陕西省HIV-Ⅰ流行毒株亚型分析

目的 了解陕西省近年来发现的人类免疫缺陷病毒(HIV)感染者所携带毒株的基因序列特征、亚型种类和毒株来源以及在各高危人群中的分布,推断其传播来源和流行趋势,为本省艾滋病防治工作提供技术资料.方法 对HIV感染者进行流行病学相关因素调查,无菌采集HIV感染者抗凝全血,提取前病毒DNA,应用套式聚合酶链式反应(nested-PCR)扩增其膜蛋白基因env,对其C2～V3区及邻区的核苷酸序列进行测定,用GCG软件(Wisconsin 公司)进行亚型分析.结果 35份样本PCR扩增阳性并得到相应序列.经基因离散率计算和系统树分析,共发现4种HIV-1基因亚型和重组毒株,即HIV-1 B'、C、CRF01-AE和CRF-BC重组型.其中泰国B'亚型为主要流行株,占82.35%(28/34),主要来源于既往采供血者及其配偶;其次是CRF-BC重组型,占11.77%(4/34),主要来源于吸毒人群:CRF01-AE和C亚型各1份,分别占2.94%,均来自劳务输出的归国人员.该组样本B'亚型内的基因离散率为5.2%(n=23);而CRF-BC亚型内的基因离散率为0.9%(n=3),彼此间显示出较近的传播关系.结论 陕西省HIV-1流行株以泰国B'亚型为主,发生在与既往有偿采供血相关的地区和人群,已有6～7年的流行史;首次在当地吸毒人群中发现HIV-1 CRF-BC重组型,并且显示近期高度流行的趋势.加强对既往有偿献血人群和吸毒人群的行为干预,控制HIV病毒在家庭内和吸毒人群中的传播,将是今后本省艾滋病防治工作重点之一.     

山东省HIV-1感染者分子流行病学研究

目的了解流行于山东省境内艾滋病病毒(HIV-1)毒株的亚型及各种亚型的分布特点。方法对93例HIV感染者进行详细的流行病学调查，并采集外周静脉防凝血，提取前病毒DNA进行体外扩增，获得包膜蛋白(env)、核心蛋白(gag)、tat区基因的核酸片段，并对各基因区核苷酸进行测定和分析。结果发现在所有目标人群中共存在B、B’、C3种亚型以及CRF07-BC、CRF08-BC、CRF02-AG和CRF01-AE 4种重组毒株，B’亚型在人群和地域上分布最广，涉及献血员、受血者、二者的配偶和性乱人群，分布在山东省10个地市；CRF07-BC、CRF08-BC亚型以吸毒人群为主，分布在5个地市；CRF01-AE和其他亚型则主要为性乱人群，集中在几个经济发达的城市。结论山东省HIV-1亚型众多，各亚型在我省高危人群和地域分布不平衡，各有特点，从总的亚型流行特征来看，HIV-1在我省有流行加快的趋势。     

深圳市男男性行为人群人类免疫缺陷病毒1型流行株的聚集性分析

目的研究深圳市男男性行为(MSM)人群人类免疫缺陷病毒1(HIV-1)亚型的聚集性,为艾滋病的预防治疗提供科学依据。方法 RT-PCR巢式扩增深圳市MSM人群HIV-1病毒的gag基因和env基因,结合HIV数据库和MEGA4.02软件分析测序结果,确定亚型;建立进化树,比较各亚型的组内基因离散率。结果深圳市MSM人群中HIV-1流行株以CRF01-AE为主,占53.0%,与CRF07-BC、CRF08-BC、B、C共同存在,各个亚型均形成了簇集(cluster);B亚型cluster的基因离散率最大(gag区:9.5%,env区:16.1%),CRF01-AE形成了3个独立的cluster。结论深圳市MSM人群中流行的HIV-1毒株是复杂的,并且不同亚型的毒株也有各自的变异,以CRF01-AE和B亚型最为典型,病毒基因的变异对病毒的表型,疾病的进程及耐药性的影响尚待进一步研究。     

