吸烟、饮酒与蒙古族高血压的关联性

目的 探讨吸烟、饮酒与蒙古族高血压的关联及关联强度。方法 对2589名≥20岁的蒙古族居民进行血压的测量及吸烟、饮酒等因素的调查，采取单因素X^2及多因素非条件Logistic回归模型分析，以OR值作为评价关联及关联强度的指标，用Mantel—HaenszelX^2趋势检验法分析饮酒与高血压间的剂量-反应关系。结果 单因素分析结果显示，年龄、性别（男性）、吸烟、饮酒、超重[体质指数（BMI）≥25]、腹型肥胖[腰臀比（WHR）≥0．9]、高血糖（血糖≥6．1）以及高血压家族史与高血压相关联（P〈0．05）。经Logistic回归模型分析，调整了年龄、性别、BMI、WHR、血糖和家族史等因素后，吸烟与高血压的关联差异无统计学意义（OR；0．823，P〉0．05），而饮酒与高血压之间的关联差异有统计学意义（OR=1．705，P〈0．0001）。剂量-反应关系分析结果显示，蒙古族人群患高血压的危险性有随着饮酒量的增加而增高的趋势。结论 饮酒可能是蒙古族高血压的独立危险因素，随着饮酒量的增加患高血压的危险性增高，而吸烟可能不是蒙古族高血压的危险因素。     

40～69岁居民肥胖类型与心血管危险因素的关联分析

目的 分析扬中市居民体质指数（BMI）和腰围（WC）与心血管危险因素（CRFs）的相关性。方法 采用多阶段分层整群抽样方法，选取40～69岁居民作为调查对象进行现场调查。对数据进行描述性分析、t检验、方差分析、χ2检验、多分类无序和二分类logistic回归分析。结果 6 581名研究对象中，高血压前期、高血压、糖尿病前期、糖尿病、高总胆固醇（TC）、高甘油三酯（TG）、高低密度脂蛋白胆固醇（LDL-C）、低高密度脂蛋白胆固醇（HDL-C）和血脂异常的患病率分别为25.54%、67.19%、11.09%、12.66%、8.92%、28.69%、0.80%、9.30%和38.70%。多分类无序/二分类logistic回归分析结果显示，调整混杂变量后，超重（OR:1.220～2.503）、肥胖（OR:1.641～3.705，高血压前期和高TC除外）、中心性肥胖（OR:1.210～2.266，高LDL-C除外）均是CRFs的独立危险因素（均P<0.05）。与单一肥胖类型相比，复合型肥胖人群（OR:1.634～3.128）患高血压、糖尿病前期、糖尿病和血脂异常的风险更高（均P<0....     

医学院校教职工脂肪肝横断面研究

目的了解医学院校教职工脂肪肝患病率,探讨脂肪肝患病率的影响因素,为脂肪肝的防治提供理论依据。方法收集该医学院校教职工体检结果,进行横断面调查。结果体检人数715人,可用于分析700人,脂肪肝总患病率34.70%,男性为43.80%,女性为26.30%。不同年龄组、不同性别脂肪肝患病率差异有统计学意义;单因素分析显示,高空腹血糖（FBG）、高血清总胆固醇（TC）、高甘油三酯（TG）、高血压、高血尿酸（UA）、高低密度脂蛋白胆固醇（LDL-C）、体质指数（BMI）增高是脂肪肝发生的可能危险因素,Logistic回归分析显示,性别、高TG、高血压、高LDL-C、BMI增高是脂肪肝发生的可能危险因素,OR值（95%CI）分别为1.576（1.055～2.354）、3.069（2.013～4.681）、1.877（1.124～3.136）、1.722（1.032～2.874）、7.275（4.613～11.475）。结论该医学院校教职工脂肪肝患病率处于较高水平。脂肪肝发生与BMI、TG、高血压、LDL-C、性别联系密切。     

