Objective:A nested-PCR assay is developed to detect and identify the genomic DNA of Brucella vaccine A19 strain. Methods:The whole genomic sequences of Brucella vaccine A19 strain and other Brucella spp. strains were compared and analyzed. The primers were designed by nucleotide difference sites. The nested-PCR assay was established to detect and identify Brucella vaccine A19 strain. The genomic DNA of Brucella vaccine A19 strain was extracted and diluted. The diluted template DNA was tested for sensitivity of using nested-PCR assay. And the specificity of nested-PCR assay was tested for the genomic DNA of other Brucella spp. strains and non- Brucella spp. strains. Results:The minimum detection limit of the nested-PCR assay was 3.43 fg. The nested-PCR assay established for amplification of Brucella vaccine A19 strain showed 246 bp electrophoresis bands, while other Brucella spp. strains showed 314 bp electrophoresis bands, and non- Brucella spp. strains did not produce electrophoresis bands. Conclusions:The nested-PCR assay established has the characteristics of high sensitivity and specificity. It can be detected when there is one copy of Brucella vaccine A19 strain genomic DNA in the reaction system. This method is particularly suitable for the detection and identification of trace genomic DNA of Brucella vaccine A19 strain in sample.

Objective:To establish a quantitative real-time PCR detection system for Brucella S2 vaccine strain. Methods:Based on the differences in the entire genome sequence between Brucella S2 vaccine strain and other reference strains of Brucella, primers and probes were designed to establish a quantitative real-time PCR detection system for Brucella S2 vaccine strain. The DNA of 22 reference strains of Brucella and 8 non- Brucella control strains were obtained from the National Institute for Infectious Disease Control and Prevention of the Chinese Center for Disease Control and Prevention. At the same time, environmental samples were obtained from the brucellosis vaccine manufacturers, and bacterial DNA from environmental samples was extracted using a blood/tissue genomic DNA extraction kit. The obtained DNA was pre-amplified by conventional PCR, and then subjected to quantitative real-time PCR secondary amplification (nested fluorescence quantitative PCR) using the amplified PCR product as a template. The specific fluorescence curve and corresponding number of cycles (Ct value) were observed, and the sensitivity was tested. Results:The quantitative real-time PCR detection system established did not detect specific fluorescence curves (without Ct values) for 21 reference strains of Brucella and 8 non- Brucella control strains, except for S2 vaccine strains. The established detection system had a minimum detection limit of 4.34 fg (genomic DNA) for detecting the DNA of Brucella S2 vaccine strain; DNA of Brucella S2 vaccine strain was detected in 3 of the 14 environmental samples collected. Conclusion:The quantitative real-time PCR detection system established can detect Brucella S2 vaccine strain in samples, with good sensitivity and specificity.

目的 探讨盐酸氨基葡萄糖在腰椎小关节骨关节炎治疗中的临床疗效,为临床治疗腰椎小关节骨关节炎寻找最佳治疗方案提供临床线索.方法 选择2014年8月-2015年8月收治的120例腰椎小关节骨关节炎伴下腰痛患者,随机分为3组,每组40例.甲组采用口服盐酸氨基葡萄糖治疗,乙组采取口服洛索洛芬钠治疗,丙组采取口服盐酸氨基葡萄糖+洛索洛芬钠治疗,疗程均为8周.随访16周,比较治疗前、治疗8周后以及停药8周后患者的Oswestry功能障碍指数(ODI)和视觉模拟疼痛评分(VAS)结果.结果 120例患者中,3例乙组患者服药后出现上消化道中度疼痛,放弃治疗;12例乙组患者出现上消化道轻度不适,经对症处理后好转;甲组和丙组未见药物相关不良反应.共117例完成8周治疗,并全部获得随访.甲、乙、丙组治疗前VAS和ODI评分比较差异无统计学意义(P＞0.05);治疗后各组VAS和ODI评分与治疗前比较差异均有统计学意义(P＜0.05);治疗8周后乙、丙组的疗效优于甲组,差异有统计学意义(P＜0.05),但乙、丙组比较差异无统计学意义(P＞0.05);停药8周后,甲、丙组的疗效优于乙组,差异有统计学意义(P＜0.05),但甲、丙组比较差异无统计学意义(P＞0.05).结论 盐酸氨基葡萄糖对腰椎小关节骨关节炎所引起的下腰痛疗效确切,并且避免了非甾体类抗炎药相关并发症风险,值得临床推广应用.

