碘盐加碘油对碘缺乏病区孕妇血清Tg和TSH含量影响的研究

对碘缺乏病区的孕妇在善食1／2万碘盐的基础上在孕前加服200mg碘油，结果显示，仅在孕3个月时血清Tg和TSH值偏低，属轻度缺碘，其它各阶段和仅吃碘盐的非孕妇同样仍处于中、重度缺碘状况，表明碘盐碘含量仍存在不足，孕妇在孕前加服碘油后，仅能满足妊娠期3个月对碘的需求．     

孕妇缺碘对婴儿智能的影响

报道了孕妇碘缺乏病（ＩＤＤ）于妊娠早期补碘成不补碘对其所生婴儿智能发育的影响。根据尿碘、血清促甲状腺激素（ＴＳＨ）值、Ｔ４值、甲状腺肿等指标诊断，缺碘孕妇于初孕１～４个月补碘一次（碘油丸含碘４００ｍｇ／丸为Ｃ组），另设缺碘不补碘组（Ｂ组）和正常对照组（Ａ组）。跟踪孕妇，产后每月测婴儿身长、体重、智能（采用ＣＤＣＣ测试法）。结果证明补碘孕妇所生婴儿的身长、体重、智能均高于缺碘对照组（Ｐ＜０．０１或０．０５），并发现母亲缺碘其婴儿智力发育明显迟缓。孕妇缺碘如能早期补碘可预防新生儿的智力发育不良。     

胚胎期碘营养充足婴儿智力发育的跟踪观察

[目的]了解胚胎期碘营养充足婴儿智力发育情况,为全民食盐加碘(USI)实施效果评估提供证据。[方法]随机选择妊娠妇女,在妊娠早期、中期和晚期分别用武汉众生生化技术有限公司提供的尿碘快速定量检测试剂盒测定尿碘,跟踪其正常分娩的婴儿,用Fagan婴儿智力测验(FTII)法测定智力发育状况。[结果]妊娠早期、中期、晚期妇女的尿碘中位数分别为261.5μg/L、222.0μg/L、239.2μg/L。总的中位数为240.9μg/L。跟踪测试婴儿215例,认知发育指数呈正态分布(P﹥0.05),平均值为59.1±4.91.智力发育正常≥54.1,发育迟缓可疑49.5-54.0,发育迟缓高危险度﹤49.4。低于49.4者3例,发育迟缓高危险率1.4%。[结论]实施食盐加碘(USI)后,通州市妊娠妇女的碘供给量达到国际组织所推荐的200μg/d/人的1.8倍左右,其胚胎期一直处于碘营养充足内环境中的婴儿,智力发育达到了正常水平,证实胎儿和婴儿大脑发育已不再受到碘缺乏的危害。     

吸烟和缺碘对育龄妇女甲状腺和卵巢功能联合作用

采用析因分析观察缺碘（ID）和吸烟（SI）对育龄妇女甲状腺和卵巢功能的联合作用。结果表明：ID和SI双因素使血液中游离甲状腺素（FT4）和雌二醇（E2）含量明显降低，FT3、促甲状腺素（TSH）和甲状腺球蛋白（TG）含量明显增高（P均＜0．01），SI亦有类似作用。提示：缺碘者吸烟会干扰女性卵细胞发育，对受孕和胚胎缺碘会造成潜在影响，对她们进行碘保护尤为重要。     

山西省轻度缺碘地区儿童精神发育迟滞流行病学研究

对山西省一个轻度缺碘地区０￣１２岁儿童进行精神发育迟滞现况调查，并以缺碘已补碘及非缺碘地区为对照。结果发现轻度缺碘地区儿童精神发育迟滞现患率为３．７５％，其他两个地区分别为１．３６％及１．１７％。对轻度缺碘地区３８名精神发育迟滞儿童采用１：１配对调查经Ｌｏｇｉｓｔｉｃ回归模型分析，与智力低下有关的因素有：母亲个性内向或外向（ＯＲ＝２．１０），母亲文化偏低（ＯＲ＝１．８５）及不满意的婚姻（ＯＲ＝１．     

出生时一过性甲状腺功能低下学龄儿童的临床追踪研究

目的 对出生时一过性甲状腺功能低下儿童进行临床10a追踪观察，研究胎儿期轻度缺碘是否对其远期智力发育和体格发育造成危害。方法 采用了儿童智商IQ值测定、儿童精神运动功能测定、甲状腺功能测定、体格发育等项国际、国内公认的先进指标，按照实验与对照配对的要求，对出生时一过性甲状腺功能低下的儿童进行了10a的追踪观察。结果 出生时一过性甲状腺功能低下，可以造成儿童的远期发育障碍，使其生长发育落后于正常儿童。并且骨龄发育也有落后于正常儿童的趋势。结 论在大、中城市必须开展对孕妇及婴幼儿的碘营养保健工作，实行全面碘营养水平监测，科学补碘是有效地开展胎儿及婴幼儿缺碘性脑损伤的唯一措旆．     

您对碘盐知多少

碘缺乏病是由于自然环境缺碘,使机体摄入碘不足所致的一系列损害,除地方性甲状腺肿和地方性克汀病两种典型表现外,最主要的危害是缺碘影响胎儿的脑发育,导致儿童的智力和体格发育迟滞或永久性障碍,造成病区人群的智能损害.缺碘也可导致流产、死产、先天畸形和新生儿病死率增高等,因此,妇女和儿童是碘缺乏最主要的受害者.     

常年补碘后学龄儿童碘代谢及垂体-甲状腺功能观察

采用放射免疫分析方法对包头市郊缺碘病区7～14岁儿童常年补碘后,碘代谢及垂体－甲状腺功能进行了观察。结果显示:病区补碘儿童T3、T4、TSH及UI含量均在正常范围之内,表明经长期补碘,儿童群体缺碘状况已基本得到纠正。但个体间摄碘不平衡现象依然存在。建议在定期监测情况下调整学龄儿童的供碘需求。     

全民食盐加碘对儿童智力发育的影响

[目的]了解全民食盐加碘对碘缺乏病区出生儿童智商的影响。[方法]用联合型瑞文测验测定儿童智商(IQ)，调查分析社会-经济-文化因素对智力的影响，测定尿碘水平、盐碘含量和甲状腺肿大情况。[结果]实施全民食盐加碘21年后，儿童甲状腺肿大率由57．4％下降到2．5％，尿碘水平由24．9μg／克肌酐升至209．6μg／L；补碘后出生的儿童IQ均值非常显著地高于补碘前，智力低下的发生率明显低于补碘前出生儿；将社会-经济-文化因素与儿童的智商进行多元逐步回归分析，R^2=0．314。[结论]实施全民食盐加碘是促进儿童智力发育的重要因素。     

早期干预改善早产低出生体重儿认知发育研究

目的 本研究旨在促进早产低出生体重儿的认知发育。方法 将１１例早产低出生体重儿随机分为干预组和对照组，其中５７例接受了自出生起开始，为期一年的早期干预。干预以发展婴儿的基本信任感为原则，以家庭为中心，通过家访、保健门诊、热线电话指导家长合理喂养和护理养育婴儿，对婴儿开展感知运动及语言等训练，掌握疾病防治的基本知识。结果 于婴儿满纠正年龄１岁进进行认发育测定，表明干预组早产儿的智能发育指数和运动发育     

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.