山东省不同出生队列脑血管疾病死亡率的变化趋势

目的 分析山东省不同出生队列的脑血管疾病死亡率变化趋势.方法 利用1970～2005年期间的4次全死因调查资料,计算脑血管疾病死亡率和世界人口标化死亡率,分析城乡的变化趋势.利用相差35年的出生队列分析其脑血管疾病死亡率的变化趋势.结果 脑血管疾病死亡率占总死亡率的百分比由1970～1974年的8.82%上升到2004～2005年的22.83%.城市脑血管疾病世界人口标化死亡率由1970～1974的100.87/10万上升到2004～2005年的108.62/10万,同期,农村则由72.93/10万上升到127.11/10万,农村超过城市.按1970年和2005年相同年龄组确定相应的出生队列,然后比较相同年龄但出生队列相差35年的脑血管疾病死亡率,发现后出生队列的脑血管疾病死亡率明显高于早出生队列.结论 在过去35中,山东脑血管疾病死亡率呈增加趋势;农村上升速度快,由低于城市到超过城市;出生队列分析显示,相同年龄但后出生队列人群脑血管疾病死亡率上升速率明显高于早出生队列人群.     

自贡市1985～2004年肺结核死亡趋势分析

[目的]分析自贡市1985～2004年间肺结核的死亡流行趋势,为制定今后的防治对策提供科学依据。[方法]依据1985～2004年自贡市肺结核疫情报告资料,采用死亡率对该地区肺结核病死亡情况进行分析。[结果]1985～2004年自贡市肺结核死亡率呈逐年下降趋势,总死亡率下降了89.14%,其中男性下降88.39%,女性下降90.63%。男女肺结核死亡率差异无统计学意义（u=1.079,P﹥0.2）。随着时间推移,肺结核在低年龄组死亡率逐步下降,死亡率高峰向高年龄组后推,且死亡率高峰处实际死亡率也在逐年下降。[结论]20年间自贡市肺结核病防治工作成效明显。但老年肺结核死亡率仍然较高,应积极采取各种相应的措施提高老年肺结核病人的发现率和治愈率。     

基于年龄-时期-队列模型分析1990—2019年中国肝癌发病趋势

目的探讨中国人群肝癌发病随年龄、时期、队列三因素变化趋势。方法基于2019年全球疾病负担研究(GBD 2019)数据库,以1990—2019年,20～79岁中国居民为研究对象,应用Stata 12.0分析,通过年龄-时期-队列模型估算中国肝癌发病率的年龄、时期和队列效应。结果 1990—2019年,中国男性和女性的肝癌标化发病率分别由1990年的34.76/10万和13.51/10万下降至2019年的15.22/10万和4.29/10万。APC模型分析显示,1990—2019年,我国肝癌发生风险的年龄效应为随年龄增加而增大[效应系数(男性):-2.357～0.809,P0.05;效应系数(女性):-1.874～1.374,P0.05]。时期效应为随着年份的增加先减低后增加[效应系数(男性)0.379～-0.353～0.002,P0.05;效应系数(女性):0.553～-0.328～-0.208,P0.05]。队列效应随出生队列的发展下降趋势显著[效应系数(男性)0.769～-0.717,P0.05;效应系数(女性):0.660～-0.915,P0.05]。结论 1990—2019年,中国人群肝癌发病率总体呈下降趋势,肝癌发病风险随着年龄的增长而增加,随着出生队列的增长而降低,随着时期的增加呈现先增后降的趋势,需加强在特殊人群,如老年人一级预防措施工作的开展,进一步降低我国未来肝癌发病率。     

2004-2005年山东省女性乳腺癌死亡率调查

[目的]通过对乳腺癌死亡资料分析,掌握山东省乳腺癌的死亡水平及变化趋势。[方法]利用山东省第三次死因调查资料．对山东省2004-2005年乳腺癌死亡病例进行分析,对其死亡特点和趋势进行描述和分析。[结果]2004～2005年山东省女性乳腺癌的粗死亡率为6．62／10万,中国人口标化死亡率为5．44／10万,世界人口标化死亡率为5．68／10万．处于中等水平。死亡率城市高于农村,经济发达的沿海地区高于内陆地区。死亡率随年龄增高而增高。20世纪90年代以来,死亡率迅速上升,主要是人口因素和非人口因素共同作用的结果。[结论]山东省女性乳腺癌死亡率处于中等水平但上升迅速,必须引起重视,加强其预防和干预。     

1991～2005年大连市城区肝癌死亡率及其疾病负担分析

[目的]了解大连市城区居民肝癌死亡特征及其变化趋势,并为制定防治策略和措施提供科学依据。[方法]对1991~2005年大连市城区居民肝癌死亡资料进行分析。[结论]1991~2005年居民肝癌合计死亡7330例,年均死亡率为24.83/10万,标化死亡率为19.20/10万。肝癌死亡率随着时间的推移呈上升趋势,标化死亡率呈下降趋势。肝癌粗死亡率男性与女性分别为36.44/10万、12.90/10万,年均分别上升1.72%和1.41%(P<0.05);标化率男性与女性分别为29.69/10万和9.56/10万,年均分别下降1.39%和2.08%(P<0.01)。粗死亡率、标化死亡率均为男性高于女性,男女比分别为2.8∶1、3.1∶1。居民去肝癌寿命为77.38岁,肝癌所致寿命损失率为0.61%。[结论]大连市城区肝癌粗死亡率呈上升趋势,标化死亡率呈下降趋势,肝癌对男性的危害明显大于女性。     

