1972 - 2016年江苏省启东市肺癌死亡流行特征分析

目的 研究启东市1972 - 2016年肺癌死亡水平及变化趋势。方法 根据启东市1972 - 2016年癌症死亡登记数据库，分别计算粗死亡率（CR）、中国标化率（CASR）、世界标化率（WASR）、35～64岁截缩率、0～74岁累积率、累积风险，死亡率年度变化百分比等。结果 1972 - 2016年启东肺癌死亡18 662例， CR为36.91/10万，占全部癌症死亡的18.88%，位居癌症死亡第2位。CASR和WASR分别为15.13/10万和25.26/10万；35～64岁截缩死亡率为32.98/10万；0～74岁累积死亡率为3.14%；肺癌死亡的累积风险为3.10%。男性肺癌死亡13 384例，CR、CASR、WASR分别为53.63/10万、23.19/10万与39.64/10万，女性肺癌死亡5 278例，CR、CASR、WASR分别为20.61/10万、8.06/10万和13.17/10万。肺癌男女死亡性比值CR、CASR、WASR分别为2.60、2.88、3.01。45年间肺癌死亡的CR、CASR、WASR的变化百分比（PC）分别为+842.85%、+194.28%与+250.01%，年均变化百分比（APC）分别为+4.88%、+1.92%、+2.18%。用年龄 - 出生队列方法分析显示，各低年龄组出生队列死亡率变化趋势也不明显，而55岁以后的各年龄组出生队列死亡率有明显的上升趋势。结论 启东45年来肺癌死亡率水平较高，且上升趋势明显。     

启东市1972～2000年癌症发病登记资料分析

目的 了解启东市1972～2000年癌症发病的流行趋势，为疾病控制与肿瘤防制提供依据。方法 采用启东癌症登记处发病登记报告资料计算发病率，用1964年全国标准人口构成及1960年世界标准人口构成计算年龄调整发病率(标化发病率)，了解恶性肿瘤发病的人群分布特点及流行趋势。结果 启东市1972～2000年恶性肿瘤发病登记55496例，其中男性35404例，女性20092例。发病有上升趋势，但标化后发病趋势稳定。29年恶性肿瘤粗发病率(CR)平均为170．74／10万，中国人口构成标化率(CASR)为118．77／10万，世界人口标化率(WASR)为169．13／10万。其中男性恶性肿瘤发病率为220．47／10万(CASR：150．68／10万，WASR：234．50／10万)、女性发病率为122．18／10万(CASR：84．70／10万，WASR：112．47／10万)。居前5位的恶性肿瘤依次为肝癌、胃癌、肺癌、食管癌及直肠癌，共占全部肿瘤的75．69％。男、女顺位与此相同，但女性第4位肿瘤为乳腺癌。近年来肺癌发病率已超过胃癌、仅次于肝癌成为启东的第2位主要癌症。结论 恶性肿瘤是启东居民的第2位主要死因，肝癌等消化道肿瘤及肺癌是最常见的恶性肿瘤，其粗率的升高可能与人口的老龄化有关。应当加强对肿瘤等慢性病的预防。     

1990—2019年江苏启东市糖尿病死亡趋势及去死因期望寿命预测

目的 研究分析1990—2019年江苏省启东市居民糖尿病死亡的变化趋势和期望寿命的影响,为制定卫生政策提供依据。方法 根据1990—2019年启东市全死因监测资料及历年人口资料,对居民糖尿病死亡率及时间趋势进行分析,采用Joinpoint 4.7.0.0软件,计算指标包括粗死亡率(CR)、中国标化率(CASR)及年度变化百分比(APC)、潜在减寿年数(PYLL)和潜在寿命损失年数率(PYLLR)等。结果 1990—2019年启东市居民糖尿病的CR为15.12/10万,其中男性为12.72/10万,女性为17.45/10万;总CASR为7.58/10万,其中男性为6.47/10万,女性为8.59/10万。趋势分析显示,男性CR的APC为9.31%,CASR的APC为5.26%,女性CR的APC为8.12%,CASR的APC为4.40%;45～64岁CR的APC为2.59%,CASR的APC为4.85%;65～岁CR的APC为7.20%,CASR的APC为9.79%,除15～44岁年龄组外差异均具有统计学意义。启东市居民期望寿命从1990年的73.95岁上升至2019年的82.91岁(AP...     

