甲型副伤寒沙门菌株的脉冲电场凝胶电泳分型研究

目的探讨台州地区甲型副伤寒沙门菌株的流行病学特征及分型情况。方法用脉冲电场凝胶电泳(PFGE)方法进行分型。结果根据细菌染色体DNA的XbaⅠ酶切图谱，可将台州地区患者中分离的65株甲型副伤寒沙门菌分成9个PFGE型别(X1～X9)。来自温岭菌株有6个PFGE型，三门菌株有4个PFGE型，玉环菌株仅有2个PFGE型，其中X2为优势菌型。结论分型研究表明，甲型副伤寒沙门菌核型上虽在台州地区存在着县区性差异，但均以X2为主要流行菌型，从而提示了同一个克隆群内的菌株广泛传播可能是造成台州地区甲型副伤寒流行的主要原因。     

中国2000-2008年间甲型副伤寒沙门菌脉冲场凝胶电泳和多位点序列分析

目的 分析我国2000-2008年间甲型副伤寒沙门菌流行株的分子分型及病原进化上的特征.方法 应用以Spe Ⅰ为限制性内切酶的脉冲场凝胶电泳(pulsed-field gel electrophoresis,PFGE)方法 和基于9个管家基因位点(aroC、thrA、hisD、purE、sucA、dnaN、hemD、adk和purA)的多位点序列分析(multilocus sequence typing,MLST)分型方法 ,对我国2000-2008年间分离自10个地区的118株甲型副伤寒沙门菌流行株进行分析.结果 应用PFGE方法 将118株甲型副伤寒沙门菌分为32个型,其中包含5株以上的优势PFGE带型有5种.而应用MLST方法 ,所有菌株只分出了2个序列分型(sequence type,ST),各菌株的管家基因序列高度保守,呈现高度克隆化.结论 中国2000-2008年间甲型副伤寒沙门菌菌株应用MLST这种分型方法 很难区分,MLST不适于甲型副伤寒沙门菌的暴发调查和流行病学监测.目前中国的甲型副伤寒是由高度克隆化的菌株引起全国范围的扩散 流行.随着年份的变迁,也积累了散在的变异.     

浙江省伤寒副伤寒沙门菌耐药及分子分型

目的了解浙江省伤寒副伤寒沙门菌耐药及分子分型特点,为伤寒副伤寒防制工作提供依据。方法采用WHO推荐的改良K-B纸片法,对209株甲型副伤寒沙门菌和5株伤寒沙门菌进行14种抗生素敏感性试验;运用脉冲场凝胶电泳分型(PFGE)方法对119株甲型副伤寒沙门菌进行分子分型及流行病学特征分析。结果209株甲型副伤寒沙门菌对红霉素、萘啶酸和利福平100%耐药,对阿米卡星100%敏感,对环丙沙星的敏感率仅为58%;5株伤寒沙门菌对红霉素和利福平100%耐药,对头孢噻吩、头孢噻肟、庆大霉素、环丙沙星、氨苄西林、阿米卡星和阿莫西林/克拉维酸100%敏感;不同地区间的甲型副伤寒沙门菌对大部分药物敏感率一致,只有多西环素存在较大差异;119株甲型副伤寒沙门菌共产生20种PFGE带型,并主要集中在2种同源性较高的型别。结论2008年浙江省伤寒副伤寒以甲型副伤寒菌株为优势株,不同地区甲型副伤寒沙门菌对大部分抗生素敏感率一致;高发地区(台州)的菌株PFGE带型比较分散,可能与菌株变异有关。     

