北京市18~65岁居民高胆固醇血症流行现状与影响因素分析

目的 了解北京市18~65岁居民高胆固醇血症流行病学现状及影响因素,为其相关疾病的防控提供科学依据。方法 数据来自2014年北京市成人慢性病与危险因素监测。该监测以多阶段分层整群抽样方法在全市范围抽取调查对象进行问卷调查、身体测量和实验室检查。结果 17 662例有效样本中,血清胆固醇均值为（4.69±0.95）mmol/L,高胆固醇血症患病率为6.26%,边缘值升高率为21.34%。男性高胆固醇血症患病率为6.33%,女性为6.20%,差异无统计学意义（Z=1.64,P=0.10）;城区居民患病率为6.73%,高于郊区居民的5.59%（Z=-7.27,P<0.01）。高胆固醇血症患病率随年龄增加呈上升趋势（趋势检验 χ²=308.85, P<0.01）,其中男性（χ²=81.65,P<0.01）、女性（χ²=318.04, P<0.01）、城区居民（χ²=201.77, P<0.01）、郊区居民（χ²=114.65, P<0.01）均呈相同趋势。多因素logistic回归分析显示,高年龄组、女性（OR=1.23,95%CI：1.04~1.45）、超重（OR=1.56,95%CI：1.34~1.81）、肥胖（OR=1.82,95%CI：1.54~2.16）、每天吸烟（OR=1.24,95%CI：1.03~1.50）、每天饮酒（OR=1.40,95%CI：1.12~1.75）、牛羊肉摄入每周>1次（OR=1.19,95%CI：1.02~1.39）是高胆固醇血症的危险因素。结论 北京市18~65岁居民高胆固醇血症患病率低于全国平均水平,年龄、性别、地区、BMI、吸烟、饮酒、牛羊肉摄入频率为患病的主要影响因素。     

北京市18~65岁慢性病患者吸烟状态、戒烟态度及危险因素分析

目的 了解北京市18~65岁高血压、糖尿病、血脂异常、COPD、哮喘患者的吸烟状态、戒烟态度及危险因素。方法 数据来源于2014年北京市成人慢性病与危险因素监测,即在北京市16个区/县采用多阶段分层整群抽样方法抽取180个社区共19 815名调查对象,以其中18~65岁人群作为研究对象。结果 18 405例有效样本中,男性高血压、血脂异常患者现在吸烟比例均高于非患者（分别χ²=17.695,P<0.001;χ²=39.292,P<0.001）;女性高血压、COPD、哮喘患者现在吸烟者比例均高于非患者（分别χ²=6.649,P=0.010;χ²=6.276,P=0.012;χ²=8.245,P=0.004）。吸烟者中,高血压患者1年内想戒烟比例低于非高血压患者（χ²=20.487,P<0.001）,COPD患者1年内想戒烟比例高于非COPD患者（χ²=6.085,P=0.048）。男性中糖尿病（χ²=9.219,P=0.010）、血脂异常（χ²=13.513,P=0.001）患者中已戒烟者控制情况好于现在吸烟者。多因素logistic回归结果显示,吸烟是高血压（OR=1.17）、血脂异常（OR=1.25）、COPD（OR=1.78）、哮喘（OR=1.57）的影响因素。结论 北京市18~65岁居民中部分慢性病患者现在吸烟比例高且戒烟意愿低;吸烟是高血压、血脂异常、COPD、哮喘的危险因素。     