济南市居民2011—2018年肺癌死亡流行趋势及减寿分析

目的 了解济南市居民肺癌死亡流行病学特征,为疾病的防制提供科学依据。方法 收集2011—2018年济南市居民肺癌死亡资料,应用SPSS 20.0软件,对死亡率、潜在减寿年数、潜在工作损失年数等进行统计分析。结果 2011—2018济南市居民肺癌年均死亡率为44.69/10万,标化死亡率为24.23/10万。农村居民肺癌死亡率、截缩死亡率、累积死亡率、减寿率等均高于城市居民。各年龄组男性死亡率、截缩死亡率、累积死亡率、减寿率均高于女性。45岁后肺癌死亡率上升明显,60岁后上升速度开始加快, 80～85岁达顶峰。15～44岁人群肺癌标化死亡率呈逐年下降趋势（APC = - 6.57%,P = 0.041）。结论 肺癌是对济南市居民健康和生命威胁最大的恶性肿瘤。应采取可行的措施,降低肺癌发病率及死亡率,提高人群的健康水平。     

1972-2016年启东市脑肿瘤死亡趋势分析

目的探究江苏省启东市1972-2016年脑肿瘤死亡率变化趋势,为开展脑肿瘤防治工作提供建议。方法脑肿瘤死亡个案数据来源于1972-2016年肿瘤登记报告。1972-1977年数据使用国际疾病分类(ICD)第8版(ICD-8),1978-1999年数据使用ICD-9,2000-2016年使用ICD-10进行编码。根据中国2000年人口结构以及世界人口结构计算年龄标化死亡率、截缩率、累计死亡率等统计指标;使用Joinpoint软件计算年度变化百分比(APC)。结果1972-2016年启东市脑肿瘤死亡数逐年增加,死亡人数占全部癌症死亡人数比例为1.99%,粗死亡率、中标率和世标死亡率分别为3.90/10万、2.38/10万和3.09/10万,APC分别为4.30%、2.00%和2.03%,上升趋势均有统计学意义(P<0.01)。男性脑肿瘤粗死亡率、中标死亡率和世标死亡率分别为4.49/10万、2.76/10万和3.66/10万,女性脑肿瘤粗死亡率、中标死亡率和世标死亡率分别为3.32/10万、2.03/10万和2.57/10万。35岁以下年龄组脑肿瘤死亡率较低,60岁及以上年龄组死亡率明显升高,60岁及以上男性死亡率明显高于女性,差异均有统计学意义(P<0.01)。结论1972-2016年启东市脑肿瘤死亡率呈现持续上升趋势,应重点关注男性、高龄居民脑肿瘤死亡情况;35岁以下年龄组粗死亡率增长较快,60岁及以上年龄组的粗死亡率明显增加,需进一步加强脑肿瘤的防治工作。     

海门市2013年恶性肿瘤发病与死亡分析

目的 分析海门市2013年居民恶性肿瘤发病、死亡情况及其影响因素.方法 以粗率、标化率、发病、死亡顺位及性别年龄分布等指标,对2013年海门市恶性肿瘤发病及死亡资料进行统计分析.结果 海门市2013年居民恶性肿瘤粗发病率为387.38/10万,中标率为248.18/10万,世标率为190.00/10万,截缩率为316.74/10万.0～64岁、0～ 74岁累积发病率分别为11.16％和21.84％,发病中位年龄为66.84岁.粗死亡率、中标率、世标率、截缩率分别为262.27/10万、149.18/10万、114.87/10万、149.57/10万,0～64岁、0～ 74岁累积死亡率分别为5.37％和12.39％.发病癌谱前5位为肺癌、肝癌、胃癌、结直肠癌、乳房癌;死亡癌谱前4位与发病癌谱一致,第5位为胰腺癌.各年龄组发病、死亡率在35岁前均处于较低水平,女性发病率略高于男性.从50岁年龄组起发病、死亡率随年龄增长呈现“陡然”上升趋势,男性发病率、死亡率明显高于女性,男女发病、死亡性别比分别为1.23∶1和1.65∶1.结论 海门市恶性肿瘤防治重点应为50岁以上居民,肺癌、消化道肿瘤及乳房癌为肿瘤防治的重点.     

