兰州市2008～2012年居民就医住院患者疾病谱分析

目的 了解兰州市居民就医住院患者疾病谱的变化趋势和分布规律.方法 对全市居民就医的患者按国际疾病分类法ICD-10编码后,通过数据录入甘肃省卫生系统疾控机构进医院信息平台,按照国际卫生统计表编码、分类统计,审核各医疗机构其2008～2012年5 年间全部住院患者系统疾病、肿瘤患病、死因情况.结果 住院患者前5 位系统疾病为循环系统疾病、呼吸系统疾病、消化系统疾病、肿瘤、损伤和中毒;死亡原因以循环系统疾病、呼吸系统疾病为主;5 年来循环系统疾病、呼吸系统疾病和肿瘤患者人数日益巨增,恶性肿瘤住院总人数前3 位疾病为气管、支气管、肺恶性肿瘤、肝恶性肿瘤和肠道恶性肿瘤.结论 循环系统疾病、呼吸系统疾病、消化系统疾病、肿瘤、损伤和中毒是居民就医住院患者的重点病种,应加以重点防范与研究.     

乌鲁木齐市某院呼吸系统疾病住院病例统计分析

目的观察乌鲁木齐市某院2010年呼吸系统疾病住院病例构成特点。方法采用回顾性调查方法对乌鲁木齐市某院2010年呼吸系统疾病5339例住院病例进行分析。对疾病谱进行分布描述。结果 2010年某院累计住院22802例。其中呼吸系统疾病患者5339例,占总体的23.41%;男女之比1.75：1。呼吸系统疾病男性显著高于女性,差异有统计学意义（χ2=798.5,P〈0.05）;呼吸系统疾病主要病种有支气管肺炎、慢性支气管炎、矽肺、肺炎、急性上呼吸道感染,此构成该系统疾病前五位,占呼吸系统疾病的70.31%。本资料各年龄段呼吸系统疾病,差异有统计学意义（χ2=3326.94,P〈0.001）。结论提示乌鲁木齐市某院2010年呼吸系统疾病住院病例,重点年龄段在0～5岁儿童和71～80岁老年。应关注儿童与老年人的健康预防、保健和治疗工作。     

临淄区人民医院2001-2009年儿科住院患者疾病病种变化及分析

【目的】 了解临淄区人民医院儿科住院患者疾病病种变化,为今后儿科医疗和儿童预防保健工作提供科学依据。 【方法】 采用SPSS13.0软件对本院2001-2009年儿科28 534例住院患者病案进行回顾性分析。 【结果】 住院人数逐年上升,疾病病种前5位分别是:支气管肺炎、上呼吸道感染、喘憋性肺炎、急性支气管炎、病毒性肠炎,支气管肺炎居疾病病种中第1位,共6 166例,占9年间儿科住院总人数的21.61%,手足口病、疱疹性咽峡炎、支气管哮喘增长较快。 【结论】 9年间儿科住院患者疾病病种发生了变化,今后工作重点为儿童呼吸系统疾病的防治工作,加强手足口病防治的管理,继续强化儿童疾病的预防工作。     

肺系疾病的中医研究进展

中医的肺系疾病,现代医学称之为呼吸系统疾病。临床常见的呼吸系统疾病包括急性上呼吸道感染、急慢性支气管炎、阻塞性肺气肿、肺源性心脏病、支气管哮喘、支气管扩张、肺炎、肺脓肿、肺结核、肺癌等,一般可归类于中医的感冒、咳嗽、哮证、喘证、肺胀、肺痈、肺痿、肺痨、咯血等范畴     

兰州市2011年疾病谱排序情况分析

目的了解兰州市疾病发生状况、分布和变化规律,为疾病的控制干预提供依据。方法按国际疾病分类疾病编码(ICD-10)分疾病系统和病种进行统计。结果门诊病例占总病例数前10位和构成的是:上呼吸道感染(6.43%),支气管炎(4.56%),阴道炎(2.70%),高血压(2.67%),胆囊炎(2.34%),糖尿病(2.21%),胃炎(1.99%),胆结石(1.92%),肺结核病(2.11%),胃肠炎(1.27%)。住院病例占住院病例总数的前10位和构成的是:胆结石(10.95%),胆囊炎(4.43%),支气管炎(4.10%),肺炎(3.60%),肺结核病(3.46%),糖尿病(3.10%),高血压(2.77%),肝硬化(2.52%),上呼吸道感染(2.23%),新生儿黄疸(1.64%),冠心病(1.70%)。结论多发病、常见病已成为影响人群健康的主要因素,开展多发病、常见病的调查,应制订干预疾病的措施,提高居民的自我保健意识。     

2003～2011年中山市某三级甲等医院住院儿童呼吸系统疾病谱分析

目的通过对我院住院儿童呼吸系统疾病谱分析,了解儿童呼吸系统疾病谱构成及变化趋势,为儿童呼吸系统疾病的防治提供参考依据。方法依据ICD-10对我院17646例因呼吸系统疾病住院的(0～14岁)儿童的第一诊断进行疾病分类,并进行统计学分析。结果呼吸系统疾病住院儿童病例呈缓慢增长的趋势,流行性感冒和肺炎、急性上呼吸道感染、下呼吸道感染位于疾病谱的前三位,年度病例数有统计学差异(χ~2=785.194,P<0.05)。结论流感及肺炎、急性上呼吸道感染及急性下呼吸道感染是我院儿童呼吸系统疾病的防治重点,应加强卫生宣教、提高疫苗接种率等措施,降低儿童呼吸系统疾病的发病。     

