湖南省郴州市2003-2012年疟疾流行特征及监测效果研究

目的 了解郴州市疟疾流行特征及监测效果,为疟疾防治和消除提供科学依据.方法 运用描述性流行病学方法对郴州市2003-2012年疟疾流行病学及监测资料进行统计分析.结果 郴州市2003-2012年共报告疟疾病例41例,年平均发病率为0.09/10万,死亡1例,无暴发疫情;其中间日疟24例（58.54％）,恶性疟15例（36.58％）,三日疟2例（4.88％）;本地病例4例（9.76％）,输入性病例37例（90.24％）,93.33％（14/15）的恶性疟病例均由非洲输入;发热患者血检107 975人次,阳性率为3.43/万,疟疾病例实验室检测率和确诊率均为100％;传疟媒介主要以中华按蚊为主（86.04％）,蚊密度高峰出现在7-8月.结论 郴州市基本消除疟疾后,疟疾疫情控制在较低水平,病例以输入性为主,在今后的疟疾防治和消除工作中,应加强流动人口监测和发热患者血检.     

萧山区2005—2014年疟疾流行特征分析

目的分析萧山区消除疟疾行动启动前后5年疟疾流行特征,评价消除疟疾行动效果。方法利用"中国疾病预防控制中心疾病监测信息报告管理系统"以及2005—2014年疟疾疫情调查资料,用Excel 2003进行统计分析。结果 2005—2014年萧山区共监测报告疟疾65例,年报告发病率在0.09/10万~0.59/10万之间。其中2005—2009年间日疟占85.00%,恶性疟占10.00%;2010—2014年间日疟占48.00%,恶性疟占52.00%。患者以青壮年为主,外来民工仍是萧山区疟疾疫情的重点人群。这10年中,感染来源已从外省感染为主转为境外感染为主。结论萧山区疟疾疫情继续保持在较低发病率水平,建议加强出入境人员的监测和宣传教育,以及对输入性疫情的管理。     

云南省临沧市1952年1月——2020年12月疟疾流行特征与防治历程

目的 分析云南省临沧市疟疾流行特征与防治历程,评估临沧市疟疾防治成效,为巩固消除疟疾成果提供依据。方法 收集临沧市1952年1月—2020年12月疟疾疫情和防治资料,采用描述流行病学方法分析临沧市疟疾流行特征和防治历程。结果 1952—2020年临沧市共报告疟疾病例493 641例,死亡1 944例,病死率为0.39%;发病高峰期为1953年和1973年;1990—2020年间日疟病例数占全市报告总数的76.37%,恶性疟占18.87%,未分型占4.75%。疟疾防治经历了疟疾流行基线调查与防治试点、控制疟疾发病率、疟疾大幅度回升与控制暴发流行、降低发病率和巩固扩大防治成果、消除疟疾5个阶段。2015年报告最后一例本地感染疟疾病例,2018年通过省级消除疟疾认证。结论 临沧市已到达消除疟疾标准,但疟疾流行因素依然存在,巩固消除疟疾成果,防止疟疾再传播依然面临严峻挑战。     

1950 - 2018年海宁市疟疾流行特征及防控策略

目的 分析海宁市1950 - 2018年疟疾的流行特征,为海宁市今后疟疾防控策略提供科学依据。方法 收集海宁市疟疾疫情数据、报表等资料,采用描述流行病学的方法进行分析。结果 1950 - 2018年海宁市共报告疟疾病例95 361例,年平均发病率为254.3/10万,死亡病例27例。2007年为最后1例本地病例,2008年起海宁市无本地疟疾感染病例报告,均为输入性病例。海宁市流行高峰分别在1954年和1960年出现,发病率分别为2 481.02/10万和7 219.20/10万,1977年第2个流行周期结束,发病率为17.91/10万。除在1963 - 1964年2年间发现过50例恶性疟病人和2014年后报告的6例病例为输入性恶性疟病例外,其余均为间日疟,恶性疟病例占全部病例的0.06%。中华按蚊是我市疟疾传播媒介。结论 海宁市近年来疟疾的流行特征以输入性疟疾为主,在今后的疟疾防控工作中要抓好以输入性传染源监测为主的疟疾防治工作,加强疟疾病情的动态监测,持续开展疟疾健康教育和对医务人员的培训工作,巩固消除疟疾防治成果。     

泸州市基本消灭疟疾后疟疾流行特征

目的了解泸州市基本消灭疟疾达标后疟疾流行特征及防治效果,为防治策略和措施的调整提供依据,以便如期实现消除疟疾目标。方法采用描述流行病学方法对泸州市2005-2012年疟疾疫情资料进行分析。结果 8年间共报告疟疾95例,无死亡,年均报告发病率为0.03/万,无继发二代病例和暴发疫情发生。其中间日疟56例,恶性疟32例（混合感染1例）,未分型7例,各年度报告发病率呈波动下降趋势;本地病例31例（无恶性疟）,输入性病例64例（恶性疟32例）,输入性疟疾构成比逐年上升。中华按蚊为唯一传疟蚊种,平均雌蚊密度为0.13只/（台.h）。结论泸州市实现基本消灭疟疾达标后采取的以消灭传染源、控制传播途径、加强疫情监测、及时发现和治管现症患者的综合性防治措施成效显著。由于疟疾传播媒介客观存在,输入性疟疾已成为泸州市的主要危险因素,加强流动人口的监测管理及媒介控制工作是巩固疟疾防治成果,实现消除疟疾的关键。     

