355例HBsAg携带者转归及其影响因素调查

目的研究HBsAg携带者的转归情况及其影响因素,为有关防治策略提供科学依据。方法 1993年普查发现的355名HBsAg携带者被确定为研究对象,1999年和2008年分别对这些研究对象进行问卷调查、回顾性查阅病历资料和血清学检测等,以了解HBsAg携带者发生阴转或发展为乙型肝炎、肝硬化、肝癌等情况,并分析影响其转归的因素。结果 355名HBsAg阳性者在回顾调查期间发生HBsAg阴转33例,乙型肝炎12例,肝硬化1例,肝癌6例,死亡14人。其中5人死于肝病。有关是否发生肝病的Logistic回归分析显示,农民、父母亲患肝病是危险因素,体育锻炼、干预治疗等为保护因素,性别、年龄及其他研究因素无统计学意义。结论 HBsAg携带者发生阴转的机率较小,少数人会发展为慢性乙肝、肝硬化和肝癌等,应加强体育锻炼和进行适当干预治疗。     

2004年武汉市餐饮业从业人员乙肝表面抗原携带状况调查

乙型肝炎（简称“乙肝”）是目前严重危害人体健康的主要传染病之一，它与肝硬化、原发性肝癌发病密切相关。我国乙型肝炎表面抗原HBsAg阳性率为9．80％，为了解武汉市餐饮业从业人员HBsAg携带状况和分布特点，并评估全市相应人群感染状况，对2004年武汉市餐饮业从业人员HBsAg阳性率情况和分布特点进行了调查。     

原发性肝癌与乙型肝炎病毒病因关系的流行病学分析和探讨

调查肝癌高发区（隆安）8，799人和低发区26，242人，高发区HBsAg阳性率显著高于低发区，其中以0~9岁组为最高。高发区以1岁组，低发区以5岁组为HBsAg携带的年龄高峰，高发区在生命的早期即已受到HBV的高度感染。
对隆安携带者，非携带者1，042人进行了2~4年前瞻性观察，发现男性儿童HBsAg阴转率低，阳转率高。认为早期的HBsAg携带与以后的慢性肝病和肝癌高发有关。由配对和非配对追踪观察，发现HBsAg携带者发生肝癌的相对危险性较非携带者高4.29和6.7倍。认为乙型肝炎感染可能是导致肝癌的主要病因，而玉米黄曲霉毒素的污染和饮水污染不是肝癌发生的主要因素。     

体检人群乙型肝炎表面抗原检测结果分析

乙型肝炎是由乙型肝炎病毒引起的一种慢性传染病，是导致肝硬化和肝癌的重要原因，对乙型肝炎的预防和治疗是降低肝硬化和肝癌发病率的重要手段。为了解体检人群乙型肝炎病毒表面抗原（HBsAg）携带状况，加强对乙肝病毒携带者的宣教和防治工作，我们对2004—2005年来我院保健中心体检的6659人进行了乙型肝炎表面抗原携带情况进行分析，现报告如下。     

阿勒泰地区不同民族中小学生HBsAg病毒感染状况调查

目的 了解汉族与哈萨克族中小学生HBsAg病毒感染情况。方法 2002年8-10日，对该地区三县一市7-18岁学生HBsAg进行了检测。结果 检测了4612名学生，阳性者166、阳性率3．6％。女性阳性率3．1％（72／2296）；男性阳性率4．1％（94／2316）；男女之间阳性率无显著性差异（x^2=2．83，P〉0．05）。汉族学生阳性率为4．9％（121／2775）；哈族学生阳性率1．9％（35／1837）汉族学生感染率高于哈族学生（x^2=25．25，P〈0．01）。结论 本次调查该地区中小学生HBsAg感染率低于全国水平。     

北京市乙肝病毒感染有关肝病死亡状况分析

目的了解北京市乙肝病毒感染有关肝病的死亡情况。方法随机抽取北京市东城区、大兴区、通州区、密云县4个区（县）1992—2002年来所有死亡者的医学死亡证明书，对乙肝病毒感染有关肝病的死亡情况进行整理、分析。结果1992—2002年北京市乙肝病毒感染有关肝病死亡中，占首位的是原发性肝癌，其次是肝硬化和慢性乙型肝炎。慢性乙型肝炎死亡的病例主要集中在30岁以上年龄段；乙肝后肝硬化和原发性肝癌死亡病例主要集中在40岁以上年龄组，尤其是60岁以上年龄段。所有乙肝病毒感染有关肝病的死亡均是男性多于女性。慢性乙型肝炎、乙肝后肝硬化和原发性肝癌的病程约分别为13．0年、5．1年和0．9年。结论北京市与乙肝病毒感染有关的肝病死亡状况仍然比较严重。     

