一起输入性登革热暴发疫情流行病学调查

目的了解2013年禹州市登革热疫情发生情况及流行特征。方法查阅禹州市登革热暴发疫情处置资料及蚊媒监测资料对2013年禹州市登革热暴发疫情进行描述性流行病学分析。结果 2013年禹州市共报告登革热病例29例,发病率为2.55/10万,无死亡病例。地区分布于神镇苗家湾村;流行时间集中于9月份;男女性别发病数之比为1:1.27;年龄分布于40至69岁人群,占总病例数的55.17%;临床表现以轻型为主;实验室检测显示,流行株为登革病毒Ⅲ型。结论 2013年禹州市神镇苗家湾村登革热疫情为输入性病例引起本地感染的一起暴发疫情。依靠群众,大力开展宣传教育和快速杀灭成蚊和消除蚊媒孳生地是控制疫情的关键。另外,应开展持续的媒介监测,为今后防控登革热疫情提供有力保障。     

中国2005-2007年登革热流行现状与监测分析

目的 分析2005-2007年中国登革热监测资料,描述中国登革热流行现状、疾病分布和特征.方法 对2005-2007年全国疾病监测信息报告管理系统网络直报的登革热病例资料及国家登革热监测点的监测资料,用描述性流行病学方法进行统计分析.结果 3年全国共报告登革热病例1623例,死亡1例.其中,实验室诊断1356例,临床诊断267例.输入性病例151例,占报告病例总数的9.3%;本地感染病例1472例.全国仅广东和福建省的9个地市报告本地感染疫情,其他省区均为输入性病例,输入地区主要为东南亚国家.夏季南方省份的蚊媒密度仍然较高,有84.6%的布雷图指数(BI)>5,约72.2% BI≥10.监测点未从蚊媒中分离到登革病毒,但广东省曾检测到病毒核酸.结论 国内本土持续性登革热流行尚未有效建立,但输入病例的威胁逐年增加.媒介伊蚊的广泛分布和较高的伊蚊密度、健康人群较低的抗体阳性率以及难以避免的登革热输入威胁使中国南方部分地区具备了发生登革热本地爆发性流行的潜在条件,有必要在重点地区建立蚊媒综合监测和控制系统.     

2019年江西省新干县一起登革热暴发疫情调查分析

目的调查2019年江西省新干县登革热暴发疫情情况及原因,为今后登革热本地暴发疫情防控提出建议。方法在新干县辖区各级医疗机构及划定的疫区范围内进行病例搜索、流行病学调查和媒介伊蚊监测,采集病例标本进行实验室检测,研判疫情及其影响因素。结果疫情持续38 d,累计报告登革热病例81例,病例均为NS1抗原阳性,其中35例登革热病毒核酸检测呈阳性,病毒为DENV-1血清型。病例发病至诊断时间间隔(中位数)为1~8 d(3 d),其中病例首诊医院的级别之间,差异无统计学意义(P>0.05);病例诊疗过程中多次转诊与未转诊之间,差异有统计学意义(P<0.05);病例就诊医疗机构是否开展登革热培训,差异有统计学意义(P<0.05)。在疫区开展蚊媒监测,首次监测平均布雷图指数(BI)为24.5,其中湄湘社区最高(28.1)、城南社区最低(16.3)。9月8日开始,所有监测点蚊媒密度均达标。结论本次疫情是由登革热输入病例导致的本地暴发疫情,病毒可能来源于东南亚国家。建议提高医疗机构登革热病例诊断能力,确保早期发现登革热疫情;同时加强由政府主导的网格化灭蚊管理和工作责任制的落实,及时控制疫情。     

海曙区登革热暴发疫情与蚊媒密度分析

目的了解登革热暴发疫情发病病例与蚊媒密度情况,为登革热防控工作提供参考。方法通过中国疾病预防控制信息系统收集海曙区登革热暴发疫情病例资料,通过海曙区疾病预防控制中心收集蚊媒密度监测资料和登革热暴发疫情资料,分析发病病例与蚊媒密度的相关性。结果海曙区共15个疫点,报告登革热病例43例。望春街道病例和疫点最多,病例29例占67.44%,疫点5个占33.33%。流行曲线呈多峰分布,8月14日—22日为发病高峰,17例占39.53%。布雷图指数为0～175.00,中位数为5.00;叮咬指数为0～20.00只/(人·h),中位数为2.00只/(人·h)。不同地区的布雷图指数和叮咬指数差异均有统计学意义(P0.05)。发病例数与布雷图指数(r=0.743,P=0.002)和叮咬指数(r=0.543,P=0.037)均呈正相关。结论海曙区登革热暴发疫情发病例数与蚊媒密度呈正相关。     

杭州市登革热核心区蚊媒应急处置效果分析

目的分析杭州市2017—2018年登革热核心区蚊媒应急处置工作情况,明确登革热蚊媒控制对策。方法收集杭州市2017—2018年登革热疫情相关资料,对病例报告发现情况以及应急处置核心区的数量、持续时间和伊蚊密度监测情况进行分析,评价核心区蚊媒应急处置工作效果。结果 2017—2018年杭州市累计报告登革热病例1 242例,划定核心区419处。本地病例核心区342处,占81.62%;首次监测布雷图指数10～20和≥20的核心区分别为87处和79处,分别占20.76%和18.85%;持续时间≤25 d的核心区298处,占71.12%。应急处置3日后布雷图指数达标率和成蚊帐诱指数达标率分别为60.38%和73.51%,8日后达标率分别为73.27%和79.95%。与2017年相比,2018年本地病例核心区所占比例(27.63%)下降,核心区持续≤25 d的比例(96.05%)增加,成蚊帐诱指数3日达标率(82.89%)提高(均P0.05)。结论杭州市登革热核心区蚊媒应急控制机制基本建立,登革热诊断延误、暴发疫情应对不及时、媒介伊蚊控制失败仍是杭州市登革热暴发响应和应急处置存在的主要问题。     

