石家庄市高血压患病现状及防治策略研究

[目的]了解2008年石家庄市15～69岁居民高血压患病现状及其主要危险因素,为制定高血压防治策略提供科学依据。[方法]采用分层整群随机抽样方法调查石家庄市23个县(市)、区中抽取的9个县(市)区的7668名15～69岁常住居民,调查方法包括问卷调查、体格测量和实验室检查。[结果]高血压患病率为27.2%(标化率25.8%),居各类慢性病首位;男性高血压患病率为26.3%,女性为27.8%,男女间差异无统计学意义(P﹥0.05);高血压患病率随年龄的增长而升高(P﹤0.01);城市高血压患病率(37.4%)高于农村(25.9%,P﹤0.01);高年龄、向心性肥胖、糖尿病、精神因素是高血压的主要危险因素,高文化程度是高血压的保护因素。[结论]石家庄市居民高血压患病率较高,应采取以全人群健康教育为主,个体干预为辅的综合防治措施,提高全人群高血压防治知识水平,提高高血压知晓率、治疗率、控制率,进而达到预防心脑血管理疾病的目的。     

国际航行船舶外来医学媒介生物传入风险的判别分析

[目的]探索国际航行船舶外来医学媒介生物传入的风险评估方法。[方法]采用1︰4频数匹配的分析性流行病学研究方法,在2007年来港国际航行船舶中选择外来媒介阳性船舶170艘,随机选择对照船舶680艘进行调查,以Bayes判别分析法筛选及判定与媒介检出相关的风险因素,并建立二次型判别函数。[结果]总吨位、曾检出外来媒介生物、到达季节、装货种类、免予除鼠证书签发日期、船舶类型等6项指标对判别分析具有统计学意义,据此建立二次型判别函数作为外来媒介检出的风险分析模型,总正确率达83.25%。[结论]贝叶斯判别分析将船舶携带外来医学媒介生物的风险表达为数字,具有直观、定量、针对个体的优点,为国际航行船舶外来媒介生物风险评估及预警系统的建立提供理论基础。     

2007年蓬莱市农村居民生活危险因素及相关慢性病患病情况调查

[目的]了解蓬莱市农村居民生活危险因素及相关慢性非传染性疾病（慢性病）患病情况,为制定慢性病防治政策和干预措施提供科学依据。[方法]2007年10月,在蓬莱市抽取部分15-59岁农村居民进行调查。[结果]调查320人（男性162人,女性158人）,每日摄取食盐（11.69±5.35）g,油脂（45.68±15.58）g;每日静坐时间男性为（2.90±1.87）h,女性为（3.00±2.15）h;男性吸烟率为51.85%,饮酒率为60.49%。肥胖率男性为17.28%,女性为32.91%（P〈0.01）;超重率、中心性肥胖率男性分别为32.71%、52.46%,女性分别为28.48%、62.66%（P〉0.05）;高血压患病率男性为33.33%,女性为36.71%（P〉0.05）。[结论]蓬莱市农村居民高血压患病率与肥胖罹患率较高,高油、高盐饮食者较多,饮酒率、吸烟率较高,运动时间较少。     

2011年济南市疾病预防控制机构慢性病防制卫生资源调查

[目的]了解济南市疾病预防控制机构慢性非传染性疾病的卫生资源配置和慢性病防制工作开展情况。[方法]2011年12月,对济南市及11个县（市、区）疾病预防控制机构的慢性病防制工作进行调查。[结果]济南市市级和11个县（市、区）疾病预防控制中心都有1名副主任分管慢性病防制工作;8个单位有独立的慢性病防制科;慢性病防制工作人员共34人,28人为专职人员,所学专业为预防医学的14人;12个单位全部配有微机、打印机,有专人负责日常死因监测上报工作;11个县（市、区）疾控中心开展了多种形式的健康教育与健康促进工作,并选择性的开展了部分干预工作。[结论]济南市慢性非传染性疾病的卫生资源严重不足,初步开展了慢性病防制工作,迫切需要各级政府给予关注和扶持。     

