SARS铁路交通检疫中“发热病人”研究

目的探索SARS铁路交通检疫中“发热病人”这一特殊群体的特征。方法对检疫中发现的870例“发热病人”流行病学特征及与SARS进行关联情况分析。结果870例“发热病人”时间分布:5月15日~6月15日出现高峰,最高一天达32例;空间分布:旅客列车占77.36%,列车车上检出率仅为73.70%,来源地中广东和湖南分别占58.74%、21.26%,居住地中湖南占45.86%;人群分布:20~29岁所占比例最高,为43.68%,男女性别比为2.97:1,职业以农民(含民工)最多,占59.43%。体温在38.4℃以下达60.12%,诊断为SARS病人(含疑似病人)的2例,与SARS有明显接触史为3例。结论SARS铁路交通检疫中的“发热病人”有独特的流行病学特征,“发热”作为检疫唯一指征宜作修正。     

东莞铁路客运口岸"发热病人"的流行病学情况分析

目的:探索东莞铁路客运口岸卫生检疫中"发热病人"这一特殊群体的流行病学特征。方法:对检疫的"发热病人"的时间、来源地、性别、年龄、职业分布等流行病学特征进行调查研究。结果:2004年1月~2006年3月期间东莞铁路客运口岸检疫出入境旅客1163969人次,发现"发热病人"46例,诊断为传染病的病人0例;来源地中以香港地区的人数最多,占65.22%;时间分布中,发热病人终年均有发现,各月份间并没有显著性差异;年龄分布中,以0~10岁所占的构成比最高(4.831/10000),10~20岁、20~30岁所占的构成比最低(分别为0.000/10000、0.116/10000),均有显著性差异(P<0.05);男女性别比为3.76:1;职业分布中商务人士、学生人数最多,分别占28.26%,30.43%。结论:东莞铁路客运口岸检疫发现的"发热病人"有独特的流行病学特征,针对其流行病学特性可以更好地对东莞铁路客运口岸人群进行传染病的检验检疫筛查。     

罗湖口岸发热病人流行病学调查分析

目的 调查分析罗湖口岸出入境人员中发热病人的流行病学资料,加强和规范口岸现场检疫查验工作,科学防制非典型肺炎.方法 2003年4月15日至7月31日对罗湖口岸出入境人员中的发热病人进行检疫查验、医疗处置、做流行病学调查登记.结果 共发现536例发热病人,其中入境人员379例,出境人员157例;可疑SARS病人57例,479例病人为完全排除SARS病例.57例可疑SARS病人追踪诊断结果:上呼吸道感染46例,急性扁桃体炎5例,肺结核2例,支气管炎1例,预防接种反应1例,肝硬化腹水合并感染1例,细菌性肺炎1例. 结论口岸现场检疫查验能有效控制非典型肺炎病人及可疑病人出入境,必须完善各项措施,加强口岸卫生检疫查验工作,科学有效地防制非典型肺炎.     

湖南省SARS早期预警症状监测数据分析

目的 通过对湖南省“发热病例”监测数据的分析，了解全省发热病人尤其是发热呼吸道病人的流行病学特征，为SARS早期症状监测预警系统的建立提供数据参考。方法 设计统一的调查表格，收集湖南省二级以上医院1～6月就诊发热病人的基本信息，用Excel录入和进行流行病学分析。结果 本次监测共报告发热病人113823例，其中发热呼吸道病人76937例，占发热病人总数的67．59％；发热肺炎病人9990例，占发热病人总数的8．78％，报告SARS预警病例4例，无SARS疑似和确诊病例报告。结论 选择在医院对发热病人进行监测对于及时发现和治疗SARS病人（疑似病人）、切断传播途径、保护易感人群等方面起到了有效的作用。     

湖北省SARS疫情监测与病人发现措施效果评估

目的 评估和探讨湖北省严重急性呼吸系统综合征(SARS)疫情监测和病人发现措施的效果。方法 调查、收集2003年4月11日～7月9日全省各地疫情监测和病人发现的有关资料和数据，分析比较措施的预防效果。结果 各类监测点中，以社区卫生服务站和村卫生室监测点的发热病人检出率最高，分别为2．024％和0．72％。各级医疗机构发热门诊共发现发热病人240949例，初诊为SARS85例，上感160948例，流感13679例，普通肺炎14082例，结核1414例，其他45518例，留验观察8823例；发热病人占监测人数的0．94％，SARS病人占发热病人的0．036％。占监测人次总数的0．0006％。结论 SARS期间采取的疫情监测和病人发现措施效果显著，有效地阻断了传染源，无疫情扩散。发热病人门诊应作为控制SARS的常规措施。     

