南京市25岁以下健康人群白喉和破伤风抗体水平调查

[目的]了解南京市白喉、破伤风健康人群免疫水平.[方法]采集健康人群血清,采用间接血凝法(IHA)测定白喉和破伤风抗体水平.[结果]白喉的几何平均滴度(GMT)为1:66.9;抗体阳性率为91.3%;破伤风的GMT为1:36.6;抗体阳性率为82.3%.白喉和破伤风各年龄组之间抗体阳性率和GMT差异均有统计学意义.[结论]白喉和破伤风抗体在25岁以下人群中形成了较好的免疫屏障,但GMT在16～25岁年龄组有明显降低,因此要加强对大年龄组白喉、破伤风的预防控制工作.     

2013年德钦县健康人群麻疹抗体水平监测分析

[目的]了解德钦县健康人群麻疹抗体水平,评价疫苗接种效果和人群免疫状况,为制定麻疹防控策略和防治措施提供依据。[方法]按分层随机抽样原则抽取健康人群360人,采用酶联免疫吸附实验(ELISA)检测麻疹IgG抗体。[结果]2013年德钦县健康人群麻疹抗体总阳性率、总保护率和几何平均浓度分别为96.11%、90.00%和2203.10 IU/ml,德钦县不同年龄组、不同免疫史抗体阳性率、保护率、GMT差异有统计学意义,不同地区GMT差异有统计学意义。德钦县≥14岁组人群麻疹抗体保护率较低;升平镇麻疹抗体阳性率、保护率、GMT均为最低;随着免疫剂次的增加,麻疹抗体阳性率、保护率、GMT均增加。[结论]德钦县应在提高常规免疫覆盖率基础上,有计划地开展14岁以上人群麻疹疫苗强化免疫活动。     

2006年青州、寿光市部分健康人群百日咳、白喉、破伤风抗体水平监测

[目的]了解潍坊市健康人群百日咳、白喉、破伤风免疫状况,评价无细胞百白破三联疫苗的免疫效果。[方法]2006年对青州、寿光2市采取划片轮转的方式,每个市抽取2个乡镇,每个乡镇抽取3月龄至60岁人群80人,全市共抽取319人,进行百日咳、白喉、破伤风免疫水平检测。[结果]百日咳抗体保护率为68.57%,几何平均滴度(GMT)为1∶326.14,免疫成功率为79.66%;白喉抗体保护率为83.70%,抗毒素含量为0.1326 IU/ml,免疫成功率为90.00%;破伤风抗体保护率为86.52%,抗毒素含量为0.1472 IU/ml,免疫成功率为90.00%;3种抗体保护率均以2~4岁和15~19岁人群较高,20岁以上人群较低,不同年龄组间的差异有统计学意义(P<0.01),不同性别间差异无统计学意义(P>0.05),百日咳抗体保护率和免疫成功率较白喉和破伤风低,2市间的差异有统计学意义(P<0.01)。[结论]3种抗体中百日咳抗体保护率最低为68.57%,抗体水平较低,平均为1∶326.14;20岁以上人群白喉和破伤风抗体保护率较低,为68.18%~75.00%,抗体水平较低,抗毒素平均值分别为0.0398 IU/ml~0.1606 IU/ml。应加强疫苗在保存、运输、接种等各个环节的冷链管理,确保疫苗效价;开展成人白破二联疫苗的接种工作,提高人群免疫水平。     

2003年潍坊市部分健康人群百日咳、白喉、破伤风抗体水平调查

[目的 ]了解潍坊市健康人群百日咳、白喉、破伤风免疫状况。 [方法 ] 2 0 0 3年抽取部分县 (市、区 ) ,对不同年龄组部分健康人群进行血清百日咳、白喉、破伤风免疫水平检测。 [结果 ]百日咳抗体保护率为 3 9 74% ,几何平均滴度(GMT)为 1∶60 5 3 ;白喉抗体保护率为 81 17% ,抗体几何均值为 0 43 6IU/ml;破伤风抗体保护率为 71 46% ,抗体几何均值为 0 13 9IU/ml。 [结论 ]百日咳保护率较低 ,15岁以上白喉、破伤风抗体水平随年龄的增长逐渐降低。     

2010年白山市健康人群百日咳、白喉及破伤风IgG抗体水平监测

目的了解白山市健康人群百日咳、白喉、破伤风血清抗体水平。方法在全市6个县(市、区)采取随机抽样的方法抽取八道江区,对0～1岁、1～2岁、3～4岁、5～6岁、7～14岁、15～19岁、﹥20岁7个年龄组的健康人群进行抗体水平监测。结果百日咳IgG抗体阳性率为80.0%,白喉IgG抗体阳性率为68.10%,新生儿破伤风IgG抗体阳性率为49.52%。不同年龄组人群百日咳、白喉、破伤风抗体阳性率比较,差异有统计学意义(P﹤0.05)。结论在进一步提高常规免疫接种率的基础上,加强人群免疫水平监测,考虑对成人进行加强免疫[1]。     