目的 掌握我国省级卫生行政主管部门实验室生物安全管理现况,分析问题与不足,为继续做好我国实验室生物安全管理工作提供依据.方法 利用流行病学动态数据采集平台下的实验室生物安全管理子平台进行《全国省级卫生行政主管部门实验室生物安全管理能力调查》问卷的定制和在线发布,收集信息,对反馈信息进行整理和分析.结果 25家参与应答的省级卫生行政主管部门中,96％的实验室生物安全管理职能设置在科教部门,64％的实验室生物安全管理工作有经费支持,72％的省级卫生行政主管部门成立了生物安全专家委员会,80％的省级卫生行政主管部门开展了省内菌(毒)种或者样本运输审批工作.结论 我国实验室生物安全管理工作已走上规范化、法制化道路,但仍然存在一定的问题和困难.建议各部门重视实验室生物安全管理工作,完善管理体系与制度,提高实验室生物安全意识,提升我国实验室生物安全管理水平.

目的 评估2015年11月国内外突发公共卫生事件及需要关注传染病的风险.方法 根据国内外突发公共卫生事件报告及重点传染病监测等各种资料和部门通报信息,采用专家会商法,并通过视频会议形式邀请省(直辖市、自治区)疾病预防控制中心专家参与评估.结果 根据近期传染病和突发公共卫生事件监测数据,结合既往流行特点分析,预计11月全国总报告事件数与往年一样会有所上升,但不会超过往年同期水平.11月我国内地出现人感染H7N9禽流感及其他可感染人类的禽流感散发病例的可能性将增大.季节性流感等呼吸道传染病将出现季节性升高.中东呼吸综合征输入我国的风险依然存在,但输入风险较前期有所下降.诺如病毒所致病毒性腹泻将进入高发季节.我国北方地区将逐步进入燃煤取暖季节,非职业性一氧化碳中毒人数将明显上升.结论 预计2015年11月全国总体报告的突发公共卫生事件数将上升,但不会超过往年同期水平;需重点关注人感染禽流感疫情,也要做好中东呼吸综合征、诺如病毒腹泻和非职业性一氧化碳中毒的预防控制工作.

经皮椎间孔镜技术治疗腰椎间盘突出症，最早由Hijikata于1970年应用于临床，取得了较好的临床效果[1]，正式开启了腰椎间盘突出症真正意义上的微创治疗时代。之后逐渐推广，后来Yeung、Tsou等不断对手术器械、手术步骤进行完善[2]。经皮椎间孔镜技术对腰椎间盘突出症的治疗效果及优越性也逐渐凸显出来，近年在我国广大医学同仁的努力下，经皮椎间孔镜技术也逐渐得到了较好的推广应用[3]。我院自2013年3月开始开展经皮椎间孔镜技术，本研究选取我院自2013年3月至2014年3月收治的97例单节段腰椎间盘突出症患者，采取随机方法分为试验组和对照组，试验组50例采取经皮椎间孔镜髓核摘除术治疗，对照组47例采取传统脊柱后路椎板开窗髓核摘除术治疗。术后随访12～24个月，平均随访18个月，评估比较手术时间、术中出血、末次随访VAS评分、术后复发率，末次随访采用改良MacNab's标准评价希望通过本研究比较分析得出有价值的临床线索，为经皮椎间孔镜技术的进一步开展提供一定的临床参考。现报道如下。