社会支持与中老年人常见慢性病患病风险的关系

探讨社会支持与中老年人常见慢性病患病风险的关系,以期为预防中老年慢性病的发生提供参考。方法 本研究于 2018年9月—2019年2月进行,采用面对面访谈方式调查重庆市11 014名50岁以上中老年人社会支持及慢性病患病状况,并采用多元Logistic回归分析数据。结果 5 667人（51.5%）患有高血压,3 743人（34.0%）患有高血脂,2 683人（24.4%）患有糖尿病, 1 011人（9.2%）患有慢性阻塞性肺疾病 。3 026人（27.5%）社会支持评分为0分,只有651人（5.9%）社会支持评分为4分。校正性别及年龄后发现,社会支持评分高的研究对象患高血压及慢性阻塞性肺疾病的风险较低,但其患高血脂的风险较高（P<0.05）。进一步校正其他社会人口学特征后,社会支持评分与高血压的关联消失,而社会支持评分与慢性阻塞性肺疾病关联减弱;该关联在调整社会人口学特征及生活方式因素后也不再显著（P>0.05）。社会支持评分与糖尿病、冠心病以及脑卒中关联均不显著（P>0.05）。与家人总是提供经济帮助相比,家人偶尔提供经济帮助可降低高血脂患病风险（P<0.05）;家人有时提供经济帮助则可增加慢性阻塞性肺疾病、脑卒中的患病风险（P<0.05）。过去1年从未与他人一起参加活动的研究对象患高血压的风险为每月与他人参加活动至少9次的研究对象的1.30倍（P<0.05）。而每月与他人参加活动次数越少,患高血脂风险越小。处于危机时从未获得人们的帮助可增加糖尿病的患病风险（P<0.05）。结论 社会支持对中老年人群身体健康有显著影响,社会支持水平低是某些慢性病的危险因素。因此,给予中老年人足够的社会支持有助于中老年人预防慢性病及延缓病情进展。     

安徽省某乡镇社区居民高血压患病率及危险因素研究

[目的]了解农村社区居民高血压患病率及主要危险因素,探讨农村社区高血压疾病的综合防制措施。[方法]整群抽样安徽省某乡镇9个农村社区年龄35岁以上、居住时间超过1年的居民进行高血压普查及其危险因素调查。[结果]安徽某乡镇社区35岁以上农民高血压患病率为23.29%,男女患病率相当。高血压的主要影响因素有:年龄、BMI、家族史、蛋类摄入、高血压知识了解情况、职业等。[结论]本地区农村居民高血压防制形势不容乐观,应加强对高血压疾病的社区干预。     

泰兴市35岁以上居民原发性高血压患病情况及其危险因素研究

[目的]了解泰兴市居民原发性高血压患病情况及其危险因素。[方法]2000年以村（居委会）为单位，抽样调查35岁以上居民20548人，调查原发性高血压的患病情况及其危险因素。[结果]调查对象中，高血压忠现率为37.5%；高血压患者的高血压知晓率、治疗率和控制率分别为19.6%、12.7%、8.8%；多因素非条件Logistic回归分析结果，高血压发病的主要危险因素为年龄、BMI、吸烟、高血压家族我、口味偏咸、睡眠时间少，蔬菜、油脂摄入量为保护性因素。[结论]泰兴市高血压患病人数众多，亟需开展社区高血压的综合防治，普及防治知识，做好查、治、管工作。     

中老年人血压水平与脑卒中患病率及患病风险的相关性研究

目的 研究中老年人群中血压水平与脑卒中患病率及患病风险之间的关系。方法 采用分层整群抽样方法,对扬州市广陵区40岁及以上常住居民开展问卷调查、体格检查和实验室检查。通过对年龄分层,采用单因素和多因素logistic回归分析不同年龄组血压与脑卒中患病率及患病风险的关系。结果 3 999例有效样本中,男性1 904例（47.61%）,女性2 095例（52.39%）;其中脑卒中243例（6.08%）,高血压1 900例（47.51%）,糖尿病929例（23.23%）,血脂异常943例（23.58%）,高血压患者中脑卒中211例（86.83%）。男性（χ2 = 9.539,P = 0.002）、高龄（t = - 13.683,P＜0.001）、缺乏运动（χ2 = 15.568,P＜0.001）、吸烟史（χ2 = 40.799,P＜0.001）、高血压（t = - 9.149,P＜0.001）、高血糖（t = - 6.832,P＜0.001）、低高密度脂蛋白胆固醇（t = 3.509,P＜0.001）、肥胖（t = - 4.964,P＜0.001）均是脑卒中重要危险因素。随着年龄和血压的增加,脑卒中的患病率增加。对年龄进行分层,并对危险因素进行校正,60岁以下人群中脑卒中患病风险随血压升高而显著增加;收缩压≥160 mm Hg脑卒中患病风险是收缩压＜130 mm Hg的8.13倍;舒张压≥110 mm Hg脑卒中患病风险是舒张压＜80 mm Hg的28.54倍。60岁及以上人群中收缩压≥150 mm Hg脑卒中患病风险开始增加;收缩压≥160 mm Hg脑卒中患病风险是收缩压＜130 mm Hg的2.12倍;舒张压与脑卒中患病风险之间无显著相关性。结论 高血压是脑卒中的重要危险因素,根据不同的年龄,设定相应的降压目标是有效预防脑卒中的重要途径。     

