2008-2011年平顶山市湛河区手足口病疫情分析

目的 分析探讨平顶山市湛河区手足口病疫情的流行因素、流行病学规律及疫情变化趋势,为制定预防控制策略提供科学依据.方法 对湛河区2008-2011年手足口病疫情资料进行描述流行病学分析.结果 2008-2011年湛河区共报告手足口病例1 956例,年均发病率为192.21/10万,重症率为8.08％,无死亡病例.2008-2010年发病呈逐年递增态势,2011年发病率有所下降.病例分布广泛,农村及城中村发病率为243.88/10万,城区发病率为143.99/10万,二者差异有统计学意义(P＜0.01).3-5月份病例占病例总数的67.54％,5岁以下病例占病例总数的92.84％.男女比例为1.67:1,散居儿童病例占病例总数的67.28％.实验室检测阳性标本中EV71占41.67％.结论 2010年是湛河区2008-2011年之间手足口病发病高峰年份.2008-2011年全区手足口病分布广泛,农村及城中村发病率明显高于城区发病率,3-5月份是发病高峰,病例以5岁以下散居儿童为主,男性高于女性.肠道病毒EV71感染性强,易引起重症.加强手足口病的监测报告和健康教育工作,采取以切断传播途径为主的综合性措施是预防控制的关键.     

务川仡佬族苗族自治县2009—2014年手足口病流行病学特征

目的了解务川仡佬族苗族自治县（以下简称务川自治县）手足口病（HFMD）发病情况,为制定HFMD疫情防控措施提供科学依据。方法采用描述流行病学方法,对2009-2014年务川自治县报告的HFMD进行分析。结果2009-2014年务川自治县共报告手足口病例912例,年均报告发病率为33.74/10万,年报告发病率为5.83/10万～87.88/10万,发病数逐年增多,2014年发病率达最高;以都濡镇发病率最高,为88.75/10万,其次是柏村镇（59.19/10万）、镇南镇（46.30/10万）。病例主要集中在4～6月,男性发病高于女性,以3岁以下散居儿童发病最高,病原以EV71病毒为主,占监测总数的45.05%。结论务川自治县HFMD发病数逐年增多,病例主要发生在夏季,散居儿童是HFMD的高发人群。     

2010-2014年南宁市手足口病流行病学特征

目的 分析近年南宁市手足口病(HFMD)分布特点和流行趋势,为制定HFMD防制对策提供依据.方法 从《国家疾病监测信息报告管理系统》和《突发公共卫生事件报告管理信息系统》分别收集2010-2014年7月南宁市报告的HFMD病例资料和暴发及聚集性疫情的现场调查资料,用描述流行病学方法进行分析.结果 2010-2014年7月南宁市共报告HFMD 230 874例,重症2 042例,死亡76例.为5岁及以下儿童发病221 617例,发病率为8 280/10万,占发病总数的95.99％.全年各月份均有病例出现,发病高峰在4-7月,其病例数占总病例数的62.38％,职业以散居和幼托儿童为主,分别占总病例数的70.97％和26.32％.实验室诊断3 144例,其中肠道病毒71(EV71)型占44.27％,柯萨奇病毒A16(Cox A16)型占24.49％;HFMD死亡儿童感染的病毒主要为EV71型,占死亡总数的82.89％.近5年来,南宁市发生5例以上的聚集性HFMD疫情50起,其中49起发生在托幼机构.结论 南宁市HFMD发病呈逐年上升趋势,隔年出现以EV71型为主的流行,重症和死亡病例也增多,对此应加强研究5岁以下儿童的防治.     

2006-2010年双塔区流行性腮腺炎流行特征分析

目的 分析双塔区2006-2010年流行性腮腺炎的流行特征.方法 对2006-2010年双塔区流行性腮腺炎疫情资料进行描述性流行病学分析.结果 双塔区2006-2010年共报告流行性腮腺炎665例,无死亡病例,年平均发病率34.43/10万;常年均有发病,呈现5～7月、11月至翌年1月2个发病高峰,占发病总数的70.97％;5～14岁组病例占发病总数的81.80％;学生、幼托儿童、散居儿童占发病总数的98.32％.结论 要加强学校托幼机构流行性腮腺炎的防控工作,倡导适龄儿童接种疫苗.     

1951~2010年贵州省流行性脑脊髓膜炎流行趋势分析

目的 为了解贵州省流脑流行趋势,为预防控制流脑制定策略和措施提供科学依据.方法 收集1951年以来贵州省流脑的发病资料,并利用描述流行病学方法进行分析.结果 1951~2010 年贵州省流脑发病率在0.047~220.41/10 万,死亡率0.013 ~25.98/10 万,有6 个流行高峰.近年来贵州省流脑发病率和死亡率呈明显下降趋势,2010年全省流脑发病率和死亡率较2005 年分别下降91.8%和71.7%.2006~2010 年,全省流脑发病和死亡排前3 位的地区是安顺、铜仁和遵义,其中安顺病例占发病总数的34.9%;1~3 月发病268 例,占发病总数的73.0%;发病主要为小于15岁儿童,占发病总数的79.5%;病例以学生和散居儿童为主,分别占发病总数的57.8%和28.1%,2010 年散居儿童构成较2009 年上升35.1%.2006~2008 年幼托儿童发病构成分别为3.7%、1.4%、7.0%,2009、2010 年幼托儿童无流脑发病.自2007 年贵州省检测出首例C 群Nm 阳性病例,2007~2010 年共检出4 例C 群Nm 阳性病例.结论 近年来贵州省流脑发病率和死亡率呈持续下降趋势,预防控制效果显著.但病例以15 岁以下学生和散居儿童为主,C 群流脑病例呈增多趋势,散居儿童依然是贵州省常规免疫的薄弱环节.     

