福州市育龄妇女铁缺乏症流行病学调查

[目的]对530名育龄妇女(孕妇405人、未孕妇125人)的营养性贫血状况进行调查提出干预措施。[方法]分别从不同孕期及未孕育龄妇女中采血测定血红蛋白(Hb)、血锌原卟啉(ZPP)和血清铁蛋白(SF)水平．并进行有关影响因素问卷调查。[结果]530名育龄妇女中,贫血患病率为23．8%(其中孕妇25．9％,未孕妇16．80),孕妇贫血患病率明显高于未孕妇,孕妇的血红蛋白随孕周的增加而下降,孕妇的血锌原卟啉与未孕妇相比差异有显著性．不同孕期的血清铁蛋白随孕周的增加而逐渐减少。[结论]缺铁性贫血是妇女最常见的营养性疾患之一,必须采取综合性防治措施,积极预防。     

孕晚期妇女贫血对妊娠结局的影响及贫血因素分析

目的:了解孕妇的贫血患病现状及其影响因素,探讨贫血对妊娠结局的影响。方法:对5308名孕产妇的年龄、文化程度、居住地、血红蛋白(Hb)及妊娠结局进行回顾性调查分析。结果:孕晚期妇女的贫血患病率为59.5%。贫血组的新生儿平均体重明显降低(P<0.01)。贫血组与非贫血组的LBW发生率无明显差异,但中度贫血组LBW发生率明显高于非贫血组。贫血组手术性分娩率明显高于非贫血组。孕妇的贫血率为农村高于城市;不同文化程度组的贫血患病率明显不同。结论:我国孕晚期妇女有近60%患有贫血,与不良妊娠结局有关;居住地、教育水平对孕妇的贫血患病率有影响。     

石河子地区缺铁性贫血人群调查

[目的]掌握石河子市易患缺铁性贫血人群(孕妇及少儿)的患病率,并检测孕妇贫血对胎儿的影响。[方法]查阅及检测592例孕妇的血常规检验结果,检测部分胎儿脐血铁蛋白,血常规及部分孕妇铁蛋白;对412名新湖县三年级体检学生血红蛋白检验结果进行整理分析。[结果]妊娠期孕妇贫血总发生率为33.1%。贫血孕妇的铁储备低;三年级学生贫血总发生率维9.57%。[结论]孕妇缺铁性贫血患病率较高,铁缺乏严重易导致胎儿出生低体重,应加强巩固措施。     

妊娠期贫血的危害及干预措施

妊娠期贫血是指在妊娠期孕妇血红蛋白<100g/L或红细胞<3.5×1012/L或红细胞比容<0.30。妊娠期贫血属高危妊娠范畴,50%以上孕妇合并贫血[1]。我国妊娠后期贫血患病率为40%[2],是妊娠期常见的并发症。严重的贫血会对孕妇、胎儿造成诸多的不良影响。     

甘肃省定西地区孕妇妊娠晚期贫血与产科相关因素调查分析

目的:通过大规模调查探讨甘肃省定西地区妊娠晚期孕妇的贫血发生情况和危险因素,为妊娠期孕妇的贫血筛查和管理提供参考。方法:抽取2009年7月～2012年2月在定西地区10家医院妇产科门诊进行产前检查并首次行血常规检查的妊娠晚期孕妇1 200例,对其贫血情况、一般情况和膳食情况进行调查。结果:发现贫血患者150例,患病率为12.5%,其中大红细胞性贫血8例,正常细胞性贫血68例,小红细胞低色素性贫血32例,其他类型贫血42例。贫血孕妇的血红蛋白(Hb)值明显低于非贫血孕妇,血红细胞游离原卟啉(FEP)值明显高于非贫血孕妇(P<0.05)。年龄、受教育程度、规律性接受补铁、富维生素C蔬菜和水果摄入频率以及家庭人均月收入是影响贫血的主要危险因素(P<0.05)。结论:定西地区妊娠晚期孕妇贫血发病率比较高,与家庭情况、膳食情况关系紧密,应加强营养知识健康教育,合理调整膳食结构,改善饮食行为。     

妊娠合并贫血状况调查分析

[目的]掌握妊娠合并贫血发生状况,制订干预措施。[方法]对1030例孕妇贫血状况进行抽样调查分析。[结果]孕妇贫血患病率为13.5%,并且随孕周增大而增高,早孕期分别与中、晚期贫血患病率比较差异有统计学意义（P﹤0.05）。[结论]加强围产期保健,孕20周起常规补充铁剂,降低因贫血引起的围产期并发症。     

