玉林市玉州区免疫接种率监测与评价

目的了解玉林市玉州区免疫接种现状，为提高免疫接种水平提供依据。方法对1999--2005年常规免疫报告接种率、调查接种率，1997--2003年强化免疫接种率进行综合分析。结果1999--2005年4种疫苗[卡介苗（BCG）、口服脊髓灰质炎疫苗（OPV）、百白破联合疫苗（DPT）、麻疹疫苗（MV）]常规免疫估算接种率为73．5％～100．0％；4种疫苗调查接种率为80．0％～100．0％；1997--2003年OPV强化免疫估算接种率为59．6％～94．2％。结论常规免疫和强化免疫存在滑坡现象。接种率监测的核心是掌握应种人数，免疫空白主要在〈1岁儿童。提示必须定期采取行之有效的查漏补种，才能消除免疫空白和提高免疫接种水平。     

贵州省1999年常规免疫接种率监测评价

贵州省 1999年常规免疫接种率监测及评价结果显示 :基础免疫卡介苗 (BCG)、口服脊髓灰质炎疫苗 (OPV)、百白破混合制剂 (DPT)、麻疹疫苗 (MV)、乙型病毒性肝炎 (乙肝 )疫苗的报告接种率分别为 94 9%、 98 4%、 96 3%、 98 1%和89 5 % ,估算接种率分别为 :70 2 %、 76 9%、 72 9%、 83 7%和 6 6 % ;加强免疫 (或复种 )中 7岁的OPV、MV、白喉破伤风二联类毒素 (DT)的报告接种率分别为 95 5 %、 94 5 %和 89 2 % ,估算接种率分别为 39 4%、 45 0 %和 31 3 % ;2岁的DPT加强免疫报告接种率为 95 0 % ,估算接种率为 73 9%。全省差值 (D)评价 ,报告接种率MV为“可疑” ,BCG、OPV、DPT、乙肝疫苗为“不可信” ;比值 (R)评价 3BCG/OPV与 3BCG/DPT为“可信” ,3MV/OPV与 3MV/DPT为“可疑”。用常规免疫、强化免疫和全省抽样调查出生率三方面的资料进行分析 ,提示 :流动儿童和超生、超龄儿童的摸底调查是计划免疫工作的难点 ,是导致我省常规免疫接种率偏低的主要原因     

2011年大连市常规免疫监测系统评价

[目的]掌握2011年大连市常规免疫接种率报告及监测状况。[方法]对大连市2011年1剂卡介苗(BCG)、乙型肝炎疫苗(HepB)、脊髓灰质炎疫苗(OPV)、无细胞百白破联合疫苗(DTaP)和麻风疫苗(MR)监测结果和接种率调查资料进行分析,并利用差值(D)和比值(R)对常规免疫报告接种率的真实性进行评价。[结果]大连市2011年12个区(市、县)常规免疫报表及时报告率为95.83%,无缺报、漏报,乡级预防接种单位常规免疫接种率报告完整性为100.00%;BCG、HepB3、OPV3、DTaP3和MR报告接种率均在99%以上;在中山区、金州新区、普兰店市共调查1.5～3.5岁儿童450人,上述5种疫苗的调查接种率分别为99.56%、100.00%、97.78%、95.56%、100.00%。D值评价,12个区(市、县)的5种疫苗中,只有旅顺口区的OPV3、DTaP3和MR,普兰店市、长兴岛的OPV3和DTaP3为"可信",其他均为"可疑"和"不可信"。全市报告接种率的R值评价,3MR与OPV3比较,3MR与DTaP3比较均为"可信",3MR与HepB3比较为"可疑";3BCG与OPV3比较为"可疑"。[结论]2011年大连市常规免疫监测系统报告接种率真实性较高。     

天津市红桥区1998～2002年常规免疫接种率报告与监测评价

目的评价红桥区常规免疫接种率的报告情况,以掌握免疫接种月报存在的问题.方法对红桥区1998～2002年常规免疫监测报表进行统计分析.结果口服脊髓灰质炎(OPV)、百白破(DPT)、麻疹疫苗(MV)、乙型肝炎疫苗HBV平均报告接种率分别为99.85%、99.86%、99.82%、99.85%,历年估算接种率范围分别为93.99%～99.91%、94.90%～99.91%、93.27%～99.63%、87.93%～97.62%.全区D值评价OPV、DPT、MV总体是可信的,乙型肝炎报告接种率40%可信,60%报告接种率可疑.比值R＝3 MV/OPV或DPT/OPV总体是可信的.结论流动儿童摸底调查是计划免疫工作重点,公安、统计、卫生各部门人口资料统计方法的整和是科学评价常规免疫监测的关键.统估算应种数＝出生数 流动儿童数,正确估算应种数是做好常规免疫监测评价的关键.     

