1963-2017年许昌市流行性乙型脑炎流行特征分析

目的 分析1963-2017年许昌市流行性乙型脑炎动态变化趋势和流行病学特征,为探索有效防控措施提供依据。方法 采用描述流行病学方法,对疫情数据进行分析。结果 1963-2017年许昌市累计报告乙脑11624例,死亡1405例,年均报告发病率为5.85/10万,死亡率为0.71/10万;乙脑报告发病率总体呈下降趋势。发病以15岁以下儿童为主,占总病例数的79.39%;有明显的季节性,7～9月为发病高峰,占总病例的94.90%。结论 近年来,许昌市乙脑疫情得到了有效控制,但由于乙脑在自然界的循环依然广泛存在,仍应加强以预防接种为主,防蚊、灭蚊、宿主管理和健康教育为辅的综合防控措施。     

黔东南州2005-2010年流行性乙型脑炎流行特征分析

目的探讨黔东南州乙脑的流行规律及疫情趋势,为有效控制乙脑的流行,制定乙脑防控措施提供依据。方法采用描述流行病学方法对黔东南州2005-2010年乙脑疫情资料进行分析。结果黔东南州2005-2010年乙脑发病391例,发病率为1.59/10万。发病有明显季节性,91.56%的病例集中在6-8月。年龄以<10岁的儿童为主,占81.84%,男性发病率高于女性。职业以散童和学生为多。结论黔东南州自2006年将乙脑疫苗纳入免疫规划后,乙脑发病率呈下降趋势,但散发病例时有发生,从江、凯里等县市发病率还较高,因此黔东南州乙脑预防工作不容乐观,要采取疫苗接种、防蚊灭蚊等综合措施降低乙脑发病。     

高县1960-2013年流行性乙型脑炎流行态势及特征分析

目的分析高县流行性乙型脑炎（乙脑）流行特征,为预防和控制工作提供科学依据。方法用描述流行病学方法对高县1960-2013年乙脑疫情资料进行统计分析。结果 1960-2013年高县累计报告乙脑629例,死亡57例,总发病率和死亡率分别为2.70/10万和0.25/10万,1972-2013年各年发病率差异具有统计学意义（χ2=329.22,P〈0.01）。疫苗使用前期,发生3次暴发流行,总发病率为5.56/10万,发病率呈现上升趋势（趋势χ2=77.22,P〈0.01）;疫苗使用初期,总发病率为2.23/10万,与疫苗使用前期相比,发病下降71.82%,总发病率呈现下降趋势（趋势χ2=14.82,P〈0.01）;计划免疫冷链运转期,总发病率为1.73/10万,1990-1994年与疫苗使用初期相比,发病率下降7.18%;规范门诊接种期,总发病率为1.04/10万,2004-2013年与冷链运转期相比,发病率下降20.44%。发病高峰在8-9月,占病例总数的75.83%。病例集中在7岁以下,占病例总数的64.39%。男女性别比为1.78∶1,差异具有统计学意义（χ2=49.80,P〈0.01）。发病最多的是散居儿童,其次是托幼儿童和学生,共占病例总数的85.85%。结论高县乙脑发病率呈现逐年下降趋势,提示疫情得到较好控制。发病具有明显的季节性,男性发病高于女性,7岁以下散居儿童和托幼儿童是高危人群,应加强预防接种和防蚊灭蚊为主的综合防治措施。     

广西流行性乙型脑炎流行趋势与疫苗接种效果

目的分析广西流行性乙型脑炎(乙脑)疫苗应急接种及乙脑疫苗纳入免疫规划后乙脑的流行趋势和特征,评价疫苗接种效果,为探索有效的乙脑预防控制策略提供依据.方法对1990~2010年法定传染病报告系统的数据资料进行描述性分析,收集统计各年份广西疾控中心的乙脑疫苗出库量,对乙脑流行趋势和疫苗接种干预效果进行分析.结果1990~2010年广西共报告乙脑病例8147例,死亡617例,年均发病率为0.85/10万,年均病死率为7.02%;乙脑报告发病率呈逐年下降趋势,个别年份波动较大,病例主要集中在河池、玉林、百色、贵港、钦州等市,5~8月份为流行季节,以<15岁儿童发病为主,1990~2007年连续采取以乙脑疫苗应急接种为主的防控措施,2008年将乙脑疫苗纳入计划免疫,全区乙脑的流行强度明显减弱,流行分布范围进一步减小.结论1990年以来广西乙脑发病率呈下降趋势,表明采用乙脑疫苗应急接种及乙脑疫苗纳入免疫规划后乙脑疫情得到控制,但某些年份发病率波动较大,存在局部暴发流行的隐患,仍需采取常规计划免疫与流行季节前突击接种相结合的防控措施.     

海南省流行性乙型脑炎不同时期流行特征分析

目的 了解海南省不同时期流行性乙型脑炎(乙脑)流行特征及其影响因素.方法 收集1952年以来乙脑疫情资料,按照乙脑自然流行期(1952-1978年)、推广使用乙脑灭活疫苗期(1979-1986年)、计划免疫使用乙脑灭活疫苗期(1987-1990年)、计划免疫使用乙脑减毒活疫苗期(1991-2007年)四期分析乙脑发病率、死亡率、病死率、乙脑疫苗接种率、病例免疫史、病例及媒介监测等资料,分析影响因素.结果 海南省不同时期中以乙脑自然流行期年均发病率最高为7.12/10万,死亡率0.89/10万;推广使用乙脑减毒活疫苗期年均发病率最低为0.11/10万,死亡率0.01/10万.海南省于2002年开始建立乙脑监测系统以来,监测报告乙脑疑似病例标本采集率达到92.8%,确诊病例发病率波动在0.05/10万～0.2/10万之间,确诊病例中86%无明确乙脑疫苗免疫史;2004-2007年乙脑疫苗年均保护率为95.69%.海南省媒介密度高,宿主动物中猪乙脑感染率从4月持续到10月呈上升趋势,个别监测点感染率高达99.3%,媒介密度和宿主动物感染呈反向曲线分布.结论 海南省应用乙脑减毒活疫苗对保护易感儿童,降低乙脑发病率.控制流行取得了显著的效果.     

