人感染H7N9禽流感病毒同源性高,存在Q226L等重要位点的突变,但PB2未发生E627K突变.     

基于纳米孔测序技术对新型重组H3N2禽流感病毒的测序鉴定及其基因特征分析

目的 利用纳米孔测序技术对新型重组H3N2禽流感病毒进行测序鉴定并分析病毒的基因特征。方法 对2021年广州市某农贸市场外环境H3N2禽流感阳性样本进行鸡胚培养,联合病毒全基因组序列靶向扩增和纳米孔测序技术进行病毒高通量测序。通过生物信息学软件,分析病毒基因特点。结果 系统发育进化树显示,该毒株各基因片段均属于欧亚进化分支,宿主来源均为禽源。其HA基因与我国H3N6禽流感病毒亲缘关系较近。NA基因与2017-2020年我国H3N2禽流感病毒亲缘关系较近。PB1基因与2016-2022年我国广西壮族自治区、福建省H5N6禽流感病毒亲缘关系较近,与广州市H5N6禽流感流行株PB1基因亲缘关系较远。其余内部基因片段来源复杂,具有明显的遗传多样性。分子特征显示,该毒株具有典型的低致病性禽流感病毒分子特征,倾向结合禽源受体。生物特性相关重要蛋白位点上,该毒株发生PB2-L89V、PB1-L473V、NP-A184K、M1-N30D/T215A、NS1-P42S/N205S等致病性增强突变。结论 本研究通过纳米孔测序鉴定一株新型重组H3N2禽流感病毒,分析发现该病毒与H5N6禽流感病毒发生了基因重组。目前该病毒跨种传播能力较低,但有必要密切关注H3亚型禽流感病毒的流行和变异。     

贵州省2014-2017年H7N9禽流感病毒HA和NA基因特征分析

目的 分析2014－2017年贵州省H7N9禽流感病毒HA和NA基因的分子特征和感染风险。方法 对2014－2017年贵州省获取的18例确诊人感染H7N9病例和6份环境样本分离的H7N9病毒株的HA和NA基因进行扩增,运用生物信息学软件解析其变异和遗传进化。结果 2014－2015年贵州省2株毒株与WHO推荐的A/Shanghai/2/2013和A/Anhui/1/2013疫苗株HA和NA基因的同源性最高,分别为98.8%～99.2%和99.2%;2016年2株和2017年14株与A/Hunan/02650/2016疫苗株同源性最高,分别为98.2%～99.3%和97.6%～98.8%;2017年其余6株与A/Guangdong/17SF003/2016疫苗株同源性最高,为99.1%～99.4%和98.9%～99.3%。所有毒株均属于长江三角洲分支,但主要聚集为3个次分支。2017年贵州省西部有6株毒株（含2例人感染病例毒株）裂解位点存在插入突变为PEVPKRKRTAR↓GLF,具备高致病性禽流感病毒的分子特征;受体结合关键位点存在A134V、G186V和Q226L突变,NA蛋白颈区“QISNT”均缺失,毒株A/Guizhou-Danzhai/18980/2017发生耐药突变R294K,9株毒株NA蛋白糖基化位点发生NCS42NCT突变。结论 2014－2017年贵州省H7N9禽流感病毒HA和NA基因存在遗传差异,关键位点的变异增强了病毒对人体的易感性和毒力,部分毒株发生耐药突变,其感染与致病风险增加。     

2016年盐城市1例人感染H7N9禽流感病毒HA、NA基因变异分析

目的 了解盐城市禽流感H7N9病毒株HA基因和NA基因分子进化特征,为更好预防和治疗人感染禽流感H7N9病例提供科学依据。方法 通过荧光定量PCR方法对标本进行流感病毒分型检测,对禽流感H7N9病毒荧光PCR阳性的标本,采用一步法RT-PCR方法对H7N9病毒HA基因和NA基因全长编码区进行扩增,扩增产物经纯化测序,采用相应的生物信息软件进行核苷酸及氨基酸序列比对及基因种系进化特征分析。结果 盐城市禽流感H7N9病毒株HA基因和NA基因有着独特的进化方式,A/JSYC/1/2016(H7N9)病毒株HA裂解位点附近氨基酸序列为PEIPKGR/GL,属于低致病性禽流感病毒。HA基因编码蛋白受体结合位点出现了G186V、Q226L氨基酸位点的变化,增强了病毒对人的感染能力,NA基因编码蛋白主要可能的神经氨酸酶抑制剂耐药位点未发生E120G、R153K、H276Y、R294K的变异。结论 2016年盐城市禽流感H7N9病毒株HA基因和NA基因处于基因点突变的抗原漂移变化中,某些变异位点具备了感染人的某些分子特征。     

芜湖市首例人感染H7N9禽流感病原检测分析

目的了解芜湖市首例人感染H7N9禽流感病例病原情况。方法采集病例呼吸道标本并提取RNA,进行流感病毒特异性基因的PCR扩增,毒株提交CNIC进行基因测序。结果患者呼吸道吸取物的样本Flu A和H7N9基因核酸扩增结果阳性。病毒HA和NA基因序列与其他已知H7N9禽流感分离株序列具有高度的一致性(HA:99.4%~99.8%;NA:99.2%~100.0%),HA基因核苷酸相似性最高毒株为KM054796-A/chicken/Jilin/2014,NA基因相似度最高的毒株为KP414837-A/chicken/Jiangxi/2014。HA和NA基因遗传进化关系最近的都为毒株KP414837-A/chicken/Jiangxi/2014。结论芜湖市首例人感染H7N9禽流感病例的病毒株HA和NA序列均与已知H7N9禽流感病毒高度同源。     