1995～2004年上海市徐汇区居民恶性肿瘤减寿分析

[目的]研究恶性肿瘤对居民寿命的影响。[方法]用2000年的世界人口作为标准人口，对1995～2004年徐汇区居民恶性肿瘤死亡资料进行分析，估计恶性肿瘤年龄别寿命损失，对10年去恶性肿瘤死因期望寿命的时间趋势拟合回归直线，计算恶性肿瘤潜在减寿年数（YPLL）、标准化潜在减寿率（SYPLL‰）和平均减寿年数（AYLL）。[结果]徐汇区居民男性恶性肿瘤死亡率高于女性，标化性别比为l，64：l；死亡率居前的是肺癌、胃癌、肠癌、肝癌和女性乳腺癌；10年居民期望寿命均存在直线上升趋势（P〈0．001），恶性肿瘤年龄别寿命减少率40岁以后上升较快，75岁之后趋于平稳；YPLL最高的男女均为肺癌，AYLL第1位是白血病。[结论]徐汇区恶性肿瘤死亡率最高的为肺癌，主要影响人群为中老年人；平均减寿年数最多的是白血病，主要影响人群是青壮年；对中老年人应主要关注肺癌，青壮年主要关注白血病、鼻咽癌、女性乳腺癌及男性肝癌。     

上海市糖尿病死亡趋势APC模型分析

[目的]通过定量描述糖尿病死亡率的年龄、时期和出生队列特征,预测上海市糖尿病死亡趋势,为预防控制糖尿病提供依据。[方法]死亡数据来自上海市疾病预防控制中心死亡登记系统。部分年份的年龄别人口数采用内插法推算。1992年至2003年间登记的疾病编码标准前后有2种(ICD-9和ICD-10),选择占全人群糖尿病提及死亡98%的30~89岁的糖尿病提及死亡个案作为研究对象。采用年龄-时期-队列模型(Age-Period-CohortModel,APC模型)的分析方法,根据模型拟合结果进行预测。[结果]模型拟合结果以同时加入年龄、时期、队列效应的模型为最佳。分性别糖尿病死亡率的年龄、时期和队列效应均表现出序列趋势。应用模型拟合预测2013~2015年上海市分性别的30~89岁年龄别糖尿病死亡率,各年龄组死亡率相对于2001~2003年均大幅上升。[结论]糖尿病将持续成为上海市居民的主要死因之一,开展以代谢综合症(MS)为先导的社区综合防治应成为糖尿病预防控制的优先策略。     

郑州市新生儿主要死因变化的趋势

[目的]了解郑州市新生儿主要死亡原因的变化趋势,探索降低新生儿死亡率的有效措施。[方法]依靠郑州市儿童保健网,按《全国5岁以下儿童死亡监测方案》及《郑州市5岁以下儿童死亡监测方案》的要求进行资料的收集、整理及分析。[结果]郑州市2000～2004年新生儿死亡率呈下降趋势（P﹤0.001）,5年中出生窒息为新生儿死亡的第一位死因。[结论]降低新生儿死亡率的重点是积极处理和预防新生儿出生窒息的发生,提高早产儿、低出生体重儿的监护和治疗水平。     

基于年龄-时期-队列模型分析2006—2020年中国冠心病死亡趋势

目的 分析2006—2020年间中国城市和农村15～84岁人群冠心病死亡率变化趋势及年龄、时期、出生队列对冠心病死亡率的影响,为预防冠心病的死亡提供科学依据和策略。方法 基于2006—2020年城乡冠心病死亡率数据,建立连接点回归模型描述冠心病死亡率的阶段性变化趋势;通过构建年龄-时期-队列模型（age-period-cohort model,APC）,估算我国城市和农村冠心病死亡率的年龄、时期及队列效应。结果 2006—2020年间,我国城市冠心病死亡率从85.66/10万增长到126.91/10万,农村死亡率从63.55/10万上升到135.88/10万,年平均变化百分比（average annual percentage change,AAPC）分别为2.85%,5.89%。APC模型分析显示,2006—2020年冠心病死亡风险随年龄增加而增大,其中城市人群年龄效应系数为：-1.60～2.53,农村为-2.05～2.34;时期效应随着时期的增加而逐渐上升,城市效应系数为：-0.29～0.23,农村：-0.17～0.14;队列效应显示,随着出生队列的推移死亡风险下降趋势明显,城市：...     

福建同安主要恶性肿瘤死亡率分析与趋势预测

[目的]分析福建省同安恶性肿瘤死因及死亡率变化趋势，为预防控制提供依据。[方法]计算标化死亡率、早死所致生命损失年，并采用灰色模型预测，对1990—2001年同安恶性肿瘤死亡资料统计分析。[结果]1990—2001年同安恶性肿瘤死亡率呈上升趋势。恶性肿瘤标化死亡率126．72／10万，食管癌、肝癌、胃癌和肺癌标化死亡率分别为39．12／10万、36．59／10万、12．82／10万和12．60／10万。肺癌死亡率上升趋势明显，女性肺癌标化生命损失年YLLs率上升18．18％。以灰色模型GM(1，1)预测2005年同安恶性肿瘤死亡率为142．06／10万。[结论]肝癌、食管癌、肺癌、胃癌是同安肿瘤研究与防治的重点。     

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.     

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.