部队徒步行军卫生保障中的几个问题

部队徒步行军是部队移动不可缺少的方式,做好徒步行军卫生保障工作对保障指战员身体健康,提高部队战斗力具有重要意义。为了探讨与总结徒步行军卫生保障经验,重点叙述了部队徒步行军卫生保障中如下几个常见问题：（１）行军疲军及其预防;（２）行军中暑及其预防;（３）行军脚外伤及其预防;（４）行军中的饮食水卫生保障。所述问题,仅供参考。     

驻疆某部秋冬季新兵训练期间伤病就诊情况分析

目的了解秋季入伍新兵训练期间伤病发生特点与规律,为制订针对性防控措施提供依据。方法选取驻疆某部2012年冬季兵、2013年秋季兵各680名进行新训期间伤病的调查与分析。结果 2013年秋季新兵训练伤发病率(13.5%)与2012年冬季新兵训练伤发病率(14.4%)未见显著差别(P0.05),但训练伤类型结构与高发时间有所变化。2013年秋季新兵新训期间疾病总就诊人次率(89.7%)较2012年冬季新兵总就诊人次率(127.4%)有明显下降(P0.01),尤其是上呼吸道感染的就诊人次明显减少,但依然是秋季新兵的高发病种;耳鼻喉疾病、皮疹和足癣的就诊人次较冬季新兵明显增加;胃肠炎就诊人次在2组新兵中变化不大。结论针对秋季新兵高发伤病类型开展防护教育,加强对高发伤病防治药物及技术贮备,并注重预防秋季食物中毒的发生等。     

某军校学员徒步行军演习脚外伤调查分析

某军校学员徒步行军演习脚外伤调查分析李永泉（解放军坦克学院门诊部，蚌埠，２３３０１３）某军校学员１９９３年４月１～７日演习中进行了４０ｋｍ徒步行军、３０ｋｍ定向越野和７０ｋｍ轻装奔袭等课目。为此我们对参加演习人员进行了脚外伤调查，报告如下。１一般情况...     

夏季野外综合演练中常见疾病的防治

为了总结野外训练常见疾病,做好防病、治病工作,现将我校4年来夏季野外综合演练期间伤病情况总结如下。1详细资料2009年至2012年参加人员共7142人次,毕业学员:6528人次,男学员:6397人次,女学员:131人次,教员、随队保障人员:614人次。     

地空导弹兵夏季戈壁演习卫生防疫措施与体会

目的总结地空导弹兵某部新疆戈壁夏季演习卫生防疫措施,为确保季节性戈壁演习部队官兵健康,改善生活质量,防止非战斗减员提供借鉴。方法对演习的卫生防疫工作进行总结分析。结果总结出开展卫生防疫工作的4项措施:(1)动态流行病学侦察;(2)合理布局宿营区,有效利用保障车辆和防晒网;(3)保证饮水、饮食供应,做好日常防疫;(4)加强卫生监督,努力减少伤病发生率。通过采取上述措施,演习期间取得了无重度中暑、无食物中毒、无因伤病减员的"三无"目标,确保了演习官兵的身体健康。结论总结出的措施为确保地空导弹兵夏季戈壁演习期间身体健康起到积极作用,可供相关部队借鉴。     

部队战役机动卫生防疫保障对策研究

未来高技术条件下局部战争中，部分实施战役机动时行动突然，方式多样，且远距离甚至跨区机动，极易遭敌火力特别是高技术武器的袭击，由于卫生防疫保障准备时间短，内容复杂，故必须深入研究其保障对策，以降低官兵伤亡，提高部队战斗力，本文就此着重论述了如下三个方面问题；（1）部队战役机动行动突然，卫生防疫保障应具有快速高效反应能力。要重点建设一定数量的，具有快速高效反应的卫生防疫队伍，完善机动时各阶段的卫生防疫保障处置预案，优先改善担负战役机动部队的卫生防疫装备，突出快速侦检和野战便携防疫器材的配备，同时要注重通过不同途径提高卫生防疫人员的综合素质。（2）战役机动方式多样，部队卫生防疫保障必须与战役机动布势同步。应根据机动时的任务，方向，地区预建卫生信息管理自动化系统。使信息流上下，左右，纵横互联，要重点突出摩托化机动时的各项卫生防疫保障措施。充分依托地方卫生防疫部门，形成联动联勤军民一体的卫生防疫保障模式。（3）战役机动途径环境恶劣。卫生防疫保障应突出特殊伤病的预防与救治。要大力强化官兵的体能训练和体育锻炼。加强官兵身心素质的养成，通过各种方式提高部队官兵的自我保障意识，应根据机动的需要建立特殊伤病防治机构及各类特殊伤病防治小组，要多途径的加快卫生防疫技术建设，以建设一支高素质的防疫专业人才。     

徒步行军中脚泡预防措施效果观察

脚泡是影响徒步行军能力、增加疲劳的重要因素。为寻找简单可行的预防脚泡方法,我们对318名徒步行军训练的女学员进行了5种预防措施效果观察。(一)观察对象及条件318名18～20     

中国军队首批医疗分队维和行动卫生防疫保障组织与实施

目的探索执行维和任务部队卫生防疫工作保障组织与实施的规律,提高去国外执行任务部队的卫生防病工作水平。方法对分队组训、运送、执行任务、归国后4个阶段的卫生防病工作进行回顾性分析。结果总结出卫生防疫保障组织与实施的4点体会和做法:(1)国内组训阶段要了解任务区的卫生流行病学情况,开展针对性的防疫技术培训与健康教育,强化各项训练,增强抗病能力。(2)长途运送阶段要制定好卫生防疫保障计划,加强卫生宣教,注意饮食饮水卫生,做好晕动病的预防。(3)执行任务期间要加强卫生流行病学侦察,做好饮食、饮水卫生监督管理工作,加强对重点疾病的防治和对卫生信息的获取,关注维和人员心理健康。(4)归国后要做好集体检疫工作,认真做好体格复查,搞好卫生防病工作总结。结论总结出的4个不同阶段的卫生防疫保障组织与实施的经验对赴国外执行任务的部队或其他援外单位做好卫生防病工作有一定指导意义。     

军校学员徒步行军演习卫生学调查分析

某部为提高野战条件下走、打、吃、住、管、训的能力,于90年4月进行了营规模的综合战术演习,演习设置了徒步行军课题,总行程140公里,时速6～7公里,行军中按规定携带背包和武器,途中设置各种战术情况,并限制干粮和饮水。参演学员共计337人。笔者拟定调查问卷,对徒步行军中的卫生学问题进行了调查,共收回问卷327份,结果报告如下: 1 一般情况与临床资料1.1 一般情况327人中部队学员288人。地方学员39人。最小20岁,最大26岁,平均21.     

某基层部队解决官兵就诊用药问题的措施

目的 认真贯彻我军的卫生工作方针,切实解决好官兵就诊用药问题,努力提高为部队官兵服务的质量。方法 采取边探索、边实践、边分析并及时进行总结。结果 通过实践总结出4点具体措施：(1)坚持“预防为主”方针,降低部队伤病发病率;(2)合理分配使用卫勤力量,增强卫勤保障能力;(3)合理优化药品结构,加强标准药品宣传力度;(4)关心伤病残官兵的疾苦,积极为官兵排忧解难。采取以上措施,提高了为官兵服务的质量,基层官兵对医疗服务保障满意率达到95％以上。结论 实践证明,这些措施,提高了为基层官兵医疗服务的保障质量,较好地解决了部队官兵“看病难、吃药难”问题,对其他基层部队有一定参考作用。     

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.