重庆市计划妊娠夫妇高血压危险因素聚集对高血压患病的影响

目的：分析重庆市计划妊娠人群高血压危险因素聚集状况及其与高血压患病之间的关系。方法于2013年4—12月,采用按比例多阶段分层整群随机抽样方法抽取了重庆市19个区（县）的11953对计划妊娠夫妇,对其进行问卷调查、体格检查和血糖检测。采用多因素二分类非条件logistic回归方法,分析危险因素聚集与高血压之间的相关性,高血压患病风险采用OR（95%CI）值表示。根据重庆市第6次人口普查数据对高血压患病率进行标化。结果重庆市计划妊娠人群高血压标化患病率为15.6%（95%CI：15.1%～16.0%）,丈夫标化患病率为16.7%（95%CI：16.0%～17.4%）,妻子标化患病率为14.2%（95%CI：13.6%～14.9%）。调查对象暴露比例较高的3项危险因素为经济压力（95.1%,22732/23906）、家族遗传史（24.9%,5950/23906）、超重和肥胖（22.3%,5341/23906）。丈夫组,具有家族遗传史、超重肥胖、吸烟、饮酒、有经济压力者患高血压风险分别是无家族遗传史、体重正常、不吸烟、不饮酒、无经济压力者的2.49（1.88~3.31）、1.85（1.68~2.03）、1.29（1.22~1.37）、1.16（1.11~1.23）、1.09（1.03~1.16）倍。妻子组,具有家族遗传史、高血糖、饮酒、有经济压力者患高血压风险是无家族遗传史、血糖正常、不饮酒、无经济压力者的3.07（2.43~3.89）、2.92（2.52~3.38）、1.28（1.12~1.49）、1.21（1.05~1.39）、2.52（1.40~4.53）倍。随着高血压危险因素聚集项数的增加,丈夫和妻子高血压患病风险升高：丈夫组危险因素聚集2~5项者高血压患病风险是危险因素聚集0项者的3.45（1.41~8.46）、5.68（2.32~13.93）、9.61（3.92~23.59）和15.20（6.10~37.87）倍;妻子组聚集2~4项者是危险因素聚集0项者的3.85（1.41~10.52）、6.18（2.23~17.15）和9.30（3.15~27.48）倍。结论家族遗传史、超重肥胖、吸烟、饮酒、有经济压力是重庆市计划妊娠夫妇高血压的主要危险因素;随着危险因素聚集项数的增加,高血压患病风险升高。     

江苏省居民血压变化趋势及与BMI和腰围关系

目的 了解江苏省居民血压水平变化趋势及其与危险因素相关关系,为高血压防制提供参考依据.方法 采用多阶段整群随机抽样方法,按照地区、人口及各地国民生产总值的不同抽取江苏省14个县(市、区)内的4 202名(2007年)和7 283名(2010年)18 ～ 69岁居民进行问卷调查和体格检查.结果 与2007年比较,2010年江苏省居民高血压自报率[17.7％(1 287/7 283) VS 13.8％ (581/4202),x2 ＝28.974,P＝0.000]、高血压发病率[32.4％(1 940/5 996) VS 22.8％ (826/3 621),x2＝104.828,P＝0.000]和高血压患病率[44.3％(3 287/7 283) VS 33.5％(1 407/4202),x2＝ 75.400,P＝0.000]均升高;2010年血压水平和男性腰围平均水平均高于2007年(P＜0.05),而女性腰围[(80.4±10.2)cmVS (79.6±8.8)cm]总体水平下降了0.8 cm;相关分析结果显示,血压水平与体质指数(BMI)和腰围均呈正相关;多因素logistic回归分析表明,年龄、BMI和腰围均是高血压的独立危险因素,BMI(OR＝ 1.085,95％ CI＝ 1.062～ 1.107,P＝0.000)对高血压风险的贡献最大.结论 江苏省居民高血压患病率及其独立危险因素水平不断升高;BMI对高血压风险的贡献相对较大;女性腰围水平有所下降.     

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.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

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.