肿瘤转移抑制基因KISS-1蛋白、基质金属蛋白酶-2和血管内皮生长因子在结肠癌组织中的表达及临床意义

目的 检测结肠癌组织中肿瘤转移抑制基因KISS-1蛋白(KISS-1)、基质金属蛋白酶-2(MMP-2)和血管内皮生长因子(VEGF)的表达,分析其与结肠癌病理特征的相关性。方法 收集2009年1月至2010年6月在潍坊市人民医院60例行结肠癌切除术患者的癌组织标本作为观察组,60例良性结肠疾病手术患者的切除组织作为对照组。采用免疫组织化学法检测KISS-1、MMP-2和VEGF的表达。结果 观察组KISS-1、MMP-2和VEGF阳性表达率分别为31.7%、58.3%和78.3%,对照组分别为73.3%、16.7%和33.3%;观察组KISS-1阳性表达率明显低于对照组,差异有统计学意义(χ²=23.489,P<0.001);观察组MMP-2和VEGF的阳性表达率明显高于对照组,差异有统计学意义(χ²=27.469,P<0.001; χ²=25.817,P<0.001)。KISS-1、MMP-2和VEGF的表达与结肠癌组织学分型和TNM分期均有明显关系,差异有统计学意义(χ²=8.997,P=0.011; χ²=6.163,P=0.013; χ²=8.519,P=0.014; χ²=9.160,P=0.002; χ²=16.577,P<0.001; χ²=10.523,P=0.001)。结论 KISS-1、MMP-2和VEGF检测有助于了解结肠癌分化程度和临床分期,并为判断预后和个体化治疗提供参考依据。     

母亲孕前BMI和孕期增重与子代孤独症之间关系的研究

目的 探讨母亲孕前BMI和孕期增重与子代孤独症之间的关系。方法 选取2013－2014年经医疗机构确诊的181例1～5岁孤独症儿童为病例组,采用1 ∶ 1病例对照研究方法选择同地区、同性别、同年龄发育正常的儿童作为对照组。按母亲孕前BMI值分为低、正常和高3组,孕期增重根据美国医学研究所标准分为低、正常和高3组,采用SPSS 18.0软件进行χ²检验和logistic回归分析。结果 两组儿童年龄和性别分布均衡(χ²=0.434,P >0.05)。病例组母亲孕前BMI平均值为(21.28±3.80)kg/m²,高于对照组的(19.87±2.83)kg/m²,差异有统计学意义(χ²=9.580,P< 0.05);病例组母亲高BMI人数(10.5%)多于对照组(2.8%);随着孕前BMI增加,子代孤独症患病风险逐渐增大,高BMI组子代孤独症发病风险是正常BMI组的3.7倍(OR=3.71,95%CI:1.34～10.24);病例组正常BMI母亲孕期增重过度(44.1%)高于对照组(33.9%);病例组高BMI母亲孕期增重过度(52.6%)明显高于对照组(20.0%),正常BMI(χ²=8.690,P< 0.05)和高BMI(χ²=4.775,P< 0.05)母亲孕期增重过度与孤独症发病有关。logistic回归分析显示,母亲孕前高BMI(调整前OR=1.89,95%CI:1.26～2.85;调整后OR=1.52,95%CI:1.19～2.27)和孕期增重过度(调整前OR=1.63,95%CI:1.08～1.25;调整后OR=1.64,95%CI:1.21～2.21)是子代孤独症发生的危险因素。结论 母亲孕前超重/肥胖和孕期增重过度与子代孤独症发生有一定的关系,可能是孤独症的危险因素。     

HBsAg阳性母亲HBeAg和新生儿调节性T淋巴细胞关系及对HBV宫内传播的影响

目的 探讨HBsAg阳性母亲的HBeAg与新生儿CD₄⁺CD₂₅⁺Foxp3⁺调节性T淋巴细胞（Treg）含量的关系以及对增加新生儿HBV宫内传播发生风险的影响。方法 选择太原市第三人民医院妇产科分娩的270对HBsAg阳性母亲及其新生儿,收集一般人口学特征及分娩情况等资料,采用荧光定量聚合酶链式反应（FQ-PCR）和化学发光免疫试验（CLIA）检测母婴外周血HBV DNA及HBV血清学标志物;流式细胞术（FCM）检测新生儿外周血Treg等免疫细胞含量。结果 母亲HBeAg阳性是HBV宫内传播的危险因素（OR=4.08,95% CI：1.89~8.82）;母亲HBeAg阳性者新生儿Treg含量高于阴性者（Z=2.29,P=0.022）;按母亲HBeAg滴度分为5组,各组间新生儿Treg、HBeAg及母亲HBV DNA随母亲HBeAg滴度增高呈上升趋势,差异均有统计学意义（χ²=18.73,P<0.001;χ²=181.60,P<0.001;χ²=183.09,P<0.001）。偏相关分析中控制母亲HBV DNA以及新生儿HBeAg后,母亲HBeAg与新生儿Treg呈正相关（r_s=0.19,P=0.039）。新生儿Treg与浆细胞样树突状细胞（pDC）、CD₄⁺T淋巴细胞含量为负相关（r_s=-0.21,P=0.017;r_s=-0.23,P=0.009）。结论 HBsAg阳性母亲的HBeAg可能通过上调新生儿Treg含量,影响树突状细胞和效应T淋巴细胞的功能及其对HBV的免疫应答,从而增加新生儿发生HBV宫内传播的风险。     

