黑龙江省新型冠状病毒肺炎本土相关疫情流行特征

目的 描述黑龙江省新型冠状病毒肺炎（新冠肺炎）本土相关疫情的流行状况及特点,为黑龙江省新冠肺炎防控策略提供参考依据。方法 新冠肺炎个案调查、聚集性疫情调查资料来源于中国CDC全国传染病报告信息管理系统和突发公共卫生事件报告管理信息系统。采用Excel 2010和SPSS 23.0软件整理数据与统计学分析,描述人群、时间及地区分布特征。结果 2020年1月22日黑龙江省报告首例新冠肺炎确诊病例,截至2020年3月11日,13个城市累计报告境内病例482例,发病率为1.28/10万,病死率为2.70%（13/482）。其中聚集性疫情81起,确诊病例数占总确诊病例的79.25%（382/482）,死亡12例;家庭聚集70起（86.42%,70/81）。与散发病例相比,聚集性疫情尤其是家庭聚集性病例中,病死率、≥60岁老年人与重/危重型的比例均较高,差异均无统计学意义（均P>0.05）。涉及病例≥5例的聚集性疫情占41.98%（34/81）,涉及病例数占聚集性病例的68.31%（261/382）,涉及6~9例病例数的聚集性疫情中,年龄≥65岁者的比例较多（26.53%,39/147）。结论 黑龙江省新冠肺炎的发病率较高,前期疫情较为严重;聚集性疫情尤其是家庭聚集涉及病例数较多。     

天津市新型冠状病毒肺炎聚集性疫情病例分析

目的 分析天津市新型冠状病毒肺炎（COVID-19）聚集性疫情病例情况,掌握不同类型聚集性病例发病特征,为COVID-19防控提供流行病学证据和经验。方法 收集截至2020年2月22日天津市全部COVID-19确诊病例的聚集性资料,梳理和分析不同类型聚集性疫情发病特点。结果 截至2月22日,天津市共报告COVID-19聚集性疫情33起,涉及病例115例。聚集性病例分为4类：家庭聚集（28起,71例）、单位聚集（1起,10例）、交通工具（3起,8例）和公共场所（1起,26例）,其中单位和公共场所聚集性疫情中的病例又导致了14起家庭聚集性疫情。家庭聚集的续发病例1~7例,中位数为2例。家庭首发病例发病到确诊时间长于续发病例（Z=-2.406,P=0.016）。公共场所聚集的潜伏期中位数为7 d。家庭、单位和公共场所3类聚集性疫情相比较,病例发病到确诊时间差异有统计学意义（H=8.843,P=0.012）,续发病例发病时间差异有统计学意义（H=16.607,P=0.000）。结论 COVID-19疫情监测应特别关注容易发生聚集性疫情场所,及时开展细致的流行病学调查和排查。出现聚集性疫情的场所内部,应及时将密切接触者转至统一的隔离观察点,严格单间管理,避免疫情扩散。部分农村地区防疫意识不强,聚集活动较多,且发病后就诊不及时,在疫情初期应该加强防控的宣传和控制措施。     