上海口岸2001—2005年HIV-1病原体变异分子流行病学研究

〔目的〕了解上海口岸2001—2005年艾滋病病毒I型感染者（HIV-1）毒株基因亚型分布、变异情况及流行特征。〔方法〕收集2001—2005年上海口岸51份HIV抗体检测确认阳性的血样标本,提取前病毒DNA,使用套式聚合酶链反应进行体外扩增,获得核心蛋白（gag）和包膜蛋白（env）区基因的核酸片段,测定其序列和进行亚型分析。〔结果〕37份标本扩增阳性,共检出8个亚型,包括B亚型11份;CRF01-AE10份;CRF02-AG5份;A亚型4份;C亚型4份;G亚型、B’,和CRF07_BC亚型各1份。上海口岸毒株亚型分布于五大洲15个国家和地区,主要流行CRF01-AE和B亚型,从2004年开始出现其它亚型逐渐增多趋势。〔结论〕上海口岸流行的HIV-1毒株复杂多样,出入境人员是我国HIV毒株输入的主要渠道,流行毒株以性接触传播为主,AE重组毒株具有较强的传播优势。     

HIV-1重组毒株gag区快速基因分型方法

目的建立一种简便、快速基因分型方法,对广西人类免疫缺陷病毒（HIV-1）重组毒株gag基因区进行亚型鉴定。方法从HIV阳性样本中提取核酸,使用HIV-1 M组通用引物对gag区进行第1轮扩增,第2轮使用分别检测C亚型和CRF01-AE重组型的二套特异性引物放入同一反应管中进行扩增,根据不同亚型扩增的目的带位置不同判断亚型。另外设计了一套引物,专门用于检测B’/C重组毒株。扩增出的所有样本均进行基因测序和系统树分析以验证结果。结果54份样本中,经基因测序和系统树分析证实CRF08-BC样本4份（7.41%）,CRF01-AE样本46份（85.18%）,4份（7.41）无法确定亚型。经亚型特异性引物PCR法检测出4份（100%）B’/C重组毒株,45份（97.83%）CRF01-AE重组毒株,灵敏度为98%,特异性为100%。2种方法检测结果经差异性检验显示,P〉0.05,差异无统计学意义,结果一致性高达98.15%。与基因分析结果吻合。重复实验显示,B’/C的平均重复性为100%（20/20）,CRF01-AE为98.3%（59/60）。结论该方法具有简便、快速,高度灵敏度和特异性的特点,可直接对广西HIV-1重组毒株CRFO 1-AE gag基因区进行分型。     

中国HIV-1基因亚型分布文献分析

目的了解中国国内不同感染人群人类免疫缺陷病毒I型(HIV-1)亚型及分布特点。方法计算机检索中国知网、万方数据资源和维普科技期刊全文数据库,下载题录,并按纳入和排除标准选择文献,提取资料,分析HIV基因亚型在不同感染人群中和不同年代的分布。结果纳入62篇文章,共2091例病例;中国主要流行的HIV-1基因亚型为B(12.4%)、B’(23.9%)、CRF01-AE(30.0%)、CRF-BC(27.2%);HIV的基因亚型与传播途径相关;近年来,中国流行的重组毒株增多。结论中国HIV基因亚型流行日趋复杂,为其监测、防控和治疗带来了更大的困扰。     

