青海省流行性脑脊髓膜炎流行病学分析

目的 了解青海省流行性脑脊髓膜炎流行病学特征,加强流行性脑脊髓膜炎防控力度,巩固防治成果,降低流脑发病率和死亡率.方法 通过青海省免疫规划监测信息管理系统,收集全省2001年1月1日～2007年12月30日报告的所有流脑病例个案数据,采用描述性方法对相关指标进行流行病学分析.结果 2001～2007年青海省累计发病380例,年平均发病率1.01/10万,死亡18例,病死率为4.74%,年平均死亡率0.048/10万;发病率呈现农村高于城市,城市高于牧区;2～4月为高发季节,占全年发病数的64.21%;发病年龄组居前3位的是5～9岁,0～4岁,10～14岁,发病率分别为2.24/10万,1.76/10万,1.00/10万;学生发病占59.11%,其次为学龄前儿童,占36.05%.结论 流脑发病呈高度散发,发病有明显季节性,发病年龄以＜15岁人群为主;流行菌群以A群为主.     

2007—2011年襄阳市襄州区0～6岁儿童传染病流行病学分析

目的掌握襄阳市襄州区0～6岁儿童传染病的流行病学特点,为有效控制其流行提供科学依据。方法采用描述性流行病学方法对2007—2011年襄阳市襄州区0～6岁儿童传染病发病资料进行分析。结果 2007—2011年襄州区0～6岁儿童共报告乙、丙类传染病19种6 789例,发病数占全人群传染病发病总数的41.70%(6 789/16 280),年均发病率为2 138.31/10万,各年发病率分别为426.99/10万、1 178.63/10万、1 503.28/10万、1 746.99/10万和4 743.47/10万,发病率呈逐年上升趋势(P<0.01)。发病数居前5位的病种为手足口病、其他感染性腹泻、流行性腮腺炎、麻疹和细菌性痢疾,占发病总数的97.57%(6 624/6 789)。全区各镇均有病例报告,城区发病率(3 375.93/10万)高于农村(1 938.17/10万)(P<0.01);全年均有病例报告,4—7月为发病高峰期(3 916例,占57.68%);男女发病性别比为1.80∶1(4 364∶2 425),2岁及以下年龄组发病占78.01%(5 296/6 789),散居儿童发病占83.72%(5 684/6 789)。结论襄阳市襄州区0～6岁儿童法定传染病报告发病率呈逐年上升趋势,手足口病为主要报告病种,应加大对手足口病的防控力度,防止暴发与流行。     

合肥市流行性脑脊髓膜炎流行特征分析

目的 分析安徽省合肥市流行性脑脊髓膜炎(流脑)流行特征.方法 运用描述流行病学方法分析2005～2007年流脑疫情资料.结果 合肥市2005～2007年流脑累计发病330例,2005年发病率为1.64/10万,至2007年上升到2.84/10万;经实验室确诊共,其中97.5%为C群,其余为未分群;冬春季发病高峰明显,每年1～4月流行期发病数均超过当年的70%;2005和2006年发病率最高为15～19岁组(8.63/10万,11.30/10万),2007年发病率最高为0～1岁组(11.15/10万),较2005年上升了近5.5倍;2005年城市发病数占病例总数的81.8%,2007年下降到43.6%,2005年农村发病数占病例总数的18.2%,2007年上升到56.4%;共发生19起聚集性流脑疫情,8起发生在学校,其中职业学校4起.结论 流脑流行病学特征逐年变化,尤其病例年龄分布特征明显,应适时调整最佳免疫策略和预防措施.     

济南市1951～2003年流行性脑脊髓膜炎流行态势分析

[目的 ]探讨济南市流脑流行特征 ,为有效控制流脑流行、制订控制措施提供科学依据。 [方法 ]对济南市 195 1～ 2 0 0 3年流脑发病法定报告资料和流脑防治资料进行分析。 [结果 ] 5 0多年来 ,济南市流脑发病呈逐年下降态势 ,期间出现 3次大的流行高峰 ;发病主要集中在 3～ 7岁年龄段 ,发病率为 8 47/10万 ,散居儿童占 63 3 5 % ,2～ 4月占 71 2 4% ;城乡结合部的历城区发病率最高。 [结论 ]济南市流脑发病率呈明显下降趋势 ,这与流脑疫苗的应用有关。     

安徽省2004-2013年流行性脑脊髓膜炎流行病学特征

目的分析安徽省2004-2013年流行性脑脊髓膜炎（流脑）流行病学特征,为预防控制流脑提供参考依据。方法用描述流行病学方法,对2004-2013年中国疾病预防控制信息系统报告的安徽省流脑流行特征进行分析。结果安徽省2004-2013年共报告1 457例,年平均发病率0.24/10万;死亡96例,病死率6.59%。病例主要集中在江淮地区,其中合肥市发病率最高（占全省发病总数的42.48%）。10~19岁年龄组高发,主要为中小学生。流行菌株以C群脑膜炎奈瑟菌（Neisseria meningitidis,Nm）为主,占所有检出菌群的86.87%。结论安徽省2004-2013年流脑流行优势菌群由A群变迁为C群,导致发病率上升,并出现新的流行特征。2009年以后,流脑防控成效显著,发病率逐年下降。2012-2013年,持续出现W135群流脑病例,表明流行隐患依然存在。应进一步加强监测,随时掌握菌群流行动态,以便采取针对性的防控措施。     

