2005～2009年福州市流行性乙型脑炎流行特征分析

[目的]分析福州市流行性乙型脑炎（乙脑）流行特征,为制定防治策略提供科学依据。[方法]对2005-2009年福州市乙脑疫情资料和个案调查资料进行分析。[结果]2005-2009年福州市共报告乙脑病例35例,呈散发状态,年均发病率为0.10/10万;累计报告死亡3例,病死率为8.57%。35例病人中,2005-2009年分别发病16、7、2、3、7例;男性23例,女性12例;散居儿童17例,学生12例;10岁以下儿童29例;7~9月发病的27例;有乙脑疫苗接种史的7例。年均发病率,城区为0.05/10万,郊区8个县为0.13/10万。[结论]福州市乙脑疫情仍处于散发状态,农村是防治的重点地区、儿童是防治的重点人群,搞好儿童乙脑疫苗的预防接种是防控工作的重要措施。     

泉州市1982-2011年乙型脑炎流行病学特征

目的 分析泉州市1982-2011年流行性乙型脑炎(乙脑)流行趋势,为乙脑防控提供依据.方法 对1982-2011年泉州市乙脑疫情资料进行分析.结果 泉州市1982-2011年共报告乙脑951例,年均发病率为0.46/10万;累计死亡70例,年均死亡率为0.033/10万;年均病死率为7.4％.高发季节为6～8月,占病例数的97.0％,发病高峰7月,占病例数的63.0％.发病前3位的地区为南安、安溪和德化,年平均发病率分别为0.832/10万、0.61/10万和0.55/10万.男女发病之比1.16∶1;发病散居儿童最多(38.6％),其次为学生(33.3％),发病第3位为农民(10.6％);15岁以下病例占77.3％.结论 开展健康教育,提高乙脑疫苗接种率,开展防蚊灭蚊,对防控乙脑的发生有重要意义.     

2003～2007年广西流行性乙型脑炎流行特征及防控效果

目的 分析广西近5年流行性乙型脑炎(简称乙脑)的流行特征,评价乙脑防控措施效果,为制定今后的防治对策提供依据.方法 对2003～2007年乙脑疫情数据、采取的防控措施和效果进行描述性分析.结果 2003～2007年广西共报告乙脑病例1 334例,死亡91例,报告发病率为0.28-0.73/10万,死亡率为0.01～0.06/10万,病死率为3.05%～7.63%.除2006年外,其余年份乙脑发病率均在0.5/10万以上,其中2006、2007年分别在乙脑防控重点县(市、区)采取以乙脑疫苗接种和防蚊、灭蚊为主的防控措施,2006年乙脑报告发病率与2005年相比下降了56.69%,下降到1958年以来的最低水平,2007年乙脑发病率与2006年相比上升了107.14%,与近5年平均发病水平基本持平.结论 乙脑重点防控县(市、区)的划分具有较强的针对性和实用性,落实乙脑重点防控县(市、区)乙脑疫苗的突击接种和应急接种对控制乙脑流行的效果显著.     

甘肃省河西走廊地区2006-2010年夏秋季脑炎脑膜炎症候群病例调查

目的分析甘肃省河西走廊地区2006-2010年夏秋季节脑炎脑膜炎症候群病例流行病学及临床特征,为河西走廊地区乙脑监测及防控策略提供理论依据。方法回顾性调查分析河西5市选取的8个市、区(县)辖区内县级及以上医院574例脑炎脑膜炎症候群病例。结果 574例脑炎脑膜炎症候群病例中以病毒性脑炎病例为主,占75.09%,15岁以下儿童发病最为常见,占44.60%,多见于学生、农民、幼托及散居儿童。脑炎脑膜炎症候群病例多急性起病,以轻型、中型为主;主要临床表现依次为头痛、恶心、精神萎靡、发热、呕吐及头晕,结核性脑膜炎患者头痛的发生率明显高于病毒性脑炎及化脓性脑炎患者,差异有统计学意义(P0.05);化脓性脑膜炎患者精神神经症状的发生率明显高于病毒性脑炎及结核性脑膜炎,差异有统计学意义(P0.05)。结论病毒性脑炎是河西走廊地区脑炎脑膜炎症候群的主要病种,结合历史数据,仍不能排除河西走廊地区存在乙脑病例的可能性。     

三明市乙脑流行特征及防控策略

目的了解三明市流行性乙型脑炎(乙脑)流行特征,为制定防控策略和措施提供依据。方法用描述流行病学方法对三明市1955—2012年乙脑疫情进行分析。结果 1955—2012年全市累计发病5 760例,年均发病率4.79/10万,年均死亡率0.73/10万,病例主要集中在1965—1974年,共报告4 130例(71.7%);自然流行、疫苗试点推广和计划免疫3个时期的平均发病率和平均死亡率均呈下降趋势;各县区年均发病率在7.82/10万~16.66/10万间,农村年均发病率(2.29/10万)高于城区(2.18/10万);发病有明显的季节分布,7~8月占91.4%。1990—2012年间男女病例数比例为1.63∶1;0~14岁儿童占95.0%,发病以散居儿童为主(64.7%)。结论开展以预防接种为主的综合防控措施是防控乙脑的关键。     

