三亚市新生儿破伤风监测

目的 确定新生儿破伤风(NNT)高危地区与人群,为消除NNT提供科学依据。方法 开展NNT监测,收集医疗单位NNT疫情报告及病例个案调查。结果 本市1995～2000年NNT监测发病率为1.51‰～2.79‰,汉族发病率为1.4‰,黎族为2.68‰,常住人口为1.95‰,流动人口为5.58‰。在家中不洁分娩的发病占87.36％,母亲无破伤风类毒素(TT)接种史的发病占96.55％。结论 高危地区与人群是黎族村庄和流动人口妇女所生的新生儿,必须提高清洁接生率和落实育龄妇女TT免疫接种,才能实现消除NNT。     

1999-2006年河北省新生儿破伤风监测分析

目的 了解河北省新生儿破伤风(新生儿破伤风)流行病学特征,讨论消除新生儿破伤风策略.方法 利用描述流行病学分析方法,对1999-2006年新生儿破伤风监测资料进行分析.结果 河北省1999-2006年共报告265例新生儿破伤风确诊病例,流动人口占16.5%,住院分娩比例为37.4%,男∶女为1.88∶ 1.265例患儿母亲中接种破伤风类毒素(TT)的占0.8%,在家分娩的146例患儿中有7.5%由经过培训的接生员接生. 结论住院分娩比例偏低,产前未接种破伤风类毒素及流动人口的增加是新生儿破伤风发病的主要因素.     

福州市2003——2006年新生儿破伤风疫情分析

目的探讨福州市新生儿破伤风（NNT）疫情的影响因素及防制措施。方法采用描述流行病学方法，对福州市2003-2006年NNT专报系统的监测资料和个案调查材料进行统计分析。结果福州市2003-2006年共报告新生儿破伤风病例65例，年平均发病率为26.07/10万，死亡数为19例，病死率为29.23％。流动人口占病例数的75.38％；男婴发病为女婴的1.95倍；绝大多数病例在家中分娩；95.45％由未经培训的接生人员接生；患儿母亲无一接种过破伤风类毒素。结论不安全接生，是NNT发病的主要因素。加强流动人口的生育管理，进～步提高孕妇卫生防病知识水平，普及住院接生、新法接生，落实NNT高危地区育龄期妇女破伤风类毒素（TT）的接种，是目前预防和消除NNT的主要措施。     

慈溪市1996-2008年新生儿破伤风监测分析

目的：了解慈溪市新生儿破伤风（Neonatal Tetanus,NT）流行病学特征,讨论消除NT策略。方法：利用描述流行病学分析方法,对1996-2008年NT监测资料进行分析。结果：全市共报告NT确诊病例57例,年平均发病率波动在0.11/‰~1.01/‰之间,病死率为15.79%。流动人口病例占98.25%（56/57）,男女性别比为3.75∶1。病例平均日龄6.5天,所有病例均采用土法接生且无新生儿破伤风类毒素（TT）免疫史。结论：旧法接生和产前未注射破伤风类毒素及人口流动是NT发病的主要因素。提高孕妇自我保健意识,推广住院分娩,对高危人群接种TT,加强新法接生培训是消除NT的基本措施。     

海南省育龄期妇女破伤风类毒素接种与新生儿破伤风病例监测的流行病学效果

为了实现消除新生儿破伤风 (NNT)的目标 ,1996年卫生部、联合国儿童基金会与海南省合作 ,在三亚市、琼中县开展了消除NNT试点研究工作。方法是 :采用按容量比例概率抽样 (PPS)方法调查项目市、县活动前后育龄期妇女破伤风类毒素 (TT)接种率 ,育龄期妇女未接种TT的主要原因。育龄期妇女TT接种以突击接种为主 ,并逐步纳入常规计划免疫系统 ,NNT病例监测纳入急性弛缓性麻痹 (AFP)病例监测系统同时运行。通过项目的开展TT3 接种率分别提高到 87 3 %、88 8% ,NNT发病率下降到1/ 10 0 0个活产儿以下 ,TT未接种的主要原因为外出打工。监测系统报告男女病例比例 1 2 5 :1。建议 :①提高新法接生率 ;②将育龄期妇女TT接种纳入常规计划免疫运转 ,并应与计划生育、优生、优育工作密切结合     

