浙江省首株产志贺毒素大肠埃希菌O157:H7的分子生物学特性研究

目的:了解自浙江省杭州市腹泻婴儿中分离的1株大肠埃希菌O157:H7(HZ1-11株)的分子生物学特性.方法:应用ATB1525细菌半动化生化鉴定系统鉴定菌种.应用O157特异性抗血清玻片凝集试验、H7特异性抗血清试管凝集试验、以及PCR检测O抗原特异性rfbE基因和H7特异性fliC基因,进行菌株血清型的鉴定.应用多重Real-timePCR和常规PCR检测stx1、stx2、hly和eae毒力基因.对菌株进行脉冲场凝胶电泳(PFGE)分型,并与国内代表菌株进行比较.ATB1525药敏检测仪和纸片法检测菌株的抗药性.结果:细菌生化鉴定为大肠埃希菌,山梨醇阴性.血清型为O157:H7.毒力基因stx2、hly和eae均阳性,stx1阴性.PFGE谱带同江苏分离O157:H7菌株几乎完全相同,带型的相似度为97%.结论:该菌株为浙江省首株产志贺毒素大肠埃希菌(STEC)O157:H7,与国内近年在江苏等地流行的STECO157:H7菌株密切相关.STEC O157:H7已开始对浙江地区的人民健康构成了威胁.     

浙江省首株产志贺毒素大肠埃希菌0157：H7的分子生物学特性研究

目的：了解自浙江省杭州市腹泻婴儿中分离的1株大肠埃希菌O157：H7（HZI-11株）的分子生物学特性。方法：应用ATB1525细菌半动化生化鉴定系统鉴定菌种。应用0157特异性抗血清玻片凝集试验、H7特异性抗血清试管凝集试验、以及PCR检测O抗原特异性rfbE基因和H7特异性fliC基因，进行菌株血清型的鉴定。应用多重Real-time PCR和常规PCR检测stx1、stx2、hly和eae毒力基因。对菌株进行脉冲场凝胶电泳（PFGE）分型，并与国内代表菌株进行比较。ATB1525药敏检测仪和纸片法检测菌株的抗药性。结果：细菌生化鉴定为大肠埃希菌，山梨醇阴性。血清型为O157：H7。毒力基因stx2、hly和eae均阳性，stx1阴性。PFGE谱带同江苏分离O157：H7菌株几乎完全相同，带型的相似度为97％。结论：该菌株为浙江省首株产志贺毒素大肠埃希菌（STEC）O157：H7。与国内近年在江苏等地流行的STEC O157：H7菌株密切相关。STEC O157：H7已开始对浙江地区的人民健康构成了威胁。     

2007年浙江省衢州地区动物中产志贺毒素大肠埃希菌O157:H7感染状况

目的:了解2007年浙江省衢州地区产志贺毒素大肠埃希菌O157:H7在动物中的分布情况及其耐药性、PFGE分型及毒力基因携带状况。方法:按全国O157:H7监测方案于5~10月份肠道传染病高发季节,在衢州地区采集各种动物粪便/肛拭,用免疫磁珠富集后进行O157:H7分离培养、鉴定,可疑菌株以PCR法检测O、H抗原及志贺样毒素(SLT1和SLT2)、粘附抹平因子(eaeA)及溶血素(hly)4种毒力基因。用脉冲场凝胶电泳(pulse field gel electrophoresis,PFGE)方法进行同源性分析,同时选择14种抗生素进行药敏试验,分析分离所得菌株的耐药状况。结果:共监测动物粪便标本300份,分离得产志贺毒素大肠埃希菌O157:H7菌株16株,分离率为5.33%。16株O157:H7菌株,毒力基因Hly、eaeA、SLT2均阳性,SLT1均阴性。脉冲场凝胶电泳分型显示,16株O157:H7菌株可分2个PFGE基因型,型间差异较小。耐药性分析显示这些菌株对红霉素、利福平的耐药率最高,达100.0%,对其他受试抗生素均敏感。结论:该地区动物中产志贺毒素大肠埃希菌O157:H7带菌率较高,所分离菌株主要携带SLT2基因,因此推测该地区存在发生产志贺毒素大肠埃希菌O157:H7感染暴发或流行的潜在危险,需增加对动物源性O157:H7的监测力度。     

不同来源产志贺毒素大肠埃希菌分布特征

目的探讨不同标本中产志贺样毒素大肠埃希菌（STEC）的分布特征。方法采集动物粪便、肉类食品和排污口污泥样品，常规分离大肠埃希菌，血清学分型，PCR鉴定产志贺样毒素（stx1，stx2）菌株。结果293份标本中鉴定出8株STEC，1株为产志贺毒素O157：H7型，2株为不产志贺毒素O157：H7型，5株为产志贺毒素非O157：H7型。结论STEC存在于不同来源的标本中，菌株表型与毒力因子存在一定差异。     

分子生物学方法鉴定由自毙鼠分离的细菌

目的 对1株由自毙鼠分离的细菌（X175菌株）进行属、种及型的鉴定。方法 ①采用16S rDNA对X175菌株进行种属鉴定;②应用荧光PCR检测X175菌株是否存在致泻性大肠埃希菌常见毒素基因（stx1/stx2/eae、lt/st、aggR/ipaH）及大肠埃希菌O104、H4基因;③应用PCR检测X175菌株是否存在肠出血性大肠埃希菌（EHEC）O104∶H4的9个毒力基因。结果 ①经16S rDNA鉴定,X175菌株与大肠埃希菌埃希菌属的一些菌株相似度达99%,进化树显示X175菌株与大肠埃希菌O104∶H4菌株的亲缘关系较近;②大肠埃希菌O104基因和ipaH基因检测结果均为阳性,stx1/stx2/eae、lt/st、aggR、志贺菌/沙门菌、H4等基因检测结果均为阴性;③肠出血性大肠埃希菌O104∶H4九个毒力因子检测结果均为阴性。结论 X175菌株为大肠埃希菌O104弱毒型菌株,H抗原和其他一些特性还需进一步研究。     