贵州省2011-2013年流行性脑脊髓膜炎流行病学特征

目的了解贵州省流脑流行病学特征,为制定流脑预防控制策略提供科学依据。方法收集2011-2013年贵州省流脑的发病资料,并利用描述流行病学方法进行分析。结果贵州省2011-2013年共报告流脑病例31例,死亡5例,发病率0.025 9/10万~0.034 4/10万。3、4月为发病高峰;发病数居前3位的地区分别是黔西南州、毕节市和遵义市;发病年龄为5月龄~16岁,发病年龄中位数9岁;学生占61.29%,散居儿童占35.48%,农民占3.23%;未完成脑膜炎球菌疫苗基础免疫、否认免疫史及免疫史不详的占93.55%。实验室病原分群C群占66.67%,A群占33.33%。全省2011-2012年未发生流脑聚集性疫情,2013年发生2起聚集性疫情。结论贵州省流脑的预防和控制效果显著,A群、C群脑膜炎奈瑟菌是全省流脑主要的致病菌群,应重点提高学生和散居儿童A群、C群脑膜炎球菌疫苗接种率。     

江西省2004-2007年流行性脑脊髓膜炎流行病学特征分析

目的分析江西省流行性脑脊髓膜炎（流脑）流行病学特征,为预防和控制流脑提供依据。方法用描述流行病学方法,对江西省疾病监测信息管理系统报告的2004-2007年流脑流行趋势进行分析。结果江西省2004～2007年流脑发病率为0．069／10万-0．129／10万,平均发病率0．105／10万;病死率为2．2％-16．7％;1-4月为发病高峰;〈15岁儿童发病占总病例数的75．4％;学生发病占总病例数的57．5％;送检的病例标本中,检出C群脑膜炎球菌的占73．9％。结论应规范接种A群、A＋C群脑膜炎球菌疫苗,加强流脑监测和在校学生流脑的预防控制。     

合肥市流行性脑脊髓膜炎流行期健康人群带菌率监测分析

目的为制定流脑防治措施提供科学依据,开展流脑疫情预测、预警积累数据。方法采取单纯随机抽样方法,以县区为单位按3～5岁、6～11岁、12～15岁、16～18岁、19～25岁分组,每个年龄组抽取20～30人,分别在流脑流行的前、中、后期连续监测两年,采集调查对象的鼻咽拭子,进行带菌率监测。结果流行前、中、后期带菌率分别为3.5%、5.4%、6.6%,流行后期较前期上升了3.1%;3期带菌率卡方检验有非常显著性差异(χ2=19.168,P=0.000)。菌群分布主要是B群和C群,3期中,C群所占比例上升幅度较大,分别为24.7%、58.0%、60.8%。城市两年流行前期带菌率分别为2.2%、4.2%;发病率分别为4.5/10万和4.3/10万。年龄组带菌率与发病构成均以16～18岁最高;流行前期流脑疫苗接种和未接种者带菌率分别为1.7%、4.5%,差异有非常显著性。结论带菌率随流脑流行前、中、后期,呈不断上升趋势。以C群为主,C群已成为合肥市流脑流行的优势菌群。     

连云港市2004～2009年流行性脑脊髓膜炎监测结果分析

目的了解连云港市流脑流行特点。方法对流脑疫情资料进行统计,采用Excel进行分析。结果全市流脑报告发病率自2004年的0.513/10万(最高值)下降至2009年的0.0204/10万,发病率呈逐年波动下降趋势。全市2004～2009年1～4月发生的流脑占总病例数的75%,发病年龄集中在0～19岁之间,占总例数的92.31%,尤以10～14岁较多,占比44.23%,发病职业分布中以学生占比最多(67.31%),正常人群流脑免疫水平监测A群、C群阳性率分别为57.24%、63.16%。结论该市流脑发病率呈逐年波动下降趋势,此现象与该市流脑疫苗接种率的不断提高及流脑疫情监测敏感性的增强有关。15岁以上正常人群中C群流脑的隐性感染率高,加强易感人群的A+C群流脑疫苗的接种已不容忽视。     

青岛市1990～2003年成人麻疹病例流行病学特征分析

青岛市 1990～ 2 0 0 3年共报告成人麻疹 2 30例 ,年平均报告发病率为 0 30 /10万 ( 0～ 1 17/10万 )。 1997年以前 ,成人麻疹呈散发 ,而 1998年以后发病明显增加 ,1998～ 2 0 0 3年年平均报告发病率为 0 6 0 /10万 ( 0 13/10万～1 17/10万 ) ,与 1990～ 1997年的年平均报告发病率 0 0 7/10万相比 ,上升了 7 5 7倍。发病高峰在每年的 3～ 5月。 71 31%的病例为 18～ 2 4岁 ,196 9年及以后出生人群的发病危险是 196 9年以前出生人群的 19 83倍。外来人口病例占总病例的 4 8 2 6 % ,外资和民营企业的工人 (占 4 4 35 % )、大学生 ( 14 78% )、农民 ( 11 74 % )等是成人麻疹发病的重点人群。外来人口发病是青岛市成人麻疹报告发病率升高的主要因素 ,无麻疹疫苗免疫史、免疫失败是导致成人麻疹发病增高的关键原因。     

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.     

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.     

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.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.