军事飞行人员体重超重流行病学调查

目的：调查分析军事飞行人员体重超重的流行特点，为飞行人员心血管疾病的防治提供依据。方法：根据人体质量指数（BMI）≥25kg/m^2和BMI＜25mg/m^2，分为体重超重组和非体重超重组。组间进行年龄、职务与相关疾病的关系比较分析。结果：军事飞行人员体重超重率为27．66％。体重超重随年龄增加而增加（P＜0．01）。现职团以上干部体重超重率47．00％，明显高于团以下干部25．07％（P＜0．01）。飞行人员体重超重组中的高血压病、高脂血症、脂肪肝的患病率明显高于非体重超重组（P＜0．01）。结论：为防治飞行人员心血管疾病的发生和发展，必须加强对飞行人员体重超重的健康教育和医疗干预。     

探讨高血脂与脂肪肝的关系

保健中心于2000年6月对省局部分职工284人进行了全面体检，血检发现高血脂47人，发生率16．55％，B超探出脂肪肝71人，发生率25．00％，分析结果表明：高血脂和脂肪肝与年龄有很大关系（P＜0．05），高血脂组脂肪肝的发生率为93．62％，血脂正常组脂肪肝的发生率为11．39％，两组差异非常显著（P＜0．01）。     

23965例成人中脂肪性肝病患病情况

目的了解柳州市普通成人中脂肪性肝病的患病情况。方法对柳州市健康体检成人23965例（其中男12656例，女11309例，平均年龄43．0±13．8岁）进行血压测量、空腹血糖、血脂和肝功能检测，并对其肝脏进行B超检查。按2006年中华医学会肝脏病学分会提出的标准诊断脂肪性肝病。然后进行统计分析。结果脂肪肝平均检出率为15．49％，男性检出率高于女性（22．50％对7．63％，P〈0．01）。脂肪肝组血清总胆固醇、甘油三酯，低密度脂蛋白胆固醇及空腹血糖均值明显增高，而高密度脂蛋白胆固醇均值则明显低于非脂肪肝组，组间差异P均〈0．01。脂肪肝组与非脂肪肝组相比，丙氨酸氨基转移酶升高的检出率为21．0％对6．67％；空腹血糖升高的检出率为28．17％对8．24％；高血压的检出率为51．11％对21．88％，组间差异P均〈0．01。结论本组成人中单纯脂肪肝及脂肪性肝炎检出率较高，脂肪性肝病患者中高血压发生率增高，且血糖、血脂代谢异常率增高。     

CT及高分辨率CT对煤工尘肺大阴影的诊断价值及临床应用

目的探讨CT／高分辨率CT（CT／HRCT）对煤工尘肺（CWP）大阴影的诊断价值。方法对62例CWP作胸部CT／HRCT扫描，并与X线胸片进行比较。结果62例CWPX线胸片检出大阴影19例，检出率为30．6％，共检出大阴影30个；CT／HRCT检出大阴影者43例，检出率为69．4％，共检出大阴影123个。CT／HRCT较X线胸片多检出大阴影93个（4．1倍）。2种检查方法的大阴影检出率比较，差异有统计学意义（Χ^2=18．58，P〈0．01）。无一例X线胸片上显示大阴影而CT／HRCT未能显示者。62例CWPX线胸片检出Ⅲ期大阴影（≥1.0cm×2．0cm）者17例，检出率为27．4％，共检出Ⅲ期大阴影27个；CT／HRCT检出Ⅲ期大阴影34例，检出率为54．8％，共检出Ⅲ期大阴影67个，CT／HRCT比X线胸片多检出Ⅲ期大阴影40个，2种检查方法的大阴影检出率比较，差异有统计学意义（Χ^2=-9．63，P〈0．01）。CT／HRCT对大阴影的形态、内部结构、边缘特征、尘肺微细病变及特殊位置的大阴影均具有良好的显示能力。结论CT／HRCT在复杂性尘肺的诊断能力明显优于X线胸片，可检出X线胸片所不能发现的大阴影，可作为尘肺的一种重要而有实用价值的辅助检查手段。     

对不同人群采用不同方法肺结核病人检出率的研究

目的 了解我国目前肺结核可疑症状者在全人口中的比例和不同人群不同方法肺结核病人检出率。方法 对无肺结核可疑症状者和有肺结核可疑症状者，分别采用胸透筛选、直接摄片、直接痰菌检查等不同方法对照研究。结果 有肺结核可疑症状者占全人口的1．27％；无症状者采用胸透筛选法检出活动性病人数、菌阳病人数和涂阳病人数分别仅占无症状者人数(受检人数)的0．13％、0．04％和0．03％，有症状者检出活动性病人数、菌阳病人数和涂阳病人数分别占有症状者人数(受检人数)的16．82％、7．98％和6．。76％。有肺结核可疑症状者采用：直接摄片的活动性肺结核病人、菌阳病人和涂阳病人检出率，分别为17．92％、8．37％和6．83％；直接痰培养的菌阳病人检出率为8．95％。直接痰涂片：2个痰标本与3个痰标本的涂阳病人检出率分别为6．17％和7．08％。结论 1．27％的全人口肺结核可疑症状者是评价可疑症状者就诊率的指标；对咳嗽、咳痰≥3周或有咯血的肺结核可疑症状者进行检查是最符合成本效益原则的结核病人发现方法。对有肺结核可疑症状者应当采用直接摄片法和3个痰标本进行病人发现；直接痰培养的菌阳病人检出率最高，有条件的单位可开展痰培养检查。     