山西省1 337名煤矿工人血脂异常患病情况及相关因素分析

目的 了解山西省煤矿工人血脂异常患病情况并分析其相关因素。方法 收集2016年4月在山西省太原市某煤矿1 337名工人体格检查与血液生化指标检测资料;按照2007年《中国成人血脂异常防治指南》诊断标准作为血脂异常的判定标准;采用χ²检验和非条件logistic回归模型对该煤矿工人血脂异常相关因素进行分析。结果 1 337例煤矿工人血脂异常总患病率为59.1%（790/1 337）,其中男性患病率为60.4%（708/1 173）,女性患病率为50.0%（82/164）,男性患病率高于女性（χ²=6.386,P<0.05）;20~34、35~49和≥50岁工人患病率分别为68.8%、58.7%和49.5%,20~34岁年龄组患病率最高。χ²检验结果显示,煤矿工人性别、年龄和BMI是血脂异常的相关因素（χ²=7.117,P<0.01;χ²=37.135,P<0.01;χ²=7.009,P<0.05）;非条件logistic回归分析结果显示,该煤矿工人性别、年龄、BMI水平、收缩压≥140 mmHg（1 mmHg=0.133 kPa）与血脂异常存在关联（P<0.05）;与女性矿工相比,男性矿工患血脂异常的风险是女性矿工的1.501倍（OR=1.501,95%CI：1.895~2.516）;从年龄分组看,35~49岁组、20~34岁组血脂异常患病风险分别为≥50岁组的1.672倍（OR=1.672,95%CI：1.501~2.392）和2.369倍（OR=2.369,95%CI：1.275~3.469）;较正常BMI组,高BMI组血脂异常患病风险为其1.443倍（OR=1.443,95%CI：1.139~1.828）;收缩压异常组血脂异常患病风险为正常组的1.829倍（OR=1.829,95%CI：1.152~2.906）;而舒张压、血糖、血尿酸、心电图检测结果与血脂异常的差异均无统计学意义。结论 该煤矿工人血脂异常患者主要为20~34岁男性,有高血压（收缩压异常）病史、高BMI（≥24.0 kg/m²）的该煤矿工人患血脂异常可能性较大,需要引起重视。     

叶酸与HPV16 E6/E7 mRNA表达在宫颈癌变中的交互作用

目的 探讨叶酸与人乳头瘤病毒16型(HPV16)E6/E7 mRNA表达在宫颈癌变中的交互作用。方法 选取经病理学确诊的宫颈鳞状细胞癌(SCC)患者64例、低度宫颈上皮内瘤样变(CIN1)患者55例、高度宫颈上皮内瘤样变(CIN2+)患者55例和正常宫颈(NC)者80例作为研究对象。采用微生物法测定血清叶酸和红细胞叶酸水平,应用real-time PCR法检测HPV16 E6/E7 mRNA表达水平。利用SPSS 16.0软件进行相关资料的χ²检验、方差分析、Welch检验、Kruskal-Wallis H检验、有序logistic回归和Spearman秩相关分析,应用相加模型进行交互作用分析。结果 随着宫颈癌变的进展,血清叶酸和红细胞叶酸水平均呈逐渐降低趋势(χ²=32.71,P<0.001; χ²=16.32,P<0.001),且血清叶酸和红细胞叶酸含量呈正相关(r=0.41,P<0.001);HPV16 E6/E7 mRNA表达水平随着宫颈癌变的进展呈逐渐升高趋势(χ²=30.11,P<0.001; χ²=38.99,P<0.001);红细胞叶酸含量与HPV16 E6/E7 mRNA表达量呈负相关(E6:r=-0.14,P=0.009;E7:r=-0.21,P=0.001),红细胞叶酸缺乏与HPV16 E6/E7mRNA高表达在CIN1、CIN2+和SCC组均存在正相加交互作用。结论 叶酸缺乏和HPV16 E6/E7 mRNA高表达均可增加宫颈癌及癌前病变发生的风险,两者在宫颈癌变进展中存在协同作用。     