常州市成人血脂异常的流行特征分析

目的探讨常州地区当前一般人群血脂异常的流行特点。方法利用2012年1 259名健康检查者资料,分析并比较不同性别、不同年龄人群血清甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）的异常率以及TG与TC、LDL-C、HDL-C的关系。结果①男性TG、TC、LDL-C、HDL-C异常率均高于女性,按年龄分层,男女TC、LDL-C异常率均随年龄增加呈上升趋势,但男性TG异常率与年龄不呈正比。无论男性还是女性,不同年龄段HDL-C异常率未见统计学差别。②男性血脂异常者中有49.9%为混合型,女性则有52.2%为混合型。③logistic回归分析表明,校正性别、年龄后,TG异常与TC异常呈正相关（OR 95%CI=1.563~3.409）,与HDL-C异常呈负相关（OR 95%CI=0.246~0.974）。结论常州地区成年人血脂异常率较高,且混合型血脂异常占较高比例,今后应积极开展预防血脂异常的健康教育。     

驻闽2471名军队干部血尿酸现状及相关因素

目的了解驻闽军队中青年干部人群高尿酸血症(HUA)的现状,并对其危险因素进行初步分析,为该人群HUA的防治提供依据。方法以2013年1-12月在某医院体检的2471名军队中青年干部为对象,测量指标包括身高、体质量、血压、血尿酸、血糖、胆固醇(TC)、甘油三酯(TG)和肌酐(Cr)等;比较HUA人群与正常人群上述指标的差异,采用单因素及多因素Logistic回归分析HUA的危险因素。结果驻闽军队中青年干部(HUA)患病率为27.1%,男性患病率(29.8%)明显高于女性(7.9%)。男性各年龄组血尿酸水平随年龄增长而明显增高。男、女性(HUA)组TC、TG、LDLC、Cr水平均明显高于正常组。多因素Logistic回归分析显示,肥胖、高血压、高甘油三酯、高胆固醇、肌酐的OR值分别为1.129、1.501、1.310、1.244、1.308,P0.01;HDLC的OR值为0.494(P0.01)。结论驻闽军队中青年干部HUA患病率较高,肥胖、高血压、高甘油三酯、高胆固醇、肌酐可能是HUA的危险因素,而HDLC可能为HUA的保护因素。     

济南市居民高尿酸血症及影响因素分析

目的调查济南市35～64岁人群高尿酸血症患病率并对其相关因素进行分析。方法对4041例健康查体人群进行横断面调查，应用Logistic回归模型分析影响因素与高尿酸血症的相关性。结果男性高尿酸血症患病人数为126例，患病率为6．4％；女性44例，患病率为2．1％。Logistic多元回归模型显示，高甘油三酯血症（OR=6．155）、高胆固醇血症（OR=2．853）、男性（OR=2．749）、高血压（OR=1．884）、腹型肥胖（OR=1．834）与高尿酸血症升高相关；农村人群（OR=0．266）、饮酒者（OR=0．807）则与高尿酸血症降低相关。结论济南市人群高尿酸血症发病率较低；高甘油三酯血症、高胆固醇血症、男性、高血压、腹型肥胖可能为高尿酸血症的危险因素；农村、适量饮酒可能为保护因素。     

正常人群非高密度脂蛋白胆固醇和血致动脉硬化指数水平分析

目的 分析甘油三酯（TG）、总胆固醇（TC）均为正常范围内体检人员的非高密度脂蛋白胆固醇（non-HDL-C）和血致动脉硬化指数（AIP）水平情况,为防治血脂异常提供依据。方法 从2001～2006年在我院体体检的45470人中,选择甘油三酯（TG）、总胆固醇（TC均为正常合适范围内的14855人,同时测定高密度脂蛋白胆固醇（HDL-C）,计算出non-HDL-C、LDL-C、AIP;并按性别及不同年龄段进行分组,将各组进行比较分析。结果 男性non-HDL-C、AIP水平明显高于女性,并随年龄增高而逐渐升高;AIP与TG、non-HDL-C、LDL-C成正相关,non-HDL-CTG、TC、LDL-C、AIP成正相关,两者与HDL-C均成负相关。结论 TG、TC均为正常人群中,仍具有发生动脉粥样硬化危险,且男性高于女性,并随着年龄增高而呈升高趋势,老年组更为明显,应引起重视。     

