中国2001～2003年流行性感冒流行特征分析

目的 分析中国2001～2003年流行性感冒(流感)流行特征。方法 收集2001～2003年全国流感监测网流感样病例(ILI)监测资料,流感病毒分离与鉴定结果以及爆发疫情信息进行分析。结果 2001～2003年,中国北方地区流感流行高峰为12月或次年1月,南方地区则为4、5、7、8月和11、12月。北方、南方地区ILI就诊百分比基线值分别为13.68％、13.08％。ILI的年龄构成与流感流行季节类型有关。流感爆发疫情以5月份最多(32％),一般在6月前后流感疫情毒株类型发生改变。结论 中国南、北方流感流行特征有所不同。南方地区可能存在春季流行高峰,尚需进一步监测和分析。南方地区4～6月期间流感爆发的毒株类型变化值得关注。     

南京市2009年流行性感冒监测分析

[目的]分析南京市流感的流行病学特征,为流感防治提供科学依据。[方法]对2009年南京的流感样病例监测资料、病原学监测资料进行分析。[结果]2009年流感监测显示,南京存在秋、冬季流感流行高峰,ILI年龄构成以低年龄为主,全年流感毒株构成变化很大。[结论]流感监测对预防流行有重要意义,监测工作应重点关注优势流感毒株的变化。     

浙江省2001～2006年流行性感冒流行特征

目的 分析浙江省2001年10月-2006年3月流行性感冒（简称流感）流行特征，为流感防制提供策略／科学依据。方法收集浙江省2001年10月-2006年3月流感样病例（ILI）监测资料和2004年1月-2006年3月流感病毒分离与鉴定结果以及爆发疫情信息进行分析。结果每年的3—5月份、7．8月份以及11月一次年1月流感活动较强。15岁以下儿童组是流感的高发群体，暴发疫情主要集中在学校。ILI就诊百分比基线值为10．6％．各监测点ILI就诊百分比相差较大。54％的暴发疫情集中乡镇中小学校，尤其是宁波、温州、杭州、湖州地区，以3月份最多（24．7％），一般在1、10月前后流感疫情优势毒株类型易发生改变。结论我省可能存在春季和夏季流行高峰，需进一步长期监测。流感暴发优势毒株类型在10月和1月前后发生改变，应提高警惕。     

重庆市2004～2006年流行性感冒流行特征分析

[目的]探讨重庆市流行性感冒(流感)的流行特征,为制定流感防制策略提供科学依据。[方法]对重庆市2004、2005流感监测年度的流感样病例(ILI)监测资料、病毒分离鉴定结果及暴发疫情信息进行描述分析。[结果]2004年3月～2005年8月,ILI%平均为11.79%,2005年9月～2006年3月为0.80%。2004年ILI%存在4月和10月2个高峰,2005年存在4月、8月和11月3个高峰。两年病毒分离率分别为20.21%和33.62%。2年共有流感暴发疫情75起,2005年明显高于2004年,高峰月均出现在4月和11月。[结论]我市可能存在春季和秋季流感流行高峰,春季高峰比较固定,秋季高峰有一定波动性。暴发疫情呈逐年上升趋势,主要发生在中小学校。两年10月前后均出现优势毒株型别的变化值得关注。     

无锡市2005—2008年流行性感冒监测分析

[目的]监测和分析无锡市流行性感冒(流感)的流行动态和病原学特征,为流感的预防控制提供科学依据。[方法]对2005年10月至2008年3月无锡市流感监测哨点的流感样病例(Influenza Like Illness,ILI)发病动态、流感病毒分离和爆发疫情资料进行监测和分析。[结果]2005年10月至2008年3月,无锡市共监测报告ILI病例37 998例,ILI占门诊病例总数的比(ILI%)平均为3.67%。采集咽拭子标本1 796份,分离出流感病毒395株,分离率为21.99%。ILI和ILI%的高峰期均为2005年12月、2006年3月、2007年7月,ILI、ILI%和流感病毒分离率三者的高峰相互吻合,并与流感优势毒株交替变化一致。ILI的年龄构成中14岁以下儿童占91.03%,学校是发生爆发流行的主要场所。[结论]我市流感病毒比较活跃,关注ILI动态、ILI%动态、毒株型别交替变化和新型毒株的出现,可以评价和预警流感流行情况。对儿童和学校等流感重点人群和场所,应在流行高峰前采取流感疫苗接种为主导的综合性预防措施。     

潮州市哨点医院2009年～2014年流感监测分析

目的监测潮州市2009年~2014年间流感流行情况,掌握季节性流感病毒优势毒株的变化及流行特征,为流感防控提供科学依据。方法对潮州市2009年~2014年流感样病例(influenzalike illness,ILI)报告数据,病原学监测数据及流感/ILI暴发疫情报告情况进行分析。结果在受理的3619份流感样病例标本中,流感病毒核酸阳性标本约占19.45%。流感病毒的优势毒株每年都发生型别变化,优势型别交替出现。病毒感染率以5岁~14岁组和15岁~24岁组较高,与其它组比较存在统计学差异(P<0.05)。结论 2009年后潮州市虽然没有发生流感大流行,但流感监测工作仍不能放松,特别是需要警惕新型流感毒株的出现,同时加强学校等聚集性场所疫情监测。     

