新生儿溶血病与HLA-DRB1相关性研究

目的探讨人类白细胞抗原(HLA)-DRB1等位基因多态性与新生儿溶血病(HDN)发生之间的关系。方法对117例HDN患者和112例非新生儿溶血病(NHDN)标本,采用PCR-SSO方法进行HLA-DRB1基因分型,对基因频率以及疾病发生的相对危险度(RR)进行研究。结果 HDN患者中HLA-DRB1*1202的基因频数较NHDN显著升高(χ2=7.653,P0.01,RR=2.598);含有HLA-DRB1*1202基因位点的HDN患者,其总胆红素值升高较不含该基因的患者差异有统计学意义(χ2=22.582,P0.01)。结论 HLA-DRB1*1202与HDN的易感性呈正相关,可能是其易感基因。     

兰州地区丙型肝炎病毒基因分型研究

根据丙型肝炎病毒(ＨＣＶ)的异质性,其基因链可分为各种不同的基因型。有资料表明ＨＣＶ基因型分布具有一定的地区差异。作者对83例丙肝患者血清进行型特异性引物分型,以了解本地区ＨＣＶ基因的优势型别。现报告如下。材料与方法　(1)标本采集:83例丙型肝炎患者抗ＨＣＶ均阳性,诊断符合1995年北京第五次全国传染病寄生虫病学术会议修订的病毒性肝炎诊断标准。标本均来源于兰州地区。(2)ＨＣＶＲＮＡ检测:试剂由华美生物工程公司提供,操作及结果判定完全按说明书进行。(3)ＨＣＶ基因分型:①分型引物设计:参照文献〔1〕由北京Ｓｙｂｅｒｓｙｒ…     

基于PCR-RDB法对陕西地区HCV基因型别的研究

目的探讨聚合酶链式反应(polymerase chain reaction,PCR)-反向点杂交法(reverse dot blot,RDB)在陕西地区丙型肝炎病毒基因分型中的应用。方法选取陕西地区610例丙型肝炎患者,利用PCR-RDB法进行丙肝病毒基因型检测,并使用SPSS对检测结果进行统计学分析。结果 610例丙肝患者检出1b型273例(44.75%),2a型286例(46.89%),3a型30例(4.92%),3b型11例(1.80%),6a型10例(1.64%);各基因型间的患者性别比例的差异具有统计学意义(P<0.05);与其他基因型别相比,HCV 3a型患者年龄水平最低,差异显著(P<0.05)。结论陕西地区丙肝病毒以2a、1b型为主,患者性别及年龄与所感染HCV型别有关联性;PCR-RDB技术在丙型肝炎病毒基因分型中的应用有利于HCV分型在临床上的推广。     

丙型肝炎病毒非结构基因NS5b研究进展

丙型肝炎病毒非结构基因5b(NS5b)区是RNA依赖的RNA聚合酶编码区，与HCV的复制及致病关系密切。同时，它也是设计抗病毒药物的重要分子区，特别是HBV聚合酶抑制剂拉米夫定成功的用于临床，使有关RNA依赖的RNA聚合酶表达、催化活性测定和特异性抑制位点等研究成为热点。本文就丙型肝炎病毒NS5b区有关的研究进展作了综述。     

皖南地区丙型肝炎病毒基因型研究

目的 探讨安徽南方地区慢性丙型肝炎患者血清ALT水平、HCV RNA定量检测和HCV基因分型的相关性.方法 用速率法和荧光定量PCR法,检测141例安徽南方地区慢性丙型肝炎患者血清ALT水平和HCVRNA定量结果,应用RT-PCR和型特异性引物法对其中50例标本进行基因分型.结果 141例患者的血清ALT与HCV RNA两指标间的相关性采用Spearman等级相关分析显示,rs=0.213,P=0.011<0.05,差异有统计学意义,存在正相关;在50例标本中,HCV基因分型Ⅰ型有45例(95.7%),Ⅱ型2例(4.3%),未分型3例.结论 安徽南方地区丙型肝炎病毒感染以Ⅰ型为主;ALT、HCV RNA和基因型是可靠且重要的治疗反应指标.     

HLA-Ⅰ基因型对HIV-1感染患儿特异性细胞毒性T细胞应答的影响

目的 对HIV-1感染患儿的人类白细胞抗原(HLA)-Ⅰ基因型进行分析,探讨其对HIV-1特异性CTL应答的影响.方法 采用酶联免疫斑点技术(ELISPOT),以HIV-1 P24区域的氨基酸序列人工合成的12个重叠肽段组成的肽段库作为特异性抗原表位,对5例接受HAART后的HIV-1感染患儿外周血单核细胞(PBMC)的IFN-γ分泌细胞频数进行测定研究.同时,还采用了PCR-序列特异引物技术(PCR-SSP)及PCR-直接碱基序列分析基因分型技术(PCR-SBT)对这5例患儿进行了HLA-Ⅰ等位基因分型及HLA-B*高分辨等位基因分型.结果 5例HIV-1感染息儿中,4例HLA-B*基因型为B*40,其中3例为HLA-B*4001,1例为HLA-B*4002.其HIV-1抗原特异性CTL应答水平差异明显.5例患儿均未出现免疫重建炎症综合征.结论 基因型为HLA-B*40的儿童可能更易感染HIV-1,HLA-B*40可能影响HIV-1感染患儿的抗原特异性CTL应答.     

