2008年内蒙古地区乙型肝炎流行病学调查

目的调查内蒙古地区不同人群乙型病毒性肝炎（乙肝）流行现状,为制定加强乙肝的预防和免疫工作的方案和策略提供依据。方法采用分地区、分年龄段随机抽样的方法,对普通人群进行血清流行病学调查。结果内蒙古部分1～65岁人群HBsAg和HBV阳性率分别为2．77％和53．66％,有无针灸史和有无创伤美容史这两个因素为乙肝感染的危险因素。结论内蒙古地区需要继续加强乙肝疫苗的人群普种,并重点加强对婴幼儿和高危人群接种乙肝疫苗,加强医源性乙肝感染的控制。     

蓬莱市农村人群乙肝疫苗接种和乙肝病毒感染相关性

目的分析评价乙肝疫苗免疫接种对蓬莱市农村居民乙肝病毒(HBV)感染变化的影响。方法采用多阶段整群抽样方法,对蓬莱市农村1～59岁常住人口共629人进行乙肝血清流行病学调查和乙肝疫苗接种率调查,采用ELISA法检测HB-sAg、抗-HBs、抗-HBc等乙肝标志物。结果 629名调查对象HBV感染率为22.26%,HBsAg、抗-HBs、抗-HBc阳性率分别为2.70%、62.32%、18.44%。乙肝疫苗接种率由1992年以前出生人群的18.89%提高到2002-2006年出生人群的100.00%,HBV感染率由42.11%降为1.31%;有乙肝免疫史的人群HBV感染率和HBsAg、抗-HBc阳性率均低于无乙肝疫苗免疫史人群,抗-HBs阳性率明显高于无乙肝疫苗免疫史人群,乙肝疫苗保护率为85.63%。结论从1992年使用乙肝疫苗以来,不仅有效的减少了乙肝病毒携带状态,且乙肝疫苗保护率达到较好的效果,进一步说明接种乙肝疫苗可有效防止乙肝病毒的感染。     

2006年枣庄市薛城区1～14岁农村儿童乙肝疫苗接种及其效果评价

[目的]了解1～14岁农村儿童乙型肝炎疫苗接种情况,分析乙肝疫苗的免疫效果。[方法]2006年10月,对枣庄市薛城区294名1～14岁儿童进行调查。[结果]调查儿童294名,乙肝疫苗第1针接种率为88.78%,3针全程接种率为85.71%,首针及时接种率为80.27%,占首针接种者的90.42%。1～14岁儿童HBV感染率为9.18%,其中有乙肝疫苗接种史的为5.75%,无乙肝疫苗接种史的为36.36%（P〈0.01）。[结论]薛城区农村1～14岁儿童乙肝疫苗接种率偏低,接种乙肝疫苗可明显降低儿童HBV感染率。     

阳泉市569名乙肝病人接触者乙肝疫苗免疫效果观察

[目的]观察接种乙肝疫苗后的免疫效果,减少HBV感染,达到消除乙肝的目的。[方法]2001年1月至2004年12月,在阳泉市第三人民医院就诊的乙肝病人的接触者(高危人群)中,筛选肝功能正常、乙肝“五项”指标阴性的569人,接种乙肝疫苗,检测抗HBs。[结果]观察对象接种乙肝疫苗后抗HBs阳性率为82.6%,阴性者加强免疫后有27.3%阳转,观察对象阳性率提高到87.3%。[结论]接种乙肝疫苗能显著提高高危人群抗HBs阳性率。     

四川省吸毒人员乙型肝炎血清流行病学和乙肝疫苗免疫效果研究

[目的]了解四川省吸毒人员乙型肝炎流行现状以及乙肝疫苗免疫效果,为制定策略提供依据.[方法]2005年在成都市、南充市、遂宁市戒毒所内随机选取既往未接种过乙肝疫苗的吸毒人员665名为研究对象.用酶联免疫吸附试验(ELISA)对HBsAg、抗-HBs和抗-HBc 3项指标进行初筛,用固相放射免疫法(SPRIA)复核3项指标全阴者,用20μg乙肝疫苗按0、1、2程序接种,1月后采血,检测抗-HBs水平.[结果]四川省吸毒人群乙肝病毒(HBV)总感染率为90.52%,男性90.40%,女性90.97%,男女无统计学差异;吸毒人员乙肝感染标志物HBsAg,抗-HBs和抗-HBc的流行率分别为26.45%,45.86%和35.34%;静脉吸毒者(IDU) HBV总感染率高于口吸者.接种乙肝疫苗后,抗-HBs阳转率为86.96%,抗-HBs几何平均滴度(GMT)为159.39mIU/ml.[结论]四川省吸毒人群HBV总感染率高于全人群,IDU是感染乙肝的高危人群.对吸毒人群进行乙肝疫苗接种效果良好.     

