2008-2017年苏州市脑卒中发病率和死亡率变化趋势分析

目的 分析2008-2017年苏州市居民脑卒中发病率和死亡率变化趋势。方法 对苏州市居民死亡登记及脑卒中监测资料进行汇总,采用趋势检验和年度变化百分比(APC)分析时间变化趋势。结果 (1)2008-2017年苏州市居民脑卒中粗发病率427.31/10万,标化发病率264.92/10万,有逐年上升趋势(APC=3.9%,P<0.001)。男性脑卒中发病率(粗发病率402.28/10万,标化发病率285.57/10万)高于女性(粗发病率453.14/10万,标化发病率243.27/10万);缺血性脑卒中发病率高于出血性脑卒中,且呈逐年上升趋势。(2)2008-2017年苏州市居民脑卒中粗死亡率93.87/10万,标化死亡率51.29/10万,呈逐年下降趋势(APC=-9.0%,P<0.001)。男性脑卒中粗死亡率(92.63/10万)低于女性(95.08/10万),标化死亡率(53.46/10万)高于女性(49.03/10万)。出血性脑卒中死亡率(粗死亡率为35.85/10万,标化死亡率为20.79/10万)高于缺血性脑卒中(粗死亡率26.84/10万,标化死亡率14.14/10万),出血性脑卒中死亡率呈下降趋势。结论 2008-2017年苏州市居民脑卒中发病率呈上升趋势,死亡率呈下降趋势。     

2017年郑州市居民心脑血管疾病监测资料分析

目的了解2017年郑州市居民心脑血管疾病发生和死亡情况,为制定防治对策和干预措施提供科学依据。方法收集河南省慢性病监测管理系统报告的郑州市2017年心脑血管疾病监测数据,计算心脑血管疾病的发病率、死亡率、标化率等指标,对心脑血管疾病的发病和死亡情况进行描述性分析。结果 2017年郑州市户籍居民心脑血管疾病发病55 669例,发病率为741.69/10万,标化发病率为597.35/10万;死亡14 658例,死亡率为195.29/10万,标化死亡率为131.27/10万。男性心脑血管病标化发病率为718.34/10万,死亡率为167.21/10万;女性心脑血管病标化发病率为435.48/10万,死亡率为89.78/10万。男性心脑血管病标化发病率和死亡率均高于女性。其中脑血管病发病率为624.87/10万,心血管病发病率为116.82/10万,脑血管病发病率高于心血管病;脑血管病死亡率为92.10/10万,心血管病死亡率为103.19/10万,心血管病死亡率高于脑血管病。心脑血管病发病率和死亡率随着年龄的增长而明显增加,发病和死亡均集中在75～岁组人群,60岁以上发病人数占总发病的83.22%,死亡人数占总死亡的84.40%。心脑血管疾病以脑卒中为主,不同类型脑卒中,脑梗死发病率和死亡率最高。结论随着危险因素的增多和人口老龄化,心脑血管疾病呈明显上升趋势,成为影响郑州市居民健康的主要疾病,应采取有效的综合性干预措施,预防和控制心脑血管疾病。     

2000年和2010年苏州市脑卒中患病率及危险因素比较分析

目的 了解苏州市居民脑卒中及其危险因素的流行趋势,为制定早期干预措施提供科学依据.方法 分别在2000年和2010年采用多阶段整群随机抽样方法和统一的调查内容,对苏州市35岁以上居民脑卒中危险因素进行调查.结果 对脑卒中标化患病率进行分析发现,无论男女性居民,还是各年龄组居民,患病率均为2010年高于2000年；2010年城市标化患病率比2000年略有降低,但农村标化患病率增加显著.2010年脑卒中危险因素有男性、年龄、高血压、吸烟、饮酒和不参加体育锻炼.结论 苏州市农村脑卒中患病率增长较快,需要引起关注；脑卒中的防治应当根据苏州市脑卒中危险因素,采取有针对性的综合干预措施.     

