Changing trends of an endemic trauma

The incidence of severe burn is extremely high in the Low and Middle Income Countries with an estimated 90% of the world incidence of which 50% is in South East Asia. Through an earlier analysis of 11,196 burn admission over 8 years (1993–2000—Phase I) to our burn unit we established the endemic nature of the injury [Ahuja RB, Bhattacharya S. An analysis of 11,196 burn admissions and evaluation of conservative management techniques. Burns 2002;28:555–61]. A continued analysis of 5566 burn admissions over the next 7 years (2001–2007—Phase II) and its comparison with the Phase I reveals a significant change in the epidemiological profile. The average yearly admissions have fallen by 43.14%, from 1399.5 patients in Phase I to 795.14 patients in Phase II. This fall in average yearly admissions is predominant in the age group 16–35 years (52.61% decline) and 36–55 years (46.51% decline). The overall female to male ratio has also changed from 1.26:1 to 0.91:1. However, the overall mean %TBSA burn has reduced only mildly from 49.12% TBSA in Phase I to 44.39% in Phase II. During Phase II there was also a significant decline of 46.93% and 56.25% in the yearly admission of flame and scald burn respectively. Non-intentional incidents still remain the main mode of injury accounting for 87.12% in Phase I and 89.89% in Phase II. But, the yearly admissions of non-intentional burns fell from 1219.25 in Phase I to 714.71 in Phase II, which is a significant drop of 41.38%. Kitchen continues to dominate as the main location for flame incidents, but the yearly admission rate from kitchen accidents dropped from 897.5 patients in Phase I to 368.43 patients in Phase II. At the same time, liquefied petroleum gas (LPG) leaks which accounted for only 0.72% of all kitchen accidents in Phase I rose to 10.74% in Phase II. Another redeeming feature is the reduction in overall mortality from 51.8% in Phase I to 40.20% in Phase II. Interestingly, a very significant negative correlation exists (being significant at 0.01 level—2 tailed) between burn admissions and the yearly per-capita income of Delhi, from 1993 to 2005, to prove that the incidence and profile of burns directly reflects the economic development of the society. We see this as the first long term study from a burn unit of a developing country to directly reflect this association of burn incidence and its changing profile with economic prosperity.     

郑州市饮水型地方性砷中毒调查

目的掌握郑州市居民饮水砷状况以及是否存在地方性砷中毒。方法根据饮水型地方性砷中毒分布规律，在全市重点地区选择调查点进行饮水砷测定及砷中毒情况调查。结果全市6个县(市)34个乡(镇)286个自然村共采集测定水样622份，水砷在0—0．1860mg/L之间。首次在位于郑州市东部平原地区的中牟县检测出高砷水井6眼，水砷最高为0．1860mg／L，最低为0．056mg/L，高砷水埋深26—40m。其他县(市)水砷均在0．05mg／L以下，全部在国家规定标准以内。在对水砷超标的重点乡走访调查中，未发现砷中毒病人。结论郑州市存在高砷地区，但是尚未发现地方性砷中毒的流行。     

江滩型地区选择性化疗加健康教育防治血吸虫病效果研究

本文报道了江滩型地区血吸虫病流行因素及采用选择性化疗加健康教育防治对策4年后，人与牛感染率分别下降了82％和95％，10岁以下儿童已无新感染，取得基本控制疾病和感染的明显效果，且防治费用低廉。提出暂不能控制传播的江滩型流行区，以控制疾病为目标的可行性。     