一株人感染H9N2禽流感病毒高通量测序及序列分析

目的 对一株人感染H9N2禽流感病毒进行高通量测序（next-generation sequencing,NGS）分析,探讨其在人群流行的可能性。方法 应用高通量测序技术进行全基因组序列测定（whole genome sequencing,WGS）。对8个基因进行相似性检索,构建系统进化树并分析其关键位点的分子特征。结果 8个基因与GenBank基因库相似度最高序列的来源不完全一致,系统进化树显示HA基因属于欧亚系I群,M基因位于G1-like分支,PB2位于G9-like分支,NA位于一独立分支,PBl,PA,NP,NS均位于SH/F/98-like分支。HA基因裂解位点为PSRSSR/GLF,226位受体结合位点为L。除M2基因S31N突变之外,NA基因茎63~65位缺失,PA和PB2基因未发生L336M和Q591R,E627K等可以增强病毒对哺乳动物适应性的突变,但发现可以增强病毒毒力的突变如M1基因N30D和T215A,PB2基因L89V,NSl基因P42S。除M2基因S31N突变外,NA基因和M2基因的药物结合位点未发生E119G,R152K,H274Y,R292K和L26F,V27A,A30T,G34E等耐药性突变。HA和NA糖基化位点预测结果都有8个糖基化位点,其中分别有7个和5个可靠程度较高。结论 该H9N2禽流感病毒的大部分关键性位点较保守,只有少部分位点发生一定程度进化与变异,在人群引起流行的可能性不大,但需加强分子方面动态监测。     

云南边境地区禽流感H5N1亚型病毒NS基因进化分析

目的 阐明云南边境地区禽流感H5N1亚型病毒NSl、NS2基因变异特征及遗传进化关系。方法 在云南边境地区采集境外家禽和野生鸟类棉拭子样品,经H5N1亚型特异性多重RT-PCR检测,阳性样品对病毒NS基因进行扩增,克隆Z至pMDl8一T载体测序,获得NSl、NS2基因序列,并与已知参考毒株序列进行序列比对及系统发育分析。结果 自1240份样品中检出H5N]亚型阳性样品71份,阳性率为5．72％;30份代表性阳性样品病毒NS基因测序获得17种序列,存在3个不同进化(亚)分支(I一1、I一2、Ⅱ);NSl／NS2基因与病毒血凝素(HA)基因呈现不同进化关系;NSl蛋白涉及核定位信号区、RNA结合区、效应区及其他致病性相关的关键性氨基酸位点存在替代或突变。结论 云南边境地区H5N1亚型病毒NSl／NS2基因具有遗传差异,2010年以来NS基因进化分支I一2、Ⅱ已成为当地流行的优势毒株。     

陕西省首例人感染G4基因型欧亚类禽H1N1猪流感病毒基因特征分析

目的分析陕西省首例人感染G4基因型欧亚类禽H1N1猪流感病毒(EA H1N1 SIV)的基因特征。方法采集患者咽拭子标本, 接种MDCK细胞进行病毒分离获得毒株, 采用全基因组深度测序方法获得分离株的8个基因节段序列, 通过GenBank数据库中Blast程序进行核苷酸同源性分析, 构建系统进化树, 分析病毒基因特征。结果病例咽拭子标本经实验室确诊为EA H1N1 SIV, 后分离毒株命名为A/Shaanxi-Weicheng/1351/2022(H1N1v)。同源性分析显示, 该分离株的PB2、NP、HA、NA和M基因均与A/swine/Beijing/0301/2018(H1N1)核苷酸同源性最高, 分别为98.29%、98.73%、97.41%、97.52%和99.08%。进化树显示, 该分离株属于G4基因型EA H1N1 SIV, 其中PB2、PB1、PA、NP和M基因来自pdm/09 H1N1, HA和NA基因来自EA H1N1, NS基因来自三源重配H1N1。其HA蛋白裂解位点为IPSIQSR↓G, 为低致病性流感病毒的分子特征。NA蛋白未出现与神经氨酸酶抑制剂相关的氨基酸...     

南宁市1株人感染高致病H7N9禽流感病毒遗传特性分析

目的通过对广西省南宁市2017年首例人感染高致病H7N9禽流感病毒株血凝素(HA)及神经氨酸酶(NA)基因测序,从分子水平分析毒株的溯源及遗传特性。方法通过RT-PCR扩增H7N9禽流感毒株HA基因和NA基因并测序,经NCBI数据库BLAST比对,利用MEGE 5.1等软件构建进化树及统计蛋白关键位点的变异情况。结果系统进化树表明中国H7N9毒株HA基因与NA基因主要为2个类群,长三角分支和珠三角地区分支,南宁毒株A/Nanning/01/2017(H7N9)HA和NA基因均在珠三角分支上,与广东毒株高度同源。病毒HA蛋白裂解位点插入4个氨基酸由PEIPKGR↓GLF突变为PEVPKRKRTAR↓GLF,含有5个碱性氨基酸,使其具有高致病性禽流感病毒的分子特征;毒力相关位点225由天冬氨酸(D)突变为甘氨酸(G)(D225G),毒力增强;受体结合186位点由甘氨酸(G)突变为缬氨酸(V)(G186V);飞沫传播关键氨基酸位点没有发生突变组合;糖基化位点高度保守。NA蛋白丢失5个氨基酸,毒力可能增强,耐药性位点、糖基化位点均相对保守,未发生突变。结论南宁市人感染H7N9禽流感病毒可能来源于广东省珠三角地区禽类的感染,人传人的可能性不大,对NA抑制剂药类敏感,但毒株已经具有高致病性禽流感病毒的分子特征,毒力增强。南宁市外环境已经检测到H7N9核酸阳性标本,提示需要加强监测有效防控传染源。     

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.