Epidemiological investigation of an outbreak of pandemic influenza A (H1N1) 2009 in a boarding school: Serological analysis of 1570 cases

BackgroundA large number of 2009 pandemic influenza A (H1N1) infections were localized in school populations.ObjectivesTo describe the epidemiology, clinical features and risk factors associated with an outbreak that occurred at a vocational boarding school in Guangzhou, P.R. China.Study designData were collected prospectively and retrospectively through the use of on-site doctors and a post-outbreak survey and blood collection. The survey was used to confirm symptoms, and to investigate a series of flu-related factors such as dormitory conditions, health habits, vaccine history and population contact history. Blood samples were taken for serological analysis. Pandemic H1N1 infection was initially confirmed by a real-time RT-PCR assay. Following the identification of the outbreak by the Guangzhou CDC on September 4, cases were diagnosed symptomatically and retrospectively by serological analysis using the hemagglutination inhibition assay and a neutralization assay.ResultsThe infection rate was 32% (505/1570) and the attack rate was 22.2% (349/1570). The asymptomatic infection rate was 9.9% (156/1570). Sharing a classroom (OR = 2.17, 95% CI: 1.62–2.91) and dormitory space (OR = 2.32, 95% CI: 1.84–2.93) was associated with higher rates of infection. Opening windows for ventilation was the only control measure that significantly protected against infection.ConclusionSocial isolation and quarantine should be used to prevent the spread of infection. Ventilation and a control of air flow between classrooms and dorms should be implemented as possible. School closures may be effective if implemented early.     

硫辛酸延缓衰老作用的研究进展

简要分析硫辛酸的一般理化及毒理学特点,并从改善老年机体的氧化状态和线粒体的氧化状态以及代谢酶活性两方面阐述了硫辛酸延缓衰老作用的研究进展。     

乡（镇）村卫生一体化管理下乡村医生报酬的优化设计

在分析乡村医生报酬对乡村医生队伍稳定与发展的影响以及乡（镇）村卫生一体化管理下乡村医生报酬水平和结构问题的基础上,阐述乡村医生报酬的优化设计,为完善乡（镇）村卫生一体化管理体制和运行机制提供决策支持。     

城市生活饮用水综合指数评价方法建立及其应用

[目的]从健康影响的角度出发,建立一套适用于城市生活饮用水水质评价的综合指数方法,并以此法评价上海市2007年的生活饮用水总体质量。[方法]将评价指标分为具有不同卫生学意义的5大类,在灵活选用内梅罗法、最差因子判别法计算各分类综合指数后,根据德尔菲专家咨询法对5类指标进行健康赋权,运用加权平均法计算水质综合指数,并对2007年上海市集中式生活饮用水进行初步的水质评价与分析。[结果]建立了适用于城市生活饮用水的综合指数评价体系。上海市2007年城市生活饮用水符合国家生活饮用水卫生标准,市区与郊区生活饮用水水质无明显差别;在2007年的4个季度中,第1季度的水质略逊于其他3个季度;经市级水厂处理过的水质最佳;长江水是上海市相对理想的供水水源。[结论]本研究所建立的城市生活饮用水综合指数评价法具有一定的借鉴意义和推广价值。上海市2007年的市区、郊区及各季度、各级水厂、各水源来源的出厂水、管网末梢水和二次供水的总体水质良好,符合国家卫生标准。     

铅污染区女性孕期血铅浓度变化及其影响因素

[目的]探讨铅污染区女性孕期不同阶段血铅浓度及其影响因素。[方法]采用前瞻性队列研究方法,以孕妇为研究对象,测定孕早期[孕（12±2）周]和孕晚期[孕（36±2）周]血铅浓度,并结合问卷信息分析其影响因素。所有研究对象均知情同意后加入队列。[结果]研究对象孕早期、孕晚期血铅浓度几何均数分别为0.15μmol/L和0.19μmol/L。孕晚期血铅浓度明显高于孕早期,差别有统计学意义（P〈0.05）。多因素分析结果显示,相对于未每天食用蔬菜的孕妇,每天食用蔬菜的孕妇孕早期血铅对数值高0.16个单位,孕晚期高0.15个单位;有过孕前重金属接触史的孕妇孕早期血铅对数值比报告无孕前金属接触史的孕妇要高0.12个单位;受教育程度高的孕妇较受教育程度低的孕妇,孕晚期血铅对数值要低0.09个单位。[结论]血铅浓度在孕期的不同阶段是变化的,孕早期血铅浓度与食用轻度铅污染蔬菜频率、孕前是否存在重金属接触有关;孕晚期血铅浓度与食用轻度铅污染蔬菜频率及孕妇受教育程度有关。     

微囊藻毒素诱导细胞凋亡和促进肿瘤发生的双重作用研究进展

微囊藻毒素（Microcystin）是世界各地水华中存在最普遍、危害最严重的一类藻类毒素,对环境和人类健康具有极大的危害性。以往研究表明,微囊藻毒素作为一种特异性的肝脏毒素,对细胞内蛋白磷酸酶具有强烈的抑制作用,表现为诱导细胞凋亡和促进肿瘤发生的双重毒性效应。本文简要综述报道微囊藻毒素诱导细胞凋亡和促进肿瘤生成双重毒性作用的研究进展。     

