2010年济南市天桥区围产儿出生缺陷监测资料分析

[目的]了解济南市天桥区围产儿出生缺陷发生情况,为制定出生缺陷预防保健措施提供依据。[方法]对2010年济南市天桥区7家出生监测医院孕28周至产后7d分娩的围产儿出生缺陷监测资料进行分析。[结果]2010年济南市天桥区共报告围产儿9693名,出生缺陷68例,出生缺陷发生率为7．01‰。出生缺陷发生率,农村为3．87‰,城镇为9．35‰（P〈0．01）;男性为7．52‰,女性为5．95‰（P〈0．01）,出生缺陷发生率前5位为的多指、先天性心脏病、马蹄足、食道闭锁或狭窄、先天性脑积水,发生率分别为1．86‰、1．24‰、0．41‰、0．31‰、0．31‰。[结论]出生缺陷是导致天桥区围产儿死亡的重要原因。     

2003—2008年漳州市围产儿出生缺陷监测情况分析

[目的]了解漳州市2003—2008年围产儿出生缺陷现状、流行病学特征及其变化趋势,采取干预措施,降低出生缺陷的发生。[方法]利用本市27所医院出生缺陷监测网收集的资料进行统计分析。[结果]共监测围产儿199563人,6年总出生缺陷发生率为9.8‰,由2003年的8.2‰上升至2008年的10.2‰,出生缺陷发生率呈上升趋势。1945例出生缺陷病种前5位顺位依次为总唇裂、神经管畸形、多指（趾）、先天性心脏病和先天性脑积水,其中先天性心脏病、多指（趾）、尿道下裂呈上升趋势,而神经管畸形、先天性脑积水呈下降趋势。1 945例出生缺陷儿中产前确诊742例（38.2%）。〈20岁及〉35岁产妇出生缺陷发生率高于20-35岁年龄组。[结论]近年来出生缺陷发生率显著上升;产前诊断水平有待提高。     

青岛市1998～2002年出生缺陷监测资料分析

[目的 ]掌握出生缺陷发生的变化趋势 ,探讨出生缺陷发生的相关因素 ,为制定妇幼卫生保健决策提供依据。[方法 ]按照全国出生缺陷监测中心制定的监测方案 ,对 1998～ 2 0 0 2年青岛市 2 0所医院分娩的围产儿进行出生缺陷监测。 [结果 ] 1998～ 2 0 0 2年的出生缺陷发生率分别为 6 40‰、4 77‰、3 47‰、4 0 7‰、3 91‰ ;前 5位出生缺陷是唇裂合并腭裂、先天性心脏病、多指 (趾 )、唇裂、先天性脑积水 ;农村的出生缺陷发生率高于城镇。 [结论 ]青市卫生缺陷发生率有所下降。要进一步普及优生知识 ,加强农村的保健工作 ,加强婚前保健、围产期保健与孕早期高危妊娠管理、产前诊断 ,降低出生缺陷发生率     

青岛市1998～2002年出生缺陷监测资料分析

[目的]掌握出生缺陷发生的变化趋势。探讨出生缺陷发生的相关因素。为制定妇幼卫生保健决策提供依据。[方法]按照全国出生缺陷监测中心制定的监测方案。对1998～2002年青岛市20所医院分娩的围产儿进行出生缺陷监测。[结果]1998～2002年的出生缺陷发生率分别为6．40‰、4．77‰、3．47‰、4．07‰、3．91‰；前5位出生缺陷是唇裂合并腭裂、先天性心脏病、多指(趾)、唇裂、先天性脑积水；农村的出生缺陷发生率高于城镇。[结论]青市卫生缺陷发生率有所下降。要进一步普及优生知识。加强农村的保健工作，加强婚前保健、围产期保健与孕早期高危妊娠管理、产前诊断，降低出生缺陷发生率。     

嘉兴市出生缺陷监测结果分析

目的了解嘉兴市2011—2016年出生缺陷发生情况,为降低出生缺陷发生率提供依据。方法收集2010年10月1日—2016年9月30日嘉兴市各级妇幼保健机构和医疗机构上报的出生缺陷资料,对出生缺陷的发生率、类型及顺位等情况进行描述性分析。结果 2011—2016年嘉兴市共监测新生儿165 369人,其中出生缺陷儿3 823例,年均出生缺陷发生率为23.12‰,呈逐年上升趋势(P0.05),其中24.56%的出生缺陷由产前诊断确诊。发生率居首位的出生缺陷为先天性心脏病,发生率为12.04‰,其次为外耳畸形、多(并)指(趾)、血管瘤及唇腭裂,发生率在2.20‰~0.63‰。农村出生缺陷发生率为29.19‰,高于城镇的19.65‰(P0.05)。不同性别出生缺陷发生率差异无统计学意义(P0.05)。结论嘉兴市出生缺陷报告发生率呈上升趋势,其中先天性心脏病发生率高居首位,农村出生缺陷发生率高于城镇。     