永康市疟疾流行特征

目的 了解永康市疟疾流行特征,为制订和实施疟疾防治策略提供依据.方法 对永康市2005-2012年疟疾监测资料进行描述性流行病学分析.结果 2005-2012年共报告疟疾67例,疟疾发病率从2.37/10万下降到0.35/10万;67例疟疾病例呈散在分布,其中间日疟52例,恶性疟15例;67例病例中输入性占86.57%（58/67）.2005-2008年疟疾发病时间集中在7月9日-9月16日;2009-2012年疟疾病例分布不具有季节性.病例主要集中在青壮年,本地人口外出感染者以务工及经商为主,占86.67%.结论 永康市疟疾疫情呈下降趋势,疟疾发病特点从外来输入感染为主转变为本地人口外出感染为主,从流行季节为主转变为无明显季节性.     

2006-2012年仪征市疟疾流行现状分析

目的分析江苏省仪征地区疟疾流行现状,为今后制定防治策略提供依据。方法资料来源于仪征市2006--2012年疟疾疫情报表及疟疾流行病学个案调查表;诊断标准为WS259—2006疟疾诊断标准;人口资源来源于仪征统计年鉴。结果仪征市2006--2012年共发生疟疾24例,年平均发病率为0．60／10万。间日疟20例,恶性疟3例,三日疟1例。2006--2009年全是间日疟的病例,2010年出现输入性恶性疟的病例,2011年出现1例输入性的三日疟病例。该地病例2例,输入性病例22例,其中国外输入性病例为7例。结论该市疟疾处于稳定态势,病例以输入性为主,2008年以来国外输入性病例呈上升趋势,且以恶性疟为主,还出现了1例三日疟病例。提示要加强对流动人口及出国务工人员的管理,开展疟疾监测,以防发生暴发疫情。     

上海市杨浦区1952—2018年疟疾疫情和防治策略研究

【目的】对杨浦区的疟疾疫情和防治过程进行回顾性研究,为进一步做好疟疾防控工作提供依据。【方法】收集杨浦区1952—2018年的疟疾疫情资料和防治策略,进行描述性研究。【结果】1952—2018年杨浦区疟疾总发病率为102.5/10万。1962年达发病顶峰,发病数达13 423例,发病率为1 678.27/10万。1990年至今,杨浦区疟疾发病率均在1/10万以下。2002年杨浦区出现最后一名本地感染病例;2015年杨浦区顺利通过上海市消除疟疾的验收。杨浦区的疟疾防治分为六个阶段:流行阶段、控制阶段、基本消除阶段、监测阶段、消除阶段和消除后维持阶段。【结论】加强输入性疟疾的监测,尤其是留学生的疟疾监测,对于消除疟疾后状态的维持,尤为重要。     

楚雄市2010—2012年疟疾流行病学监测分析

目的分析楚雄市疟疾流行趋势,为实施消除疟疾提供依据。方法连续对楚雄市本地居民、外出务工返乡人员进行病原监测,计算疟疾血片阳性率和疟疾发病率。结果 2010—2012年对发热病人血检共6 783例,血片阳性4例,阳性率0.59‰,本地居民检出率0(0/4 035人),外出务工返乡人员检出率1.46‰(4/2 748),4例阳性者3例为间日疟,1例为间日疟和恶性疟混合感染。2010年务工返乡者阳检率3.67‰(2/545),2011年1.54‰(2/1 301),2012年未检出阳性病例。2010和2011年疟疾年均发病率均为0.039/万,2012年为0。结论楚雄市连续3年无本地感染病例,4例均为到国外虐区务工的输入型病例,无输入继发病例,说明采取的疟疾防控措施有效,2014年基本消除疟疾目标有望实现。     

1950—2020年安徽省太湖县疟疾流行情况分析

目的 分析太湖县疟疾流行情况,总结流行趋势及特点,探讨下一步疟疾防控工作重点。方法 利用传染病监测报告信息系统等收集整理太湖县1950—2020年疟疾疫情数据等资料,描述性分析太湖县疟疾流行情况。结果 1950—2020年70年间太湖县共发生疟疾162 542例,死亡54例。2011年发现最后一例本地感染病例(间日疟)。2012—2020年共报告6例境外输入病例,包括5例输入性恶性疟,1例输入性卵形疟。结论 现阶段太湖县疟疾的发病模式已由本地感染间日疟转变为境外输入性恶性疟为主,今后应加强对输入性疟疾防控。     

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.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.