高危型HPV感染与阴道微生态检测的相关性分析

目的 探讨高危型人乳头瘤病毒(HPV)感染与阴道微生态之间相关性。方法 收集2020年9月—2021年8月于北京大学第三医院妇科同时实施HPV和阴道微生态检测的5 159例患者资料,患者年龄20～65岁。按是否感染高危型HPV分组,高危型HPV阳性组953例,HPV阴性组4 206例,比较两组阴道微生态环境并进行相关性分析。结果 高危型HPV感染率18.5%,感染者阴道微生态失衡中细菌性阴道病(BV)168例(17.5%)、滴虫性阴道炎(TV)0例、外阴阴道假丝酵母菌病(VVC)28例(2.9%)、需氧菌性阴道炎(AV)83例(8.7%)、混合性阴道炎16例(1.7%)、清洁度异常193例(20.3%)。混合性阴道炎以BV与VVC混合感染为主、其次为BV+TV混合感染。与HPV阴性组比较,BV、VVC阳性率组间差异有统计学意义,TV、AV、混合性阴道炎、清洁度异常组间差异均无统计学意义。结论 女性下生殖道感染中,混合性阴道炎以BV与VVC混合感染为主、其次为BV+TV混合感染;BV阳性为高危型HPV感染的危险因素,VVC阳性为保护因素。     

阴道炎和高危型人乳头瘤病毒感染关系

目的：探讨阴道炎与高危型人乳头瘤病毒感染(HR-HPV)关系。方法：回顾性分析2021年1月-2022年9月本院妇科门诊行宫颈癌筛查(HPV联合TCT)和阴道分泌物检测的1747例资料，其中HR-HPV检测阳性423例为阳性组，HPV检测阴性1324例为阴性组。比较两组阴道炎检出情况，并分析与HR-HPV感染相关的危险因素。结果：阳性组细菌性阴道病(BV)、外阴阴道假丝酵母菌病(VVC)检出比例(23.2%、7.1%)均高于阴性组(15.2%、4.5%)(均P<0.05);两组滴虫性阴道炎(TV)、需氧菌性阴道炎(AV)检出率(1.7%比1.4%)(14.9%、16.2%)无差异(均P>0.05)。经logistic回归分析，BV、VVC感染是HR-HPV感染的危险因素。结论：BV、VVC与HR-HPV感染有关，TV、AV与HR-HPV感染未见影响。     

妊娠期糖尿病孕妇阴道微生态变化及其对妊娠结局的影响

目的探讨妊娠期糖尿病(GDM)孕妇发生阴道微生态变化及其对妊娠结局的影响。 方法选取2017年1月至2018年12月,在上海健康医学院附属第六人民医院东院妇产科门诊就诊的132例GDM孕妇为研究对象,纳入研究组。选取同期于本院进行产前检查的132例正常妊娠孕妇作为对照,纳入对照组。根据阴道分泌物6联检查结果,将研究组GDM孕妇,进一步分为阴道微生态失衡亚组(n＝54)与阴道微生态正常亚组(n＝78)。研究组与对照组孕妇阴道微生态失衡率比较,采用χ²检验。2个亚组孕妇孕前体重、孕期体重增加值、空腹血糖、口服葡萄糖耐量试验(OGTT) 2 h血糖、糖化血红蛋白(HbA1c)及糖化白蛋白(GA)水平比较,采用成组t检验。2个亚组孕妇及其分娩新生儿不良妊娠结局发生率比较,采用χ²检验。研究组与对照组孕妇,2个亚组孕妇年龄、孕龄、经产妇与初产妇构成比等一般临床资料分别比较,差异均无统计学意义(P>0.05)。 结果①研究组与对照组细菌性阴道病(BV)孕妇分别为7例与2例,BV＋滴虫性阴道炎(TV)分别为1例与0例,BV＋外阴阴道念珠菌病(VVC)分别为3例与0例,TV分别为2例与0例,VVC分别为10例与4例,其他类型阴道炎分别为31例与7例。研究组孕妇阴道微生态失衡率为40.9%(54/132),显著高于对照组的9.8%(13/132),并且差异有统计学意义(χ²＝33.623、P<0.001)。②阴道微生态失衡亚组GDM孕妇孕期体重增加值为(19.5±2.7) kg、HbA1c为(9.5±1.3)%、GA为(11.2±1.2)%,均分别显著高于阴道微生态正常亚组的(14.3±1.4) kg、(7.3±1.1)%、(8.6±0.9)%,2组分别比较,差异均有统计学意义(t＝3.406、P＝0.020,t＝3.313、P＝0.026,t＝3.014、P＝0.039)。③阴道微生态失衡亚组GDM孕妇早产、产褥期感染发生率分别为22.2%(12/54)与25.9%(14/54),其分娩新生儿的低出生体重儿、感染发生率分别为20.4%(11/54)、9.3%(5/54),均分别显著高于阴道微生态正常亚组的9.0%(7/78)、11.5%(9/78)、7.7%(6/78)及2.6%(2/78),并且差异均有统计学意义(χ²＝4.545、P＝0.008,χ²＝4.591、P＝0.032,χ²＝4.571、P＝0.033,χ²＝4.525、P＝0.033)。 结论GDM孕妇阴道微生态失衡率显著高于正常妊娠孕妇。孕期体重增加值、HbA1c和GA是影响GDM孕妇发生阴道微生态失衡的重要因素,其异常增高,可使其不良妊娠结局发生率增高。     

