云南省2000、2010年结核病流行病学抽样调查分析

目的了解近10年云南省结核病的流行状况与变化趋势,为下一阶段制定结核病防治措施提供建议。方法对云南省2000、2010年2次结核病流行病学调查（流调）资料进行比较。结果≥15岁人群活动性肺结核患病率,2000年为636．33／10万,2010年为1085．44／10万（P〈0．01）;活动性肺结核标化患病率,2000年为709．85／10万,2010年为1013．86／10万,年递增率为3．63％。≥15岁人群涂阳肺结核患病率,2000年为240．12／10万,2010年为150．46／10万（P〉0．05）;涂阳肺结核标化患病率,2000年为249．18／10万,2010年为142．57／10万,年递降率为5．43％。活动性肺结核患者中,新发现者所占比例,2000年为79．250．4,2010年为94．06％（P〈0．01）。活动性肺结核患病率,2000年男性为675．43／10万,女性为330．57／10万（P〈0．01）;2010年男性为1625．84／10万,女性为554．13／10万（P〈0．01）。活动性肺结核患病率,2000年15～59岁为451．93／10万,≥60岁为1947．42／10万（P〈0．01）;2010年15～59岁为797．55／10万,≥60岁为2300．79／10万（P〈0．01）。2010年活动性肺结核患病率,有可疑症状者为5722．46／10万,无可疑症状者708．81／10万（P〈0．01）。结论2010年与2000年相比,云南省调查点≥15岁人群活动性肺结核患病率呈上升趋势,涂阳肺结核患病率呈下降趋势;新发现患者所占比例有所增高。活动性肺结核患病率,男性高于女性,≥60岁高于15～59岁;有可疑症状者高于无可疑症状者。     

泰州市结核病流行现状及控制对策

目的：分析泰州市结核病流行现状及面临的问题，提出相应的控制对策。方法：对第四次，第三次全国结核病流行病学抽样调查资料进行比较分析。结果：第四次全国结核病流调结果显示，泰州市活动性肺结核患病率482／10万，涂阳患病率241／10万，与第三次流调结果比较，患病率，涂阳患病率分别上升了50．4％和60．2％，年递增率分别为7．3％和9．6％，结论：结核病流行是一个严重的公共卫生问题，控制结核病的任务仍然十分艰巨。     

湘西自治州结核病流行状况及其控制对策

目的：分析湘西自治州结核病流行状况，评价现行结核病控制对策实施效果，为此区今后结核病控制规划提供依据。方法：将1978年、1985年、1990年、2000年4次结核病流行病学调查进行对比分析。结果：活动性肺结核患病率2000年高达2067／10万，1978年～1990年12年间呈上升趋势，平均年递增率为1．9％，1990年-2000年10年l司有所下降，平均年递降率为2．6％。〈15岁年龄组肺结核构成比逐渐下降，2000年仅为5．3％。复治率高达40．5％～54．5％。结论：湘西自治州结核病疫情很严重，过去10年间疫情下降缓慢，因地制宜，结合实情切实落实DOTS方案是此区结核病控制的基本保证。     

某市1996～2003年结核病流行趋势分析

目的分析某市1996～2003年结核病的流行趋势，探索其流行规律，旨在为制订控制结核病疫情的策略提供科学依据。方法收集该市1996～2003年结核病防治所和县(市)级综合医院确诊为活动性肺结核的5176例患者和肺外结核的28例患者(均来自该市结核病月、季、年度报表)，进行描述性研究。结果活动性肺结核总的发病趋势呈曲线波动上升，活动性肺结核患病率从1996年的44．45／10万上升到2003年的72．16／10万；发病高峰集中在3月到5月，到12月份发病趋势又有所抬升；肺结核涂阳病人男性多于女性，平均男女比例为2、44：1，以青壮年为主；患病率／发病率(P／I)从1996年的2．60下降至2003年的1．03。结论结核病疫情的增长趋势不容忽视，各级政府和组织应引起高度重视。高治愈率、高发病率、高患病率(三高)现象是该市结核病的流行特点。     

