青海省海东地区三县4～18岁人群先天性心脏病的流行病学调查

目的 调查研究青海省海东地区平安县、乐都县、互助县等3个县4～18岁人群先天性心脏病(COHD)流行病学特征.方法 对3个县97 718名4～18岁在校学生按初筛、复筛、彩色超声多普勒确定3个阶段进行调查.分析了COHD病种分布,比较了性别、各年龄段及各民族之间的患病率差异.结果 检出COHD 496例.总患病率为5.076‰(496/97 718).男、女性患病率分别为5.046‰(256/50 730)和5.108‰(240/46 988),两者间差异无统计学意义(X2=0.018,P>0.05).3个县患病率分别为:乐都县5.46‰、互助县5.45‰、平安县3.64‰,不同县之间患病率差异有统计学意义(X2=10.62,P<0.01),其中乐都县、互助县患病率高于平安县(X2值分别为8.37、9.91,P<0.01).汉族的COHD患病率为5.09‰(391/76 822),藏族为5.45‰(23/4220),蒙古族为4.04‰(3/743),土族为5.02‰(57/11 345),不同民族间患病率差异无统计学意义(X2=0.33,P>0.05).在496例COHD中,房间隔缺损(ASD)与室间隔缺损(VSD)分别占37.30%和35.69%,动脉导管未闭(PDA)占22.18%.结论 青海省海东3个县4～18岁人群COHD总患病率为5.076‰,不同性别、不同民族的COHD患病率基本相同.     

海南藏族自治州4～17岁人群先天性心脏病调查

目的 分析青海省海南藏族自治州4～17岁人群先天性心脏病(CHD)状况和分布特点.方法 采用整体普查法,对青海省海南藏族自治州53 827名幼儿园、中小学4～17岁人群进行流行病学调查.结果 CHD患病率为5.68‰,其中男性患病率为3.95‰,女性患病率为7.66‰,男女患病率差异有统计学意义(P<0.001).在CHD的不同类型中,房间隔缺损患病率最高,为1.84‰,占CHD总数的32.35%;其他类型CHD患病率由高到低依次为:室间隔缺损、动脉导管未闭及其他类型,不同病种之间患病率差异有统计学意义(P<0.001).不同年龄段人群之间患病率差异有统计学意义(P<0.001),<7岁患病率为2.92‰,与其他各年龄组患病率相比差异均有统计学意义(P<0.05).兴海县为8.90‰,同德县为7.20‰,贵南县为5.88‰,共和县为5.78‰,贵德县为3.80‰,不同县的患病率差异有统计学意义(P<0.05).患病率与海拔高度无相关关系.不同民族患病率由高到低依次为:回族8.21‰,土族7.26‰,汉族7.18‰,藏族4.57‰,蒙古族4.18‰,藏族、蒙古族较低,与汉族、土族、回族患病率比较,差异均有统计学意义(P<0.001).结论 青海省海南藏族自治州CHD人群存在区域、民族、性别差异.     

新疆少数民族儿童先天性心脏病流行病学调查分析

目的 了解新疆南部少数民族聚居区内5~14岁儿童先天性心脏病的流行病学资料.方法 新疆医科大学第一附属医院于2013至2014年对新疆南部3个地区部分中小学生、幼儿园幼儿共39 350人进行调查,并将该三地区六县儿童先天性心脏病的患病率、病种分布、性别间差异进行比较.结果 共检出先天性心脏病儿童203例,总体患病率为5.16‰.8~14岁组的患病率高于5~7岁组,两组差异有统计学意义(χ2=3.832,P<0.05).病种构成以房间隔缺损最为多见,患病率及构成比均居首位(2.26‰、43.84%).结论 新疆南部少数民族5~14岁儿童先天性心脏病的总体患病率与全国水平相当,8~14岁组患病率高于5~7岁组;先天性心脏病构成比以房间隔缺损为主.     

柬埔寨5省儿童先天性心脏病患病率及病种对比分析研究

目的了解柬埔寨不同地区学校儿童先天性心脏病患病率及病种情况,为开展社区筛查治疗及柬埔寨国家先心病防控提供依据。方法2018年1月-2019年7月,柬埔寨马德望、暹粒、磅通、磅湛、特本克蒙五个省81个中小学为调查点,14岁及以下儿童为调查对象。通过心脏听诊及B超检查,横断面调查收集接受儿童先天性心脏病筛查人数、病例数、病种及地点年龄分布情况,并进行对比分析,结合对部分当地医务人员访谈。结果共筛查38652人,确诊先心病患儿82人,患病率为2.12‰。马德望、暹粒、磅通、磅湛、特本克蒙五个省患病率分别为2.34‰,1.80‰,2.32‰,1.76及1‰。5省患病率差异无统计学意义(P>0.05),主要病种为VSD例(40.2%)。不同年龄、性别、病种及地区间先心病患病率差异无统计学意义。结论柬埔寨儿童先天性心脏病患病率较低,以VSD为主。地域间无明显差异。     

