德清县农村社区代谢综合征家庭聚集性研究

目的：了解浙江省德清县农村社区代谢综合征家系人群代谢综合征及其各组分的患病率和代谢综合征的家庭聚集性。方法：采用横断面研究,于2020年7—12月在浙江省德清县整群抽取4个村开展代谢综合征家系调查,按亲缘关系将研究对象分为5组进行问卷调查、家系登记、体格检查和实验室检查。家庭聚集性采用二项分布拟合检验。结果：1 113名代谢综合征家系研究对象中,总体代谢综合征患病率为29.8%,各级亲属的患病率随亲缘级数升高而降低,配偶患病率高于二级亲属。各组分中高血压患病率最高(54.0%),高血糖患病率最低(19.6%)。代谢综合征在家系人群中病例分布的实际频数与二项分布的理论频数差异有统计学意义(χ²=41.95,P<0.05)。结论：代谢综合征家系成员为代谢综合征及其各组分的高风险人群,代谢综合征有家庭聚集性。     

脑梗塞家族聚集性的研究

目的研究脑梗塞是否存在家族聚集性.方法采用病例对照研究,对哈尔滨市95个脑梗塞先证家系和95个对照家系进行了脑梗塞家族史的遗传易感性的研究.结果病例和对照家系年龄及性别有良好的均衡,病例组一级亲属总的患病率为16.94%,与对照组的3.70%相比,有显著性差异(x2=81.32,P＜0.01),不论其父母或同胞,均以病例亲属的患病率显著高于对照,而子女两者无显著性差异;二项分布分析显示,脑梗塞家族中实际发病数超过其二项分布的理论概率范围,即脑梗塞的分布呈明显的家族聚集性;单因素和多因素Logistic回归模型拟合也提示,遗传因素在脑梗塞发病中有重要地位.结论脑梗塞存在家族聚集性.     

零截尾Poisson分布和零截尾负二项分布的参数估计及其应用

本文给出了零截尾Poisson分布和零截尾负二项分布的特征值，并利用Newton-Raphson迭代给出了两种分布参数的矩估计与最大似然估计。应用这两种分布分别配合了零截尾的肝癌家族分布的资料，探讨了肝癌的家族聚集性。     

住院患者鼻咽癌的出生序列分析

目的探讨环境因素和遗传因素在鼻咽癌发生中的作用。方法于2006年6月—2009年12月,调查了835例来自广西和广东省的经病理确诊为鼻咽癌的住院病人作为先证者,通过该病例确定家系,应用Haldane-Smith法和Greenwood-Yule法进行出生序列分析。结果 Haldane法分析结果显示,出生顺序越大的个体越易患鼻咽癌。Greenwood-Yule法分析结果显示,出生于第3胎次及以上的鼻咽癌患者实际分布值大于期望分布值,提示鼻咽癌多发生于出生较晚的个体。结论鼻咽癌的发生与出生顺序有关,好发于出生较晚者,提示环境因素对鼻咽癌的发生有较大的影响。     

Poisson分布和负二项分布对肾综合征出血热病例空间聚集性的拟合

目的 通过对肾综合征出血热病例县区层面空间聚集性的拟合,展示Poisson分布与负二项分布的详细计算过程.方法 对河南省2010年肾综合征出血热病例县区层面分布数据按发病数进行归类整理,利用Poisson分布与负二项分布原理对其进行拟合与检验.其中负二项分布聚集性参数k采用最大似然法估算.结果 Poisson分布x2=67.1213,P＜0.05;负二项分布聚集性参数k=0.8455,x2 =7.2543,P＞0.05.结论 河南省2010年肾综合征出血热病例在县区层面服从负二项分布,具有空间聚集性.     

