0～2岁儿童低血红蛋白与铅中毒对智能发育的影响

目的：了解铅中毒、低血红蛋白对儿童智能发育的影响及相关性。方法：在城区初级保健门诊随机对201例0～2岁儿童检测血铅、血红蛋白及发育指数。采用CDCC量表，通过智力发育指数（MDI）、心理运动发育指数（PDI）评估儿童智商状况。结果：血铅≥100μg／L32例，占15．92％，其MDI均值为（94．18±9．49），PDI均值为（91．43±10．70）。正常对照组MDI均值为（106．18±16．24），PDI均值为（94．42±12．55），两组相比智力发育有明显差异。血红蛋白≤110g／L24例，占11．94％，均为轻度贫血，其MDI为（102．25±16．50），PDI为（88．95±11．33），两项指标均为低水平，但差异不显著。结论：与轻度贫血相比，铅中毒更能导致婴幼儿智力发育落后，低浓度铅中毒与贫血相关性尚不明显。     

铅中毒对婴幼儿智能发育的影响

【目的】探讨铅中毒对婴幼儿智能发育的影响。【方法】对100例6个月～1岁婴幼儿进行血铅测定，采用要幼儿智力发育检测量表进行运动及智能发展指数的测定。【结果】铅中毒组智能发展指数(MDI)和运动发展指数(PDI)比对照组分别落后5．93和4．97分，经统计学处理；差异有显著性。【结论】铅污染影响要幼儿智能发育，值得广泛关注。     

轻度缺铁性贫血婴幼儿体格生长及智能行为发育研究

目的:探讨轻度缺铁性贫血(MIDA)对婴幼儿体格生长和智能行为发育的影响。方法:对254例定期进行儿童保健的婴幼儿的生长发育进行纵向监测,定期对体重、身高、智力发育指数(MDl)、精神运动发育指数(PDl),以及行为发育进行测试。智能及行为测试采用Bayley婴幼儿发育量表。根据2岁时有无MIDA分为病例组(104例)和对照组(150例)。结果:病例组2岁体重、身高都较对照组低,体重差异有统计学意义(P<0.05),1～2岁男女婴幼儿体重年增长率都较对照组低(P<0.01,P<0.05)。2岁MIDA患儿MDI、PDI明显低于对照组,两组智能发育水平存在显著性差异(P<0.0001,P<0.01,P<0.05),且MIDA患儿血红蛋白水平与其MDI和PDI分值呈正相关(P<0.01)。MIDA患儿与背景资料相同的同龄儿相比,存在社交退缩、不快乐、注意力持续时间短、易疲劳、手指及手腕的精细运动协调性差等行为问题(P<0.05)。结论:MIDA对婴幼儿体格生长和智能行为发育均产生不良影响,积极防治缺铁性贫血对保证婴幼儿正常生长发育具有重要现实意义。     

Peabody运动发育量表评价贫血对婴儿运动发育的影响

目的探讨Peabody运动发育量表(PDMS-2)评价贫血对婴儿运动发育状况的影响。方法选择2014年100例缺铁性贫血婴儿及100例与之背景资料相匹配的正常婴儿为对照组,采用PDMS-2量表、智力发育指数(MDI)、精神运动发育指数(PDI)测定婴儿精细运动发育及智能行为发育情况。贫血纠正后对两组随访1年,再次采用上述量表进行重复测量,比较两组婴儿精细运动及智能发育情况。结果贫血组年体重增长率小于对照组(P0.05),而两组身高年增长率比较无统计学差异(P0.05)。贫血组入组时MDI、PDI、PDMS-2总分及其各维度评分均低于对照组(P0.05)。随访1年后,贫血组MDI、PDI、PDMS-2总分仍低于对照组(P0.05)。经相关分析可知,MDI、PDI、PDMS-2总分与婴幼儿期血红蛋白呈正相关(P0.05)。结论婴幼儿期缺铁性贫血可影响其运动及智力发育,贫血纠正后1年这一影响仍然存在,因此家长应重视缺铁性贫血对婴幼儿生长发育的影响,降低缺铁性贫血发病率。     