母亲MTHFR 677C/T多态性和孕期状况与子代发生先天性心脏病的相关性研究

目的 探讨母亲孕期MTHFR 677C/T多态性、孕期状况在子代先天性心脏病(CHD)发生中的相互关系。方法 采用病例对照研究,调查100对CHD胎儿和无CHD胎儿生物学母亲有关人口学、孕期环境相关情况、优生认知,并检测MTHFR 677C/T基因多态性以及血清同型半胱氨酸(HCY)、叶酸、VitB12水平,进行单因素和多因素非条件logistic回归分析。结果 病例组和对照组MTHFR 677C/T基因型和等位基因频率差异无统计学意义(χ²=1.08,P=0.582;χ²=0.53,P=0.468),血清HCY水平两组差异有统计学意义(t=-8.14,P=0.000)。单因素分析,14个因素有统计学意义(P<0.05);多因素logistic逐步回归分析,母亲教育程度(OR=3.386,95%CI:1.279~8.961)、家庭年收入(OR=8.699,95%CI:2.177~34.765)、患慢性病(OR=0.343,95%CI:0.134~0.881)、优生认知得分(OR=0.906,95%CI:0.836~0.981)、血清HCY水平(OR=1.734,95%CI:1.458~1.986)、异常生育史(OR=3.710,95%CI:1.217~11.308)等因素与子代CHD相关。结论 母亲MTHFR 677C/T多态性与子代CHD发生未发现关联;母亲教育程度低、家庭年收入低、异常生育史、优生认知得分低、血清HCY水平高可能增加子代CHD的发生危险。     

浙江省城乡社区60岁以上老年人害怕跌倒而减少活动的流行特征及影响因素分析

目的 了解浙江省城乡社区60岁以上老年人害怕跌倒而减少活动的发生现状及其影响因素。方法 2013年10-12月由经过培训的调查员入户对1 972名60岁以上老年人进行问卷调查, 采用单因素和多因素logistic回归分析其影响因素。结果 因害怕跌倒而减少活动的老年人比例为43.15%(95%CI: 40.97%~45.34%), 其中男性和女性分别为41.79%(95%CI: 38.61%~44.98%)和44.36%(95%CI: 41.34%~47.38%), 不同性别的差异无统计学意义(χ²=1.32, P>0.05);60~、70~及≥80岁组因害怕跌倒而减少活动的比例分别为37.07%、44.87%和59.04%(趋势χ²=48.93, P<0.01)。过去12个月发生过跌倒老年人中, 因害怕跌倒而减少活动的比例为51.94%, 未曾发生过跌倒老年人中的比例为41.52%, 差异有统计学意义(χ²=11.56, P<0.01)。多因素logistic回归分析显示, 自评健康状况一般(OR=1.53)或不好(OR=1.69)、视力不良(相距1~5 m视物无困难: OR=1.95, <1 m才能辨认: OR=2.98)、听力不良(需大声交谈: OR=1.77)、经常使用辅具(OR=2.71)、年龄≥80岁(OR=1.56)、被诊断骨质疏松(OR=3.35)、被诊断眩晕症(OR=3.05)是老年人因害怕跌倒而减少活动的可疑危险因素, 而文化程度高(大学及以上: OR=0.54, 中学/中专: OR=0.54, 小学: OR=0.74)是保护因素。结论 浙江省城乡社区60岁以上老年人中害怕跌倒而减少活动的比例高。应针对患骨质疏松和眩晕症、视力和听力困难及自评健康状况差、经常使用辅具、文化程度低、高龄老年人开展健康教育, 鼓励其适当运动, 减少跌倒发生。     

