艾滋病合并乙型肝炎患者CD_4~+T淋巴细胞及血浆病毒载量与肝功能的相关性分析

目的分析艾滋病合并乙型肝炎患者CD_4~+T淋巴细胞水平及血浆病毒载量与肝功能的相关性。方法选取2013年5月-2018年6月遂宁市中心医院收治的艾滋病合并乙型肝炎患者84例为研究组,未合并乙型肝炎的单纯艾滋病患者100例为对照组,分析患者CD_4~+T淋巴细胞水平、HIV RNA载量、肝功能指标:谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、白蛋白(ALB)水平,分析CD_4~+T淋巴细胞、病毒载量与肝功能的相关性。结果研究组CD_4~+T淋巴细胞数、ALB水平低于对照组,而HIV RNA载量、ALT、AST、TBIL水平高于对照组(P<0.05);随着CD_4~+T淋巴细胞数增加,HBV DNA载量、HIV RNA载量及ALT、AST、TBIL水平逐渐下降,ALB逐渐升高,差异均有统计学意义(P<0.05);随着HBV DNA拷贝数增加,CD_4~+T淋巴细胞数、ALB逐渐降低,而HIV RNA载量、ALT、AST、TBIL逐渐升高,差异有统计学意义(P<0.05);艾滋病合并乙型肝炎患者CD_4~+T淋巴细胞数与ALB呈正相关,与HBV DNA载量、HIV RNA载量、ALT、AST、TBIL呈负相关(P<0.05),HBV DNA载量与HIV RNA载量呈正相关(P<0.05)。结论艾滋病合并乙型感染患者CD_4~+T淋巴细胞、血浆病毒载量及肝功能存在明显相关性,随CD_4~+T淋巴细胞数减少,病毒载量上升,肝功能受损更严重,同时两种病毒可能有相互促进作用,加重患者肝损伤与免疫缺陷。     

有效抑制HIV复制下AIDS儿童患者外周血T淋巴细胞亚群的变化分析

目的 研究高效抗逆转录病毒治疗持续有效抑制HIV复制下AIDS儿童患者的T淋巴细胞亚群变化.方法 16例AIDS儿童患者接受HAART治疗1年以上,病毒载量检测低于50 IU/ml,在有效抑制HIV复制时M0和跟踪治疗3个月M3时用NucliSens EasyQ病毒载量检测仪检测血浆病毒载量,流式细胞仪检测外周血T淋巴细胞亚群,分析CD4+、CD8+T淋巴细胞及其相关亚群的变化.结果 16例儿童患者继续治疗3个月后血浆病毒载量持续低于50 IU/ml,在血浆病毒载量被持续有效抑制的情况下CD4+T淋巴细胞数、CD4+/CD8+T无明显增加.结论 有效抑制HIV复制下AIDS儿童患者外周血T淋巴细胞亚群短时间内变化不明显.     

HIV感染者/AIDS病人CD_4~+T淋巴细胞与HIV病毒载量关联性分析

目的:研究HIV感染者/AIDS病人CD4+T淋巴细胞与HIV病毒载量之间的相互关系。方法:使用NASBA方法(Easy Q)和流式细胞仪绝对计数法检测30名HIV感染者/AIDS病人的HIV病毒载量和CD4+T淋巴细胞数。结果:经过对115对有效数据进行双变量相关分析,结果显示:HIV病毒载量与CD4+T淋巴细胞数二者呈显著性负相关关系(r=-0.184 P=0.049)。结论:研究结果为观察和了解HIV感染者/AIDS病人感染状况或病程发展提供更科学的依据。     

HIV/AIDS患者经HAART治疗后低病毒载量与免疫重建间的相关性研究

目的 探讨HIV/AIDS患者经抗逆转录病毒治疗（highly active antiretroviral therapy,HAART）后低病毒载量与免疫重建的相关性,为HIV低病毒载量人群在临床治疗和病毒学失败方面提供科学依据。方法 以2017—2020年在云南省传染病医院抗病毒治疗12个月后且HIV病毒载量<1 000拷贝/ml的所有HIV/AIDS患者作为研究对象,收集其HIV病毒载量和CD4+、CD8+T淋巴细胞数;对不同的CD4+T淋巴细胞数分组,用Spearman分析HIV低病毒载量与CD4+、CD8+T淋巴细胞的相关性,用卡方检验比较不同低病毒载量组与免疫重建之间的组间差异。结果 2017—2020年云南省传染病医院抗病毒治疗12个月后的HIV/AIDS患者共741例,按照治疗完成后CD4+T淋巴细胞数分为3组：免疫无应答（INRS）(<200个/μl)79例,免疫应答不足（IIRS）(200～500个/μl)289例和免疫应答（IRS）(>500个/μl)373例。统计分析发现,HIV低病毒载量与CD4+T淋巴细胞存在负相关性（r=-0.484,P&l...     

