河南省2006-2010年流行性乙型脑炎病例监测

目的 分析河南省流行性乙型脑炎(乙脑)流行特点及流行因素.方法 通过描述性流行病学方法分析2006-2010年河南省乙脑发病的流行病学特点及其影响因素,采用ELISA方法检测病例血液或脑脊液乙脑病毒IgM抗体.结果 2006-2010年共报告乙脑3099例,发病率波动在0.39/10万～ 1.08/10万,发病趋势呈波动性下降;信阳、南阳、洛阳3市为高发区,其发病数占总病例的60.12％;7-9月为流行高峰,占93.26％;全省发病以0～ 14岁为多(83.61％),洛阳市≥15岁年龄组发病升高明显(57.63％),与全省≥15岁年龄组发病构成比相比,经x2检验差异有统计学意义(x2=330.0341,P＜0.05);全程接种乙脑疫苗的占4.95％,非全程接种的占15.28％,无疫苗接种和接种史不详的共占79.77％;实验室确诊病例占42.98％,临床诊断病例占45.95％,疑似病例占11.07％.结论 河南省乙脑病例的分布呈现季节性、地域性和人群差异的特点.乙脑疫苗的基础免疫和加强免疫有待规范,病例实验室诊断率需要进一步提高.     

2010-2015年黔南布依族苗族自治州流行性乙型脑炎实验室监测结果分析

目的 了解黔南布依族苗族自治州乙脑监测情况,为乙脑防控提供依据.方法 采用酶联免疫吸附试验(ELISA)检测2010-2015年黔南州疑似乙脑病例标本,并对乙脑实验室监测资料进行分析.结果 2010-2015年黔南州共报告疑似乙脑病例154例,采集标本131例,采集率为85.1％;血清/脑脊液采集率为45.8％,恢复期血清采集率为33.6％.疑似病例均为＜15岁儿童.乙脑IgM抗体阳性50例,阳性率为38.2％,阳性病例都集中在2～6岁、6～10岁两个年龄段,男性阳性率40.4％ (36/89),女性阳性率33.3％ (14/42).发病后4～10天采集标本82例,采集率为62.6％,阳性42例,阳性率为51.2％.省级乙脑实验室对黔南州实验室开展盲样考核和标本复核工作,符合率为100％和93.9％.结论 乙脑疑似病例发病后4～10天采集的标本阳性检出率高,为最佳的标本采集时间.     

2007—2014年郑州市流行性乙型脑炎流行特征分析

目的分析郑州市2007—2014年流行性乙型脑炎(乙脑)流行特征,为制定防控策略和开展防治工作提供依据。方法用描述流行病学方法对所收集资料进行分析,对各医院疑似病毒性脑炎患者的血清或脑脊液标本应用酶联免疫吸附试验(ELISA)进行JEV-Ig M抗体检测,进行早期快速诊断。结果郑州市2007—2014年共报告66例乙脑病例,年平均发病率为0.13/10万,发病高峰为7和8月,占全年总发病数的83.33%;48.48%的病例分布在中牟县及巩义市;0~15岁组病例居多,占总病例数的69.69%;乙脑病例中主要以无免疫史和免疫史不详者为主,有43例,占病例总数的65.15%;24 h内诊断为乙脑比例为12.12%。结论郑州市乙脑发病率总体呈下降趋势,近年来呈低水平流行,但仍有散在病例产生,乙脑防控工作应继续加强。     

1971-2010年贵州省流行性乙型脑炎流行特征

目的 分析贵州省1971-2010年流行性乙型脑炎(乙脑)的流行病学特征,为乙脑防控提供依据.方法 利用1971-2010年的乙脑发病数据资料进行描述性流行病学分析.结果 贵州省1971-2010年乙脑报告发病率0.61/10万～18.96/10万,呈下降趋势,2004-2010年下降较为明显,但仍高于全国平均水平;乙脑发病季节性明显,8月达到高峰;仍以小年龄发病为主,1990-2010年15岁以下儿童病例占89.9％～97.8％;1971-2003年发病率前3位的是安顺市、铜仁地区、遵义市,2004-2010年发病率前3位的是黔西南州、毕节地区和遵义市.2007-2010年目标儿童病例中无免疫史和免疫史不详的比例分别为89.7％、80.0％、81.7％和72.3％.结论 贵州省2004-2010年乙脑防控效果明显;免疫接种未改变乙脑发病的季节性和年龄分布.应进一步加强乙脑监测,提高乙脑常规免疫及时接种率和接种质量;考虑通过强化免疫来提高目标儿童的乙脑疫苗接种率和抗体水平.     

