山东省肾综合征出血热疫区型别演变及其趋势分析

:为了解山东省自 1962年以来肾综合征出血热 (HFRS)季节发病高峰和疫区型别的演变 ,比较了该省 60年代和 70年代、80年代、90年代疫区型别的变化、秋冬季和春季发病高峰的发病率和病死率变化 ,并对其发展趋势采用灰色模型GM ( 1,1)进行预测。结果表明 :山东省在 60年代和70年代HFRS发病以秋冬季 ( 10月～翌年 1月 )为主 ,其发病数占全年发病数的 89 87% ,病死数占全年的 88 99% ;疫区限于 6个地区 ,疫区型别为姬鼠型。 80年代 ,除秋冬季发病高峰外 ,出现春季 ( 3～ 6月 )发病高峰 ,其发病数和病死数分别占 4 2 78%和 2 1 73 % ;疫区扩大至全省 14个地区 ,疫区型别为姬鼠型和家鼠型的混合型。 90年代情况与 80年代类同 ,春季发病与死亡数分别占全年的 4 3 68%和 37 55% ;疫区型别仍为混合型。预测今后 5年该省HFRS全年、秋冬季和春季发病均呈上升趋势 ,疫区型别为混合型。应考虑同时预防和控制姬鼠型和家鼠型病例发生     

1980-2006年平邑县肾综合征出血热流行病学调查

目的 了解山东省平邑县肾综合征出血热(HFRS)的流行趋势,为制订综合防治措施提供科学依据.方法 利用平邑县1980-2006年HFRS发病资料、宿主动物监测资料等,应用描述流行病学分析方法进行流行趋势分析.结果 1980-2006年共报告HFRS病例9519例.年均发病率26.28/10万,死亡277例,病死率2.91%,发病率高峰期出现在1992-1998年;HFRS发病呈周期性变化,流行周期3～5年,主要集中于春季和秋冬季,高发区域多位于河网平原地带,病例以男性青壮年农民为主;病死率呈下降趋势,秋冬季病死率大于春季.鼠密度高峰在第3季度,鼠带病毒率第4季度最高.结论 平邑县HFRS的流行呈现出周期性、季节性和人群聚集性的特点.近年来,HFRS发病率和病死率虽有较大下降,但人群发病率、鼠密度和鼠带病毒率仍维持在较高水平.为控制HFRS的流行,必须实施以"灶点灭鼠"、重点人群接种HFRS疫苗为主的综合性防制措施.     

武进市肾综合征出血热疫情监测

武进市是江苏省肾综合征出血热（HFRS）监测点之一，市卫生局、卫生防疫站领导认真贯彻落实江苏省“八五”期间出血热防治规划，重点抓了以灭鼠为主的综合性防制和水利工地的出血热防治以及监测工作，由于措施得力，使全市HFRS发病率、病死率逐年呈下降趋势。本文报告1993—1995年武进市肾综合征出血热疫情监测情况。一、材料与方法1疫情资料由市卫生防疫站提供，发病情况为法定疫情上报并经流调确诊病例统计数。2宿主动物监测HFRS监测点每年分别在3—4月于室内和9～10月于野外进行鼠密度监测，另在春季、秋冬季捕获当地优势鼠种100只…     

鲁东南地区1975至1993年肾综合征出血热流行病学调查分析

鲁东南是我区肾综合征出血热（HFRS）重疫区，自1975年经临床和病理学首次证实存在本病后，疫区范围不断扩大，发病人数逐年增加，迄至1993年12月累计发病11970例，病死161例，平均病死率为1.35%。为查清该地区HFRS流行病学特征，为制定防制对策提供依据，现将19年来调查结果报告如下：一、流行概况：首例HFRS病人发生于1975年12月，1975～1979年每年发病几例至数十例；1980年后发病急骤增加，1980年发病157例，超过历年发病总和；1983年后发病数成倍上升，1988年发病高达1705例，发病率为189.44／10万，平均病死率为1.35%；历年发病具…     