阿克苏地区某院12136例住院儿童疾病构成分析

目的 了解新疆阿克苏地区第一人民医院住院儿童的疾病构成,为卫生行政部门和医院管理部门制定儿科疾病的预防与治疗措施以及合理配置卫生资源提供参考.方法 收集新疆阿克苏地区第一人民医院2015年0~14岁出院儿童的住院病案首页信息,将主要诊断按照国际疾病分类(ICD-10)编码对其疾病构成进行分析.结果 在收集的12136例住院儿童的病例首页信息中,患肺炎、腹泻和急性上呼吸道感染的儿童分别占住院儿童总数的23.4%、11.8%和9.6%.患肺炎、急性上呼吸道感染、急性支气管炎和新生儿黄疸的汉族儿童所占比例高于少数民族,患腹泻和尿石病的汉族儿童低于少数民族.位列疾病构成前3位的系统疾病分别是呼吸系统疾病(37.2%)、起源于围生期疾病(15.6%)、传染病和寄生虫病(12.2%).呼吸系统疾病位居0~4岁儿童疾病构成第1位,损伤与中毒居5~14岁儿童疾病构成第1位.结论 呼吸系统疾病是威胁该地区儿童健康的主要疾病,儿童聚集的场所应采取预防隔离措施.儿童传染病高发,其防治仍是该地区疾病预防与控制的重点.根据不同性别、民族、年龄段的疾病顺位差异,提出有针对性的防治措施.     

2013-2015年广东省妇幼保健院儿科住院疾病构成情况

目的调查广东省妇幼保健院儿科住院疾病构成情况,合理配置医疗卫生资源,为儿科疾病的医疗和预防保健工作提供科学依据。方法选取该院2013年1月-2015年12月儿科住院患儿37 719例进行回顾性调查分析,并对疾病构成情况进行统计学分析。结果儿科病例前5位系统疾病:呼吸系统疾病占35.80%;消化系统疾病占19.40%;神经系统疾病占17.50%;循环系统疾病占9.70%;免疫系统疾病占8.9%;累积构成比91.30%。单病种疾病前5位:肺炎占23.15%;急性支气管炎占12.93%;上呼吸道感染占9.15%;手足口病占8.15%;小儿腹泻病占7.97%,累计构成比61.35%。结论针对该院儿童疾病构成情况,开展有效的预防工作,降低疾病发病率,提高儿童健康水平和生活质量;其次应开展医院重点专科的研究,扩大重点专科的床位,根据就医需求合理配备卫生资源。     

肺炎支原体诊断试剂盒在诊断呼吸道感染患儿中的价值

目的:了解住院患儿呼吸道肺炎支原体(MP)感染的疾病种类及其分布,探讨Serodia-MycoⅡ(简称MycoⅡ)试剂盒检测MP-IgM的应用价值。方法:用肺炎支原体抗体检测试剂盒MycoⅡ做微粒凝集试验,对疑诊MP感染的患儿尤其呼吸道MP感染的患儿,进行血清MP特异性抗体IgM检测。结果:353例MP-IgM阳性者中以呼吸道感染为主诉的334例(94.62%),占同期住院呼吸道感染的20.07%。10例于起病早期MP-IgM阴性,1周后动态检测转阳性。呼吸道MP感染的疾病种类和构成比依次为急性支气管炎58.98%、上呼吸道感染(简称上感)30.84%、支气管肺炎6.59%、支气管哮喘3.59%,上述病种占同期住院患儿同病种的比例分别为29.62%、14.39%、15.07%、8.76%。结论:小儿呼吸道MP感染在小儿呼吸道感染中发生率较高,以上呼吸道感染、急性支气管炎多见;MycoⅡ试剂盒检测血清MP-IgM简便快捷,敏感性及特异性较高,值得临床推广;对于高度疑诊MP感染的患儿可动态检测MP-IgM,抽血检测时间最好在起病1周后,必要时可提前至起病4～6天,以提高阳性率。     

某院校学员2009-2015年住院急性呼吸道疾病分析

目的 分析某院校学员近年因急性呼吸道疾病的住院情况,提出防治措施.方法 回顾性分析2009-2015年该院校急性呼吸道疾病住院战士学员资料.结果 2285例住院学员,51.25％患急性呼吸道疾病,47.74％以急诊入院.前五位病种分别是肺炎、上呼吸道感染、急性扁桃体炎、急性支气管炎、腺病毒感染,占比78.48％.肺炎病例超过三分之一.近2年发生2次腺病毒感染暴发.结论 急性呼吸道疾病是学员主要的住院原因,提高对急性呼吸道疾病的防治能力是基层医疗机构的工作重点.     

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.     

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.