长春市126例婴儿智力及运动发育影响因素分析

目的:分析长春市3月龄婴儿的智力及运动发育状况及其影响因素.方法:采用气相色谱法测定母乳中8种多不饱和脂肪酸(PUFA)水平,以贝利婴幼儿发展量表(BSID-CR,中国城市修订版)测定月龄为3月～3月+7天内的126例健康要儿的智力发育指数(MDI)及运动发育指数(PDI).结果:MDI均值为(126.631±12.715),PDI均值为(114.116±12.707);母乳中二十二碳四烯酸(DTA)水平及胎龄与婴儿MDI相关(R2=0.117,P=0.013);母亲生育年龄及婴儿出生体重与婴儿的PDI相关(R2=0.099,P=0.021).结论:所检测婴儿的智力发育平均水平为优秀,运动发育平均水平为中上等.母乳中较高水平DTA能促进婴儿智力发育;母亲妊娠年龄过大及婴儿低出生体重不利于婴儿运动发育.     

孤立性侧脑室增宽胎儿出生后智力与运动发育的研究

目的 研究孤立性侧脑室增宽胎儿的智力运动发育水平,用于孕期优生优育的指导和发育异常患儿的早期发现和治疗。方法 对孕期诊断为孤立性侧脑室增宽的患儿进行随访,采用儿童发育量表评估患儿的智力运动发育水平。结果 72例孤立性侧脑室增宽儿童中37例(51.4%)智力发育指数MDI≥80,27例(37.5%)神经运动发育指数PDI≥80 。57例妊娠末期侧脑室扩张未消失的儿童16例(28.1%)智力发育指数MDI≥80,18例(31.6%)神经运动发育指数PDI≥80。15例妊娠末期侧脑室扩张逐渐消失的儿童11例(73.3%)智力发育指数MDI≥80,10例(66.7%)神经运动发育指数PDI≥80。68例轻度侧脑室增宽儿童智力发育指数78.86±19.663,神经运动发育指数72.40±18.579。10例单侧侧脑室增宽儿童智力发育指数86.10±11.836,神经运动发育指数81.40±14.804。4例重度侧脑室增宽儿童智力发育指数<50,神经运动发育指数<50。轻度侧脑室增宽、单侧侧脑室增宽与重度侧脑室增宽的儿童智力发育指数和神经运动发育指数差异有统计学意义(P<0.05),轻度侧脑室增宽与单侧侧脑室增宽的儿童智力发育指数和神经运动发育指数差异无统计学意义(P>0.05)。三组儿童的智力发育指数和神经运动发育指数均低于健康儿童的平均水平。结论 孤立性轻度侧脑室增宽智力发育指数和神经运动发育指数均低于健康儿童的平均水平,且重度侧脑室增宽儿童出现了明显的发育障碍。今后应加强此类胎婴儿的监测,争取早期发现和治疗。     

湖州市0～6岁儿童血铅水平检测结果分析

[目的]了解湖州市0～6岁儿童血铅水平。[方法]采用原子吸收光谱分析方法对3756例儿童进行末梢血血铅水平检测。[结果]3756例儿童血铅水平均值为(70.63±30.85)μg/L,其中血铅水平≥100μg/L者524例,铅中毒发生率为13.95%。2033例男童血铅水平均值为(71.45±31.63)μg/L,其中血铅水平≥100μg/L者293例,铅中毒发生率为14.41%。1723例女童血铅水平均值为(69.67±29.87)μg/L,其中血铅水平≥100μg/L者231例,铅中毒发生率为13.41%。男女儿童血铅水平均值及铅中毒率差异均无统计学意义(P﹥0.05);2285例城市儿童血铅水平均值为(70.51±30.10)μg/L,其中血铅水平≥100μg/L者331例,铅中毒发生率为14.49%,1471例农村儿童血铅水平均值为(70.82±31.99)μg/L,其中血铅水平≥100μg/L者193例,铅中毒发生率为13.12%。城乡儿童血铅水平均值、铅中毒率差异均无统计学意义(P﹥0.05);各年龄段之间血铅水平、铅中毒率差异有统计学意义(P﹤0.01);同年龄段男女儿童血铅水平、铅中毒率差异均统计学意义(P﹥0.05);儿童血铅水平、铅中毒率随年龄增长而升高。[结论]湖州市0～6岁儿童血铅水平低于公认允许水平,但血铅超标现象仍然存在,且有随年龄增长而升高趋势,应引起有关部门的重视,加强铅污染防治力度,加强健康教育和饮食指导等,保障儿童健康成长。     