2012年四川省结核病流行病学调查结果分析

目的了解四川省结核病患病情况及流行特征,分析全省结核病流行变化趋势,为制定有针对性的策略措施提供科学依据。方法2012年采用分层整群随机抽样的方法在l~tJll省抽取9个调查点,平均每个点调查1200人。对所有15岁及以上调查对象作x线胸片检查,对所有胸部x线检查异常者和肺结核可疑症状者进行3次痰涂片检查。对发现的所有肺结核患者进行结核病相关情况问卷调查。结果共调查10894人,发现活动性肺结核患者56人,其中痰涂片抗酸杆菌阳性（涂阳）患者7人,活动性肺结核和涂阳肺结核患病率分别为514／10万和64／10万。活动性肺结核患病率在35岁以后随年龄的增长上升,75—79岁最高（969／10万）;山区患病率最高（973／10万）,分别是平原（194／10万）和丘陵（520／10万）的5．02和1．87倍;农村人群患病率（674／10万）是城市人群（194／10万）的3．47倍;活动性肺结核患者和涂f【日患者中复治患者比例分别为35．71％和28．57％;无症状者占活动性患者的19。64％。结论~lJll省结核病疫情较为严重,农村地区和贫困山区疫情不容忽视;复治患者比例较高,暴露出治疗管理上存在问题。     

漯河市2002-2007年空洞性肺结核的控制效果

目的研究空洞性肺结核流行状况，为卫生主管部门提供科学依据，降低空洞性肺结核的发病率。方法对漯河市2002-2007年空洞性肺结核病例资料进行流行状况分析，研究其分布规律和总病趋势。结果该市2002年空洞性肺结核患病率5．82／10万，2007年患病率为3．23／10万，下降44．5％。结论通过中国结核病控制项目的实施，空洞性肺结核患病率明显下降。     

2005-2012年通道县肺结核流行病学分析

目的了解通道县肺结核病的流行情况,为今后更好开展结核病控制工作提供科学依据。方法对2005--2012年通道县肺结核患病率、不同年龄与性别分布的情况进行统计学分析。结果8年的涂阳患病率为46．7／10万,涂阴患病率为32．3／10万,总患病率为79．0／10万,均呈逐年下降趋势,总患病率的8年定基比为-32．4％;25-34岁年龄组的患病率最高（139．7／10万）,0-14岁年龄组的患病率最低（3．2／10万）;男女患病率之比为3．5：1,差异具有显著性（P〈0．01）。结论2005-2012年通道县肺结核病患病率逐年下降,应继续实施结核病控制项目。     

抓住机遇,做好结核病控制防治工作

在九十年代，由于种种原因，结核病死灰复燃，全球结核病正处于危急状态，ＷＨＯ发布１９９５年因结核病死亡病例３００万人，创近百年的最高记录。１　结核病发病情况根据１９９０年全国流行病学调查显示，近十年我国结核病发病情况是：１－１　结核病感染率：７岁儿童的感染率为７８％，年感染率为１１％，１４岁儿童的感染率为２０－４％，年感染率为１６％［１］。１－２　结核病患病率：我国现有活动性肺结核病人６００万，其中１５０多万是传染源，１９８４／８５全国结核病患病率为５５０／十万，涂阳患病率为１５６／十万；省与省之…     

海盐县7年流动人口肺结核病的监测

目的：分析海盐县1996～2002年流动人口肺结核监测结果。方法：对1996～2002年结核病监测年报表资料进行描述性统计分析。结果：7年间，新登记肺结核病人119例，年均新登记率90．46／10万，其中涂阳新登记率34．41／10万；发病数呈逐年上升趋势，从占全县病例数的4．76％上升到16．13％；以15～34岁为主，占75．63%；新发涂阳病人治愈率82．98％。结论：流动人口肺结核发病率高，病情重，对其进行肺结核免费治疗管理，提高发现率和治愈率是控制结核病至关重要工作。     

新洲区第四次结核病流行病学抽样调查结果与分析

目的调查新洲区结核病疫情，分析疫情变化及流行趋势，考核防治效果，为制定防治措施提供科学依据。方法采取随机整群分层抽样方法抽取3个调查点进行调查，通过结素试验、X线及痰结核菌检查发现肺结核病人。结果调查4408人，发现活动性肺结核31例，菌阳肺结核10例，活动性肺结核患病率为703．3／10万，涂阳患病率为181．5／10万，涂菌阳患病率为226．9／10万。结论新洲区结核病疫情较高，形势十分严峻，且有上升趋势，呈农村疫情明显高于集镇，贫困地区疫情明显高于富裕地区的特点。     

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.