清远市健康人群SARS冠状病毒抗体血清流行病学研究

目的 了解清远地区健康人群不同年龄、职业的SARS冠状病毒(简称SARS-CoV)抗体水平状况。通过对SARS流行后期(非疫区)健康人群血清中SARS-CoV抗体水平调查，以发现是否存在隐性感染，确定易感人群和高危人群，寻找与病源有关的人群和动物。方法 2003年8月～2004年1月，采集该地区各县区不同年龄、不同职业的健康人群血液，用酶联免疫法检测血清中SARS-CoV抗体Ig6水平。结果 共检测健康入血清4268份，SARS-CoV抗体Ig6阳性率为0．75％(32／4268)，其中1～6岁年龄组的阳性率为1．54％(15／975)，7～12岁年龄组的阳性率为1．23％(8／651)，13～18岁年龄组的阳性率为0．33％(1／306)，19岁～成年年龄组的阳性率为0．34％(8／2336)。2642份不同职业的健康人群阳性率为12．50％(3／24)，其他职业健康人群的阳性率为0．23％(6／2618)。结论 该地区SARS-CoV抗体水平比较低，低龄组(1～12岁)健康人群SARS-CoV抗体IgG阳性率高于高龄组(13岁～成年)组健康人群的阳性率；从事野生动物屠宰职业的健康人群SAILS-CoV抗体IgG阳性率高于其他健康人群的阳性率。提示SARS-CoV可能存在隐性感染、隐性传播和隐生感染聚集性；也提示从事野生动物屠宰职业的人群可能是SARS-CoV的高危人群。     

广东省不同人群SARS病毒抗体水平调查

目的对不同人群进行SARS-IgG抗体水平检测，分析SARS流行规模和特征，评价暴露的危险性，了解人数中是否存在SARS病毒隐性感染，为寻找SARS病毒传染源提供线索。方法抽取7708份不同人群标本，按临床症状和暴露因素分为临床确诊SARS病人、病人或污染物的接触者、普通健康人群和动物销售人员4类，采用酶联免疫方法(ELISA)进行SARS-IgG抗体检测，用免疫荧光法(IFA)复核，并结合流行病学资料进行分析。结果127例临床确诊SARS病人抗体阳性率为66．9％；密切接触者中女性发病率高于男性；SARS病人或其污染物的密切接触者抗体阳性率为0．88％；动物销售人员为13．4％；野生哺乳动物销售者的抗体阳性率显著高于其他动物销售者，普通健康人群未检出抗体阳性。低年龄健康人群ELISA检测阳性率为2．06％，高于总体水平。结论人群总体抗体水平很低，普通健康人群无SARS冠状病毒抗体，但可能存在某种可与SARS冠状病毒起交叉反应的抗体；有无接触史是影响抗体阳性率的重要因素；密切接触者可能存在隐性感染；野生动物可能是本次SARS的传染源。     

广西肝癌高发区壮族自然人群中流行的HCV,HBV的分子生物学研究

在广西肝癌高发区壮族自然人群中采集血清标本１７７６人份，采用ＥＬＩＳＡ方法检测抗－ＨＣＶ、ＨＢｓＡｇ，ＰＣＲ技术检测ＨＣＶ－ＲＮＡ、ＨＢＶ－ＤＮＡ，并对ＨＣＶ－ＲＮＡ阳性的６９份标本采用型特异性引物进行基因分型。结果显示：（１）研究人群中ＨＣＶ－ＲＮＡ阳性率为３．８８％；（２）流行的ＨＣＶ基因以Ｉ型或与其它型别的混合感染为主；（３）Ｉ型感染者中ＬＡＴ的异常率高于其它型别的感染者；（４）当地ＨＣＶ伴     

