河南省2011-2015年艾滋病哨点吸毒人群HCV感染状况及影响因素分析

目的 分析河南省艾滋病哨点吸毒人群HCV感染情况及影响因素,为制定防治策略提供依据。方法 2011-2015年,在哨点监测期(4-6月)内以重复横断面调查的方法对河南省吸毒人群进行问卷调查和血清学检测,分析该人群HCV感染情况及影响因素。结果 2011-2015年,河南省吸毒人群HCV感染率从2011年的3.70%上升到2015年的6.54%(趋势χ²=25.93,P<0.01)。多因素分析结果显示:年龄较高(OR=1.23,95%CI:1.13~1.35,P=0.00)、外省户籍(OR=3.45,95%CI:2.59~4.60,P=0.00)、传统毒品和混合毒品使用者(OR=1.46,95%CI:1.10~1.93,P=0.01;OR=1.82,95%CI:1.18~2.81,P=0.01)、有注射毒品史(OR=2.88, 95%CI:2.45~3.39,P=0.00)、最近一年有商业性行为史(OR=1.44,95%CI:1.20~1.72,P=0.00)、来自强制戒毒所和美沙酮门诊的吸毒人员(OR=1.79,95%CI:1.28~2.50,P=0.00;OR=1.74, 95%CI:1.17~2.58,P=0.01)是感染HCV的危险因素。结论 河南省吸毒人群HCV抗体阳性率较高,且呈上升趋势,应加强对吸毒人群的监管,制定有效干预措施,控制HCV的传播。     

胃癌和结直肠癌术后器官/腔隙感染的风险因素分析与预测模型的建立

目的 探讨胃癌和结直肠癌手术后手术部位感染中器官/腔隙感染发生率及危险因素, 旨在为患者构建一个简单、有效的风险预测模型。 方法 回顾性收集2018年1月—2022年10月某院进行根治性手术治疗的356例胃癌和305例结直肠癌患者的临床资料, 通过单变量及多变量logistic回归分析确定器官/腔隙SSI的独立风险因素, 并构建列线图模型。采用一致性指数(C-index)与校准曲线评价模型对胃肠癌术后器官/腔隙SSI的预测能力。 结果 胃癌与结直肠癌患者术后器官/腔隙SSI发生率分别为8.4%(30/356)、9.5%(29/305)。与非SSI患者相比, 器官/腔隙SSI患者住院日数明显延长(P < 0.001)。多因素分析结果显示, 男性(OR=5.203, 95%CI: 1.167~23.193)、术前ASA Ⅲ级(OR=5.078, 95%CI: 2.047~12.598)、联合脏器切除(OR=3.479, 95%CI: 1.261~9.546)及术中失血量(OR=3.629, 95%CI: 1.577~8.350)是胃癌术后器官/腔隙SSI的独立风险因素(均P＜0.05);ASA分级(OR=3.128, 95%CI: 1.334~7.337)、联合脏器切除(OR=3.442, 95%CI: 1.292~9.168)及手术时间(OR=3.091, 95%CI: 1.367~6.991)是结直肠癌器官/腔隙SSI独立风险因素(均P＜0.05)。基于以上风险因素分别构建预测胃癌、结直肠癌术后器官/腔隙SSI的列线图模型, C-index分别为0.808(95%CI: 0.722~0.894)、0.763(95%CI: 0.674~0.852)。校准曲线表明模型预测曲线与理想参考线之间具有良好一致性。 结论 列线图模型对胃癌和结直肠癌术后器官/腔隙SSI具有良好预测能力, 可为临床医生识别高风险SSI个体提供一种简单、有效的工具。     