目的 了解2013年媒体报道乙型肝炎(乙肝)疫苗事件后,部分省儿童家长对预防接种信任度的变化,评估家长带儿童接种疫苗的意愿.方法 在湖南省衡阳市常宁县、衡山县,怀化市洪江市;广东省深圳市罗湖区;河北省石家庄市长安区,保定市北市区和邯郸市曲周县各随机选择100名儿童家长,于2013年12月18 ～22日开展无记名预防接种信任度电话调查.结果 3个省7个县(区)共调查701名儿童家长,362名(51.6％)儿童家长听说过湖南乙肝疫苗事件,80％的儿童家长对死亡病例与接种乙肝疫苗关联持怀疑或不确定态度,肯定儿童死亡与乙肝疫苗有关联或无关的各占10％,28％的家长认为国产乙肝疫苗非常安全或安全,25％的家长带孩子去接种疫苗时会发生犹豫,28％的家长不愿意带孩子接种疫苗.结论 2013年媒体报道乙肝疫苗事件后,公众对疫苗的安全性产生质疑,对预防接种产生担忧,儿童家长产生了接种犹豫和不愿意接种的现象,有必要尽快采取一系列宣传和社会动员措施,提升儿童家长预防接种的信心.

目的 分析中国(未包括香港、澳门特别行政区和台湾地区,下同)实现无脊髓灰质炎(脊灰)目标后,疫苗衍生脊灰病毒(Vaccine-derived Poliovirus,VDPV)的发生情况.方法 分析31个省(自治区、直辖市,下同)报告的急性弛缓性麻痹(Acute Flaccid Paralysis,AFP)病例数据库、中国疾病预防控制中心(Center for Disease Control and Prevention,CDC)病毒病预防控制所国家脊灰实验室,对脊灰病毒阳性分离物的基因测序结果,各级CDC对VDPV及病例的调查和处置报告.结果 2001 ～ 2013年,中国AFP病例监测系统从37名儿童粪便标本中分离到VDPV,来源于12个省,其中AFP病例22例,AFP病例接触者13人,健康儿童2人.其中2004年贵州省2例Ⅰ型(Type 1)VDPV(VDPVⅠ)病例形成循环(Circulating)(cVDPVⅠ),2011 ～ 2012年四川省Ⅱ型(Type 2)疫苗高变异脊灰病毒(Vaccine-hypervariable Poliovirus,VHPVⅡ)病例/VDPVⅡ病例形成cVHPVⅡ/cVDPVⅡ.结论 VDPV可在健康儿童粪便中检出,也能导致儿童麻痹.其发生有疫苗因素,也有受种者因素和疫苗使用因素.口服脊灰减毒活疫苗(Oral Poliomyelitis Attenuated Live Vaccine,OPV)接种率低,是造成发生cVDPV的原因.只有达到人群OPV的高免疫覆盖率,通过高质量的AFP病例监测系统及时发现病例,采取有效措施及时控制疫情,才能阻断病毒的传播.

Objective To assess the risk of public health emergency and communicable diseases concerned in August in the mainland of China,2013.Methods The analysis was conducted on the previous surveillance data of public health emergency and communicable diseases reported in China through different channels.Results Previous surveillance indicated that the incidence of public health emergency in August was lowest during a year.The incidence trend of public health emergency during January-July 2013 was similar with that in previous years,the monthly public health emergency numbers in 2013 was similar with those in the same period 2012 and this number declined in July compared with June.Now it is the high risk season for enteric communicable diseases(such as cholera,typhoid,paratyphoid,dysentery) and vector-borne infectious diseases(such as dengue).Food poisoning risk is still high.Although Middle East respiratory syndrome-Coronavirus(MERS-CoV) has not been recognized as an international public health concern yet,close attention still needs to be paid to it.Extreme hot weather in July in southern China had caused many heat stroke cases and some deaths,and it is forecasted that the extreme hot weather would last in August.Recently,earthquake,typhoon,flood and drought occurred frequently in China,and all of these natural disasters might cause secondary public health consequences.Conclusion It is expected that the incidence trend of public health emergency in August 2013 would be at low level,similar with those in previous years,but the surveillance of MERSCoV,food poisoning and heat stroke should be strengthened.