2007年菏泽市围产儿出生缺陷监测资料分析

[目的]掌握围产儿出生缺陷发生情况,为制定干预措施,提高出生人口质量提供依据。[方法]对菏泽市2007年围产儿出生缺陷监测资料进行分析。[结果]2007年菏泽市共有围产儿83 786名,出生缺陷865例,出生缺陷发生率为103.24/万。出生缺陷发生率,城镇为79.02/万,农村为119.50/万(P<0.01);男性为116.65/万,女性为87.87/万(P<0.01)。出生缺陷儿前5位类型为总唇裂(占15.84%)、先天性心脏病(占14.45%)、多指趾(占14.34%)、神经管畸形(占7.40%)、先天性脑积水(占5.55%)。[结论]菏泽市围产儿出生缺陷发生率较低,总唇裂、先天性心脏病、多指(趾)、神经管畸形和先天性脑积水是最多发的出生缺陷类型。     

承德市2004～2008年出生缺陷流行病学分析

[目的]分析承德市出生缺陷发生情况、流行病学特征及影响因素,为制定干预措施提供依据. [方法]对2004～2008年承德市全人群出生缺陷监测报告病例进行流行病学分析. [结果]5年监测218 300例围产儿,其中出生缺陷儿1 792例,平均出生缺陷发生率为8.21/‰,5年的出生缺陷发生率分别为7.04/‰、7.91/‰、7.66/‰、9.23/‰、9.42/‰,呈上升趋势.前6位出生缺陷依次为神经管畸形、总唇裂、先天性脑积水、多指、先天性心脏病、马蹄内翻足;出生缺陷发生率与性别无关(X2=2.452,P>0.05);乡村发生率明显高于城市(X2=8.52,P<0.01);产妇年龄≤20岁和≥35岁组高于平均发生率(P<0.01). [结论]加强优生遗传工作力度,广泛开展宣传教育,增强出生缺陷防范意识,加强婚检、孕前、孕期保健、产前筛查与产前诊断是减少出生缺陷发生的根本措施,而贫困农村是当前工作重点,应加大政府对农村妇幼保健工作投入,保障预防保健措施实施.     

浦口区2005～2008年出生缺陷调查分析

目的了解2005~2008年浦口区出生缺陷的发生情况,分析影响因素,提出干预措施。方法用现况研究方法,对目标人群自2005~2008年实施全出生人口监测的结果进行分析。结果出生缺陷的发生率为8.82‰,前5位分别是:多指(趾)、足外翻、先天性脑积水、外耳道畸形、神经管畸形;围产儿死亡率为7.94‰。结论加强宣教,加强婚前、孕前保健,加强产前检查、产前诊断,是降低出生缺陷发生率和围产儿死亡率的关键。     

云南省出生缺陷、先天性心脏病流行趋势与全国的比较分析

[目的]对云南省和全国的出生缺陷、先天性心脏病流行趋势进行比较分析,为出生缺陷、先天性心脏病的防控干预提供依据。[方法]通过全国妇幼卫生监测网、云南"三网监测"和年报数据、围产保健监测系统与出生缺陷监测系统收集相关数据,并进行比较分析。[结果]①出生缺陷总体趋势:全国出生缺陷发生率最低为1996年的87. 34/万、最高为2010年的149. 1/万,出生缺陷发生率呈逐年上升趋势(P 0. 01),1996-2004年,农村出生缺陷发生率高于城市,2005年后农村开始低于城市;云南省1989-2002年出生缺陷发生率呈波浪式下降,2003-2004年有所上升,2005-2007年逐年下降,2008-2010年又直线上升,总体随时间的推移而上升(趋势χ2=6. 054,P=0. 014);②出生缺陷病种及顺位:全国出生缺陷主要病种是:先天性心脏病、多指/趾、总唇裂、外耳其他畸形、N管缺陷、脑积水等。全国2005-2014年先天性心脏病(先心病)上升为第一病种,2010-2014年先天性心脏病发生率为42. 66/万;云南省在1992年及以前,出生缺陷以唇腭裂、多指趾、马蹄内翻等为主。1996年先天性心脏病首次进入出生缺陷前五位病种,2007年上升为第四位,2008年上升为第三位; 2009年之后已稳居第一位。③先心病发生率:全国来看,浙江、广东、陕西、湖南和云南等5省先心病发生率最高,除贵州、江苏和青海3个省外、其他27个省市区出生缺陷发生类型先心病均为第一位病种。以先心病的发生率为因变量,经逐步回归分析发现,只有纬度进入方程,其复相关系数r=0. 392,决定系数R 2=0. 154,P=0. 032。[结论]全国和云南省出生缺陷总体呈上升趋势,先天性心脏病在出生缺陷中处于上升趋势,云南省先天性心脏病发生率高于全国水平,纬度是影响先心病发生率的主要因素。     

深圳市3年出生缺陷监测分析

目的了解深圳市出生缺陷发生率、出生缺陷顺位以及流行病学特征,为制定干预措施提供参考依据。方法按照广东省出生缺陷监测方案,监测2003~2005年孕满28周到产后7d的围生儿。结果深圳市出生缺陷率从2003年的14.27‰提高到2005年的16.38‰,差异有统计学意义(χ2=7.09,P=0.029),平均发生率为15.74‰,3年来出生缺陷前3位分别是先天性心脏病(33/万)、总唇腭裂(19/万)、多指(16/万),≥35岁的产妇、男孩、多胞胎出生缺陷率高发。结论深圳市围生期出生缺陷监测率近年有升高趋势,深圳市不同区、产妇年龄、胎儿性别、胎数等出生缺陷的发生率不同。     

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.