麻疹疫苗免疫人群隐性感染的观察研究

对分布在三个斑级的在１２年前麻疹疫苗免疫成功者７１人，暴露于自然麻疹后隐性感染情况的观察。显示：（１）麻疹疫苗免疫人群中麻疫的隐性感染普遍存在，三个斑级的隐性感染率波动在１８．５％－７５．０％，平均为４５．１％。（２）麻疹疫苗免疫人群麻疹隐性感染的血凝抑制抗体滴度范围在〈１：２－１：１６，高峰在１：２和／或１：４水平。因此麻疹疫苗免疫人群在暴露时隐性感染率的高低主要取决于该人群中麻疹血凝抑制抗体１     

12省市人群中微小病毒B19—IgG抗体水平调查

用ＥＬＩＳＡ方法对全国１２省部分地区人群共７６０份血清Ｂ１９－ＩｇＧ水平进行了调查。２８３份健康人血清抗体阳性率为３０．２％－９０．５％，平均４５．６％，病人血清４４５份，其中表现出与Ｂ１９感染所致疾病相似症状者Ｂ１９－ＩｇＧ阳性率为３８．３８％，水平高于患其它疾病人群；另外调查孕妇３２例，阳性率４０．６％。说明微小病毒Ｂ１９在中国人群中存在着广泛的感染。     

12省市人群中微小病毒B19IgG抗体水平调查

用ＥＬＩＳＡ方法对全国１２省部分地区人群共７６０份血清Ｂ１９ＩｇＧ水平进行了调查。２８３份健康人血清抗体阳性率为３０．２％～９０．５％，平均４５．６％；病人血清４４５份，其中表现出与Ｂ１９感染所致疾病相似症状者（３３２份）Ｂ１９ＩｇＧ阳性率为３８．８％，水平高于患其它疾病人群（１１３份血清，阳性率２５．７％，ｕ＝２．５３３，０．０２＞Ｐ＞０．０１）；另外调查孕妇３２例，阳性率４０．６％。说明微小病毒Ｂ１９在中国人群中存在着广泛的感染     

部队驻地人体旋毛虫病血清流行病学调查

我们于１９９１年１１月－１９９２年８月，对济南部队驻地部分地区健康人群进行了旋毛虫病流行病学调查，其中对平顶山市进行了重点调查，查明该市健康人群旋毛虫隐性感染率为４．６０％；不同年龄，性别人群旋毛虫抗体阳性率无显著差别（Ｐ＞０．０５）；但居住于远市区人群的阳性率明显高于近市区（Ｐ＜０．０１）。     

珠海口岸出入境人员人间禽流感病毒抗体水平调查

[目的] 调查珠海口岸出入境人员中H5和H92种亚型禽流感病毒血清抗体水平，以了解上述2种禽类甲型流感病毒亚型以往隐性感染情况，为防治人间禽流感提供科学依据。[方法] 采集珠海口岸出入境健康体检人员血清508份，通过血凝抑制试验(HI)进行H5和H9型禽流感病毒抗体检测。[结果] 出入境人员中H9亚型抗体阳性率为9．65％，同时发现有1份血清H5抗体阳性，H5抗体阳性率为0．20％。[结论] H9亚型在出入境健康人群中存在隐性感染；出入境健康人员中H5亚型抗体的存在也应值得注意。     

健康人群乙脑抗体水平与发病关系的探讨

本文对不同发病强度地区的健康人群的乙脑抗体水平进行了检测。结果发现不同地区健康人群的乙脑抗体水平有明显差异，乙脑高发区人群的抗体阳性率及ＧＭＴ明显高于中发疫区和低发疫区的人群。而且乙脑抗体阳性率的高低与发病率无相关关系存在。不同年龄组人群的抗体阳性率有随年龄增长而增加的趋势。大年龄组人群的隐性感染率高于低年龄组，可能与暴露机会较多有关。在流行期，每个年龄组人群都被感染。流行期前体内无抗体或滴度较低者，感染率高于体内高滴度者。提示人群滴度达到一定程度后受到再次感染的机会相对减少。健康人群的阳性率普遍低于文献报道的达到保护作用的阳性率，因此，乙脑疫苗的注射应给予加强。     