6月龄～3岁儿童口服脊髓灰质炎减毒活疫苗估算接种率探讨

目的估算6月龄～3岁儿童口服脊髓灰质炎(脊灰)减毒活疫苗(OralPoliomyelitisAttenuatedLiveVaccine,OPV)接种率,评估新疆维吾尔自治区(新疆)输入脊灰疫情应急免疫活动的OPV实际接种率。方法利用2004年全国计划免疫审评OPV3剂(OPV3)接种率和非脊灰急性弛缓性麻痹(Non-polioAcuteFlaccidParalysis,NPAFP)病例OPV3免疫史,建立6月龄～3岁儿童OPV3估算接种率线性回归方程,估算新疆输入脊灰疫情应急免疫后的OPV3接种率。结果 6月龄～3岁儿童调查OPV3接种率与NPAFP病例OPV3接种率两个变量间具有直线趋势,波松(Pearson)相关系数为0.782,P<0.001;回归方程表达式为Y=41.232+0.578X(F=143.632,P<0.001)。根据回归方程估算6月龄～3岁儿童OPV3接种率,在应急免疫前,全疆接种率<90%,南疆5个地区(州)(包括和田地区、巴音郭楞蒙古自治州、喀什地区、克孜勒苏柯尔克孜自治州和阿克苏地区)估算接种率为73.34%～87.68%;5轮应急免疫后,6月龄～3岁儿童OPV3接种率>95%。西部地区部分省(自治区,下同)6月龄～3岁儿童OPV3估算接种率较低。结论该接种率回归方程模型可以用于估算以省为单位6月龄～3岁儿童OPV3接种率,为风险评估提供重要依据。新疆输入脊灰疫情发生前OPV3接种率较低,通过5轮应急免疫后OPV3接种率达到阻断脊灰野病毒传播的水平。     

四川省1999～2003年常规免疫接种率监测结果评价

为了解四川省常规免疫接种率监测现状 ,对 1 999年以来的常规免疫接种率监测结果进行分析。结果显示 :全省市 (州 ,下同 )、县 (区、市 )级报告的及时率和完整性 1 999年分别为 93 7%和 97 5 %;2 0 0 3年提高到 1 0 0 0 %和99 4%。 1 999～ 2 0 0 3年卡介苗、口服脊髓灰质炎疫苗、百日咳白喉破伤风联合疫苗、麻疹疫苗、乙型肝炎疫苗的常规免疫报告接种率为 6 5 9%～ 97 2 %,1 999～ 2 0 0 3年卡介苗等 5种疫苗估算接种率为 36 9%～ 81 2 %,与报告接种率有一定的差距。D值显示 :6个市的资料为可信 ,8个市可疑 ,7个市不可信。提示计划免疫工作发展不平衡 ,主要与流动儿童的计划免疫管理不完善和部分市工作薄弱有关。     

武山县计划免疫四种疫苗合格接种率调查

为了解武山县计划免疫四种疫苗合格接种率 ,于 2 0 0 2年 7月对 1999年 7月 1日～ 2 0 0 1年 6月30日出生儿童进行了抽样调查 ,现简报如下。本次调查 7个乡 (镇 ,下同 )的 5 3个村 6 88名适龄儿童 ,卡介苗 (BCG )、口服脊髓灰质炎疫苗(OPV)、百白破联合疫苗 (DPT)、麻疹疫苗 (MV)的合格接种率分别为 83 87%、89 2 4 %、75 15 %、82 4 1%,四苗全程免疫覆盖率为 6 9 91%。 7个乡中有 3个乡OPV接种率 >90 %,4个乡 <90 %;7个乡的BCG、DPT、MV接种率均 <90 %。 4个乡的BCG、7个乡的DPT、5个乡的MV接种率 <85 %。7个乡的四苗全…     

