中国2003--2007年甲状腺癌发病死亡现状及流行趋势分析

目的分析中国甲状腺癌发病和死亡现状及流行趋势。方法2003-2007年甲状腺癌发病和死亡数据来源于全国32个肿瘤登记处,分别计算粗率、年龄别发病率和死亡率、中国人口标化率(中标率)和世界人口标化率(世标率)及变化趋势;采用Jionpoint模型对部分登记地区的20年发病和死f数据进行趋势分析。结果2003-2007年中国甲状腺癌发病率为4.44／10万,市标率为2.89／10万,世标率为3.31／10万;甲状腺癌死亡率为0.44／10万,中标率0.21／10万,世标率o 29／10万,分别占恶性肿瘤发病死亡构成的1.67％和0.26％;女性发病率和死亡率明显高于男性,分别为男性的3.38倍和1.75倍;城市人群发病率和死亡率高于农村;2003--2007年中国甲状腺癌发病率和死亡率呈上升趋势,每年分别以14.51％和1.42％的速度上升。结论中国甲状腺癌发病率和死亡率均呈上升趋势,应有效控制其高发现状。     

2009年浙江省恶性肿瘤发病与死亡情况分析

目的 分析2009年浙江省肿瘤登记地区恶性肿瘤发病与死亡情况.方法 收集2009年浙江省6个肿瘤登记地区上报的肿瘤发病与死亡资料,共报告恶性肿瘤新发病例30 613例,恶性肿瘤死亡病例16 920例.6个地区共计覆盖人口9 560 699名.计算恶性肿瘤发病与死亡的粗率、累积率(0 ～ 74岁)、截缩率(35 ～64岁)、年龄别率以及前10位恶性肿瘤发病与死亡顺位和构成等.采用1982年中国标准人口构成和Segi's世界人口构成分别计算中国和世界人口年龄标化发病率和死亡率(以下简称中标率和世标率).结果 2009年浙江省6个肿瘤登记地区恶性肿瘤粗发病率为320.20/10万,中标率为161.99/10万,世标率为207.92/10万,累积发病率为23.83％,截缩率为346.87/10万;恶性肿瘤粗死亡率为176.97/10万,中标率为79.17/10万,世标率为107.02/10万,累积死亡率为23.83％,截缩死亡率为139.75/10万.恶性肿瘤发病率在0～ 34岁人群处于较低水平,从35 ～39岁组(116.46/10万,954例)后上升明显,45 ～ 49岁(272.97/10万,2388例)后上升急剧,80 ～84岁组(1564.36/10万,2272例)达到高峰,死亡率从40 ～ 44岁组(48.06/10万,424例)后上升明显,80 ～84岁组(1392.23/10万,2022例)达到高峰.发病前10位的恶性肿瘤依次为肺癌、胃癌、结直肠癌、肝癌、乳腺癌、食管癌、甲状腺癌、胰腺癌、宫颈癌和淋巴瘤,占全部发病的74.37％(22 763/30 613);死亡前10位的肿瘤依次是肺癌、肝癌、胃癌、结直肠癌、食管癌、胰腺癌、白血病、淋巴瘤、脑肿瘤和乳腺癌,占全部死亡的87.75％(14 848/16 920).结论 2009年浙江省肿瘤登记地区恶性肿瘤发病率和死亡率均有所上升.肺癌、消化系统恶性肿瘤和乳腺癌仍然是浙江省肿瘤防治工作的重点,甲状腺癌发病率的升高不容忽视.     