广西1960-2010年乙脑流行趋势及特征分析

目的分析广西壮族自治区1960-2010年流行性乙型脑炎(乙脑)流行趋势和特征,掌握其流行规律,为制定防控对策提供科学依据。方法收集广西壮族自治区1960-2010年乙脑的疫情资料,对该地区乙脑的流行趋势和特征进行统计学描述。结果广西1960-2010年共发生乙脑65 384例,死亡11 875例,年均发病率为3.38/10万,年均死亡率为0.61/10万,病死率为18.2%;发病主要集中在20世纪60和70年代,年均发病率分别为8.59/10万和9.24/10万,此后发病呈明显下降趋势;广西14个市均有病例发生,主要以贵港、防城港、北海、来宾、和玉林市发病较多,发病率分别为5.40/10万、4.12/10万、4.02/10万、3.88/10万和3.81/10万,分别占全省总病例数的14.3%、1.9%3、.4%、5.7%和12.5%;乙脑发病呈明显季节性,主要集中于5～9月份,占总发病例数的95.8%;患者以0～14岁散居儿童为主,男性发病多于女性。结论广西壮族自治区乙脑发病呈明显下降趋势;病例高度散发,发病有明显季节性;患者主要为低年龄散居儿童。     

玉林市乙脑疑似病例标本检验

目的分析玉林市2008-2010年乙型脑炎疑似病例检测资料,为今后防控乙脑提供科学依据。方法应用IgM-捕获ELISA法检测2008-2010年送检疑似乙脑病例IgM抗体,并对收集的资料进行综合分析研究。结果 2008-2010年共检测血清、脑脊液142份,乙脑IgM抗体阳性43份,阳性率30.28%,其中血清标本阳性率25.38%(33/130),脑脊液标本阳性率83.33%(10/12),确诊病例36人;连续3年乙脑IgM抗体检测阳性率分别是33.33%、22.72%和41.17%,各年间阳性率差异无统计学意义(χ2=3.88,P>0.05),6月形成高峰86.04%(37/43),每年12月至次年5月均无阳性病例的检出;送检病例均为14岁以下儿童,最小6月龄,最大12岁,检出36例病例,不同年龄段乙脑病例构成比以3～6岁最高,占52.78%(19/36),7～10岁居次22.22%(8/36),0～2岁居第3位19.44%(7/36),11～14岁最低5.56%(2/36),10岁以下儿童乙脑病例占94.44%(34/36);男性病例24例,女性病例12例,男、女比为2∶1,3～6岁年龄段男女比例基本相等,但在其他年龄段男性高于女性;确诊病例多以辖区内和周边地市及流动的农村散居儿童为主。结论玉林市2008-2010年乙脑发病有明显的季节性,以夏季为主,病例均为儿童,3～6岁病例数最高,应加强疫苗接种和防蚊灭蚊工作是乙脑防控关键。     

江苏省2007-2012年流行性乙型脑炎流行病学特征分析

目的 分析江苏省流行性乙型脑炎(epidemic encephalitis B)即日本乙型脑炎(Japanese type Bencephalitis,简称乙脑)的流行特征.方法 用SPSS 18.0和Excel 2010软件分析江苏省2007-2012年乙脑疫情信息,采用酶联免疫吸附测定(enzyme-linked immunosorbent assay,ELISA)方法检测病例血液或脑脊液乙脑病毒IgM抗体.结果 2007-2012年,年均发病率为0.06/10万,年均病死率为6.41％.连云港市、宿迁市和苏州市为高发市,其发病数占总病例的54.80％.7、8月为发病高峰,占93.59％.全省发病主要集中在0～14岁儿童,占94.66％;以散居儿童为主,占55.87％.全程接种乙脑疫苗的占19.22％,非全程接种占13.52％,无接种和接种史不详者合计占60.85％.实验室确诊病例占88.26％.结论 江苏省乙脑病例的分布呈现季节性、地域性和人群差异的特点.     

