2006年江苏省农药中毒状况分析

[目的]探讨农药中毒发生的特点,为制定相应防治策略提供科学依据.[方法]对2006年江苏地区农药中毒报告资料进行描述性分析.[结果]2006年江苏省发生农药中毒5847例,每天平均16例中毒,其中死亡273例,总的死亡率4.67%.中毒主要集中在6、7、8月份.中毒多发生在生产性自用和非生产性自服,涉及7大类30个品种的农药中毒.引起农药中毒和死亡的农药种类以有机磷杀虫剂占首位,其次是除草剂和杀鼠剂.[结论]2006年江苏省农药中毒由自服和生产性中毒所致,自服中毒的人数超过生产性中毒,杀虫剂、除草剂和杀鼠剂中毒病例数居前3位,杀虫剂中又以有机磷中毒人数最多.     

有机磷农药中毒肾脏损伤的临床研究

[目的]研究有机磷中毒肾脏损的诊断与治疗。[方法]应用临床农药中毒资料进行研究。[结果]2279例有机磷中毒患者中,有27例并发肾脏损伤,占1．2％[结论]对有机磷农药中毒的病人,为了早期预防肾脏损伤的发生,入院后的前5日内必须每天作尿常规检查1次;每2日作肾功能检查1次。治疗以改善肾脏的微循环为主,早期应用激素对肾脏功能的恢复极有利。     

五种有机磷农药中毒大鼠的心电图时程变化研究

目的研究有机磷农药的心脏毒性,探寻合理的治疗措施。方法大鼠用五种常用的有机磷农药乐果、敌百虫、马拉硫磷、甲胺磷和对硫磷染毒中毒后,观察心电图随中毒时间的变化。结果有机磷农药中毒确实引起大鼠的心电图改变,常见者为Ｓ－Ｔ期间延长,Ｒ波及Ｔ波的波幅改变,Ｐ－Ｒ期间改变等等,提示有机磷农药中毒有心脏损害。心电图改变与有机磷农药的品种、给予剂量及所处中毒过程的时相有关。结论有机磷农药可以引起心脏损伤,致心电图表现随农药、中毒时程而不同。这有助于对临床报告的中毒病人不同心电图表现的理解。建议在治疗有机磷农药中毒过程中,对心脏损害给予足够的关注,并采取相应的措施     

急性有机磷农药中毒心肌酶及肌钙蛋白变化对心肌损害诊断的价值

目的 探讨心肌酶及肌钙蛋白在急性有机磷农药中毒心肌损害诊断中的价值.方法 检索国内1979至2010年学术期刊及PubMed上发表的急性有机磷农药中毒并且有心肌酶及肌钙蛋白研究的文献,进行统计和分析.纳入有机磷农药中毒患者病例数2129例.结果 与对照组比较,轻、中、重度中毒组血清肌酸激酶(CK)和肌酸激酶同工酶(CK-MB)活力和肌钙蛋白(cTnI)水平均明显增高,差异有统计学意义(P＜0.05);各中毒组血清CK和CK-MB活力和cTnI水平的差异有统计学意义(P＜0.05);中、重度中毒组CK-MB/CK明显低于对照组,差异有统计学意义(P＜0.05).中间期肌无力综合征( IMS)组血清CK、CK-MB活力和cTnI水平均明显高于非IMS组,差异有统计学意义(P＜0.05).与非呼吸肌麻痹重度中毒组比较,呼吸肌麻痹组血清CK、CK-MB活力均明显增高,CK-MB/CK的比值明显降低,差异有统计学意义(P＜0.05).结论 单纯血清CK、CK-MB活力升高作为有机磷农药中毒患者心肌损害的诊断依据不足,CK-MB/CK的比值的诊断价值更高;cTnI水平作为诊断有机磷农药中毒患者心肌损害的依据值得怀疑.CK、CK-MB活力及cTnI水平可作为有机磷农药中毒病情轻重的辅助判断依据.     

急性有机磷农药中毒并肝损害临床分析

目的　探讨急性有机磷农药中毒对肝损害的程度。方法　对 5 2例急性有机磷农药中毒病人的肝功能进行测定分析。结果　 5 2例中 38例伴有不同程度的肝损害 ,占 73% ,其中轻度有机磷农药中毒的肝损害程度与中、重度有机磷农药中毒相比 ,有显著性差异 (P <0 0 5 )。结论　急性有机磷农药中毒造成的肝损害程度与中毒程度有关。     

36例急性有机磷农药中毒的诊治

近年来 ,因职业性及自杀行为等明确中毒史的有机磷农药中毒逐渐减少 ,而不明中毒史的有机磷农药中毒相对增多。后者往往造成诊断上的困难 ,而延误治疗。我院自1993～ 1998年共收治有机磷农药中毒 6 3例 ,其中不明中毒史 36例 ,占 5 7% ,现就其诊断问题讨论如下。临床资料1.一般     

川芎嗪注射液对有机磷农药中毒性心肌损害的治疗作用

急性有机磷农药中毒常引起各种脏器损害,拮抗期引起的中毒性心肌损害是治疗的重要环节.2002年1月-2007年6月,我们采用川芎嗪注射液治疗急性有机磷农药中毒致心肌损害,观察其对心电图(ECG)、心肌酶(CK)及胆碱酯酶(chE)的影响,取得较好的疗效,现报告如下.     

氯解磷定治疗急性有机磷农药中毒的研究现状--附二例少见的不良反应

有机磷农药中毒在广大农村非常常见 ,虽有特效解毒药肟类复能剂和拮抗剂阿托品治疗 ,死亡率仍在 1 0 %左右[1 ] 。近年来的文献报道 ,在抢救有机磷农药中毒时应及时、足量和持续应用肟类复能剂 ,以减少临床症状的反复 ,提高重度中毒抢救的成功率[2 6 ] 。使用肟类复能剂可以减少阿托品的用量 ,即减少了阿托品中毒的发生。国内临床治疗有机磷农药中毒时 ,较普遍使用的肟类药物是碘解磷定。我们复习文献发现 ,氯解磷定治疗有机磷农药中毒有更多可取之处 ,值得推广 ,特介绍如下 ,并报告我们在治疗中观察到的 2例罕见的不良反应 ,对治疗中引发…     

血液灌流抢救重度有机磷中毒疗效的Meta分析

[目的]探讨国内血液灌流抢救重度有机磷中毒的疗效.[方法]对国内10篇有关血液灌流抢救重度有机磷中毒疗效的研究结果采用Review Manager 4.2分析软件,进行固定效应模型的Meta分析.[结果]入选的10项研究中,共包含重度有机磷中毒患者646例,治疗组均为常规内科治疗加血液灌流,对照组均给予常规内科治疗.治疗组治愈率高于对照组,合并RR值为1.18,95%7信区间为1.09～1.27.[结论]血液灌流可提高重度有机磷中毒患者的治愈率.     

急性有机磷农药中毒反跳11例救治体会

目的:探讨急性有机磷农药中毒反跳发生的原因及防治措施。方法:分析11例急性有机磷农药中毒反跳患者的临床资料。结果:急性有机磷农药中毒反跳发生率为5.3%,以乐果及氧化乐果中毒多见,且与中毒程度有关,治愈10例,死亡1例。结论:及时诊断和治疗是改善有机磷农药中毒反跳患者预后的关键。     

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.