唐县地区妇女阴道需氧菌感染情况调查分析

目的:了解唐县地区妇女阴道需氧菌感染情况。方法:使用Donders湿片镜检法对2011年1～9月在唐县人民医院妇科132例疑似需氧菌性阴道炎(aerobic vaginitis,AV)患者进行检测。结果:在132例疑似AV患者中,共检出AV41例,占31.06%。包括单纯AV感染15例(36.59%),混合感染26例(63.41%),其中合并BV感染12例(46.15%)、合并VVC感染8例(30.77%)、合并TV感染6例(23.08%)。结论:AV易合并BV、VVC、TV感染。诊断AV时,应注意是否合并其他阴道感染。     

成都地区女性生殖道感染研究

目的:了解成都地区女性生殖道感染的基本状况。方法:随机调查5598例在我院就诊的妇科、产科和计划生育科病人,通过阴道分泌物检查了解滴虫性阴道炎(TV)、假丝酵母菌外阴阴道炎(VVC)、细菌性阴道病(BV)及淋病的感染率。结果:BV、VVC、TV及淋病的感染率依次为17·1%、12·9%、2·7%、0·3%;合并感染率中,BV合并VVC感染率为10·2%,显著高于其它合并感染率(P<0·05)。结论:BV是女性生殖道最常见的感染性疾病,且易于与VVC合并感染,应引起临床医生的高度重视。     

妇科门诊患者不同阴道微生态状态下人乳头瘤病毒感染现状

目的分析女性不同阴道微生态状态下人乳头瘤病毒(HPV)感染现状,并分析HPV感染与阴道微生态之间的关联。方法选取2019年5月—2020年4月于包头医学院第二附属医院妇产科门诊就诊同时进行HPV与阴道微生态检测的752例女性患者为研究对象。结果752例患者中,阴道微生态正常率为56.91%;阴道微生态失调率为43.09%,其中细菌性阴道病(BV)中间型7.71%、BV12.77%、外阴阴道假丝酵母菌病(VVC)5.85%、滴虫性阴道炎(TV)1.86%、阴道混合感染1.86%、无明确感染的阴道微生态失调13.03%。HPV感染率24.20%,所检测的HPV 16、18、31、33、35、39、45、51、52、56、58、59、66、68、8215个基因型均有检出,感染率排前4位的是52型(5.85%)、16型(5.59%)、58型(3.99%)、18型(2.66%)。阴道微生态、pH、乳杆菌、BV异常组HPV感染率高于正常组,差异有统计学意义(P<0.05);白细胞计数(WBC)、VVC、TV异常组与正常组比较,差异无统计学意义(P>0.05);阴道微生态、pH、BV异常组HPV16/18感染率高于正常组,差异有统计学意义(P<0.05);WBC、乳酸杆菌、VVC、TV异常组与正常组比较,差异无统计学意义(P>0.05)。logistic回归多因素分析显示:pH值异常、BV阳性HPV感染率增加(OR_(pH)=1.589、OR_(BV)=2.328),乳杆菌数量减少、BV、VVC阳性HPV16/18感染率增加(OR_(乳杆菌)=3.152、OR_(BV)=14.260、OR_(VVC)=5.403)。结论妇产科门诊就诊患者HPV感染与阴道pH、BV有关联,HPV16/18感染与乳杆菌数、BV、VVC有关联。此研究属于横断面资料,难以揭示阴道微生态变化与HPV感染孰先孰后的问题,关于这两者之间的因果发展顺序,还需队列研究方法进行阐明。     

阴道微生态改变与高危型人乳头状瘤病毒感染相关性分析

目的 探讨阴道微生态改变与宫颈高危型人乳头状瘤病毒(HR-HPV)感染的相关性。方法 选择2017年1月-2018年12月在本院妇科就诊妇女1 543例进行阴道微生态检测、常规行薄层液基细胞学(TCT)检查、PCR-反向点杂交法检测HPV 23种亚型; TCT阴性且HR-HPV感染人群设为HR-HPV组,TCT和HPV检测结果均阴性人群设为HPV阴性组,比较2组阴道微生态检查结果。结果 1 543例受检者TCT阳性152例,1 391例TCT阴性受检者141例感染HR-HPV。细菌性阴道病(BV)、外阴阴道假丝病(VVC)、需氧菌性阴道炎(AV)、p H值 4. 5、阴道清洁度异常及乳酸杆菌减少组HR-HPV感染率均明显高于对应阴性组(P 0. 01); HR-HPV组BV、VVC、AV、p H值 4. 5、阴道清洁度异常及乳杆菌减少检出率均明显高于HPV阴性组(P 0. 01)。结论 BV、VVC、AV、p H值 4. 5、阴道清洁度异常及乳酸杆菌减少等阴道微生态变化与HR-HPV感染之间存在相关性。     