2013-2014年济南市居民脑卒中急性病例监测资料分析

目的了解2013-2014年济南市居民脑卒中急性发病及死亡情况,为制定脑卒中预防措施,在我市全面开展发病监测提供依据和经验。方法收集山东省济南市疾病监测系统报告的济南市居民脑卒中急性发病监测资料,对2013-2014年济南市7个项目区居民脑卒中急性发病和死亡情况进行描述性分析。结果 2013-2014年,济南市7个项目区居民脑卒中累计报告发病26 513例,累计报告死亡6 484例,年均发病率为296.59/10万,年均死亡率为72.53/10万。根据2000年中国标准人口计算,年均标化发病率和死亡率分别为183.29/10万、42.15/10万。2014年同2013年相比,全市监测人群脑卒中粗发病率上升了48.31/10万,标化发病率下降了7.02/10万,差异有统计学意义(P0.01);而年度粗死亡率上升了40.25/10万,标化死亡率上升了14.08/10万,差异有统计学意义(P0.01)。年均男性发病率、死亡率分别为329.58/10万、79.05/10万,均高于女性(发病率为264.24/10万,死亡率为66.14/10万,差异均有统计学意义(P0.01);60岁以上年龄组发病率、死亡率分别为1 343.65/10万、372.91/10万,均高于60岁以下年龄组(发病率为85.59/10万、死亡率为12.00/10万),差异均有统计学意义(P0.01)。发病病例分型为脑梗死者占70.61%,脑出血占17.88%,未分类脑卒中占9.61%,蛛网膜下腔出血占1.90%。结论 2013-2014年济南市居民脑卒中急性发病类型以脑梗死为主。脑卒中发病率随年龄增长上升趋势明显,男性发病率高于女性。     

连云港市2016年心脑血管疾病监测分析

目的了解2016年连云港市居民心脑血管疾病发生和死亡情况,为制定卫生政策和干预措施提供科学依据。方法收集连云港市2016年心脑血管疾病监测数据,计算心脑血管疾病的发病率、标化发病率、死亡率、标化死亡率等指标,并进行描述性分析。结果 2016年连云港市监测心脑血管发病21 118例,发病率469.22/10万,标化发病率311.50/10万;死亡5 803例,死亡率128.94/10万,标化死亡率76.56/10万。脑梗死是最主要的病种,发病、死亡分别占心脑血管疾病的72.2%、48.4%。男性心脑血管疾病发病率、死亡率均高于女性,差异均有统计学意义(P值均<0.01)。心脑血管疾病的发病率和死亡率从45岁开始显著增加,均以≥85岁组最高。城市居民心血管发病率高于农村,心血管和脑血管死亡率均低于农村(P值均<0.01)。结论连云港市心脑血管发病率和死亡率处于较高水平,脑卒中发病率、死亡率均为最高,应采取有效的综合干预措施。     

2014-2018年青岛市脑卒中发病和死亡趋势分析

目的 描述青岛市2014-2018年脑卒中发病和死亡变化趋势,为脑卒中防治策略的制定提供证据。方法 发病和死亡病例来源于“青岛市脑卒中发病和死亡监测系统”。使用2000年全国人口进行计算标化发病和死亡率,计算年化百分比（PC）和年度变化百分比（APC）。结果 2014-2018年青岛市共报告脑卒中发病104 031例,脑卒中的粗发病率为261.48/10万,标化发病率为126.19/10 万;死亡42 751例,粗死亡率为107.45/10万,标化死亡率为46.28/10万。发病率和死亡率均为男性高于女性（发病率:289.25/10万和234.15/10万;死亡率:116.32/10万和98.73/10万。均为P<0.001）,农村高于城市(发病率:269.08/10万和235.44/10万;死亡率:123.82/10万和51.37/10万。均为P<0.001)。男、女发病率APC分别为3.46%(P=0.991)和3.36%(P =0.820)。男性死亡率呈下降趋势,APC为1.01%(P=0.008)。发病和死亡的类型以缺血性脑卒中为主（72.95%、56.14%）,发病和死亡的季节以春冬季为主（26.35%、30.05%）。结论 脑卒中是影响青岛市居民健康的主要问题,应积极控制危险因素,加强脑卒中防治网络建设,降低高危人群发病风险。     

苏州市2019年社区居民急性胃肠炎流行病学特征分析

目的 分析苏州市社区居民急性胃肠炎(acute gastrointestinal illness,AGI)患病情况及分布特征.方法 2019年采用多阶段随机抽样法开展社区居民AGI回顾性调查.结果 有效调查10 492人,AGI月患病率为0.84％,年发病率为0.11次/人年;月标化患病率为0.76％,年标化发病率为0.10次/人年,每年约有156.9万人次罹患AGI.73.86％患者自述可疑病因是受污染的食物.家庭常住人口 1～2人、有出差旅游史是AGI发生的危险因素(P值均＜0.05).结论 苏州市社区居民AGI患病率相对较低,主要为食源性.应完善社区居民AGI监测网络,加强督导,制定干预措施并进行评估.     

