河南省濮阳市城区部分儿童尿液筛查结果分析

目的探讨河南省濮阳市学龄前儿童血尿和/或蛋白尿的检出率及其意义,为早期发现和预防肾脏疾病提供依据。方法 2008年8-11月采用干化学方法检测河南省濮阳市城区7 919名1～6岁儿童晨尿标本中的血尿和蛋白尿。第一次尿检阳性者于1～2周后复检。对复检仍为阳性者进行临床诊断、治疗和随访。结果 7 919儿童中初次尿筛阳性者109人,初检阳性率为1.38%,复查尿筛检阳性者75人,复检阳性率为0.95%,占初筛阳性的68.81%。其中无症状性血尿检出率为0.62%,无症状性蛋白尿为0.10%,血尿+蛋白尿为0.01%。经过3次检查确诊为泌尿系疾病67人,检出率为8.46‰。结论尿液筛查可发现无症状尿检异常的儿童,并早期发现肾脏疾病、预防肾脏疾病的发展。对无症状尿检异常的儿童应该坚持随访。     

深采煤井下矿工血尿增多调查

目的 分析煤矿井下矿工的尿液隐血情况,探讨血尿的来源、形成机制及防治对策。 方法 采用回顾性分析方法,收集2013年5月至6月期间两家煤矿的4 372例井下工人的尿液标本,与地面健康查体的1 884例尿液标本对比,经尿液化学分析仪筛查和显微镜人工复检,比较井下与地面工人的隐血阳性率差别。 结果 煤矿井下职工尿隐血436例,阳性率为9.97%,隐血1+及以上的占98.17%,同时伴蛋白尿者占9.40%;地面其他行业健康查体人群尿隐血122例,阳性率为6.47%。两者在尿隐血阳性率、隐血程度分布及蛋白尿阳性率方面相比,差异均有统计学意义(χ2=19.82、156.24、17.02,P < 0.01)。 结论 血尿程度和高温高湿环境下重体力劳动有关。随着矿井开采日益加深,井下高温高湿的极端工作环境日益增多,职业病防治工作中应加强对井下矿工尿液常规的隐血监测。     

广州市萝岗区3~6岁集体儿童无症状性血尿及其病因的流行病学调查

目的 了解广州市萝岗区3~6岁集体儿童无症状性血尿的发病率,进一步查找病因并进行追踪随访。方法 运用流行病学调查的方法,对萝岗区5 602名3~6岁集体儿童进行尿常规筛查,2周内连续3次尿检镜下血尿均阳性者确诊为无症状性血尿。对确诊患儿进一步检查病因。结果 确诊无症状性血尿49例,总发病率为0.88%(49/5 602)。其中,男19例(0.64%),女30例(1.14%),差异有统计学意义(P<0.05)。40例接受检查者中发现左肾静脉压迫综合征9例(22.5%)、特发性高钙尿症5例(12.5%)、尿路感染5例(12.5%)、急性肾炎3例(7.5%)、紫癜性肾炎1例(2.5%)、IgA肾病1例(2.5%)、多囊肾1例(2.5%)、肾积水1例(2.5%)、14例(35.0%)暂时病因不明。结论 无症状性血尿在3~6岁儿童中有一定的发病率,其中部分患儿为器质性疾病,存在远期肾损害可能,应早期给予积极治疗。建议将尿常规筛查纳入儿童保健检查项目中。     

小儿无症状性血尿的诊断探讨

上世纪八十年代,中华儿科学会肾脏组对我国21个省市约22.4万例3～14岁健康儿童尿筛查结果显示,确诊为无症状性血尿者儿童比例为0.42%.可见无症状性血尿在健康儿童中存在一定的发生率.无症状性血尿诊断较为困难,患儿除血尿外不伴任何其它症状.临床上相对于症状性血尿来讲缺乏可供诊断参考的其它症状,二十多年过去了,随着医疗科技的发展和对无症状性血尿认识水平的提高,对小儿无症状血尿的诊断步骤和思路也在逐步完善.但至今无症状性血尿的部分病因尚不明确,还属儿科肾脏病临床研究课题之一,笔者就目前小儿无症状性血尿的诊断进行探讨.     