2015年厦门市常规免疫接种率的评价及分析

目的了解厦门市2015年常规免疫接种率监测工作情况,评价常规免疫接种率水平并分析原因。方法运用Excel2000进行数据分析,利用比值(R)评价法、估算接种率、差值(D)评价法对厦门市2015年常规免疫报告接种率质量进行评价。结果 2015年常规免疫报表报告完整率及及时率均为100%(72/72);2015年厦门市疫苗报告接种率在96.57%~100%之间。R值评价市级4个R值均可信,区级可疑、不可信R值各有2个,其余R值均可信。加强免疫估算接种率,市级百白破三联疫苗、麻腮风三联疫苗、脊髓灰质炎疫苗(DPT4、MMR、OPV4)均在95%以上,流行性乙型脑膜炎疫苗、白破二联疫苗及A+C群流脑疫苗(JE2、DT及Men A+C2)均未达到90%;区级疫苗加强免疫估算接种率在90%以上的包括思明区有5种疫苗,湖里区有3种疫苗,海沧区、集美区及同安区只有2种疫苗,翔安区0种疫苗。D值评价中,市级仅OPV 4的D值可信,DPT 4、MMR、JE 2及Men A+C 1这4种疫苗D值可疑,DT和Men A+C 2的D值不可信;区级除思明区及湖里区的DPT 4、集美区的Men A+C 1及同安区的OPV 4的D值可信外,其他疫苗D值均为可疑或不可信。结论厦门市常规免疫接种率继续保持在较高水平,但R值评价及D值评价提示可能存在虚高现象,同时对评价方法是否适合厦门市提出思考,今后要加强对该项工作的管理与督导,探索出适合厦门市情况的疫苗接种率评价方法。     

甘肃省2003年保持无脊髓灰质炎状态进展

目的　为全面评价甘肃省 2 0 0 3年消灭脊髓灰质炎 (脊灰 )工作 ,保持无脊灰状态。方法　对急性弛缓性麻痹(AFP)病例监测系统和口服脊灰疫苗 (OPV)免疫资料进行分析。结果　 2 0 0 3年共报告AFP病例 1 2 8例 ,<1 5岁儿童非脊灰AFP病例报告发病率 1.94/1 0万 ,其它监测指标均达到卫生部和世界卫生组织的标准。AFP病例中格林 巴利综合征占 54 %。从AFP病例粪便标本中分离出脊灰病毒 (PV)疫苗株 6株 ,其它肠道病毒 1 1株 ,病毒分离率为 1 4.1 7% ,所有PV阳性株经中国疾病预防控制中心病毒病预防控制所国家脊灰实验室鉴定为疫苗株。OPV常规免疫报告接种率 >95% ,估算接种率 71 %。 2 0 0 3/2 0 0 4年部分地区强化免疫活动共免疫 0～ 3岁儿童 4944 98人次 ,两轮报告接种率均 >98% ,估算接种率均 >90 %。结论　自 1 993年至今已连续 1 1年未发生脊灰野病毒引起的病例 ,继续保持无脊灰状态 ,但部分地区存在着监测和免疫薄弱区域 ,应在今后的工作中采取并有效落实各项措施     

包头市2010-2011年常规免疫接种率监测结果

目的了解包头市12个月龄儿童常规基础免疫接种情况,来促进免疫规划工作的平衡开展。方法利用估算接种率、差值(D值)、比值(R)值等方法,对包头市2010-2011年度12个月龄儿童常规免疫接种率报告进行综合评价。结果 5种疫苗累计报告接种率均达到98%以上,通过比较报告接种率与估算接种率两者的差距计算差值(D),评价报告接种率的可信性。D值显示:2010-2011年BCG、OPV、DPT为不可信,MV、HepB为可信。通过比较各疫苗间的应种人数计算比值(R)。R值显示:3BCG/OPV、3BCG/DPT、3BCG/HepB为可信,2010年3MV/OPV、3MV/DPT3、MV/HepB为不可信,2011年3MV/OPV、3MV/DPT3、MV/HepB为可信。结论通过加强流动儿童管理,注重对免疫规划管理人员的培训等措施,可有效提高儿童常规免疫接种率水平。     

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.