广州市3起本地新型冠状病毒肺炎疫情流行特征及分析

目的 分析广州市3起本地新型冠状病毒肺炎（COVID-19）疫情的流行特征,为优化疫情防控策略和措施提供参考依据。方法 资料来源于中国疾病预防控制信息系统传染病报告信息管理系统截至2021年6月18日广州市COVID-19本地病例数据,采用Excel 2019和SPSS 22.0软件进行数据整理和统计学分析。结果 3起本地COVID-19疫情累计报告病例726例,其中我国湖北省关联疫情366例,病例以女性（51.6%,189/366）、18~65岁（81.4%,298/366）、职业以家务/待业（32.2%,118/366）和离/退休人员（20.2%,74/366）为主,首发症状以发热（71.6%,250/349）和咳嗽（60.7%,212/349）为主;非洲国家及地区（非洲）入境关联疫情207例,以男性（69.6%,144/207）、18~40岁（72.9%,151/207）和商业服务职业（62.3%,129/207）为主,首发症状以无明显不适（55.6%,15/27）和咳嗽（37.0%,10/27）为主;Delta变异株关联疫情153例,以女性（58.8%,90/153）、≥ 41岁（64.7%,99/153）和离/退休人员（32.0%,49/153）为主,首发症状以咳嗽（32.9%,48/146）和无明显不适（28.1%,41/146）为主。我国湖北省关联疫情、非洲入境关联疫情和Delta变异株关联疫情的家庭续发率分别为11.2%、5.7%和11.5%;潜伏期M（P₂₅,P₇₅）分别为6.5（4.0,10.8）d、4.0（2.5,6.0）d和4.0（3.0,5.0）d;代间距M（P₂₅,P₇₅）分别为4.0（3.0,8.0）d、4.0（2.5,6.0）d和3.0（2.0,5.0）d。3起本地COVID-19疫情在性别、年龄、职业、首发症状、家庭续发率和潜伏期等的差异有统计学意义（均P<0.05）。病例发现途径中,我国湖北省关联疫情主要是自主就医（44.3%,162/366）,非洲入境关联疫情和Delta变异株关联疫情主要是社区主动排查[58.5%（121/207）和27.5%（42/153）]和密切接触者管理[33.3%（69/207）和67.3%（103/153）]。结论 广州市3起COVID-19本地疫情因感染来源、变异株类型和防控策略的不同导致流行特征在社会人口学特征、临床、传播特征及病例发现等方面存在较大差异。提示在疫情常态化防控阶段,应不断完善重点人群和常见症状监测、强化聚集性疫情排查等措施,严防疫情反弹。     

北京市新发地市场新型冠状病毒肺炎疫情相关病例的流行病学特征分析

目的 分析并比较北京市新发地市场疫情中新型冠状病毒肺炎（COVID-19）确诊病例与无症状感染者的流行病学特征。方法 收集并整理传染病报告信息管理系统中北京市新发地市场疫情中COVID-19感染者数据和流行病学调查报告资料,应用SPSS 19.0软件分析并比较确诊病例和无症状感染者的流行病学特征。结果 2020年6月11日至7月10日北京市共诊断新型冠状病毒感染者368例,其中确诊病例335例（91.03%）,无症状感染者33例（8.97%）。病例分布于11个区,其中丰台区病例数占总病例数的68.48%（252/368）。发病曲线呈现暴发流行模式,发病高峰为6月13日。全部感染者年龄M（Q_R）为43（31~51）岁,无症状感染者的年龄M（Q_R）为32（29~49）岁,低于确诊病例的年龄M（Q_R）[43（31~52）岁],差异有统计学意义（Z=2.416,P=0.016）。感染者男女性别比为1.26：1。从事餐饮及商业服务和公共场所服务的人员最多,占64.13%（236/368）。73.91%（272/368）的感染者有新发地市场直接暴露史。通过核酸筛查发现全部感染者的54.08%（199/368）。确诊病例中轻型和普通型病例占99.10%（332/335）,无死亡病例。结论 北京市新发地市场疫情呈暴发流行模式,COVID-19病例以餐饮和服务业人员为主。无症状感染者的年龄低于确诊病例。     

北京市一起新型冠状病毒Omicron变异株聚集性疫情特征分析

目的 分析北京市海淀区一起新型冠状病毒肺炎聚集性疫情流行病学特征及传播链。方法 采用描述性流行病学方法分析疫情流行病学特征,应用现场调查和大数据技术分析传播链。结果 2022年4月27日至5月13日, 海淀区发生一起新型冠状病毒肺炎聚集性疫情,全基因组测序系Omicron变异株（BA.2.2进化分支）;涉及感染者38例,确诊病例34例,无症状感染者4例;临床分型以轻型（88.2%）为主,无重型、危重型和死亡病例;早期临床症状以咽部不适（50.0%）、咳嗽（29.4%）为主;17 d内传播7代,涉及3起社区聚集、2起单位聚集和8个家庭内传播;暴露方式以同住（47.6%）、同时空暴露（31.6%）为主;代间距M（Q₁,Q₃）为3（1,6）d;总续发率为1.5%（37/2 482）,其中家庭续发率为36.7%（18/49）。结论 本起Omicron变异株疫情临床症状轻,家庭、社区聚集性明显,疫情传播速度较快,同时空暴露感染风险较高,需利用信息化技术全面摸排密切接触者,以快制快,有效阻断疫情传播。     

