佛山地区重症SARS病例存在抗SARS冠状病毒抗体

目的：求证佛山地区首批临床诊断的SAILS患者血清中是否存在抗SARS冠状病毒抗体。方法：以SARS冠状病毒全病毒裂解液作抗原，利用ELLSA技术检测佛山地区首批出现急性呼吸窘迫综合征并具有明显传染特征的SARS康复患者和患者居住地“健康者”血清中抗SARS冠状病毒抗体。结果：4组有流行病学关系的19例SARS患者血清中抗SARS冠状病毒抗体全部阳性，而400名患者居住地的“健康者”血清中抗SAILS冠状病毒抗体则全部阴性。结论：佛山地区首批SARS病例血清学调查结果发现在所有的患者血中均发现有抗SAILS冠状病毒抗体，支持其病原体为SARS冠状病毒；抗SARS抗体IgG在ESARS康复者血清中至少可存在6个月。     

酶联免疫吸附试验间接抗体夹心检测SARS-CoV抗原方法的建立和应用

目的制备和鉴定严重急性呼吸综合征冠状病毒(SARS-CoV)核衣壳(N)蛋白单克隆抗体(rnAb)和多克隆抗体建立SARS—CoVN抗原捕获抗体夹心酶联免疫吸附试验(ELISA)方法用于SARS-CoV感染的早期诊断。方法用基因重组SARS-CoV N蛋白免疫BALB/c小鼠和新西兰大白兔制备mAb和多克隆抗体，采用ELISA间接法、免疫荧光和免疫印迹进行筛选和鉴定，用单克隆抗体与兔多克隆抗体进行配对试验，建立抗原捕获抗体夹心ELISA法测定SARS-CoV N抗原。结果获得9株特异性针对SARS-CoV N蛋白的mAb和高效价的兔多克隆抗体，通过高亲和力的mAb与兔多抗的配对试验，筛选出3株单抗N1E8、N8E1和N10E4混合作为捕获抗体，与兔多克隆抗体和辣根过氧化物酶标记羊抗兔IgG组合作为测定抗体，建立了抗体夹心ELISA法，测定重组SARS-CoV N蛋白最高灵敏度为50pg／ml，特异性达99．86％，测定420份血清学确诊的SARS患者血清，其中发病1—10天阳性检出率为90.1％，11—20天检出率为23％，21天以上均为阴性，与其他呼吸道病毒和冠状病毒无交叉反应。结论获得特异性好、亲和力高的单克隆抗体和高效价的兔多克隆抗体，经过抗体的配对和优化，建立了一种灵敏度高、特异性强的SARS-CoV抗原的ELISA捕捉法．可应用于SARS早期诊断、溯源及流行病学研究。     

间接免疫荧光法在检测SARS冠状病毒特异性抗体中的应用

目的 利用间接免疫荧光技术(IFA)建立SARS冠状病毒(SARS—CoV)特异性抗体血清学诊断方法。方法 采用组织培养技术，用SARS病人的咽漱液样本，在Vero—E6细胞中培养，分离SARS冠状病毒；用已制备的SARS病毒抗原片与临床确诊为SARS的病人双相血清和正常人对照血清作用，再用荧光标记羊抗人IgM/IgG抗体与之结合，在荧光显微镜下观察荧光图像。结果 通过建立检测SARS冠状病毒特异性抗体的间接免疫荧光方法，在44份SARS临床病例标本中，检出IgG抗体阳性3l份，与临床诊断符合率为70．45％。31份IgG阳性者的急性期血清中IgM检出率为38．70％，IgM最早产生于发病第3天，发病7d以上的6例的IgM抗体均为阳性，滴度在发病12～15d达到高峰(1：80)；恢复期血清中IgG抗体最早产生于发病第8天，滴度在发病15～20d达到高峰(1：320～1：640)。97份正常人的血清标本中IgG抗体阳性率为3．09％，IgM抗体为阴性。结论 利用此方法，证实被SARS冠状病毒感染后，在机体中产生有特异性的IgM／IgG抗体；本方法检测结果与临床诊断符合率较高，可以用于早期临床诊断SARS病毒感染和辅助临床做出鉴别诊断。     

抗重组SARS病毒N蛋白单克隆抗体制备及性质初步研究

目的：制备抗重组SARS病毒N蛋白单克隆抗体。方法：重组SARS病毒N蛋白免疫BALB／c雌性小鼠获得免疫脾细胞，利用杂交瘤技术将免疫脾细胞同骨髓瘤Sp2／0细胞融合，间接ELISA方法筛选阳性克隆并扩增。结果：获得了能稳定分泌抗重组SARS病毒N蛋白抗体的杂交瘤细胞株，经鉴定分泌的抗体IgG亚类为IgM。结论：制备了鼠源性单克隆抗体并初步研究了该抗体性质。     

