德州市1990～1994年健康人群麻疹血清流行病学监测

山东省德州市 １９９０～ １９９４年间，对健康人群 １１３７人进行麻疹血凝抑制（ＨＩ）抗体水平的监测。结果表明，麻疹ＨＩ抗体平均阳性率９３．８４％，几何平均滴度（ＧＭＴ）１：２４．４６。通过加强计划免疫管理，麻疹ＨＩ抗体阳性率和ＧＭＴ有增高的趋势。但亟需免疫保护的８～２３月龄儿童麻疹ＨＩ抗体阳性率仪为８２．５０％，ＧＭＴ为１：１５：６３，均极明显地低于其它年龄组人群，应加强麻疹疫苗的基础免疫工作。     

4～7月龄婴儿接种沪_(191)麻疹疫苗临床反应和血清学效果观察

１９９５年在藁城市农村进行了４－７月龄婴儿接种沪１９１麻疹疫苗（ＭＶ）临床反应和血清学效果观察，以及对婴儿母亲麻疹抗体的监测。结果表明：婴儿的母亲麻疹抗体阳性率为８Ｉ．１５％，几何平均滴度倒数（ＧＭＲＴ）为３７３。４～７月龄婴儿胎传抗体阳性率仅为２．１７％，为６一７月龄婴儿接种０．２ｍｌ或０．５ｍｌＭＶ，免疫成功率均８０％，ＧＭＲＴ为２５２－３５６；４月龄婴儿接种０．２ｍｌ和０．５ｍｌＭＶ，免疫成功率分别为３３．３３％和２８．５７％，ＧＭＲＴ分别为１５９和１２２：５月龄婴儿接种０２ｍｌ和０．５ｍｌＭＶ免疫成功率分别为５０．００％和７１．４３％，ＧＭＲＴ分别为２００和２４４。婴儿自身免疫系统的发育完善似乎是决定能否免疫成功的主要因素。接种ＭＶ高热率（＞３８．６℃）为５．３８％，皮疹率为１０％。     

瑞安市育龄妇女与儿童麻疹抗体检测结果分析

目的　探索麻疹散发和低月龄组发病的原因及防制方法。方法　用ＨＩ检测育龄妇女和儿童麻疹抗体水平。结果　育龄妇女ＨＩ试验滴度≤１∶２ ,占５．８ ％ ,新生儿＜ １∶２ ,占４．３％ ,３ ～７ 岁儿童组ＨＩ阴性占６．０％ ;待产妇滴度几何均数ＧＭＴ＝３９．５３±２．８１;新生儿ＧＭＴ＝ ２０ ．１６ ±３．２８,３ ～７ 岁ＧＭＴ＝ ２４．２７ ±７ ．００。结论　育龄妇女和儿童中ＨＩ阴性是麻疹散发和低月龄组发病的原因。应把麻疹ＨＩ试验列为婚检、入托入幼入学体检常规项目,凡阴性者,及时予以接种麻苗,提高其免疫力。     

1991年应县麻疹疫苗白喉类毒素初免后抗体水平的血清学监测

１９９１年应县麻疹疫苗，白喉类毒素初免后的抗体，分别用麻疹血凝抑制试验检测１９０名儿童，麻疹ＨＩ抗体阳性率为８７．３７％，ＧＭＴ为１：１５．８。用白喉抗毒素间接血凝法检测１９２名儿童，白喉抗毒素抗体保护率为９６．８８％，ＧＭＴ为０．３１７９Ｉｕ／ｍｌ。８～１２月龄儿童初免麻疹疫苗后，５个月龄组间麻疹ＨＩ抗体滴度，差别显著性非常明显。     

4~7月龄婴儿麻疹胎传抗体及初次接种麻疹疫苗免疫应答的研究

笔者对１４３名４￣７月龄婴儿麻疹胎传抗体及其对麻疹疫苗的免疫应答情况进行了研究，结果表明：４￣７月龄婴儿麻疹胎传抗体的阴性率为７５．００％￣９４．８７％，且６￣７月龄婴儿较４￣５月龄婴儿的阴性率更低（χ＾２＝５．１１，Ｐ〈０．０５）；而４￣７月龄婴儿初免麻疹疫苗后，其免疫成功率为８４．３８％￣１００．００％，６￣７月龄婴儿的免疫成功率显著高于４￣５月龄的婴儿（χ＾２＝５．３７，Ｐ〈０．０５），ＧＭ     