山西省疑似流行性乙型脑炎病例血清学检测分析

为了解山西省流行性乙型脑炎(乙脑)的流行状况,对该省1994～1999年的乙脑疫情报告和血清学诊断病例做了分析.对1994、1998年该省乙脑两个高峰期的疑似乙脑病人的血清,采用反向被动血凝抑制试验检测了血清特异性抗体和IgM抗体.结果显示1994～1999年共报告乙脑病例1796例,绝大多数是经临床诊断的,经实验室检测的仅399例,占22.2%(399/1796),确诊188例,10.5%(188/1796).1994、1998年231例疑似乙脑病人,经血清学确诊115例为乙脑(49.8%).此115例分布在该省9个地区(市),＞40岁中老年人占50%以上.中老年人接种乙脑疫苗,对降低乙脑发病率十分必要.     

贵州省乙脑实验室网络的建立及运转

目的 分析评价贵州省乙脑实验室网络建立和运转情况,为提高乙脑实验室检测质量及监测信息管理水平提供参考数据.方法 对贵州省2006～2010年乙脑实验室网络的各项实验室监测指标进行分析,对网络建立后的各项运转指标进行评价.结果 (1)贵州省乙脑实验室网络于2006年8月建立,含1个省级和9个市(州、地区,下同)级乙脑血清学实验室,形成了贵州省乙脑疑似病例的实验室快速反应诊断系统. (2) 2006～2010年采集到报告疑似乙脑及病毒性脑炎病例血清和/或脑脊液标本共3814例(疑似乙脑3627例,病脑187例)4749份,疑似乙脑病例标本采集率为85.1％ (75.2％～98.6％). (3)对所有采集到标本的3814例报告病例进行乙脑IgM抗体检测,阳性2533例(疑似乙脑2496例,病脑37例),疑似乙脑病例乙脑IgM阳性率在48.0％～85.9％之间,实验室确诊率在70.3％～83.2％之间;对2006～2007年381例乙脑阴性病例进行腮腺炎等10种其他常见病脑病毒IgM抗体检测,阳性206例,阳性率54.1％;从2006年报告病例的113份脑脊液中分离到2株基因Ⅰ型乙脑病毒. (4) 2009年、2010年接受国家对省级乙脑实验室每年一次的职能考核,成绩均为满分;2009年、2010年省级每年组织对市级乙脑实验室进行职能考核,每年9个市级考核成绩均达100分;2007～2010年省级对市级乙脑实验室的抽样复核省地符合率在92.3％～100％之间.结论 (1)贵州省已建立了省、市级CDC乙脑血清学和病原学监测实验室网络,并且运转良好. (2)通过乙脑实验室网络的良好运转,提高了乙脑报告病例的标本采集率和实验室确诊率,为贵州省控制乙脑工作奠定了实验室基础. (3)但仍需加强网络实验室管理和质量控制,克服松懈麻痹思想.     

2010—2019年茂名市流行性乙型脑炎实验室监测病例特征分析

目的 收集茂名市流行性乙型脑炎(简称乙脑)实验室病例监测结果,分析近十年乙脑的流行病学和临床特征,为乙脑的防控提供科学依据。方法 用ELISA对2010—2019年茂名市乙脑监测病例进行IgM抗体检测,使用描述性流行病学对确诊病例资料进行回顾性分析。结果 2010—2019年茂名市共报告乙脑监测病例423例,其中实验室确诊病例69例,死亡4例。年平均发病率0.11/10万,病死率5.80%。男女比例为1.76∶1;流行时间以5—6月份为主;地区分布呈高发区域环形分布特点;发病人群以散居儿童和学生为主,病例集中在2~12岁年龄儿童,无成人病例。病例人群以无免疫史和免疫史不详为主,占89.86%。病例临床分型以中重型为主,临床症状明显。结论 茂名市近十年乙脑的流行呈明显下降趋势,病例发病具有明显的季节性、人群特异性和周边县区多发的地域特点,发病以低龄免疫空白的散居儿童为主。需加强乙脑疫苗适龄儿童的查漏补种和防蚊灭蚊的控制措施,并持续开展乙脑病例和媒介的监测,以防止乙脑的流行暴发。     

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.     

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.