2010-2019年苏州市相城区甲状腺癌发病与死亡分析

目的分析苏州市相城区2010-2019年甲状腺癌发病与死亡情况。方法提取2010-2019年户籍为苏州市相城区的甲状腺癌病例资料,计算甲状腺癌发病率、死亡率及年度变化百分比(annual percentage change,APC),采用2010年全国第六次人口普查数据为标准计算标化率。结果2010-2019年,苏州市相城区甲状腺癌新发562例,粗发病率为13.97/10万,标化发病率为12.22/10万;其中男120例,粗发病率为6.10/10万,标化发病率为5.39/10万;女442例,粗发病率为21.50/10万,标化发病率为18.76/10万。累计死亡18例,粗死亡率为0.45/10万,标化死亡率为0.21/10万;其中男5例,粗死亡率为0.25/10万,标化死亡率为0.11/10万;女13例,粗死亡率为0.63/10万,标化死亡率为0.31/10万。2010-2016年,甲状腺癌粗发病率APC为34.04%,标化发病率APC为34.17%,差异有统计学意义(P<0.05);2016-2019年,甲状腺癌粗发病率APC为-3.35%,标化发病率APC为-2.67%,差异无统计学意义(P>0.05)。2010-2019年,甲状腺癌粗死亡率APC为-1.29%,标化死亡率APC为0.26%,差异无统计学意义(P>0.05)。结论应针对甲状腺癌的发病与死亡特征,采取积极有效的防控措施,有效遏制甲状腺癌的健康危害。     

天津市区成人脑卒中流行病学特征及相关因素分析

目的了解天津市区成人脑卒中流行病学特征及相关因素,为防治脑卒中提供科学依据。方法采用多级(区-街道-社区居委会-社区居民)随机抽样方法,抽取天津市区的30个社区居委会居民进行调查,获取人口学信息、病史和体格检查结果。采用2000年第五次全国人口普查数据计算标化患病率。结果共调查18岁及以上居民28515人,报告脑卒中826例,其中单纯缺血性脑卒中691例,单纯出血性脑卒中117例,同时合并有两者18例,脑卒中患病率为2896.72/10万,其中缺血性卒中患病率为2486.41/10万,出血性卒中患病率为473.44/10万,年龄结构标化后患病率分别为1289.93/10万、1073.30/10万和249.80/10万。脑卒中患病率随年龄增长而升高,男性高于女性,差异有统计学意义(P<0.01)。Logistic回归分析显示,较高的文化程度和人均收入水平为脑卒中的保护因素;男性、年龄、高血压、血脂异常、糖尿病为脑卒中的危险因素,尤其是高血压危险最高(OR=4.225,P=0.001)。结论天津市区成人脑卒中的患病率高于全国水平,应强化有效控制各种危险因素的措施,尤其是高血压。     

2014—2020年杭州市居民脑卒中发病及死亡变化趋势分析

目的 分析2014—2020年杭州市居民脑卒中发病及死亡变化趋势，为脑卒中综合防治决策的制定和效果评估提供科学依据。方法 利用2014—2020年杭州市慢性病监测管理系统收集的脑卒中发病与死亡监测数据，对脑卒中的发病率、死亡率、人群特征及年度变化趋势进行统计分析。以2010年全国第六次人口普查为标准人口计算脑卒中的标化发病率、死亡率。应用Joinpoint软件对脑卒中发病、死亡的变化进行趋势性检验。结果 2014—2020年杭州市居民脑卒中的年均粗发病率为335.47/10万，标化发病率为209.15/10万；脑卒中年均粗死亡率为68.16/10万，标化死亡率为36.86/10万。脑卒中男女标化发病比为1.22∶1，标化死亡比为1.04∶1。2014—2020年杭州市脑卒中标化发病率无明显年度变化趋势，年度平均变化百分比（annual avearge percentage change,AAPC）为-0.88%(t=-0.96,P=0.381)；标化死亡率呈下降趋势，AAPC为-10.94%(t=-15.37,P=0.001)。脑卒中的发病率和死亡率均呈现随年龄增长增加。但2014—2...     

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.     

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.     

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.     

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.     

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.