云南不明原因猝死病区环境和人体硒、铬的研究

[目的]探讨云南不明原因猝死病区与非病区硒、铬水平以及与云南不明原因猝死的关系.[方法]采集云南不明原因猝死病区、非病区水,土,粮食,头发、血清,分别用荧光法和原子吸收分光光度法测定样品硒、铬含量.[结果]云南不明原因猝死病区水硒、铬,土壤硒、铬,粮食硒、铬水平均低于非病区组(P<0.05);云南不明原因猝死病区人体发硒、铬,血清硒、铬水平均低于非病区组(P<0.05),云南不明原因猝死病区环境硒、铬水平与人体硒、铬水平呈正相关关系.[结论]低硒与低铬可能是云南不明原因猝死的发病因素之一.     

1975-2004年云南不明原因心源性猝死回顾性调查

目的 探索云南不明原因心源性猝死的流行病学规律和发病特点.方法 选择曾上报云南不明原因心源性猝死病例的23个县进行云南不明原因心源性猝死病例回顾性调查及病例搜索,以1975-2004年21年中的猝死病例为调查对象,逐级培训调查员,统一调查方法,统一制定及下发调查表格,死者家属、见证人、救治医生、村干部为询问对象. 结果 299例被定为"云南不明原因心源性猝死",其中死亡病例286例(95.65%),同发病例13例(4.35%).死亡病例中有36例(12.04%)为该次回顾性调查中搜索到.该病发病具有明显的家庭和村庄聚集性、明显的季节分布、青壮年多发等流行病学特点及突然发病、突然死亡的发病特点;病区自然村主要分布在2 1002 300 m高海拔地带.结论 云南不明原因心源性猝死是一种新的、尚未被完全认知的一类疾病;可能是由多种病因共存,遭受某种致病因子打击而表现出以"猝死"为主要发病特点的疾病.     

地方病

041 8 96　陕西省黄陵县克山病病区硒现状分析/杨占田…∥西安交通大学学报(医学版) 2 0 0 2 ,2 3 (5 ) 5 0 2～5 0 3 ,5 1 5了解陕西省黄陵县克山病病区硒现状,为进一步防治研究提供科学依据。用2 ,3_二氨基萘荧光法测定粮食、头发和食用盐硒含量。结果,病区当地产小麦、大米、玉米和黄豆硒含量仍处于低水平,而病区居民所食外地麦面硒含量明显高于同期当地产小麦硒含量(P <0 0 1 ) ;病区儿童发硒含量达到了非病区儿童发硒水平;病区食用硒碘盐硒含量明显高于非硒碘盐硒含量(P <0 0 1 )。病区外环境硒水平相对恒定,而内环境硒水平有了…     

克山病病区人群和用病区粮饲养的动物血中谷胱甘肽过氧化物酶活力的研究

1.比较了用病区和非病区玉米、大米饲料饲养的大白鼠的全血中GSH-px活力,并与吃常备饲科的大白鼠血GSH-px活力进行对比。结果是:常备饲料组的酶活力大于非病区??粮组和病区粮组的,非病区粮组的酶活力大于病区粮组的。同时测定体外用维生素C氧化血红蛋白生成的高铁血红蛋白,胆绿蛋白和Heinz小体的百分数,所得结果是:常备饲料组小于非病区粮组和病区粮组,非病区粮组小于病区粮组。2.给喂以病区玉米饲料三个月造成乏硒的大白鼠补充硒(Na_2SeO_3)50天后,血硒和红细胞GSH-px活力均上升到接近喂以常备饲料的大白鼠的水平。3.测定了非病区儿童和成人及病区的克山病患儿和非克山病儿童和成人的全血GSH—px活力,结果是:职工户儿童大于农业户儿童,非病区儿童大于病区儿童。病区的非克山病儿童的酶活力与克山病患儿的无明显差别。4.克山病地区的儿童按规定服用亚硒酸钠后,GSH-px活力明显上升,达到70单位左右。5.人群的GSH-px活力与血硒和发硒有非常显著的相关性。     

