合溪水库流域2000-2013年血吸虫病螺情分析

目的：了解合溪水库流域血吸虫病中间宿主钉螺分布和消长规律，为制订控制和消灭钉螺措施提供科学依据。方法采用5米系统抽样结合环境抽查2框的方法，调查合溪水库流域2000—2013年螺情变化情况，分析螺情变化原因。结果2000—2006年有螺面积呈逐年上升，2006年以后上升趋势得到有效遏制。2003年以前有螺面积主要集中于沟渠，2004年以后开始分布于苗木地，并呈逐年上升，2010年以后苗木地有螺面积占90％以上。结论合溪水库项目建设及相关控制措施有效遏制了螺情回升，大面积种植苗木是合溪水库流域的钉螺难以消灭的主要原因。     

浙江省2011年血吸虫病疫情监测结果分析

目的 及时掌握浙江省血吸虫病疫情动态变化,为制定防治策略提供科学依据.方法 根据《浙江省血吸虫病监测巩固方案(2007年修订版)》,在全省开展螺情和病情监测.螺情监测用系统抽样结合环境抽查法,查到的钉螺用压碎法检查血吸虫感染情况,用土埋结合药物方法灭螺;病情监测用血清学筛查阳性者粪检,对有螺村和来自尚未控制血吸虫病县人(畜)采用血清学筛查监测病情,血清阳性者进一步粪检.结果 在17个流行县(市、区)中查出有螺面积59.62 hm2,其中新查出有螺面积0.53 hm2;解剖钉螺71 450只,未发现感染性钉螺.血清学查病139 896人,阳性1279人,阳性率为0.91％;发现输入性血吸虫病病例9例,其中2例急性病例,未发现本地粪检阳性患者(畜).结论 今后要继续加强监测,查清螺情,压缩残存钉螺,防控外来传染源.     

2008-2011年浙江省省级血吸虫病监测点监测结果分析

目的掌握浙江省省级血吸虫病监测点疫情状况,为制定防治对策提供参考。方法按《浙江省血吸虫病监测点监测方案》要求,在全省9个省级血吸虫病监测点开展螺情、病情及相关因素等调查。结果 2008-2011年监测点螺情监测在6个监测点查出有螺面积54 970m2,2011年有螺面积、有螺框出现率和活螺密度分别较2008年下降了71.81%、80.99%和93.79%,未查到输入性钉螺和感染性钉螺。病情监测未发现本地急性感染病人、新感染病人(畜),尚存4例历史晚期血吸虫病患者,发现14例输入性血吸虫病患者,其中2例为急性血吸虫病患者。结论监测结果基本反映了浙江省达到血吸虫病传播阻断标准后当前的疫情状况和防治现状,残存钉螺和输入性传染源的存在增加了血吸虫病重新流行的危险性,必需加强本地螺情和输入性传染源的监测。     

2007年浙江省血吸虫病疫情监测结果分析

目的 掌握血吸虫病疫情,为制定防治策略提供科学依据.方法 螺情调查与疫区人群的检查相结合.螺情监测用系统抽样结合环境抽查法,查到的钉螺用压碎法检查血吸虫感染,用土埋结合药物方法灭螺;病情监测用血清学筛选阳性者后粪检,检查有螺村和来自尚未控制血吸虫病县人(畜).结果 对浙江省53个县的427个乡(镇)4193个村开展查螺,在22个县的84个乡349个村查到钉螺,面积122.02hm2,捕获并解剖钉螺107 613只,结果均阴性.查病210 989人,未发现本地患者,但查到输入性病例24例.全省共确认晚期血吸虫病患者1060例,并已展开救助.结论 浙江省血吸虫病疫情稳定,但残存钉螺面积居高不下,输入性病例时有发生,今后血防重点是查灭钉螺和防控外来传染源.     

地理信息系统技术在浙江省钉螺监测中的应用

目的 探索地理信息系统(GIS)在浙江省血吸虫病中间宿主钉螺监测中的应用.方法 收集浙江省2005-2009年血吸虫病调查资料,建立GIS螺情数据库,应用ArcGIS9.2软件,导入GIS数据库各项属性并制作所需钉螺面积空间分布电子图和差值图.结果 2005-2009年共有28个县先后查出钉螺,5年累计查出有螺村1580个,有螺面积513.28 hm2.建立了"十一五"期间全省GIS螺情数据库;根据钉螺面积大小标记不同颜色,制作了电子分布图,实现全省钉螺分布信息电子化;2009年与2005年有螺面积比较,差值空间分布图显示有螺面积压缩或增加的县数分别占48.0%(12/25)和52.0%(13/25);在国家级血吸虫病监测点建立了有螺环境卫星迭加图,呈现17个螺点,每个螺点显示螺情有关信息.结论 应用GIS制作的钉螺面积分布图、差值空间分布图能直观地显示螺情变化,为掌握血吸虫病疫情以及制定防治策略提供科学依据.     

