苏州市一起疑似类志贺邻单胞菌引起的食物中毒调查与分析

目的分析2019年6月苏州市某幼儿园食物中毒的原因,了解病原菌的基因分型和耐药谱情况。方法通过问卷调查、电话访谈,查阅医院就诊记录、餐厅订餐记录等主动搜索病例,开展病例个案调查和现场卫生学调查,采集相关样品进行实验室检测。以分离培养,质谱快速鉴定,VITEK-2 Compact全自动细菌鉴定仪生化鉴定进行鉴定分析,脉冲场电泳(pulsed-field gel electrophoresis,PFGE)进行基因分型,药敏试验采用微量肉汤稀释法。结果共搜索到17位病例(包括确诊病例4人),临床表现为腹痛、腹泻等胃肠道不适症状,均无头痛、发热等其他不适症状。6月20日中餐为可疑餐次,此外无其他共同饮食史。现场共采集47份样本(包括菜品、环境样本和肛拭子),其中4份学生肛拭子检出类志贺邻单胞菌。PFGE分型结果显示其中3株菌100%同源,属于同一型别,另一株菌与其差异较大,属于不同型别。对14种抗生素的药敏分析显示,3株菌(同一型别)除对氨苄西林耐药外还对甲氧苄胺嘧啶/磺胺甲噁唑耐药,对其它抗生素均敏感。另1株菌对氨苄西林耐药,对其它抗生素均敏感。结论此次事件很可能是一起由类志贺邻单胞菌引起的食物中毒,并且可能来源于不同的传染源。     

Transmission response for in-plane and out of plane propagation for a 2D photonic crystal with a planar cavity

Using the transfer matrix technique the transmission response of a rectangular lattice photonic crystal with and without a planar cavity defect has been studied. The response has been studied both within and out of the periodic plane of the crystal for both the perfect and planar cavity defect crystal. The planar cavity defect in the crystal introduces a defect state into the photonic band gap region of the crystal. The frequency of the defect state was predicted to be dependent on the external incidence angle of the exciting plane wave impinging on the crystal. The angular dependence for in-plane propagation has been verified experimentally and found to be in good agreement with predicted results.     

Facilities for Centralized Isolation and Quarantine for the Observation and Treatment of Patients with COVID-19

The coronavirus disease 2019 (COVID-19) pandemic increased the burden on many healthcare systems and in the process, exposed the need for medical resources and physical space. While few studies discussed the efficient utilization of medical resources and physical space so far. Therefore, this study aimed to summarize experiences related to facilities used for centralized isolation for medical observation and treatment during the COVID-19 pandemic in China and to provide suggestions to further improve the management of confirmed cases, suspected cases, and close contacts. In China, three types of facilities for centralized isolation (Fangcang shelter hospitals, refitted non-designated hospitals, and quarantine hotels) underwent retrofitting for the treatment and isolation of confirmed and suspected cases. These facilities mitigated the immediate high demand for space. Moreover, in order to minimize infection risks in these facilities, regulators and governmental agencies implemented new designs, management measures, and precautionary measures to minimize infection risk. Other countries and regions could refer to China's experience in optimally allocating social resources in response to the COVID-19 pandemic. As a conclusion, government should allocate social resources and construct centralized isolation and quarantine facilities for an emergency response, health authorities should issue regulations for centralized isolation facilities and pay strict attention to the daily management of these facilities, a multidisciplinary administration team is required to support the daily operation of a centralized isolation facility, in-depth studies and international collaboration on the centralized isolation policy are encouraged.     

舒肝丸辐照灭菌剂量的设定及辐照后其对大鼠肝功能的评价试验

探索舒肝丸辐照灭菌剂量,及辐照后其对大鼠肝功能的影响,为辐照灭菌舒肝丸的临床安全应用提供实验依据。测定舒肝丸初始污染菌,经钴源辐照灭菌后,测定D10值及SD;用辐照灭菌后的舒肝丸对大鼠进行灌胃给药,测定大鼠血液生化指标,观察辐照的舒肝丸对大鼠生化指标的影响。本次实验舒肝丸初始污染菌范围在50-1800 CFU/g,D10值为1.81 kGy,经计算辐照灭菌剂量为11.322 kGy,确定灭菌保证水平为10-3,辐照后的舒肝丸对实验大鼠肝功能指标无明显损害作用。舒肝丸辐照灭菌剂量为11.322 kGy,经12 kGy辐照后的舒肝丸对实验大鼠肝功能指标无明显损害作用。     

苏州某市一起肠炎沙门氏菌食物中毒事件调查分析

目的用现场流行病学方法,分析本次食物中毒事件的原因和可疑危险因素,指导临床救治并提出预防措施。方法通过查阅医院就诊记录和医务室门诊记录、考勤记录、员工订餐记录等主动搜索病例,开展病例个案调查和现场卫生学调查,采集相关样品进行实验室检测等,判断引起本次食物中毒事件的可疑餐次和食物。结果通过访谈、个案调查、实验室检查等共搜索到可能病例67人(包括确诊病例27人),临床特征主要为腹泻(83.58%,56/67)、发热(79.10%,53/67)、腹痛(76.12%,51/67)等。可疑食品是3月3日晚餐的回锅肉,59份肛拭子分离到25份肠炎沙门氏菌,其中一株分离自厨师。经脉冲场电泳(pulsed-fieldgel electrophoresis, PFGE)分型, 25株肠炎沙门氏菌同源性为100%。经药敏分析显示, 25株肠炎沙门氏菌对头孢噻肟、头孢他啶具有较好的药物敏感性;对氨苄西林、氯霉素耐药性强。结论食用被肠炎沙门氏菌污染的回锅肉是导致本次事件的主要原因,建议监管部门加强对集体配餐单位的监督管理,提高从业人员食品安全意识,防范类似事件的发生。     

Comparison of four task-based measurement indices with full-shift dosimetry in a complicated noise environment

This study was conducted to verify the agreement between four task-based measurement indices (TBMs) and full-shift dosimetry in a complicated noise environment. The study involved six production lines and 63 fixed jobs from an automobile wheel manufacturer. The subjects were simultaneously measured by the TBMs and a personal dosimeter, and 158 measurements were completed in total. There were two methods for measuring the level-at-task: average dosimetry noise level (ADL) and direct measure noise level (DML), and two methods for measuring time-at-task: worker diary (WD) and observation diary (OD). As for the differences, Pearson correlation coefficients, paired-samples t-tests, scatter and Bland–Altman plots were undertaken to assess the agreement between TBMs and the dosimeter. The results indicated that the TBMs agreed well with the personal dosimeter; the differences between them ranged from 0.16 to 3.07 dBA. The DML of level-at-task was less than the ADL result of 3.39 dBA and using the DML could cause a systematic error. The results showed that the TBMs from WD were as accurate as the TBMs from OD, and the WD recorded 88% of the task transitions of OD. Our research suggests that the TBMs, which uses ADL and OD, can be a reliable and more feasible as a cost effective strategy for assessing the full-shift noise exposures in practice. The study showed a high degree of agreement between TBM and dosimetry in fixed jobs and complicated noise environments. However it is not clear how well the agreement between TBM and dosimetry is in mobile jobs, and thus requires further studies to assess these environments.