基因重组乙型肝炎疫苗的免疫效果研究

目的：评价基因重组乙型肝炎（乙肝）疫苗对人群的免疫效果。方法：C地195名新生儿、191名中学生及219名不同HBV感染接种疫苗,进行效果观察,并比较重组酵母来源和血源来源的2种不同检测乙型表面抗体的放射免疫分析方法试剂。结果：新生儿免疫后,抗－HBs阳性转率均达到85％以上,但中华地鼠卵巢细胞基因重组乙肝疫苗不论是在抗体阳转率还是在抗体滴度上效果都优于酵母乙肝疫苗,中学生免疫后,抗－HBs阳转率达70％以上,免疫后2年时10μg－5μg－5μg剂量组的免疫效果要优于5μg－5μg－5μg组。对HBV不同感染免疫后,可使51．14％的感染抗－HBs阳转或抗－HBs滴度上升,重组酵母来源试剂检测抗－HBs的阳转率（81．42％）,比血源来源试剂检测（73．33％）可提高近10％。结论：基因重组乙肝疫苗10μg－5μg－5μg剂量为宜。在监测人群免疫后抗－HBs时,应选用相应抗原制备的试剂检测相应抗体,以提高检测的敏感性。     

血源乙肝疫苗免疫4年后用基因工程疫苗再免效果观察

目的 观察国产基因乙肝疫苗再免的效果。方法 以出生时全程接种血源乙肝疫苗4年后的儿童为对象,用5ug基因乙肝苗进行再免,同时用10ug血源惭肝疫苗作对照。观察两种疫苗再免后1、12、24个月抗－HBs水平。结果 用5ug基因乙肝疫苗进行再免能取得良好的抗－HBs应答。不论再免前抗－HBs水平高低,再免后能呈现免疫回忆反应。再免的抗体的 模式与用10ug血源乙肝疫苗相似,差异无统计学意义。结论 用5ug基因乙肝疫苗与10ug血源惭肝疫苗再免能获得相同的再免效果。     

两种剂量重组酵母乙型肝炎疫苗加强免疫后血清抗-HBs观察

为了观察5μg和10μg两种剂量的重组酵母乙型肝炎(乙肝)疫苗加强免疫的效果,将出生时全程接种过血源乙肝疫苗的小学1年级学生随机分成3组,分别加强接种5μg和10μg重组酵母乙肝疫苗.采用放射免疫试验(RIA)检测血清中HBsAg和抗-HBs.加强免疫前3组人群血清抗-HBs阳性(≥10mIU/ml)率均＞70%,说明血源乙肝疫苗具有良好的免疫持久性.用重组酵母乙肝疫苗加强免疫后1个月,5μg剂量的两组血清抗体阳性率分别上升到90%和98.31%,10μg组上升到98.48%,重组酵母乙肝疫苗可用于血源乙肝疫苗基础免疫后的加强接种.     

血源乙肝疫苗免疫4年后用基因工程疫苗再免效果观察

[目的]观察国产基因乙肝疫苗再免的效果。[方法]以出生时全程接种血源乙肝疫苗4年后的儿童为对象,用5μg基因乙肝疫苗进行再免,同时用10μg血源乙肝疫苗作对照。观察两种疫苗再免后1、12、24个月抗-HBs水平。[结果]用5μg基因乙肝疫苗进行再免能取得良好的抗-HBs应答,不论再免前抗-HBs水平高低,再免后能呈现免疫回忆反应。再免的抗体反应模式与用10μg血源乙肝疫苗相似,差异无统计学意义。[结论]用5μg基因乙肝疫苗与10μg血源乙肝疫苗再免能获得相同的再免效果。     

重组酵母乙型肝炎疫苗血清学免疫效果的观察

目的：探讨国产重组酵母乙型肝炎（乙肝）疫苗不同剂量，不同间隔时间免疫后4年的血清学免疫效果。方法：对乙肝表面抗原（HBsAg)阳性母亲和阴性母亲的新生儿，按第1针分别接种10μg或5μg乙肝疫苗，4年后观察免疫效果，同时对HBsAg阴性母亲的新生儿选择第3针与第1针的不同间隔时间进行接种，全程免疫后4年观察免疫效果。结果：乙肝疫苗全程免疫4年后，HBsAg阳性母亲的新生儿第1针接种10μg组抗－HBs阳性率高于5μg组，差别有显著性，对HB－sAg阴性母亲的新生儿进行免疫时，乙肝疫苗第3针与第1针间隔5，6，8个月，其抗－HBs阳性率及抗体水平，差别均无显著性，所有接种对象，全程免疫4年后抗－HBs阳性率及抗体水平均较低。结论：HBsAg阳性母亲的新生儿国产重组酵母乙肝疫苗第1针10μg组全程免疫效果优于5μg组，HBsAg阴性母亲的新生儿乙肝疫苗第3针与第1针间隔5，6，8个月都是可行的，4周岁儿童乙肝疫苗加强接种是必要的。     

