北京市东城区2007-2011年学生流行性腮腺炎防控工作分析

了解北京市东城区学校流行性腮腺炎防控体系运转情况,为进一步做好学校、托幼机构流行性腮腺炎的防控工作提供依据.方法 对2007-2011年北京市东城区麻疹、风疹、流行性腮腺炎(MMR)联合疫苗接种情况进行汇总,对学生流腮疫情进行描述性流行病学分析.结果 2007-2011年北京市东城区适龄儿童MMR联合疫苗报告接种率为99.99%~100.00%;学生流行性腮腺炎平均年发病率为67.11/10万,无多发、暴发疫情;有免疫史的病例占78.84%,临床表现较轻,无免疫史和免疫史不详的病例分别占2.88%,18.27%;流行性腮腺炎以春夏季发病较多.结论 北京市东城区在适龄儿童中构建起了牢固的免疫屏障,学校流腮防控体系运转良好.应重点关注突破病例及高中学生的查漏补种问题,加快全国预防接种信息化建设.     

中国2018-2019年风疹流行病学特征

目的分析中国2018-2019年风疹流行病学特征。方法利用全国麻疹/风疹监测信息报告管理系统收集中国2018-2019年风疹发病数据,描述性分析风疹发病特征。结果中国2018年、2019年分别报告风疹3930例(0.28/10万)、32539例(2.33/10万)。2018年10-19岁、20-29岁病例分别占45.12%、29.87%,2019年分别占68.98%、18.79%。2018年10-19岁、≥20岁病例中无或不详风疹免疫史分别占91.67%、98.49%,2019年分别占93.77%、98.41%。结论中国2018-2019年风疹发病水平持续上升,无风疹免疫史的10-29岁人群发病风险高;建议开展中学生风疹补充免疫工作。     

福建省风疹类疫苗纳入免疫规划后的影响

目的评价福建省风疹类疫苗纳入免疫规划后的影响,为探讨风疹控制策略提供依据。方法对2008-2011年福建省风疹类疫苗接种数与风疹发病资料进行分析。结果 4年来风疹类疫苗基础免疫接种率分别为48.2%、77.4%、62.6%和98.9%;加强免疫接种率分别为7.8%、35.7%、96.2%和99.4%。2008-2011年风疹发病8 947例,年均发病率为6.08/10万,发病高峰4～6月,占全年病例数的70.0%。男女性别比为1.40∶1,发病主要集中在10～19岁青少年（64.8%）,风疹暴发疫情均发生在中、小学。2009年风疹病例中,1～4岁构成比接种麻腮风疫苗地区低于接种麻腮疫苗地区,2011年2～4岁儿童风疹发病率接种麻腮风疫苗地区低于接种麻腮疫苗地区。结论风疹类疫苗纳入免疫规划是有效的,应进一步加强风疹类疫苗免疫,完善风疹监测系统。     

2005—2019年广州市风疹流行病学特征分析

目的 分析广州市2005—2019年风疹流行病学特征,为制定风疹防控策略提供依据。方法 对中国疾病监测信息报告管理系统报告的风疹病例进行流行病学特征分析。结果 2005—2019年,广州市共报告风疹病例4865例,年均发病率为2.61/10万。2005—2011年风疹发病率呈波折上升趋势,2011年发病率达到最高为6.50/10万,随后下降,2014年小幅反弹后,2015年大幅下降至0.69/10万,2019年再次出现一个升幅达3.44/10万; 4-5月为发病高峰;2005—2009年中心城区发病率高于非中心城区,2010年后中心城区发病率降至低于非中心城区;发病年龄组构成以15～29岁发病最多,约占全部病例的54.84%,其次为0～14岁儿童,约占27.36%,30岁以上人群病例占17.8%;0～14岁儿童男性多于女性,男女性别比为1.56[DK]∶1,15岁以上人群女性多于男性,15～29岁病例男女性别比为0.75[DK]∶1,30岁以上男女性别比为0.54[DK]∶1;病例以学生最多,占病例总数的28.12%。结论 2011—2019年风疹发病大体呈现下降趋势,但仍存在波动反复,15岁以上女性人群发病应受到重视。考虑制定切实可行的防控策略,减少先天性风疹综合征的发生。     

济南市1998-2006年风疹爆发疫情的流行病学特征分析

目的分析济南市1998-2006年风疹爆发疫情的流行病学特征,预测风疹流行趋势,判定高危人群,预防和控制风疹爆发和流行。方法根据济南市法定传染病报告系统和风疹监测系统资料,对1998-2006年风疹爆发疫情进行描述流行病学分析。结果济南市1998-2006年报告风疹爆发疫情74起、1212例,占全部风疹病例数的73．10％（1212／1658）。爆发疫情中本市人口病例占94．14％（1141／1212）;中学爆发疫情43起,占爆发总起数的58．11％;5-14、15-19、20-29岁病例分别占50．50％、45．21％、3．80％。爆发疫情病例中有风疹减毒活疫苗（Rubella Attenuated Live Vaccme,RubV）免疫史的仅占0．49％,无RubV免疫史和免疫史不详的分别占93．65％和5．86％。结论预防和控制风疹爆发的重点在5-19岁人群。高质量的RubV常规预防接种是减少风疹发病,控制风疹爆发的重要手段。     

