江西省首例人感染H5N6禽流感病例流行病学调查分析

目的通过对江西省首例人感染H5N6禽流感病例的调查分析,探讨人感染H5N6禽流感感染因素。方法调查病例的发病就诊经过、可能的暴露来源,医学观察密切接触者,采集病例鼻咽拭子标本、暴露环境标本进行实验室检测,运用描述流行病学方法进行分析。结果江西省首例人感染H5N6禽流感患者,咽拭子标本检测为H5N6禽流感病毒核酸阳性,为外地感染,有活禽暴露史,医学观察密切接触者25人未发现异常;病例明确诊断较晚,有基础性疾病史,早期缺乏针对性治疗,导致病情加重,最后因呼吸衰竭死亡。结论江西省人感染H5N6禽流感病例可能与活禽暴露有关。     

江西省首例人感染H7N9禽流感病例流行病学调查

目的开展江西省首例人感染H7N9禽流感病例流行病学调查,探索可能的感染来源,为进一步认识与防治禽流感提供科学依据。方法运用描述流行病学方法对患者、密切接触者、患者暴露的小区菜场和小区周边活禽市场开展现场流行病学调查,并采集密切接触者、农贸市场环境标本进行检测分析。结果发现江西省首例人感染H7N9禽流感确诊病例无明确病死禽接触史,密切接触者中无不明原因肺炎病例,未发现人与人之间传播证据,相关农贸市场环境标本H7N9禽流感病毒核酸检测阳性。结论江西省首例人感染高致病性禽流感病例属本地感染、非人传人的病例,感染来源可能与农贸市场环境暴露有关。     

盐城市盐都区首例人感染H7N9禽流感病例流行病学调查

目的开展盐城市盐都区首例人感染H7N9禽流感病例流行病学调查,探索可能的感染来源,为进一步认识与防治禽流感提供科学依据。方法运用描述流行病学方法,对患者、密切接触者、患者暴露的活禽市场开展现场流行病学调查,并采集密切接触者、活禽市场环境标本进行检测分析。结果盐城市盐都区首例人感染H7N9禽流感确诊病例有明确病活禽接触史,密切接触者中无不明原因肺炎病例,相关活禽市场环境标本H7N9禽流感病毒核酸检测阳性。结论盐城市盐都区首例人感染高致病性禽流感病例属本地感染、感染来源可能与活禽市场环境暴露有关,建议加强农贸市场的卫生管理和消毒工作,规范禽类宰杀与销售。     

江西省首例人感染H9N2禽流感病例流行病学调查

目的分析江西省首例人感染H9N2禽流感病例的流行病学特征,为防控人感染H9N2禽流感提供参考。方法对江西省首例人感染H9N2禽流感病例的流行病学调查及病例共同暴露者与接触者进行观察。采集病例咽拭子等标本,应用Real-time RT-PCR方法对病例标本进行核酸检测。结果病例确诊为人感染H9N2禽流感病例,于第12病日解除隔离。病例第3病日和第8病日咽拭子标本检测均为禽H9流感病毒核酸阳性。病例发病前2周有禽H9流感病毒核酸阳性活禽市场暴露,家人、幼托机构儿童等密切接触者医学观察期内均未出流感样症状。结论该病例为江西省首例人感染H9N2禽流感病例确诊病例,感染来源可能与活禽市场暴露有关。     

一例人感染H5N6禽流感患儿流行病学调查与分析

目的 分析阜阳市首例人感染H5N6禽流感轻症患儿流行病学特征,为做好病例诊治及防控工作提供参考.方法 调查人感染H5N6禽流感患儿发病就诊情况、密切接触者、可疑禽类及活禽市场环境情况,采集患儿及其涉及的人群、活禽和环境标本并进行流感病毒检测,应用描述性流行病学方法进行分析.结果 阜阳市1例人感染H5N6禽流感患儿为流感常规监测发现,发病约10 h服用磷酸奥司他韦,约20 h症状消失,密切接触者无感染,可疑活禽摊位环境标本检测出现H5型禽流感病毒.结论 患儿有活禽市场环境暴露史,早发现早治疗,对减轻病情,提高治疗效果,具有重要意义,未发现人传人现象.     