泸州地区细菌性阴道病的调查研究

目的:了解阴道炎患者细菌性阴道病(Bacterial vaginosis,BV)的发生率和发病的原因。方法:采用快速检测法对3 443例阴道炎患者进行BV的检测,同时采用生理盐水直接涂片法进行阴道清洁度、霉菌及阴道滴虫感染的观察。检查结果采用χ2检验进行不同年龄组间BV发生率的差异分析。结果:阴道炎患者BV的发生率38.11%(1 312/3 443),明显高于霉菌20.88%(719/3 443)、阴道滴虫3.60%(124/3 443)的感染率(P<0.05)。≤20岁、21～30岁、31～40岁、41～50岁和>50岁年龄组BV的发生率分别为39.69%、41.02%、40.10%、34.84%和20.25%,组间比较41岁以上组BV的发生率低于40岁以上组,以>50岁年龄组BV的发生率最低(P<0.05),其他年龄组间比较差异无统计学意义(P>0.05)。阴道清洁度Ⅰ～Ⅱ和Ⅲ～ⅣBV的发生率分别为44.09%和30.98%。BV患者中,同时伴有霉菌感染者占22.56%(296/1 312),阴道滴虫感染患者占5.49%(72/1 312)。结论:泸州地区阴道炎患者以BV为主,亦有合并霉菌和阴道滴虫感染的病例,BV的发生有年龄差异,与阴道清洁度有一定的关系。     

海岛地区孕妇阴道炎情况分析

目的：探讨海岛地区孕妇各种阴道炎的发病率及其影响因素。方法选择在舟山医院孕检的妇女3554例为观察对象,年龄17～45岁,采用镜检联合需氧菌阴道炎／细菌性阴道病联合测定技术检测需氧菌阴道炎（AV）、细菌性阴道病（BV）、外阴阴道假丝酵母菌病（ VVC）、滴虫性阴道炎（ TV）。分析当地月份、孕期、年龄对各种阴道炎发病率的影响。结果孕妇阴道炎年发病率为44．3％,AV年发病率为27．7％,高发月份8月（40．7％）;VVC发病率6．5％,高发月份6月（9．6％）;BV发病率9％,高发月份4月（16．0％）;TV发病率1％,高发月份10月（2．4％）。不同孕期AV、BV、TV各自的发病率无明显异常,而VVC检出率有显著性差异（χ2＝8．99,P＜0．05）。孕妇不同年龄段BV发病率有显著性差异（χ2＝87．78,P＜0．01）,随着年龄增加而增加。结论海岛地区孕妇4种阴道炎发病率一年中变化较大,而不同孕期、不同年龄分别只对VVC和BV的发病率影响较大。     

孕期妇女阴道炎发病情况及病原菌调查

目的 了解孕期妇女阴道炎发病情况及病原菌感染分布,为临床防治孕期阴道炎提供参考依据.方法 选取产科门诊进行产前检查的孕期妇女328例作为研究对象(孕妇组),其中115例为早孕组,104例为中孕组,109例为晚孕组,并且选取同期门诊行体检的育龄期妇女100例作为对照(非孕组),进行阴道分泌物检查确定有无滴虫性阴道炎(TV)、真菌性阴道炎(VVC)、细菌性阴道炎(BV).结果 孕妇组阴道炎发病率29.57％,非孕组发病率19.00％,两组差异有统计学意义(P＜0.05);根据感染病原菌不同,孕妇组TV、VVC、BV感染率分别为2.44％、8.54％、18.60％,非孕组感染率分别为5.00％、6.00％、8.00％,TV、VVC感染率两组差异无统计学意义,BV感染率两组差异有统计学意义(P＜0.05);阴道炎发病率早孕组29.57％,中孕组29.81％,晚孕组29.36％,各组比较差异无统计学意义;早孕组TV、VV、BV感染率分别为0.87％、9.57％、19.12％,中孕组感染率分别为2.88％、9.62％、17.31％,晚孕组感染率分别为3.67％、6.42％、19.27％,各组比较差异无统计学意义;早孕组、中孕组、晚孕组与非孕组阴道炎发病率比较差异无统计学意义;TV、VVC、BV感染率在早孕组、中孕组、晚孕组与非孕组之间分别比较,TV、VVC感染率差异无统计学意义;BV感染率差异有统计学意义(P＜0.05).结论 孕期妇女阴道炎发病率较非孕妇女有所增加,并且以BV感染率升高更为明显.     

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.