镇江市流动儿童新生儿破伤风监测分析

目的：分析镇江市流动儿童新生儿破伤风（NNT）的流行病学特征,为消除NNT提供科学依据。方法：利用描述流行病学方法分析镇江市2003—2010年流动儿童NNT监测资料。结果：镇江市2003—2010年NNT年平均总发病率为0.17‰,其中流动儿童NNT发病率为1.36‰,病死率为32.14%;NNT发病率总体呈下降趋势,但2006年出现一个相对高峰期;病例散在分布,无明显地区聚集性,患儿主要来自于四川、云南和贵州;男女性别比为1.55∶1,在家分娩者占89.29%;母亲均无破伤风类毒素（TT）接种史。结论：镇江市流动儿童NNT为散在发病,病死率高。提高流动妇女住院分娩率与提倡TT接种,才能彻底消除非高危地区NNT疫情。     

漳州市1999-2004年新生儿破伤风监测分析

[目的]了解漳州市1999-2004年新生儿破伤风(NNT)发病分布特征,完善主动监测体系。[方法]采用描述流行病学方法对6年内的NNT疫情监测及个案资料进行分析。[结果]2003—2004年NNT平均发病率是前4年平均发病率的2.5倍。NNT的高危县(区)2003年是芗城区,2003—2004年是龙文区。NNT患者中,外来流动儿童占44.8%,男婴发病数为女婴的1.6倍。93.6%患儿在家中出生,其中91.8%由未经培训的人员接生;患儿母亲都未接种过破伤风类毒素。[结论]不安全接生、育龄妇女未接种破伤风类毒素是漳州市NNT发病的直接原因。提高住院分娩率和新法接生率,对NNT高危人群育龄妇女接种破伤风类毒素,加强对流动人口的生育管理,完善疫情监测是消除NNT的主要措施。     

清远市1999-2007年新生儿破伤风流行病学分析

目的探讨清远市新生儿破伤风（新破）发病情况及其影响因素和防制措施。方法采用描述性流行病学方法,对清远市1999—2007年新破专报系统的监测资料和个案调查材料进行统计分析。结果清远市1999—2007年共报告新破267例,年平均发病率0．80‰;死亡63例,年平均死亡率0．19‰;年平均病死率23．60％。报告发病率呈逐年下降趋势。病例主要集中在农村和边远山区。男、女要总发病率分别为1．08‰、0．46‰,差异有统计学意义（Х^2=8．734,P〈0.05）,男女性别比为2．84：1。在家中分娩的病例占94．70％;由未经培训的人员接生占93．63％;病例母亲94．01％未接种过破伤风类毒素,82．77％未接受过产前检查或不详;属计划外生育的病例占36．70％。结论产妇卫生知识缺乏和不安全接生是清远市新生儿破伤风发病的主要影响因素。普及住院分娩、新法接生,加强流动人口中育龄妇女的妇幼保健工作,育龄妇女接种破伤风类毒素是预防和消除新破的主要措施。     

陕西省1999～2002年新生儿破伤风病例流行病学分析

为了解新生儿破伤风 (NT)的发生原因 ,对陕西省 1999～ 2 0 0 2年NT的监测资料进行了流行病学分析。结果显示 :NT发病率波动在 0 11‰～ 0 18‰ ,发病率≥ 1‰的县有 2～ 8个 ,病死率为 10 4 %～ 2 6 7%,居甲、乙类传染病 2～ 4位。全年均有病例发生 ,以男性为多 ,发病日龄平均 6d。NT病例中在家分娩的占 82 5 %～ 95 1%,其中接生员未接受过培训的占 4 2 1%～ 4 8 2 %;所有母亲几乎均未接种过破伤风类毒素 (TT)。在实施消除NT中 ,陕西省工作重点在商洛、安康等市的 18个县。提高孕妇自我保健意识 ,去卫生条件好的医院分娩 ,对高危人群接种TT ,加强新法接生培训 ,是消除NT的基本措施。提高医务人员NT报告意识和流行病监测人员的责任心 ,是提高监测质量的关键。     

育龄妇女破伤风类毒素血清学效果观察

新生儿破伤风(NNT)是严重威胁儿童健康和生命的疾病。目前我国消除NNT的策略包括推广清洁接生、对育龄妇女开展破伤风类毒素(TT)接种和开展监测[1]。推广清洁接生是消除NNT的最根本措施,但它受制于经济、文化水平和交通条件等。所以在一些老少边穷地区对育龄妇女实施TT接种是消除新生儿破伤风最经济有效的方法。为了解育龄妇女TT的免疫效果,我们在河南省4个县区开展了育龄妇女TT免疫效果观察,现将结果报告如下。1 材料与方法1.1 观察对象 采取整群抽样,在我省4个县区随机抽取18-35岁的健康妇女共1000人。1.2 免疫程序及实验方法 共接种TT3剂次:第1剂与第2     

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.     

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.     

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.     

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.