高校教职工脂肪肝患病情况及其相关因素

目的了解高校教职工脂肪肝患病情况及其相关因素，为预防和治疗脂肪肝提供依据。方法问卷调查某高校教职工性别、年龄、病史、饮食和行为习惯等，测量身高、体重、血压，同时进行腹部B超、血糖、血脂的检查。结果1348名高校教职工中，脂肪肝患病率为16．69％，男性（19．67％）高于女性（13．09％），差别有统计学意义（χ^2=10．40，P〈0．01），45～64岁男性患病率高于女性（P〈0．05），女性随年龄增长患病率有增高的趋势。经多因素Logistic回归分析，脂肪肝的患病率与体质指数（χ^2=13．471，OR=I．841，95％CI：1．232～2．748）、糖尿病（χ^2=8．326，OR=I．622，95％CI：1．050～2．504）、高脂血症（X2=26．312，OR=3．161，95％cf：2．101—4．754）、高血压（χ^2=11．392，OR=I．748，95％CI：1．171—2．611）、饮酒（χ^2=14．574，OR=I．867，95％CI：1．251～2．789）等因素密切相关。结论高校教职工脂肪肝患病率较高，应针对肥胖、糖尿病、高脂血症、高血压、饮酒等危险因素加强预防和治疗。     

宁波市农村老年人高尿酸血症与血脂异常检出率的关系

目的探讨农村老年人高尿酸血症与血脂异常之间的相关性。方法比较高尿酸患者和尿酸正常组的发病率,分析高尿酸与血脂异常之间的关系。结果农村老年男女尿酸(UA)增高合并甘油三酯(TG)增高患者发生率均明显高于UA正常的发生率(χ2男=17.5,P<0.01;χ2女=32.2,P<0.05)。此外老年女性UA增高合并总胆固醇(TC)增高、低密度脂蛋白胆固醇(LDL-C)增高、高密度脂蛋白胆固醇(HDL-C)增高、混合性血脂增高发生率均明显高于UA正常的发生率。高尿酸危险因素分析示TG是高尿酸的危险因素(OR=2.378)。结论农村老年人高尿酸血症与TG检出率密切相关,TG是高尿酸血症的危险因素,因此在健康体检中推行血尿酸和血脂分析常规筛查,对早期发现早期治疗有相当意义。     

黔南地区布依族和苗族妇女围绝经期难治性高血压影响因素比较研究

目的探讨黔南地区布依族和苗族妇女围绝经期难治性高血压的影响因素,并比较两民族影响因素,为两民族妇女围绝经期难治性高血压的干预措施提供依据。方法对2013年3月-2016年2月在黔南布依族苗族自治州中医院就诊确诊为围绝经期难治性高血压女性患者325例作为研究对象。按民族分为布依族组167例,苗族组158例,采用自行设计的《黔南地区妇女围绝经期难治性高血压患病影响因素调查表》进行问卷调查,并对影响妇女围绝经期难治性高血压患病的相关因素进行Logistic多元回归分析。结果两民族妇女围绝经期难治性高血压患病影响因素比较:布依族组年龄和高血压病程年限分别与苗族组比较,差异均有统计学意义(t值分别为3.383、3.259,均P0.01);布依族组甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)含量水平分别与苗族组比较,差异均有统计学意义(t值分别为5.538、2.423、3.334、3.532,均P0.01);布依族组吸烟史、饮酒史、高血压家族史、血脂异常、糖耐量异常(IGT)、慢性肾脏病(CKD)、肥胖和糖尿病病例数分别与苗族组比较,差异均有统计学意义(χ2值分别为1.941、10.461、22.881、30.795、9.862、11.256、25.669、37.925,均P0.01)。多因素Logistic回归分析结果表明,年龄(OR=5.352)、血脂异常(OR=4.687)、TG(OR=4.251)、TC(OR=4.113)、糖尿病(OR=4.028)、CKD(OR=3.908)和高血压病程(OR=3.822)是影响布依族妇女围绝经期难治性高血压因素。糖尿病(OR=4.025)、CKD(OR=3.917)和高血压病程(OR=3.764)是影响苗族围绝经期难治性高血压因素。结论黔南地区布依族和苗族妇女围绝经期难治性高血压患病影响因素有一定的差别。     

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 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.     

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.     

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.     

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.