新生儿基础免疫接种不同剂型乙型肝炎疫苗不同时间免疫水平比较

目的探讨新生儿分别接种10μg与5μg乙型肝炎(乙肝)疫苗免疫后不同时间免疫水平,为调整新生儿乙肝疫苗免疫程序提供科学依据。方法采用病例对照研究方法观察新生儿接种不同剂量乙肝疫苗后不同时间段人群抗体水平变化,采用化学放光法检测血清抗体水平。结果两队列新生儿在全程接种乙肝疫苗后1个月、6个月、12个月,低无应答率接种10μg组均低于接种5μg乙肝疫苗组,乙肝表面抗体滴度接种10μg组均高于接种5μg乙肝疫苗组,免疫后12个月内两组乙肝表面抗体滴度均呈下降趋势,免疫后12个月10μg乙肝疫苗组的乙肝表面抗体阳性率高于接种5μg乙肝疫苗组。结论新生儿接种10μg乙肝疫苗的免疫效果优于5μg乙肝疫苗。     

接种乙肝疫苗后不出现抗体怎么办

接种乙肝疫苗是预防乙肝最好的措施。目前我国生产的基因工程乙肝疫苗免疫效果非常显著，接种后免疫获得成功的标志是乙肝表面抗体(抗HBS)转为阳性。成年人接种疫苗后，保护性的表面抗体阳转率95％左右，学龄前儿童为96．6％，新生儿为96．2％。但仍会有5％左右的人接种后表面抗体不转阳，也就是说没有起到预防作用。     

乙肝疫苗免疫策略对乙型肝炎发病和流行的影响

目的为了探索乙肝疫苗免疫策略对乙型肝炎发病和流行的影响,进一步探索防治策略,控制乙肝的流行态势。方法采用流行病学对比分析的方法,分析国家将乙肝疫苗纳入免疫规划后不同的免疫策略对安定区乙型肝炎流行趋势的影响。结果将乙肝疫苗纳入免疫规划,特别是开展新生儿乙肝疫苗及时接种免疫策略后,安定区乙型肝炎发病率呈明显下降趋势,5岁以下儿童的乙肝感染率及发病率得到有效的控制。结论重点做好新生儿乙肝疫苗及时接种工作是控制乙肝流行最有效的途径;同时也提出了进一步加强成人乙肝疫苗免疫的问题。     

接种乙肝疫苗后不出现抗体怎么办?

接种乙肝疫苗是预防乙肝最好的措施,目前我国生产的基因工程乙肝疫苗的免疫效果非常显著。接种后免疫获得成功的标志是乙肝表面抗体(抗HBs)成为阳性,成年人接种疫苗后,保护性的表面抗体阳转率95％左右,学龄前儿童为96.6％,新生儿为96.2％。但仍会有5％左右的人接种后表面抗体不转阳,也就是说没有起到预防作用,对于这部分人怎么办?根据目前已经掌握的资料,可以采取以下措施:     

新生儿乙肝疫苗免疫效果调查

新生儿乙肝疫苗的免疫效果是评价乙肝疫苗接种质量的重要工作。1995～1997年,淄川区卫生防疫站对部分孕妇HBsAg携带状况及新生儿乙肝疫苗免疫效果进行了调查,现将结果报告如下: 1 材料与方法 1.1 对象 选自淄川区医院、淄城区妇产医院、淄博矿务区中心医院及昆(山仑)分院出生的新生儿 1.2 免疫方法 分为两种,第一种孕妇HBsAg阳性的新生儿,在出生后24h内,按0、1、6个月免疫程序接种10μg×3针乙肝血源疫苗。第二种免疫方法是新生先接种乙肝免疫球蛋白,后按程序接种乙肝疫苗,HBsAg和HBeAg双阳性孕妇所生新生儿出生24h之内接种乙肝免疫球蛋白,然后按1、2、7个月接种乙肝疫苗。     

