甘露糖结合蛋白基因多态性与肺结核发病关系的研究

目的 探讨甘露糖结合蛋白（MBP）基因多态性与中国人肺结核发病的关系。方法 采用病例对照研究，收集肺结核病例125例和健康对照198名的环境因素暴露情况及静脉血。MBP基因多态性分析采用特异引物PCR方法，用SPSS11．5软件进行危险因素的单因素分析和多因素非条件logistic回归分析。结果 病例组和对照组MBP-52、54、57位点的等位基因突变频率分别为8．0％、7．2％、0．4％和5．3％、4．3％、0．5％，按性别分层的Mantel—Haensezl x^2分析两组间差异无统计学意义。单因素分析表明体重指数、婚姻状况、卡介苗接种史、卡痕、结核病接触史及家族史、体力劳动、文化程度与肺结核的发生有关。在多因素分析中调整上述危险因素后，总MBP（OR=2．182，95％CI：1．058～4．499）和MBP52突变型等位基因型（OR=2．574，95％CI：1．028～6．446）与肺结核发病有统计学意义。结论 总MBP和MBP-52突变型等位基因可能与肺结核发病有关。     

MBP-52位点多态性与肺结核易感性的病例对照研究

[目的]探讨甘露糖结合蛋白(MBP)基因多态性与汉族人群肺结核发病的关系。[方法]采用病例对照研究,用特异引物PCR方法进行MBP的基因分型,对肺结核发病影响因素进行问卷调查,并进行单因素分析和多因素非条件Logistic回归分析。[结果]对126例病例和202例对照的MBP基因52位点进行分型,野生型、突变型(杂合子 纯合子)两种基因型在病例组和对照组中的分布频率分别为男性86.7%、13.3%、95.7%和4.3%;女性93.0%、7.0%、85.9%和14.1%。男性病例的突变频率显著高于对照组(OR为6.222,OR95%CI为1.285～30.134),而女性病例的突变频率明显低于对照组(OR为0.646,OR95%CI为0.564～0.740)。在多因素分析中调整卡介苗接种史、卡痕和家族史后,MBP-52基因突变与肺结核发病仍有统计学意义,与单因素分析的结果相同。[结论]MBP-52位点C/T突变可能与肺结核发病相关。     

白细胞介素-6基因多态性与肺结核易感性的关系研究

[目的]探讨白细胞介素-6（IL-6）基因多态性与汉族人群肺结核发病的关系。[方法]采用病例对照研究，对142例病例和135例对照进行肺结核发病影响因素问卷调查，应用聚合酶链反应-限制性片段长度多态性（PCR—RFLP）分析方法进行IL-6基因的-597、-572、-190和174分型，并进行单因素分析和多因素非条件Logistic回归分析。[结果]IL-6基因-174位点GG型占98．6％，仅4例为GC型；-190位点CC型占99．6％；仅1例为TT型；-597位点均为GG型．未发现GA和AA型。IL～6基因-572位点包括GG、GC、CC3种基因型，在病例组和对照组中的分布频率差异有统计学意义。在多因素分析中调整接触史、卡痕和家族史后，-572位点CC基因型与肺结核发病仍有统计学意义，调整OR（95％CI）为0．282（0．141-0．561）。[结论]IL-6—572位点CC型可能与肺结核发病相关。     

Mμ阿片受体基因（OPRM1）A118G多态性可能是散发原发性帕金森病一个潜在的易感位点

目的探讨Mμ阿片受体基因（OPRM1）基因A118G多态性对散发原发性帕金森病（parkinson＇s disease,PD）发病的潜在影响。方法利用Pyrosequencing技术对114例PD患者和133例健康对照进行OPRM1 A118G突变位点（rs1799971）分析。结果114例PD患者中62例为OPRM1 118A野生型（A／A,54．4％）,43例为杂合型突变（A／G,37．7％）,9例为纯合型突变（G／G,7．9％）。133例对照中OPRM1 118A野生型为90例（67．7％）,A118G杂合型为39例（29．3％）,118G纯合型为4例（3．0％）,两组差异无统计学意义（Х^2=5．849,P=0．054）。比较PD患者与对照人群OPRM1 118位点野生型（A／A）和突变型（A／G＋G／G）的阳性率,二者差异有统计学意义（Х^2=4．576,P=0．032）;等位基因A和G频率病例组分别为0．732和0．268,对照组分别为0．823和0．177,二者差异有统计学意义（Х^2=5．932,P=0．015,OR=1．702,95％CI：1．107～2．617）,提示OPRM1 118G等位基因的携带与PD的发生呈正相关,该突变可能会增加PD的发病风险。结论OPRM1基因A118G多态性可能是散发原发性PD发病的一个潜在的易感位点。     

