脐血铅含量与新生儿神经行为发育的关系

为了探讨宫内铅暴露与新生儿神经行为发育的关系，选择了北京地区１０１例新生儿，以脐血铅含量作为新生儿宫内铅暴露的指标，新生儿神经行为评分作为效应指标。结果：新生儿脐血铅含量与神经行为总分及行为能力评分间存在负相关关系。以脐血铅含量０．４８μｍｏｌ／Ｌ为分界，高铅组与相对低铅组新生儿行为能力评分差异有显著性，其行为能力分项评分结果表明，非生物听定向反应、生物性视和听定向反应两组比较差异有显著性。提示：宫内铅暴露对新生儿神经行为发育，特别对视和听功能可产生不良影响。     

影响新生儿听定向反应及其附加分的多因素分析

目的 探讨影响新生儿听定向反应及其附加分的多种环境因素及敏感性。方法 随机选取武汉市某医院妇产科1999年1-10月出生的足月新生儿103例，测定新生儿神经行为能力并疏集有关影响因素，同时测定新生儿脐血铅和胎粪铅含量。分别以新生儿非生物听定向反应评分及非生物听定向反应附加评分作为因变量，以影响因素及脐血铅，胎粪铅等24项指标作为自变量，采用多项有序分类反应型变量的logistic逐步回归的分析方法，在P=0.10水平筛选出相应的影响因素。结果 家庭人口数，孕期感染及孕期感染月份3项因素选入影响新生儿非生物听定向反应评分的模型，孕期情绪，孕期服药，新生儿性别，孕期感染，孕期感染月份，孕周，胎粪铅等7项因素选入影响新生儿非生物听定向反应附加评分的模型。结论 孕周长、女性新生儿，孕期情绪好有利于新生儿非生物听定向反应附加评分的发育，孕期早期感染，孕期服药，高胎粪铅水平不利于新生儿非生物听定向反应附加评分的发育。     

脐血,胎粪铅含量对新生儿神经行为发育的影响

为探讨在宫内低水平铅暴露状态下,新生儿脐血铅含量及胎粪铅含量与神经行为发育的关系。随机选取某医院妇产科１９９９年１～１０月出生的足月新生儿１０３例,以脐血铅（ＣＢＰｂ）含量与胎粪铅（ＭＰｂ）含量作为新生儿宫内铅暴露的指标,新生儿神经行为评分（ＮＢＮＡ）作为效应指标。结果显示,与脐血铅含量比较,胎粪铅含量与新生儿神经行为发育的关系更为密切,可作为妊娠期胎儿体内铅蓄积的指标。     

脐血铅与初乳铅含量与新生儿神经行为发育关系

目的探讨在宫内低水平铅暴露状态下,新生儿脐血铅含量及初乳铅铅含量与神经行为发育的关系。方法随机选取南京市妇幼保健院医院产科2010-01/04出生的足月新生儿170例。以脐血铅和初乳铅铅含量作为新生儿铅暴露的指标,新生儿神经行为（NBNA）发育评分作为效应指标。结果高暴露组在新生儿主动肌张力、原始反射和神经行为发育总评分上低于低暴露组,差异有统计学意义（t=4.625,P〈0.05）,在新生儿行为能力、被动肌张力、一般估价上差异无统计学意义。结论初乳铅脐血铅水平和与婴儿的早期发育有关,铅可通过乳汁和脐血造成新生儿的铅接触,对新生儿婴儿早期神经行为发育产生不良影响。     

影响新生儿神经行为发育的多因素分析

目的：探讨影响新生儿神经行为发育的多种因素及敏感性。方法：随机选取中国第一冶金建筑公司职工医院妇产科1999年1-10月出生的足月新生儿103例，用鲍秀兰的20项新生儿神经行为检查法测定新生儿神经行为能力，用武汉科技大学医学院附属医院儿科设计的问卷收集有关影响因素，同时测定新生儿脐血铅和胎粪铅含量。以新生儿神经行为总评分作为因变量，以问卷中的影响因素及脐血铅、胎粪铅等24项指标作为自变量，采用多项有序分类反应型变量的logistic逐步回归的分析方法，在P=0.10水平筛选出相应的影响因素。结果：孕周、孕期服药月份、血红蛋白、孕期情绪、胎粪铅、孕期服药6项选入模型。结论：新生儿神经行为发育受多项因素的影响。孕期营养状况好、孕周长、孕期情绪好有利于新生儿神经行为的发育。孕期服药不利于新生儿神经行为的发育，尤其是妊娠早期用药。胎粪铅含量增高将不利于新生儿神经行为的发育。     