2005-2012年常山县血吸虫病监测点监测结果分析

目的分析常山县国家级血吸虫病监测点2005-2012年疫情状况,为制定血吸虫病防治对策提供科学依据。方法根据《全国血吸虫病监测方案》,每年对常山县国家级血吸虫病监测点开展病情、螺情监测,并进行相关流行因素调查。结果在2005-2012年期间,监测点仅在2006年发现1例输入性急性血吸虫病病人,未发现本地急性感染和新感染病人(畜)。8年累计发现有螺面积14 520 m2,活螺2 559只,未查到感染性钉螺。结论监测点疫情稳定,有少量残存钉螺,仍存在引起血吸虫病重新传播流行的潜在危险,应重点加强本地螺情和输入性传染源的监测,继续探索推进查灭螺运行机制,全面提升查螺队伍整体素质,巩固血防三无成果。     

扬州市邵泊湖淮河入江水道整治后血吸虫病传播风险评估

目的 评价淮河入江水道整治工程实施后邵伯湖血吸虫病传播风险.方法 收集工程范围、工程实施情况、工程涉及的滩块资料,及2008-2018年滩情、人畜病情、螺情等资料,建立邵伯湖滩情、螺情数据库、人畜病情数据库.开展血吸虫病风险监测,对血吸虫病传播风险进行评估.结果 切滩工程实施后,湖滩面积减少41.17％,减少钉螺孳生环...     

上虞市血吸虫病传播阻断后15年监测结果分析

[目的]掌握血吸虫病传播阻断后疫情动态,为血防工作提供依据。[方法]按血吸虫病传播阻断地区监测巩固方案进行监测。[结果]连续15年螺情监测,查螺面积416.5×105m2,在一个村断续7年查出残存钉螺,有螺面积1.5×105m2,查出螺点36处,解剖活钉螺6 267只,未检出血吸虫感染钉螺。病情监测,查病24 042人,粪检血清学阳性者1 052人,疫区耕牛1 292头,解剖家畜及野生动物358只,均未查到病原。[结论]本地无血吸虫病原存在,血吸虫病传播途径被阻断。今后工作重点应放在根除残存钉螺和加强外来传染源的监测上。     

南汇区1996-2006年血吸虫病疫情分析

目的掌握上海市南汇区达到阻断血吸虫病传播标准后血吸虫病流行及影响因素，为巩固成果和评价防治效果，预测流行趋势，制定防治策略提供依据。方法建立血吸虫病监测系统，进行螺情和病情的同步监测。结果1996～2006年查螺水面积达6578203m^2，发现钉螺面积270m^2，没有发现阳性钉螺；检查外来流动人员139091人，抗体阳性率为0．17％，对抗体阳性者进行病原追踪，在2005年查获1例血吸虫病输入病例；调查39995头耕乳牛情况，未发现感染血吸虫病牛；南汇区没有发现内源性血吸虫病人，小面积的残存钉螺及时得到有效消灭，也未见输人性钉螺；征兵、招生等新感染监测均未发现病人；居民和学生血防知识的知晓率分别为80％和75％。结论螺情仍有反复，故要加大监测，尤其是与有螺区县共用河道地区的监测力度，以便做到早发现、早控制。该地区病情监测的重点应是外来流动人员。     

嘉兴市秀洲区2012-2014年省级血吸虫病监测点监测结果分析

通过掌握嘉兴市秀洲区省级血吸虫病监测点疫情动态,为评价全省水网型地区血吸虫病防治措施和防治效果提供依据。本研究根据《浙江省血吸虫病监测点监测方案(2012年修订版)》要求,开展螺情、病情和相关因素等监测工作,纵向观察、分析水网型地区疫情变化趋势。结果显示2012-2014年查螺面积累计18.99hm2,本监测周期内未发现钉螺。本地居民血吸虫病IHA监测阳性率为1.14%。在秀洲区输入性传染源监测中,查出实验室确诊病例3例。2012-2014年监测点虽未发现钉螺,但前期时有钉螺复现,并有输入性传染源存在,警惕有局部流行的风险。重点应做好本地螺情和输入性传染源的监测工作,巩固取得的防治成果。     

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.     

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.