广西壮族自治区1990～2001年钩端螺旋体病流行病学分析

广西是我国钩端螺旋体病 (钩体病 )的重灾区之一 ,为此就广西近 12年来人间钩体病流行情况进行分析。 1990～2 0 0 1年全区累计发病 8381例 ,死亡 4 0 8例 ,病死率为 4 .78% ,年发病率在 0 .2 6 / 10万～ 5 .0 8/ 10万 ,年均发病率为 1.5 5 / 10万。发病呈现明显的季节性 ,1～ 5月份病例较少 ,6月份病例明显增加 ,7～ 9月份维持在较高水平 ,8月份是发病高峰 ,10月份病例逐渐下降。 7～ 9月份的病例数占全年总病例数的 87.6 0 % ,是钩体病的流行季节。钩体病分布广泛 ,全区 8个地区均有病例报告 ,年均发病率由高到低依次为河池、桂林、南宁、…     

陕西省1959～1999年钩端螺旋体病流行病学分析

目的　了解陕西省钩端螺旋体病 (简称钩体病 ) 40年发病、死亡、三间分布情况及预防接种对该病的影响。方法　用病原培养和血清凝集试验调查疫区宿主动物。结果　 195 9～ 1999年钩体病共发生 5 973 5例。年平均发病率 6 185 3 /10万 ,1960～、 1970～、 1980～、 1990～、 4个时期平均发病率为 2 8 4761/10万、1 863 1/10万、 0 63 5 0 /10万和 0 42 3 0 /10万 ,发病率逐期下降。累计死亡 65 8人 ,年平均病死率 1 14 %。累计发病 3 6个县 ,发病县数有扩大的趋势。主要发病季节、职业、性别、年龄和地区分别是 9、 10月 ( 91 81% )、农民 ( 83 40 % )、男性 ( 74 2 7% )、青壮年 ( 79 0 2 % )和汉中地区 ( 91 81% )。结论　构体病流行强度在使用菌苗 ( 1965年 )后较使用菌苗前减弱 (P <0 0 1)。啮齿动物为主要传染源 ,黑线姬鼠为优势种 ,黄疸出血群为主要的血清型。     

钩端螺旋体病的研究进展

钩端螺旋体病(钩体病)是全世界范围内流行的人兽共患病,也是洪涝灾区重点监控的传染病之一.2007年6月,我国多个省市遭受暴雨洪灾,钩体病一旦爆发,将成为重大公共卫生问题.此文就钩体病的病原学、流行病学、发病机制、诊断及预防进行综述.     

四川省1997～2000年钩端螺旋体病流行特征及监测分析

为掌握钩端螺旋体病(简称钩体病)流行规律,制定有效的防治措施,对1997～2000年我省钩体病流行特征及监测结果分析如下. 1.流行特征:全省累计发病4 412例,死亡42例;平均发病率为1.314/10万,平均死亡率为0.013/10万;病死率为0.95%.除甘孜、阿坝2州外,其余市州均有病例报告,平均发病率居前6位的是雅安市(7.982/10万),乐山市(4.762/10万),宜宾市(3.761/10万),眉山市(2.867/10万),绵阳市(2.322/10万),凉山州(2.262/10万).全年均有病例报告,有明显的季节性.6月份开始逐渐增多,9月份达到高峰,10月份开始下降,11～12月为最低水平.发病最小年龄为1岁,最大为85岁,其中15～39岁组占发病数的69.73%.男性占66.70%,农民占82.26%.     

1998年衢州市钩端螺旋体病监测

我市钩端螺旋体病 (简称钩体病 ) ,1997年发病 86例 ,发病率 3 6 4/10万 ,病例数占全省总病例数的 5 0 %。为摸清我市钩体病菌群 ,了解鼠间带毒情况 ,按照衢州市钩体病防治规划及 1998年监测计划 ,1998年在我市的龙游、常山、江山等县 (市 )开展了监测工作 ,现将结果报告如下。     

利用患者血清鉴定钩端螺旋体感染血清型的研究

近年湖北省江汉平原地区的一些县市在洪涝灾害后 ,暴发钩体病流行。钩体病临床表现多样 ,容易引起临床误诊 ,钩体菌群的分离由于抗菌素广泛使用而十分困难 ,我们试图用患者的血清直接进行钩体病血清型的分群分型 ,取得了较为满意的效果 ,现报告如下。1　材料与方法1.1　患者血清采样　分别从仙桃市、枝江县、荆州区等地区采集确诊钩体患者双份血清 11例 ,恢复期患者血清 19例。1.2　标准抗原　用钩体 15群及相应各型的参考菌株 ,生长良好后制作标准抗原 ,钩体菌株由中国药品生物制品检定所提供。1.3　检测方法　用显微凝集试验 (MAT)进行…     