克山病病区粮食中补充蛋氨酸对大鼠膳食硒生物利用的影响

为研究在克山病病区粮食中补充蛋氨酸对大鼠组织硒和谷胱甘肽过氧化物酶 (GPX)活性的影响 ,用克山病病区生产的低硒粮食为主配成低硒基础饲料 ,其硒含量为 0 .0 0 7mg/kg。在此基础上添加不同量的硒蛋氨酸 ,使饲料硒水平分别达到 0 .0 0 7、0 .0 6和 0 .5 0 mg/kg。每一硒水平又分别补充或不补充 4g/kg DL -蛋氨酸 ,配制成含不同硒和蛋氨酸的 6种饲料 ,分别喂养雄性 Wistar断乳大鼠 8周。结果在饲料硒水平为0 .0 0 7mg/kg时 ,补充蛋氨酸组动物除肌肉硒含量低于未补充组外 ,其它组织硒含量和各组织 GPX活力与不补充蛋氨酸动物无显著差异 ;在饲料硒水平为 0 .0 6 mg/kg时 ,补充蛋氨酸组动物组织中的硒含量出现了重新分布 ,最明显的是补充蛋氨酸组动物肌肉的硒含量减少 ,而肝脏和血硒含量增加 ,且各组织中 GPX活力显著大于未补充蛋氨酸组的动物 ;在饲料硒水平为 0 .5 0 mg/kg时 ,补充蛋氨酸组动物组织中硒含量有不同程度下降 ,但 GPX活力仍保持不变。研究结果认为病区粮食中蛋氨酸不足时 ,机体首先利用膳食中的硒蛋氨酸(谷类食物中硒的主要形式 )以替代蛋氨酸参与组织蛋白质的合成。补充蛋氨酸后 ,硒蛋氨酸即可发挥其应有生理功能。进一步提示病区粮食中蛋氨酸不足可能是与克山病发病有关的另一因素。     

云南省2002—2004年不明原因心源性猝死事件流行病学和临床特征分析

目的分析2002-2004年云南不明原因心源性猝死事件流行病学和临床特征。方法对2002-2004年所有云南不明原因心源性猝死报告病例进行现场调查,利用描述流行病学方法,总结流行病学、临床调查和实验室检查结果,分析其特点。结果2002-2004年共报告64例死亡病例和18例同发病例,事件分布在12个县的23个自然村。以自然村为单位发病率为1.83%,死亡率为1.51%,病死率为78.1%。91.3%的病区村位于山区和半山区,7-8月的病例数占总病例数的93.94%,15～50岁组的发病者为59.8%,64.63%的病例具有家庭聚集性,89.02%的病例具有村庄聚集性。大多数病例的病程很短,病程在24h内的患者主要症状有恶心、呕吐、头昏、晕厥、乏力、胸痛和气促等。结论病例分布具有高度的时间和空间聚集性;死亡病例主要表现为心源性猝死。     

硒和维生素E对饲予克山病病区粮大鼠肝脏自由基代谢的影响

饲予克山病病区粮对大鼠肝脏自由基代谢的影响及补充硒和维生素E的预防作用研究结果显示:病区粮组动物肝脏谷胱甘肽过氧化物酶活性明显下降,脂质过氧化物含量和自由基水平显著升高。在病区粮饲料中分别加入100ppmDL-α-生育酚和0.22ppm亚硒酸钠,均可明显降低脂质过氧化物含量和自由基水平。病区粮组动物肝脏α-生育酚和还原型谷胱甘肽含量均明显增加,提示硒缺乏可增加其对维生素E的需要量和使还原型谷胱甘肽生成增多。结果表明,克山病病区粮食中的致病因素能引起动物肝脏自由基代谢的紊乱,硒和维生素E对其都有很好的预防作用,提示维生素E的相对不足也有可能在克山病发病机制中起重要作用。     