TNFα rs1800629和LTA rs909253突变位点可能不是我国散发性帕金森病发生的易感因素

目的探讨TNFα基因-308G〉A和LTA基因252A〉G多态性对PD发病潜在影响。方法利用Pyrosequencing技术对114例我国汉族散发性帕金森病（Parkinson’s disease,PD）患者和133例正常对照进行TNFα-308G〉A和LTA252A〉G突变位点分析。结果病例组TNFα-308突变型（G／A＋A／A）和野生型（G／G）阳性率与对照组相等,差异无统计学意义（x^2=3．46,P=0．0627）。病例组LTA252突变型（A／G＋G／G）阳性率稍高于对照组,差异无统计学意义（x^2=0．28,P=0．5999）。单倍体型分析表明,TNFα-308杂合突变型（G／A）患者LTA252位点均为突变型（A／G或G／G）。结论TNFα-308和LTA252位点可能不是我国散发性PD发病易感因素。     

白细胞介素-10基因多态性与肺结核易感性的关系研究

[目的]探讨白细胞介素-10(IL-10)基因启动子区基因多态性与中国汉族人肺结核发病的关系. [方法]采用病例对照研究设计,选择135例健康对照和141例肺结核患者为研究对象,对肺结核发病影响因素进行问卷调查,应用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)分析方法,对全部研究对象的IL-10基因启动子区-1082、-819位点单核苷酸多态性(SNP)进行基因分型,对各危险因素进行单因素分析和多因素非条件Logistic回归分析.[结果]接触史、卡痕、家族史与肺结核的发生有关.IL-10-1082位点各基因型在病例组和对照组中的分布频率未见差别(X2=0.906,P=0.636).IL-10-819位点野生型(CC)、突变型杂合子(CT)、突变型纯合子(TT)3种基因型在病例组和对照组中的分布频率不同(X2=14.376,P=0.001).在多因素分析中调整接触史、卡痕和家族史后,IL-10-819突变型纯合子(TT)与肺结核发病密切相关,差异有统计学意义,以野生基因型CC为参照,调整后突变型纯合子TT(OR=0.312,95%CI为0.167～0.582),为肺结核发病的保护因素. [结论]IL-10-819位点TT基因型可能与肺结核发病相关.     

维生素D受体基因多态性与肺结核易感性的病例对照研究

目的 探讨维生素D受体(VDR)基因多态性与中国汉族人群肺结核发病间的关系。方法 采用病例对照研究设计，用聚合酶链反应—限制性片段长度多态性分析(PCR—RFLP)检测VDR基因中T／C多态性位点，对肺结核相关的环境因素进行问卷调查，并进行单因素分析和多因素1ogistic回归分析。结果 对76例病例和171名对照进行了VDR的基因分型，VDR—FF、VDR—Ff与VDR—ff三种基因型在病例组和对照组中的分布频率分别为38．2％、44．7％、17．1％和52．6％、40．9％、6．4％，其中ff基因型在病例组中的频率显著高于对照组，OR值95％CI：3．668(1．483—9．071)；在多因素分析中调整卡介苗接种史和吸烟状况后，VDR—ff基因型与肺结核发病仍有显著性关联，调整OR值95％CI：3．036(1．117—8．253)。结论 VDR—ff基因型可能是中国汉族人群肺结核病的易感基因型。     

