上海市金山区2008-2010年手足口病流行病学特征分析

目的了解上海市金山区手足口病疫情流行特征,为制定预防和控制措施提供参考依据。方法对金山区2008-2010年疾病监测信息报告系统上报的手足口病病例进行描述性流行病学分析。结果 2008-2010年金山区共报告手足口病病例3 370例,年发病率在130.13/10万~209.37/10万之间,呈"V"分布;男性发病高于女性,以散居儿童和幼托儿童为主,集中于0~5岁组,占发病总数的95.04%;病例集中分布于5-6月份;各镇(街道)均有病例发生;幼托机构是发生手足口病聚集性疫情的主要场所,占疫情总数的94.57%,病原学监测以肠道病毒CoxA16为主,占39.16%,引起重症病例的病原体主要是肠道病毒EV71,占重症总数的90.00%。结论金山区手足口病发生有明显的年龄、性别、职业和季节差异,应做好社区5岁及以下儿童手足口病防控工作是当前手足口病防控工作的重中之重。     

上海市金山区枫泾镇2012—2014年手足口病流行病学特征分析

目的分析上海市金山区枫泾镇2012—2014年手足口病流行病学特征,为手足口病的预防及控制提供科学依据。方法收集枫泾镇2012—2014年中国疾病预防控制信息系统中手足口病个案信息,采用描述性流行病学方法进行统计分析。结果 2012—2014年枫泾镇共报告手足口病389例,平均发病率为203.82/10万,2012、2013和2014年发病率分别为113.21/10万、141.13/10万和357.17/10万;手足口病全年均有发病,发病高峰期在5—7月,2012、2013和2014年均在11月份出现了一个发病小高峰;年龄分布以1~5岁儿童发病居多,占发病总数的80.46%;职业分布以散居儿童为主,占发病总数的50.6%,其次为幼托儿童,占发病总数的37.5%;本地人口报告病例数93例,占发病总数的23.91%;外来人口报告病例数296例,占发病总数的76.09%。结论枫泾镇手足口病防控工作的关键时期在5—7月和11月,应在1~5岁儿童,尤其是流动人口聚居地区内散居和幼托儿童中广泛开展手足口病宣传教育,加强监测,及时发现病例并采取有效措施控制疫情。     

2009—2020年钦州市手足口病流行病学及病原学分析

目的:了解2009—2020年钦州市手足口病的流行病学及病原学特征,为手足口病防控提供科学依据。方法:通过中国疾病预防控制信息系统与儿童免疫规划信息系统获取手足口病病例信息与肠道病毒71型疫苗接种数据并进行描述性流行病学分析。结果:2009—2020年钦州市累计报告手足口病60 652例,年均报告发病率为157.14/10万,累计报告重症病例1 493例,重症占比为2.46%;死亡病例21例,年均死亡率为0.05/10万,病死率为0.03%。发病年龄主要分布在≤5岁儿童,占病例总数的92.89%;男女性别比为1.68∶1,男、女性手足口病发病水平差异具有统计学意义(χ~2=2169.19,P0.05)。病例以散居儿童和幼托儿童为主,分别占报告病例总数的88.27%、8.97%。发病曲线除2017和2019年呈单峰分布外,其余年份呈双峰分布,春夏高峰为4—7月,秋冬高峰为9—10月,病原学特征上每年优势病原体有所变化,重症和死亡病例的优势病原为EV71,EV71疫苗的接种率仅为18.5%。结论:手足口病在钦州市存在明显的季节性和地区分布差异,优势病原体有所改变,散居儿童和幼托儿童为高危人群,应大力推广手足口病EV71疫苗的接种,加强宣传教育工作,加强疫情监测和病原分型监测,有效处理和控制疫情。     