110名婴幼儿认知发育的影响因素

目的：探讨影响2~30个月婴幼儿认知发育的相关因素,为婴幼儿发育的早期促进提供参考依据。方法在内蒙古呼和浩特市随机抽取城乡各一个点作为项目点,共抽取2~30个月龄婴幼儿110人。以问卷形式调查影响婴幼儿认知发育的相关因素,采用Bayley婴幼儿发育量表对婴幼儿进行发育评估。采用相关分析、方差分析、多元线性回归模型等统计方法对数据进行分析。结果智力发育指数均值(MDI)为102.51±15.55,运动发育指数均值(PDI)为98.26±15.18。城市儿童的MDI得分高于农村儿童的MDI得分(t=8.03,P=0.005);城市与农村儿童的运动发育水平无显著性差异(P>0.05)。性别、分娩方式、父母受教育程度对婴幼儿智力及运动发育均无显著影响(均P>0.05)。出生体重与MDI及PDI均有显著的正性相关(r=0.21, P=0.028;r=0.28,P=0.003)。多元线性回归分析提示出生体重是2~30个月婴幼儿MDI及PDI的独立影响因素。结论生长在城市的婴幼儿认知发育较好,出生体重与婴幼儿认知发育有一定正相关。     

母子交流时间对婴幼儿认知发育影响的研究

目的 探讨母子交流时间对婴幼儿认知发育影响,为科学育儿提供科学依据。方法 选择江苏省淮安市城区和乡镇医院各一个点作为项目点,随机抽取2~30个月婴幼儿共140名。家长填写儿童个人及家庭社会环境问卷,专业人员采用《贝莉婴幼儿发育量表》对儿童进行认知发育评估。结果 入组儿童平均年龄(12.52±7.78)月龄;男童占52.9%;城区婴幼儿占74.6%;智力发育指数(mental development index,MDI)为104.16±13.036,运动发育指数(psychomotor development index,PDI)为 103.34±11.431。城市与乡镇婴幼儿的MDI无统计学差异(103.27±13.81 vs 106.20±9.95,F=3.36,P=0.250),城市婴幼儿PDI为101.92±12.01,显著低于乡镇婴幼儿PDI 106.51±8.09(F=7.31,P=0.013)。父亲文化程度不同,儿童的MDI存在差异(F=2.71,P=0.047)。城乡差异、父母文化程度和家庭结构等因素对母子交流的影响无统计学差异。母子交流时间越多,婴幼儿智力发育指数越高(F=3.28,P=0.023),且多元线性回归显示控制儿童年龄、性别、父亲文化程度等相关因素后,母子交流仍是婴幼儿MDI的独立影响因素。结论 母子交流时间对婴幼儿认知发育尤其是智力发育指数有显著的促进作用。     

血铅对3岁以下儿童智能发育影响分析

目的:了解血铅水平对儿童智能发育的影响。方法:对儿童保健门诊的1043例3岁以下儿童,用0~6岁儿童神经心理量表进行智能发育水平的测试和原子吸收光谱仪测定血铅。结果:1043例儿童血铅水平最低26μg/L,最高239μg/L,平均(66.77±34.68)μg/L。其中铅中毒174例,铅中毒率为16.68%,铅中毒组儿童智能发育明显低于正常组。结论:儿童智能发育程度与血铅水平密切相关,应开展有效的健康教育和铅污染环境的干预。     

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.