SARS患者7年随访血清抗体变化规律及胃肠道免疫组化研究

目的 连续7年随访严重急性呼吸综合征(SARS)患者血清特异性IgM、IgG及N蛋白抗体滴度变化,应用胃肠镜观察胃肠道的病理改变并进行免疫组织化学研究.方法 应用免疫荧光(IFA)和双抗原夹心ELISA方法,对SARS患者发病1年后采用每隔1年检测一次血清SARS病毒(SARS-CoV)特异性IgM、IgG及N蛋白抗体滴度;用抗SARS-CoV N蛋白单克隆抗体对SARS恢复期患者胃肠道组织进行免疫组化研究.结果 14例SARS患者特异性IgG抗体1年后平均滴度为1/71(95%CI:1/58～1/85),连续追踪7年呈下降趋势,7年后大部分患者IgG抗体滴度消失,特异性IgM抗体1年后消失,N蛋白抗体1年后平均滴度为1/146(95%CI:1/122～1/171),与IgG抗体变化同时呈下降趋势.7年后其中9例患者检测N蛋白抗体全部为阴性,另5例临床症状较重的患者,N蛋白抗体仍检测阳性,其中3例N蛋白抗体滴度维持在1/156～1/210之间,2例N蛋白抗体滴度接近正常.该5例患者行胃肠镜检测和细胞免疫组化试验,血中N蛋白抗体检测阳性的3例患者胃组织黏液腺上皮细胞免疫组化呈阳性表达,大部呈胞浆着色.其中1例患者在肠组织浆液柱状上皮及间质细胞亦有表达,另2例血清N蛋白抗体检测接近正常的患者,细胞免疫组化为阴性.5例患者病理活检:1例明确诊断为"胃印戒细胞癌并直肠多发转移"、1例"胃息肉"、1例"浅表性胃窦炎",其余2例正常.结论 SARS患者血清特异性IgM、IgG、N蛋白抗体在恢复期呈下降趋势,7年后大部分消失;N蛋白抗体变化规律与病情轻重程度有关.     

SARS患者7年随访血清抗体变化规律及胃肠道免疫组化研究

目的 连续7年随访严重急性呼吸综合征(SARS)患者血清特异性IgM、IgG及N蛋白抗体滴度变化,应用胃肠镜观察胃肠道的病理改变并进行免疫组织化学研究.方法 应用免疫荧光(IFA)和双抗原夹心ELISA方法,对SARS患者发病1年后采用每隔1年检测一次血清SARS病毒(SARS-CoV)特异性IgM、IgG及N蛋白抗体滴度;用抗SARS-CoV N蛋白单克隆抗体对SARS恢复期患者胃肠道组织进行免疫组化研究.结果 14例SARS患者特异性IgG抗体1年后平均滴度为1/71(95%CI:1/58～1/85),连续追踪7年呈下降趋势,7年后大部分患者IgG抗体滴度消失,特异性IgM抗体1年后消失,N蛋白抗体1年后平均滴度为1/146(95%CI:1/122～1/171),与IgG抗体变化同时呈下降趋势.7年后其中9例患者检测N蛋白抗体全部为阴性,另5例临床症状较重的患者,N蛋白抗体仍检测阳性,其中3例N蛋白抗体滴度维持在1/156～1/210之间,2例N蛋白抗体滴度接近正常.该5例患者行胃肠镜检测和细胞免疫组化试验,血中N蛋白抗体检测阳性的3例患者胃组织黏液腺上皮细胞免疫组化呈阳性表达,大部呈胞浆着色.其中1例患者在肠组织浆液柱状上皮及间质细胞亦有表达,另2例血清N蛋白抗体检测接近正常的患者,细胞免疫组化为阴性.5例患者病理活检:1例明确诊断为"胃印戒细胞癌并直肠多发转移"、1例"胃息肉"、1例"浅表性胃窦炎",其余2例正常.结论 SARS患者血清特异性IgM、IgG、N蛋白抗体在恢复期呈下降趋势,7年后大部分消失;N蛋白抗体变化规律与病情轻重程度有关.     