卫生相关事件数据时间聚集性的综合分析与判定

目的探讨卫生相关事件数据时间聚集性的综合分析与判定。方法应用集中度、负二项分布、聚类分析、圆分布四种方法对河南省某县狂犬病门诊就诊人群月分布数据进行分析。结果集中度法M=0.54,说明就诊人群具有较强季节性;负二项分布P=0.3119,可认为就诊人群时间分布以天为单位具有时间聚集性;聚类分析显示春夏季是就诊人群集中季节,3-6月为就诊高峰,5月就诊人数最多;圆分布法计算结果显示日就诊高峰在5月8日。结论集中度、负二项分布、聚类分析、圆分布等方法可用于卫生相关事件数据时间聚集性的综合分析与判定。     

南通市食管癌遗传流行病学研究

[目的]探讨家族遗传因素在食管癌发生发展中的作用。[方法]调查分析食管癌病例组和对照组的一级亲属患食管癌的情况进行遗传流行病学研究。[结果]南通市食管癌具有家族聚集性,Li-Mantel-Gart法显示食管癌属于多基因遗传性疾病,分离比为0.183,(95%CI:0.156～0.210),遗传度为(82.8±19.2)%,存在家族聚集性,出生顺序分析显示南通食管癌的发生与出生顺序无关。[结论]遗传因素在南通食管癌的发病中占有重要地位,具有明显的家族聚集倾向。     

胆石病家族聚集性及遗传方式的研究

目的　探索胆石病家族聚集性及遗传方式。方法　采用遗传流行病学病例对照研究方法 ,对 317个家系 ( 138个胆石病先证家系和 179个对照家系 )进行研究。结果　病例组一级亲属总的胆石病患病率为 2 .60 % ,显著高于对照组的 1.2 9% ( χ2 =4.78,P =0 .0 2 88) ;分离比为显著低于 0 .2 5 ,不符合单基因遗传疾病的特征 ;遗传度估算显示 ,该病一级亲属中 ,遗传度为2 1.80 % ,其中男性亲属的遗传度为 36.34% ,显著高于女性亲属的 14 .15 %。结论　在胆石病的病因中 ,遗传因素起一定作用 ,尤其对男性作用更为明显。     

零膨胀负二项回归模型在共存疾病影响因素研究中的应用

目的 探讨零膨胀负二项回归模型在居民患有共存疾病及其影响因素研究中的应用。方法 分别用Poisson分布、负二项分布和零膨胀模型来拟合居民共存疾病数量并分析聚集性,筛选出共存疾病的主要影响因素。结果 拟合分布的结果显示,共存疾病数量不符合Poisson分布（χ2=196.419,P<0.001）,符合负二项分布（χ2=6.677,P=0.154）;聚集指数K=1.779,过离散检验统计量O=15.18>1.96,所以资料存在聚集性。零膨胀检验统计量Vuong=6.58,P<0.001,零膨胀模型要优于Poisson或负二项模型。零膨胀负二项回归分析显示:在负二项部分得出,年龄越大、有高强度运动、焦虑程度越高、体质指数越高、糖化血红蛋白（hemoglobin A1c,HbA1c）水平越高、有糖尿病家族史、有高血压史、高收缩压和高水平胆固醇的居民发生共存疾病的数量会增加;在Logit部分得出,年龄越大、焦虑程度越高、体质指数越高、甘油三酯水平越高、空腹血糖（fasting blood glucose,FPG）越高、有高血压家族史和高收缩压的居民发生慢性病的风险较大。结论 居民患共存疾病有聚集性和零计数过多的特点,零膨胀负二项回归模型在拟合具有该类特点的数据中优势明显。     

泰兴市乙型肝炎表面抗原家庭聚集性研究

目的探讨泰兴市乙型肝炎(乙肝)表面抗原(HBsAg)分布是否有家庭聚集性,为今后乙肝的防制工作提供依据。方法利用乙肝流行病学抽样调查方法调查泰兴市4 745户家庭,其中有1 565例乙肝表面抗原阳性病例,分布在1 309户家庭中。本研究针对该数据,分别采用负二项分布和二项分布的方法进行拟合。如果服从负二项分布或不服从二项分布,则乙肝表面抗原的分布呈家庭聚集性。结果经负二项分布和二项分布模型拟合,所得统计学检验分别为P0.05和P0.05,说明乙肝表面抗原分布服从负二项分布,不服从负二项分布。结论泰兴市乙肝表面抗原的分布有家庭聚集性,实施母婴阻断和加强乙肝疫苗免疫接种可缓解乙肝家庭聚集现象。     

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 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.     

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.     

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.     

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.     

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.