广西流行性乙型脑炎流行趋势与疫苗接种效果

目的分析广西流行性乙型脑炎(乙脑)疫苗应急接种及乙脑疫苗纳入免疫规划后乙脑的流行趋势和特征,评价疫苗接种效果,为探索有效的乙脑预防控制策略提供依据.方法对1990~2010年法定传染病报告系统的数据资料进行描述性分析,收集统计各年份广西疾控中心的乙脑疫苗出库量,对乙脑流行趋势和疫苗接种干预效果进行分析.结果1990~2010年广西共报告乙脑病例8147例,死亡617例,年均发病率为0.85/10万,年均病死率为7.02%;乙脑报告发病率呈逐年下降趋势,个别年份波动较大,病例主要集中在河池、玉林、百色、贵港、钦州等市,5~8月份为流行季节,以<15岁儿童发病为主,1990~2007年连续采取以乙脑疫苗应急接种为主的防控措施,2008年将乙脑疫苗纳入计划免疫,全区乙脑的流行强度明显减弱,流行分布范围进一步减小.结论1990年以来广西乙脑发病率呈下降趋势,表明采用乙脑疫苗应急接种及乙脑疫苗纳入免疫规划后乙脑疫情得到控制,但某些年份发病率波动较大,存在局部暴发流行的隐患,仍需采取常规计划免疫与流行季节前突击接种相结合的防控措施.     

云南省2001-2010年流行性乙型脑炎流行病学分析

目的分析云南省2001-2010年流行性乙型脑炎的动态变化趋势和流行病学特征,为探索有效的乙脑预防控制策略提供依据。方法对云南省2001-2010年法定传染病报告系统中的流行性乙型脑炎数据资料进行描述性分析。结果 2001-2010年共报告乙脑病例4 918例,死亡246例,年均发病率为1.1287/10万,年均死亡率为0.0563/10万;乙脑报告发病率总体呈逐年下降趋势,个别年份波动较大,病例主要集中在西双版纳州、德宏州、保山市、昭通市、文山州、普洱市和红河州等,发病季节性明显,6-9月为流行季节,以〈15岁儿童发病为主,发病以散居儿童和学生为主。结论云南省乙脑发病率总体呈下降趋势,表明乙脑预防控制取得显著成效,但个别年份发病率波动较大,仍存在局部暴发流行的隐患,但发病率有所波动,在边境一线热带和亚热带地区乙脑的威胁仍然存在,应继续加强防控措施。今后几年应采取疫苗常规免疫和季节性突击接种相结合的措施。     

2005-2018年甘肃省庆阳市流行性乙型脑炎流行特征分析

目的 分析庆阳市流行性乙型脑炎（乙脑）的流行特征,为制定乙脑防控策略提供依据。方法 对2005-2018年庆阳市报告的乙脑病例数据进行描述性流行病学分析。结果 2005-2018年庆阳市共报告乙脑病例119例,年均报告发病率0.37/10万（0~3.06/10万）;死亡11例,病死率11.46%。发病覆盖范围逐年扩大,南部县区发病率（5.53/10万）较北部县区（0.63/10万）高。病例集中在7-9月份,8月份最多（63.87%）;病例年龄中位数为59岁（4~84岁）,45岁以上年龄人群发病数最多,占74.79%;职业以农民为主,占88.24%;98.32%的病例无明确的疫苗免疫史。结论 庆阳市乙脑发病率南部县区高于北部县区,主要发病人群为农村居住的中老年人,绝大多数病例无免疫史。应及时调整防控策略,提高成人乙脑疫苗接种率,加强农村地区环境卫生整治和农村居民的健康宣教。     

甘肃省2005-2019年流行性乙型脑炎时空分布特征北大核心

目的分析2005-2019年甘肃省流行性乙型脑炎(乙脑)发病的时空聚集性。方法通过中国疾病预防控制信息系统收集2005-2019年甘肃省乙脑发病率数据,进行描述性流行病学分析、三维趋势分析、空间自相关分析和时空扫描分析。结果甘肃省2005-2019年共报告乙脑1525例,年均发病率为0.39/10万。三维趋势分析显示,甘肃省乙脑发病呈现由北向南、由西向东逐渐升高。全局自相关分析显示,2005-2012年、2013-2019年乙脑发病率Moran’s I值分别为0.589、0.652。局部自相关分析显示,2005-2012年、2013-2019年乙脑发病率分别有18个、31个高值聚集县区。时空扫描分析显示,2005-2012年和2013-2019年乙脑发病各扫描到1个一类时空聚集区,聚集时间分别为2006-2007年和2017-2018年,聚集区半径分别为189.05km、244.37km。结论甘肃省2005-2019年乙脑发病存在明显的时空聚集性,高发病区域和有病例报告地区有所扩大;应施行分区域、有重点、综合性的乙脑防控策略。     

泰安市2007—2013年流行性乙型脑炎流行病学特征分析

目的了解2007—2013年泰安市流行性乙型脑炎(乙脑)流行病学特征,为防治提供科学依据。方法应用描述性流行病学方法对泰安市2007—2013年乙脑疫情资料进行分析。结果 2007—2013年泰安市共报告乙脑病例75例,呈散发状态,年均发病率为0.19/10万;死亡1例,病死率1.33%。整体疫情趋势平稳,2013年度乙脑发病有大幅提高;8—9月份为高发季节,占全部病例的88.00%;发病主要集中在40岁以上(55例,占73.33%),小于15岁发病者共计13例,占全部发病的17.33%。患者以农民(46例,61.33%)为主。患者未接种过乙脑疫苗的有28例,占调查病例的37.33%。结论泰安市乙脑疫情仍处于散发状态,2013年受乙脑自然流行周期影响,发病有大幅增加,农村是防治的重点地区。加强乙脑病例监测,落实乙脑疫苗的预防接种、防蚊灭蚊为主的综合防治措施是降低乙脑发病的关键。     

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.