2010—2013年邢台市手足口病流行病学特征分析

目的 了解邢台市手足口病(HFMD)的流行特点,掌握其流行趋势,为制定HFMD控制策略提供依据。方法 采用流行病学方法对2010—2013年邢台市HFMD数据资料进行统计分析。结果 2010—2013年HFMD发病率分别为122.63/10万,55.96/10万,77.68/10万,37.57/10万,发病率年度间差异有统计学意义(χ2=54.78,P<0.05)。0~4岁儿童发病率占报告总病例数的93.70%,托幼和散居儿童分别占发病总数的8.17%和89.82%。从病毒构成看,HFMD高发年(2010年、2012年)病毒分型以肠道病毒EV71为主,发病较低的年份以其他肠道病毒或Cox A16为主。结论 HFMD呈现季节流行的特点,具有“隔年”流行的周期性规律,易感人群以4岁以下托幼儿童和散居儿童为主。因此,建立对托幼儿童的晨(午)检、因病缺勤登记及原因追踪等制度是必要的。     

祁阳县2009-2012年手足口病流行病学特征分析

目的 了解祁阳县手足口病的流行病学特征,探讨有效控制策略. 方法 对祁阳县2009-2012年网报的手足口病病例进行描述性流行病学分析. 结果 祁阳县2009-2012年网报手足口病病例3 439例,死亡2例,年均发病率为82.80/10万;病例集中分布在5-6月份,占病例总数的44.87％;发病高危人群5岁以下儿童,占发病总数的93.84％;以散居儿童为主,占发病总数的90.81％;男性发病高于女性,乡村地区发病高于城镇地区;病原学监测以EV71为主,占总数的51.01％,2例死亡病例均为EV71感染. 结论 祁阳县2009-2012年手足口病有明显的地区、季节、人群差异,在流行季节针对乡村地区5岁以下儿童采取重点防控措施,加强托幼机构、学校等儿童聚集性场所的预防和控制工作,防止疫情的大规模暴发.     

2009-2013年中宁县手足口病流行病学分析

目的分析中宁县2009-2013年手足口病发病情况和流行特征,为制定防控策略提供依据。方法运用描述流行病学方法分析中宁县手足口病发病的三间分布特征。结果中宁县2009-2013年累计报告手足口病823例,年平均发病率为50.54/10万,2010年发病率为76.18/10万,2009年为36.67/10万。4-7月发病病例占全部例数的52.16%;≤5岁散居儿童和托幼儿童占全部病例的95.01%;男性平均发病率为64.45/10万,女性平均发病率为36.27/10万;病原学检测2010年和2012年均以肠道病毒COx16为主,2011年以EV71为主,2013年以其他肠道病毒为主。结论中宁县手足口病发病高峰为4-7月,≤5岁散居儿童和托幼儿童是手足口病的主要发病人群,男性多于女性,病原监测各年不同。     

安徽省2010年手足口病流行状况分析

目的 通过分析安徽省2010年手足口病( hand-foot-mouth disease,HFMD)发病流行情况,为制定有效的预防控制策略提供依据.方法 采用描述性流行病学方法对2010年“中国疾病监测信息报告管理系统”报告的HFMD疫情资料和2010年安徽省开展的HFMD病原学监测结果进行核实和分析.结果 安徽省2010年共报告HFMD 85155例,发病率为138.89/10万,重症病例615例,死亡病例22例,发病集中在4～6月,男性多于女性,以1～5岁散居儿童为主.病原学监测结果显示,肠道病毒71型(enterovirus 71,EV71)占阳性标本的52.9％,柯萨奇病毒A组16型(coxsackievirus A16,CoxA16)占阳性标本的31.1％.结论 安徽省2010年HFMD发病有明显的年龄、性别、地区和季节性差异,EV71是近年来引起儿童HFMD的主要病原体,但较2009年EV71的比例有所下降,CoxA16的比例有所上升.     

1951～2010年贵州省流行性脑脊髓膜炎流行趋势分析

目的为了解贵州省流脑流行趋势,为预防控制流脑制定策略和措施提供科学依据。方法收集1951年以来贵州省流脑的发病资料,并利用描述流行病学方法进行分析。结果 1951~2010年贵州省流脑发病率在0.047~220.41/10万,死亡率0.013~25.98/10万,有6个流行高峰。近年来贵州省流脑发病率和死亡率呈明显下降趋势,2010年全省流脑发病率和死亡率较2005年分别下降91.8%和71.7%。2006~2010年,全省流脑发病和死亡排前3位的地区是安顺、铜仁和遵义,其中安顺病例占发病总数的34.9%;1~3月发病268例,占发病总数的73.0%;发病主要为小于15岁儿童,占发病总数的79.5%;病例以学生和散居儿童为主,分别占发病总数的57.8%和28.1%,2010年散居儿童构成较2009年上升35.1%。2006~2008年幼托儿童发病构成分别为3.7%、1.4%、7.0%,2009、2010年幼托儿童无流脑发病。自2007年贵州省检测出首例C群Nm阳性病例,2007~2010年共检出4例C群Nm阳性病例。结论近年来贵州省流脑发病率和死亡率呈持续下降趋势,预防控制效果显著。但病例以15岁以下学生和散居儿童为主,C群流脑病例呈增多趋势,散居儿童依然是贵州省常规免疫的薄弱环节。     

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.