2013年合肥市庐阳区麻疹疑似病例血清学分析

目的了解2013年合肥市庐阳区麻疹血清流行病学特征。方法采用酶联免疫吸附试验(ELISA),对330例麻疹疑似病例的血清标本,进行麻疹IgM和风疹IgM抗体检测。结果麻疹IgM抗体阳性率为28.18%,风疹为8.18%。麻疹IgM阳性病例中≥18岁组最多(占45.16%),风疹IgM阳性病例主要集中在≥12岁组(占96.30%)。麻疹发病时间主要集中在1-6月,风疹主要集中在1-5月。93例麻疹病例中,有明确免疫史占18.28%,无免疫史占46.24%,不详占35.48%。结论应加强麻疹疫苗的常规免疫工作,提高免疫接种质量,重视人群的免疫水平监测。     

福建省2006-2011年风疹流行病学特征分析

目的分析福建省风疹流行病学特征,为制定防控策略提供依据。方法对2006-2011年风疹发病资料进行流行病学分析。结果福建省2006-2011年共报告风疹发病10 355例,无死亡病例;发病率2009-2011年较2006-2008年上升了131.0%。除厦门和福州外,其它设区市发病具有年度间疫情波动幅度大的特征;宁德发病构成比持续在较高水平（年均18.6%）,厦门持续较低水平（年均3.8%）,其他设区市具有历史发病构成比水平越低,暴发/高发导致的升幅越大的特征;发病地域集中性明显,波及范围不断扩大;农村病例占80.9%,但城市病例呈逐渐增多趋势。发病高峰期3～6月（77.3%）;男女性别比为1.4∶1,发病集中在30岁以下人群（94.7%）,其中20～29岁育龄人群呈逐年增多趋势。聚集性疫情均报告自院校,与全省发病水平呈正相关。结论风疹防控工作应密切结合其流行病学特征,重点做好学校聚集性疫情的及时预测、预警和防控以及育龄妇女的健康防护。     

福建省实施风疹疫苗免疫规划前后风疹流行特征变化

目的分析福建省含风疹成分疫苗(Rubella containing vaccine, RCV)2008年纳入免疫规划前后不同时期的风疹流行特征。方法通过中国疾病监测信息报告管理系统和麻疹专病监测系统收集福建省风疹病例,比较2005-2007年、2008-2010年和2011-2016年风疹发病特征。结果 2005-2007年、2008-2010年和2011-2016年风疹年均报告发病率分别为3.59/10万、5.94/10万和1.82/10万;2005-2007年和2008-2010年出生儿童在3-6岁时的风疹发病率分别为7.77/10万和1.84/10万,1岁发病率从2011年出生儿童的20.35/10万降至2016年出生儿童的1.51/10万;2005-2007年、2008-2010年和2011-2016年风疹病例中10-14岁所占比例分别为41.25%、36.71%和17.94%,≥15岁所占比例分别为38.11%、45.05%和54.16%。结论福建省RCV纳入免疫规划后有效控制了目标人群的风疹流行,应做好儿童RCV基础免疫,针对青少年和育龄期女性开展疫苗补种。     

分析不同时期麻疹暴发疫情特点思考控制措施

目的 了解不同时期麻疹暴发疫情特点,制定有效可行的防制措施.方法 用描述性流行病学的方法分析比较1990-2000年和2001-2007年武隆县麻疹暴发和流行的特征及因素.结果 1990-2000年麻疹暴发病例≤1岁发病占10%、≤15岁发病占56.15%、≥20岁发病占25.38%,2001-2007年≤1岁发病占15.56%、≤15岁发病占82.22%、≥20岁发病占11.11%;1990-2000年暴发病例有免疫史与无免疫史发病差异有统计学意义,2001-2007年暴发病例有免疫史与元免疫史发病差异无统计学意义,高接种率地区出现麻疹疫情.结论 两个时期麻疹暴发病例的发病年龄段发生了变化,应根据不同时期麻疹暴发特点制定控制麻疹疫情,加强基础免疫和疫情报告的管理;加强疫苗储存、接种质量管理,提高业务人员素质;控制麻疹暴发疫情的最佳手段是及时开展应急接种.     

2007—2010年天津市和平区风疹流行病学分析

目的了解天津市和平区风疹发病概况,为有效预防控制风疹流行提供科学依据。方法利用中国疾病预防控制信息系统的数据分析天津市和平区2007—2010年风疹的流行病学特征。结果 2007—2010年全区共报告377例风疹,年平均发病率25.56/10万,无死亡病例。高发时间每年4—6月份,70%的病例集中在人口密度较大的南营门街、劝业场街和新兴街,60.21%的病例为在校学生,年龄集中在10～19岁的病例占全部病例的53.31%,全部病例中有免疫史的仅10%。结论对高发地区应加强疾病监测,对学龄儿童及青少年可考虑接种风疹疫苗,准备妊娠的妇女可考虑接种麻腮风疫苗,有利于减少风疹及先天性风疹综合征的发生。     

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.     

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.     

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.