大肠埃希菌O157∶H7携带stx2::IS1203v基因研究

目的了解中国部分地区大肠埃希菌O157：H7菌株携带志贺毒素基因变异状况。方法采用聚合酶链反应扩增志贺毒素基因，使用核苷酸序列测定判断是否存在志贺毒素的新变种，用HeLa细胞毒性实验研究其细胞毒性的变化。结果1992—2002年中国部分地区分离到的289株产志贺毒素的大肠埃希菌O157：H7中有3株菌携带的志贺毒素2（stx2）基因有1．3kb的插入序列（IS）插入，且这段IS和IS1203变种（IS1203 variant，IS1203v）有100％的核苷酸序列同源性。IS1203v插入到3株大肠埃希菌O157：H7 stx2基因的位置及开放性读码框（ORF）方向有所不同。除此之外，3株菌原有的stx2基因序列完全一致且为Stx2原型毒素。和Stx2原型毒素相比，这3株携带stx2：：IS1203v基因的菌株对HeLa细胞的毒性明显降低。结论分离到IS1203v插入stx2基因的大肠埃希菌O157：H7菌株；IS1203v的插入可导致对HeLa细胞的细胞毒性降低。     

2005～2007年中国食品中疑似O157大肠埃希菌的鉴定及毒素基因的检测

目的对中国2005～2007年食源性疾病监测网分离疑似O157大肠埃希菌进行鉴定,了解各种不同类型监测食品中大肠埃希菌O157的分布及毒力基因的携带情况。方法运用API20E生化试剂条进行初步鉴定,使用血清分型和PCR方法确定菌株,并检测毒力基因。结果(1)通过API20E生化初步鉴定共获得154株疑似O157大肠埃希菌。(2)通过血清学方法和特异基因的检测,共确定89株大肠埃希菌O157,其中42株是O157:H7(47%),其余的菌株为O157:NM和O157:hund(未确定型)。(3)毒力基因的检测:42株O157:H7和6株O157:NM携带eaeA+hlyA基因;共29株菌携带stx基因,主要分布在不发酵山梨醇O157:H7菌株中。(4)监测的生羊肉、生牛肉、生猪肉、生鸡肉、蔬菜沙拉等食品中均检出了携带stx基因的O157:H7。结论鉴定结果显示中国部分监测食品中均分离到有一定程度致病力的大肠埃希菌O157。     

多重PCR方法快速检测E.coli O157毒力及rfbEO157基因

[目的]探索一种快速、特异的检测大肠埃希菌O157的多重PCR(multiplex PCR)方法。[方法]选用针对大肠埃希菌O157志贺样毒素1、2(stx1、stx2)基因、溶血素(hlyA)基因、粘附抹平因子(eae)基因和O157特异性基因(rfbEO157)的5对引物，在同一扩增体系中进行PCR，检测9株不同来源的O157和其他大肠埃希菌21株。[结果]通过优化多重PCR反应条件和循环参数，5对特异性引物只扩增相应的基因片段，检测结果与应用常规PCR获得的结果一致。[结论]该多重PCR方法能够在一次扩增中同时反应待测菌株是否为大肠埃希菌O157及其携带毒力基因的情况，可为大肠埃希菌O157的诊断及流行病学调查提供一种简便、经济、快速的检测手段。     

大肠埃希菌O157:H7嵌合荧光RAM检测分析

目的建立大肠埃希菌O157：H7的嵌合荧光法（SYBR Green I）实时网状分枝扩增（RAM）检测技术.方法将产志贺样毒素大肠埃希菌O157：H7靶基因递比稀释确定SYBR Green I实时RAM的灵敏度,并进一步检测临床分离的菌株.结果SYBR Green I实时网状分枝扩增技术最低能检测10个产志贺样毒素大肠埃希菌O157：H7,检测信号出现的时间与靶基因的浓度成正比,临床分离3株产志贺样毒素大肠埃希菌O157为阳性,而非致病性大肠埃希菌为阴性.结论SYBR Green I实时RAM是一种快速、灵敏、准确、实时、环保的检测大肠埃希菌O157：H7的新核酸扩增技术.     

中国部分地区大肠埃希菌O157的分子分型及变异研究

目的了解出血性大肠埃希菌（EHEC）O157的分子流行特征和遗传变异关系并完善EHECO157：H7感染性腹泻监测制度。方法采用聚合酶链反应分析毒力基因的分布情况；用脉冲场凝胶电泳技术对1988-2005年部分地区分离到的249株EHECO157：H7（其中产志贺毒素的245株，不产志贺毒素的4株）和51株O157非H7进行分子流行病学分析。结果stx2基因在我国的EHECO157：H7菌株中有着很高的分布率，部分菌株携带stx2基因变种。300株O157共分为161种带型，其中51株O157非H7菌株共有42种带型，4株O157：H7非产毒株分别为4种带型，245株EHECO157：H7共有115种带型。结论EHECO157间的基因变异较大；产stx2原毒素的菌株和5衄2毒素发生变异的菌株带型相差较大。部分菌株之间存在着一定的交叉，说明虽然这两大类菌株有其特有的流行克隆系，但是它们的克隆系之间亲缘关系较近。     

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.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

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.     

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.     

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.     

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.