杭州市2002-2008年甲型副伤寒沙门菌分子分型研究

目的研究2002-2008年杭州市甲型副伤寒疫情分离株的亲缘性,并探讨脉冲场凝胶电泳（PFGE）、多位点序列分型（MLST）在甲型副伤寒沙门菌分子分型中的应用。方法对404株甲型副伤寒沙门菌运用脉冲场凝胶电泳（PFGE）进行分子分型,并用K-B法测定菌株抗生素敏感性。挑选9株甲型副伤寒沙门菌进行多位点序列分型（MLST）以及稳定性试验。结果 404株甲型副伤寒沙门菌可分为6个PFGE型和4个耐药型,P1型和P2型属于同一个克隆系,该克隆系菌株占试验菌株数的99%,分离自临安市的310株菌均为P1型,分离自杭州市西湖区的主要菌型是P2型和P1型。9株甲型副伤寒沙门菌根据SucA位点的差异可分为2个MLST型。结论杭州市2002-2008年的甲型副伤寒疫情由同一克隆系的菌株主导。PFGE、MLST分型方法各有侧重,可互为补充。     

宁波地区甲型副伤寒沙门菌基因分型

目的 了解宁波地区甲型副伤寒沙门菌的脉冲场凝胶电泳（PFGE）基因型和流行优势型，为探讨传播途径和追踪传染源等提供依据。方法 用全自动细菌鉴定仪（Vitek32）确定细菌的生物学特征；用诊断血清确定细菌的血清型；用PFGE方法对细菌的染色体进行基因分型。结果 102株甲型副伤寒沙门苗可分成9个PFGE型，其中X2型73株，占71．57％。X1型21株，占20，58％，X7型2株，占1．96％，其他6个型各1株，分别占0．98％。其中优势型为X2型，菌株的带型变化在1～3条范围内，表明宁波地区的甲型副伤寒沙门菌变异不大，有可能是同一克隆系的甲型副伤寒沙门菌。结论 PFGE分型对探讨伤寒、副伤寒疫情内在联系具有重要意义，该法特异性高、重复性好、结果容易判读，有实际应用价值。     

2011-2012年杭州市肠道沙门菌临床分离株的分子型别分析

目的研究2011-2012年杭州市肠道沙门菌临床分离株的型别,了解本地菌株分子流行病学特征。方法对66株肠道沙门菌临床分离株进行血清分型和多位点序列分型(MLST)。对其中主要血清型:鼠伤寒、甲型副伤寒、萨雷甲尼和肠炎沙门菌菌株进行脉冲场凝胶电泳(PFGE)分型。结果分布于21个血清型的66株沙门菌分成26个ST型别。发现一株纽波特沙门菌为新型ST1690。菌株血清型与MLST型别数据库中所对应的血清型符合率为100.00%。9株甲型副伤寒沙门菌的PFGE带型完全一致(P7型),与先前杭州流行菌株有差异(P1-P6型)。6株肠炎沙门菌分成4个PFGE型,型间最小相似性为92.70%。13株鼠伤寒沙门菌分为11个PFGE型,型间最小相似性为71.70%。7株萨雷甲尼沙门菌分成4个PFGE型别,型间最小相似性为91.00%。结论近年杭州腹泻病人中流行的肠道沙门菌菌株主要血清型为鼠伤寒、甲型副伤寒、萨雷甲尼和肠炎等。甲型副伤寒沙门菌菌株在杭州出现了新PFGE型别。MLST数据可以对沙门菌血清学鉴定提供一定的帮助。     