泰安市肾综合征出血热流行病学分析

目的 了解泰安市肾综合征出血热(HFRS)流行病学特点。方法 对泰安市1984-2001年不同季节、年龄、性别和职业人群HFRS发病情况进行分析，对宿主动物带病毒、疫源地类型及健康人群隐性感染情况进行调查。结果 泰安市HFRS呈周期性流行，每10年左右出现一次发病高峰；年内呈明显季节性高发，以春季发病为主。鼠种构成繁杂，室内以褐家鼠、野外以黑线姬鼠为优势鼠种。病区人群隐性感染率明显高于非病区。结论 泰安市HFRS发病以青壮年、男性、农民为主，学生发病比例有上升趋势；目前主要传染源为褐家鼠；属于家鼠型疫区，疫源地广泛、稳固。     

2010年中国肾综合征出血热监测及疫情分析

目的 分析2010年中国肾综合征出血热(HFRS)流行特征和趋势.方法 利用描述性流行病学对2010年中国HFRS病例资料及国家监测点监测资料进行统计分析.结果 2010年全国共报告HFRS病例9526例,发病例数较2009年上升8.93％,报告死亡118例,病死率为1.24％.全国发病明显呈春季和秋冬季两个季节高峰,11月为全年最高发病月份,多数省份春季高峰发病所占比例呈现下降趋势,秋冬季高峰发病所占比例逐步增加;各年龄组男性发病均高于女性,多数年龄组(除25～30岁和＞65岁组外)男性病死率高于女性,＞60岁年龄组病例所占比例有所升高;病例职业仍以农民最多.与往年相比,各监测点鼠密度及带病毒率变化不明显.各监测点鼠种多且构成复杂,野外以黑线姬鼠占主导优势,居民区以褐家鼠占主导优势,但云南省国家级监测点野外和居住区的优势鼠种分别为黄胸鼠和大绒鼠,并在野外大绒鼠监测到新型汉坦病毒(泸西病毒).结论 HFRS在中国分布广泛,发病呈地域性和聚集性,局部地区仍存在暴发和流行的风险,发病人群特征及不同类型疫区的发病季节分布均有变化.     

宿县地区1992～1994年肾综合征出血热流行病学分析

肾综合征出血热(HFRS)是我区秋冬季节重点传染病之一,为探讨发病趋势和流行规律,以便指导今后我区HFRS的防治工作,现将1992～1994年流行病学资料分析如下:1 流行特征 1.1 流行强度 三年全区共报告HFRS病人615例,年均发病率为2.97/10万,死亡15例,病死     

鄂伦春自治旗2005-2012年肾综合征出血热发病情况调查

为加强鄂伦春自治旗肾综合征出血热(HFRS)预防控制,对2005-2012年HFRS发病情况进行调查分析,全旗HFRS发病率为122.93/10万,病死率为0.29%。HFRS 10-12月为发病高峰,16~55岁为高危人群,男性发病高于女性,男女之比为3.8∶1。1985-1993年曾对人间HFRS发病进行调查,发病率为119.73/10万,病死率为3.07%[1]。2005-2012年再次进行HFRS流行情况调查,无论是季节分布还是年龄分布和男女比例,其流行规律基本一致,为有效预防和控制HFRS提供了科学依据。     

2005年山东省肾综合征出血热调查分析

山东省是肾综合征出血热（HFRS）的高发省之一，近20年发病数居全国前列。我们于2005年6月起，按照中国疾病预防控制中心《全国肾综合征出血热监测方案》要求开展了HFRS监测工作，现将有关调查资料分析如下。     

1971-2012年资兴市肾综合征出血热流行特征及防控措施分析

目的分析资兴市1971-2012年肾综合征出血热(HFRS)疫情监测资料,为制定HFRS防控措施提供依据。方法收集1971-2012年全市HFRS疫情、宿主动物和一般人群发病监测资料和防控措施资料进行分析。结果 42年间累计报告HFRS病例1 045例,年均发病率7.42/10万,20~60岁患者占发病总数的81.34%,农民占80.11%;一年四季均有发病,以冬春季节发病为主;累计病死62例,年平均病死率5.93%;鼠密度6.76%~9.5%;黑线姬鼠带毒率3.67%~7.63%,褐家鼠带毒率1.83%~5.29%;人群HFRS隐性感染率2.67%~24.65%;疫苗接种抗体阳转率为81%。结论资兴市为野鼠型和家鼠型并存的HFRS疫源地,黑线姬鼠和褐家鼠是该市HFRS的主要宿主动物和传染源;加强对HFRS病例监测,开展对重点人群预防接种,以及灭鼠防鼠是控制HFRS的主要有效措施。     

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.     

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.     

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.     

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.     

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.