甘肃省新型冠状病毒肺炎流行病学特征分析

目的 对甘肃省确诊的新型冠状病毒肺炎（COVID-19）病例进行流行病学特征分析,探索疫情流行的阶段性特征。方法 通过流行病学调查收集甘肃省COVID-19病例资料,包括基本资料、流行病学史、发病、就诊和确诊时间、临床表现等信息。结果 截至2020年2月25日,甘肃省共报告91例确诊病例,COVID-19流行分为输入病例期、输入病例与本地病例并存期、本地病例为主期3个阶段。聚集性疫情病例共63例（69.23%）。医务人员有3例,均为非职业暴露感染。首发症状为发热、咳嗽和乏力的比例分别为54.95%（50/91）、52.75%（48/91）和28.57%（26/91）,且在3个阶段中的比例呈下降趋势,但只有发热与乏力症状的差异有统计学意义（趋势χ²值分别为2.20和3.18,P<0.05）;3个阶段的重型/危重型病例比例分别为42.86%（6/14）、23.73%（14/59）和16.67%（3/18）,呈下降趋势（H=6.40,P<0.05）;潜伏期随着疫情的3个阶段有延长的趋势（F=51.65,P<0.01）;发病到就诊、发病到确诊的时间间隔随着疫情进展有缩短的趋势（F值分别为5.32和5.25,P<0.01）;基本再生数（R₀）从输入病例期的2.61降至本地病例为主期的0.66。结论 甘肃省COVID-19流行早期均为湖北省输入,聚集性疫情占三分之二,未发现医务人员职业性暴露感染。总体流行呈阶段性变化特征,随着疫情进展有首发症状不明显和潜伏期延长的特点,并提示体温监测不能作为单一的早期筛查手段。     

基于广州市聚集性疫情的新型冠状病毒传染力及续发率研究

目的 基于广州市新型冠状病毒肺炎（COVID-19）聚集性疫情,分析新型冠状病毒的传染力和续发率,为COVID-19疫情防控的策略提供参考依据。方法 对广州市COVID-19（确诊病例和无症状感染者）区分输入病例和本地病例,选择聚集性疫情首发病例为指示病例,以最短潜伏期1~3 d分别评估传染力和续发率。结果 截至2020年2月18日,广州市共报告新型冠状病毒感染病例349例,其中,确诊病例339例（占97.13%）,无症状感染者10例（占2.87%）。共报告聚集性疫情68起,涉及新型冠状病毒感染病例217例（确诊病例210例,无症状感染者7例）。每起聚集性疫情的新型冠状病毒感染例数中位数为3例,确诊病例数中位数为2例,无症状感染者数中位数为1例。最短潜伏期1~3 d的传染力平均值为2.18（即每起聚集性疫情中每个病例平均传染2.18人）,家庭成员传染力平均值为1.86,家庭成员传染力比例为85.32%（1.86/2.18）。最短潜伏期为1~3 d的全部密切接触者续发率为17.12%~18.99%,其中,家庭成员续发率为46.11%~49.56%。结论 广州市COVID-19聚集性疫情以家庭聚集性为主,传染力强,加强防控措施可有效控制社区传播。     