浙江省孕妇巨大儿相关知识的流行病学调查

目的 了解浙江省孕妇对巨大儿相关知识的知晓率及影响因素,为有针对性地开展孕前、孕期保健指导提供科学依据。方法 采用多阶段整群随机抽样方法,用自行设计的调查问卷,对浙江省20个县(市、区)1 512名孕妇进行面对面调查,分析巨大儿知晓率及其影响因素。结果 共回收有效问卷1 494份,巨大儿诊断标准的知晓率为40.7%(95%CI:38.2%~43.2%);巨大儿发生原因知晓率为55.0%(95%CI:52.4%~57.6%)、预防知识知晓率为62.4%(95%CI:59.9%~64.9%),两者均知晓的比例为49.0%(95%CI:46.4%~51.6%)。多因素logistic回归分析显示,孕晚期(OR=1.906,95%CI:1.128~3.221)、城市户籍(OR=1.335,95%CI:1.014~1.756)、教育程度为大专(OR=2.474,95%CI:1.635~3.744)和本科及以上(OR=2.072,95%CI:1.338~3.209)、参加孕期保健知识培训(OR=1.936,95%CI:1.509~2.484)和自学孕期保健知识(OR=2.065,95%CI:1.338~3.189)能够提高孕妇对巨大儿诊断标准和预防知识的知晓率。高龄孕妇(OR=2.103,95%CI:1.330~3.323)对巨大儿发生原因和预防知识知晓率高于低年龄者。结论 浙江省孕妇对巨大儿诊断标准的知晓率不到50%,应加强对育龄妇女的孕前、孕期宣传教育和保健指导,特别是在农村地区多开展孕期保健知识培训。     

母亲MTHFR 677C/T多态性和孕期状况与子代发生先天性心脏病的相关性研究

目的 探讨母亲孕期MTHFR 677C/T多态性、孕期状况在子代先天性心脏病(CHD)发生中的相互关系。方法 采用病例对照研究,调查100对CHD胎儿和无CHD胎儿生物学母亲有关人口学、孕期环境相关情况、优生认知,并检测MTHFR 677C/T基因多态性以及血清同型半胱氨酸(HCY)、叶酸、VitB12水平,进行单因素和多因素非条件logistic回归分析。结果 病例组和对照组MTHFR 677C/T基因型和等位基因频率差异无统计学意义(χ²=1.08,P=0.582;χ²=0.53,P=0.468),血清HCY水平两组差异有统计学意义(t=-8.14,P=0.000)。单因素分析,14个因素有统计学意义(P<0.05);多因素logistic逐步回归分析,母亲教育程度(OR=3.386,95%CI:1.279~8.961)、家庭年收入(OR=8.699,95%CI:2.177~34.765)、患慢性病(OR=0.343,95%CI:0.134~0.881)、优生认知得分(OR=0.906,95%CI:0.836~0.981)、血清HCY水平(OR=1.734,95%CI:1.458~1.986)、异常生育史(OR=3.710,95%CI:1.217~11.308)等因素与子代CHD相关。结论 母亲MTHFR 677C/T多态性与子代CHD发生未发现关联;母亲教育程度低、家庭年收入低、异常生育史、优生认知得分低、血清HCY水平高可能增加子代CHD的发生危险。     

吉林省居民中心性肥胖及其前期流行特征的影响因素分析

目的 了解吉林省居民中心性肥胖及其前期的流行特征的影响因素,为制定相关预防与控制策略及措施提供参考依据。方法 本研究以2017-2018年吉林省心血管病高危人群早期筛查与综合干预项目为基础,纳入吉林省6个项目点35~75岁常住居民11 903人为研究对象,进行体格检查、实验室检测和问卷调查。采用χ²检验、趋势χ²检验、F检验计算不同特征人群和健康指标的中心性肥胖及其前期情况,其影响因素采用多因素logistic回归模型分析。结果 吉林省居民中心性肥胖率为33.35%（3 970/11 903）,标化率为31.73%,中心性肥胖前期率为28.79%（3 427/11 903）,标化率为28.86%。多因素分析结果显示,农村居民（OR=1.99,95%CI：1.78~2.23）、女性（OR=1.76,95%CI：1.57~1.97）、65~75岁组（OR=1.21,95%CI：1.03~1.45）、高中/中专文化程度（OR=1.38,95%CI：1.17~1.63）、家庭年收入>10万元（OR=1.65,95%CI：1.20~2.26）、超重（OR=9.27,95%CI：8.26~10.41）、肥胖（OR=82.82,95%CI：62.63~109.52）、正常高值血压（OR=1.49,95%CI：1.27~1.74）、高血压（OR=1.70,95%CI：1.42~2.04）、糖尿病（OR=2.30,95%CI：1.94~2.73）、血脂异常（OR=1.33,95%CI：1.18~1.50）与中心性肥胖及其前期发生风险呈正相关。结论 吉林省居民中心性肥胖及其前期率均处于较高水平,农村居民、女性、年龄大、高中/中专文化程度、高收入、超重、肥胖、正常高值血压、高血压、糖尿病、血脂异常是吉林省居民中心性肥胖及其前期的危险因素。     

