脉冲场凝胶电泳技术对成都市两起细菌性痢疾暴发的分型研究

目的 运用脉冲场凝胶电泳技术(PFGE)和聚合酶链反应(PCR)技术对成都市两起细菌性痢疾暴发分离株进行分析.方法 利用PCR检测志贺菌分离株ipaH基因和ial基因.用PFGE对菌株进行分型,所得结果用BioNumeries V 4.0软件UPGMA方法进行聚类分析.结果 所试54株分离菌ipaH基因均为阳性,48株为ial阳性.以Xba Ⅰ酶切后PFGE分型,崇州可分为4个带型,有26株型别一致,占实验菌株(36株)的72%,为优势菌株.自凉拌白肉中分离的菌株带型与优势菌株相同.大邑县可分为8个带型,有10株型别一致,占实验菌株(18株)的56%.崇州和大邑县的优势菌株带型差异较大.结论 利用PFGE能够有效地鉴别细菌性痢疾的暴发和传播来源.     

安徽省2008-2010年宋内氏志贺菌分子流行病学分析

目的对安徽省2008-2010年宋内氏志贺氏菌进行分子流行病学分析,为安徽省的菌痢检测和监测搭建分子平台。方法应用纸片扩散（kirby-bauer,K-B）法进行药物敏感试验;应用聚合酶链式反应（polymerase chain reaction,PCR）方法对20株宋内氏志贺氏菌进行基因分析;运用脉冲场凝胶电泳（pulsed-field gel electrophoresis,PFGE）技术进行亲缘性分析。结果 20株宋内氏志贺菌对氟哌酸（ciprofloxacin,CIP）和先锋必（cefoperazone,CPZ）最为敏感,敏感率达100%;多重PCR结果显示除志贺毒素1（shiga toxin 1,SET1）为阴性外,其余三种基因:侵袭性质粒H抗原（invasion plasmid antigen H,ipaH）、志贺肠毒素2（shiga toxin 2,SET2）、志贺菌增殖和侵袭相关的毒力基因（invasion associated locus,ial）皆为阳性;20株菌用XbaⅠ酶切后经PFGE电泳后可分为6个主要型别。结论安徽省受试20株宋内氏志贺菌多重耐药现象严重且基...     

安徽省2008—2010年宋内氏志贺菌分子流行病学分析

目的对安徽省2008-2010年宋内氏志贺氏菌进行分子流行病学分析,为安徽省的菌痢检测和监测搭建分子平台：,方法应用纸片扩散（kirby-bauer,K-B）法进行药物敏感试验;应用聚合酶链式反应（polymerasechainreaction,PCR）方法对20株宋内氏志贺氏菌进行基因分析;运用脉冲场凝胶电泳（pulsed-fieldgelelectrophore．sis,PFGE）技术进行亲缘性分析。结果20株宋内氏志贺菌对氟哌酸（ciprofloxacin,CIP）和先锋必（cefoperazone,CPZ）最为敏感,敏感率达100％;多重PCR结果显示除志贺毒素1（shigatoxin1,SETI）为阴性外,其余三种基因：侵袭性质粒H抗原（invasionplasmidantigenH,ipaH）、志贺肠毒素2（shigatoxin2,SET2）、志贺菌增殖和侵袭相关的毒力基因（invasionassociatedlocus,ial）皆为阳性;20株菌用XbaI酶切后经PFGE电泳后可分为6个主要型别。结论安徽省受试20株宋内氏志贺菌多重耐药现象严重且基因型高度一致;菌型呈多种型别并存的趋势,说明安徽省宋内氏菌的来源属于多克隆系。     

2009年四川省副溶血性弧菌血清型、致病力及分子分型研究

目的 了解四川地区2009年副溶血弧菌食物中毒疫情分离株和监测食品样品分离菌株菌型分布、致病力及分子分型特征,为四川地区副溶血性弧菌疾病防治提供科学依据.方法 采用血清玻片凝集试验对2009年从食物中毒疫情和常规监测食品中分离的副溶血孤菌菌株进行血清分型、应用PCR方法进行耐热直接溶血素基因(tdh)和耐热直接溶血素相关基因(trh)的检测、小鼠腹腔注射进行致病力实验和进行脉冲场凝胶电泳(PFGE)分析等.结果 40株菌分属于5个血清群,疫情分离株分属于O3和O4群,监测分离株主要为O1群占43.75％ (7/16),其中2起疫情分离到多个血清型的菌株;所有菌株trh基因均为阴性,其中20株携带tdh毒力基因,携带tdh毒力基因和不携带tdh、tlh毒力基因的菌株均有致病力.40株菌通过PFGE分型,共得到29个带型,同一疫情分离株具有多个PFGE型别..结论 四川省食品分离株和暴发疫情无太多联系,食品分离株血清型和PFGE型别呈多样性.对于从同一起暴发疫情中检出的不同血清型和不同PFGE型别的副溶血性弧菌需要确认各菌株与暴发的关系.     