丽水市HIV抗体阳性男男性行为人群中HLA-A-B-DRB1基因多态性研究

目的从基因水平了解丽水市HIV阳性的男男性行为人群(MSM)中HLA-A、HLA-B、HLA-DRB1等位基因的频率,分析其与HIV感染者自身病毒载量和月均CD4+T淋巴细胞计数自然变化的关系。方法应用聚合酶链反应-序列特异性引物技术(PCR-SSP),对丽水市49例HIV阳性MSM进行HLA-A、HLA-B、HLA-DRB1等位基因分型;应用RT-PCR测定HIV病毒载量;应用流式细胞仪对CD4+T淋巴细胞计数。结果鉴定出最常见的等位基因A*02(36.73%)、B*40(22.45%)和DRB1*15(22.45%)。含A*02和B*46者较不含者病毒载量低(P0.01,P0.05),CD4+T淋巴细胞降低较缓;含A*11、B*40和DRB1*15者病毒载量较不含者高(P0.01,P0.05,P0.01),且含A*11和B*40者CD4+T淋巴细胞降低较快;含HLA基因纯合子者较杂合子者病毒载量高(P0.05),CD4+T淋巴细胞降低较快。结论丽水市HIV阳性MSM人群HLA-A、HLA-B、HLA-DRB1基因多态性较高。A*02和B*46在该人群中可能延缓AIDS疾病进程,而A*11、B*40和DRB1*15可能加速AIDS疾病进程。含有HLA基因杂合子者对疾病显示出更好的抵御力。     

湖北地区肾综合征出血热与HLA-DRB基因多态性关联的研究

目的 探索湖北省汉族人白细胞抗原(HLA)-DRB基因多态性与肾综合征出血热(HFRS)的相关性.方法 采用PCR/SSP方法对湖北省汉族病例组114例、对照组213例进行HLA-DRB基因多态性分析,同时采用RT-heminested PCR方法对汉坦病毒(HV)进行病毒分型.结果 HLA- DRB1*0401-0411、*1101-1105基因频率在HFRS患者组明显升高,分别为3.1%、2.2%、15.7%,与对照组比较,RR=13.87、9.72、2.00,χ2=10.006、6.324、6.472,P<0.05;DRB1*1501-1502、DRB4、DRB5基因频率在对照组分别为11.0%、19.0%、16.9%,与HFRS患者组比较,RR=0.45、0.58、0.23,χ2=6.138、4.583、21.076,P<0.05,而其他HLA-DRB基因频率差异无统计学意义.湖北地区为HV混合感染疫区且两型病毒多集中于江汉平原地区,汉滩型(THNV)略多于汉城型(SEOV),湖北地区HFRS患者中具有HLA-DRB1*1101-1105等位基因的有81.8%(27/33)为THNV感染,而SEOV感染只有18.2%,差异有统计学意义(P<0.05).结论 湖北省汉族人中,HFRS与DRB1*0401-0411、*1001、*1101-1105呈正相关;HFRS与DRB1*1501-1502、DRB4、DRB5呈负相关.THNv的HV变异株在湖北地区具有一定的地理聚簇性.     

婚检人群乙、丙型肝炎、梅毒及艾滋病毒检测

目的 了解北京市婚检人群乙型和丙型肝炎、梅毒及艾滋病病毒感染情况。方法 乙型肝炎表面抗原、丙型肝炎抗体和艾滋病毒抗体采用酶免法检测；梅毒采用快速血浆反应素环状卡片试验(RPR)和梅毒螺旋体血凝试验(TPHA)检测：乙型和丙型肝炎病毒载量采用PCR荧光定量方法检测，病毒基因型采用直接PCR基因分型法测定。结果 800例婚检人群乙型和丙型肝炎感染率分别为12．0％，6．0％，梅毒和艾滋病病毒未检出。96例乙肝表面抗原阳性婚检人群中。乙型肝炎病毒载量小于10^5拷贝／ml占88．5％，大于10^5拷贝／ml仅占11．5％。5例丙型肝炎病毒RNA阳性中，病毒载量均小于10^4拷贝／ml，该婚检人群HBV感染中，B型占18．6％，B和C混合型占42．4％．C型占23．7％。3例丙型肝炎病毒感染均为HCV1b型。结论 该婚检人群中，乙型和丙型肝炎病毒感染率相对较高，但病毒载量相对较低。未发现梅毒和艾滋病毒感染。     

422例儿童病毒性肝炎病例分析

为了解儿童病毒性肝炎的病原分型以及各地区、各年龄组中病毒性肝炎感染状况 ,对本院收治的42 2例病毒性肝炎儿童病例分析如下。1　材料与方法1 .1　对象　 42 2例病毒性肝炎儿童均为我院住院患儿 ,其中男 2 79例 ,女 1 43例 ,年龄 1月～ 1 3岁。诊断标准与分型参照 1 995年 (北京 )全国第五次传染与寄生虫病学术会议修订的标准。1 .2　检测方法　血清病原的抗原抗体检测采用酶联免疫吸附试验 (ELISA) ;乙型肝炎病毒 (HBV)DNA、尿巨细胞病毒 (CMV) DNA检测采用聚合酶链反应 (PCR)法 ;血清丙型肝炎病毒 (HCV) RNA采用逆转录 -聚合…     

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.