沈阳市围生儿出生缺陷监测分析

对沈阳市1996－2000年的围生儿出生缺陷监测资料进行了统计分析。5年的出生缺陷发生率为86．05／万，低于全国水平；涉及出生缺陷病种63种：总唇裂，神经管畸形，多指（趾），先天性脑积水等居前列，出生缺陷的发生率农村明显高于城市（P＜0．01），男性明显高于妇性（P＜0．05）。母龄大于等于30岁母亲出生缺陷儿发生率高于母龄小于30岁组（P＜0．05）；出生缺陷是我国围生儿死亡的首位原因，严重影响我市人口期望寿命的提高和出生人口素质，因此应积极采取有效措施，降低出生缺陷发生率，围生儿死亡率。     

江苏省26803例围生儿出生缺陷监测

目的分析本地区人群出生缺陷发生情况和类型,为今后制定出生缺陷预防措施提供科学依据。方法对2002年6月-2004年8月期间纳入出生缺陷监测项目并随访分娩结局的围生儿（包括死胎、死产、病理性引流产、新生儿死亡）26803例中的出生缺陷类型及地域分布进行分析。结果人群出生缺陷总发生率为134．31／万（360／26803）;360例出生缺陷中,71．67％（258／360）为产前诊断发现的,28．33％（102／360）为随访发现。出生缺陷前5位为先天性心脏病、唇腭裂、先天性脑积水、染色体异常、神经管缺损;按系统分类结果显示,面颈部畸形发生率最高,占3．21‰（86／26803）,其次为神经系统畸形,占2．72‰（73／26803）,循环系统和呼吸系统畸形占1．98‰（53／26803）,苏南、苏中、苏北围生儿肌肉骨骼系统出生缺陷发生率比较,差异有统计学意义（P〈0．05）。结论减少出生缺陷的工作重点在预防,应加强优生知识的宣传,提高产前检查质量及产前诊断技术,以降低围生儿出生缺陷的发生率,提高出生人口素质。     

江苏省26 803例围生儿出生缺陷监测

目的分析本地区人群出生缺陷发生情况和类型,为今后制定出生缺陷预防措施提供科学依据。方法对2002年6月-2004年8月期间纳入出生缺陷监测项目并随访分娩结局的围生儿（包括死胎、死产、病理性引流产、新生儿死亡）26803例中的出生缺陷类型及地域分布进行分析。结果人群出生缺陷总发生率为134．31／万（360／26803）;360例出生缺陷中,71．67％（258／360）为产前诊断发现的,28．33％（102／360）为随访发现。出生缺陷前5位为先天性心脏病、唇腭裂、先天性脑积水、染色体异常、神经管缺损;按系统分类结果显示,面颈部畸形发生率最高,占3．21‰（86／26803）,其次为神经系统畸形,占2．72‰（73／26803）,循环系统和呼吸系统畸形占1．98‰（53／26803）,苏南、苏中、苏北围生儿肌肉骨骼系统出生缺陷发生率比较,差异有统计学意义（P〈0．05）。结论减少出生缺陷的工作重点在预防,应加强优生知识的宣传,提高产前检查质量及产前诊断技术,以降低围生儿出生缺陷的发生率,提高出生人口素质。     

南京市1990—2000年围生儿出生缺陷监测结果分析

目的：为了解南京市围生儿出生缺陷的发生种类及分布情况，寻找影响出生缺陷的相关因素。方法：1990年1月－2000年12月监测南京市11所医院住院分娩孕28周－产后7d的围生儿。按全国出生缺陷监测统一标准要求，由医院逐月上报《围生儿数月报表》、《出生缺陷登记卡》至市妇女保健所。结果：围生儿出生缺陷发生率7．95‰（1254／157637），唇腭裂，畸指（趾），神经管畸形是南京市围生儿出生缺陷前3位高发种类；男性出生缺陷发生率为8．75‰（721／82432）高于女性6．86‰（516／75188）；产母年龄≥35岁是出生缺陷的高发风险因素。结论：进一步开展婚前生殖健康教育和医学检查，指导新婚妇女服用小剂量叶酸预防神经管畸形，孕期开展产前诊断、遗传咨询、Down综合征筛查和新生儿疾病筛查工作，降低出生缺陷的发生率。     

2016—2021年余姚市围生儿出生缺陷结果及趋势预测分析

目的 分析2016—2021年余姚市围生儿出生缺陷监测数据，预测其发展趋势，为卫生行政部门制定出生缺陷防治措施提供参考依据。方法 收集2016—2021年余姚市围生儿出生缺陷资料，进行描述性分析，建立GM (1,1)灰色预测模型预测2022—2024年余姚市出生缺陷发生率。结果 余姚市出生缺陷平均年发生率为146.74/万，发生率呈逐年递增趋势；男性出生缺陷发生率（160.47/万）高于女性（132.22/万）；流动人口围生儿出生缺陷发生率（188.70/万）高于常住人口（125.05/万）；居前10位的出生缺陷类型是先天性心脏病、多指（趾）、总唇裂、外耳其他畸形、并指（趾）、小耳（无耳）、马蹄内翻足、隐睾、尿道下裂和直肠肛门闭锁或狭窄；产前诊断构成比（29.31%）明显低于产后诊断（70.69%）;GM (1,1)灰色预测模型预测2022—2024年余姚市出生缺陷发生率分别为200.38/万、219.59/万、240.62/万，呈继续上升趋势。结论 余姚市围生儿出生缺陷发生率呈逐年递增趋势，围绕三级预防制定积极有效的出生缺陷防治措施迫在眉睫。     