河南省2008－2013年男男性行为人群艾滋病流行趋势分析

目的 分析河南省MSM人群HIV感染流行趋势,为河南省艾滋病防治政策与策略制定提供科学依据。方法 分析2008-2013年艾滋病病例报告系统中同性性传播HIV/AIDS病例的变化趋势,利用MSM人群艾滋病综合防治专项调查数据分析该人群HIV感染率及危险行为变化。结果 2008-2013年河南省同性性传播病例构成从1.3%上升到17.1%,呈现快速增长趋势;专项调查数据显示,MSM人群HIV感染率呈现快速上升趋势,从2008年的4.69%增至2013年的8.33%(趋势χ²=39.24,P<0.001).单因素分析结果显示,年龄(χ²=21.03,P<0.001)、文化程度(χ²=31.66,P<0.001)、职业(χ²=14.59,P=0.01)、最近1次肛交行为安全套使用情况(χ²=134.97,P<0.001)、最近6个月同性性行为安全套使用情况(χ²=97.15,P<0.001)、最近1年性病症状(χ²=67.21,P<0.001)以及梅毒感染(χ²=163.60,P<0.001)均为感染HIV的影响因素。多因素分析结果显示,年龄、性病症状史、感染梅毒与艾滋病防治知识不知晓为感染HIV的危险因素。结论 河南省MSM人群中HIV感染呈不断上升趋势,男男同性性传播已经成为主要感染途径,该人群不安全性行为普遍存在,亟需采取有效措施控制HIV在该人群中的传播。     

The prevalence of occupational asthma and rhinitis among woodworkers in south-eastern Nigeria

Wood dusts are known to cause respiratory disorders like rhinitis and asthma. This study was therefore done to determine the magnitude of the problem among woodworkers in south-eastern Nigeria exposed to high level of wood dust. Five hundred and ninety one woodworkers were selected using a stratified random sampling. The prevalence of woodwork-related rhinitis and asthma were then observed in the study population. Also the peak expiratory flow rate (PEFR) of each woodworker was obtained. The prevalence of occupational rhinitis was 78%, while that of asthma was 6.5%. As period of woodwork increased the prevalence of rhinitis and asthma increased (rhinitis: chi2 trend = 53.015, df = 1, P = 0.000). For asthma, chi2 trend = 19.721, df = 1, P = 0.000). Also the PEFR significantly became low with increasing years of exposure to woodwork (chi2 trend = 75.965, df = 1, P = 0.000). In conclusion the prevalence of rhinitis and asthma in woodworkers was high and significantly increased with years of working as a woodworker.     

青岛市成人麻疹发病相关因素的病例对照研究

目的 探讨青岛市成人麻疹发病的相关因素。方法 采用病例对照研究的方法，收集青岛市2002～2003年发生的全部成人麻疹病例70例和140名健康对照人群的一般社会人口经济学因素、麻疹疫苗免疫史、人口性质等信息。结果 单因素及多因素分析结果显示：病例组中无麻疹疫苗免疫史的比例明显高于对照组（x^2=26．88，P〈0．05，OR=5．12.95％ CI：2．69～9．73），按照接受免疫的次数，分为0次、1次、≥2次3个等级进行比较分析，0次麻疹疫苗免疫史与1次免疫史比较，两组的差异无统计学意义（x^3=1．86，P=0．173）；0次麻疹疫苗免疫史与≥2次免疫史进行比较显示，两组间的差异有统计学意义（x^2=45．24，P=0．000，OR=13．35，95％CI：5．80～30．71）；有1次麻疹疫苗免疫史与≥2次免疫史在两组中的分布差异也有统计学意义（x^2=26．23，P=0．000，OR=7．91，95％CI：3．37～18．59）。外来人口的麻疹发病比例明显高于本地人（x^2=21．60，P〈0．01，OR=4，06，95％CI：2．21～7．45）；单因素分析提示，两组人群经济收入水平差异有统计学意义（x^2=2．23，P〈0．05，OR=2．08，95％CI：115～3．76）。结论无麻疹疫苗免疫史人群、外来人口、低经济收入人群是青岛市成人麻疹发病的高危人群。     

Does employment improve the health of lone mothers? The ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood.