1996至2000年全国5岁以下儿童死亡监测主要结果分析

目的了解1996至2000年全国5岁以下儿童年龄别和主要死因别死亡率的变化趋势。方法采用全国5岁以下儿童死亡监测网收集的1996至2000年以人群为基础的监测资料,计算不同地区的新生儿、婴儿、5岁以下儿童死亡率及5岁以下儿童主要死因别死亡率。结果2000年全国新生儿、婴儿和5岁以下儿童死亡率分别为22．8‰、32．2‰和39．7‰,较1996年(24．0‰、36．0‰和45．0‰)分别下降了5．0％、10．6％和11．8％;2000年城市新生儿、婴儿和5岁以下儿童死亡率分别为9．5‰、11．8‰和13．8‰,较1996年(12．2‰、14．8‰和16.9‰)分别下降了22．1％、20．3％和18．3％;2000年农村新生儿、婴儿和5岁以下儿童死亡率分别为25．8‰、37．0‰和45．7‰,较1996年(26．7％0、40．9％0和51．4％0)分别下降了3．4％、9．5％和11．1％。1996至2000年,全国5岁以下儿童的痢疾、肺炎、腹泻、神经管缺陷和溺水死亡率有明显下降趋势。结论1996至2000年,我国城市和农村的新生儿、婴儿、5岁以下儿童死亡率有明显的下降趋势,且肺炎、腹泻等可避免死因的死亡率下降在农村地区尤为明显。     

云南省不同时期不同地区儿童生存水平的调查

对云南省不同时期、不同地区儿童生存水平进行调查。结果显示:云南省婴儿死亡率为58.4‰,农村为50.0‰～100.0‰,平均70.0‰～75.0‰,城乡之间、山区与平原之间、发达与不发达地区之间都有显著区别,NMR/IMR为60.0％～75.0％,IMR/USMR为70.0％～83.0％;婴儿死亡的前5位死因为肺炎、新生儿窒息、新生儿破伤风、早产、腹泻等。同时分析了影响儿童生存的有关因素,以及卫生行为与死亡的关系。     

天津市区糖耐量低减的流行病学调查

为了摸清本市城区居民糖耐量低减（IGT）的患病率及其人群分布情况,采用整群随机抽样方法进行了IGT的流行病学现状调查,结果显示IGT患病率男,女及合计分别为13．13％,19．18‰,19.18‰16．23‰,中国人口标化患病率（世界人口标化率）分别为9．81‰（15.36‰）,14.37‰（19.03‰）12．18‰（17．42‰）,IGT患病率按年龄,性别,民族及职业分布显著不同。     

先天性心脏病学科建设的发展策略

先天性心脏病是先天畸型中最常见的一类疾病，也是小儿最常见的心脏病。患病率占出生成活婴儿的6．9‰，学龄前患病率为4.7‰，先天性心脏病于儿童期内如未能得到纠治，至成年依然存在。因此，成人也有较高的发病率。随着环境污染的加重和诊断技术的提高，先天性心脏病将日趋增多。由于其诊断治疗的特殊性，建议在大型综合性医院或心血管病专科医院，有必要成立一门独立的学科一先天性心脏病科或先天性心脏病诊疗中心。     

四川省农村贫困居民卫生服务需要研究

目的：了解四川省农村贫困居民的卫生服务需要状况并分析其影响因素，促进农村卫生服务网络建设。方法：对第3次国家卫生服务调查的四川省农村地区共372名15岁及以上贫困居民资料进行分析。结果：四川省农村15岁及以上贫困居民的两周患病率为346．8‰，慢性病患病率为255．4‰(按人数计)和298．4‰(按例数计)，均高于非贫困居民。贫困居民的两周患病率、慢性病患病率均受年龄、婚姻状况、户厕类型等多种因素影响。结论：针对多种影响因素，采取多种措施，降低农村贫困人群的患病率，满足他们的卫生服务需要，提升农村居民健康水平。     

河南省部分地区儿童青少年风湿热监测及风湿性心脏病流行病学调查

1992～1994年期间,对河南省部分地区5～18岁儿童、青少年进行了风湿热监测及风湿性心脏病调查,首次得出河南省风湿热年均发病率3.62/10万,农村5.14/10万,城市1.92/10万;两年间风湿性心脏病患病率0.16‰,城市0.22‰,农村0.11‰,男性0.07‰,女性0.26‰。此为制定河南省风湿热、风湿性心脏病防治策略及对全国此两病的调查奠定了基础。     

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.     

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.     

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.     

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.