245例胸部X线摄影受检者体表入射剂量调查

目的了解不同级别医院不同X线摄影方式下受检者胸部体表剂量的差别。方法用热释光计量计贴于受检者胸部,当受检者进行胸部X线摄影诊断时记录热释光计量计的测量值,进行统计分析。结果一级医院数字摄影体表剂量大于屏片摄影体表剂量;二级医院屏片摄影体表剂量大于数字摄影体表剂量;同为数字摄影方式,一级医院摄影条件大于二级医院,二级医院大于三级医院。结论熟练掌握数字X线摄影业务,采用胸部数字X线摄影方式可降低受检者胸部体表剂量。     

上海市2007年X射线诊断的医疗照射剂量水平

[目的]掌握当前上海市各主要类型x射线诊断检查的剂量水平。[方法]根据x射线诊断设备种类、应用发展趋势及医院级别的差异,分别抽查约3％的普通x射线机和约25％的计算机X射线摄影、数字化X射线摄影以及x射线计算机断层扫描（x—cT）机,通过布放热释光剂量计测量成年人在不同检查方式和体位的入射体表剂量;利用标准的X—CT剂量模体和电离室测量不同扫描条件下的CT剂量指数,进而估算受检者的有效剂量。[结果]X射线摄影所致受检者的入射体表剂量平均值的变化范围为0．13～4．35mGy,其中手部摄影最低、腰椎侧位摄影最高。胸部透视时胸部表面的平均剂量为3．79mGy。胆囊和尿路造影以及上消化道钡餐和钡灌肠检查的受检者上腹部体表的平均剂量最大,分别为30．24、30．97、25．28、23．02mGy;消化道钡餐检查时胸部体表的平均剂量为24．27mGy,钡灌肠检查时下腹部体表的平均剂量为21．62mGy。头部X-CT扫描时受检者的平均有效剂量为（0．58±0．22）mSv,体部x—CT扫描时受检者的平均有效剂量为（5．18±1．92）mSv。[结论]较全面地得到了当前上海市主要类型x射线诊断所致受检者的剂量水平,可为推动进一步完善x射线诊断的医疗照射指导（参考）水平和加强受检者防护提供重要资料。     

X 线受检者体表照射量与器官剂量关系的研究

X 线透视检查包括胸部透视,节育环透视和上消化道检查(俗称胃肠检查)。其特点是:照射野大小不定而且移动,各部位曝光照射时间不同,病情和医生的检查程序各异。故受检查处于上述非均匀且变化着的辐照场中。欲研究这类受检者体表照射量与器官剂量的关系比较困难。为了较准确地测定受检者的器官剂量,我们采用非均匀组织等效人体体模和多野重叠照射法模拟辐照场,实验研究了受检者入射处体表照射量和器官剂量的关系,现报导如下。     

2015年广西数字化摄影受检者入射体表剂量水平调查与分析

目的 了解广西地区数字化摄影(DR)所致受检者的入射体表剂量水平。方法 采用分层随机抽样方法,选取广西区内14家医院不同时间段进行DR检查的受检者,使用热释光剂量计测量受检者不同部位的入射体表剂量。结果 广西地区一级医院的头颅(PA)、头颅(LAT)、胸部(PA)、胸部(LAT)、胸椎(AP)、腰椎(AP)6个部位入射体表剂量的75%位值超出了国家医疗照射指导水平;二级和三级医院的胸部(PA)和胸部(LAT)两个部位入射体表剂量的75%位值超出国家医疗照射指导水平。结论 广西地区DR摄影的入射体表剂量较高,应进一步加强受检者的入射体表剂量监测。     

成人体检胸部X射线摄片体表照射量分布及有效剂量估算

成人体检胸部Ｘ射线摄片体表照射量分布及有效剂量估算李士骏，严惟力，冯定华，朱南康（苏州医学院，苏州市２１５００７）Ｘ射线诊断照射是人类受到人工辐射照射最重要的来源。为全面了解Ｘ射线诊断所致受检者照射水平，我们曾对胸部Ｘ射线透视检查的照射水平作过调查［...     