In Britain the government is currently proposing legislation that will encourage welfare recipients to gain employment. A central tenet of this 'welfare to work' policy is that employment will not only reduce the poverty of welfare recipients, but also improve their health. This research assessed the extent to which the movement from 'welfare to work' is likely to benefit the mental and physical health of lone mothers with preschool children. The sample was 719 lone mothers and a comparison group of 8779 women with partners drawn from the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC). Data collected by self completion questionnaire at 33 months postpartum provided information about average weekly take home family income and the mother's employment status. The health outcomes measured were general well being, both minor and major depression (using the Edinburgh Postnatal Depression Scale), self report of respiratory symptoms (cough/cold, wheeze, influenza) from 18-33 months postpartum and self report of symptoms common in the childbearing years (backache, haemorrhoids) also from 18-33 months postpartum. Lone mothers who were not employed were the poorest group in the sample; 94% of this group (402) had a family income of less than pound sterling 200 per week, compared with 72% (188) of lone mothers who were employed, 25% (905) of partnered women who were not employed and 12% (466) of partnered women who were employed. Lone mothers were significantly more likely than women with partners to report poorer well being (chi2 = 11.7, df = 3, P = 0.01), to have a major depressive disorder (chi2 = 92.6, df = 1, P = 0.0001) and to report wheeze (chi2 = 31.1, df = 1, P = 0.0001), but significantly less likely to report cough/cold (chi2 = 9.9, df = 1, P = 0.0001) or haemorrhoids (chi2 = 16.6, df = 1, P = 0.0001). Lone mothers who were unemployed and living on less than pound sterling 100 per week were significantly more likely to be depressed (chi2 = 3.9, df = 1, P = 0.05) than those who were employed and living on pound sterling 200 or more per week, and significantly less likely to report cough/cold (chi2 = 3.8, df = 1, P = 0.05). Logistic regression analyses showed no significant independent association between employment and better health for lone mothers. Rather, when compared with lone mothers who were not working, those who were employed were more likely to report minor respiratory symptoms such as cough/cold (OR = 1.51, 95% CI = 1.00,2.31). Overall, the results suggested that the movement from 'welfare to work' is unlikely to improve the health of lone mothers.     

非意愿性行为危险因素病例对照研究

目的研究非意愿性行为的危险因素,为制定降低非意愿性行为的规划、改善青少年的生殖健康服务.方法采用病例-对照研究方法.研究对象是从寻求人工流产(人流)服务年轻妇女中选取的,以人流者中,经历过非意愿性行为的512名妇女作为病例组,以同一人群中,从未经历过非意愿性行为的517名妇女作为对照组,来比较两组间各种因素的差异.结果增加非意愿性行为发生的危险因素主要有高中以下文化程度[χ2=15.27,P＜0.01,比值比(OR)1.71],没有与父母同住(χ2=10.18,P＜0.01,OR1.50),因醉酒而发生性行为(χ2=34.22,P＜0.01,OR5.04),被男方殴打过(χ2=6.79,P＜0.01,OR2.72),被男友辱骂过(χ2=4.22,P＜0.05,OR1.71),曾经与几个男性发生性关系(χ2=19.08,P＜0.01,OR2.17),流动人口(χ2=20.60,P＜0.01,OR1.78)以及男方与女方年龄之间的差距(χ2=11.04,P＜0.01,OR2.17).结论文化程度较低、单独居住、外来人口、多性伴及男女之间关系的不平等,易增加发生非意愿性行为的风险.     

银川市结核发病危险因素病例对照研究

目的 分析银川市结核病发病危险因素,为结核病预防提供参考依据.方法 选取119例结核病患者为病例组,选取179例体检人员为对照组进行结核病发病危险因素病例对照研究,进行单因素和非条件logistic回归多因素分析.结果 单因素分析表明:文化程度(χ2=2.363,P=0.018)、月人均收入(χ2=3.040,P=0.002)、吸烟史(χ2=2.500,P=0.012)、健身活动(χ2=2.330,P=0.020)、卡介苗接种史(χ2=22.151,P=0.000)、结核接触史(χ2=15.740,P=0.000)与结核病发生显著相关.多因素分析中月人均收入、吸烟史、健身活动、卡介苗接种史、结核接触史等因素进入方程模型(χ2值分别为5.880,7.368,3.891,21.127,14.536;OR值分别为0.529,1.571,0.774,0.264,3.978;P值均＜0.05).结论 结核接触史、吸烟史是银川市结核发病的危险因素.月人均收入高、接种卡介苗、多参加健身活动是银川市结核发病的保护因素.     