湖北省健康人群流行性出血热隐性感染研究

对湖北省不同地区8400份健康人群血清进行流行性出血热病毒 IgG 抗体检测,抗体阳性率4.13％,抗体滴度1∶20～1∶80者占83.00％,GMT 为52.91。5个地理小区均存在隐性感染,疫区与未报病地区隐性感染率有非常显著差异;高、中发区隐性感染率显著高于低发区。隐性感染率的高、低和当时的流行强度有关,与流行时间的长短不存在必然的一致性。     

Effectiveness of postgraduate training of the heads of women's consultation clinics

The second stage of the efficacy assessment of the postgraduate education of the heads of women's consultation clinics was analyzed. They underwent training at the Central Order of V.I. Lenin Institute of Advanced Training of Physicians according to the experimental cycle of the problem-target programme which was developed on the basis of the claims raised for heads of women's consultation clinics. Postgraduate students were characterized according to their length of service and the posts occupied. The second stage of the efficacy assessment of advanced education involved the analysis of the introduction of new forms and methods of work in women's consultation clinics. The analysis was carried out by means of introduction charts used at the students' places of work, special assessment criteria being applied. The study findings were grouped by the type of activity of the clinic's heads. The conclusions were very specific and indicated the necessity of improving the work of this out-patient chain of the obstetric and gynecologic service.     

Reciprocal Influences Between Burnout and Effectiveness in Professional Care for Elders

In community care, the quality of life of the care recipient and the quality of the care provider affect each other. This is a proposition derived from the dialectical perspective, which envisions the importance of promoting the quality of life of both the care recipient and provider. The proposition hinges on mediation by caring effectiveness. This mediation model is the focus of the present study. This study surveyed 232 dyads of Hong Kong Chinese older care recipients and their professional care providers in two waves. Psychological well-being and functional disability were the indicators of the quality of life of care recipients, whereas burnout was an indicator of the low quality of life of professional care providers. The results reinforce the mediation model by showing that caring effectiveness mediates the impact of the earlier burnout of the professional care provider on the subsequent psychological well-being of the care recipient. In turn, the earlier psychological well-being and functional disability of the care recipient also affect the burnout of the professional care provider. The results support the dialectical perspective.     

水质卫生指数综合评价方法在农村改水中的应用研究

目的为科学的指导农村选择、评价居民生活饮用水源,给农村改水提供可行性的依据。方法在对全县范围农村饮用水普查的基础上,对不同地理类型的114个水源质量进行了参数检验,并应用国内外目前较为新颖先进的水质卫生指数综合评价的方法,对其中不同地理类型的塘水、河水、井水、水库水等33个水源及2个水厂出厂水中的18个参数进行了分级评价。结果无论是山区、丘陵和圩区,各类水源毒理学指标基本安全。在以国家发布的《农村实施生活饮用水准则》为标准对水质的18个参数进行综合分级评价,5级水占15.5%,4级水占75.5%,3级水占9.10%。分指数最大值(Kimax)以细菌总数最高。在去除细菌总数单项参数后,5级水消失,4级水下降为3.03%,而3级水上升为87.87%,2级水占9.1%,表明了在农村不同的饮水条件下,细菌总数单项指标对水质分级影响程度较大。结论应用目前较为先进新颖的水质卫生综合指数(KI)评价方法来判断农村生活饮用水源质量的级别具有较高的可行性和实用性。     