江苏省2011年健康人群脊髓灰质炎抗体水平监测分析

目的了解江苏省健康人群脊髓灰质炎(简称"脊灰")中和抗体水平,为及时制订免疫策略、维持无脊灰状态提供科学依据。方法采用随机抽样的方法抽取连云港、扬州两市健康人群,应用细胞中和实验法检测脊灰中和抗体。采用SPSS18.0统计软件进行分析。结果在检测的736名健康人群的血清标本中,脊灰Ⅰ型、Ⅱ型和Ⅲ型抗体的阳性率分别为98.51%、98.37%和94.97%;几何平均滴度(GMT)分别为1︰186.21、1︰125.89和1︰47.86;不同地区健康人群脊灰抗体阳性率和GMT无显著性差异;不同年龄段健康人群脊灰抗体阳性率有差异,抗体水平总趋势随着年龄增长而递减。结论江苏省健康人群脊灰抗体阳性率和GMT均保持在较高水平,已经形成了牢固的免疫屏障。     

乐至县健康人群麻疹抗体水平调查分析

[目的]为了了解健康人群对麻疹的抵抗力,掌握健康人群的免疫水平。[方法]取受检者耳垂血或指尖血0.2ml分离血清作麻疹血凝抑制试验测其抗体。[结果]受检人群抗体阳性率为93.54%,几何平均滴度(GMT)为1︰38.90,≥1︰16抗体滴度占80.26%,各年龄组抗体水平分布不同。[结论]通过调查不同区域、不同年龄组健康人群的抗体水平,城乡健康人群抗体水平差异无统计学意义,复种组抗体水平具有城乡差异,提示今后工作应提高有效接种率,重点抓好8月龄～2岁组儿童的基础免疫和复种工作,建立应对麻疹入侵的免疫屏障,实现控制和消除麻疹目标。     

2017年北京市昌平区健康人群百日咳、白喉、破伤风抗体水平监测

目的 了解北京市昌平区健康人群百日咳、白喉、破伤风抗体水平,为制定免疫策略提供依据。方法 2017年采取多层抽样方法对360名健康人群采集血标本,采用酶联免疫吸附试验(ELISA)对血清进行百日咳、白喉、破伤风IgG抗体检测,分析不同年龄组、性别、户籍等之间抗体水平情况。结果 昌平区健康人群百日咳、白喉、破伤风抗体阳性率分别为5.00%、59.44%、68.33%,抗体几何平均滴度(geometric mean concentration,GMC)分别为9.18、0.55、0.86 IU/ml。不同年龄组白喉、破伤风抗体水平差异有统计学意义(P<0.001)。不同性别、户籍和免疫剂次人群间百日咳、白喉、破伤风抗体水平差异均无统计学意义(P>0.05)。接种末剂DTaP和/或DT和/或DTaP-IPV/Hib≤1年、2~5年、6~14年后的百日咳、白喉、破伤风抗体水平差异均有统计学意义(P<0.001)。结论 昌平区15岁以上人群白喉、破伤风抗体阳性率较低,随着免疫后时间延长,百日咳、白喉、破伤风抗体水平均明显降低。应加强小月龄婴儿、青少年及成人百日咳、白喉、破伤风的监测,推荐15岁以上人群、与1岁以下儿童有密切接触的成人及医务人员接种1剂Tdap疫苗。     

福建省2～19岁人群百日咳白喉破伤风免疫水平监测

目的：了解福建省2－19岁人群百日咳、白喉、破伤风抗体水平。方法：百日咳以微量凝集试验（血凝板法），白喉、破伤风以间接血凝法检测。结果：2－19岁人群百日咳抗体阳性率为96．8％，保护率为43．4％，凝集抗体几何平均滴度（GMT）为1：182．53。白喉抗毒素阳性率为99．3％，GMT为0．413IU／ml。破伤风阳性率95．5％，GMT为0．299IU／ml。不同年龄组百日咳、白喉、破伤风血清抗体几何平均滴度随年龄增长呈下降趋势。结论：在进一步提高常规免疫接种率的基础上，加强人群免疫水平监测，考虑对成人进行加强免疫。     

临沂市健康人群白喉和破伤风抗体水平调查

目的为有计划地进行人群抗体水平监测,了解人群免疫状况,为制定免疫对策、评价免疫效果提供依据。方法采用分层随机抽样的方法,2001、2003、2004年调查了临沂市10个县(区)0~39岁847人的白喉和破伤风抗体水平。结果白喉和破伤风抗体总阳性率分别为77.80%和74.03%,阳性率均是0~4岁组最高,20~39岁组最低;山区县低于平原县和市区。白喉和破伤风抗体几何平均浓度分别为0.0997U/ml和0.0674U/ml,均是8~10岁组最高,20~39岁组最低。结论临沂市白喉和破伤风疫苗基础免疫的效果可靠,但随着年龄的增长,免疫力衰退而重新成为易感者,故应及时对成人加强百日咳、白喉的免疫,并在新生儿破伤风高危县区对育龄期妇女开展破伤风疫苗免疫。     

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.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.