2009-2011年河南省部分未治疗艾滋病病毒感染者/艾滋病患者的CD4和病毒载量情况分析

目的了解2009-2011年河南省未治疗艾滋病病毒感染者/艾滋病患者的CD4+T淋巴细胞计数和病毒载量状况。方法通过"河南省艾滋病检测实验室数据应用平台"收集2009-2011年河南省部分未治疗艾滋病病毒感染者/艾滋病患者的相关信息以及CD4+T淋巴细胞计数和病毒载量信息,分析比较该人群CD4+T淋巴细胞和病毒载量的中位数和构成比。结果 2009-2011年3年间河南省未接受抗病毒治疗人群的病毒载量变化差异无统计学意义(χ2=3.345,P=0.188),病毒载量在103拷贝/ml和105拷贝/ml两个区间的患者构成比均有所增加(分别为:χ2=7.965,P=0.019和χ2=22.869,P=0.000)。2009-2011年3年间河南省未治疗艾滋病感染者人群的CD4有所升高(χ2=16.567,P=0.000),CD4在200~349个/μl区间的构成比有所减少(χ2=12.236,P=0.002),而在350~499个/μl区间的构成比则有所增加(χ2=10.412,P=0.005)。结论 2009-2011年河南省未治疗艾滋病病毒感染者/艾滋病患者的机体状况有所好转,目前河南省的抗病毒治疗工作要以应治尽治的为基础同时加强关注高病毒载量的患者。     

河南省HIV-1感染者抗病毒治疗前免疫学、病毒学及耐药性指标的调查

目的了解河南省部分地区HIV-1感染者抗病毒治疗前CD4+T淋巴细胞、病毒载量分布及耐药性毒株存在情况的调查。方法用流式细胞技术对CD4+T淋巴细胞计数,使用NASBA方法测定病毒载量,用RT-PCR方法扩增HIV-1pol区基因,进行基因型耐药性分析。结果该地区HIV感染人群中68.57%的患者CD4+T淋巴细胞计数<200个/μL,患者病毒载量对数平均值为4.364±1.052,检测样本中有3例出现基因型耐药。结论河南省部分地区HIV-1感染者已进入发病高峰期,但HIV-1耐药株的产生和传播水平还较低,应在进行抗病毒治疗的同时作好耐药性监测工作,起到良好的抗病毒治疗效果。     

性传播感染的HIV/AIDS抗病毒治疗CD4~+T淋巴细胞计数和HIV病毒载量结果分析

目的探讨性传播感染的人类免疫缺陷病毒(感染者)/艾滋病(患者)(HIV/AIDS)抗病毒治疗CD4+T淋巴细胞计数和HIV载量变化。方法选取2012年1月—2015年1月凉山彝族自治州第一人民医院就诊的通过性传播途径感染HIV/AIDS 160例,分别使用流式细胞仪和依赖核酸序列的扩增技术(NASBA)方法检测抗病毒治疗前及6个月后CD4+T淋巴细胞计数和病毒载量。结果 1治疗前患者CD4+T淋巴细胞计数为(262.7±21.8)个/μl,治疗后为(316.4±208.9)个/μl,治疗前患者病毒载量为(4.55±0.91)log/ml,治疗后病毒载量为(1.48±0.47)log/ml,治疗前后差异有统计学意义(P0.01);2不同性别、年龄分组研究对象CD4+T淋巴细胞计数和病毒载量治疗前后均有不同;3CD4+T淋巴细胞计数与病毒载量之间呈显著负相关(r=-0.486,P0.01)。结论性传播感染HIV/AIDS抗病毒治疗后CD4+T淋巴细胞计数上升,病毒载量下降,应结合指标变化制定合理方案开展抗病毒治疗。     

河南省抗HIV治疗效果及耐药变异分析

目的 研究河南省人类免疫缺陷病毒/艾滋病(HIV/AIDS)患者应用高效抗逆转录病毒治疗后治疗效果及耐药变异产生情况.方法 对采用2种治疗方案的河南省HIV/AIDS患者进行病毒载量、CD4+T淋巴细胞数、耐药变异基因型监测.结果 2种治疗方案都在部分HIV/AIDS患者身上取得病毒载量抑制和提升CD4+T淋巴细胞数效果,但用药后均有耐药变异发生,2005年D4T/ddI/NVP、AZT/ddI/NVP高度耐药相关突变率分别为19.7%,16.2%;2006年分别为19.4%,19.5%.结论 河南省HIV/AIDS患者应用高效抗逆转录病毒治疗(HAART)治疗基本上取得了预期的疗效,但在应用逆转录酶抑制剂后有耐药变异发生,且多为交叉耐药、多药耐药.所以应用逆转录酶抑制剂时要加强耐药监测,规范管理,及时调查用药以节省有限的药物资源并防止耐药株的产生.     