接种乙型肝炎疫苗儿童乙肝病毒感染情况调查

乙肝是世界性分布的传染病,我国是乙肝高发区之一。国内对未接种乙肝疫苗人群乙型肝炎病毒(HBV)感染情况的报导甚多。但目前对已接种乙肝疫苗人群HBV感染的情况则报导较少。一般认为通过接种乙肝疫苗人群HBV感染情况调查,可评价乙肝疫苗     

2009年广东省部分地区基层医务人员乙型肝炎血清流行病学分析

目的了解广东省部分地区基层医务人员乙型病毒性肝炎（乙肝）流行现状,为制定乙肝高危人群的防制策略提供科学依据。方法2009年7月,在广东省韶关南雄市、汕尾海丰县和云浮新兴县采取分层比例随机抽样方法,抽取1243名基层医务人员作为样本,开展血清流行病学调查。采用雅培试剂化学发光法检测HBsAg、抗-HBs、抗-HBc,应用SPSS10．0软件对数据进行统计分析。结果共调查基层医务人员1243人,男性486人,女性757人。HBV感染率为69．03％（858／1243）,HBsAg阳性率为9．49％（118／1243）、抗-HBs阳性率为74．18％（922／1243）,抗-HBc阳性率为58．81％（731／1243）。不同调查地区基层医务人员HBV感染率、HBsAg和抗一HBc阳性率差异均有统计学意义（P〈0．05或P〈0．01）。男性的HBV感染率和抗-HBc阳性率（分别为75．31％、66．46％）高于女性（64．99％、53．90％）（P〈0．01）;HBV感染率和抗-HBc阳性率随着年龄的增长而升高（P〈0．01）。接种过乙肝疫苗的医务人员,HBV感染率、HBsAg和抗-HBc阳性率低于未接种过乙肝疫苗和接种史不详的医务人员（P〈0．01）,而抗-HBs阳性率则高于未接种过乙肝疫苗和接种史不详的医务人员（P〈0．01）。结论广东省受调查基层医务人员HBsAg阳性率高于全国一般人群水平,而低于省内一般人群水平,且该人群年龄越高感染的机会越高。要控制医务人员乙肝流行,应加强对医务人员的健康教育,并大力推行乙肝疫苗接种。     

中国乙型肝炎疫苗预防效果分析

目的了解10多年来中国乙型肝炎(乙肝)疫苗预防接种效果。方法利用2002年“中国居民营养与健康状况调查”保留的血清,以美国Abbott公司乙肝酶联免疫吸附试验(EILSA)试剂为标准,选择中国乙肝ELISA检测试剂开展乙肝病毒感染标志的血清学检测,并用固相放射免疫(SPRIA)方法校对检测结果。结果①乙肝疫苗接种人群乙肝病毒表面抗原(HBsAg)阳性率、乙肝病毒(HBV)感染流行率,经调整后分别为5.28%、54.44%,3~12岁儿童分别为3.63%、26.88%。②未接种乙肝疫苗人群HBsAg阳性率、HBV感染流行率,经调整后分别为9.51%6、4.63%,3~12岁儿童分别为11.19%、47.03%。③接种乙肝疫苗人群城市、农村HBsAg阳性率分别为2.55%7、.10%,未接种乙肝疫苗人群分别为7.24%、10.12%;3~12岁接种乙肝疫苗儿童城市、农村HBsAg阳性率分别为1.96%、6.65%,未接种儿童分别为2.39%、10.84%。结论中国乙肝疫苗预防接种效果好;同时反映了农村乙肝疫苗的预防接种是中国乙肝防制的重中之重。     

上海市卢湾区人群乙型肝炎和甲型肝炎感染情况调查

目的调查现阶段卢湾区人群乙型肝炎和甲型肝炎感染情况。方法应用血清流行病学方法调查分析人群乙肝和甲肝感染水平。结果全人群HBV总感染率为7·41%,HBsAg阳性率为2·96%,抗-HBs阳性率为42·96%,甲肝抗-HAVIgG阳性率为60·74%。医务人员HBV感染率最高,为25·93%。疫苗时代出生人群HBV感染率为1·14%。男女性别HBV感染率无显著差异。结论新生儿接种乙肝疫苗是预防和控制乙肝感染的有效手段。应加强医生等职业人群乙肝疫苗接种。建议基础免疫5年后对乙肝标志阴性者加强免疫。     

张家港市人群乙型肝炎血清流行病学调查研究

[目的]了解张家港市人群乙型肝炎病毒(HBV)感染现状,评价乙肝疫苗纳入儿童免疫策略后的效果.[方法]按<006年全国人群乙肝等有关疾病血清学调查方案>样,开展问卷调查,并采静脉血进行乙肝血清学检测分析. [结果]张家港市人群乙肝疫苗接种率为50.83%,15岁以下人群组乙肝疫苗接种率(99.09%)明显高于15岁以上人群组(2.71%);人群HBsAg阳性率为5.73%,抗-HBs阳性率为52.19%,抗-HBc阳性率为24.43%,HBV感染率为32.43%,HBV感染标志全阴率为37.25%;15岁以下人群组HBsAg阳性率0.30%明显低于15岁以上人群组的11.14%,农民及文盲的HBsAg阳性率和HBV感染率最高. [结论]张家港市乙肝疫苗纳入儿童计划免疫效果显著,今后应加强以成人乙肝疫苗接种为主的综合防制措施.     

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.     

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.     

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.     

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.     

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.