<正>1美国突发事件应急体系概况2003年,美国颁布了"国土安全第8号总统令"(Homeland Security PresidentialDirective-8,HSPD-8),该法令类似于我国的《中华人民共和国突发事件应对法》,旨在加强美国在应对恐怖袭击、重大灾害或灾难以及各种危害(Hazards)时的预防、保护、响应和恢复等各项应急准备工作。这项法令构成了美国现行的国家突发事件

为了给参与禽流感病例现场流行病学调查的专业人员提供参考,本研究对我国2005年以来确诊的40例禽流感病例的调查结果进行汇总分析,结果显示3例(7.50%)暴露史不详,21例(52.50%)有直接或间接接触病死禽史,14例(35.00%)有活禽市场或禽类制品暴露史,2例(5.00%)有与同类病例接触史。有病死禽暴露史的病例主要与居住在农村(95.24%)、住家或附近环境(85.71%)、成年人(66.67%)、女性(66.67%)和家务劳动(61.90%)等线索有关;有活禽市场或禽类制品暴露史的病例主要与成年人(85.71%)、居住在城市(78.57%)和饮食习惯(50.0%)等线索有关。既往现场调查经验提示,任何一例禽流感新发病例均可能具有与既往病例完全不同的特点,开展感染来源调查应结合实际情况灵活运用调查方法。

Objective To understand the epidemiological characteristics of leptospirosis in China from 2006 to 2010 and provide evidence for leptospirosis prevention and control.Methods The descriptive analysis was conducted on the incidence data of leptospirosis in China from 2006 to 201 collected from national disease reporting information system and national leptospirosis sentinel surveillance system.Results From 2006 to 2010,the incidence of leptospirosis in China continued to decline,and the average annual case number was 719.The overall case fatality was 2.47%.The cases occurred in 6 provinces in southern China accounted for 74.58% of the national total.The incidence peak was during August-September and the cases during this period accounted for 38.96% of the annual total.Totally 75.24% and 11.01% of the cases were distributed in farmers and students and the cases in people aged35 years accounted for 66.82%.The age specific sub-peak of the incidence was in children aged 10-15 years and the peak was in middle aged adults and the elderly.Totally 34 outbreaks of leptospirosis with 174 cases and 39 deaths were reported during this period in China.Among 1020 cases reported by surveillance system,62.94% had the history of pathogen contaminated water one month before onset,in which 91.74% were infected during work in rice field and recreational activity in water.The disease pathogen was detected in rats,frogs,pigs,cattle and muntiacus,The antibodies to leptospira in serogroup Icterohaemorrhagiae,Grippotyphosa,Australis,Autumnalis and Hebdomadis were most frequently detected in the population.Conclusion The incidence of leptospirosis remained at low level in recent years in China,but the factors which could facilitate the spread of the disease still exist.The case fatality is still high and local outbreaks occur occasionally.The disease situation in southern China is serious with high incidence in summer and autumn.The disease is still mainly caused by the infection when working in rice field.Middle-aged and elder people has become the mostly affected population instead of young adults.The possibility of local leptospirosis outbreak still exists.It is necessary to strengthen the training and health education about leptospirosis prevention and control in medical care providers and general population respectively.

肩锁关节脱位是创伤骨科的常见病,对于TossyⅢ型损伤常需要行切开复位内固定[1].我院2009年10月至2010年6月采用双Endobutton技术治疗TossyIII型肩锁关节脱位患者20例,效果满意,现报道如下.

Objective To understand the incidence trend of leptospirosis in China and provide scientific evidence for the revision of prevention and control measures.Methods The descriptive epidemiological analysis was conducted on the surveillance and laboratory data of leptospirosis in China in 2009.Results The reported leptospirosis cases number and death number were low,the constituent of the cases didn't change obviously The disease situation in local surveillance areas was concordant with national situation.The overall rat density was 3.63%,a little higher than that in 2008(3.43%).Apodemus agrarius was still the major rodent captured in surveillance areas,accounting for 44.36%.The serum antibody titer indicating positive result varied by regions,resulting in the fail to compare the surveillance data between the areas.Conclusion The overall incidence of leptospirosis in China was low,sporadic cases were found in some areas.It is necessary for provinces to strengthen the surveillance and improve the laboratory capacity for the prevention and control of leptospirosis.

