检测HBV DNA评价在岗饮服人员HBV感染者的传染性

目的　检测感染HBV饮服人群的HBVDNA ,研究HBVDNA阳性者的家庭聚集性 ,探讨其传染性 ,为修订有关法规提供依据。　方法　用反向间接血凝法检测HBsAg ,用赖氏法检测ALT ,酶联免疫吸附试验检测HBVM ,聚合酶联反应 -微孔杂交法和荧光定量PCR法检测HBVDNA。对HBVDNA阳性者的家庭聚集性进行对照研究。　结果　在 4110 5名饮食服务人员中检出HBsAg阳性 14 82人 ,阳性率 3 .61%。在HBsAg <1:5 12、ALT <40、且HBeAg阴性的90 0人中检出HBVDNA阳性者 3 12人 ,阳性率 3 4.67%。HBVDNA阳性者的家庭聚集率为 86.49% ,家庭成员HBV感染率为 64 .3 8% ,相对危险性 6.5 8。HBVDNA阳性者的家庭成员HBV感染呈家庭聚集性。　结论　血清学检验结果同时表现为HBsAg <1:5 12、ALT <40、HBeAg阴性、但HBVDNA阳性的在岗饮食服务人员是HBV的危险传染源。     

饮服行业人群乙型肝炎病毒感染状况及其传染性研究

目的:了解镇江市饮服从业人员乙型肝炎病毒的感染状况及其传染性,为制订控制措施提供依据。方法:用聚合酶链反应-微孔杂交法和实时荧光定量法对HBsAg阳性并HBeAg阴性的饮服从业人员跟踪检测HBV-DNA。结果:1999年～2001年镇江市饮服从业人员HBsAg平均阳性率为3.61％。HBsAg阳性人员中,HBeAg阳性者占15.81％。HBsAg<1:512且HBeAg阴性者900例中,HBV-DNA阳性312例,阳性率为34.67％。结论:HBsAg<1:512且HBeAg阴性的饮服从业人员仍有一部分是HBV的传染源。     

检测HBV DNA评价感染HBV饮食服务人员的传染性

目的　检测饮食服务人群HBV感染状况 ,研究HBVDNA阳性者的家庭聚集性 ,探讨其传染性 ,为修订相应法规提供依据。方法　用反向间接血凝法检测HBsAg ,用赖氏法检测ALT ,酶联免疫吸附试验检测HBVM ,聚合酶链反应 微孔杂交法和荧光定量PCR法检测HBVDNA。对HBVDNA阳性者的家庭聚集性进行对照研究。结果　在 14 4 92名饮食服务人员中检出HBsAg阳性 4 96人 ,阳性率 3.4 2 %。其中HBsAg≥ 1∶5 12或ALT >4 0者 137人 ,占阳性者的 2 7.6 2 %。ALT <4 0 ,HBsAg <1∶5 12 ,且HBeAg阳性者 5 5人 ,占 15 .32 %。在HBsAg <1∶5 12、ALT <4 0、且HBeAg阴性的 30 4人中检出HBVDNA阳性者 113人 ,阳性率 34.6 7%。HBVDNA阳性者的家庭聚集率为 86 .4 9% ,家庭成员HBV感染率为 6 4 .38% ,相对危险性 6 .5 8。HBVDNA阳性者的家庭成员HBV感染呈家庭聚集性。结论　血清学检验结果同时表现为HBsAg <1∶5 12、ALT <4 0、HBeAg阴性、符合现行法规要求 ,但HBVDNA阳性的在岗饮食服务人员是HBV的危险传染源。     

