宜昌市2008-2012年手足口病流行病学分析

手足口病（HFMD）是由多种肠道病毒（包括EV71病毒、柯萨奇A16型病毒等1引起的婴幼儿常见传染病,该病可在多个年龄组人群引起感染,但在5岁以下婴幼儿中易发生暴发流行[1J。EV71病毒是目前常见的手足口病流行病毒,因患儿发病较严重,并多伴发轻重程度不等的中枢神经系统症状,而受到人们的关注翻。卫生部于2008年5月2日将手足口病纳入《中华人民共和国传染病防治法》规定的丙类传染病进行管理。为了解其发病水平及流行特征,     

武汉市东西湖区2008-2009年手足口病流行病学分析

手足口病(HFMD)是由肠道病毒引起的传染病,多发生于5岁以下儿童,可引起手、足、口腔等部位的疱疹,少数患儿可发生心肌炎、肺水肿、无菌性脑膜脑炎等并发症.个别重症患儿,可导致死亡.手足口病的肠道病毒有20多种(型),柯萨奇病毒A组的16、4、5、9、10型,B组的2、5型,以及肠道病毒71型均为手足口病较常见的病原体,其中以柯萨奇病毒A16型((Cox A16)和肠道病毒71型(EV 71)最为常见.自2008年3月安徽阜阳市暴发了EV71引起的HFMD流行后[1],我国将该病纳入了丙类传染病.文章对武汉市东西湖区2008年和2009年手足口病的发病情况进行分析,结果如下.     

实时荧光RT-PCR及RT-PCR快速检测肠道病毒71型和柯萨奇A16病毒

肠道病毒71型(Enterovirus 71,简称EV71)和柯萨奇病毒A组16型(Coxsackievirus A16,简称CA16)是引起手足口病的两种主要的病原体,常相伴造成手足口病的暴发流行,每次流行中两种病毒中所占的比例有所不同[1].EV71感染引起HFMD常有严重的神经系统并发症发生,CA16感染引起自限性的手足口病,极少发生严重并发症和死亡[2～6].2008年安徽、广东(包括深圳市)、浙江等28个省市出现手足口病暴发流行,因此,亟须一种特异性强,灵敏度高的方法对这两种病毒进行快速区分检测.     

肠道病毒71型灭活疫苗使用技术指南

正肠道病毒71型(Enterovirus type 71,EV71)是人类肠道病毒的一种。EV71感染可引起多种疾病,其中以手足口病(Hand,foot and mouth disease,HFMD)最为常见。2007年以来,EV71感染相关HFMD在我国婴幼儿人群中持续流行,发病率高,并导致一定比例的患儿死亡。由于EV71病毒主要通过接触传播,儿童普遍易感且隐性感染比例高,常规     

鹤岗市2009-2010年手足口病病原检测结果分析

<正>手足口病(HFMD)由肠道病毒感染引起,主要表现为口腔黏膜溃疡性疱疹及四肢末端水疱样皮疹,主要病原体为肠道病毒71型(EV71)和柯萨奇病毒A组16型(CA16)。其中EV71不仅引起HFMD,而且可引起严重中枢神经系统并发症,如脑膜炎、脑炎、急性迟缓性瘫痪等。近年来,马来西亚、台湾、新加坡、澳大利亚、香港等地不断有HFMD暴发流行。2008年5月2日卫生部将HFMD     

黑龙江省2009-2010年手足口病疫情监测结果分析

目的了解黑龙江省手足口病(hand-foot-mouth disease,HFMD)流行特征,为制定防控对策提供科学依据。方法通过国家疾病监测信息管理系统收集全省2009年和2010年HFMD疫情资料进行描述流行病学分析,并对部分病例标本进行肠道病毒病原学检测。结果黑龙江省HFMD发病率较高的地区主要位于南部;全省发病高峰是7月,呈典型的单峰型曲线;发病年龄以1～6岁居多;男性多于女性;散居儿童多于托幼机构儿童,暴发病例多发生在托幼机构。HFMD病原有EV71、CVA16和其他肠道病毒,以EV71和CVA16为主。结论 HFMD发病有明显的季节性和年龄、性别差异,小年龄组儿童是HFMD预防控制重点人群,流行的优势毒株为EV71和CVA16。应加强疫情监测和分析,防止其暴发流行。     