SARS早期预警监测试点项目结果分析

目的 对广东省佛山市顺德区第一医院开展SARS早期预警监测试点项目中的门诊病人监测结果进行评价。方法 于2003年12月10日-2004年1月10日，对该医院内科门诊、内科急诊及发热门诊病人进行监测，按卫生部及中国疾病预防控制中心制定的监测病例定义和预警指标进行诊断。结果 共监测就诊病人23045人次，发现发热呼吸道病例101例，占监测总数的0．44％；发热肺炎病例19例，占监测总数的0．08％；未发现SARS预警病例。结论 完善的监测系统，可及时发现发热呼吸道病人及发热肺炎病人，确认或排除SARS疫情，及时有效的采取公共卫生防控措施。     

福州空港口岸发热病人的流行病学研究

目的 分析2011年福州长乐国际机场空港口岸出入境人员中发热病人的流行病学特征,规范口岸现场检疫查验工作,科学防控传染性疾病.方法 对现场检疫查验中发现的发热病人进行流行病学调查分析.结果 共发现发热病人133例(入境125例,出境8例),采样送检的51例中,15例确诊甲型H1N1流感,1例甲型H1N3流感,5例乙型流感,1例登革热.结论 体温监测是现场发现发热病人最主要的手段,应针对发热病人的流行病学特征,加强口岸重点人群的体温监测和医学巡查,加大宣传力度,防止传染病传入传出.     

广东省传染性非典型肺炎流行病学特征分析

目的 了解广东省局部地区流行的传染性非典型肺炎(SARS)的流行病学特征，为制定预防控制对策和措施提供科学依据。方法 采用统一的流行病学个案调查表对SARS，临床确诊病例进行调查。分析SARS病例在广东省的流行过程、地区、时间、人群分布及聚集性等特征。结果 截止2003年6月6日，广东省21个地级市有15个市报告SARS病例1511例，发病率为1．98／10万，病死率为3．77％。发病主要集中在1月下旬到2月下旬(2月上旬达到高峰)，占病例总数的54．00％，。首例发病时间为2002年11月16日，末例发病时间为2003年2003年5月9日。病例主要集中在广州、深圳、江门、中山、佛山5个市，占96．03％，其中广州占86．04％。20～49岁发病占病例总数的65．45％；医务人员发病较多，占病例总数的22．90％；聚集性病例占31.97％(483／1511)。潜伏期1～12d，中位数4d。结论 广东省SARS疫情波及面广，发病相对集中，有明显的家庭和医院聚集现象；传播途径主要为近距离飞沫和密切接触传播。     

四川省传染性非典型肺炎疫情分析

目的：分析四川省传染性非典型肺炎[严重急性呼吸综合征(SARS)]的流行病学特点。方法：运用描述流行病学的方法，收集、整理、汇总四川省SARS病例资料，分析疫情的三间分布、来源和病例发现方式、临床症状及诊疗情况。结果：2003年4月16日至5月7日是四川省SARS疫情发生的高峰，其中泸州市和广元市病例数占全省病例总数的60％，病例中民工占68％；20--岁年龄组发病人数员多，男女发病之比为1．5：1；80％的病例来源于广东省。患者症状以发热、咳嗽为主，X线胸片有阴影。结论：四川省SARS病例均为输入性，人员流动(特别是外出务工人员返乡)是影响疫情波动的主要因素。对此采取以隔离传染源为主导措施(设立留验站、定点医院、发热门诊等)的防制方法，有效控制了疫情。     

北京市东城区393例SARS流行特征分析

目的 分析2003年3～6月间北京市东城区SARS流行特征。方法 根据东城区疾病预防控制中心的疫情日报表，并从其他有关渠道，收集疫情资料信息。结果 东城区首例输入性病例3月14日发病，3月16日入院，4月初病例开始增多，4月中、下旬发病达高峰，5月上旬开始下降，5月22日无新发确诊病例，5月26日后，再无病例报告。全区共报告临床确诊SARS病人393例，10岁以下年龄组无病人，其余各年龄组均有发病，其中20～49岁年龄组发病人数占病例总数的70．0％，平均发病年龄为40．64岁。男女发病比例无显著差异。SARS发病有明显的家庭聚集现象。病例中东城区的病人占66．9％，外区、外省占32．0％；驻区医院收治SARS病人358人，占91．09％。393例病人中无接触史的占33．3％。医护人员感染SARS 79人，占病人总数的20.10％、其中区属四所医院18名医护人员感染为8．33％。结论 本次SARS流行，除10岁以下年龄组外，普遍易感，其中以青壮年、老年人、医务人员更易罹患。与病人直接接触是主要的传播方式，家庭聚集传播明显。医院、工地是防控重地。本区制定的防控策略、措施及原则是有效的。     

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.