2006—2007年南昌县城区秋季入托儿童乙型肝炎表面抗体阳性率分析

目的了解南昌县城区秋季入托儿童乙肝疫苗免疫状况，为南昌县制定乙肝防治对策提供科学依据。方法对2006年、2007年南昌县城区秋季入托儿童进行查验预防接种证，对完成乙肝疫苗3针全程接种的儿童开展乙肝5项检测，并对检测结果进行统计学分析。结果共调查1011名秋季入托儿童，抗-HBs阳性率为65．28％，HBsAg阳性率为0．40％，男、女儿童抗-HBs阳性率分别为63．80％、67．39％，差异无统计学意义（P〉0．05）。结论南昌县城区秋季入托儿童乙肝疫苗接种后抗-HBs阳性率偏低，建议对有条件实施有偿接种的新生儿加大乙肝疫苗基础免疫的接种剂量，及时开展乙肝疫苗加强免疫，以保证儿童乙肝疫苗免疫效果。     

新生儿接种酵母重组基因工程乙肝疫苗的免疫效果

目的：研究基因乙肝疫苗免疫效果,方法：（1）选HBsAg阳性母亲所生新生儿102名随机分两组,A组接种基因乙肝疫苗,B组接种血源乙肝疫苗。（）选HBV感染标志阴性母亲所生新生儿168名随机分两组,C组接种基因乙肝疫苗,D组接种血源乙肝疫苗。结果：A组阻断乙肝母婴传播保护率为83．09％;B组为80．78％（P＞0．06）,C组,D组抗－HBs阳性率免后1个月（T7）分别为73．83％,60．66％,免后6个月（T12）分别为96．23％,80．77％,。结论：基因乙肝疫苗有良好的阻断乙肝母婴传播效果和免疫应答。     

乙肝疫苗扩免策略实施效果评价

目的:评价乙肝疫苗扩免策略实施效果。方法:分析烟台市新生儿乙肝疫苗接种及影响因素,整群随机检测1 543名7～12月龄儿童乙肝表面抗体(Anti-HBs)水平;描述分析15岁以下儿童乙肝发病状况。结果:烟台市新生儿乙肝疫苗接种率、及时率保持在97%以上,阳性母亲的新生儿77.35%采用乙肝免疫球蛋白(HBIG)联合阻断;5μg啤酒酵母扩免乙肝疫苗具有较高的免疫原性,80.75%儿童能够产生保护性应答,接种医院级别及父母乙肝感染状况是影响免疫应答的因素;扩免策略实施后儿童乙肝发病率大幅下降,5年降低了78.99%。结论:烟台市新生儿乙肝疫苗免疫策略效果显著,强化产科培训,正确把握接种禁忌,普及孕妇HBV检测,完善低/无应答者免疫将进一步降低乙肝发病率。     

乙肝疫苗接种对乙型肝炎流行特征的影响

目的了解南京市鼓楼区乙肝疫苗接种前后16年乙型肝炎流行特征的变化，为今后实行新的预防对策提供依据。方法对1990～2005年南京市鼓楼区乙肝疫情报告资料进行分析。结果1992年起该区将乙肝疫苗接种纳入计划免疫管理，目前全区新生儿乙肝疫苗接种率达99％以上。接种疫苗改变了乙肝的流行特征，人群乙肝发病率呈下降趋势，10岁以下儿童下降最明显。结论乙肝疫苗免疫是防制、消除乙肝的有效途径。为进一步降低发病率，在做好新生儿乙肝疫苗接种工作的同时，必须扩大疫苗的接种范围。     

非新生儿人群接种乙肝疫苗与乙型肝炎发病关系的Meta分析

目前，新生儿接种乙型肝炎（乙肝）疫苗控制乙肝的效果已得到公认，但一般人群的HBsAg携带率仍较高，可见仅对新生儿的乙肝疫苗免疫策略，在短时期内难以完全控制乙肝病毒在人群中传播。因此，国内外一些地区相继在不同程度上加强了对新生儿以外人群同时实施乙肝疫苗免疫的策略。由于大多数研究的样本量不够充分，对于非新生儿人群接种乙肝疫苗后与乙肝发病关系的研究结果存在差异，两者关系尚不十分明确。我们采用Meta分析对近年来国内外有关非新生儿人群接种乙肝疫苗与乙肝发病的关系进行综合分析，以便更准确地探索两者的关系，为非新生儿接种乙肝疫苗提供科学依据。     

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.     

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.     

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.