山东莒南HFRSⅡ型灭活疫苗效果观察

报告了ＨＦＲＳ地鼠肾细胞Ⅱ型灭活疫苗,自１９９４年以来,在莒南县高发疫区５个乡镇１７个村,对１６～６０岁的１１５１０人,全程免疫后４年的观察结果。疫苗初免３针后１４天、１年,血清中和抗体阳性率分别为６８９７％、１８５２％。加强１针后１４天达到１００％,加强后１年、２年、３年,中和抗体阳性率分别为６０００％、５３３３％、５０００％。几何平均滴度依次为８４、３２、１７０５、５７５、５３９、３６９。荧光抗体阳性率依次分别为９２００％、６２０７％、１００００％、５６００％、３２００％、２５００％。基础免疫后４年内,接种组发病１人,发病率为２１７／１０万;对照组发病６１人,发病率为１２８９１／１０万。疫苗保护率４年年均为９８３２％,安全性较好。疫苗接种者在流行高峰期后,荧光抗体滴度增高６人,均无临床表现。结论：ＨＦＲＳⅡ型灭活疫苗接种４年内,预防效果良好;接种人群未出现免疫增强反应病例。     

肾综合征出血热Ⅰ型灭活疫苗血清学免疫效果研究

采用０、７、２８天３针免疫程序接种ＨＦＲＳⅠ型灭活疫苗，１年后加强１针，采用间接免疫荧光法（ＩＦＡＴ）和微量细胞病变中和试验（ＭＣＰＫＮＴ）法分别检测血清荧光和中和抗体。本次研究共全程接种１０１７８人，对照１６１５９人。全程接种后两周荧光抗体阳性率为９８．５５％（６８／６９），中和抗体阳性率为４４．８３％，几何平均滴度分别为６９．３６和４．４４，经两个流行期的观察，接种组无发病，对照组发病１５例，人群保护率达１００％。接种疫苗１年后血清荧光抗体阳性率为２７．８７％，中和抗体阳性率为１６．６７％，几何平均滴度分别下降到１９．２０和２．８１，加强针两周后血清荧光抗体阳性率上升到８４．２１％，中和抗体阳性率上升到５６．６７％，几何平均滴度分别上升到１９．５７和５．００。     

脊髓灰质炎Ⅲ型液体活疫苗人体接种反应和免疫效果观察

对卫生部北京生物制品研究所制备的脊髓灰质炎Ⅲ型液体疫苗（４５７－ⅢＰＦＩＺＥＲ－ＳｏＲｔ１），进行了人体接种反应和免疫效果观察。用加样枪口腔深部滴入疫苗后第６、８、１０、１２、１４天，有３０３％、６０６％、３０３％、１２１２％、９１０％接种儿出现全身弱反应，未见到中、强反应。未有发生皮疹、腹痛和腹泻者。免疫一个月后用中和试验查中和抗体，９６５５％（２８／２９）婴儿中和抗体升至１：１２８～１：１０２４，ＧＭＲＴ为４１２９０±３４７。结果表明，一次该疫苗免疫后Ⅲ型中和抗体的阳转率，和国内常规三价脊灰活疫苗３次免疫的一致。     

浓缩狂犬病疫苗接种反应及血清学效果观察

本文报告了１５６例接种地鼠肾组织培养浓缩狂犬病疫苗的临床反应和血清学效果。全身弱反应（体温３７１～３７５℃）０６％，中反应（３７６～３８５℃）１９％，无强反应（≥３８６℃）；局部弱反应（红肿＜２５ｃｍ）１３％，中反应（２６～５０ｃｍ）５８％，强反应（≥５１ｃｍ）４５％。经用ＥＬＩＳＡ法检测，注射５针浓缩狂犬病疫苗后两周，抗体阳转率为９４９％。抗体未阳转者增加３针免疫，即全部阳转。     

陕西省肾综合征出血热疫苗免疫效果及免疫策略研究

本研究报告了肾综合征出血热（Ⅰ型）鼠脑纯化灭活疫苗及沙鼠肾组织培养灭活疫苗在陕西省高发病乡、高发人群的免疫效果。鼠脑疫苗全程接种后２周，血清中和抗体阳转率７８．５７％，几何平均滴度９．３８，接种组发病１例，发病率８．１７／１０万；对照组发病２４例，发病率１６７．９７／１０万，保护率９５．１３％，效果指数２０．５６。沙鼠肾疫苗接种后血清中和抗体阳转率７３．０８％，几何平均滴度１３．３９，接种组发病１例，发病率为６．０２／１０万；对照组发病６６例，发病率３４０．７３／１０万，保护率９８．２３％，效果指数５６．６０。两种疫苗接种反应轻微或无反应，无异常反应，表明疫苗安全性好，近期免疫防病效果好。     

