上海某区2005～2007年手足口病流行病学分析

[目的]了解上海市某区2005～2007年手足口病流行特征,为制订合理的防控措施提供依据. [方法]对2005～2007年辖区医院报告的临床诊断手足口病病例情况进行分析,结合实际提出控制策略. [结果]3年中辖区医院共报告临床诊断手足口病病例3 406例.发病年龄以5岁以下儿童为主,占93.83%.职业以散居、幼托儿童为主,占96.18%;其中幼托儿童与散居儿童比例为1.73:1.发病高峰集中在每年6～7月,占58.81%. [结论]5岁以下儿童是手足口病高发人群,加大对托幼机构和流动儿童集聚地疫情监测和消毒隔离管理、完善疫情暴发后应急处置体系,是防止疫情暴发,有效控制疫情的关键.     

南京地区2009年6733例手足口病流行病学分析

[目的]了解南京地区手足口病流行病学规律,探索正确的应对措施,有效地开展预防控制工作。[方法]利用国家疾病监测网络直报信息系统中属于本区2009年1月1日～12月31日手足口病疫情信息,对本地区手足口病定点医院6733例手足口病病例进行临床流行病学分析。[结果]手足口病好发于春夏季节,4月及6月达到高峰;属于南京地区本地发病患者5024例,占74.62%;外来人口发病患者1709例,占25.38%;3岁以下儿童多见,共5322例,占79.04%,其中尤以1岁以下最为多见,共2387例,占35.45%;散居儿童发病多于幼托儿童,学龄儿童发病较少,仅占2.88%;6733例手足口病患儿中重症手足口病患儿194例,占2.88%,194例重症手足口病患儿年龄分析表明,重症病例主要发生于4岁以下,其构成比达到90.21%。[结论]手足口病是儿童常见传染病,落实各项预防措施,控制传染源;切断传播途径;及保护易感人群是控制手足口病流行的关键。应加强手足口病各项监测,进行流行病学分析,掌握流行规律,开展病毒与变异监测,及时准确地预测手足口病流行趋势。     

南通市崇川区2011—2013年手足口病疫情分析

目的了解崇川区手足口病疫情,为控制流行提供依据。方法对2011—2013年崇川区手足口病疫情资料进行流行病学分析。结果 2011—2013年崇川区共报告手足口病病例3957例,年均报告发病率180.72/10万;报告重症病例13例,无死亡病例;报告聚集性疫情37起,无暴发疫情。发病呈典型春、秋季双高峰,4—7月和10—12月发病占总数的70.36%;病例男女性别比1.39∶1,≤5岁的占93.13%,散居儿童和幼托儿童占94.57%。结论 2011—2013年崇川区手足口病疫情处于较高水平,应采取有效措施,控制手足口病的传播。     

2009年公主岭市手足口病疫情分析

[目的]探讨公主岭市手足口病发病特点,为今后防控工作提出控制措施。[方法]利用国家传染病网络直报系统,对公主岭市2009年手足口病疫情资料用描述流行病学方法进行分析。[结果]2009年公主岭市共发生手足口病病例1 331例,发病率为124.296/10万,较2008年上升了249.60%,死亡4例。发病年龄7个月至26岁;男性792例,女性539例,男女之比为1.47∶1。病例主要集中在5岁以下,占89.56%;发病以散居儿童和幼托儿童为主,占91.66%;全市手足口病发病区域性聚集分布明显,北部乡镇发病占发病总数的78.51%;手足口病聚集性病例出现多。[结论]针对重点人群加大宣传力度,提高卫生意识,是控制手足口病最有效的措施。     

灌云县某院2009-2010年手足口病就诊病例分析

目的分析医院就诊的手足口病病例分布特征,为做好防控工作提供依据。方法病例资料来源于中国疾病预防控制信息系统,采用描述性流行病学进行统计学分析。结果 2009-2010年共报告手足口病病例921例,无死亡病例。病例主要集中在4-6月份,占发病总数的57.20%;5岁以下儿童占总发病数的94.60%;职业以散居儿童为主,占发病总数的90.36%;男女性别比例为2.07∶1。结论严格执行消毒隔离制度、加大健康教育宣传力度、开展病原学监测,是医疗机构控制手足口病疫情的关键措施。     

2009年德州市德城区手足口病病例的流行病学分析

[目的]了解德城区手足口病流行特征,为更好地控制手足口病发生和流行提供科学依据。[方法]对德城区2009年3-12月报告的手足口病病例资料进行流行病学分析。[结果]2009年3-12月共报告手足口病病例1 120例,无死亡病例,发病率为191.09/10万,未出现暴发疫情。城区发病率为209.36/10万,农村为154.29/10万,差异有统计学意义（P〈0.01）。1 120例中,男性713例,女性407例,男女性别比为1.75∶1;病例年龄以5个月至5岁为主,占96.43%（1 080/1 120）;散居儿童占26.70%,幼托儿童占70.98%;5-10月为高发季节（占82.59%）。[结论]德城区手足口病发病率较高,防控形势严峻,应采取有效措施,控制手足口病的传播。     