广州市猴痘疫情流行病学特征分析

目的 了解广州市猴痘病例流行特征，为疫情防控工作提供科学依据。方法 基于广州市猴痘监测网络体系，各级各类医疗卫生机构发现猴痘样症状者后报告疾控机构进行采样、处置，并落实明确诊断。广州市猴痘疫情流行特征采用描述性流行病学方法，对截至2023年6月23日24时广州市猴痘确诊病例基本信息、临床特征、就诊情况和阳性检出率等情况进行分析。使用Illumina Miniseq高通量测序平台进行病毒全基因组测序。结果 6月10日，广州市报告广东省首例猴痘确诊病例。截至6月23日24时，广州市累计发现猴痘确诊病例25例，均为男性，年龄M（Q₁，Q₃）为32（26，36）岁，96.0%为MSM。病例发病至就诊时间间隔为1~12 d，M（Q₁，Q₃）为5（4，7）d。临床特征以皮疹（100.0%，25/25）、淋巴结肿大（100.0%，25/25）、发热（52.0%，13/25）为主，出疹部位多位于生殖器及其周边（88.0%，22/25）。密切接触者以家庭同住人员为主（40.4%，23/57），暂未出现发热、出疹等可疑症状。病例家庭环境样本阳性率为30.5%。3条猴痘病毒基因全序列分型均为西非型Ⅱb分支，B.1.3家系。结论 猴痘病毒在广州市MSM中已发生隐匿性传播，但涉疫人群相对局限，社会面广泛传播可能性较低。     

宁波市15起新型冠状病毒肺炎聚集性疫情的传播力研究

目的 描述新型冠状病毒肺炎（COVID-19）聚集性疫情病例的基本特征。方法 收集15起COVID-19聚集性疫情病例的基本信息,采用伽马分布拟合病例代际间隔时间（Tg）,使用基于SEIR模型计算基本再生数（R₀）。结果 15起聚集性疫情中共有确诊病例52例、涉及5例核酸阳性无症状感染者。病例发病时间主要集中在1月23日至2月4日,以女性为主,潜伏期为（6.11±3.38）d。Tg为（6.93±3.70）d,在<60岁、≥60岁组及男、女性之间,Tg差异无统计学意义（P=0.551）。按照本研究估算的Tg计算,宁波市新冠肺炎感染的R₀为3.06（95% CI：2.64~3.51）;按照文献报告的病例Tg为7.5 d计算,R₀为3.32（95% CI：2.51~9.38）。结论 COVID-19聚集性疫情病例的Tg在不同年龄、性别间差异不大,COVID-19早期致病和传播力较高。     

聊城市一起某超市新型冠状病毒肺炎聚集性疫情调查

目的 调查一起聊城市新型冠状病毒肺炎（COVID-19）聚集性疫情,分析其病例感染情况及疫情传播链。方法 2020年1月30日聊城市、区两级CDC专业人员组成疫情处置联合调查组,针对来源于ZH超市COVID-19指示病例,2月1日开展密切接触者及相关对象追踪和筛查,包括ZH超市员工、与相关病例1月13－26日有接触史的家庭成员、1月16－30日超市顾客及其相关病例家属,完成流行病学个案调查,并采集其鼻/咽拭子标本送到聊城市CDC实验室,采用实时荧光定量RT-PCR法进行新型冠状病毒核酸检测。结果 2020年1月30日至2月9日,共筛查调查对象8 437人（超市员工120人、病例家属93人、超市顾客8 224人）,该疫情是ZH超市造成的传播链并引起4起家庭聚集性病例,新型冠状病毒感染病例25例,调查对象总的感染率为0.30%（25/8 437）,其中,确诊病例22例（0.26%,22/8 437）,无症状感染者3例（0.04%,3/8 437）,无症状感染者占全部感染病例的12.00%（3/25）;超市员工、病例家属和超市顾客的感染率分别为9.17%（11/120）、12.90%（12/93）和0.02%（2/8 224）。结论 这是一起聊城市某超市输入性病例引起COVID-19聚集性疫情,提示聚集性疫情防控工作重点在于社区传播链和家庭聚集性病例,还需关注无症状感染者的传播风险。     

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.     

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.     

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.