沂蒙山区1997～2003年肾综合征出血热监测结果分析

目的探讨肾综合征出血热（HFRS）在当地流行的特征和规律。方法统计分析沂蒙山区1997～2003年HFRS疫情资料。人群血清流行病学调查，HFRS疫苗接种效果观察。宿主动物带毒率调查采用荧光抗体实验（IFAT）方法，宿主动物密度调查采用夹夜法。结果1997～2003年全市累计报告HFRS病例32792例，年平均发病率为47．71／10万，男、女比例1．79：1（21051／11741），病例中农民占87．20％。健康人群HFRS抗体阳性率为1．85％。室内鼠密度平均为3．87％，野外平均为3．84％。鼠带毒率室内平均为5．05％，野外平均3．86％。HFRS临床诊断符合率平均85．26％。HFRS疫苗接种近期保护率为100％。结论当地HFRS的流行呈双峰型，疫区类型为家鼠型为主的混合型，HFRS疫苗接种近期预防效果肯定。     

2005～2007年邢台市肾综合征出血热流行病学分析及防制对策

目的分析邢台市2005—2007年肾综合征出血热（HERS）流行特征，为制定HFRS预防和控制措施提供科学依据。方法资料来源于疫情报告、个案调查表和实验室监测结果。鼠密度调查采用夹夜法。采用免疫荧光法检测鼠肺抗原。结果邢台市2005—2007年共报告HFRS病例117例，发病以男性青壮年农民为主，男性病例占总病例数的65．81％，其中青年患者占总病仍鹾我的45．30％，农民患者占总病例数的51.28％；发病季节呈明显春夏高峰型。宿主动物监测褐家鼠占总捕获数的64．71％（22／34），居民区鼠密度为2．10％，野外鼠密度为1．08％；鼠带病毒率为2．94％。结论邢台市HFRS流行符合家鼠型流行特点，褐家鼠是该市HFRS的主要宿主动物和传染源。应加强对HFRS的监测，科学灭鼠、防鼠，开展重点人群的疫苗预防接种。     

天台县2001 至 2003年肾综合征出血热监测分析

目的探讨天台县。肾综合征出血热(HFRS)的流行特征和发展趋势，以制定有针对性的防制措施。方法采用描述流行病学方法统计分析HFRS疫情资料，人间疫情流行病学调查，采用间接免疫荧光法检测病人及健康人血清抗体；宿主动物带病毒率调查，采用直接免疫荧光法检测鼠肺汉坦病毒(HV)抗原。结果2001～2003年全县累计报告HFRS病例165例，年平均发病率为9．94／10万。男女发病比例为3．23：1(126／39)，以农民发病为主，占81．82％。室内鼠密度平均为2．51％，野外为5．22％，总鼠密度为4．53％，鼠带病毒率平均为16．38％。病人血清阳性率81．37％。结论天台县是以姬鼠型为主的混合型HFRS疫区，需要进一步加大监测和预防力度。     

承德市肾综合征出血热监测分析及防制对策

目的分析承德市肾综合征出血热（HFRS）的流行特征、影响因素，为制定防制对策提供依据。方法对报告病例进行流行病学分析；鼠密度、鼠带病毒率监测，人群血清学监测；预防知识调查。结果从1984年发现首例HFRS病例至2007年共发生115例，死亡3例，病死率为2．60％；2001年前病例呈散发，2002年出现流行趋势，年平均发病率0．48／10万，发病率呈逐年增高趋势。患者年龄15～80岁，男女比例为6．46：1，农民病例最多占57．58％；36月是高发期。发病与鼠害、鼠污染暴露因素有关，年平均鼠密度为12．20％，鼠带病毒率为0．72％；病例血清学符合率86．46％。结论加强HFRS疫情监测，灭鼠、防鼠和推广疫苗预防接种，是防控疫情流行的基本策略。     

辽源市流行性出血热疫区鼠密度及带毒率调查分析

目的分析辽源市肾综合征出血热(HFRS)流行特征,为制定HFRS预防和控制措施提供科学依据。方法通过疫情报告、个案调查对重点疫区鼠密度监测、鼠带病毒率调查,了解目前本市HFRS发病现状。结果本市疫情呈散发分布,但近几年来疫情有上升和向城区扩散的趋势,监测表明局部地区鼠密度较高,鼠抗体阳性率达14%以上,全市平均带病毒鼠指数为0.069 8,处于高强度流行阶段。存在暴发流行的潜在危险。结论本市HFRS流行符合家鼠型流行特点,褐家鼠是主要宿主动物和传染源。应加强对HFRS的监测,对重点疫区应加大灭鼠力度,开展重点人群疫苗预防接种。     

