2009-2012年公主岭市肾综合征出血热疫情分析

目的探讨肾综合征出血热（HFRS）的流行规律与流行趋势,为制定防治措施提供科学依据。方法对公主岭市2009--2012年HFRS疫情资料进行分析。结果2009--2012年共发病117例,无死亡,各年发病率分别为3．5486／10万、2．7858／10万、2．7436／10万和1．7184／10万,年均发病率为2．6917／10万。发病男性多于女性,男女发病性别比为5．88：1;发病年龄集中在20～49岁,占发病总数的87．18％;从农民发病84例,占发病总数的71．79％;每年的1—6月为发病高峰,10—12月为发病小高峰,2个发病高峰期间共发病94例,占发病总数的80．34％。结论该市近几年HFRS发病率逐年下降,提高重点人群HFRS疫苗接种率和积极灭鼠是控制出血热疫情的关键。     

华亭县1993—1995年肾综合征出血热流行病学分析

华亭县自1990年首发肾综合征出血热（HFRS）以来，1991、1992年出现暴发流行。虽经全县大力灭鼠，但疫情未能彻底控制。1993年发病率为36．63／Ic万，病死率11．47％；1994年发病率为98．86／10万，病死率6．63％；1995年发病率为532／10万，病死率11．11％。近3年HFRS流行情况如下：1流行特征1．1人群分布236例病人，男女之比为二37：1。年龄20～45岁占78．39％，其余占ZI．61％。职业以农民为主，占73．73％；工人次之，占11．02％；其他人群占15．25％。12地区分布1993年病例分布于7个乡镇，1994年波及10个乡镇，1995年局限于3个乡…     

邵阳市1991—1996年肾综合征出血热流行病学分析

为探讨我市肾综合征出血热（HFRS）流行规律，现将该病1991～1996年的流行情况分析如下．1资料来源资料来自全市12个县（市、区）1991～1996年传染病疫情月报、年报表以及流行病学调查资料．2结果2．1流行强度．1991～1996年全市HFRS，年均发病率为11．68／10万，病死率为0．51％．发病率，以1994最高（表1）．2．2地区分布．全市12个县（市、区）均有HFRS发生，但以市郊区年均发病率最高（表2）。2．3季节分布．全年各月均有病例报道，1～12月依次为479例，占9．86％；437例，占9．00％；436例，占8．98％；543例，占11．18％，524例…     

梅州市1991～2002年乙型肝炎流行特征分析

目的 分析梅州市1991～2002年乙型肝炎(以下简称乙肝)的流行规律，为制订预防控制对策提供科学依据。方法 对1991～2002年梅州市的乙肝疫情资料进行描述性流行病学分析。结果 1991～2002年乙肝平均总发病率为26．94／10万，年平均总发病率从1991年的20．98／10万上升到2002年的30．59／，10万，上升了45．81％。乙肝年平均总病死率为0．01／10万；发病无明显季节高峰；男性发病高于女性，以16～45岁年龄组发病率最高，占总病例数的40．49％；职业分布以农民、学生、干部职工发病为主。结论 应加强新生儿乙肝疫苗接种，进一步做好学龄前儿童、中小学生和其他年龄组人群(尤其是高危人群)的乙肝疫苗接种工作。     

肾综合征出血热高发疫区疫情监测与控制研究

目的：为控制肾综合征出血热（HFRS）高发疫区的发病率。方法：以肾综合征出血热疫苗接种，控制鼠密度等措施。结果：在从事野外劳动的16—60岁青壮年农民中，免疫覆盖率达51．86％，其免疫阳转率为97．6％，从而使沙畈乡5个村的发病率1997年的490．23／10万，至1999～2005年发病率均为零。结论：以疫苗接种为主，灭鼠等防治措施，对HFRS高发疫区的控制，效果理想。     

广州市2000～2003年肾综合征出血热监测分析

目的分析广州市2000～2003年肾综合征出血热(HFRS)的流行特点和趋势，为制定防治策略提供科学依据。方法收集疫情资料，描述其流行病学特征。HFRS抗体与抗原检测采用免疫荧光分析、病毒分离及分子生物学检测。结果广州市2000～2003年共检出HFRS病人247例，年发病率0．59／10万～0．63／10万。病例多为青壮年男性民工、农民。主要分布于天河、海珠、番禺等地，春季为流行高峰。鼠间疫情监测显示鼠密度为6．78％，总带毒率5．4％(187／3463)．均为Ⅱ型(家鼠型)汉坦病毒。优势鼠为褐家鼠．带毒率6．1％(181／2946)。带毒鼠在地区和时间上的分布与人间疫情分布大致相同。结论广州HFRS疫情平稳，但流行因素仍广泛存在，应加强疫情监测、防鼠灭鼠及重点人群的疫苗接种工作。     

沂蒙山区1997～2003年肾综合征出血热监测结果分析

目的探讨肾综合征出血热（HFRS）在当地流行的特征和规律。方法统计分析沂蒙山区1997～2003年HFRS疫情资料。人群血清流行病学调查，HFRS疫苗接种效果观察。宿主动物带毒率调查采用荧光抗体实验（IFAT）方法，宿主动物密度调查采用夹夜法。结果1997～2003年全市累计报告HFRS病例32792例，年平均发病率为47．71／10万，男、女比例1．79：1（21051／11741），病例中农民占87．20％。健康人群HFRS抗体阳性率为1．85％。室内鼠密度平均为3．87％，野外平均为3．84％。鼠带毒率室内平均为5．05％，野外平均3．86％。HFRS临床诊断符合率平均85．26％。HFRS疫苗接种近期保护率为100％。结论当地HFRS的流行呈双峰型，疫区类型为家鼠型为主的混合型，HFRS疫苗接种近期预防效果肯定。     

肾综合征出血热流行病学调查及控制对策

目的：探索济南市肾综合征出血热(HFRS)流行规律和流行特征及防制对策。方法：应用描述流行病学、血清流行病学等方法进行分析。结果：济南市1982—2001年HFRS年均发病率为16．56／10万。发病主要集中在郊县农村，占94．36％。查出2类(哺乳类的鼠形动物和鸟类的家鸡)6科动物自然携带HV抗原。居民区以褐家鼠最高为5．99％，野外以黑线姬鼠最高为1．64％。灭鼠和疫苗接种等干预措施取得了较好预防和控制HFRS发病的效果。结论：该市今后应有针对性地加强疫情监测，推广普及HFRS双价疫苗接种。     

胶南市1984～2004年肾综合征出血热人间疫情分析

[目的]了解胶南市HFRS发病及死亡状况，为HFRS的防治提供科学依据。[方法]对1984～2004年HFRS疫情资料进行分析。[结果]1984～2004年共报告HFRS病人2633例，死亡171例。1984～1990年发病率最高，年均发病率为29．49／10万。10～4月高发，发病数占全年的84．9％；发病率男性为20，24／10万，女性为9，66／10万；发病以中青年为主，15～45岁发病率为15．42／10万；农民发病2053例，占发病总数的77．98％。[结论]胶南市是HFRS高发区，发病以青壮年农民为主，且有周期性规律。     

天津市1995～1999年肾综合征出血热人间疫情监测

本将天津市1995～1999年的HFRS人间疫情流行病学资料复核汇总后分析，结果显示1995年以来HFRS发病呈明显上升态势，城乡结合部发病增加明显，春季3～5月为发病的高峰季节，男性发病率明显高于女性，20～50岁的青壮年占发病率的78．5％。5年中本市共483人发病，平均年发病率为1．07／10万，病死率为6．21％，人群隐性感染率为1．07％。     

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.