一起由3型腺病毒引起的咽结膜热病原学研究

目的　探讨2 0 0 4年7月上旬广州市某幼儿园暴发的一起咽结膜热的病原学。方法　采集急性咽结膜热患儿急性期眼或咽拭子标本用Hep 2细胞进行病毒分离,并对原始标本及病毒分离物使用PCR方法及序列测定进行检测鉴定。用分离鉴定的毒株作为抗原,测定7例患儿及2名健康儿童(阴性对照)双份血清中病毒的中和抗体。结果　2 2份患儿的咽拭子和眼拭子标本用PCR测定显示12份为腺病毒阳性,2 2份标本中只分离出9株毒株,经鉴定所有病毒株均为3型腺病毒,且与朝鲜分离的3型腺病毒同源性高达97%。以分离到的1株毒株与7例患儿自身急性期和恢复期血清的中和试验显示恢复期中和抗体较急性期有4倍或4倍以上增长,2例阴性对照中和抗体无增长。结论　该起急性咽结膜热暴发是由3型腺病毒引起的     

一起急性呼吸道感染症暴发疫情的病原学和流行病学研究

目的：对一起急性呼吸道感染症暴发疫情进行流行病学和病原学研究，以明确诊断，控制疫情。方法：通过流行病学调查描述疫情流行特征；采用病例对照研究分析流行因素；患者的咽拭子标本中提取核酸；PCR法检测病毒特异性基因片段；组织培养法（Hep-2细胞）分离病毒；电子显微镜观察病毒形态；型特异血清及型特异引物鉴定分离毒株型别；中和实验检测患者急性期和恢复期血清抗体效价。结果：疫情报告病例871例，波及10个乡镇，主要为在校中小学及幼儿园学生（占94．37oA），具有班级聚集性。病例对照研究显示危险因素为与病人的接触、与鸡接触及家庭内共用毛巾等。35份咽拭子标本分离出15株病毒，分离阳性率42．9％。分离病毒经鉴定为腺病毒3型。PCR法检测腺病毒DNA，112份咽拭子标本中68份阳性，阳性率60．7％。18例双份血清中13例中和效价呈4倍以上增长或转阳，阳性率72．2％。对病毒进行全基因序列测定，确定为腺病毒3型。结论：本起急性呼吸道感染症暴发疫情由腺病毒3型引起，传播途径以呼吸道传播和密切接触为主。     

用3种方法检测一起新甲型H1N1型流感病毒感染暴发流行的结果分析

目的探讨用3种方法检测2013年5月赣州市某小学暴发的一起急性上呼吸道病毒感染病原学的检测结果。方法采集患者急性期咽拭子标本进行流感病毒核酸检测(荧光PCR);咽拭子标本用MDCK细胞进行病毒分离;用患者急性期和恢复期双份血清进行新甲型H1N1型流感病毒的红细胞凝集抑制试验(HI)。结果 14份咽拭子标本中用荧光PCR扩增检测到了13份新甲型H1N1型流感病毒核酸,阳性率为92.9%。14份咽拭子标本用MDCK细胞分离到10株新甲型H1N1型流感病毒,阳性率为71.4%。14名患者中有9名患者双份血清的新甲型H1N1型流感病毒HI试验恢复期抗体比较急性期抗体有4倍或以上增长(阳性率为64.3%)。结论该次急性上呼吸道感染是由新甲型H1N1型流感病毒引起的,3种检测方法各有特点。     

北京地区2002年秋冬儿童急性上呼吸道感染爆发的病原学调查

目的 了解2002年11～12月北京地区急性上呼吸道感染爆发的病原。方法 收集2002年11～12月北京地区80例患急性上呼吸道感染儿童咽拭子标本,应用经典病毒学方法(病毒分离和血凝试验)进行流行性感冒(流感)病毒、副流感病毒、呼吸道合胞病毒及腺病毒分离鉴定,应用巢式聚合酶链反应方法进行流感病毒、呼吸道合胞病毒、腺病毒及肺炎支原体(Mp)的检测。结果 80例标本中检测到B流感病毒18例(阳性率22.5％)、A3型流感病毒2例(阳性率2.5％)、肺炎支原体13例(阳性率16.3％),未检测到A1型流感病毒、副流感病毒、呼吸道合胞病毒及腺病毒;其中2例同时检测到B型流感病毒与Mp,1例检测到A3型流感病毒与Mp。结论 B型流感病毒是此次儿童上呼吸道感染的首要病原,Mp感染是第二位病原。     

2003年福建省流行性感冒监测结果分析

[目的]对福建省2003年流行性感冒进行病原学、流行病学监测分析。[方法]采集监测医院和疑似流感暴发点流感样病例(ILI)的咽拭子或漱口液、双份血清和一般人群血清标本;用MDCK细胞和鸡胚接种法分离病毒;血凝抑制法鉴定毒株和测定血清抗体。[结果]监测医院报告ILI7467例,占门诊病例总数的3．7％。从792份ILI呼吸道标本中分离出流感病毒97株,其中H3N2亚型90．7％,B型9．3％。75例中的31例双份血清抗体呈≥4倍升高,其中H3N2亚型20例,B型11例。150份一般人群血清的H1N1、H3N2亚型和B型流感病毒抗体阳性率分别为57．3％、90．7％和48．0％。[结论]2003年福建省同时存在H3N2亚型和B型流感病毒流行,前者为优势毒株,未发现H1N1亚型。一般人群大多具有H3N2亚型流感病毒抗体,但H1N1和B型抗体阳性率较低。     