安徽省移民建镇试区血吸虫病流行因素调查

目的　调查移民建镇地区血吸虫病流行因素 ,为制订该类地区血吸虫病控制对策提供依据。　方法　选择退人不退耕的单退点和退人又退耕的双退点各 2个 ,采用常规方法调查各试点钉螺分布、人畜感染以及滩地野粪污染情况。　结果　移民建镇试区钉螺分布广 ,单退点感染螺密度较双退点高 ,两个单退点钉螺感染率分别为 0 .69%、1.88% ,两个双退点钉螺感染率分别为 0 .3 9%、0 .2 9% ;滩地野粪污染仍较严重 ,尤其以单退点为甚 ;人、畜血吸虫感染在单退点相当严重 ,居民血吸虫抗体阳性率 (IHA)高达 2 0 %以上 ,耕牛粪检阳性率最高达 3 4.48%。　结论　移民建镇地区依然存在血吸虫病流行因素 ,单退点血吸虫病流行更为严重     

陕西省燃煤型氟中毒病区及改炉灶进展调查

目的 了解陕西省燃煤型氟中毒病区的分布，掌握改炉灶降氟进度，为氟中毒病区制定改炉灶规划提供依据。方法 对陕西省燃用石煤区的8～12岁儿童进行氟斑牙检查，按氟斑牙患病率进行病区划分，同时登记病区改炉灶进展情况。结果 在2市9个县(区)124个乡镇1666个村，划分出病区村1309个，受危害25．06万户、97．79万人。目前已经改炉灶3．48万户，受益13．75万人，尚有21．58万户、84．04万人急需改炉灶。燃用石煤的病区人口以每年10％的速度递增，改炉灶率仅为13．90％，低于全国平均水平。结论 由于退耕还林政策的实施，中、高山区居民逐渐下迁，病区范围继续扩大，仍要维持一定时间。居民燃料结构逐渐向多元化发展，清洁燃料和低氟煤炭的输入，将会为综合治理提供有利条件。建立可持续发展的销售服务、技术指导网络迫在眉睫。     

Changing nutrient cycling in Lake Baikal,the world’s oldest lake

Lake Baikal, lying in a rift zone in southeastern Siberia, is the world''s oldest, deepest, and most voluminous lake that began to form over 30 million years ago. Cited as the “most outstanding example of a freshwater ecosystem” and designated a World Heritage Site in 1996 due to its high level of endemicity, the lake and its ecosystem have become increasingly threatened by both climate change and anthropogenic disturbance. Here, we present a record of nutrient cycling in the lake, derived from the silicon isotope composition of diatoms, which dominate aquatic primary productivity. Using historical records from the region, we assess the extent to which natural and anthropogenic factors have altered biogeochemical cycling in the lake over the last 2,000 y. We show that rates of nutrient supply from deep waters to the photic zone have dramatically increased since the mid-19th century in response to changing wind dynamics, reduced ice cover, and their associated impact on limnological processes in the lake. With stressors linked to untreated sewage and catchment development also now impacting the near-shore region of Lake Baikal, the resilience of the lake’s highly endemic ecosystem to ongoing and future disturbance is increasingly uncertain.