伊盟地区健康人群麻疹及白喉抗体水平

１９９６年对伊盟地区进行了健康人群的麻疹及白喉抗体水平的调查。调查结果显示，伊盟地区人群中麻疹抗体阳性率达９８．５％，ＧＭＴ为１∶２６．７４，而２１岁以上人群ＧＭＴ较高达１∶３９．６８。白喉抗体阳性率为５０．９７％，ＧＭＴ为１∶４．２７（０．０１７ＩＵ）。０～５岁组抗体阳性率为８７％，ＧＭＴ为１∶１６．８４（０．０６６ＩＵ）明显高于其它组，而２１岁以上人群抗体水平最低，阳性率１７．２４％，ＧＭＴ１∶１．４８（０．００５８ＩＵ）。大年龄组麻疹抗体较高可能与前几年这个地区麻疹流行有关。而白喉抗体在大年龄组较低也与该地区自１９９２年以来未有白喉流行有关     

婴儿麻疹胎传抗体及初次接种麻疹疫苗免疫效果观察

为了解婴儿麻疹胎传抗体状况及探讨麻疹疫苗的初免月龄,１９９９年我们对广州市产妇和新生婴儿进行麻疹抗体水平检测并对６月龄和８月龄婴儿初次接种麻疹疫苗（ＭＶ）的免疫成功率进行血清学效果观察。结果表明,产妇和新生儿麻疹抗体阳性率均为９８．４％,ＧＭＲＴ分别为１５８８．３４和１３５４．７３;６月龄和８月龄婴儿免前抗体阳性率分别为１３．４％和１１．１％,ＧＭＲＴ为２．０７和１．８０;免后１个月抗体阳性率升至９３．９％和９８．９％,ＧＭＲＴ升至１２６０．４５和２３５８．０３,免疫成功率分别为８９％和９７．８％。２．０７和１．８０;免后１个月抗体阳性率升至９３．９％和９８．９％,ＧＭＲＴ升至１２６０．４５和２３５８．０３,免疫成功率分别为８９％和９７．８％。８月龄的血清免疫效果明显优于６月龄,提示目前应加强育龄妇女及婴儿麻疹     

麻疹,流行性腮腺炎,风疹活疫苗血清学效果监测

对广州市１１０名干８～９月龄完成麻疹基础免疫的１岁健康儿童,给予默沙东公司生产的麻疹、流行性肋泉炎和风疹活疫苗（Ｍ－Ｍ－ＲⅡ）接种,进行血清学效果监测。结果：麻疹ＥＬＩＳＡ－ＩｇＧ抗体在接种疫苗１个月后,阳性率由接种前的６４．５％上升到１００％,抗体几何平均滴度（ＧＭＴ）由１．４４．６上升至１：２１６５．１;流行性肋腺炎ＨＩ抗体免疫全部阴性,免后１个月阳笥率达８９％,ＣＭＴ由零上升至１：１４．６;     

两种剂型的脊髓灰质炎疫苗基础免疫的血清学效果观察

比较了脊髓灰质炎（脊灰）糖丸疫苗和液体疫苗基础免疫的血清学效果。观察对象为近５年无脊灰流行的农村．共１０２名２～６月龄未服过脊灰疫苗的婴儿，按月龄和性别均衡地分为糖丸疫苗组和液体疫苗组。两组都有部份婴儿有母传抗体，服苗前各型脊灰中和抗体的阳性率为１１．７６％～１９．１５％。几何平均滴度（ＧＭＴ）１：１．１８～１：２．４５。全程３次服苗后，抗体阳转率和４倍增长率均达到１００％，两组之间差异无显著的统计学意义；ＧＭＴ亦达到１：７８．７６～１：１１５．３６，两组之间也无显著性差异。这表明两种剂型的脊灰疫苗均有良好的免疫效果。液体疫苗因服用方便，更适合于０～８月龄婴儿。     

海南省12～24月龄儿童麻疹疫苗接种率及抗体水平调查

海南省１９９５年对１２～２４月龄儿童进行了麻疹疫苗（ＭＶ）接种率及抗体水平调查，入册率为９８．９％，建证率为６８．５％，接种率为９０．２％；抗体阳性率为８１．９８％，几何平均滴度（ＧＭＴ）为１：４３７。抗体检测结果表明，城乡间、不同民族地区间有非常显著性差异。个别乡镇接种率虽然达１００％，但抗体阳性率仅为５５．６％     

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.