西安市大骨节病区小学生饮食行为研究

目的 了解西安市大骨节病区小学生饮食行为情况,为大骨节病病因研究和防治提供科学依据.方法 采用分层随机整群抽样法,用自行设计的问卷对1 076名小学生进行自填式问卷调查.结果 调查对象中当地小麦的食用率为78.81％,其次为外地大米(58.92％)和当地玉米(52.51％).调查对象中坚持食用大米的行为率为51.30％,食用富硒食品的行为率为21.28％;中、重病区食用大米和富硒食品的行为率均低于轻病区(x2=9.351、54.818,均P＜0.05).五年级学生坚持食用大米和富硒食品的行为率高于三年级(x2=17.104、6.262,均P＜0.05).50.93％的调查对象愿意食用大米,24.67％的调查对象愿意食用富硒食物.四、五年级学生食用大米的意愿高于三年级(x2=19.384,P＜0.05),轻病区学生食用富硒食物的意愿高于重中病区(x2=33.331,P＜0.05).病区学生最近1周内副食食用情况中蔬菜(73.04％)、新鲜水果(57.43％)和奶及奶制品(44.05％)食用率较高,而家禽及禽产品(18.40％)、猪牛羊肉(15.33％)、鱼类(13.01％)较低.结论 西安市大骨节病病区小学生的饮食行为不合理,存在主食种类单一,以当地小麦、玉米为主,肉类、家禽、鱼类等食用率偏低的情况.相关部门应加强对病区居民大骨节病防治知识的健康教育,促进居民改善不良的饮食行为,提高病区儿童身体素质.     

硒和维生素E对喂克山病病区粮大鼠胰岛素、C肽水平的影响及其发生机制

饲以克山病病区粮对大鼠胰岛B细胞分泌功能的影响及补充硒和维生素E(VE)的保护作用研究结果表明,病区粮组大鼠血清胰岛索、C肽水平显著下降,胰岛B细胞C肽分泌贮备减少,胰腺谷胱甘肽过氧化物酶(GSH-Px)活力明显降低,脂质过氧化物(LPO)含量升高。在病区粮内分别加入0.44mg/kg亚硒酸钠和500mg/kg VE及联合补充上述剂量硒和VE可明显提高血清胰岛素、C硒水平,增加C肽分泌贮备,升高胰腺GSH-Px活力及降低LPO含量。此结果提示,克山病病区粮可引起大鼠胰岛B细胞功能受损,胰岛素分泌不足,此改变在克山病时可能成为加重心肌损害的原因之一。     

我国人民硒需要量的研究——一、生理需要量、最低需要量和最低供给量标准

硒在人体营养上的重要性近年来受到特殊的重视。在我国克山病和大骨节病地区,每年数以百万计的居民需要进行硒的补充,硒的人体需要量急待弄清。本文根据克山病病区及非病区大量主食硒的分析结果推测出人体每日最低硒需要量约为18μg,实际测定“健康岛”上居民的最低摄入防病量为16μg,两者均值为17μg。用不同水平硒蛋氨酸补充病区居民,观察血中GSHPx活力上升达最高恒定值时硒的摄入量约为40μg。考虑到病区居民对低硒可能存在的适应性,建议成人供给量标准暂定在每日40～240μg范围内。最高安全摄入量尚在研究中。     

Trends in meningococcal disease in Italy in 1988

Meningococcal disease in Italy decreased 15% in 1988 from the previous year (290 vs. 342 cases). The decline was particularly evident in military cases (1.7/100,000 in 1988 vs. 5/100,000 in 1987) reflecting the full coverage of bivalent serogroup (A + C) meningococcal polysaccaride vaccine in army recruits, achieved since January 1988. The highest proportion of cases was seen in people older than 25 years of age (25%). Serogroup C constituted 60% of the isolates, while 19% belonged to serogroup B. The proportion of strains resistant to sulphonamides was 45%, while 15% were resistant to Minocycline and none to Rifampin. Out of the five military cases, only one (due to serogroup C) was attributable to the vaccine failure. A single coprimary case, but no secondary cases occurred among civilians. These findings are consistent with the trends reported in Italy in the previous years.     

Benzene in blood and phenol in urine in monitoring benzene exposure in industry

Determinations of benzene concentration in blood and of phenol in urine were made by head-space gas chromatography techniques on samples taken near the end of the work day from two groups of workers potentially exposed to low levels of benzene in the work-place atmosphere. Preliminary results suggest that benzene in blood is more reliable than phenol tests for assessing both exposure and uptake of benzene. Normal values of phenol in urine (10 mg/liter or less) were found in nearly all those cases in which benzene was detected in the blood.     