Objective The laboratory quality control,QC,for an epidemiological study of HIV/ HCV infection in Shanxi province of China was analyzed,so as to study the influence of laboratory QC measures upon the quality of epidemiological study result.Methods Laboratory QC measures,including laboratory QC samples testing and confirmatory testing on sampled specimens from the site laboratory were carried out during all phases of the epidemiological study.Strengthening measures,including more training for the testing personnel,more frequent testing proficiency evaluation and higher percentage of sampling of the site specimens for confirmatory testing were implemented in the main study.Results HIV specimens for quality control were congruent between the site and QC laboratory during the pilot study.During the main study,all 4 specimens with undetermined testing results were confirmed negative.With site testing procedure checked and quality record analyzed,the validity of all HIV testing results were obtained.During the pilot phase of HCV study,the site laboratory only obtained congruency rates of 66.7％ and 95.1％ on the QA samples and on the sampled specimens for confirmatory testing,respectively,resulting in the invalidity of all HCV testing results in the pilot study.With corrective QC measures in place,such as adequate personnel training and intensive testing proficiency evaluation,the congruency rate achieved 100％ on the QA samples and on the sampling specimens for confirmatory testing during the HCV main study.Thus the validity of all HCV testing results in the main study was obtained.Conclusion Laboratory QC is especially important in timely identifying deficiencies in laboratory testing,adjusting and optimizing QC protocols,which further guarantee accuracy and reliability of the studies.

OBJECTIVE:This study was to compare the performance of three HIV antibody confirmatory assay kits in confirming early HIV infection. METHODS:Five HIV antibody-positive plasma specimens were ten-fold serially diluted and then detected by ELISA. The above diluted specimens were detected with the following three HIV antibody confirmatory assay kits to analyze their sensitivity, including Wantai-RIBA (Recombinant immunoblot assay, Beijing Wantai Biological Pharmacy, China), MP-WB (HIV Blot 2.2 WB, MP Biomedicals Asia Pacific Pte. Ltd., Singapore) and INNO-LIA (INNO-LIA(TM) HIV I/II Score, Innogenetics N.V., Belgium), respectively. These kits were further used to detect 48 ELISA-reactive specimens from 11 sets of HIV seroconversion specimens (a total of 48 samples) which were previously detected as HIV antibody-positive by ELISA. RESULTS:When 5 samples were diluted to 100 fold, Wantai-RIBA still can detect them positive. Among the 48 HIV antibody-positive specimens detected with ELISA, the confirmation positive rate for Wantai-RIBA, MP-WB and INNO-LIA were 97.92% (47/48), 81.25% (39/48) and 91.67% (44/48), respectively. There was statistically significant difference between the confirmatory results of Wantai-RIBA and MP-WB (χ(2) = 6.13, P < 0.05), as well as between those of INNO-LIA and MP-WB (χ(2) = 5.48, P < 0.05); however, there was no statistically significant difference between those of Wantai-RIBA and INNO-LIA (χ(2) = 1.33, P > 0.05). For other six HIV seroconversion panels containing indeterminate specimens, the average seroconversion period of time for Wantai-RIBA, MP-WB and INNO-LIA were 0.7, 13.3 and 3.7 days, respectively. CONCLUSION:Compared with MP-WB, Wantai-RIBA and INNO-LIA could reduce the window period to confirm early HIV infection.