肿瘤坏死因子βNcoI位点多态性与胃癌易感性

目的探讨江苏省南京市汉族人群肿瘤坏因子β（TNF-β）等位基因多态性与癌易感性的关系。并分析与环境危险因素的交互作用。方法采用聚合酶链反应一限制性片段长度多态性（PCR—RFLP）技术对294例胃癌患者及对照进行（TNF-β）基因的单核苷酸多态性（SNP）检测，分析TNF-β基因多态性与胃癌易感性的关系。结合环境危险因素分析，了解TNF-β基因多态性与环境危险因素在胃癌发生中的交互作用。结果TNF-β G／A杂合子是胃癌的危险因素，其在病例组与对照组中的频率分别为50．0％与44．2％，OR=1．6615，95％CI=1．0777～2．5617，P=0．0210），TNF-β A／A出现的频率在胃癌组与对照组比较差异无统计学意义（P〉0．05），未发现与环境因素存在交互作用。结论．TNF-β G/A杂合子与胃癌的易感性有关。     

NRAMP1基因3'UTR多态性与大理地区彝族肺结核易感相关性研究

目的 探讨NRAMP1基因3'UTR位点多态性与大理彝族肺结核病易感相关性及抗结核疗效的联系。方法 采用PCR - RFLP方法检测102例彝族肺结核病人及108例彝族健康人群的NRAMP1基因3'UTR位点的基因型,分析其与彝族人群患肺结核病的易感相关性,且对病人进行抗结核治疗1月后随访及不良反应观察,分析NRAMP1基因多态性与病人抗结核疗效的关系。结果 病例组中NRAMP1基因3'UTR位点AA基因型频率为20.59%,对照组中为5.55%,组间分布差异有统计学意义,χ2 = 14.135,P＜0.001。具有AA基因型的彝族患者肺结核的OR值为6.250,95% CI为2.404～16.247。抗结核治疗后,各基因型患者间胃肠道反应、肝损害及关节损害不良反应的发生率不同,突变型（GA + AA）患者比野生型（GG型）患者更易发生胃肠道反应、肝损伤、关节损害3种不良反应（P＜0.05）。需临床处理的较重不良反应在突变型（GA + AA）患者及野生型（GG型）患者中无统计学差异（P＞0.05）。结论 NRAMP1基因3'UTR位点多态性与大理彝族人群肺结核的易感性相关,可能是大理地区彝族人群肺结核易感的影响因素。A等位基因可能是大理彝族人群肺结核病发病危险因素（OR = 2.069,95% CI = 1.389～3.082 ）。患者抗结核治疗后发生的不良反应情况与NRAMP1基因3'UTR位点多态性存在相关性。     

安徽汉族人群PDCD1基因单核苷酸多态性与系统性红斑狼疮易感性分析

目的探讨程序性细胞死亡基因（PDCD1）单核苷酸多态性（SNP）对安徽籍汉族人群系统性红斑狼疮（SLE）患者易感性的影响。方法利用病例对照研究方法，收集122例SLE确诊患者和143名正常对照的血标本，用酚-氯仿-蛋白酶K提取法提取基因组DNA，用DNA单向测序法进行SNP因子检测和筛查。结果PDCD1基因7809位点的基因型全部为G／G型，PDCD1基因7872位点存在C和T2种多态性，PDCD1基因8162位点存在G和A2种多态性，在两组中分布差异有统计学意义（x^2=8．55，x^2=11．85，P〈0．05）。PDCD1基因7872位点，病例组C／C、C／T、T／T基因型频率分别为36．1％、41．8％、22．1％，对照组分别为51．7％、35．0％、13．3％，两组间基因型分布差异有统计学意义（0=7．411，P〈0．05）；PDCD1基因8162位点病例组G／G、G／A、A／A基因型频率分别为50．1％、20．3％、28．6％，对照组分别为57．6％、20．8％、22．6％，两组间等位基因型分布差异有统计学意义（x^2=7．547，P〈0．05）。PDCD1-7872杂合型、PDCD1-8162杂合型可能具有阻止汉族人发生SLE的作用（OR=0．583，OR=0．485）。结论安徽籍汉族人群PDCD1基因7809位点不呈现SNP，7872和8162位点SNP与SLE的易感性相关。     

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.     

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.