北京地区X射线摄影受检者体表入射剂量调查分析

目的对比不同级别医院在使用数字X射线摄影及屏片X射线摄影对受检者进行摄影诊断时受检者剂量的差别。方法采用热释光剂量计(TLD)法测量X射线摄影成人受检者入射体表剂量(ESD),选择20家医院年龄在20~70岁之间的受检者,男性体重在55~80kg之间,女性体重在50~70kg之间。测量部位包含头颅(PA、LAT)、胸部(PA、LAT)、腰椎(PA、LAT)及胸椎(PA、LAT)。结果共对961次摄影进行了调查,比较各级医院头颅(PA、LAT)、胸部(PA、LAT)、腰椎(PA、LAT)及胸椎(PA、LAT)的受检者体表剂量平均值,三级医院的受检者体表剂量平均值最小,分别为:0.28 mGy、0.37 mGy、0.32 mGy、0.10 mGy、2.59 mGy、1.99 mGy、4.02 mGy和4.73 mGy。结论数字X射线摄影对受检者产生的剂量比屏片X射线摄影低;使用同种摄影设备对受检者产生的剂量中,三级医院最低,一级医院最高。     

乳腺X射线摄影所致患者乳腺受照剂量调查及控制对策

目的 调查乳腺摄影受检者受照剂量情况。方法 采用LiF(Mg,Cu,P)热释光粉末探测器监测乳腺摄影受检者乳房压缩厚度和乳腺平均受照剂量。结果 随机抽测46例受检者,乳房平均压缩厚度为4.61 cm,受检者平均入射体表剂量CC位7.14 mGy。MLO位6.78 mGy。受检者平均透射线剂量CC位0.18 mGy,MOL位0.17 mGy。结论 本次调查结果显示乳腺X射线摄影所致患者的入射体表剂量比普通胸透高2.4倍,是胸部正位摄片剂量的19.8倍,应引起广大医务人员的重视。     

河北省部分医院数字X射线摄影应用及剂量调查

目的调查河北省部分医院数字X射线摄影设备(DR)应用情况及受检者接受辐射剂量情况。方法选取河北省5个设区市30家不同级别医院,应用医院信息系统,了解其2017年6月—2018年6月DR应用情况。另采集938名DR受检者6种不同检查部位的体表入射剂量。结果所有DR诊断部位中胸部摄影人数相对较高,男性多于女性。不同级别医院在应用人次和单台设备日均检查人次上,三级二级一级。受检者胸部正位、颈椎正位、颈椎侧位、腰椎正位、腰椎侧位、骨盆的体表入射剂量分别为0.34±0.31(0.42)、0.48±0.34(0.78)、0.55±0.50(1.00)、4.04±2.65(5.91)、6.95±5.23(10.00)、3.26±2.79(4.10)mGy。结论 DR设备在一级医院的利用率低于二级和三级医院。部分受检者所受体表入射剂量高于医疗照射指导水平。     

受检者体表剂量的测量

目的 结合我国已经颁布执行的医用诊断X射线受检者体表剂量相关法规与标准,着重介绍使用RD98智能型诊断X射线剂量仪测量受检者体表剂量的方法。方法 分析医用诊断X射线受检者体表剂量的目前现状。结果 推荐使用医用诊断X射线剂量指导水平。结论 采用诊断X射线剂量仪定期监测X射线机输出量,降低受检者电离辐射剂量。     

福州市透视受检者入射体表剂量率现况与控制措施研究

目的 了解福州市医用常规X射线机透视受检者入射体表空气比释动能率典型值水平,并研究控制措施,保障受检者健康权益。方法 参照《医用常规X射线诊断设备影像质量控制检测规范》（WS 76-2011）对透视受检者入射体表空气比释动能率典型值水平进行调查与评价,并对控制措施结果开展追踪调查。结果 共调查87台X射线影像增强器透视设备,透视受检者入射体表空气比释动能率典型值>25 mGy/min为22台,对其中（市级及以下卫计委管理）17台开展干预。5台经过设备维修,5台采用"高电压、低电流、厚滤过"操作方法,透视受检者入射体表空气比释动能率典型值降为≤ 25 mGy/min。停机4台。待置换新机3台。结论 加强监督管理,开展放射工作人员培训,提高放射卫生防护意识;强化质量控制检测,及时维修或更换透视机;采用"高电压、低电流、厚滤过"等合理操作方法,是控制透视受检者入射体表空气比释动能率典型值的主要措施。     

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 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.     

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.     

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.