天津市中老年社区居民性活跃现状及相关因素分析

目的 了解天津市中老年社区居民性活跃现状及其相关因素。方法 2020年6月至2022年12月，通过多阶段抽样方法，对天津市≥50岁中老年社区居民开展横断面调查。样本量估计数为735名。通过调查员面对面收集问卷，包括社会人口学特征、健康特征以及性生活方式有关特征等相关信息。采用多因素logistic回归模型分析性活跃状态的相关因素。结果 共纳入776名研究对象（男性和女性分别为510名和266名），年龄以50~59岁（45.9%）为主。总体性活跃率为45.6%。年龄更大（60~69岁：aOR=0.67，95%CI：0.45~0.99；≥70岁：aOR=0.12，95%CI：0.07~0.21）、男性（aOR=1.93，95%CI：1.32~2.82）、城镇居民（aOR=0.18，95%CI：0.12~0.28）、同居/已婚（aOR=2.80，95%CI：1.41~5.58）、独居（aOR=0.51，95%CI：0.27~0.96）、爬楼或行走困难（aOR=0.55，95%CI：0.31~0.97）、现患慢性病（1种：aOR=0.55，95%CI：0.36~0.85；≥2种：aOR=0.53，95%CI：0.33~0.84）与性活跃状态有关。结论 相当比例的中老年社区居民仍然保持性活跃。身体健康状况与中老年社区居民的性活跃状态存在关联。应将性健康服务纳入中老年社区居民卫生保健服务范围，加强社区卫生服务人员的性健康相关服务意识和技能。     

125例新生儿先天性甲状腺功能减低症围产因素分析

目的 探讨围产期相关因素与先天性甲状腺功能减低(甲减)症(CH)的关系。方法采用病例对照研究。选择2012年1月至2013年12月在福建省新生儿疾病筛查中心诊断为CH的新生儿125例为病例组,按1:3比例随机选择非CH的新生儿为对照组。采用单因素及二项分类logistic同归模型分析CH的围产期相关危险因素。结果 单因素分析显示,病例组中母亲妊娠期高血压、妊娠期糖尿病、妊娠合并甲状腺疾病、高龄产妇的发生率高于对照组,差异有统计学意义(均P<0.05);病例组新生儿在女性、早产儿、过期儿、低出生体重儿、巨大儿、双胎及多胎、伴发其他出生缺陷和感染的发生率均高于对照组,差异有统计学意义(均P<0.05)。多因素logistic回归分析显示,高龄产妇(OR=2.518,95%CI:1.186~5.347)、妊娠期糖尿病(OR=1.904,95%CI:1.190~3.045)、妊娠合并甲减(OR=12.883,95%CI:2.055~80.751)或甲亢(OR=30.797,95%CI:3.309~286.594)、早产儿(OR=4.238,95%CI:1.269~14.155)、过期儿(OR=12.799,95%CI:1.257~130.327)、低出生体重儿(OR=3.505,95%CI:1.059~11.601)、巨大儿(OR=3.733,95%CI:1.415~9.851)、双胎及多胎(OR=5.493,95%CI:1.701~17.735)、伴发其他出生缺陷(OR=3.665,95%CI:1.604~8.371)和胎儿窘迫(OR=3.130,95%CI:1.317~7.440)为新生儿CH的高危因素(均P<0.05)。结论 新生儿CH与母亲孕龄、妊娠期糖尿病、妊娠合并甲状腺疾病以及新生儿出生体重、胎龄、胎数、胎儿窘迫、伴发其他出生缺陷等有一定关系,应加强围孕期保健,减少高危因素,降低CH发病率。     