湖南省HIV-1分子流行病学研究

目的 了解HIV毒株在湖南省的亚型别特点和流行规律。方法 收集湖南省不同地区40名既往已确认为HIV-1感染者的抗凝全血样品，提取前病毒DNA，用套式聚合酶链反应方法（nested-PCR）扩增病毒膜蛋白env基因的C2-V3区，并进行序列测定。序列的排列、比较和同源性分析使用威斯康星GCG公司软件完成，确定亚型。结果 通过PCR扩增得到33份样品的结果，依据env区基因序列，与HIV-1各个亚型国际参考株比较，通过系统进化分析，最后确定湖南省样品分属6个亚型，分别为HIV-1B亚型中的泰国B（B’）亚型10份，欧美B亚型3份，流行重组型CRF-BC5份，流行重组型CRF01-AE13份，A亚型1份和D亚型1份。结论 湖南省已存在多种HIV-1亚型，应加强对HIV-1毒株亚型变异的监测，及时调整防治策略。     

山东省HIV-1流行株多基因区亚型分析

目的 了解流行于山东省境内HIV-1毒株的亚型,尤其是流行重组型毒株的种类及变异情况,分析其来源并推测其流行趋势。方法采集93份HIV-1感染者的外周静脉防凝血,提取前病毒DNA进行体外扩增,获得包膜蛋白（env）、核心蛋白（gag）、tat区基因的核酸片段,并对各基因区核苷酸进行测定和分析。结果发现在所有目标人群中共存在B、B,、C3种亚型以及CRF07-BC、CRF08-BC、CRF01-AG和CRF01-AE4种重组毒株,其中B’亚型数量最大71株（占77．2％）,CRF01-AE9株（占9．8％）,CRF07-BC、CRFOB-BC各3株（均占3．3oA）,B、C和CRF02-AG各2株（占2．2％）。3个基因区env区变异最大,gag和tat相对保守。3种优势亚型中,A／E变异最大,B’次之,B’／C最保守。结论山东省HIV-1流行毒株亚型众多。各优势毒株发生了不同程度的变异,在山东省有流行加快的趋势,应加强防控。     

广东国际旅行人员HIV-1基因亚型分析

〔目的〕通过对广东口岸国际旅行人员中HIV感染者的亚型分析,监测HIV毒株的流行状况及其变化。〔方法〕从22份HIV-1抗体阳性样品中提取RNA或DNA,逆转录后或直接巢式PCR扩增HIV env及gag基因,对PCR产物进行核苷酸序列测定和分析,确定基因亚型。〔结果〕22份样品中共发现8种HIV-1亚型和重组型,其中CRF-BC重组型8份,CRF01-AE重组型4份,C亚型2份,B亚型2份,A1、G、J亚型及CRF02-AG重组型各1份,2份样品分型不明确。这些不同亚型的感染者来自包括中国在内的8个不同国家。〔结论〕国际旅行人员中HIV-1亚型和重组型种类复杂多样,是我国HIV毒株输入的主要来源。监测国际旅行人员中HIV感染者基因型分布及其变异,及时发现新型毒株对于艾滋病的预防和控制十分重要。     

湖北省HIV-1分子流行病学研究

目的了解湖北省HIV-1基因型分布特征。方法对湖北省HIV-1主要流行区域进行流行病学调查，应用巢式聚合酶链反应对其中102例HIV-1感染者的env基因V3～V4区、gag基因P17/P24区和tat基因第一外显子区进行扩增，对各基因区阳性扩增样本进行序列测定，并对各基因区核苷酸进行序列分析。结果所有目标人群中共存在B^＋、C2种亚型以及CRF08-BC和CRF01-AE2种重组毒株，B^＋亚型在人群和地域上分布最广，涉及献血员、受血者以及二者的配偶和性乱人群，主要分布既往有偿献血员集中的地区。CRF08-BC、CRF01-AE重组主要涉及性乱人群，分布于经济发达的城市或地理位置偏南方的地区。C亚型为离散病例，主要涉及静脉毒品注射者。结论湖北省已由既往单一HIv-1 B^＋亚型转变为多种亚型、重组亚型流行的复杂局面，各亚型在省内高危人群和地域分布不平衡，各有特点，从总的亚型流行特征来看，HIV-1在湖北省有加快流行和进一步复杂化的趋势。     

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.