高州市2002～2008年流行性乙型脑炎疫情分析

[目的]探讨高州市乙脑的流行规律及流行趋势,为制订防治措施提供科学依据。[方法]对高州市2002～2008年乙脑疫情资料进行分析。[结果]高州市2002～2008年乙脑呈散发状态,合计发病29例,死亡1例,年均发病率为0.26/10万,年发病率均不超过0.62/10万。29例病人均在4～6月发病;≤6岁的占72.41%;有乙脑疫苗免疫史者占13.79%,无免疫史和免疫史不详者占86.21%。[结论]高州市乙脑发病率不高;存在乙脑疫苗报告接种率虚高和免疫空白。     

1999～2005年博白县流行性乙型脑炎疫情分析

[目的]探讨博白县流行性乙型脑炎（乙脑）流行趋势及发病因素,为制定乙脑防治策略提供依据。[方法]采用描述流行病学现况分析方法对1999-2005年乙脑疫情资料进行统计分析。[结果]1999-2005年博白县报告乙脑病人140例,其中1999年84例、2004年38例,发病率分别为6.03/10万、2.54/10万,其余年份呈低水平散发;病例均于5-7月发病;2-7岁发病123例,占87.86%;有乙脑疫苗免疫史的40例,占28.57%。2000-2005年的56例中,30例既往接种过乙脑疫苗但当年未接种。[结论]博白县乙脑流行季节较早,在预测可能流行年份提前对低年龄儿童进行乙脑疫苗普种具有现实意义。     

甘肃省及河西走廊地区乙型脑炎疫区变迁分析

目的 分析甘肃省及河西走廊地区乙型脑炎(乙脑)疫区变迁趋势,探讨甘肃省乙脑重点防控区及河西走廊地区乙脑疫情特征.方法 利用甘肃省疾病预防控制中心1958-2010年疫情资料和法定传染病报告系统资料,运用描述流行病学方法和局部地区调查,分析1980年开始使用乙脑疫苗前后甘肃省乙脑发病率和疫区地理分布变化及河西走廊地区乙脑疫情.结果 1958-1980年,甘肃省乙脑年均发病率为0.65/10万;1980年开始推广使用乙脑疫苗,到2010年,发病降至0.13/10万,未出现乙脑较大流行;发病率较高的县(市、区)分布于甘肃省陇南市、天水市和平凉市,发病趋势与全省平均发病趋势基本一致,是甘肃省乙脑防控的重点地区;1958-1980年,河西走廊累计报告乙脑病例88例,年均发病率为0.13/10万,1981年以来,仅张掖市甘州区报告1例非本地发病乙脑病例;2011年8月调查河西走廊地区7个县(区、市)县级以上医院的住院病例,共发现疑似脑炎病例587例.结论 甘肃省在使用乙脑疫苗后,乙脑发病水平明显降低,东南部地区是甘肃省乙脑重点防控区,河西走廊是否存在乙脑病例尚需进一步调查并进行全面监测.     

三明市乙脑流行特征及防控策略

目的了解三明市流行性乙型脑炎(乙脑)流行特征,为制定防控策略和措施提供依据。方法用描述流行病学方法对三明市1955—2012年乙脑疫情进行分析。结果 1955—2012年全市累计发病5 760例,年均发病率4.79/10万,年均死亡率0.73/10万,病例主要集中在1965—1974年,共报告4 130例(71.7%);自然流行、疫苗试点推广和计划免疫3个时期的平均发病率和平均死亡率均呈下降趋势;各县区年均发病率在7.82/10万~16.66/10万间,农村年均发病率(2.29/10万)高于城区(2.18/10万);发病有明显的季节分布,7~8月占91.4%。1990—2012年间男女病例数比例为1.63∶1;0~14岁儿童占95.0%,发病以散居儿童为主(64.7%)。结论开展以预防接种为主的综合防控措施是防控乙脑的关键。     

广东省2003年流行性乙型脑炎流行病学特征及控制策略的探讨

广东省流行性乙型脑炎 (乙脑 )经过连续 6年的低水平流行 (发病率 0 13/10万～ 0 19/10万 )后 ,2 0 0 3年发生局部地区的流行。为了解其流行病学特征 ,对当年乙脑监测资料进行了分析。结果显示 :乙脑疫情波及全省 2 1个市中的 19个市 ,乙脑发病率 0 5 0 /10万 ,病死率 7 81%。其中 4个市的病例数占全省的 6 8 4 9% ( 2 6 3/384 )。 6月为发病高峰 ,当月病例数占全年病例数的 6 5 10 %。乙脑病例中≤ 6岁占 5 7 5 5 % ,7～ 9岁占 2 9 4 3% ,≥ 10岁占13 0 2 % ,与往年相比 ,2 0 0 3年大年龄组病人比例有增高的趋势。无免疫史或免疫史不详者占乙脑病例的82 0 3%。为了控制乙脑流行 ,5～ 6月在流行地区开展乙脑灭活疫苗应急接种 ,在非流行地区开展乙脑疫苗的查漏补种 ,适龄儿童报告接种率达 96 6 8% ( 5 5 4 4 4 81/5 7346 5 9)。结果使全省乙脑流行时间缩短了 1个月。为全面落实乙脑疫苗的预防接种 ,建议把乙脑疫苗纳入儿童计划免疫。     

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.