吉林省2010年7-12月上呼吸道感染病毒病原学检测结果分析

目的了解2010年吉林省地区急性上呼吸道感染患者5种呼吸道病毒感染情况,为以后的急性呼吸道感染监测做出指导。方法采集门诊就诊的456例患者咽拭子标本,对其进行核酸提取后,采用(RT)-PCR方法检测甲型流感病毒(IVA)、呼吸道合胞病毒(RSV)A/B、副流感病毒(PIV)1-4型、腺病毒(ADV)以及博卡病毒(HBoV)等5种常见呼吸道病毒。结果检测出阳性标本92例,阳性率20.18%,以流感病毒感染阳性率(8.11%)最高。结论 2010年7-12月吉林省地区上呼吸道感染主要以流感病毒、呼吸道合胞病毒、腺病毒为主。其中流感病毒感染居首位。     

2013年度贵州省发热呼吸道症候群病毒感染状况调查

摘要:目的　了解贵州省发热呼吸道症候群病毒性疾病的感染状况。方法　调查贵州省2013年度发热呼吸道症候群病例432例,采集呼吸道标本421份,通过相应试剂盒提取核酸,进行实时荧光定量（Real-Time）PCR检测流感病毒、副流感病毒、冠状病毒、呼吸道合胞病毒、腺病毒、博卡病毒,鼻病毒及偏肺病毒。结果　从421份标本中检测出阳性标本128份,阳性率为30.41%。其中流感病毒60份,阳性率为14.25%;冠状病毒8份,阳性率为1.90%;博卡病毒3份,阳性率为0.71%;腺病毒10份,阳性率为2.38%;偏肺病毒9份,阳性率为2.14%;鼻病毒38份,阳性率为9.03%;未检出呼吸道合胞病毒和副流感病毒。检出3例流感病毒和鼻病毒混合感染。结论　呼吸道病毒是导致发热呼吸道症候群的重要病原体,其中以流感病毒最为常见,鼻病毒其次,腺病毒、偏肺病毒等检出率较低。     

湛江市1998—2001年流行性感冒监测分析

[目的]及时掌握湛江市流行性感冒流行规律和毒株变异动态，为及早发现和控制疫情提供科学依据。[方法]1998—2001年用鸡胚双腔法对湛江市流感样病人咽拭子和鸡咽拭子进行病毒分离，用血凝抑制试验进行病毒鉴定；用微量半加敏血凝抑制试验圈定一般人血清流感抗体。[结果]合计采集病人咽拭子1805份，分离出7株H1N1和4株B型流感病毒；鸡咽拭子96份，分离出4株H5N2禽流感病毒，1名职业密切接触者血清H5N1亚型抗体阳性；一般人群甲3型流感抗体阳性率各年龄组均在75％以上；0-4岁组儿童甲1型流感抗体阳性率和B型流感抗体阳性率，分别为21．7％和30．4％，均较其他年龄组低。[结论]湛江市近几年流感流行株是甲3型流感病毒，甲1、B型流感病毒近年流行呈上升趋势，要对容易感染H9N2亚型流感病毒的重点人群加强预防与检测。     

2002年福建省急性出血性结膜炎病原分离和鉴定

[目的]查明2002年我省急性出血性结膜炎(AHC)流行的病原。[方法]采集福州和漳州市临床诊断为AHC的患者眼拭子57份、双份血清7份。分别用Hep-2和Vero细胞对标本进行病原分离；用免疫血清微量中和试验对分离出的毒株进行鉴定；用诊断血清鉴定的4株病毒，对7例患者的双份血清进行中和抗体效价测定。[结果]从57份眼拭子标本中分离出47株(阳性率82．5％)；经诊断血清微量中和试验鉴定，均为柯萨奇病毒24变异株(CA24v)；7例患者双份血清经微量中和试验测定，中和抗体均呈≥4倍增长。[结论]CA24v是引起2002年我省AHC流行的病原。     

阜阳市2010～2013年流感病原学检测结果分析

目的了解流感病毒感染情况,动态观察流感病毒变异规律。方法使用RT-PCR或Real-time PCR方法对病例咽拭子标本进行流感病毒核酸检测,阳性标本再用MDCK细胞进行病毒分离培养,用红细胞凝集法和红细胞凝集抑制法鉴定病毒。结果 2010年1月～2013年12月共检测流感样病例标本2 723份,流感病毒核酸阳性359份,阳性率为13.18%。其中甲型H1N1、季节性H3、B型、A未分型的流感病毒核酸阳性分别为133份、54份、156份、16份,分别占流感病毒核酸阳性标本的37.05%、15.04%、43.45%、4.46%。5岁以下人群检出率最低,为7.69%。2012～2013年200份核酸阳性标本共分离出69株毒株,分离率为34.5%。结论 2010～2013年阜阳市流感流行以B型流感病毒和甲型H1N1病毒为优势病原,同时有季节性H3型流感病毒的存在。     

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.