2010-2013年西安市手足口病流行特征分析

目的掌握西安市手足口病发病强度和流行特征,为制定手足口病防治策略提供科学依据。方法收集中国疾病预防控制信息系统中2010-2013年手足口病信息,并用各区县疾控中心的个案调查表对病例信息进行订正和完善,采用描述流行病学方法对病例资料进行统计分析。结果 2010-2013年手足口病年均报告发病率为261.21/10万;男女性别比为1.48∶1,2010-2012年重型手足口病主要病毒株是EV71病毒;报告病例数主要集中在4-7月,占病例总数的71.34%;幼托儿童、散居儿童报告手足口病病例数分别占全部报告发病数的63.01%和34.18%。结论西安市2010-2013年手足口病呈典型的夏季发病高峰;以幼托儿童、散居儿童发病为主,持续开展健康教育宣传,加强监测、有效处理疫情是控制西安市手足口病疫情的关键措施。     

2009-2013年重庆市北碚区手足口病疫情及病原学分析

目的了解重庆市北碚区2009-2013年手足口病的流行病学特点及病原学特征,为预防和控制手足口病提供参考依据。方法采用描述流行病学方法对北碚区2009-2013年手足口病疫情资料进行分析。结果北碚区2009-2013年共报告手足口病4 441例,年均发病率为136.07/10万;街道发病率为169.87/10万,乡镇发病率为108.40/10万,城乡发病率差异有统计学意义(χ2=224.63,P0.01);1年出现2次高峰,分别是4~6月和10~12月;人群主要集中5岁以下儿童占病例总数的95.61%,职业以散居儿童为主,占病例总数的51.97%;男性年均发病率150.73/10万,女性年均发病率120.97/10万,男女发病率差异有统计学意义(χ2=53.20,P0.01)。病原学监测显示,EV71占42.03%,Cox-A16占27.46%,其他肠道病毒占30.51%。结论 2009-2013年重庆市北碚区手足口病发病率街道高于乡镇,男性高于女性,发病时间集中在4~6月和10~12月,人群集中在5岁以下散居儿童。     

2010-2014年张家港市幼托儿童手足口病流行特征分析

摘要:目的 分析张家港市幼托儿童手足口病的流行特征,制定流行趋势预警预测值,为采取针对性防控措施提供科学依据。方法 对2010-2014年传染病报告信息管理系统报告的张家港市幼托儿童手足口病疫情资料进行描述流行病学分析。结果 张家港市2010-2014年共报告幼托儿童手足口病病例4 041例,年均发病率2.29%,其中重症病例28例,年均发病率15.87/10万;男女性别比为1.57∶1, 重症病例男女性别比为2.5∶1;病原学方面EV71型肠道病毒、CoXA16型病毒和其他肠道病毒感染所占比例分别为38.81%、 29.85%和31.34%;发病主要以3～4岁儿童为主,共2 714例,占发病总数的67.16%。重症病例也是3～4岁为主,共23例,占重症病例总数的82.14%;发病时间曲线有两个明显的高峰和低谷,报告发病数增减的趋势,与幼托儿童在校、放假的时间有明显的关联性。结论 张家港市幼托儿童手足口病发病存在明显的时间和年龄分布特征,在常规防控措施的基础上,应加强幼托机构健康宣教的力度,培养幼托儿童良好的卫生习惯。     

2016-2019年大连市手足口病流行病学特征分析

目的分析2016-2019年大连市手足口病(hand-foot-mouth disease,HFMD)流行病学及病原学特征,为制定防控策略提供科学依据。方法采用描述性流行病学方法,从中国疾病预防控制信息系统中获取2016-2019年大连市手足口病病例信息及病原学检测结果并进行分析,应用SPSS 17.0统计学软件进行χ2检验,以P0.05为差异有统计学意义。结果2016-2019年大连市共报告手足口病病例27 927例,年均发病率为100.94/10万,单峰型,主要集中在7~8月;男性发病率高于女性;5岁以下儿童为主占病例总数的75.27%,3岁~组病例数最多占病例总数20.11%;发病人群主要以散居儿童和幼托儿童为主占病例总数的91.16%;城乡结合部和农村发病数较多。实验室确诊病例2 105例中柯萨奇病毒A6型(Cox A6)为主(38.62%);重症确诊病例120例中EV 71为主占38.33%,其次Cox A6(34.17%)。Cox A6引起的重症病例所占比例逐渐增多,2018年和2019年分别达到66.09%和87.50%成为主要病原。结论大连市手足口病具有明显的季节、地区、人群差异,Cox A6成为大连市手足口病优势病原之一,应密切关注Cox A6和其他肠道病毒,进一步加强病原监测分析。     