东莞市虎门镇一起登革热暴发疫情分析及蚊虫媒介的综合治理

目的对东莞市虎门一起登革热暴发疫情进行分析,以及对蚊虫媒介进行综合治理,为有效控制登革热疫情提供参考。方法针对2014年9月~11月东莞市虎门镇暴发的登革热,采用流行病学调查法分析疫情数据、布雷图指数法监测蚊媒密度以及分析可能传播途径来源等。结果东莞市虎门镇发生一起登革热暴发疫情,本次疫情共报告了57例登革热确诊病例,所有病例均痊愈,没有出现重症病例或死亡病例。疫情主要分布在东方社区,共有39例,占68.42%。本次疫情男女性别比为1:1.28。年龄最小3岁,最大90岁,平均50岁。以30~59岁中年病例最多,占54.39%。疫情发生时蚊媒密度的布雷图指数最高达92.38,经采取各项综合防治措施,蚊媒密度下降,疫情得到较好控制。结论本起疫情为由输入性病例或病媒引起的本土暴发疫情,经过清除积水,消灭蚊虫孳生地,有效将蚊媒密度布雷图指数一直保持在5以下水平;使疫情得到控制。     

广州市2012—2013年登革热流行特征分析

目的分析广州市登革热流行特征,为防控提供依据。方法对广州市2012—2013年登革热疫情资料进行描述性分析。结果 2012—2013年全市共报告登革热疫情10起1 486例,其中本地感染1 388例(93.4%),累计发病率10.89/10万,无死亡。高发9~11月(94.9%),以青壮年为主。2012年本地感染涉及5个区,输入性病例涉及7个区市;2013年疫情波及所有区县,局部暴发强度高。蚊媒监测全市平均布雷图指数(BI)高于上年同期水平。2012年毒株为Ⅲ型和Ⅳ型,2013年为Ⅰ型和Ⅱ型。结论 2013年广州市登革热病例大幅度上升,同一地区出现多种型别毒株,使防控面临更严峻的挑战。     

重庆市万州区2015年登革热与蚊虫媒介监测结果分析

目的掌握重庆市万州区登革热情况及其传播媒介伊蚊的种类分布、密度及季节消长规律,评估登革热流行风险,为登革热的预防控制提供依据。方法 2015年5-10月,在4个监测点开展蚊幼虫密度监测,采用布雷图指数法监测伊蚊幼虫密度,双层叠帐法调查成蚊种群密度;采用流行病学比较法分析病例资料。结果 2015年万州区登革热输入性病例1例,发病率为0.62/10万,未发生因该输入病例造成的疫情扩散。在4个监测点开展蚊幼虫密度监测,伊蚊布雷图指数为3.74~7.54,5-10月采用双层叠帐法共监测6次,捕获成蚊15只,其中中华按蚊1只,骚扰阿蚊14只。均未捕获到登革热媒介目标蚊种,成蚊、伊蚊叮咬指数均为0。结论万州区人口流动频繁,发生输入病例的可能性大,该区有登革热传播媒介白纹伊蚊分布,存在因登革热输入性病例引发本地疫情暴发的低风险,应加强监测。     

2013年广州市登革热流行病学特征及病毒E基因进化特征分析

目的了解登革热流行病学特征,分析分离毒株E基因分子进化特征。方法采用描述性流行病学方法分析2013年广州市登革热疫情,采用酶联免疫法(ELISA)对登革热疑似病例血清进行抗体检测,阳性病例的急性期血清标本以C6/36细胞进行病毒分离培养;采用RT-PCR扩增分离毒株的E基因,并对扩增产物进行序列分析,应用MEGA 5.05进行进化特征分析。结果 2013年广州市累计报告登革热确诊病例1 270例,发病率为9.96/10万,以本地病例为主(占98.66%),输入病例以东南亚国家为主(占88.24%)。发病高峰为10-11月(占85.28%)。169份登革热病例急性期血清共分离48株登革病毒(Ⅰ型47株,Ⅱ型1株),与近年来广州、东南亚分离株高度同源。结论广州市登革热发病率呈上升趋势,暴发风险较大,须加强监测力度,强化蚊媒的控制,降低登革热传播风险。     

东莞市一起Ⅳ型登革热暴发疫情流行病学调查分析及处置

目的 对2016年东莞市某街道发生的一起登革热暴发疫情进行调查,分析其感染来源,并对防控措施效果进行评价。 方法 采取描述性流行病学方法对东莞市2016年发生的一起登革热暴发疫情进行描述;用新发病例数和蚊媒密度变化来评价防控措施的效果。 结果 东莞市莞城街道在8月7日-9月3日之间发生3例登革热轻症病例,2男1女,为同一商铺工作人员。其中两名确诊患者血清标本Ⅳ型登革病毒核酸阳性并分离到2株登革病毒株, 2株病毒株E基因测序、进化分析同源性为99.3%,与印度2014年病毒株同源性为99.1%。经采取人工灭蚊、清除蚊虫孳生地、开展健康教育等措施,疫点核心区和监控区的蚊媒密度逐渐降低,疫情于9月3日平息。 结论 本起疫情为一起由输入性病例或病媒引起的本地感染的Ⅳ型登革热暴发疫情。采取杀灭成蚊和清除蚊虫孳生地为主的措施可有效控制蚊媒密度,进而控制疫情。     

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.