新报告HIV感染者/AIDS基线病毒载量水平与CD4+/CD8+比值分析

目的 分析江西省2015—2019年新报告艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV感染者/AIDS)的基线病毒载量水平与其细胞免疫水平之间的关系。方法 对2015—2019年在江西省疾病预防控制中心确证的HIV感染者/AIDS进行基线CD4⁺T淋巴细胞、CD8⁺T淋巴细胞和病毒载量检测,用SPSS软件对数据进行相关性分析和二元logistic回归分析。结果 新报告HIV感染者/AIDS 513例,CD4⁺T淋巴细胞计数中位数为209个/μl,CD4⁺/CD8⁺比值中位数为0.233,病毒载量中位数为5.06 log₁₀ 拷贝/ml。病毒载量水平与CD4⁺T淋巴细胞、CD4⁺/CD8⁺比值总体呈显著负相关; CD4⁺/CD8⁺比值<0.20 的HIV感染者/AIDS其病毒载量≥10⁵拷贝/ml的风险为CD4⁺/CD8⁺比值≥0.20的3.775倍。结论 江西省新报告HIV感染者/AIDS中高病毒载量比例高,中位病毒载量高,CD4⁺/CD8⁺比值<0.2是高病毒载量的预测因素。应进一步加强扩大检测人群和比例,尽早发现感染者并进行抗病毒治疗,提高患者期望寿命。     

AIDS患者高效抗逆转录病毒联合治疗后外周血CD4+、CD8+、ALT与病毒载量同步变化

[目的]了解艾滋病(AIDS)患者高效抗逆转录病毒联合治疗(HAART)前后外周血CD4+、CD8+T细胞、ALT与病毒载量(VL)的变化. [方法]应用流式细胞仪采用双色荧光抗体检测技术检测CD4+、CD8+T细胞数,用核酸扩增荧光定量聚合酶链反应(PCR)法检测血浆病毒载量(VL),定期进行CD4+、CD8+、ALT及病毒载量检测. [结果]HAART后,91%VL逐渐下降,CD4+T细胞数比治疗前明显上升,与VL呈负相关.在12周VL无法检测时73.7%患者CD4+T细胞仍继续上升;治疗至12周时,59.6%患者CD8+T细胞同步下降,与VL呈正相关,12周后CD8+T细胞数与VL无统计学意义;在整个HAART过程中,ALT与VL之间无相关. [结论]HAART治疗下,ALT检测是治疗用药的首选项目,CD4+T细胞计数和病毒载量检测有助于临床上对病情变化和抗病毒治疗疗效进行评估.     

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.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

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.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

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.     

The rise and fall in incidence of malignant mesothelioma from a British Naval Dockyard, 1979-1999

BACKGROUND: The incidence of malignant mesothelioma in Britain is predicted to rise over the next 15-25 years because of past failure to protect the workforce against inhalation of asbestos. In British Naval dockyards, alternative insulation materials and respiratory protection were introduced from the mid-1960s. Aims This study was carried out to investigate the effects of these control measures on mesothelioma deaths in dockyard workers. METHODS: Cases of mesothelioma of the pleura and peritoneum between 1979 and 1999 in workers from the Devonport Naval Dockyard, south-west England, were sought from coroners' and medico-legal records. RESULTS: Three hundred and one cases were identified, 7% peritoneal. The peak incidence occurred in 1991 with 25 cases per annum (quadratic model fit R(2) = 74.2%, P < 0.001) and we predict that by 2003 the incidence will fall to fewer than five cases per annum. The mean time between first exposure and presentation was 48.5 years [95% confidence interval (CI) = 47.3-49.8], but this was significantly shorter in the more heavily exposed trades, when compared with the less heavily exposed (42 years, 95% CI = 39.0-45.0, versus 49.5 years, 95% CI = 48.2-50.9). Those with higher exposure were also at significantly greater risk of peritoneal disease (P < 0.023, Fisher's exact test). CONCLUSION: The reduction in incidence of mesothelioma is greater than can be accounted for by reduction in numbers of dockyard workers over the last 50 years. Changes in insulation materials and improved industrial hygiene measures introduced into the Devonport Dockyard from the mid-1960s have resulted in an earlier decline in the incidence of malignant mesothelioma than that predicted for the British workforce as a whole.