Differences between infants and adults in the social aetiology of wheeze. The ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood

OBJECTIVES: To compare the relation between relative deprivation, its associated social risk factors and the prevalence of wheeze in infancy and in adulthood. DESIGN: A cross sectional population study. SETTING: The three District Health Authorities of Bristol. SUBJECTS: A random sample of 1954 women stratified by age and housing tenure to be representative of women with children < 1 in Great Britain and selected from the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC). MAIN OUTCOME MEASURES: The prevalence of wheeze for infants at six months after birth and for their mothers and fathers at eight months postpartum. Potential mediators of the relation between relative deprivation and wheeze measured were overcrowded living conditions, number of other siblings in the household, damp or mouldy housing conditions, maternal and paternal smoking behaviour, and infant feeding practice. RESULTS: 63.4% (1239) of the sample lived in owner occupied/mortgaged accommodation (relatively affluent) and 36.6% (715) lived in council house/rented accommodation (relatively deprived). Wheeze was significantly more likely for infants living in council house/rented accommodation (chi 2 = 15.93, df = 1, p < 0.0001), their mothers (chi 2 = 9.28, df = 1, p < 0.001) and their fathers (chi 2 = 7.41, df = 1, p < 0.01). For those living in council house/rented accommodation backward stepwise logistic regression analyses showed that infants with other siblings in the household were significantly more likely to wheeze (OR = 1.83, 95% CI = 1.27, 2.65), as were infants whose mothers smoked (OR = 1.82, 95% CI = 1.30, 2.55) and those who were breast fed for less than three months (OR = 0.66, 95% CI = 0.44, 0.98). Mothers with a partner who smoked were significantly more likely to report wheeze (OR = 1.73, 95% CI = 1.05, 2.85). There was no independent association between the social factors included in the analysis and the likelihood of wheeze for fathers. CONCLUSIONS: This study identified differences in the social factors associated with a higher prevalence of wheeze in infancy and in adulthood; results suggested that this symptom was commonly linked to infection in infancy, but not in adulthood. While environmental tobacco smoke was associated with a higher prevalence of wheeze in infancy and in adulthood, this does not necessarily indicate a common underlying mechanism; possible explanations are discussed.     

毒物代谢酶基因多态性与职业性慢性苯中毒危险性的单纯病例研究

目的研究环境暴露因素与毒物代谢酶基因多态性对发生慢性苯中毒危险性的影响.方法以152例慢性苯中毒工人为研究对象,应用单纯病例方法进行分析.结果中等强度接触组慢性苯中毒工人GSTT1基因缺失突变的发生率明显高于低接触组,差异有显著性(68.63%vs38.00%,ORadj=4.32,95%CI1.75～10.66,p=0.002);NQO1 C.609T/T基因在饮酒组的比例明显高于不饮酒组,差异有显著性(61.11%vs20.00%,ORadi=8.03,95%CI 2.28～28.25,P=0.001),在吸烟又同时饮酒组的比例明显高于其他组,差异有显著性(85.71%vs22.76%,ORadj=18.62,95%CI2.01～172.72,P=0.01),在饮酒×接触等级组的比例明显高于非饮酒×接触等级组,差异有显著性(61.11%vs 20.00%,ORadj=3.18,95%CI 1.55～6.52,P=0.002);GSTM1基因缺失突变在饮酒×接触等级组的比例明显高于非饮酒×接触等级组,差异有显著性(66.67%vs47.06%,0Radj=1.99,95%CI 1.05～3.76,P=0.036).结论 GSTT1的基因多态与中等强度苯接触存在交互作用;不同强度的苯接触同饮酒一起与GSTM1基因缺失突变增加了个体发生慢性苯中毒的风险性;NQ01基因C.609位点的多态与饮酒存在交互作用,而吸烟*饮酒与NQO1基因多态的交互作用更是增加了苯中毒的风险性.     