肾综合征出血热地鼠肾细胞Ⅱ型灭活疫苗现场考核及效果评价

为考核肾综合征出血热地鼠肾细胞Ⅱ型灭活疫苗的安全性、免疫性及防病效果，对接种组７４９９人、对照组７２６１人进行系统观察。疫苗接种反应率在１２１％～８９２％之间，以弱反应为主。疫苗接种者在接种后２周，荧光抗体阳转３８５８％，中和抗体阳转率为６３３３％，疫苗接种一年后荧光抗体全部阴转，加强一年后抗体又有６７８６％阳转。经过两次流行高峰期前后，对疫苗接种人群血中荧光抗体进行检测，流行高峰期后（５３６％～１５２６％）高于流行高峰期前（４４６％～５０８％），且有阴性再次阳转的情况，证明有良好的特异性回忆反应。疫苗接种后４周年，对照组发病３例，接种组无一例发生，疫苗保护率为１００％。     

肾综合征出血热双价灭活疫苗免疫原性和安全性观察

目的　在肾综合征出血热双价灭活疫苗随机对照试验现场,观察接种人群的免疫效果和副反应发生情况。方法　分别检测１６７ 名和６９ 名基础三针接种者免疫后２ 周血清荧光抗体和中和抗体（Ⅰ和Ⅱ型） ,重点观察６５７ 名接种者免疫后７２ 小时内副反应发生情况。结果　荧光抗体阳转率和几何平均滴度分别为９９．０４％ （１６６／１６７）和２４．５１±２．０６;中和抗体总阳转率为１００ ％ ,其中Ⅰ型为９１．３０％ （６３／６９）、Ⅱ型为８８．４１％（６１／６９） ;中和抗体对Ⅰ型和Ⅱ型几何平均滴度分别为１８．２７±２．２１ 和１２．４７±２．１６ ;接种３ 针疫苗局部反应发生率为１．４８％ ,全身体温反应发生率为０ ．３６ ％ ;未见人群接种后发生严重副反应和异常反应。结论　肾综合征出血热双价灭活疫苗免疫效果良好,接种副反应低。     

杭州市3所小学风疹暴发和应急接种效果调查

对１９９６年杭州市３所小学的风疹暴发，和应急接种冻干风疹减毒活疫苗的效果进行了调查。结果显示：病儿风疹ＩｇＭ抗体检出率与采血时间密切相关，以出疹后５～２８天检出率最高（９７７３％）；风疹血凝抑制（ＨＩ）抗体临界滴度，显性感染为１∶１６，隐性感染为１∶２５６；抗体阴性的未接种疫苗者，经过风疹暴发，显性和隐性感染率分别辊为１３７９％、４４８３％，显性与隐性感染之比为１∶３６２５；暴发前抗体阳性率４０％，暴发后升至８８２４％，提示人群风疹抗体阳性率＞９０％可阻断风疹传播。抗体阴性者接种风疹疫苗后抗体全阳转，几何平均滴度倒数（ＧＭＲＴ）为２１８６９。风疹罹患率接种组和未种组分别为５８３％、２７６１％，疫苗保护率为７８８８％。     

湖南省肾综合征出血热Ⅰ型灭活疫苗效果免疫(感染)增强和免疫策略研究

采用ＩＦＡＴ法检测特异ＩｇＧ荧光抗体,用ＭＣＰＥＮＴ法检测中和抗体滴度,追踪流行病学防病效果。结果表明,该疫苗的安全性较好,总反应率为３１９％,中强反应１８２％,反应以局部一过性疼痛多见,无异常反应。疫苗３针全程免疫后２周、加强前、加强后２周、１年和２年,３年中和抗体阳转率分别为３１４０％、９３３％、８７５０％、５３８５％、３８１０％和３５００％。荧光抗体阳转率分别为８４９１％、２２５０％、８５００％、１５７９％、１０２０％和９０５％。疫苗的流行病学防病效果好,３针全程免疫后（１９９５４）至今（１９９９．３）接种者无人发病,对照组发病８例,保护率为１００００％,观察到试区疫情较四周非试区低,疫苗复盖率达５０％以上,似可有效控制疫情。发现有１例接种者在经过一个流行高峰期后荧光抗体较前呈４周以上增高,但无临床表现。未发现接种人群中有免疫（感染）增强问题。     

脊髓灰质炎三价糖丸疫苗免疫持久性——9年随访观察

观察了６９名儿童口服脊髓灰质炎三价糖丸疫苗（ＯＰＶ）的免疫持久性。基础免疫后４年（再免疫前）Ⅰ、Ⅱ、Ⅲ型中和抗体阳性率分别为９１０７％、９４６４％和９４６４％，几何平均滴度倒数（ＧＭＲＴ）分别为１１７９８、１４３９９和７９９３。４周岁再免疫后１个月Ⅰ、Ⅱ、Ⅲ型抗体ＧＭＲＴ分别升至９０４７８、９７４５４和４８７２７。基础免疫后１个月至基础免疫后６年，３个型≥１：１６的抗体保护滴度在９４６４％～１００％。基础免疫后第７、９年３个型≥１：１６的抗体平均保护滴度分别占９２８６％和７０２４％。     

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.     

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.