乙型肝炎病毒医院感染阈值及实用价值

目的 测定医务人员和患者在乙型肝炎病毒医院感染过程中分别适合使用的防护阈值,探讨使用该阈值筛查和控制传染源应该采用的病毒标志和适合使用的防护方法.方法 定量检测HBsAg携带者的传染性,确定HBV交叉感染阈值,选择传染源替代指标,制定医院感染监控方法.结果 将HBsAg携带者分为HBeAg阳性者和阴性者两个部分;156例HBsAg携带者中11 5例HBV-DNA阳性,阳性率73.7％,传染性范围0～109ID/ml;31例HBeAg阳性者的HBV-DNA均阳性,传染性范围102～109 ID/ml;125例HBeAg阴性者中84例HBV-DNA阳性,阳性率67.2％,传染性范围0～106 ID/ml,所有HBeAg阳性和26.4％ HBeAg阴性者的HBV浓度≥102 ID/ml,所有HBeAg阴性和54.8％ HBeAg阳性者的HBV浓度＜107 ID/ml.结论 HBV经交叉感染患者的阈值为102ID/ml,适合采用HBsAg监控法进行预防;经交叉感染医务人员的阈值为107ID/ml,适合使用HBeAg监控法进行预防.     

乙型肝炎病毒经手术传播感染阈值的实验研究

目的探讨围术期乙型肝炎病毒（HBV）感染阈值。为建立其监控方法以及评价该方法的防护效果提供依据。方法使用ELISA法检测992例手术患者的HBsAg和HBeAg．套式PCR法检测156例HBsAg阳性和100例阴性者的HBVDNA。套式PCR极量稀释法检测HBVDNA阳性者的感染剂量,缝针刺伤接种模拟试验法检测HBV经手术传播的感染阈值。结果HBsAg阳性和阴性、HBeAg阳性和阴性者的HBVDNA阳性率分别为73．7％和9．0％、100．0％和67．2％：其传染性范围分别在0—109ID/ml和0～104ID/ml、102-109ID!ml和0～106ID／ml。缝针刺伤单层手套传播HBV的感染阈值为手术传播的基本阈值,其值是105ID／Ⅱd,HBsAg阴性HBV携带者都不能成为传染源;保护手术患者的感染闽值是103ID／ml,68．6％HBsAg阳性者不能成为传染源．15．2％HBeAg阴性者可成为传染源：保护外科医生的感染阂值是108.5ID!ml,所有HBeAg阴性者和99．4％HBsAg阳性者不能成为传染源。结论围术期保护医生或患者的HBV感染阈值不同．使用的防护措施也应该不同。     

乙肝病毒血清标志物与HBV传染性关系的探讨

[目的]探讨预防性健康查体中HBsAg携带者HBV传染性检测的最佳指标.[方法]对2007年1～12月到山东省潍坊市疾病预防控制中心查体的全体人员采用RPHA检测HBsAg,对HBsAg滴度≥1:8阳性者随机抽取156例取静脉血分2份,用ELISA法检测乙肝病毒血清标志物;用FQ-PCR检测血清HBV-DNA含量,>1000拷贝/ml为阳性.[结果]共检测17 693人,HBsAg阳性的294例.阳性率为1.66%.HBV-DNA阳性率71.79%.HBeAg阳性模式的HBsAg携带者HBV-DNA阳性率为94.74%,HBeAg阴性模式的HBsAg携带者HBV-DNA阳性率为50%;HBsAg滴度≥1:128阳性的携带者HBV-DNA阳性率为78.79%,HBsAg滴度≤1:64阳性的携带者HBV-DNA阳性率为33.33%.[结论]乙肝病毒血清标志物与HBV传染性无明确的关系,FQ-PCR检测HBV-DNA是最为灵敏.可确定HBsAg携带者有无传染性的最佳指标.     