新生儿乙肝疫苗免疫后13年免疫效果及用重组酵母乙肝疫苗的免疫应答

目的确定国产乙肝血源疫苗低剂量免疫保护持久性及用重组酵母乙肝疫苗加强免疫的免疫应答。方法采用放射免疫（ＲＩＡ）法测定新生儿免疫后１３年的血清学效果和加免实验的抗体反应。结果９４１名免疫儿童乙型肝炎表面抗体（抗－ＨＢｓ）阳性率和滴度已明显下降，６６．０％的儿童抗－ＨＢｓ水平在保护性水平（ｍＩＵ／ｍｌ＜１０）以下，但仍有较高保护效果，乙型肝炎病毒表面抗原（ＨＢｓＡｇ）阳性率（０．５３％）与免疫后１年时（１．４％）相比较，无显著性差异（Ｐ＞０．０５），说明国产乙肝血源疫苗具有持久的免疫预防效果。使用５．０μｇ剂量的乙肝酵母基因工程疫苗对１０５名抗－ＨＢｓ阴性的儿童进行加强免疫接种，结果加强免疫后１个月抗－ＨＢｓ阳转率达７０．５％，回忆反应较好。结论国产乙肝血源疫苗低剂量免疫有很好的免疫保护持久性，用重组酵母乙肝疫苗加强免疫有较好的回忆反应。     

乙肝疫苗不同剂量加强免疫的效果观察

目的：评价儿童乙肝疫苗不同剂量加强免疫1剂后的免疫效果,为实施乙肝疫苗加强免疫提供依据。方法选择玉环县户籍5～11岁且1岁内完成乙肝疫苗基础免疫但未加强免疫的儿童,分别采用含5μg 甲乙肝联合疫苗547人和10μg 乙肝疫苗688人加强免疫1剂,在加强免疫前、后1个月分别检测乙型肝炎表面抗体（抗－HBs）浓度水平。结果加强免疫1个月后,使用含5μg 和10μg 两组儿童抗－HBs 阳性率分别为97.81％和96.08％,抗－HBs GMT 分别为1433.18和2111.43 mIU /mL。加强免疫前抗－HBs 阴性儿童抗－HBs阳转率分别为94.78％和93.62％;年龄越小,免疫阳转率越高（P ＜0.05）。加强免疫前后,两种不同剂量疫苗在抗－HBs 阳性率和抗－HBs GMT 的差异均有统计学意义（P ＜0.01）;抗－HBs GMT 差值均数10μg 乙肝疫苗高于含5μg 甲乙肝联合疫苗（P ＜0.05）。多因素分析提示,5岁以上儿童加强免疫,年龄越小其阳转率越高（OR ＝0.698,95％CI 为0.602～0.808）。结论5～11岁儿童加强乙肝免疫无论剂量大小均有较好的效果,年龄越小其免疫反应越好;10μg 乙肝疫苗加强后的抗－HBs GMT 高于含5μg 甲乙肝联合疫苗。     

儿童应用重组乙型肝炎疫苗(汉逊酵母)加强免疫的效果观察

目的了解儿童应用重组乙型肝炎(乙肝)疫苗(汉逊酵母)加强免疫的效果。方法采用血清流行病学调查方法,对新生儿按0、1、6个月程序完成重组乙肝疫苗(酵母)10μg、5μg、5μg3针接种,经筛查乙肝病毒表面抗原(HBsAg)、乙肝病毒表面抗体(抗-HBs)、乙肝病毒核心抗体(抗-HBc)均阴性的3~5岁儿童,加强接种重组乙肝疫苗(汉逊酵母)10μg,在免疫后5~6周采血,检测血清中抗-HBs。结果抗-HBs阳转率100%,抗体几何平均浓度809.00毫国际单位/毫升(mIU/ml)。结论儿童应用重组乙肝疫苗(汉逊酵母)加强免疫,能够刺激机体产生免疫反应,取得良好的加强免疫效果。     

重组酵母乙型肝炎疫苗血清学免疫效果观察

为探讨国产重组酵母乙型肝炎(乙肝)疫苗不同剂量、不同间隔时间免疫后的安全性和血清学免疫效果，在五总乡和兴东镇对乙肝表面抗原(HBsAg)阳性母亲和阴性母亲的新生儿，按第1针分别接种10μg或5μg乙肝疫苗，1个月后接种第2针(0.5μg)，第3针(0.5μg)与第1针分别间隔5、6、8个月，观察免疫效果。结果显示，所有接种对象均未发现严重副反应。完成3针乙肝疫苗免疫后，HBsAg阴性母亲的新生儿第1针接种10μg组抗－HBs阳转率及抗体水平均高于5μg组，差别均有极显著的统计学意义。第3针乙肝疫苗与第3针百白破混合制剂（DPT）联合免疫，乙肝疫苗的免疫效果良好，DPT的免疫应答率及水平与非联合免疫的差别无显著的统计学意义。这表明国产重组酵母乙肝疫苗的安全性好，第1针10μg组免疫效果优于5μg组，与DPT的联合免疫是可行的。     

新生儿乙型肝炎疫苗诱导抗体阴转者对HBsAg的免疫记忆

观察乙型肝炎(乙肝)血源疫苗新生儿期接种9～10年后,疫苗诱导抗体转阴者是否仍对乙肝表面抗原(HBsAg)保持免疫记忆.采用RIA方法测定并比较乙肝疫苗加强免疫(加免)前后受试对象的抗HBs水平.结果48名受试儿童加免后1个月,抗HBs阳性率与滴度均明显高于免前(p<001),709%(34/48)的加免儿童保持免疫记忆,持续时间至少已3年.提示3针10μg乙肝血源疫苗新生儿期接种9～10年后,大部分诱导免疫抗体阴转的免疫儿童保持着免疫记忆.初免后10年仍未见有加强免疫的必要.     

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.