贵州省1997～2004年流行性乙型脑炎流行病学分析及控制策略

目的：分析贵州省1997-2004年流行性乙型脑炎（乙脑）流行趋势，为乙脑预防控制策略提供科学依据。方法：疫情信息监测管理系统的监测资料及2004年个案调查资料进行分析。结果：累计报告13664例乙脑病例，年均发病率为4．65／10万；累计死亡540人，年均死亡率为0．12／10万；年均病死率为3．95％；男性与女性发病之比为1．48：1，病例中以散居儿童为主（67．54％），其次为学生（23．06％）。10岁以下病例占88．00％；高发季节为6～10月，发病高峰是7～8月。结论：该省应对高发地区和高发县开展健康教育和宣传动员，对0～10岁儿童开展乙脑疫苗预防接种，开展防蚊灭蚊。以降低乙脑发病率。     

福州市1992-2005年流行性乙型脑炎流行特征

目的分析福州市1992-2005年流行性乙型脑炎（乙脑）流行趋势，为制定乙脑预防控制策略提供科学依据。方法对疫情信息监测管理系统的监测资料及2005年个案调查资料进行分析。结果累计报告167例乙脑病例，年均发病率为0．21／10万；累计报告死亡9例，平均死亡率为0．011／10万；病死率为5．39％；男女发病之比为1．74：1，病例中以散居儿童为主（61．68％），其次为学生（34．13％）。10岁以下病例占76．04％（127／167）；流行季节为6—10月，高峰在7、8月。市区的发病率远低于8个县。结论建议加强农村的健康教育和卫生防病知识的宣传，搞好0—10岁儿童乙脑疫苗预防接种工作，特别是流动儿童。同时，在流行季节开展防蚊灭蚊，降低乙脑发病率。     

西双版纳州2004年～2010年流行性乙型脑炎流行特征分析

[目的]了解2004年～2010年西双版纳州流行性乙型脑炎（乙脑）的流行情况,分析其流行病学特征,为制定防控策略提供依据。[方法]对法定传染病报告系统报告的乙脑疫情资料进行描述性流行病学分析。[结果]西双版纳州2004年-2010年共报告乙脑病例246例,死亡13例,年均发病率为3．40／10万,年均死亡率为0．19／10万,年均病死率为5．28％;发病主要集中在5月～8月,占病例总数的96．34％,6月形成发病高峰;发病主要以10岁以下儿童为主,共169例,占病例总数的52．84％;男性发病多于女性,性别比为1．51：1;以散居儿童、学生和农民居多,占病例总数的85．37％。[结论]西双版纳州为乙脑的高发地区,应采取以预防接种、灭蚊防蚊和健康教育为主的综合性防控措施,有效地控制乙脑发病率。     

1994～2004年陆川县流行性乙型脑炎流行病学研究

目的了解陆川县流行性乙型脑炎（乙脑）流行病学特征，为制定防治措施提供科学依据。方法对1994—2004年陆川县乙脑疫情报告资料采用描述性流行病学方法进行分析。结果1994-2004年共报告病例85例。死亡7例。年均发病率0．92／10万。年均死亡率0．08／10万，年均病死率8．23％。5-7月为发病高峰。发病年龄以10岁以下散居儿童为主。占总病例数的98．82％，男女性别比为1．13：1。全程免疫占3．53％，未全程占11．76％。无免疫史占52．94％，免疫史不详占31．76％。结论乙脑发病主要表现为散发，乙脑疫苗覆盖率低是发病的重要原因。发病有明显的季节性。发病人群以低年龄组为主，应加强乙脑疫苗的预防接种，并在流行季节开展防蚊、灭蚊等综合防治措施。     

泉州市1982-2011年乙型脑炎流行病学特征

目的 分析泉州市1982-2011年流行性乙型脑炎(乙脑)流行趋势,为乙脑防控提供依据.方法 对1982-2011年泉州市乙脑疫情资料进行分析.结果 泉州市1982-2011年共报告乙脑951例,年均发病率为0.46/10万;累计死亡70例,年均死亡率为0.033/10万;年均病死率为7.4％.高发季节为6～8月,占病例数的97.0％,发病高峰7月,占病例数的63.0％.发病前3位的地区为南安、安溪和德化,年平均发病率分别为0.832/10万、0.61/10万和0.55/10万.男女发病之比1.16∶1;发病散居儿童最多(38.6％),其次为学生(33.3％),发病第3位为农民(10.6％);15岁以下病例占77.3％.结论 开展健康教育,提高乙脑疫苗接种率,开展防蚊灭蚊,对防控乙脑的发生有重要意义.     