Ancient lakes have long been associated with both high levels of biodiversity and endemicity. However, they are also being threatened by anthropogenic forcings that have led to impacts ranging from the warming of lake waters (1), hydrological modifications (2), increases in aquatic toxicity (3), and declining endemic populations due to introductions of nonnative species (4). With global populations increasingly reliant on large and ancient lakes for ecosystem services, the biodiversity (5) and value of aquatic systems to society (6), particularly in ancient lake systems (7), are at risk. Lake Baikal (Russia) is an exceptional example of an ancient lake (Fig. 1). In addition to containing ∼20% of global surface freshwater, the lake is characterized by its high degree of biodiversity with over 2,500 flora and fauna, the majority of which are endemic (8). This has been attributed to the lake’s age and fully oxygenated water column, driven by seasonal overturning and deep water renewal (9, 10) that sustains an almost completely endemic deep water fauna (8).Open in a separate windowFig. 1.Location of Lake Baikal and its catchment (gray) together with the location of World Meteorological Organization station in Irkutsk, major catchment rivers (brown), coring sites (BAIK13-1, BAIK13-4), and sites providing additional data used in this study (BAIK13-7).Concerns exist over the future health of this unique ecosystem, amid evidence of extensive shoreline eutrophication (11, 12) and climate-induced shifts in primary productivity (13, 14). Together, these changes have impacted organisms ranging from sponges and gastropods to ciliates, flagellates, and algal communities (15). Given the likelihood of future anthropogenic disturbance on Lake Baikal, further disrupting productivity exchanges through the lake’s food web, there is a need to place these contemporary observations into their historical setting. In Lake Baikal, we have evidence that algal communities have undergone rapid multidecadal to multicentennial timescale changes over the last 2,000 y (16). However, there is a need to also gain a clearer insight into how biogeochemical and nutrient cycling has altered over the same timescale, both to contextualize natural and anthropogenic drivers of change and to understand the susceptibility of the lake’s ecosystem to further alteration under different climate states (17). Annual primary productivity in Lake Baikal is ultimately regulated by photic zone nutrient availability, in addition to ice/snow cover, which regulates light availability for photosynthesis (10, 18). Here, by analyzing the silicon isotope composition of diatom silica (δ³⁰Si_diatom), we show that nutrient supply to the surface waters of Lake Baikal has rapidly increased through the 20th and 21st centuries coincident with increased wind-driven Ekman transport and reduced ice cover. These changes in photic zone nutrient availability have the potential to alter resource competition and prey–predator interactions across the lake (15, 19).     

江西省第6次碘缺乏病病情调查结果分析

目的通过调查全省碘缺乏病病情和居民碘营养水平,为调整江西省食盐加碘浓度提供依据。方法按人口比例概率抽样方法在全省抽取30个县（市、区）的30所小学．每所小学采用B超法测定40名学生甲状腺容积．抽取上述小学8～10岁儿童尿样345份,并在每所学校周边的3个乡（镇）分别采集孕妇和哺乳期妇女尿样共894份．采用砷铈催化分光光度法进行尿碘含量检测,并对学校所在村分别采集饮用水进行水碘含量检测。结果监测结果表明．全省儿童学生甲状腺肿大发生率为1．25％;盐碘中位数为30．80mg／kg,居民合格碘盐食用率为97．00％;儿童、孕妇和哺乳期妇女尿碘中位数分别为308．95、206．75、206．72μgg/L,其中儿童尿碘大于或等于300μg／L的样品数占52．20％,而孕妇尿碘小于150μg/L的样品数占34．73％;全省水碘中位数4．62μg/L。结论江西省人群碘缺乏状况总体控制良好,仍要加强对重点人群碘营养水平的监测,适时调整碘盐浓度。     

2010年福建省碘缺乏病高危地区重点调查结果分析

目的 调查福建省碘缺乏病高危地区新发地方性克汀病(简称地克病)、地方性甲状腺肿流行现况及防治措施落实情况,为制订有针对性的防治策略措施提供科学依据.方法 2010年,在碘盐监测覆盖率较低的秀屿区、翔安区、平潭县、东山县各抽取3个乡(镇),进行10岁以下新发地克病病例搜索;在每个乡(镇)抽取2所小学,每所小学抽取40名8～ 10岁儿童进行甲状腺B超检查,同时采集尿样,用砷铈催化分光光度法测定尿碘;在小学所在村抽取20名18 ～40岁育龄妇女,采集食用盐样和尿样,用半定量法测定盐碘,砷铈催化分光光度法测定尿碘.结果 病例搜索未发现新发地克病及疑似地克病病例;8 ～ 10岁儿童总体甲状腺肿大率为3.6％ (37/1027),但东山县为5.4％( 13/240),超过国家消除碘缺乏病标准(＜5％);8～10岁儿童和18～40岁育龄妇女的尿碘中位数分别为175.3、152.7 μg/L;碘盐覆盖率为82.7％ (382/462).结论 福建省碘缺乏病高危地区未发现新发地克病及疑似地克病病例,人群尿碘中位数处于适宜水平.