2015年郑州市饮用水放射性水平状况调查

目的了解郑州市不同地区、不同季节、不同水源类型的放射性水平。方法分别于丰水期和枯水期采集郑州市区黄河水源水、井水源水、丹江口水源水、出厂水和末梢水各一份;以县为单位,每单位采集出厂水、末梢水、水库水、河水、井水各1份,按《生活饮用水生活标准检验方法》(GB/T 5750.13-2006)检测饮用水中总α和总β放射性水平,依据《生活饮用水卫生标准》(GB 5749-2006)进行判定。结果丰水期、枯水期水体总α、总β放射性水平均低于国家标准限值。结论郑州市不同水源类型均处于正常的天然放射性本底水平。     

2019年中国肿瘤流行病学研究进展

恶性肿瘤已成为中国居民的主要死因之一。近些年来,中国政府积极推进肿瘤预防和控制领域的研究工作,取得了很大的进步。本文简要汇总中国在肿瘤流行病学领域的研究进展,具体包括2019年的肿瘤负担、癌症危险因素及其干预、筛查和早期发现、癌症防治专项行动(2019-2022年)方案等方面,以期为我国肿瘤防治工作的有效开展提供技术支撑和理论依据。     

2012年绵阳市蔬菜中农药残留状况

目的 了解绵阳市2012年市售蔬菜中农药残留情况,为食用蔬菜监管提供依据.方法 全部样品均按照GB/T 5009-2003的方法进行农药的残留检测.依据GB 2763-2005《食品中农药最大残留限量》进行判定.结果 2012年共检测蔬菜165份,农药检出率和超标率分别为72.12％和23.64％.豆类、根茎类、叶菜类、瓜果菜类和食用菌类蔬菜检测农药残留超标率分别为8.00％、23.53％、36.00％、5.26％和27.03％,差异有统计学意义(x2=11.41,P＜0.01).不同种类农药超标率差异有统计学意义(x2 =62.42,P＜0.01).夏季和冬季蔬菜农药超标率差异无统计学意义(x2=3.44,P＞0.05).结论 绵阳市叶菜类蔬菜中农药残留情况较为严重,应采取有效措施,加强蔬菜的监督管理,从源头禁止高毒农药的使用,加大蔬菜种植、销售环节的监测,确保市民食用蔬菜的安全.     

Occupational stress in nurses in psychiatric institutions in Taiwan

Nurses are known to be exposed to occupational stress. However, occupational stress is not well documented for nurses in psychiatric institutions in Taiwan. A cross-sectional study was conducted to explore the work-related stress and risk factors of nurses in psychiatric institutions in Taiwan. A structured questionnaire was distributed to nurses at five state-owned psychiatric hospitals in Taiwan in 2001. Demographic information, working environment, and personal health status were inquired. Occupational stress was assessed based on the Chinese version of Job Content Questionnaire (JCQ). General health status and mental health were evaluated by the International Quality of Life Assessment Short Form-36 (IQOLA SF-36). A total of 573 questionnaires were disseminated to nurses and 518 (90.4%) were satisfactorily completed by nurses, including 408 female full-time nurses who had been in their current work for more than 6 months. In the past one month, 17.2% of nurses reported being under significant stress often or always. Assault episodes were reported by 45.1% of nurses in the past 6 months. Among the nurses, 16.9%, 25.2%, 50.0%, and 7.8% belong to the "High strain", "Low strain", "Active", and "Passive" groups, respectively. Perceived occupational stress was associated with young age, widowed/divorced/separated marital status, high psychological demand, low workplace support, and threat of assault at work. Lower general health score was associated with low job control, high psychological demand, and perceived occupational stress. A lower mental health score was associated with low job control, high psychological demand, low workplace support, and perceived occupational stress. We concluded that nurses in psychiatric institutions are under significant stress related to work factors.     

Changes in nursing administration in supporting transplantation in Brazil

This historical and bibliographic study aimed to understand how Nursing was organized to support care in transplantation. The HISA, LILACS, BDENF, PERIENF and DEDALUS databases were consulted, and thirteen references were found, ten of which were scientific articles, two were master's dissertations and one was a doctoral thesis. The span of time chosen for study ranges from the date of the first kidney transplant in Brazil (1965), to the date of publication of the last scientific article found in the databases mentioned above (2003). After reading these articles, the ones that were similar in topic were grouped together, thus creating the thematic axis for the presentation of the results. The results showed that the Nursing profession has played an important and active role in transplants ever since the first procedure in 1965.