2009年浙江省恶性肿瘤发病与死亡情况分析

目的 分析2009年浙江省肿瘤登记地区恶性肿瘤发病与死亡情况.方法 收集2009年浙江省6个肿瘤登记地区上报的肿瘤发病与死亡资料,共报告恶性肿瘤新发病例30 613例,恶性肿瘤死亡病例16 920例.6个地区共计覆盖人口9 560 699名.计算恶性肿瘤发病与死亡的粗率、累积率(0 ～ 74岁)、截缩率(35 ～64岁)、年龄别率以及前10位恶性肿瘤发病与死亡顺位和构成等.采用1982年中国标准人口构成和Segi's世界人口构成分别计算中国和世界人口年龄标化发病率和死亡率(以下简称中标率和世标率).结果 2009年浙江省6个肿瘤登记地区恶性肿瘤粗发病率为320.20/10万,中标率为161.99/10万,世标率为207.92/10万,累积发病率为23.83％,截缩率为346.87/10万;恶性肿瘤粗死亡率为176.97/10万,中标率为79.17/10万,世标率为107.02/10万,累积死亡率为23.83％,截缩死亡率为139.75/10万.恶性肿瘤发病率在0～ 34岁人群处于较低水平,从35 ～39岁组(116.46/10万,954例)后上升明显,45 ～ 49岁(272.97/10万,2388例)后上升急剧,80 ～84岁组(1564.36/10万,2272例)达到高峰,死亡率从40 ～ 44岁组(48.06/10万,424例)后上升明显,80 ～84岁组(1392.23/10万,2022例)达到高峰.发病前10位的恶性肿瘤依次为肺癌、胃癌、结直肠癌、肝癌、乳腺癌、食管癌、甲状腺癌、胰腺癌、宫颈癌和淋巴瘤,占全部发病的74.37％(22 763/30 613);死亡前10位的肿瘤依次是肺癌、肝癌、胃癌、结直肠癌、食管癌、胰腺癌、白血病、淋巴瘤、脑肿瘤和乳腺癌,占全部死亡的87.75％(14 848/16 920).结论 2009年浙江省肿瘤登记地区恶性肿瘤发病率和死亡率均有所上升.肺癌、消化系统恶性肿瘤和乳腺癌仍然是浙江省肿瘤防治工作的重点,甲状腺癌发病率的升高不容忽视.     

2000-2009年浙江省肿瘤登记地区癌症死亡情况分析

目的探讨浙江省肿瘤登记地区2000-2009年癌症死亡的流行特征,为制定肿瘤防治计划提供参考依据。方法数据来源于6个登记地区上报的2000-2009年癌症死亡资料,经过分类、审核后计算粗死亡率、标化死亡率、年龄别死亡率、前10位癌症死亡顺位和构成、各年龄段癌症死亡顺位和构成、年度变化百分比(APC)及其95%CI。结果 2000-2009年浙江省登记地区共报告癌症死亡病例为95 254例,其中男性为61 944例,女性为33 310例。恶性肿瘤粗死亡率为158.56/10万,中标率为76.88/10万,世标率为103.31/10万,0~74岁死亡累积率为11.89%,35~64岁截缩率为137.19/10万。男性死亡率为203.46/10万,女性死亡率为112.38/10万。男女性死亡率比为1.81。45岁以后死亡率上升幅度显著,在80~84岁年龄组达到高峰。死亡率从2000年的130.61/10万上升到2009年的176.98/10万,APC为3.99%(95%CI:2.98%~5.01%)。2000-2009年浙江省登记地区死亡前10位的肿瘤依次为肺癌、肝癌、胃癌、结直肠癌、食管癌、胰腺癌、脑肿瘤、白血病、淋巴瘤和乳腺癌,占癌症死亡的86.69%。从年龄组死亡情况来看,白血病和脑肿瘤为儿童期主要肿瘤,肝癌和肺癌为青年组主要癌种,肺癌为中年组和老年组的主要癌种。结论浙江省肿瘤登记地区癌症死亡率呈上升趋势,肺癌、肝癌、胃癌、结直肠癌、食管癌和女性乳腺癌是浙江省肿瘤防治的重点癌种,需进一步加强癌症的健康教育和早诊早治工作,增强癌症的规范化治疗和康复工作,提高生存质量,降低癌症危害。     