畸变产物耳声发射用于1 106例新生儿听力筛查及相关因素分析

【目的】了解畸变产物耳声发射筛查的检出率及可能的影响因素。【方法】用美国WEICH ALLYN公司的听力障碍筛选仪,对新生儿做双耳测试,初查未能通过者建议30-42 d复查,复查仍未通过者建议进一步作脑干诱发电位检查以便确诊。【结果】初次筛查通过率为86.8%,复查通过率为66.4%,复查仍未通过者中有3例(3耳)确诊为先天性听力障碍。【结论】兰州市的听力损害发病率为2.7‰,新生儿听力筛查应在出生3 d后进行。     

长春市2～6岁儿童听力保健的可行性探讨

【目的】探索2～6岁儿童定期听力普遍筛查的有效模式，以便对听力障碍儿童进行早期发现、早期治疗和干预。【方法】应用耳声发射（otoacoustic emissions，OAE）筛查技术对3459名2～6岁儿童进行听力筛查；对筛查阳性者行进一步诊断性检查，并给予相应的治疗和干预措施。【结果】3459例2～6岁儿童听力筛查经确诊有334例患有单耳或双耳不同程度的听力障碍，阳性率为9．66％，其中绝大多数属轻、中度传导性耳聋。【结论】对2～6岁儿童进行定期的听力筛查是非常必要的。     

12岁儿童肥胖与尿液筛查分析

目的了解12岁儿童肥胖及尿液检测异常情况,同时探讨二者的相关性。方法对长沙市两所寄宿制中学1520名12岁儿童进行体格检查与尿液筛查,采用SPSS软件对数据进行统计分析。结果12岁儿童肥胖率为5.46%,尿液检测初筛及复查阳性率分别为11.18%及5.20%,肥胖儿童显著高于正常儿童。结论12岁儿童肥胖及尿液筛查阳性率高,对肥胖儿及尿液检测阳性儿童应实行追踪管理,以减少代谢综合征及肥胖性肾病的发生。     

小儿无症状性蛋白尿、血尿与隐匿性肾炎

无症状性蛋白尿和血尿是近年来被注意的一个课题。研究表明,其中包括各种肾脏疾病和不同程度的肾脏病变。其大部分(约60～70％)是由所谓隐匿性肾炎所致,然而还有30％左右是由其他疾病引起,必须加以鉴别。     

1 291名小学生尿常规检查结果分析

目的了解小学生尿常规情况,以期早期发现和治疗泌尿系统疾病,确保学生健康.方法对1 291名小学生使用尿 项试带和尿分析仪进行初查;对初查阳性者,嘱家长带其去医院复查,并将复查结果反馈.结果小学生泌尿系统疾病患病率为1.68%,复查诊断为泌尿系统疾病的学生占初查尿检阳性学生的42.10%,女生患病人数比男生多.结论小学生泌尿系统疾病患病情况不容忽视,应加强对学生和家长的健康教育,注意卫生习惯,并保证学生能得到及时有效的治疗和保健.     

厦门市9 517名学龄前儿童肥胖检出率及原因分析

【目的】 了解厦门市学龄前儿童肥胖的患病率及主要影响因素,为预防儿童肥胖提供科学依据。 【方法】 应用随机整群抽样法,随机抽取厦门市城区34所幼儿园作为调查的研究现场。收集9 517名2～6岁学龄前儿童年龄、性别、身高、体重等基本信息,计算肥胖检出率,并对肥胖危险因素进行分析。 【结果】 厦门市学龄前儿童肥胖患病率为7.40%,其中男童9.03%,女童5.48%;2～6岁儿童肥胖发生率随年龄的升高而上升。儿童肥胖的发生与父母肥胖及家庭高收入有关,与儿童饮食习惯及看电视时间、体育活动有关。 【结论】 学龄前儿童肥胖患病率较高,儿童肥胖的发生状况与性别、年龄及不良生活方式等因素有关。     

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.