2008～2009年流感监测结果分析

[目的]了解深圳市龙岗区流感的流行特征及流行毒株的变迁情况。[方法]回顾性收集2008～2009年的流感样病例监测资料、流感病毒分离和暴发疫情资料进行统计分析。[结果]2008～2009年,各监测点共上报流感样病例63743例,占门诊就诊病例总数的8.02%,2009年的ILI%年平均值显著高于2008年的ILI%年平均值(χ2=256.09,P﹤0.01);共报告流感暴发疫情60起,主要集中在3～8月(90.00%),以学校和托幼机构(80.00%)暴发为主;2008～2009年,A、B型季节性流感均引起流感暴发流行,但2008年以B型流感流行为主,而2009年则以A型流感流行为主;不同年度间流感监测点中ILI标本的病毒分离率差异有统计学意义(χ2=14.57,P﹤0.01)。[结论]A、B型流感在不同年度以不同强度同时或交替在当地交替流行,学校是流感暴发疫情监测的重点,应加强流行高峰前的流感疫苗接种等综合性预防措施。     

江苏省2009-2012年流感监测结果分析

目的掌握江苏省2009-2012年流感的流行特征,为今后的流感防制工作提供科学依据。方法对江苏省2009-2012年流感样病例（influenza-like illness,ILI）报告数据、病原学监测数据及流感/ILI暴发疫情报告情况进行分析。结果江苏省流感高发人群为14岁以下婴幼儿及儿童,2009-2012年每年病例人数分别占各年ILI数的71.64%、81.39%、83.70%和84.03%;流感全年出现冬季12月份和夏季8月份两个小流行高峰,近3年,发病水平呈下降趋势（Z=-247.91,P<0.001）;2009-2012年分离到流感阳性毒株数分别为1 615株、806株、555株和993株,毒株类型以B型和A（H3N2）型交替出现为主,偶尔伴有A（H1N1）等其他毒株散发;2009-2012年,江苏省共报告流感/ILI暴发疫情147起,其中84起发生在中小学校及托幼机构,占总疫情数的57.14%。结论2009年后江苏省虽然没有发生流感大流行,但流感监测工作仍然不能放松,特别是需要警惕新型流感毒株的出现,同时加强学校等聚集性场所暴发疫情监测。     

江苏省2009—2012年流感监测结果分析

目的掌握江苏省2009—2012年流感的流行特征,为今后的流感防制工作提供科学依据。方法对江苏省2009—2012年流感样病例（influenza—likeillness,ILI）报告数据、病原学监测数据及流感／ILI暴发疫情报告情况进行分析。结果江苏省流感高发人群为14岁以下婴幼儿及儿童,2009—2012年每年病例人数分别占各年ILI数的71．64％、81．39％、83．70％和84．03％;流感全年出现冬季1～2月份和夏季8月份两个小流行高峰,近3年,发病水平呈下降趋势（Z=-247．91,P〈0．001）;2009—2012年分离到流感阳性毒株数分别为1615株、806株、555株和993株,毒株类型以B型和A（H3N2）型交替出现为主,偶尔伴有A（H1N1）等其他毒株散发;2009—2012年,江苏省共报告流感／ILI暴发疫情147起,其中84起发生在中小学校及托幼机构,占总疫情数的57．14％。结论2009年后江苏省虽然没有发生流感大流行,但流感监测工作仍然不能放松,特别是需要警惕新型流感毒株的出现,同时加强学校等聚集性场所暴发疫情监测。     

广州市2004-2008年流行性感冒流行特征分析

目的分析广州市2004-2008年流行性感冒（简称流感）流行特征。方法收集2004-2008年广州市流感监测系统流感样病例（ILI）监测资料,对病毒分离与鉴定结果以及暴发疫情信息进行分析,用季节解构、互相关等方法揭示广州市流感流行特征。结果 2004-2008年广州市流感样病例就诊百分比（ILI%）夏季最高,季节指数为1.637;流行季节与非流行季节ILI%差异有统计学意义（P〈0.05）;2004、2005、2007年以H3N2型为主要毒株;2006、2008年以H1N1型为主要毒株。暴发疫情的发生强度以小学最大（P〈0.05）。对暴发疫情序列分别与ILI%、病毒分离率两条序列进行互相关分析,当lag=-1、-2、-3时,病毒分离率与暴发疫情、ILI%与暴发疫情相关系数均有统计学意义。结论 2004-2008年,广州市流感的流行季节为夏季（5～7月）。H3N2和H1N1交替为流感主要毒株,小学是流感暴发疫情的高发地点。广州市流感监测系统可以客观地反映本市流感的流行特点。     

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.