1981-2005年昆山市居民肺癌死亡率趋势

目的 分析1981-2005年昆山市居民肺癌死亡率变化趋势.方法 采用昆山市1981-2005年全死因登记报告资料,计算肺癌粗死亡率、中国人口标化率及世界人口调整率、35～64岁截缩调整率、0～74岁累积死亡率、变化百分比(PC)及年度变化百分比(APC),并对不同年龄、不同时期居民的死亡率进行比较和分析.结果 肺癌年平均粗死亡率为27.88/10万.其中男性为43.19/10万,女性为12.56/10万,死亡率的性别比为3.44:1.世界人口调整率为22.52/10万,其中男性为37.28/10万.女性为9.67/10万.35～64岁肺癌截缩调整率为31.54/10万,0～74岁累积死亡率为0.10%.粗死亡率的PC为144.56%,APC为4.08%;世界人口调整率的PC为23.57%,APC为1.01%.结论 1981-2005年昆山市肺癌死亡率较高,且呈上升趋势.     

1972-2005年启东癌症发病谱研究

目的 分析江苏省启东市1972-2005年癌症发病谱,为癌症控制服务.方法 在约110万人口规模的启东地区建立以人群为基础的癌症登记报告系统,1972-2005年期间报告各种癌症发病病例70646例,用国际疾病分类第10版(ICD-10)进行分类编码,用发病率(CR)、标化率(ASR)对资料进行常规描述分析,用变化百分比(PC)、年均变化百分比(APC)、时期和出生队列方法进行发病趋势分析.结果 启东市:1972-2005年各种癌症年均发病率为184.77/10万,ASR为109.32/10万,其中男、女性发病率(ASR)分别为239.22/10万(136.08/10万)和131.58/10万(79.26/10万).启东居民发生癌症的终生累积危险为16.31%(男女分别为21.62%与11.1l%).启东前10位癌症部位(CR)分别为肝癌(60.69/10万)、胃癌(32.97/10万)、肺癌(27.59/10.万)、食管癌(9.34/10万)、直肠癌(8.06/10万)、乳腺癌(6.48/10万)、胰腺癌(5.97/10万)、白血病(3.84/10万)、脑(CNS)肿瘤(3.43/10万)、结肠癌(2.93/10万).乳腺癌(12.59/10万)和宫颈癌(4.62/10万)分别位居女性主要癌症的第4位和第8位.所有癌症中,肝癌占32.84%,消化系统癌症占65.85%.癌症粗发病率有逐年上升的趋势,PC和APC分别为87.19%和1.85%,但ASR却显示下降的趋势,PC和APC分别为-12.14%和-0.51%.ASR有显著上升趋势的癌症包括肺癌、乳腺癌、结直肠癌,有显著下降的包括胃癌、食管癌等.出生队列分析显示35岁以下青年人肝癌发病率、40岁以上人群的胃癌发病率、45岁以上人群的膀胱癌和50岁以上人群的食管癌发病率下降趋势明显.30岁以上人群的肺癌发病率、45～59岁人群的胰腺癌发病率以及40岁以上女性乳腺癌的发病率均有上升趋势.结论 启东市34年人群癌症登记资料的分析研究,显示了主要癌症的发病谱和流行趋势,提示了主要癌症的病因线索和癌症防治的重点.     

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.     

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.     

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.     

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.     

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.