三亚市2004—2006年流行陛腮腺炎流行病学分析

[目的]为了解三亚市流行性腮腺炎的流行特征，有效控制该病提供科学依据。[方法]采用描述性流行病学分析方法对2004。2006年三亚市流行性腮腺炎发病情况进行分析。[结果]2004～2006年共发生流行性腮腺炎病侧615例。年均发病率39．05／10万。城市发病观显高于农村地区，市区年均发病率为70．42／10万，农村年均发病率为24．63／10万，两地区差异有统计学意义（X^2=179．64，P〈0．0001）；全年均有发病，季节高峰不明显；患者男女比例为2．06：1，人群发病主要集中在3～10岁，占全部病例的86．02％，病例主要分布在学生、幼托儿童和散居儿童3个群体中，占91．54％。[结论]降低学生、幼托儿童和散居儿童发病率是今后防控工作的重点。     

大连市2004-2012年猩红热流行病学分析

目的掌握大连市猩红热流行趋势，为制订防制工作策略提供科学依据。方法采用描述性流行病学方法对大连市2004--2012年猩红热疫情资料进行分析。结果2004--2012年大连市累计报告猩红热6839例，年均发病率为12．44／10万；年均发病率城区（24．49／10万）高于农村（5．50／10万），差异有统计学意义（P〈0．01）。发病时间相对集中在5-7月（2251例，占32．91％）和11—12月（1721例，占25．16％）。男性4220例，女性2619例，男女性别比为1．61：1；男性发病率为15．21／10万，女性发病率为9．61／10万，差异有统计学意义（P〈0．01）。发病年龄主要集中在4～7岁年龄组，共报告4419例，占总病例数的64．61％；其中6—7岁年龄组发病率最高（222．92／10万），其次为4～5岁（216．45／10万）。托幼儿童发病3432例，占50．18％；学生发病2779例，占40．63％。结论托幼儿童、学生是大连市猩红热防治的重点人群。     

2004年贵州省人间狂犬病流行病学分析及控制对策

目的 通过对2004年贵州省狂犬病病例监测，分析流行状况，以探讨控制方法。方法 对疫情信息监测管理系统及个案调查资料进行综合分析。结果 2004年共报告狂犬病206例，发病率和死亡率均为0．53／10万。黔西南州安龙县的病例占全州病例数的65．67％。全年均有发病，发病高峰时间为3月和7～10月。7～10月病例数占总病例数的46．12％。男女发病比例为2．68：1。发病以农民为多，占57．28％，其次是学生，占27．18％。高发年龄为10～44岁组，占66．50％。发病年龄最小的2岁，最大的76岁。结论 贵州省狂犬病发病主要以农民和学生为多，7～10月病例较多。高发地区是黔西南州、黔南州、黔东南州和安顺市。建议进一步加强犬类的“管、免、灭”；加强宣传和健康教育，使人们在被带狂犬病毒的犬类咬伤后及时获得狂犬病暴露后的免疫预防；尽可能地对高危人群和高发地区开展暴露前免疫，降低贵州省狂犬病发病率。     

贵州省流行性乙型脑炎病例监测的研究

目的通过对贵州省2004-2005年流行性乙型脑炎（乙脑）病例监测的研究，了解乙脑实验室确诊病例占报告病例的比例，掌握贵州省乙脑真实流行状况，为乙脑防治提供科学依据。方法根据疫情信息监测管理系统、个案调查资料、实验室结果及2个国家级监测县的病例监测进行综合分析。结果2004、2005年分别报告乙脑病例1230和1038例，15岁以下病例分别占总病例数的96．58％（1188／1230）和97．69％（1014／1038），男性与女性病例之比分别是1．58：1和1．57：1；发病主要集中在7-8月，分别占78．21％（962／1230）和79．09％（821／1038）。监测县7-8月病例占88．36％（319／361）。发病有明显季节性，且为高度散发；有免疫史的分别为6．90％（26／377）和8．86％（32／361）；实验室乙脑IgM抗体阳性率分别为74．90％（188／251）和71．74％（259／361）。监测县乙脑IgM抗体阳性率为71．88％（23／32）。乙脑病例监测：2005年比2004年下降15．61％。监测县2005年乙脑发病数比2004年下降39．47％。结论贵州省实验室确诊乙脑病例数占总报告病例数的71．88％-74．90％。应进一步加强乙脑专项监测和提高实验室诊断技术，使非乙脑报告病例得到明确诊断；继续对15岁以下儿童实施乙脑疫苗预防接种为主的综合防治措施。     

开江县1960至2003年流行性乙型脑炎流行特征及监测分析

目的探讨开江县流行性乙型脑炎（乙脑）疫情变化动态及流行趋势，为防制提供科学依据。方法搜集开江县1960～2003年乙脑疫情资料，2002～2003年开展乙脑常规监测，血清学检测采用反向被动血凝抑制试验（RPHI）。结果1960～2003年乙脑年均发病率为8．16／10万，病死率为5．68％，流行高峰在8月份，浅丘、平坝发病率为8．82／10万，显著高于深丘、山区的6．86／10万（χ^2=20．43，P〈0．005），10岁以下儿童病例数占发病总数的94．51％。健康儿童乙脑抗体阳性率为51．97％，2～4岁年龄组抗体阳性率为31．03％，显著低于5—14岁年龄组的64．89％（χ^2=16．86，P〈0．005）。猪乙脑抗体阳性率高峰在7月份，6～7月各旬之间抗体阳性率差异有统计学意义（χ^2=84．68，P〈0．005）。临床病例血清学确诊率为61．54％。结论各年度发病率相差显著，原因可能与当年气温、雨量、蚊媒数量及免疫水平有关，加强10岁以下儿童乙脑疫苗预防接种和免疫覆盖率是防制乙脑的有效措施。     

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.