北京市东城区围生儿出生缺陷监测研究

目的 了解北京市东城区围生儿出生缺陷发生的现况，为预防出生缺陷、提高出生人口素质提供科学依据。方法 以医院为基础，按北京市出生缺陷监测方法，对2001年至2003年在北京市东城区孕28周至产后7天新生儿进行出生缺陷及其相关因素监测。结果 ①3年监测28249例围生儿，出生缺陷平均发生率为15．89‰，2003年呈显著下降趋势；②城市人口平均出生缺陷发生率为17．09‰；③春季出生缺陷发生率均显著高于其它3个季节；④先天性心脏病、指趾四肢畸形始终处于第一、二位，神经管畸形已降至第五位；⑤出生缺陷产前诊断率为22．88％～28．85％，但不同出生缺陷病种的产前诊断率不同。结论 出生缺陷是当前围生儿死亡的首因，以先天性心脏病、指趾四肢畸形发生率最高，提高产前诊断水平，及早发现严重畸形儿并终止妊娠是降低围生儿死亡的有效途径。     

鞍山市190726例围生儿出生缺陷监测结果分析

目的了解鞍山市出生缺陷发生情况，为制定干预措施提供依据。方法对1997--2006年鞍山市190726例围生儿进行监测，对筛查出的1453例出生缺陷儿的相关因素进行分析。结果出生缺陷发生率76．18／万，10a监测结果呈逐年上升趋势。农村地区出生缺陷发生率高于城镇（分别为82．69／万和66．66／万），出生缺陷以总唇裂、神经管畸形和多指较多，分别占5位发病人数444例的17．79％、9．91％和9．91％。结论加强围生期保健工作，大力开展健康教育，提高产前诊断技术，做好孕早期补充叶酸，可降低出生缺陷发生率。     

中国部分地区男性围生儿尿道下裂的流行特征

目的了解男性围生儿尿道下裂的流行病学特点，为中国出生缺陷的预防提供参考依据。方法资料来源于“中美预防出生缺陷和残疾合作项目”以人群为基础的出生缺陷监测系统。研究对象是江苏、浙江和河北省的27个县（市）1993年1月1日至2000年12月31日孕20周以上到出生后42d的611730例男性围生儿。结果男性围生儿尿道下裂总患病率为4．7／万，其中冠状沟型患病率为1．6／万，阴茎型患病率为1．8／万，会阴型患病率为0．7／万，未分类型患病率为0．6／万。河北、江苏和浙江的患病率依次递增（X2=24．71，P：0．000；趋势矿=24．60，P=0．000）；南方高于北方（X2=14．20，P=0．00）；城市高于农村（X2=4．94，P=0．026）；1993～2000年浙江省患病率呈上升趋势（趋势X2=4．61，P=0．032）。结论中国部分地区男性围生儿尿道下裂患病率南方高于北方、城市高于农村，浙江省的患病率有上升趋势；应积极开展尿道下裂的病因学研究，并采取必要的措施及早预防、遏制其上升的势头。     

围产儿先天性脑积水的流行病学调查

探讨我国围产儿先天性脑积水的流行病学特征，为降低该畸形的发生率提供科学依据。１９８６年１０月至１９８７年９月间，对全国原２９省、市、自治区９４５所医院进行出生缺陷监测，观察对象为妊娠２８周至出生后７天的围产儿。结果：在监测的１２４３２８４例住院分娩的围产儿中，共检出１１４６例先天性脑积水。全国平均发生率为９．２／万，仅次于神经管缺陷发生率；各省发生率波动在４．４～２２．９／万范围。低体重儿（５１．３／万）或早产儿（６０．８／万）中先天性脑积水发生率分别高于正常体重儿（６．１／万，Ｐ＜０．００１）、足月儿（６．２／万，Ｐ＜０．００１）；乡村发生率（１６．５／万）高于城镇（５．６／万，Ｐ＜０．０１）。患儿无性别差异。在检出的病例中，死胎占５０．８％、死产２７．１％、７天内死亡１２．１％，存活的患儿仅占７．７％。２４．３％的先天性脑积水患儿伴有其他畸形。产前诊断病例占３１．９％，其中仅有６．３％进行治疗性引产。先天性脑积水是我国常见且严重的先天畸形，患儿预后较差。     

安庆市16134例围产儿出生缺陷监测报告分析

文章资料来源于安庆市1999—2002围产儿出生缺陷情况季报表及出生缺陷儿登记卡，共监测产妇16029人，围产儿16134例，其中围产儿出生缺陷108例。分析发现：安庆市出生缺陷发生率66．94／万，低于全国1998年95．60／万的平均水平，出生缺陷围产儿死亡是围产死亡的重要原因之一；农村围产儿出生缺陷发生率高于城市，30岁以上组孕妇所生子女出生缺陷发生率最高，25～29岁组出生缺陷发生率最低。并提出加强宣传教育，重视优生咨询，加强孕期监测．提高监测质量等干预措施。     

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.     

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.