绵阳市2008～2009年手足口病疫情分析

[目的]了解2008～2009年绵阳市手足口病的流行病学特征,为制定预防控制策略提供依据。[方法]对绵阳市手足口病疫情资料进行描述性流行病学分析。[结果]2008～2009年绵阳市累计报告手足口病1869例,占同期法定传染病报告数的5.67%。全年均有病例报告,4～6月份和11～12月份呈现发病高峰,发病数分别占全部病例的48.10%和28.09%。男女性别比为1.96︰1,以散居儿童(62.17%)和幼托儿童(31.51%)为主,0～5岁占95.02%。[结论]做好疫情监测、隔离治疗病人和健康教育是手足口病预防控制工作的重点。     

上海市儿童医院2012-2014年手足口病流行病学特征分析

目的 了解上海市儿童医院手足口病流行病学特征,为手足口病防治提供科学依据。 方法 对2012-2014年上海市儿童医院的手足口病资料进行分析。 结果 2012-2014年上海市儿童医院累计报告手足口病13 377例,占该院就诊人数的0.31%,占该院法定传染病报告数量的75.20%, 按报告病种排序,手足口病连续三年均居首位。2012-2014年报告病例数呈逐年上升趋势,2014年手足口病病例的构成比显著高于2012、2013年(P<0.01);疫情高发期为每年4-10月,发病数占总报告病例数的80.00%;发病人群以0~5岁儿童发病最多见,占报告总数的82.48%;三年间男女发病比例为1.58:1,0~15岁均有发病, 0~5岁病例数共11 034例,占累计报告总数的82.48%,较之其他年龄段的构成比明显偏高。手足口病病例以散居和幼托儿童为主(分别占54.74%和39.30%)。 结论 上海市儿童医院2012-2014年手足口病报告病例数较高,且呈逐年上升趋势,春夏季为高发季节,多发于0~5岁散居和幼托儿童。应在高发季节加强重点人群的手足口病防控知识的宣教,实施行为干预。     

上海市金山区枫泾镇2012—2014年手足口病流行病学特征分析

目的分析上海市金山区枫泾镇2012—2014年手足口病流行病学特征,为手足口病的预防及控制提供科学依据。方法收集枫泾镇2012—2014年中国疾病预防控制信息系统中手足口病个案信息,采用描述性流行病学方法进行统计分析。结果 2012—2014年枫泾镇共报告手足口病389例,平均发病率为203.82/10万,2012、2013和2014年发病率分别为113.21/10万、141.13/10万和357.17/10万;手足口病全年均有发病,发病高峰期在5—7月,2012、2013和2014年均在11月份出现了一个发病小高峰;年龄分布以1~5岁儿童发病居多,占发病总数的80.46%;职业分布以散居儿童为主,占发病总数的50.6%,其次为幼托儿童,占发病总数的37.5%;本地人口报告病例数93例,占发病总数的23.91%;外来人口报告病例数296例,占发病总数的76.09%。结论枫泾镇手足口病防控工作的关键时期在5—7月和11月,应在1~5岁儿童,尤其是流动人口聚居地区内散居和幼托儿童中广泛开展手足口病宣传教育,加强监测,及时发现病例并采取有效措施控制疫情。     

上海市金山区2008-2010年手足口病流行病学特征分析

目的了解上海市金山区手足口病疫情流行特征,为制定预防和控制措施提供参考依据。方法对金山区2008-2010年疾病监测信息报告系统上报的手足口病病例进行描述性流行病学分析。结果 2008-2010年金山区共报告手足口病病例3 370例,年发病率在130.13/10万~209.37/10万之间,呈"V"分布;男性发病高于女性,以散居儿童和幼托儿童为主,集中于0~5岁组,占发病总数的95.04%;病例集中分布于5-6月份;各镇(街道)均有病例发生;幼托机构是发生手足口病聚集性疫情的主要场所,占疫情总数的94.57%,病原学监测以肠道病毒CoxA16为主,占39.16%,引起重症病例的病原体主要是肠道病毒EV71,占重症总数的90.00%。结论金山区手足口病发生有明显的年龄、性别、职业和季节差异,应做好社区5岁及以下儿童手足口病防控工作是当前手足口病防控工作的重中之重。     

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.     

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.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

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.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.