体质指数与脂肪肝相关性研究

目的探讨体质指数与脂肪肝之间的相关关系。方法应用脂肪肝诊断标准与体质指数的判定标准,对2006年河南科技学院医院门诊1226名健康体检对象的体质指数和脂肪肝检出率进行相关分析。结果在1226被检者中,共检出脂肪肝312例,检出率为25.4%;在体重正常、超重、肥胖人群中,脂肪肝检出率分别为4.4%,35.6%和81.9%,差别有统计学意义(P<0.01);体质指数分布与相应脂肪肝检出率之间存在等级相关(r=0.987,P<0.01)。结论控制体重增加是预防脂肪肝发生的重要措施之一。     

粤东平原和山区健康人群血清弓形虫抗体检测比较

目的：了解粤东健康人群弓形虫病感染情况，分析丘陵山区和平原地区的感染差异，方法：间接血凝试验（IHA）和酶联免疫吸附试验（ELISA），结果：共检测丘陵山区和平原地区健康人群1291人，阳性151人，检出率为11．7％，其中丘陵山区为15．56％（126／810），平原地区为5．19（25／481）。结论：粤东丘陵山区与平原地区弓形虫病感染率差异有显著性（P＜0．01）。     

常州市化工行业工人脂肪肝患病情况调查

目的了解化工产业工人脂肪肝发病情况，探索相关预防措施。方法选择常州市多家化工企业作业工人1880名为观察组，其他行业人员1852人作为对照组，检测工作场所中有害物质浓度，采用B型超声仪对人体肝脏进行检查，同时检查其肝功能、血脂水平。结果观察组工作场所中存有甲苯、二甲苯、氯乙烯、苯胺、正己烷，但检测数据未超标；观察组1880人中检出脂肪肝患者366人，检出率为19．5％；对照组1852人检出脂肪肝274人，检出率为14．8％，2组差异有统计学意义（x^2=14．3，P〈0．01）；2组间不同年龄组脂肪肝检出率差异有统计学意义（x^2=12．56，P〈0．01）。结论化工作业工人脂肪肝发病率高于其他行业，需进一步采取措施改善该职业人群的健康状况。     

广东某高校教职工血脂水平调查分析

目的:了解广东某高校教职工的血脂水平，为有关疾病的早期预防提供科学依据。方法:2000—2002年分别对在校教职工进行血清胆固醇和甘油三酯检测。结果:3年男、女性胆固醇升高总检出率分别为6．02％和2．44％，男性高于女性(P＜0．01)；升油三酯升高总检出率分别为14．30％和5．53％，男性高于女性(P＜0．01)。≤40岁和＞40岁胆固醇升高检出率分别为3．60％和4．47％，差弄无显性(P＞0．05)；甘油三酯升高检出率分别为10．01％和10．51％，差异无显性(P＞0．05)。结论：预防和控制高血脂，要建立健全监测、随访制度，进行针对性的健康指导和有效干预。     

2006～2010年济南地区铁路职工脂肪肝患病情况分析

[目的]探讨铁路企业职工脂肪肝患病情况的变动趋势,为脂肪肝的防治提供科学依据。[方法]对济南地区铁路系统在职职工2006～2010年健康体检者脂肪肝检测资料进行分析。[结果]2006～2011年铁路在职职工脂肪肝患病率分别为28．10％、25．73％、28．76％、33．82％、39．04％（P〈0．01）,平均患病率为30．61％。2006～2010年平均患病率,男性为36．14％,女性为11．12％（P〈0．01）;〈25岁为10．06％,25～34岁为25．20％,35444岁为31．17％,45～54岁为35．79％,55～65岁为37．94％（P〈0．01）;机务段为34．05％,车务段为34．12％,工务段为29．76％,电务段为32．51％,车辆段为29．63％,客运段为25．97％,济南站为32．02％（P〈0．01）;轻体重者为1．21％,正常体重者为8．05％,超重者为36．59％,肥胖者为70．17％（P〈0．01）。[结论]2006～2010年济南地区铁路在职职工脂肪肝患病率有逐年上升趋势。男性、35岁以上、机务段、车务段、超重和肥胖的职工患病率较高。     

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 human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

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.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

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.