影响新生儿视定向反应及其附加分的多因素分析

本资料来源于足月正常的新生儿,排除了先天性疾病及后天性疾病对其发育的干扰,着重研究日常生活环境中各种因素对新生儿非生物性视定向反应评分及非生物性视定向反应评分附加分的影响。1　对象与方法1 .1　对象　随机选择一冶职工医院妇产科1 999年1～1 0月出生的新生儿1 0 3例。新生儿断脐前用含肝素的密封的一次性玻璃自动采血器,采取脐血5 m l。新生儿出生后统一使用一次性的纸尿裤(妇产科统一分发) ,收集出生2 4小时内的胎粪。标本收集齐全后,统一在华中科技大学同济医学院职业病流行病学实验室进行测定,用石墨炉原子吸收光谱法测定脐血…     

脐血铅、初乳铅含量对新生儿神经行为发育的影响

目的 探讨在宫内低水平铅暴露状态下,新生儿脐血铅含量及初乳铅铅含量与神经行为发育的关系.方法 随机选取南京市妇幼保健院医院产科2010年1-4月出生的足月新生儿170例.以脐血铅和初乳铅铅含量作为新生儿铅暴露的指标,新生儿神经行为NBNA发育评分作为效应指标.结果 高暴露组和低暴露组在新生儿主动肌张力、原始反射和神经行...     

围产期干预铅对新生儿神经行为发育影响

目的：探讨围产期干预铅对新生儿神经行为发育的影响。方法：采用Ebselen对围产期铅暴露进行干预流病学调查及原子吸收法测定脐血铅、双道束荧光光度计测定脐血硒和新生儿出生后第26－28天采用双盲法进行神经行为发育（NBNA）评分。结果：干预组脐血铅为0．34μmol／L,显著低于对照组（0．5μmol／L）,血硒,血锌,GSH－Px均高于对照组（P均＜0．01）,LPO含量低于对照组（P＜0．01）。干预组婴儿NBNA＞35达65．8％,显著优于对照（P＜0．01）。结论：围产期干预铅对减轻新生儿铅毒,改善微量营养素水平,提高抗氧化能力和保护新生儿智力正常发育均有明显的促进作用。     

新生儿游泳与新生儿行为神经测评相关性的临床研究

目的探讨新生儿游泳与新生儿行为神经发育的相关性。方法选剖宫产、顺产的正常足月儿,分为游泳组和非游泳组。通过新生儿行为神经测评(NBNA),比较游泳组与非游泳组间的差异。结果新生儿在生后第1、7、14、28天的比较中,NBNA总分游泳组均高于非游泳组,P均<0.01,有显著性差异;在NBNA附加分(非生物视定向反应、生物视定向反应)评估项目中游泳组均高于非游泳组,P<0.01,有显著性差异。结论新生儿游泳在新生儿行为神经发育方面起积极促进作用,给新生儿带来了更健康、更安全的成长道路。     

新生儿脐血铅含量与神经行为发育的关系

目的 :探讨孕期低水平铅暴露下 ,脐血血铅含量对新生儿神经行为发育的影响。方法 :随机选择 2 0 0 3年 1～4月出生足月新生儿 135例。以脐血铅作为孕期铅暴露的指标 ,新生儿神经行为发育 (NBNA)评分作为效应指标 ,采用描述性分析方法评价二者之间的相关性。结果 :高暴露组和低暴露组在新生儿主动肌张力、神经行为发育总评分上差异有显著性 (P<0 .0 5 ) ,原始反射评分差异有非常显著性 (P<0 .10 ) ,在新生儿行为能力、被动肌张力、一般估价上差异无显著性。结论 :孕期低水平铅暴露对新生儿神经行为发育影响明显。     

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.