2009-2013年济南地区重症手足口病病原学及流行病学分析

目的了解2009-2013年济南地区重症手足口病(HFMD)病原及流行特征,为防控提供科学依据。方法对辖区哨点医院送检的138例重症HFMD病例标本,应用RT-PCR技术检测肠道病毒71型(EV71)、柯萨奇病毒A组16型(CVA16)、非EV71和CVA16的其它肠道病毒(EV);并采用描述流行病学方法对重症HFMD病例进行流行病学分析。结果 138例重症HFMD病例中,有132例感染了肠道病毒,阳性率为95.65%。其中感染EV71的有114例,占阳性病例的86.36%;感染CVA16的有9例(6.52%),感染其他EV的9例(6.52%)。HFMD重症病例呈散发,主要集中于5-8月份(74.64%),病例人群男性明显高于女性(χ2=48.75,P0.01),其中3岁以下幼儿是重症病例发生主要年龄段(84.06%)。结论重症HFMD具有明显的人群特征,EV71是重症及死亡病例的主要病毒类型;应关注高危人群,早期识别重症并及时干预治疗是降低病死率的关键。     

6例危重症手足口病死亡原因分析及防治要点

手足口病(hand-foot-mouth disease,HFMD)为全球流行的儿童传染病之一[1],由多种肠道病毒感染所致,包括柯萨奇病毒(Coxsackie virus,COX)A4,5,8,9,10和16型及COX B 2,35和7型,肠道病毒(enteroviruses,EV)71型,艾柯病毒(ECHO virus)等,尤以COXA16型及EV71型最常见。近10年来,     

手足口病重在预防

手足口病(Hand,foot andmouth disease,HFMD)是由肠道病毒引起的传染病,多发生于婴幼儿,可引起手、足、口腔等部位的疱疹,个别患者可引起心肌炎、肺水肿、无菌性脑膜脑炎等并发症.引发手足口病的肠道病毒有20多种(型),柯萨奇病毒A组的16、4、5、9、10型,B组的2、5型,以及肠道病毒71型均为手足口病较常见的病原体,其中以柯萨奇病毒A16型(CoxA16)和肠道病毒71型(EV71)最为常见.当然,肠道病毒EV71型感染主要表现为手足口病,但也可表现为其他疾病,只是与其他肠道病毒引起的手足口病相比,由肠道病毒71型感染引起的疾病发生重症感染的比例较大,病死率也较高,重症病例病死率可达10%～25%.     

手足口病暴发20起疫情调查

<正>手足口病(HFMD)是一种由多种肠道病毒引起,以侵袭婴幼儿为主的常见传染病,柯萨奇病毒A16型(COXAl6)及肠道病毒71型(EV71)为其主要病原体[1]。我国自1981年在上海地区首次报道以来,许多省市已有流行,特别是近几年手足口病流行有加剧的趋势。为做好手足口病暴发疫情的控制工作,本文对2008～2010年某市发生的20起手足口病暴发疫情进行分析,现将结果报道如下。     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.     

The reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

Function of the protein RPE65 in the visual cycle

A protein called RPE65 performs a key role in the trans-cis isomerization of retinol in the retinal pigment epithelium of the eye. The palmitoylation of RPE65 serves to switch off the visual cycle in darkness and to switch it on in the light.     

Acute symptoms following work with pesticides

BACKGROUND: Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms. AIM: To explore the frequency, nature and determinants of acute symptoms following work with pesticides. METHODS: A postal survey of men in three rural areas of England and Wales provided data on occupational use of five categories of pesticide, occurrence of 12 specified symptoms within 48 h of using pesticides and tendency to somatize. Risk factors for pesticide-related symptoms were assessed by modified Cox regression. RESULTS: Of 10 765 responders (response rate = 31%), 4108 had at some time used pesticides occupationally, including 935 (23%) who reported symptoms following such work on at least one occasion. In two areas, acute symptoms were most frequent following use of sheep dip (29 and 32% of users), but in the third area the rate was significantly lower (13% of users). The relative frequency of symptoms was similar for all five categories of pesticide, and flu-like symptoms did not cluster unusually among users of sheep dip. Risk of pesticide-related symptoms increased with somatizing tendency (prevalence ratio for highest versus lowest category 2.4, 95% confidence interval 2.0-3.0) and was higher in men who had used pesticides most often or handled concentrate. CONCLUSION: Acute symptoms are common following work with pesticides, but in many cases the illness may arise through psychological rather than toxic mechanisms.     