15797例医保参保人员乙型肝炎5项结果分析

目的调查河北衡水市乙型病毒性肝炎感染情况，为今后乙型病毒性肝炎的防治提供科学依据。方法采用酶联免疫吸附（ELISA）法对15797名医保参保人员进行乙型肝炎5项检测，统计年龄、性别、各阳性模式人数。结果15797例医保参保人员的乙型肝炎5项结果中出现阳性模式13种。其中，表面抗原（HBsAg）总阳性率3．96％（625／15797）；核心抗体（抗-HBc）总阳性率13．15％（2078／15797）；单表面抗体（抗-HBs）阳性率13．34％（2108／15797）。大、小三阳阳性率年龄分布：20～29岁（177％）、30～39岁（3．38％）、40～49岁（3．23％）、50～59岁（4．16％）、60～69岁（1．87％）、≥70岁（1．92％）。抗原阳性模式、抗体阳性模式和疫苗阳性模式在男女之间均显著不同，危险比（RR）分别为：2．25（4．2×10^-19），1．96（5．4×10^-33）和1．32（8．7×10^-11）；男女的HBsAg阳性率也显著不同，RR=2．26（P=1．0×10^-18）。结论衡水市15797例医保参保人员中慢性乙型肝炎或乙型肝炎携带者占4．06％，既往感染者8．88％，产生免疫力者13．34％；大、小三阳患者在30～59岁为发病高峰期；男性HBsAg阳性率是女性的2．26倍，男性发病率显著高于女性。     

沅陵县肺结核患者乙型肝炎病毒感染状况分析

目的了解沅陵县肺结核患者乙型肝炎病毒感染状况，为肺结核病的治疗工作提供科学依据。方法采用酶联免疫法对2005—2007年929例肺结核患者进行乙肝“两对半”和ALT检测。结果近三年肺结核患者HBsAg总阳性率为6．46％（60／929），ALT异常为0。HBsAg阳性患者中职业以农民为主；年龄组中以青、壮年为主；大三阳占HBsAg阳性总数的8．33％（5／60），小三阳占HBsAg阳性总数的61．67％（37/60），其他感染模式占HBsAg阳性总数的30％（18／60）。结论该县肺结核患者乙肝病毒携带者低于全国平均水平。该县疾控中心结核病防治科为有乙型肝炎的肺结核患者制定科学的结核病治疗方案，效果满意。     

103例HBsAg携带者第16—21年追踪观察

对１０３例ＨＢｓＡｇ携带者进行了第１６～２１年（平均１８．６（年）随访。其中康复３０例，病后携带２６例，无症状携带２１例，乙型肝炎急性发作６例、慢性活动性肝炎７例，死亡１３例。ＨＢｓＡｇ阴转率为３３．３％，＜３０岁者阴转率（１３．８％），显著低于＞３０岁者（４２．６％）；原高滴度携带者的ＨＢｓＡｇ阴转率和康复率非常显著低于低滴度携带者，而乙型肝炎急性发作率和慢性活动性肝炎发生率又显著高于低滴度携带者。     

3165名入托儿童乙型肝炎血清标志物检测结果分析

我国是乙型肝炎高发区,人群感染率达60％以上,HBsAg慢性携带率为9．75％,其中儿童是乙肝的主要感染者。新生儿、婴幼儿及青少年普遍易感,他们在感染HBV后容易成为隐性感染者或无症状携带者,有部分HBV携带者可成为慢性乙型肝炎,最终部分发展成为肝硬化或死于原发性肝癌。     

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.     

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.     

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.     

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.     

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 risk of heat exhaustion at a deep underground metalliferous mine in relation to surface temperatures

The risk of heat exhaustion at a deep underground metalliferous mine was assessed in relation to thermal conditions prevailing on the surface. For each day of a 1-year prospective case series of heat exhaustion, surface 24-h mean wet and dry bulb temperatures were recorded. From this data, 24-h mean wet bulb globe temperatures were derived using certain assumptions. The three surface temperature variables were significantly higher on those days on which heat exhaustion occurred, compared to those days on which it did not occur (P < 0.001). The relative risk of heat exhaustion on days when the 24-h mean wet bulb globe temperature was in the range 26.0-28.0 degrees C was 4.82 (95% confidence interval 2.12-10.96). Surface temperature data could be used at this mine to warn miners about the risk of heat exhaustion.