1991-2015年中国9省份18~64岁男性吸烟状况与肥胖风险的关系

目的 分析1991-2015年中国9省份18~64岁成年男性居民吸烟状况与肥胖患病风险的关系。方法 利用"中国健康与营养调查"1991-2015年9轮调查资料，选取参加两轮及以上、有完整人口统计学特征、吸烟状况和体格测量数据的18~64岁成年男性居民作为研究对象，共计32 169名。依据研究对象是否吸烟以及吸烟者每日吸烟数量将研究对象分为不吸烟、轻度吸烟（1~14支/d）、中度吸烟（15~24支/d）和重度吸烟（≥ 25支/d）组。观察不同吸烟程度下研究对象的BMI、腰围、全身性肥胖和中心性肥胖的分布情况，利用两水平混合效应线性回归模型和logistic回归模型分析男性吸烟状况与肥胖患病风险的关系。结果 不同吸烟程度下调查对象的BMI、腰围、全身性肥胖和中心性肥胖的患病率呈现逐年上升的趋势。在校正混杂因素后，轻、中和重度吸烟者BMI分别比不吸烟人群减少了0.19 kg/m²（95%CI：-0.27~-0.10）、0.40 kg/m²（95%CI：-0.49~-0.31）和0.36 kg/m²（95%CI：-0.53~-0.19）；腰围分别减少了0.49 cm （95%CI：-0.76~-0.21）、0.80 cm （95%CI：-1.08~-0.51）和0.79 cm （95%CI：-1.38~-0.36）。男性轻、中和重度吸烟者患全身性肥胖的风险分别是不吸烟者的0.70倍（OR=0.70，95%CI：0.62~0.79）、0.61倍（OR=0.61，95%CI：0.55~0.69）和0.78倍（OR=0.78，95%CI：0.65~0.96）；患中心性肥胖的风险分别是不吸烟者的0.78倍（OR=0.78，95%CI：0.73~0.84）、0.74倍（OR=0.74，95%CI：0.70~0.79）和0.84倍（OR=0.84，95%CI：0.76~0.95）。结论 1991-2015年间，男性不吸烟与吸烟（轻、中和重度）居民的BMI、腰围和肥胖患病率均呈现显著上升趋势。成年男性居民吸烟与肥胖患病风险呈显著性负向关联。     

江苏省部分地区人群丙型肝炎病毒感染状况及危险因素研究

目的 调查江苏省一般人群HCV抗体的阳性率分布,分析感染HCV的危险因素。方法 在江苏省3个地区的传染病防制示范区以乡镇和行政村为单位随机整群抽样,进行问卷调查和血清HCV抗体检测,利用SPSS软件分析抗体阳性率在不同人群中的分布差异,Cox模型拟合1:4配对的logistic回归分析HCV感染危险因素。结果 HCV感染情况在不同人群分布有差异,女性感染率(0.965%,95%CI:0.899%~1.035%)高于男性(0.572%,95%CI:0.517%~0.632%);3个县人群感染率(分别为0.131%,95%CI:0.103%~0.164%;0.316%,95%CI:0.268%~0.370%;2.173%,95%CI:2.039%~2.315%)的差异有统计学意义;50~59岁年龄组感染率最高(1.577%,95%CI:1.425%~1.740%),<30岁年龄组最低(0.161%,95%CI:0.125%~0.204%); 受教育程度越低感染率越高,其中流动人口感染率高。危险因素分析显示,感染率最低的地区多因素分析显示住院史(OR=3.049,95%CI:1.322~7.036)、输血史(OR=14.319,95%CI:2.318~88.459)和共用剃刀(OR=3.604,95%CI:1.096~11.851)是HCV感染的独有危险因素;感染率较低的地区分析显示仅血制品使用史(OR=7.202,95%CI:1.170~44.310)是独有危险因素;感染率最高的地区显示献血史(OR=7.496,95%CI:6.121~9.180)、输血史(OR=2.305,95%CI:1.578~3.369)和侵入性检查史(OR=1.258,95%CI:1.021~1.549)为独立危险因素。不同年龄组单因素分析显示,30~39岁组与他人共用剃刀是独有危险因素,50~59岁组有针灸史是该年龄组危险因素,50~59岁和60~69岁组有侵入性检查是危险因素。结论 HCV感染在中老年人、教育程度低、流动性强的人群中感染率高,不安全献(输)血、血制品使用可能是既往几十年中HCV感染的主要危险因素;针灸、侵入性检查以及共用剃刀等在不同人群中的危险度有差异。     