2005-2009年浙江省天台县肾综合征出血热监测分析

目的探讨天台县肾综合征出血热（HFRS）的流行特征和发展趋势,以制定有针对性的防制措施。方法人间疫情流行病学调查,采用间接免疫荧光法检测患者及健康人群血清抗体;宿主动物带病毒调查,采用直接免疫荧光法检测鼠肺汉坦病毒（HV）抗原。结果 2005-2009年全县累计报告HFRS病例181例,年平均发病率6.39/10万;男女发病之比为2.42∶1（128/53）,以农民发病为主,占86.74%;室内鼠密度平均为2.10%,野外为5.76%,总鼠密度为4.87%,鼠带病毒率平均为7.48%;患者血清阳性率为77.70%。结论天台县是以姬鼠型为主的混合型HFRS疫区,需要进一步加大监测和预防力度。     

2007年河北省肾综合征出血热流行特征分析

目的通过对2007年河北省肾综合征出血热（HFRS）流行特征及监测数据进行分析,为控制该病的流行提供科学依据。方法总结分析全省HFRS流行概况,对宿主动物进行监测。结果2007年河北省共报告HFRS病例372例,死亡2例,发病率0．54／10万,病死率为0．54％.病例分布于全省101个县（市、区）,主要集中于秦皇岛和唐山市。季节特征呈春峰型,以青壮年为主,男女发病之比为2．84：1;农民发病占69．09％。居民区鼠密度为2．21％,带病毒率为1．77％;野外鼠密度为1．17％,带病毒率为1．42％。居民区和野外的优势鼠种均为褐家鼠。结论河北省HFRS发病符合家鼠型流行特征,重点防病区域为东部的秦皇岛和唐山市.为此,采取针对家鼠型为主的加强重点区域的综合防治措施,以控制HFRS的流行.     

2005年河北省肾综合征出血热监测分析

目的 分析河北省2005年肾综合征出血热（HFRS）流行特征，对监测数据进行综合分析，为制定防制对策提供科学依据。方法 收集全省HFRS疫情资料，对监测点宿主动物进行监测和人群隐性感染率调查，对阳性鼠肺进行基因分型。结果 2005年河北省共报告HFRS病例1741例，死亡7例，发病率为2．54／10万，病死率为0.40％。病例分布于全省139个县（市、区），主要集中于秦皇岛和唐山市。季节特征呈春峰型，3—6月发病数占全年总发病数的57．96％。以青壮年为主，20～59岁组发病1351例，占发病总数的77．60％；男女之比为2．77：1；农民发病数占69．50％。居民区鼠密度为148％，带病毒率为4．62％；野外鼠密度为0．99％，带病毒率为0．97％。居民区和野外的优势鼠种均为褐家鼠。人群隐性感染率为5．36％。阳性鼠肺进行PCR分型，结果均为家鼠型（Ⅱ型）。结论 河北省HFRS疫区是以家鼠型为主的混合型疫区，应以高发病较集中的8个县（区）为重点，贯彻“灭鼠和免疫并重”的防制策略，科学开展HFRS的综合防制。     

2007年安义县肾综合征出血热监测分析

目的了解安义县2007年肾综合征出血热（HFRS）的流行特点和流行趋势,为防治提供依据。方法对安义县2007年人间疫情及宿主动物监测资料进行分析。结果2007年安义县HFRS发病率为6．13／10万,5—6月和11—12月发病较多,占全年病例总数的81．25％。人群隐性感染率高,达21．00％,无死亡病例。捕获鼠类7种207只,其中居民区以褐家鼠为优势种,野外以黑线姬鼠为优势种;鼠带病毒率为1．49％,带病毒鼠均为居民区小家鼠。鼠血总抗体阳性率为12．08％。结论安义县HFRS符合家鼠型为主的混合型疫区流行特征。2007年发病率上升较快,应继续加强疫情监测,贯彻“灭鼠和免疫并重”的措施,控制HFRS的发病率.     

河北省肾综合征出血热国家级监测点自然疫源地监测研究

目的了解河北省肾综合征出血热（HFRS）国家级监测点疫源地宿主动物的构成、分布及汉坦病毒携带状况。方法在全省4个国家级监测点，分别于春季、秋季开展宿主动物调查，采用夹夜法调查鼠密度，间接免疫荧光法检测汉坦病毒抗原携带情况。结果2005—2007年监测点居民区鼠密度波动在0．50％～3．19％之间，野外鼠密度波动在0．13％-0．94％之间。居民区鼠密度高于野外（χ^2=45．022，P〈0．01）。宿主动物构成以褐家鼠占绝对优势（77．57％），其次为大仓鼠（13．63％）和小家鼠（8．81％）。居民区汉坦病毒抗原阳性6只，鼠带病毒率1．91％，野外汉坦病毒抗原阳性2只，鼠带病毒率1．23％。8只阳性鼠中，褐家鼠7只，大仓鼠1只。结论河北省是以褐家鼠为主要宿主动物的混合型疫源地，应采取以消灭住宅区褐家鼠为主的综合性防制措施。同时应进一步加强北部地区的疫源地监测工作，从而有效地控制河北省HFRS的发生和流行。     

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.