惠州市企业女工贫血状况及影响因素分析

[目的]了解惠州市企业女工缺铁性贫血状况及相关影响因素。[方法]以整群抽样方法抽取大型三资企业的育龄女工1239人检测血红蛋白,用问卷法调查个人信息并进行贫血影响因素的分析。[结果]惠州市大型三资企业女工贫血患病率12．4％,轻度占84．2％;贫血的影响因素与年龄、生育状况、家庭经济收入及人口数、家庭消费结构、是否有体育锻炼以及对贫血知识的了解程度和膳食质量密切相关。[结论]三资企业女工缺铁性贫血患病率仍较高,要加强对这类人群的贫血防治工作。     

我国不同城市妊娠晚期贫血的患病状况、相关因素及妊娠结局分析

目的调查我国3大城市妊娠晚期贫血危险因素及其对妊娠结局的影响。方法回顾性分析2013年6月至2015年5月在3个城市21家医院分娩,且有晚孕期(检测孕周≥28周)血红蛋白(hemoglobin,Hb)记录的39 454例单胎孕妇的病例资料,根据世界卫生组织推荐,将孕妇分为贫血组(Hb110 g/L)与非贫血组(Hb≥110 g/L)。对贫血的患病率、相关危险因素及妊娠结局进行回顾性分析。结果妊娠晚期贫血的总体患病率为16.4%(6 485/39 454),其中北京市、广州市和成都市的患病率分别为12.3%、32.7%及15.6%。贫血发生的危险因素包括年轻偏瘦女性、经产妇、农村户籍、受教育程度低及家庭收入偏低者。贫血组的早产(8.3%)、低出生体重儿(5.1%)及新生儿转儿科(9.8%)的发生率均高于非贫血组(4.9%、3.4%及6.1%),差异均有统计学意义(P0.05)。但贫血组妊娠期糖尿病(15.8%)和胎儿窘迫的发生率(9.5%)较非贫血组(19.8%、12.5%)低,差异均有统计学意义(P0.05)。剖宫产、妊娠期高血压疾病、子痫前期中度贫血组与非贫血组相比,疾病的发生率显著增加;而胎膜早破及巨大儿方面,两组差异无统计学意义(P0.05)。结论我国孕妇妊娠晚期贫血的高患病率与不良妊娠结局息息相关。     

妊娠晚期贫血对妊娠结局影响

目的 探讨孕妇妊娠晚期贫血与出生体重、出生身长等妊娠结局及脐血清铁的关系.方法 以2006年6月～2007年2月在某院参加孕期保健的526名孕妇为研究对象,采用历史前瞻性队列研究方法收集孕妇孕前、孕期保健和妊娠结局资料.结果 孕妇妊娠晚期贫血患病率为42.95%,其中轻度贫血患病率为22.25%,中度贫血患病率为19.60%,重度贫血患病率为1.10%.中/重度贫血组的新生儿出生身长、出生体重和孕龄均小于非贫血组.孕妇妊娠晚期血红蛋白含量与新生儿出生身长、出生体重和孕龄呈线性相关.孕妇妊娠晚期血红蛋白含量与脐血清铁含量无线性相关关系(r=-0.012,P>0.05).结论 孕妇妊娠晚期贫血对妊娠结局存在负面影响,脐血清铁水平可能与妊娠晚期孕妇贫血状态无关.     

中、晚期孕妇缺铁性贫血的调查分析

目的 了解广州城区中、晚期孕妇缺铁性贫血患病率及膳食影响因素.方法 测定699名孕妇的血红蛋白、平均红细胞体积、平均红细胞血红蛋白含量、血清铁及铁蛋白,进行24小时膳食调查,并对数据进行分析.结果 孕妇血红蛋白平均为115.8±11.2g/L.按血红蛋白<105g/L诊断标准,孕妇缺铁性贫血患病率为18.3%,中、晚期患病率分别为13.9%和28.6%,经比较有显著性差异(χ2=21.123,P<0.05).贫血孕妇膳食铁摄入不足,以植物性铁为主,肉类、蛋类、奶类等动物性食物和水果摄入量显著低于对照组(均P<0.05),促进铁吸收的营养素(蛋白质、维生素A、核黄素、维生素C、锌)显著低于对照组(均P<0.05).结论 广州城区中、晚期孕妇铁缺乏问题仍然突出,与膳食结构不合理、不良的饮食习惯密切相关;合理膳食指导是防治缺铁性贫血的有效措施.     

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.