The Life Events Inventory: re-scaling based on an occupational sample.

The objective of this study was to compare the validity of the original weightings used by the Life Events Inventory (LEI) with those obtained from a contemporary occupational sample. Fifty male and 62 female manufacturing employees (age range 16-55 years) assigned scores to each item on a slightly modified version of the LEI scale. The current sample consistently assigned higher weights to events/items than did the original sample, but there was high agreement in terms of item ranking. Some distinct age and gender differences in scoring were apparent, and are discussed further. It was concluded that when separate weightings are employed for age and gender groups, the LEI remains a useful tool for quantifying background levels of stress in both workplace stress audits and epidemiological studies where statistical control for non-occupational sources of stress is required.     

Maxillofacial injuries related to work accidents: a new concept of a hospital-based full electronic occupational trauma surveillance system

The objective of this study was to investigate the occurrence of occupational maxillofacial injuries using a newly installed relational database. Twenty-six injuries were identified out of 28,624 patients admitted to the emergency unit during a 12 month period. Falls from height or being struck by moving objects were common causes of these injuries. Two-thirds of those identified were construction workers. This paper demonstrates the power of modern databases to identify specific occurrences that may provide the basis for prevention in the future.     

Rôles physiologiques des endocannabinoïdes dans le contrôle de l’homéostasie énergétique

Endocannabinoids are endogenous lipids which modulate the release of neurotransmitters and activate different signaling pathways, through the binding to cannabinoïd receptors, CB1 and CB2. Endocannabinoids are involved in the control of a variety of behavioural and neuroendocrine functions, including feeding behaviour. In the central nervous system, they essentially modulate the expression of orexigen or anorexigen neuropeptides thus resulting in the stimulation of food intake. Their peripheral targets are mainly the liver and the white adipose tissue where they stimulate lipogenesis, through the modulation of several enzymes and proteins expressions. Cannabinoïd receptor agonists are nowadays prescribed to improve appetite of people suffering from cancer or AIDS. In the same way, CB1 antagonist, such as Rimonabant, could provide efficient treatment of obesity.     

Stress in police officers: a study of the origins,prevalence and severity of stress-related symptoms within a county police force

BACKGROUND: High levels of stress-related illness are causing concern across industry. Against a background of impending legislative moves to try to improve this situation, there is a need to identify key work-related stressors. Police work tends to be regarded as inherently stressful because of the personal risk of exposure to confrontation and violence and the day-to-day involvement in a variety of traumatic incidents. As a result, high levels of stress-related symptoms might be expected in this population. OBJECTIVE: To examine the sources of stress-related symptoms within police officers and measure the prevalence of significant associated mental ill-health. METHOD: A cross-sectional questionnaire survey of a population of 1206 police officers was performed to assess levels of strain associated with a series of potential home and work related stressors. Participants were then split into low and high scoring groups on the basis of a General Health Questionnaire (GHQ) threshold score in order to identify those stressors most associated with mental ill-health effects. RESULTS: Occupational stressors ranking most highly within the population were not specific to policing, but to organizational issues such as the demands of work impinging upon home life, lack of consultation and communication, lack of control over workload, inadequate support and excess workload in general. The high scoring group constituted 41% of the population and differed significantly from those with low scores in perception of all stressors, ranking both personal and occupational stressors more highly, and from personality constraints appeared significantly more 'stress-prone'. A significant association between gender and mental ill-health was found, with females more likely to score more highly on the GHQ than males. CONCLUSION: This study confirms previous findings of organizational culture and workload as the key issues in officer stress. Given that the degree of symptomatology appears to be worsening, management action is required. Further research is indicated within the police population into a possible increased susceptibility in female officers.