河北省2011年恶性肿瘤发病与死亡分析

目的 评估2011年河北省肿瘤登记地区恶性肿瘤发病与死亡。方法 收集2011年河北省8个肿瘤登记地区上报的恶性肿瘤发病与死亡资料, 计算恶性肿瘤发病率、死亡率、前10位恶性肿瘤顺位、构成、累积率;采用2000年中国标化人口构成和Segi''s世界人口构成分别计算中国和世界人口年龄标化发病/死亡率(中标率和世标率)。结果 2011年河北省8个肿瘤登记地区共覆盖人口4 573 293人(其中城市2 139 779人, 农村2 433 514人), 恶性肿瘤新发病例11 269例, 死亡病例7 477例。恶性肿瘤病理诊断比例为75.26%, 只有死亡证明书比例为3.85%, 死亡发病比为0.66。全部恶性肿瘤发病率为246.41/10万(男性264.55/10万, 女性227.75/10万), 中标率为207.13/10万, 世标率为206.61/10万, 累积率(0~74岁人群)为23.57%。城市地区发病率为242.64/10万, 中标率为200.19/10万;农村地区发病率为249.72/10万, 中标率为214.11/10万。全部恶性肿瘤死亡率为163.49/10万(男性196.54/10万, 女性129.51/10万), 中标率为144.48/10万, 世标率为147.69/10万, 累积率(0~74岁人群)为14.71%。农村地区死亡率(167.91/10万)高于城市地区死亡率(158.47/10万)。胃癌、肺癌、食管癌、乳腺癌、肝癌、结直肠癌是河北省常见的恶性肿瘤, 约占全部新发病例的71.66%。肺癌、胃癌、食管癌、肝癌和结直肠癌是威胁河北省居民生命健康的主要恶性肿瘤, 约占死亡病例的74.79%。结论 2011年河北省肿瘤登记地区主要恶性肿瘤为胃癌、肺癌、食管癌、乳腺癌、肝癌、结直肠癌。     

浙江省2000--2,009年肿瘤登记地区脑肿瘤发病与死亡分析

目的分析浙江省肿瘤登记地区2000--2009年脑肿瘤的发病与死亡情况。方法数据来源于浙江省6个肿瘤登记处上报于浙江省肿瘤防治办公室的肿瘤发病、死亡及人口资料,分别计算发病(死亡)例数、粗发病率(死亡率)、构成比和顺位、中国标准人口构成(中标率)、Segi’s世界标准人口构成(世标率)、累积率、截缩率、年龄别发病率(死亡率)、发病率(死亡率)年度变化百分比(APc)及95%CI等指标。结果2000--2009年浙江省6个肿瘤登记地区共计报告脑肿瘤新发病例5 123例,占症新发病例的3.14%。脑肿瘤发病率为8.53／10万,中标率为5.72／10万,世标率为6.64／10万,居癌症发病顺位的第7位。脑肿瘤年龄别发病率随年龄增长而增加,在70～74岁组达高峰(24,09／10万)。脑肿瘤发病率历年变化呈总体增长趋势,发病率从2000年的6.87／10万上升到2009年的8.35／10万,APC为1.58%(95%CI：一2.17%一5.47%),差异无统计学意义。共计报告脑肿瘤死亡病例2 357例,占癌症死亡病例的2.47%。脑肿瘤死亡率为3.92／10万,中标率为2.45／10万,世标率为2.96／10万,居癌症死因顺位的第7位。脑肿瘤年龄别死亡率在0-39岁期间处于较低水平,在80-84岁组达高峰(17.64／10TY)。脑肿瘤死亡率历年变化呈现波动下降趋势,死亡率从2000年的4.30／10万上升到2006年4.63／10万的最高水平,然后降至2009年的3.83／10万,APC为一0.65%(95%CI：一3.35%.2.12%),差异无统计学意义。结论浙江省肿瘤登记地区脑肿瘤发病呈上升趋势,发病率和死亡率处于较高水平。中老年人群特别是70岁以上老年人群是脑肿瘤发病和死亡的重点人群。     