2004—2007年宜宾市钩端螺旋体病流行病学分析

目的分析宜宾市钩端螺旋体（钩体）病疫情动态和流行规律,为有效预防控制钩体病的发生与流行提供科学依据。方法对2004—2007年宜宾市钩体病疫情资料进行描述性流行病学分析。结果4年共发病299例,无死亡病例,年平均发病率为1．51／10万;发病主要集中在8～9月,占发病总数的91．30％,男女性别比为2．69：1;病例主要集中在10～35岁年龄组,占报告病例总数的76．59％;农民、学生是发病的主要人群,分别占发病总数的59．87％和36．79％。结论宜宾市钩体病发病高峰在8、9月份,青壮年农民及学生为主要发病对象。     

宁乡县2007-2011年钩端螺旋体病监测结果分析

目的了解宁乡县钩端螺旋体病的流行特征及因素,为预防和控制钩体病提供科学依据。方法按照《全国钩端螺旋体病监测实施方案》开展人间疫情监测以及对宿主动物带菌率与带菌种群调查,对疫情资料、实验室检测资料进行描述性流行病学分析。结果 2007-2011年宁乡县共报告钩体病13例,年平均发病率为0.17/10万,死亡病例1例。病例发病时间主要集中在7、8、9月,共12例,10月发生1例。13例病例分布在9个乡镇,主要分布在沩水流域沿岸。发病人群主要是中老年人,男女性别比是12：1,职业分布以农民为主,占发病总数的92.3%。5年共采集鼠肾、猪肾、蛙肾923份,未检出钩体菌株;采集健康人群血清511份,检出9个血清群9个血清型。采集钩体病例恢复期血清13份,检出4个血清群4个血清型。结论宁乡县钩体病近年发病大幅度下降,说明之前所采取的防控措施有效,但仍然存在钩体病暴发流行的风险,仍需继续采取综合性防控措施。     

广州市1996至2002年钩端螺旋体病流行病学分析

钩端螺旋体病 (简称钩体病 )是人兽共患的自然疫源性疾病 ,长期以来分布在广州市各区域。夏秋季 ( 6～ 10月 )为高峰并有局部小的暴发性流行 ,严重危害我市人民健康。现将1996～ 2 0 0 2年钩体病流行情况分析如下。1　材料与方法　1.1　资料来源　根据广州市 1996～ 2 0 0 2年钩体病的疫情资料、流行病学个案调查表加以整理并统计分析。1.2　检测方法　血清学检测由有关医疗单位抽取患者及健康人群静脉血送广州市疾病预防控制中心检验科进行显微镜钩体凝溶试验。单份血清抗体滴度呈 1∶40 0以上或恢复期有 4倍以上增长判为阳性。2　结果与分…     

名山县钩端螺旋体病流行情况与监测分析

目的：通过了解43年铯体病流行情况和17年监测结果，为预防和治疗钩体病提供依据。方法：根据钩体病的发病资料和监测方案，研究传染源贮存宿主的种类与带菌，钩体病发病规律，流行因素与防治对策。结果：全县43年累计发病8286例，年均发病率为88．76／10万，死亡81例，年均病死率0．98％，共出现6个发病高峰，发病高峰为每年9－10月，有明显的地区性，平坝高，丘陵低，青壮年发病最高，男女之比为1．13：1，以农民发病为主占75．72％，流行形式以“稻田型”为主，感染方式主要以收割水稻接触疫水而感染，鼠密度7．27％，鼠种群为2目3科9种，已从8种动物中分离出钩体，证明啮齿和食虫动物为“稻田型”钩体的主要传染源，流行菌群有6群，以黄胆出血群为主占93．73％，次为秋季热，七日热群，猪，牛血清抗体阳性率分别为41．0％和60．0％，经观察本县流行菌群基本稳定，鼠种有变化，黑线姬鼠减少，四川短尾Qu增多。结论：钩体病的发病率与宿主动物数量，带菌率高低，人群免疫水平，接触疫水，水稻收割季节气温，降雨量密切相关，应加强钩体病宿主动物的监测管理，控制传染源，有针对性地对接触疫水的人群接种钩体菌苗。     

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 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.     

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.     

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.     

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.