伤寒与甲型副伤寒沙门菌基因分型与耐药性研究

目的:通过追溯菌株的流行优势型,了解菌株的耐药性,分析流行因素,为查明宁波地区伤寒、副伤寒疫情回升原因提供科学依据。方法:水产品检测采用GB、PCR和mini VIDAS联合检测方法;病人、从业人员检测采用全国临床操作规程或GB方法;菌株鉴定采用VITEK、ATP方法;药物敏感试验采用K-B纸片扩散法;基因分型采用PFGE方法。结果:从11类1500份海产品中检出6株沙门菌,检出率为0.40%,其中甲型副伤寒沙门菌2株,检出率为0.13%,肠炎等沙门菌3株,检出率为0.20%,伤寒沙门菌1株,检出率为0.07%;住院病人及暴发疫情标本中分离到沙门菌593株,其中伤寒沙门菌25株,占4.22%,乙型副伤寒沙门菌1株,占0.17%,甲型副伤寒沙门菌567株,占95.62%;食品、公共场所从业人员检出甲型副伤寒沙门菌2株;病人胆汁中分离到甲型副伤寒沙门菌1株。182株甲型副伤寒沙门菌和3株伤寒沙门菌药敏试验显示,大多数菌株对常用多种抗生素均敏感,其中1株分离于水产品伤寒沙门菌出现多重耐药。14株伤寒沙门菌可分为3个PFGE型,364株甲型副伤寒沙门菌可分为12个PFGE型。结论:宁波地区伤寒、副伤寒疫情回升与食源性有关,同源性试验提示菌株来是同一克隆系的可能性较大,优势流行型为PFGE 2型,且发现宁波地区副伤寒疫情的流行强度与此型细菌相关。检出的伤寒、副伤寒沙门菌对氧哌嗪青霉素、妥布霉素及头孢哌酮等第3代头孢菌素药物显示良好的敏感性,可作为当前预防和治疗的首选药物。伤寒出现多重耐药株,应引起我们的关注。PFGE分型有助于病原的追溯,分析菌株的变迁,为流行病学进一步分析病因提供支持,在确定传播途径等方面具有重要意义。     

中国四省甲型副伤寒分离株脉冲场凝胶电泳分析及分型数据库建立

目的对中国4个甲型副伤寒流行省份的分离株进行标准化脉冲场凝胶电泳（PFGE）分型分析。方法对来自4个省的甲型副伤寒沙门菌利用XbaⅠ酶切染色体DNA进行PFGE分析，利用BioNumerics建立数据库和进行相似性聚类。结果分离自1998-2002年的89株甲型副伤寒分离株共有11种PFGE带型，这些菌株中具有优势带型。有3种带型相似性在96．3％，这3种带型的菌株占到分析菌株的865％，并在不同省份和年度中出现。结论建立了中国甲型副伤寒沙门菌的用于网络监测分析的PFGE技术和数据库，近年中国部分省份的甲型副伤寒沙门菌分离株PFGE型别集中，存在同型菌株的广泛流行。     

玉溪红塔区212株甲型副伤寒沙门菌脉冲场凝胶电泳(PFGE)结果分析

[目的]了解玉溪红塔区甲型副伤寒沙门菌脉冲场凝胶电泳(PFGE)基因型和流行优势型,为探讨传播途径、追踪传染源和确定流行范围等提供依据。[方法]利用XbaⅠ酶切染色体DNA进行PFGE分析。[结果]212株甲型副伤寒沙门菌共分为13种PFGE型,其中0002型123株,占58.02%,0003型46株,占21.7%,0001型32株,占15.1%,0007型2株,占0.94%,其余9个型各1株,分别占0.47%。其中优势型为0002型、0003型和0001型,这3种带型的菌株占到分离菌株的94.8%,并在不同月份和绝大部分乡镇中出现。菌株的带型变化在l～3条范围内,表明红塔区甲型副伤寒沙门菌变异不大,有可能是同一克隆系的甲型副伤寒沙门菌。[结论]红塔区甲型副伤寒沙门菌分离株PFGE型别集中,存在同型菌株的广泛流行。另外10种菌型少见,可能与红塔区甲型副伤寒高度散发有关。     

2005-2007年河南省甲型副伤寒沙门菌PFGE分型

目的了解2005-2007年河南省甲型副伤寒沙门菌流行基因型别。方法菌株用XbaI限制性内切酶酶切,脉冲场凝胶电泳(PFGE)进行分型,NTSYSpc 2.1软件聚类分析。结果来自河南省登封市伤寒、副伤寒沙门菌监测点的70株甲型副伤寒人源分离菌株,根据XbaI酶切PGFE基因指纹图谱分析,70株菌出现三个PFGE基因型别,分别是0001、0002、0007基因型,其中0001是首次在河南发现的甲型副伤寒基因型别。结论 0001基因型2005年在河南省首次发现,2006-2007年成为甲型副伤寒在当地流行的优势基因型。     

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.