2015年我国35岁及以上高血压患者社区健康管理与高血压治疗控制情况分析

目的 了解2015年我国≥ 35岁高血压患者的社区健康管理及高血压治疗控制情况并探索其影响因素。方法 利用2015年中国成人慢性病与营养监测项目收集的问卷调查及体格测量等信息,以乡镇卫生院（社区卫生服务中心）或以上级别医疗卫生机构医生诊断为高血压的≥ 35岁的患者为研究对象,对样本进行复杂加权后,分析其一般特征、高血压社区健康管理情况及高血压治疗控制情况。结果 共纳入高血压患者23 974名,经复杂加权后,我国≥ 35岁高血压患者的社区健康管理率为54.10%（95%CI：51.02%~57.17%）,社区规范管理率为45.72%（95%CI：42.93%~48.51%）;高血压治疗率为88.16%（95%CI：87.00%~89.31%）,控制率为22.67%（95%CI：21.25%~24.09%）,治疗控制率为27.76%（95%CI：26.09%~29.42%）。多因素分析结果显示,城市和农村年龄≥ 65岁（OR=1.40,95%CI：1.05~1.87;OR=3.11,95%CI：2.22~4.36）、按医嘱服药（OR=2.15,95%CI：1.46~3.15;OR=1.35,95%CI：1.13~1.62）、进行血压监测（OR=2.34,95%CI：1.88~2.90;OR=3.10,95%CI：2.72~3.53）的高血压患者更愿意接受高血压社区健康管理;文化程度大专及以上（OR=0.51,95%CI：0.39~0.66）、适量饮酒（OR=0.69,95%CI：0.57~0.84）或过量饮酒（OR=0.73,95%CI：0.58~0.92）的城市高血压患者接受社区高血压管理的情况不佳。城市和农村超重（OR=0.74,95%CI：0.61~0.91;OR=0.83,95%CI：0.71~0.98）、肥胖（OR=0.54,95%CI：0.45~0.65;OR=0.67,95%CI：0.54~0.83）的高血压患者血压控制情况较差,按医嘱服药（OR=4.58,95%CI：3.16~6.63;OR=2.84,95%CI：2.18~3.69）的高血压患者的血压控制状况较好。地处中部（OR=0.74,95%CI：0.61~0.89）、过量饮酒（OR=0.72,95%CI：0.54~0.97）的城市高血压患者血压控制情况较差,合并其他慢性疾病（OR=1.22,95%CI：1.04~1.44）、参加高血压社区规范管理（OR=1.29,95%CI：1.06~1.58）的城市高血压患者血压控制情况较好;地处中、西部地区（OR=0.71,95%CI：0.58~0.87;OR=0.62,95%CI：0.47~0.80）、适量饮酒（OR=0.81,95%CI：0.67~0.98）、人均每日食盐摄入量>6 g （OR=0.80,95%CI：0.69~0.93）的农村高血压患者血压控制情况较差,进行血压监测（OR=1.38,95%CI：1.18~1.61）的农村高血压患者血压控制情况较好。结论 我国≥ 35岁高血压患者社区健康管理情况较之前有所改善,但是高血压控制情况距离相关政策指标还有一定差距。     

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.