SARS患者7年随访血清抗体变化规律及胃肠道免疫组化研究

目的 连续7年随访严重急性呼吸综合征(SARS)患者血清特异性IgM、IgG及N蛋白抗体滴度变化,应用胃肠镜观察胃肠道的病理改变并进行免疫组织化学研究.方法 应用免疫荧光(IFA)和双抗原夹心ELISA方法,对SARS患者发病1年后采用每隔1年检测一次血清SARS病毒(SARS-CoV)特异性IgM、IgG及N蛋白抗体滴度;用抗SARS-CoV N蛋白单克隆抗体对SARS恢复期患者胃肠道组织进行免疫组化研究.结果 14例SARS患者特异性IgG抗体1年后平均滴度为1/71(95%CI:1/58～1/85),连续追踪7年呈下降趋势,7年后大部分患者IgG抗体滴度消失,特异性IgM抗体1年后消失,N蛋白抗体1年后平均滴度为1/146(95%CI:1/122～1/171),与IgG抗体变化同时呈下降趋势.7年后其中9例患者检测N蛋白抗体全部为阴性,另5例临床症状较重的患者,N蛋白抗体仍检测阳性,其中3例N蛋白抗体滴度维持在1/156～1/210之间,2例N蛋白抗体滴度接近正常.该5例患者行胃肠镜检测和细胞免疫组化试验,血中N蛋白抗体检测阳性的3例患者胃组织黏液腺上皮细胞免疫组化呈阳性表达,大部呈胞浆着色.其中1例患者在肠组织浆液柱状上皮及间质细胞亦有表达,另2例血清N蛋白抗体检测接近正常的患者,细胞免疫组化为阴性.5例患者病理活检:1例明确诊断为"胃印戒细胞癌并直肠多发转移"、1例"胃息肉"、1例"浅表性胃窦炎",其余2例正常.结论 SARS患者血清特异性IgM、IgG、N蛋白抗体在恢复期呈下降趋势,7年后大部分消失;N蛋白抗体变化规律与病情轻重程度有关.     

SARS冠状病毒多抗原表位融合蛋白的表达及其诊断应用

目的 制备SARS冠状病毒(SARS-CoV)多抗原表位融合蛋白,建立一种可特异性诊断SARS的血清学方法,用于SARS的明确诊断和流行病学调查研究.方法 设计含有SARS冠状病毒S、M和N蛋白优势抗原表位区的多表位融合蛋白SMN,利用大肠杆菌表达SMN蛋白,并作为包被抗原建立ELISA方法,用于SARS患者血清检测.结果 设计出包含S603-635 M2-31、N362-412表位区的多表位融合蛋白SMN,并在大肠杆菌中成功表达.以SMN蛋白为包被抗原,ELISA检测74份SARS患者血清全部为阳性,另44份非SARS-CoV感染的发热病人血清和62份健康人血清均为阴性.结论 SARS-CoV多抗原表位融合蛋白SMN在大肠杆菌中成功表达,以SMN为检测抗原建立的ELISA方法为SARS血清学诊断奠定了基础.     

SARS冠状病毒S2基因原核表达及免疫学特性

目的研究严重急性呼吸道综合征（SARS）冠状病毒S2蛋白表达并对其免疫学特性。方法克隆SARS冠状病毒S2基因。并在大肠埃希菌中表达谷胱甘肽硫转移酶（GST-S2）融合蛋白。通过免疫印迹（Western blot）和酶联免疫吸附试验（ELISA）方法鉴定表达GST—S2融合蛋白的活性。结果通过原核系统表达的GST-S2融合蛋白可与谷胱甘肽硫转移酶（GST）多克隆抗体结合，并在85千道尔顿（KD）处出现特异性结合条带。GST-S2蛋白能与SARS患者恢复期血清反应，而不与正常人血清反应。结论本项研究获得了SARS冠状病毒GST-82融合蛋白，它可与GST多克隆抗体特异性结合，并与SARS患者恢复期血清发生特异性反应。     

台湾地区SARS可疑病例中衣原体与支原体的血清学流行率

20 0 3年台湾地区SARS流行期间 ,在判定衣原体肺炎与支原体肺炎引起的非典型肺炎上存在困难。为此 ,对 3月至 7月间 3 2 5例SARS可疑病例的配对血清进行实验室检测。衣原体肺炎用微量免疫荧光法 ,支原体肺炎用酶联免疫法 ,依据为存在IgM或IgG效价上升。冠状病毒阳性依据咽拭PCR阳性或血清抗体IFA或中和抗体检测阳性确定。在 3 2 5例中 13 2例 ( 4 0 .6%)判为冠状病毒阳性 (SARS阳性 )。SARS阳性群中 ,193例 ( 5 9.4%)判为冠状病毒阴性 (SARS阴性 )。SARS阳性群中 ,42例 ( 3 1.8%)衣原体抗体阳性 ,2 4例 ( 18.2 %)支原体抗体阳…     

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.     

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.     

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.     

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.