Infestation of S. Paulo State, Brazil, by Aedes aegypti and Aedes albopictus

OBJECTIVE: To study the influence of the distance between infested and non-infested areas in the geographical spread of Aedes aegypti and Aedes albopictuspopulations in the state of S. Paulo. Regional patterns were also studied, considering the determinants related to soil occupation. METHODS: Information related to the counties in the state of S. Paulo where were concentrations of Ae. aegypti and Ae. albopictus and counties infested up to the end of each year (1985 to 1995), both in the state of S. Paulo and in the neighboring states, were used. Four indicators were defined to analyze the infestation process. RESULTS/CONCLUSIONS: The analysis indicated the contribution of the states of Mato Grosso do Sul and Paraná for the initial Ae. aegypti infestation in the state of S. Paulo and Ae. albopictus infestation in the states of Rio de Janeiro and Minas Gerais. In the counties where there was a concentration of these species, their establishment was more frequent among those closer to the infested area. Seventy-five percent of the counties where there were established populations of Ae. aegypti and Ae. albopictus were situated up to 34 km and 60 km, respectively, from the nearest infested county. The analysis of the geographical spread rate of the Ae. aegypti revealed three different large areas with unexpected patterns: the area with greater demographic population density (east of the state) had the lower rate of geographical mosquito spread, indicating the existence of other factors with preponderant influence on the macro-regional patterns. For Ae. albopictus, there was no evidence of a relationship between their geographical spread patterns and the demographic population density.     

口腔局部麻醉两种注射方法的比较

目的了解口腔局部麻醉时两种注射方法的效果,为新的无痛注射方法的临床应用价值提供依据。方法通过整群随机抽样的方法,选择口腔科60例患者,分为两组,每组各30例,实验组采用新法注射,对照组采用传统方法注射,通过患者对注射时痛觉的评价及患者注射时的面部表情来进行比较,并做统计学分析。结果受试者60人中,仅对照组有一例患者麻醉失败外,其余均有效,试验组无痛率为76.67%,对照组无痛率为3.33%,对照组与实验组无痛率差异有统计学意义(p<0.05)。结论新的无痛注射方法操作简便,效果确切,未见并发症,有一定的临床应用价值。     

Occupational medicine monitoring of workers exposed to benzene

Based on the present level of perception of the benzene biotransformation, the influence of reactive metabolites on the haematopoetic system - maintaining low MAK rates of 5 mg/m3 and below them - is presented. Consequences for the rate of the biological exposition test utilized at present result from this statement. The importance of a regular SCE determination in circulating lymphocytes, of the longtermed examination of possible damages of sperm and the differentiated analysis of individual kinds of lymphocytes, incl. of the cell-mediating immunity is emphasized besides the performance of a regular supervision of the external exposition, i.e. by means of personal dosimeters. To clarify the benzene influence, the research should be orientated on the damages of the cytoskeleton and the stroma cells within the haematopoetic system.     

一起使用未经消毒河水致学校甲肝爆发的流行病学调查

目的了解某中学甲肝爆发的原因，为有效开展学校传染病防治工作提供参考。方法应用描述性流行病学方法分析病例的分布情况，提出初步病因假设，进行病例对照研究、访谈、现场观察和实验室检测，进一步验证假设。结果甲肝病例发病时间为2006年11月2日-12月8日，爆发时间为11月13日-12月8日，发病高峰为11月28日。男生罹患率显著高于女生；学生年龄越小，罹患率越高；病例有班级和宿舍集聚性。病例对照研究结果显示，使用河水洗手显著增加学生发生甲肝的相对危险性，是仅使用自来水洗手学生的7．53倍，且使用河水洗手次数越多，危险性越高。混用喝水杯也显著增加发生甲肝的相对危险性。病例组与对照组的饮食和饮水差异均无统计学意义（P〉0．05）。现场调查显示，该校取水口处于厕所排污口的下游，学校使用的河水被甲肝病毒污染。结论此次疫情爆发主要是由于早期发病的学生污染了河水，其他学生使用被污染的河水洗手、刷牙、漱口和刷碗，从而引起学校甲肝爆发。密切接触以及甲肝免疫空白也是此次疫情发病数较多的原因之一。     

承德市冬季室内不同采暖方式与人体健康效应

学校和家庭不同采暖方式的４４０名９岁组儿童的健康效应调查结果表明：集中供暖学校儿童肺功能中ＦＥＶ１．０％和Ｖ７５均高于燃煤炉采暖学校儿童，学校家庭均集中供暖的女生高于学校家庭均燃煤炉采暖的女生；家庭采暖方式相同的不同采暖方式学校间，集中供暖学校男女生嗜中性白细胞噬菌率高于燃煤炉采暖学校，学校家庭均集中供暖的男女生均高于学校家庭均燃煤炉采暖的男女生；家庭集中供暖的燃煤采暖学校学生血清ＩｇＧ高于集中供     