蔗糖喂饲GK大鼠和Wistar大鼠致胰腺病理结构的改变

[目的]观察蔗糖喂饲Goto-Kakizaki（GK）大鼠和Wistar大鼠致胰腺病理结构及超微结构的改变。[方法][GK和Wistar大鼠各26只,随机分为（1）Wistar（W）组;（2）Wistar＋30%蔗糖（WS）组;（3）GK（G）组;（4）GK＋30%蔗糖（GS）组。WS、GS组给予30%蔗糖饮水,另两组给予正常饮水。实验第6周结束时处死动物,分离胰腺,采用组织化学染色法及电镜技术对其组织结构改变进行观察。[结果]给予30%蔗糖饮水后,Wistar大鼠胰岛出现一定程度的纤维化,胰岛β细胞数量显著下降,细胞核出现不规则变形,细胞内分泌颗粒明显减少,线粒体出现空泡变性;与Wistar大鼠相比,GK大鼠给予30%蔗糖饮水后胰岛组织出现严重的纤维化病变,胰岛β细胞仅零星可见,细胞核出现固缩,细胞内分泌颗粒大量减少,线粒体严重空泡变,并出现嵴溶解和嵴断裂,胰岛组织出现更为严重的病理改变。[结论]高蔗糖摄入可引起或加重GK和Wistar大鼠胰腺的病理性损伤,提示30%蔗糖喂饲GK大鼠可以用作非肥胖型糖尿病胰腺病变动物模型的优先品种。     

Living in the Context of Poverty and Trajectories of Breast Cancer Worry,Knowledge, and Perceived Risk after a Breast Cancer Risk Education Session

ObjectivesThe purpose of this paper was to demonstrate how living in neighborhoods with high levels of poverty (while controlling for personal income) impacts personal characteristics, which in turn impacts retention of breast cancer risk knowledge and changes in worry and perceived risk.MethodsThe data from this project come from a larger, National Cancer Institute-funded study that included a pretest, a breast cancer risk education session, a posttest, the option of an individualized risk assessment via the Gail Model and three follow-up phone calls over the next 9 months.ResultsThe percent of individuals living below poverty in the community in which the participant resided was predictive of the personal characteristics assessed, and these characteristics were predictive of changes in breast cancer worry and knowledge across time.ConclusionDifferentiation of self and monitoring, two of the individual characteristics that seem to allow people to process and use information to make “rational” decisions about health care, seem to be impacted by the necessity for adaptation to a culture of poverty. Thus, as a health care community, we need to tailor our messages and our recommendations with an understanding of the complex intersection of poverty and health care decision making.     

拟除虫菊酯农药暴露对婴儿生长发育的影响

【目的】 探讨拟除虫菊酯农药暴露对婴儿生长发育的影响,为预防儿童农药中毒提供科学依据。 【方法】 选取江苏某县1岁婴儿449名,收集随机尿样检测拟除虫菊酯代谢物顺式-3-(2,2-二氯乙烯基)-2,2-二甲基环丙烷-1-羧酸(cis-Cl₂CA)、反式-3-(2,2-二氯乙烯基)-2,2-二甲基环丙烷-1-羧酸(trans-Cl₂CA)和3-苯氧基苯甲酸(3-PBA)水平,测量婴儿身长、体重、头围、胸围,用“0~6岁儿童发育筛查测验”(DST)评估婴儿智能发育状况,分析两者之间关系。 【结果】 研究对象尿样拟除虫菊酯代谢物cis-Cl₂CA、trans-Cl₂CA和3-PBA检出率分别为70.4%、97.6%和84.2%。按照总拟除虫菊酯浓度P₂₅、P₇₅分为低中高三组,不同暴露水平组之间婴儿的体重、胸围不完全相同,具有统计学意义(P<0.05),但身长、头围和发育商差异无统计学意义。多重线性回归分析亦提示尿拟除虫菊酯的浓度与体重有相关性(P<0.05)。 【结论】 拟除虫菊酯暴露对婴儿体重有一定的影响。     

Characteristics of the Bibliometric Indexes of Chinese Core Journals on Environmental and Occupational Medicine

This paper investigated the current characteristics and changing trends of major journals on Chinese environmental and occupational medicine in order to promote the development of these journals. This study focused on the seven core journals in the area of environmental and occupational medicine listed on the Chinese Scientific and Technical Journal Citation Reports (2008 version). These journals were China Occupational Medicine, Chinese Journal of Industrial Hygiene and Occupational Diseases, Chinese Journal of Industrial Medicine, Industrial Health and Occupational Diseases, Journal of Environment and Health, Journal of Environmental and Occupational Medicine, Occupation and Health. Various observations were based on data from www. cnki.net and Chinese Scientific and Technical Journal Citation Reports (2008 version), including cover of the journal, issue period, exposure to the internet, level of open source, impact factor, cited half-life, web immediacy index and rate of downloads per year. The outcomes showed that in appearance, the overall characteristics were continuous improvement of the covers, issue period, and moving toward the internet. In terms of contents, all factors had been improving.Nevertheless the level of influence was not very stable. The use of internet and the level of resource openness still have a long way to go to meet the international standard. There is still a huge gap for improvement. The contents and the appearance both need to be improved to serve the ever developing environmental and occupational medicine career.