江苏省2006-2015年卵巢癌变化趋势及现状分析

目的 分析2015年江苏省卵巢癌发病和死亡现状及2006-2015年卵巢癌发病和死亡变化趋势,为江苏省卵巢癌防治提供依据。方法 利用2018年江苏省CDC收集的35个登记处2015年肿瘤登记资料,从中抽取卵巢癌数据,计算分城乡、年龄组发病（死亡）率、中国人口标化率（中标率）、世界人口标化率（世标率）、累积发病（死亡）率（0～74岁）、截缩发病（死亡）率（35～64岁）等指标,结合2015年江苏省户籍人口资料,估算全省卵巢癌发病（死亡）数。汇总2006-2015年全省肿瘤登记资料,利用Joinpoint 4.7.0.0软件分析卵巢癌发病（死亡）粗率、中标率、世标率的年度变化百分比（APC）。结果 2015年江苏省估计卵巢癌新发病例2 229例,约占女性全部恶性肿瘤发病的2.23%,位居女性恶性肿瘤发病顺位第12位;估计卵巢癌死亡1 239例,占女性全部恶性肿瘤的2.18%,位居女性恶性肿瘤死亡顺位第13位。江苏省女性卵巢癌发病率为5.91/10万,中标率为4.01/10万,世标率为3.81/10万,累积发病率（0～74岁）为0.42%。卵巢癌死亡率为3.29/10万,中标率为1.99/10万,世标率为1.96/10万,累积死亡率（0～74岁）为0.24%。2006-2015年江苏省卵巢癌发病粗率APC为4.66%（95% CI：2.11%～7.29%）,死亡粗率APC为7.45%（95% CI：5.46%～9.47%）,均P<0.05;卵巢癌发病中标率APC为2.30%（95% CI：-0.32%～4.99%）,发病世标率APC为2.41%（95% CI：-0.29%～5.20%）,均P>0.05;死亡中标率APC为4.43%（95% CI：2.54%～6.36%）,死亡世标率APC为4.55%（95% CI：2.58%～6.57%）,均P<0.05。结论 江苏省卵巢癌发病率、死亡率处于较低水平,城市高于农村,卵巢癌发病粗率、死亡粗率均呈上升趋势,经标化后发病趋势尚平稳,但死亡趋势上升明显。     

浙江省2007—2011年甲状腺癌发病及死亡特征分析

目的分析浙江省2007—2011年甲状腺癌发病与死亡特征及趋势。方法采用浙江省卫生监测区2007—2011年的肿瘤发病监测与全死因监测数据,分别计算甲状腺癌发病(死亡)粗率、年龄别发病率以及用中国和世界人口作标化的发病(死亡)率;同时采用趋势χ2分析甲状腺癌发病(死亡)变化趋势。结果浙江省2007—2011年甲状腺癌报告发病率为8.37/10万(中标率5.28/10万,世标率6.14/10万);甲状腺癌死亡率为0.34/10万(中标率0.17/10万,世标率0.24/10万)。无论发病率还是死亡率,女性均明显高于男性,城市高于农村。死亡率随年龄增加而上升,发病率先升后降,30~59岁是发病高峰年龄。2007—2011年甲状腺癌发病率每年以29.95%的速度呈快速上升趋势,但是死亡率上升不明显。结论浙江省甲状腺癌发病率增长迅速,应积极寻找甲状腺癌发生的危险因素,遏制其快速增长的发病趋势。     

中国2003-2007年口腔和咽喉癌发病与死亡分析

目的分析中国32个肿瘤登记地区2003-2007年口腔和咽喉癌的发病率与死亡率,为其防控以及公共卫生政策制定提供参考依据。方法选取32个登记地区2003-2007年肿瘤登记数据,计算不同地区、不同性别人群口腔和咽喉癌发病(死亡)率和年龄标化发病(死亡)率[中国人口标化率(中标率)和世界人口标化率(世标率)],不同年龄组的发病(死亡)率以及不同部位口腔和咽喉癌的发病(死亡)构成比。结果口、舌、唾液腺是口腔和咽喉癌最常见的好发部位。2003-2007年全国32个肿瘤登记地区口腔和咽喉癌的发病率是3．15/10万,中标率是1．75/10万,世标率是2．26/10万;同期口腔和咽喉癌的死亡率是1．37/10万,中标率是0．69/10万,世标率是0．94/万。口腔和咽喉癌的发病率和死亡率标化前后均是男性高于女性,城市高于农村;随年龄的增长呈上升趋势。年龄标化后,广东省中山市口腔和咽喉癌的发病率和死亡率居32个肿瘤登记地区之首。2003-2007年口腔和咽喉癌的各年发病中标率在不同地区和城乡人群中均略微上升,死亡率各年变化不大。结论2003-2007年中国口腔和咽喉癌的发病率和死亡率水平较低,但由于相关危险因素暴露水平居高不下,发病率缓慢升高,仍需引起重视。     