六号染色体短臂MHC区DRB3、DRB1基因多态性与精神分裂症症状的关系探讨

目的 探讨六号染色体短臂MHC区DRB3、DRBl基因多态性与精神分裂症症状的相关性。方法 采用聚合酶链反应(PCR)和限制性内切酶片段长度多态性(RFLP)方法检测两个基因位点上的单核苷酸多态性(SNPs)，并对116例精神分裂症患者家系进行连锁不平衡分析。结果 DRBl的SNP(rs707954：G／T碱基互换)等位基因与关系妄想症状呈显著相关(X^2=5．484，df=l，P=0．019)，GG、GT、TT三种基因型频率在关系妄想症状中呈显著相关(X^2=6．771，df=2，P=0．034)。rs707954的三种基因型频率与情感淡漠症状呈显著相关(X^2=12．110，df=4，P=0．017)。结论 DRBl位点等位基因与关系妄想和情感淡漠症状高度相关，DRBl基因型与关系妄想症状高度相关。     

孕早期邻苯二甲酸酯暴露对胎停育的影响研究

目的 了解胎停育患者邻苯二甲酸酯（phthalates,PAEs）的暴露水平,探讨PAEs暴露与胎停育的关系。方法 采用病例对照研究方法于2018年6月至2019年1月收集山西医科大学第一附属医院产科胎停育患者和同期胚胎发育正常的孕妇作为研究对象,现场进行流行病学调查研究,并采集尿液备检,采用logistic回归分析胎停育的危险因素。结果 病例组与对照组的年龄（t=-3.51,P<0.001）、孕次（〖XC小五号.EPS;P〗=14.29,P<0.001）、是否行人工流产术（〖XC小五号.EPS;P〗=6.94,P=0.008）、是否使用塑料餐具/水杯（〖XC小五号.EPS;P〗=4.57,P=0.033）差别具有统计学意义。两组尿液中邻苯二甲酸单甲酯（MMP）、邻苯二甲酸单乙酯（MEP）、邻苯二甲酸单丁酯（MBP）、邻苯二甲酸单苄基酯（MBzP）检出率均大于70%。在调整了年龄、孕次、是否行人工流产术后,使用塑料餐具/水杯的孕妇胎停育的患病风险是不使用者的1.80倍（OR=1.80,95%CI:1.03~3.13）; MMP Q3、Q4暴露水平患病风险分别是Q1暴露水平的2.68倍（OR=2.68,95%CI:1.21~5.96）、2.58倍（OR=2.58,95%CI:1.15~5.81）;MBP Q4暴露水平患病风险是Q1暴露水平的2.39倍（OR=2.39,95%CI:1.08~5.28）。结论 孕早期较高的邻苯二甲酸酯暴露水平可能是胎停育的危险因素。     

Socio-demographic correlates of screening intention for colorectal cancer

OBJECTIVE: To assess the relationship between socio-demographic factors and screening intention for colorectal cancer (CRC). METHODS: A cross-sectional survey of a random sample of 884 Queenslanders aged 40-80 years was conducted using a computer-assisted telephone interviewing system. The factors measured included socio-demographic characteristics, personal history of CRC, knowledge of others with CRC and perceived symptom status. Chi-squared and Monte Carlo estimates of Fisher Exact Tests were performed to determine the associations between socio-demographic factors and screening intention. In multivariate analyses, multinomial logistic regression (MNLR) was utilised to examine potential determinants of screening intention. RESULTS: 77.5% (95% CI 74.0%-80.7%) of the respondents indicated their intention to participate in CRC screening if it were recommended by their doctor or health authorities. The likelihood ratio chi-squared tests in the MNLR analyses show that age (chi(df = 6)2 = 15.0; p = 0.02), education (chi(df = 8)2 = 19.4; p = 0.01), perceived symptom status (chi(df = 4)2 = 22.9; p = 0.00), sex (chi(df = 2)2 = 4.5; p = 0.11), income (chi(df = 14)2 = 19.6; p = 0.14) and personal history of CRC (chi(df = 2)2 = 4.3; p = 0.12) were potential determinants of screening intention. Other socio-demographic factors, including country of birth, private health insurance status, Socio-economic Index for Areas, and Rural and Remote Areas Classification codes, were not associated with screening intention. CONCLUSIONS AND IMPLICATIONS: The results indicate that a variety of socio-demographic factors are associated with screening intention and need to be considered in the future development of a population-based screening program for CRC.