2001～2007年聊城市饮食与公共场所从业人员HBV感染检测资料分析

[目的]了解聊城市饮食服务与公共场所从业人员HBV感染状况,为卫生监督部门搞好卫生管理提供科学依据。[方法]对2001～2007年聊城市饮食服务与公共场所从业人员体检资料中血清HBsAg检测资料及HBsAg阳性者HBeAg检测资料进行分析。[结果]2001～2007年合计检测73283人,HBsAg阳性的1942人,阳性率为2．65％;HBsAg阳性者HBeAg阳性率为59．37％,占检测总人数的1．57％。2001～2007年HBsAg阳性率有下降趋势（P〈0．01）;HBeAg阳性率及阳性者在全部检测人群中所占比例均有较大波动（P〈0．01）。HBsAg阳性者HBeAg阳性率及在全部检测人群中所占比例,40～55岁最高,21～30岁最低（P〈0．01）。HBsAg阳性率、HBeAg阳性者在检测总人数中所占比例,公共场所从业人员高于饮食服务行业从业人员（P〈0．01）。HBsAg阳性率男性为2．83％,女性为2．51％（P〈0．01）。HBsAg阳性率、HBeAg阳性者在检测总人数中所占比例,均为从业工龄0～5年者最高,6～10年最低（P〈0．01）。[结论]聊城市饮食服务及公共场所从业人员HBsAg阳性率和HBeAg阳性率均较低。     

2007年贺州市食品及公共场所从业人员HBsAg、HBeAg携带情况

目的了解贺州市食品及公共场所从业人员HBsAg、HBeAg携带情况，旨在更有效地控制乙型肝炎流行。方法采用酶联免疫吸附试验（ELISA），对该市食品及公共场所从业人员进行HBsAg、HBeAg检测。结果共检测7261人，其中HBsAg阳性661人，阳性率9．1％，男性高于女性。在661人HBsAg阳性者中，HBeAg阳性219人，阳性率33．13％，其阳性率随年龄递增而下降。结论该市食品及公共场所从业人员HBsAg阳性率低于全国HBsAg阳性率平均水平（9．75％），但仍需继续加强对HBsAg、HBeAg携带者的管理。     

2006年青岛市崂山区饮食从业人员乙肝五项及ALT检测结果分析

[目的]了解饮食从业人员乙肝表面抗原（HBsAg）、E抗原（HBeAg）等五项以及丙氨酸氨基转移酶（ALT）异常情况,防止乙型肝炎在人群中传播。[方法]对崂山区2006年饮食从业人员和从事与食品相关的其他人员包括服务员、行政管理人员共8067人,采用乳胶法进行乙肝五项检测,用赖氏法测定ALT,并进行比较分析。[结果]2006年共检测8067人,HBsAg阳性者218例,阳性率2．70％。其中,小三阳（HBsAg、HBeAb、HBcAb均阳性）115例,阳性率为1．43％;大三阳（HBsAg、HBeAg、HBcAb均阳性）89例,阳性率为1．10％;HBsAg、HBcAb阳性者4例,单纯HBsAg阳性者6例。HBsAg、HBeAg阳性者4例。HBsAg阳性者ALT异常18例,异常率为8．25％,明显高于HBsAg阴性者异常率0．20％,差异有统计学意义（P〈0．01）。[结论]崂山区饮食从业人员HBsAg阳性率低于一般人员,由于工种的关系,加强监测十分必要。另外对ALT异常者应进一步明确诊断,以防止传染病传播。     

选择手术中乙型肝炎病毒传染源筛查指标

目的选择手术中乙型肝炎病毒（HBV）传染源筛查指标。方法以手术中HBV感染阈值、传染源和外科医生易感性为基础，选择HBV传染源筛查指标。结果乙型肝炎疫苗免疫前，HBsAg阳性者和HBeAg阳性者中传染源分别为19．2％和83．9％，阴性者为0和3．2％；以HBsAg筛查传染源的灵敏度显著高于HBeAg，而特异度显著低于HBeAg；乙型肝炎疫苗免疫后，HBsAg阳性者和HBeAg阳性者中传染源分别为0．6％和3．2％，阴性者均为0；HBeAg为指标筛查传染源的灵敏度与HBsAg相同，但特异度显著高于HBsAg。结论乙型肝炎疫苗预防前筛查手术中HBV传染源应以HBsAg为指标，而其后应以HBeAg为指标。     

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.