一起细菌性痢疾暴发疫情的病原检测及分子分型

目的:分析引起一起细菌性痢疾暴发疫情的宋内氏志贺菌菌株生化特征、抗生素抗性、毒力基因携带情况,并用脉冲场凝胶电泳(PFGE)进行分子分型、了解遗传相关性。方法:对该起疫情中分离的6株宋内氏志贺菌用K-B法进行药敏试验;用PCR方法检测其四种毒力基因携带情况;用XbaI酶切进行PFGE分子分型,结果用BioNumerics软件UPGMA方法进行聚类分析,观察菌株是否为同源株。结果:6株分离株对诺氟沙星、头孢噻肟、头孢噻吩、阿莫西林均敏感,对氨苄西林、庆大霉素、萘啶酸均耐药;6株菌均携带ipaH基因、均不携带set1基因,其中5株携带ial基因,其中3株携带sen基因;经XbaI酶切后产生同种带型,带型之间的相似性系数≥97.6%。结论:宋内氏志贺菌是引发此次疫情的病原,多重耐药,含毒力基因。菌株间遗传关系紧密,来自同一克隆群。     

脉冲场凝胶电泳分型技术在追溯O139霍乱传染来源中的应用

目的分析四川省2004年7起因聚餐暴发霍乱疫情的分离菌株之间,及其与常规监测中从外环境、水产品中分离的霍乱弧菌之间的分子分型特征和遗传相关性,查找霍乱传染来源.方法利用聚合酶链反应检测霍乱毒力基因（ctxAB）,用脉冲场凝胶电泳（PFGE）对菌株进行分子分型,所得结果以BioNumerics V4.0软件UPGMA方法进行聚类分析.结果所试72株O139群霍乱弧菌中所有4株从河水分离的菌株ctxAB阴性,其余均具有ctxAB,为产毒株.对其中的67株菌以Not I酶切后PFGE可分为16个型别.从甲鱼分离的O139群霍乱弧菌与同期流行的O139群霍乱弧菌优势PFGE型别一致,并且也为产毒株.7起暴发中分离的菌株型别各不相同.结论2004年四川省O139霍乱暴发感染来源复杂,提示并非因为菌株在该地持续存在而引起,但甲鱼可能是2004年度霍乱聚餐暴发的主要传染来源之一.     

济源市福氏志贺菌毒力基因分型与分析

目的：对河南省济源市2002—2005年分离之福氏志贺菌株进行基因分型和分析。方法：应用多重PCR方法检测志贺菌肠毒素1基因（ShET-1B）、志贺菌肠毒素2基因（ShET-2）、侵袭性质粒抗原H基因（ipaH）和侵袭相关基因（ial），根据产物分子量定性判断结果。结果：90株福氏志贺菌具有2种毒力基因型，ShET-1阳性率达到98．9％。结论：济源市福氏志贺菌毒力基因型具有高度的一致性。     

福氏志贺菌4c型暴发和散发菌株的脉冲场凝胶电泳分型

目的了解杭州地区福氏志贺菌4c型暴发菌株和散发菌株的分子分型特征。方法对2003和2005年杭州地区的2次食物中毒暴发分离的福氏志贺菌菌株（暴发1和暴发2,菌株数分别为13株和12株）和2005年1例散发腹泻患者分离的福氏志贺菌4c型离株（1株）进行生化鉴定和血清分型,PCR检测侵袭性抗原基因ipaH,改良Kirby-Bauer纸片法检测菌株的耐药谱及脉冲场凝胶电泳（pulse field gel electrophoresis,PFGE）进行分子分型。结果暴发1中分离的13株菌株均为福氏4c型,但检测的6株菌株间的PFGE图谱存在着相当的差异,Dice系数为0．78至0．92。暴发2中分离的菌株有10株福氏4c型和2株福氏x型,所有菌株的PFGE图谱几乎完全一致。暴发2分离株和暴发1的部分分离株可能存在着一定相关性（Dice系数大于0．8）,而散发菌株与2起暴发的绝大部分菌株间的距离较远（Dice系数小于0．8）。暴发1、暴发2的分离株和1株散发菌株对14种抗生素的耐药谱略呈差异,暴发2中分离的福氏4c型和x型菌株的耐药谱一致。结论PFGE能够很好地辨别福氏志贺菌4c型的两起暴发菌株和1株散发菌株。福氏志贺菌4c型菌株具有易变性,可在暴发流行过程中产生PFGE图谱的差异、血清亚型的转换、耐药谱的变化等。     

广东省福氏志贺菌毒力基因的研究

目的对2004年广东省4个不同地区分离的35株福氏志贺菌进行毒力基因的检测,以了解其毒力基因的携带情况。方法应用聚合酶链反应(PCR)方法,以志贺肠毒素1(ShET-1)基因set1、志贺肠毒素2(ShET-2)基因sen、侵袭性质粒抗原H基因(ipaH)和侵袭相关位点基因(ial)为靶基因进行检测,并用set1和sen对其进行基因分型。结果35株福氏志贺菌中,有33株(94.29%)为ShET-1阳性,34株(97.14%)为ShET-2阳性,所有菌株的ipaH基因均为阳性,只有20株(57.14%)的ial基因为阳性。35株菌共分3种基因型:1株为set1(-)/sen(-),1株为set1( )/sen(-),33株为set1( )/sen( )。结论广东省的福氏志贺菌的ShET-1和ShET-2携带率非常高,set1( )/sen( )为优势基因型。     

天津地区志贺菌志贺肠毒素基因分布与脉冲场凝胶电泳分型研究

目的 了解天津地区志贺菌流行株的志贺肠毒素基因分布和PFGE分子分型情况.方法 采用PCR方法检测天津地区2005-2007年分离的62株志贺菌编码志贺肠毒素的基因(set1A、set1B、sen),并用脉冲场凝胶电泳(PFGE)对菌株进行分子分型和聚类分析.结果 62株志贺菌中福氏志贺菌占58.06%,其中福氏2b...     

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.