[Objective] To understand the situation of rabies prevention knowledge,rabies exposure risk behaviors and post-exposure prophylaxis behaviors in primary school students from rabies epidemic areas in China,and provide the technical evidence for making decision for disease prevention and control.[Methods] This population-based investigation was conducted in Guizhou and Guangdong,which were the severe rabies epidemic areas in China.Two prefectural primary schools,two county schools,four township schools and four village schools were selected in the 2 provinces.Students were sampled from each grade of the 12 schools.[Results] Among the 2 408 primary school students interviewed,59.51% of them didn't know the basic characteristic of rabies dog,22.30% of them never heard about 'rabies',above a half of students didn't know that cat can transmit rabies to human,and above four tenths students didn't know rabies can be prevented by post-exposure prophylaxis.When chased by dog,about half students would choose the wrong way to deal.Near half of the students played with domestic dogs or cats,3.20% of them ever kissed pet and 18.65% of them ever licked by pet.12.13% of the students played with stray dogs or cats and 5% of them ever attacked them.7.10% of students attempted to play with the dogs when dogs were eating,sleeping or breast-feeding,which actions most likely cause animal bite.When exposure,most students would inform their parents.When the wound was slight or only being licked on anus,eyes or wound,most students did nothing or didn't know how to do with it,only about three tenths students would cleanse wound by themselves.The situation of rabies prevention knowledge,rabies exposure risk behaviors and post-exposure prophylaxis behaviors of students in Guangdong province were all better than students in Guizhou,the same to the prefectural and county primary schools students compared with the township and village level students.There were no statistic significant difference between male and female students except for the rabies exposure risk behaviors,and no statistic significant difference among each grade students on the rabies exposure risk behaviors.[Conclusion] The rabies prevention knowledge of Chinese primary school students was unsatisfactory and their rabies exposure risk behaviors were common.The post-exposure prophylaxis behaviors should be improved.This situation in rural students was more serious and the primary school rabies health education and behavior intervention need be strengthened immediately.

目的 探讨广西农村地区人群狂犬病相关知识、态度和行为情况及其影响因素.方法 采用多阶段抽样方法对来宾市兴宾区5个乡10个村的1007名居民进行问卷调查.结果 人群平均知识得分为11.3±3.7分(总分20分).当自己或家人被狗咬伤后,69.5%(436名)户主选择去乡镇卫生院进行暴露后处置.7.8%的调查对象在1年内有度或Ⅲ度暴露史,Ⅱ度、Ⅲ度暴露者接受全程正确处置的比例分别为68.0%、12.5%.结论 人群对狂犬病的危害有所认识,暴露后就医意愿高,但暴露后采取预防措施的意识仍有待提高.

Objective To investigate the significance of procalcitonin(PCT),C-reactive protein (CRP)and WBC counts in predicting the postoperative jnfections in patients with bone fractures.Methods Clinical data of 49 patients with open fractures were retrospectively analyzed,and the patients were grouped into the infeeted(n=24)and non.infected(n=25).PCT,CRP and WBC values were detected 1,4,7and 10 days after the operations,and the results were compared with those taken from the healthy controls.Areas under the receiver operating characteristic(ROC)curves were used to determine the value in predicting postoperative infections.Results PCT,CRP and WBC values in the infected group and the noninfected group were higher than those in health controls(F=19.84,57.71 and 35.44,P＜0.01).PCT,CRP and WBC values in the infected group were higher than those in the non-infected group 4.7 and 10 days after the operations(tPCT=7.31,7.74 and 4.59;tCRP=2.23,5.75 and 8.01;tWBC=2.34,2.51 and 4.07,P＜0.05).ROC curves suggested that PCT value was more sensitive and had higher specificity than CRP and WBC values in the diagnosis of postoperative infections.Conclusions PCT,CRP and WBC values arise in bone fracture patients with postoperative infections.Detection of PCT has higher sensitivity and specificity.which can be used in early diagnosis of postoperative infections.

[Objective]The purpose of this article is to discuss the application and the effects of multimedia technology in laboratory medicine intemship teaching.[Method]The multimedia technology was adopted to save the morphology pictures used in clinical laboratory,to make courseware to assist the teaching of morphology,and to evaluate the effects of teaching on interns through examination.[Results]The results showed that the application of multimedia courseware in the laboratory medicine internship teaching can improve the interns' cognition rate for the morphology,and to promote the effects of teaching.[Conclusion] Multimedia technology is one of teaching methods in the laboratory medicine intemship teaching.The combination of multimedia technology and traditional teaching methods can improve the quality of teaching practice.