The evolution of the management system of hospitals in Greece

The administration system of the health units--hospitals of the country presented different alteration during its course from the formation of the Greek state until now days. To be more specific, we can observe that: a) During the first period, the management of the few hospitals in the country is practiced by a complicated and multiform systems. Moreover, some hospitals were managed by a fraternity, other by a committee, other by an administrative committee and finally other by a board of directors. In any case, members of these collective sectors are members of the state such as mayors, chief of the community, simply private citizens, or well off citizens who participated in the formation and function of some hospitals as benefactors. But, supreme place to these of organisation and management of the hospitals has the private initiative because of the financial adversity of the state. The turn of the health sector to the well off citizens is obvious, as they dispose great deal of money for health. During this period, the state just supervises the few hospitals, public benevolent and state hospitals. b)The second period from the reform of the compulsory Law 965/1937 until the year 1983 is characterized by two substantial legislative Acts, which changed radically the border of the organisation and management of health units. Firstly, the compulsory Law 965/1937 establishes officially the boards of the directors as the institution initially covered public hospitals of the country and in the meantime the hospitals of the rest of the categories. It is also established for the first time along with that institution, the institution of the Governmental Trustee. The second legislative Act of that period is the Law Order 2592/1953, through which public health is put into a new basis according to the demands of that period. The Administrative system of public hospitals remains the same without particular changes to it. c)During the third period from the establishment of the National Health System--Law 1397/1983 until nowadays. This period is characterized by two great facts: 1. The foundation of National Health System [Law 1397/1983]. It is a historical event for health in Greece. The health system has for the first time totally public features and the civilian enjoys the social good of health without any cost. However, the administrative system of health preserves from the establishment of the state until nowadays its centralizing character. 2. The reformation of the N.H.S, Law 2889/2001. It leads to the radical change of the valid administrative system after 175 years of state function. The country is divided into health districts, where in each one the peripheral health system is created (P.H.S.). It is managed by an administrative board, in which substantial authorities are given for the first time in history of Greek health sector. Consequently, we have today a decentralizing management system in health, which is applied by the seventeen (17) peripheral health systems in Greece.     

Dust and Collagen Content of Lungs of Coal-Workers with Progressive Massive Fibrosis

In order to test the silica theory of the origin of progressive massive fibrosis (P.M.F.) in coal-miners' pneumoconiosis, separate dust analyses have been made of the massive lesions and of the rest of the lung from 18 coal-workers with P.M.F. who had been employed in several coalfields. The dry weight of the massive lesions ranged from 5 to over 100 g. and the dust concentration in the P.M.F. lesions was on an average twice as high as in the rest of the lung. It was found that the quartz percentage of the lung dust was almost identical in the two samples from each lung (Table 3). The quartz content of the average lung dust (P.M.F. and “rest of lung”) of 32 cases of P.M.F. was compared with that of 58 cases of simple pneumoconiosis. The quartz content of the P.M.F. dust was slightly higher but, allowing for variable dust composition in different coalfields, the difference was not significant (Table 8). The silica theory of P.M.F. cannot be supported by this study.

Comparisons of the collagen content of the P.M.F. lesions and of the rest of the lung in 17 lungs and of lesions of P.M.F. and of simple pneumoconiosis in 31 and 27 lungs, respectively, showed no clear difference between any of the groups and surprisingly low values for the massive lesions. A possible way in which this result could be reconciled with the histopathological observations is suggested. One gram of coal-mine dust produced, on an average, 0·4 g. of dust produced between 2 and 7 g. of extra collagen.

extra collagen. In five silicotic lungs, where the lung dust contained 15 to 50% of free silica, 1 g. of dust produced between 2 and 7 g. of extra collagen.