平塘县首例人感染H7N9禽流感病例流行病学调查分析

目的通过对贵州省平塘县首例人感染H7N9禽流感病例的流行病学调查分析,为平塘县下一步防控人感染H7N9禽流感提供依据。方法运用描述流行病学方法对患者、密切接触者、患者暴露前接触的活禽及活禽饲养场所开展流行病学调查,并采集患者家、县城农贸市场环境样本及活禽样本进行检测分析。结果平塘县首例人感染H7N9确诊病例有明确活禽接触史,且患有基础性疾病糖尿病史1年,密切接触者中无不明原因肺炎病例,未发现人与人之间传播证据,活禽及相关农贸市场环境标本H7N9禽流感病毒核酸检测阳性。结论平塘县首例人感染H7N9禽流感病例属本地感染,非人传人的病例,感染来源可能与活禽及农贸市场环境暴露有关。     

湖北省首例人感染H5N6禽流感确诊病例的调查

目的 分析湖北省首例确诊人感染H5N6禽流感病例的流行病学调查资料,为今后更好地防控人禽流感疫情提供依据。方法 收集患者流行病学、临床资料并对相关标本进行检测与分析。结果 湖北省首例人感染H5N6禽流感确诊病例为单个散发病例,发病前无直接活禽市场暴露史,密切接触者在观察期内未出现流感样聚集性疫情。结论 该病例为本地感染非人传人病例 ,传播途径可能为禽-环境-人。     

湖北省首例人感染H5N6禽流感病例流行病学调查

目的分析湖北省首例人感染H5N6禽流感病例流行病学特征,探索可能的感染来源,为制定防控措施提供依据。方法对人感染H5N6禽流感病例、密切接触者和感染来源进行流行病学调查,采集相关标本进行实验室检测,并应用描述性流行病学方法进行分析。结果病例确诊为人感染H5N6禽流感病例,有明确的禽类暴露史,未发现人与人之间传播病例,相关外环境和家禽标本H5N6禽流感病毒核酸检测阳性。结论湖北省首次发现人感染H5N6禽流感,传播途径可能为禽-环境-人。提高医疗机构诊断敏感性和强化不明原因肺炎监测工作是及时发现与救治人感染H5N6禽流感疫情的重要手段,加强活禽交易市场的消毒、实行"集中宰杀、冷链派送、冰鲜上市"制度是控制疫情的关键措施。     

安徽省首例人感染H5N6禽流感病例流行病学调查结果分析

目的对安徽省首例人感染H5N6禽流感病例流行病学资料进行分析,探讨病例发现过程和调查处理措施。方法按照《人感染高致病性禽流感应急预案》及《安徽省人感染禽流感应急处置技术方案》开展流行病学调查及处置,调查病例禽类接触史、诊疗过程、密切接触者以及当地流感样病例发病情况,采集病例、密切接触者和可疑暴露环境标本进行实验室检测分析。结果安徽省首例人感染H5N6禽流感病例有明确的病死禽接触史,密切接触者中未出现二代病例,部分禽类环境中检出H5N6病毒核酸。结论安徽省首例人感染H5N6禽流感病例为本地感染病例,可能的感染途径为接触病死禽。提高医疗机构诊断敏感性和强化不明原因肺炎监测工作是及时发现与救治人感染H5N6禽流感疫情的重要手段,活禽交易市场消毒与休市是控制疫情的关键措施。     

江西泰和县一起人感染H7N9禽流感家庭聚集性疫情调查

目的 分析江西省首起人感染H7N9禽流感家庭聚集性疫情的流行病学特征,追溯病例的感染来源,并探讨其传播途径。方法 运用描述性流行病学方法对病例及其密切接触者进行调查与分析,采用实时反转录-聚合酶链式反应方法对病例和环境标本进行H7N9禽流感病毒核酸检测。结果 2例H7N9禽流感确诊病例为母子关系,经积极救治病愈出院。首发病例（病例A）于2016年4月1日发病,8日返回江西泰和县就诊,发病前1周在福建晋江市有活禽接触和活禽市场暴露史,并在可疑暴露市场标本中检出H7N9禽流感病毒。病例A的密切接触者中,除病例B（病例A母亲）于4月5日发病外,其余密切接触者经医学观察未出现异常。结论 2例病例系江西省首起输入性人感染H7N9禽流感家庭聚集性病例,其感染途径为共同暴露还是有限的人传人尚无明确证据。     

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.