2012-2015年温州市鹿城区手足口病流行病学分析

目的 分析2012-2015 年浙江省温州市鹿城区手足口病流行特征。方法 对2012-2015年鹿城区中国疾病预防控制信息系统中上报的手足口病数据资料进行描述性流行病学分析。结果 2012-2015年全区共报告手足口病16 654例,年均发病率320.82/10万。发病高峰为4-7月,占病例总数的57.93%。男女性别比1.52∶1。年龄分布以≤5 岁儿童为主,占病例总数的93.01%。职业分布以散居儿童为主,占病例总数的78.66%;其次为幼托儿童,占17.74%,且有上升趋势,托幼机构有聚集发病现象。病原学监测结果EV71、CoxA16和其他肠道病毒感染分别占43.63%、17.37%和40%。结论 鹿城区手足口病具有明显的季节和人群分布特点,应加强病原学监测,重视5岁以下儿童家长的健康教育及落实托幼机构的防控工作。     

2012 - 2016年上海市松江区幼托儿童传染病发病特征分析

目的 了解2012 - 2016年上海市松江区幼托儿童传染病的发病趋势。方法 根据2012 - 2016年松江区幼托儿童传染病疫情资料,对传染病的发病顺位、主要传染病的三间分布情况进行描述性流行病学分析。结果 2012 - 2016年全区幼托儿童共报告传染病11种10 714例,年均发病率55.11‰,总体呈现下降趋势,无甲类传染病报告,无死亡病例,发病占同时期全人群发病的20.36%。5年间传染病主要以肠道传染病为主,占总发病数的76.98%;其次为呼吸道传染病,占23.00%;其他传播途径传染病占0.02%。手足口病、水痘、猩红热为发病率前3位的传染病,分别占发病总数的75.64%、9.66%、4.90%;发病病例月份分布以5、6 月(32.42%) 和11、12、1月( 27.09%) 为高峰,呈季节性双峰分布;发病地区主要集中在流动人口较多的九亭镇、新桥镇、泗泾镇。结论 2012 - 2016年松江区幼托儿童传染病总体呈下降趋势,现阶段应根据手足口病、水痘、猩红热的不同流行特征采取监测和防控措施。     

2009-2013年上海市普陀区手足口病流行病学特征和病原学监测分析

摘要:目的　分析2009-2013年上海市普陀区手足口病疫情和病原学监测结果,为手足口病防制工作提供依据。方法　对2009-2013年普陀区疾病监测信息报告系统上报的手足口病病例和实验室检测结果进行描述性流行病学分析。结果　2009-2013年普陀区共报告手足口病病例6 863例,年发病率波动在77.74/10万～126.80/10万之间,2013年发病率最高,2009年最低,男性发病高于女性。以散居儿童和幼托儿童为主,占发病总数的94.39%;集中于0～6岁组,占发病总数的95.04%;病例集中分布于4-7月份;各街道（镇）均有病例发生。病原学监测结果显示,2009-2013年共1 074例病人1 725份标本中（疱疹液145份,咽拭子1 023份,肛拭子557份）肠道病毒阳性率67.97%,其中EV71占20.67%,CoxA16占21.69%,其他肠道病毒占25.61%。结论　普陀区手足口病呈现明显的季节和人群分布特点,主要病原体一直交替变化,开展手足口病流行病学和病原学研究,将有助于提出进一步有针对性的防控措施。     

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.