2014—2016年肇庆市端州区恶性肿瘤发病与死亡分析

目的 分析2014—2016肇庆市端州区居民恶性肿瘤发病和死亡情况。方法 收集2014—2016年肇庆市端州区恶性肿瘤发病及死亡数据,计算恶性肿瘤发病与死亡粗率、标化率、35~64岁截缩率、累积率与前10位恶性肿瘤顺位等。结果 2014—2016年肇庆市端州区恶性肿瘤粗发病率为312.50/10万（男性为334.97/10万,女性为289.41/10万）,中标率为219.16/10万,世标率为214.30/10万,35~64岁截缩率为379.76/10万,0~74岁累积率为24.31%。粗死亡率为165.27/10万（男性为208.55/10万,女性为120.79/10万）,中标率为100.33/10万,世标率为99.52/10万,35~64岁截缩率为153.81/10万,0~74岁累积率为11.50%。端州区发病率居前10位的恶性肿瘤分别为肺癌、结直肠癌、肝癌、女性乳腺癌、鼻咽癌、脑瘤、胃癌、甲状腺癌、白血病和前列腺癌,占全部恶性肿瘤发病的74.31%。端州区死亡率居前10位的恶性肿瘤分别为肺癌、肝癌、结直肠癌、鼻咽癌、胃癌、女性乳腺癌、白血病、食管癌、胰腺癌和淋巴瘤,占全部恶性肿瘤死亡的83.06%。结论 肺癌、消化系统癌症、女性乳腺癌和鼻咽癌是严重影响肇庆市端州区居民健康的重点恶性肿瘤,应加强预防与控制。     

2017年河南省濮阳市恶性肿瘤发病和死亡特征分析

目的 探讨2017年濮阳市居民恶性肿瘤的发病和死亡情况。方法 利用《河南省肿瘤登记直报信息管理系统》,收集2017年濮阳市2个国家级肿瘤登记处的肿瘤登记资料,按性别和年龄分别计算恶性肿瘤粗发病率和粗死亡率,并分别利用中国人口和世界人口对率值标化获得中标率和世标率,获得恶性肿瘤发病和死亡顺位。结果 2017年濮阳市2个国家级肿瘤登记点覆盖人口1 587 271人,占全市总人口的41.76%。2017年濮阳市恶性肿瘤粗发病率为269.02/10万(男性275.58/10万,女性262.44/10万),中标率291.13/10万,世标率229.28/10万,35～64岁截缩率、0～64岁和0～74岁累积率分别为335.41/10万、11.82%和27.22%;肺癌、食管癌、胃癌、肝癌、乳腺癌、甲状腺癌、宫颈癌、直肠癌、结肠癌和中枢神经系统恶性肿瘤是发病前10位恶性肿瘤,占82.09%;恶性肿瘤粗死亡率137.72/10万(男性177.13/10万,女性98.24/10万),中标率156.28/10万,世标率121.24/10万,35～64岁截缩率133.98/10万,0～64岁和0～74岁累...     

2017年江苏省恶性肿瘤流行情况分析

目的 根据全省肿瘤登记资料,估算江苏省2017年恶性肿瘤发病和死亡情况。方法 收集整理全省47个登记处上报的2017年肿瘤登记数据,以43个符合标准的登记处数据为基础,按城乡、性别和年龄别分层,计算不同癌种的发病率和死亡率,估算全省2017年恶性肿瘤的发病(死亡)数、发病(死亡)率、中国人口标化率(中标率)、世界人口标化率(世标率)、0～74岁累积发病(死亡)率和前10位恶性肿瘤发病(死亡)顺位等指标。结果 估计2017年全省新发恶性肿瘤26.22万例,发病率为336.60/10万,中标率为187.10/10万,世标率为182.38/10万,0～74岁累积发病率为21.19%。城市地区恶性肿瘤发病率为355.04/10万,中标率为199.55/10万;农村地区发病率为320.66/10万,中标率为176.10/10万。肺癌、胃癌、结直肠癌、食管癌、肝癌和女性乳腺癌是江苏省常见恶性肿瘤。2017年全省估计因恶性肿瘤死亡16.62万例,死亡率为213.34/10万,中标率为105.53/10万,世标率为104.13/10万,0～74岁累积死亡率为11.66%。城市地区死亡率为209.69/...     

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.     

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.     

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.     

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.     

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.     

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.