脂联素基因rs2241766、rs1501299多态性与结直肠癌发生风险研究

目的　探讨脂联素基因（ADIPOQ）rs2241766、rsl501299位点多态性与结直肠癌发生风险的关系,并分析2个位点与环境因素的交互作用在结直肠癌发生中的作用。方法　采用1：1匹配的病例对照研究,应用自行设计的调查问卷对400例经组织病理学确诊的结直肠癌原发新发病例及400例同期体检者进行面对面调查,收集两组研究对象的一般情况、生活方式及饮食习惯等资料,应用聚合酶链反应一限制性片段长度多态性（PCR-RFLP）对两组研究对象ADIPOQ rs2241766、rs1501299基因型进行检测。结果　调整结直肠癌家族史、BMI、每日静坐时间、每周红肉摄入频次和经常饮茶等因素后,条件logistic回归分析结果表明,rs2241766TG+GG携带者结直肠癌发生风险高于TT携带者（OR=1．354,95％CI：1．004～1．827）,rsl501299 GT+TT携带者结直肠癌发生风险低于GG携带者（OR=0．680,95％CI：0．501～0．923）。广义多因子降维法分析结果显示,ADIPOQ rs2241766、rsl501299与红肉摄入可能存在交互作用（P=0．001）。趋势X²分析显示,风险基因型携带个数与结直肠癌发生风险之间存在剂量一反应关系（X²=8．458,P=0．004）。结论　ADIPOQ rs2241766、rs1501299位点多态性可能与结直肠癌发生有关,且可能与红肉摄入存在交互作用,共同影响结直肠癌发生。     

CD36基因多态性与急性冠脉综合征关联性的研究

目的　探讨新疆地区汉族、维吾尔（维）族人群CD36基因多态性与急性冠脉综合征（ACS）的关联性。方法　采用聚合酶链反应一限制性片段长度多态性（PCR-RFLP）方法,对522例ACS患者和1215名健康体检者CD36基因单核苷酸多态性（SNP）进行基因型鉴定。结果　在汉族和维族人群中,ACS组和对照组rs1722505的基因型及等位基因分布差异均有统计学意义（P值均<0．05）。在汉族人群ACS组中rs17154181的A等位基因频率明显低于对照组（P=0．034）。logistic回归分析在调整混杂因素后,在汉族和维族人群中rs1722505的AA+AG基因型者患ACS风险明显高于GG基因型者,汉族（DR=1．436,95％CI：1．047～1．970,P=0．025）,维族（OR=1．589,95％CI：1．009～2．473,P=0．046）。汉族人群rs17154181的AA+AG基因型者患ACS风险明显低于GG基因型者（OR=O．667,95％CI：0．494。0．900,P=0．008）。结论　CD36基因多态性在新疆地区汉族和维族人群闻存在差异,且CD36基因可能与两族人群ACS的发生相关,rs1722505的AA+AG基因型可能是汉族和维族人群ACS的危险因素,rs18154181的AA+AG基因型可能是汉族人群ACS的保护因素。     

儿茶酚胺氧位甲基转移酶基因单核苷酸多态性与2型糖尿病的关联研究

目的　探讨儿茶酚胺氧位甲基转移酶（GOMT）基因的单核苷酸多态性（SNP）与广东地区汉族人群T2DM的关联性。方法　采用SNPscan^TM多重SNP分型试剂盒,在595例T2DM患者（病例组）和725名健康对照（对照组）中对筛选的2个tagSNP（rs4646312、rs4680）进行基因分型,并应用X²检验、logistic回归模型等方法分析SNP位点与T2DM的关联性。结果　病例组rs4646312的TT、CT、CC基因型频数分别为304（51．1％）、234（39．3％）、57（8．6％）,对照组分别为323（44．6％）、319（44．0％）、83（11．4％）;病例组rs4680位点的GG、GA、AA基因型频数分别为311（52．4％）、236（39．8％）、46（7．8％）,对照组分别为417（57．7％）、265（36．6％）、41（5．7％）。校正性别、BMI和TG等因素后,rs4646312在等位基因关联分析和基因型关联分析（隐性模型）中的差异均有统计学意义[P值分别为0．020、0．022,OR值（95％CI）分别为1．26（1．04～1．53）、1．35（1．05～1．74）],而rs4680的差异均无统计学意义（等位基因关联分析P=0．099,显性模型下基因型关联分析P=0．081）。rs4680与BMI有关联。结论　在广东地区汉族人群中,COMT基因的rs4646312位点与T2DM的遗传易感性有关,而rs4680与T2DM则无关联。     

健康技能在大学生健康知识及其行为间的中介／调节效应

目的　探索健康技能在大学生健康知识与健康行为间的中介效应和调节效应。方法　采用分层整群随机抽样方法,对2 181名长沙市在校大学生进行问卷调查。采用EpiData3．0软件建立数据库,SPSS 17．0软件进行相关和回归分析。结果　健康知识与健康技能显著相关（r=0．592,P<0．01）,健康知识与健康行为显著相关（r=0.647,P<0．01）,健康技能与健康行为也呈显著相关（r=0．629,P<0．01）。健康技能在健康知识和健康行为之间的部分中介效应显著（34．55％）。交互作用项“健康技能×健康知识”的回归系数在以健康行为为因变量的回归方程中达到显著性水平（β=一0.093,t=5．212,P=0.000）,且引入交互作用项后新增解释量（⊿R²）亦达到显著性水平（⊿R²=0．006,P=0．000）,对健康行为变异量的解释增加了0．6％。结论　健康技能在大学生健康知识与健康行为间起中介效应和调节效应     

HBV感染者精液HBV-DNA载量对子代垂直传播的影响

目的　探讨HBV感染者精液HBV-DNA载量对子代垂直传播的影响。方法　选择福建省妇幼保健院2009年8月至2011年11月初次产前检查孕妇（母）血清HBsAg阴性、丈夫（父）血清HBsAg阳性的138个家庭及其新生儿为研究对象。知情同意下收集孕妇血液、其夫血液和精液及分娩时新生儿脐带血,检测HBV血清学标志物（HBVM）、HBV-DNA。以脐带血HBV-DNA载量≥5 X 10² copies／ml为病例组,脐带血HBV-DNA载量<5×10² copies／ml为对照组。结果　（1）新生儿脐带血HBV-DNA阳性率为34．8％（48／138）、HBsAg阳性率为28．3％（39／138）,HBeAg阳性率为15．2％（21／138）。（2）父血清HBVoDNA阳性率为76．8％（106／138）、HBeAg阳性率为42．8％（59／138）;精液HBV-DNA阳性率为21．0％（29／138）。（3）单因素分析显示,父血清HBV-DNA阳性、父血清HBeAg阳性、精液HBV-DNA阳性、父对乙型肝炎（乙肝）传播途径及预防方法、乙肝一级家族史为HBV垂直传播的危险因素（P<0．05）。（4）多因素分析显示,父血清HBV-DNA阳性、父HBeAg阳性、精液HBV-DNA阳性为HBV父婴垂直传播的危险因素,OR值（95％CI）分别为5．7（1．1—29．1）、4．2（1．7～10．0）、6．7（2．4～18．9）。（5）父血清HBV-DNA载量与精液HBV-DNA载量存在剂量反应关系。（6）ROC曲线分析表明,父血清HBV-DNA载量为10< sup>5 copies／ml、精液HBV-DNA载量为10 ³ copies／ml其预测的敏感度和特异度较高,是预测发生HBV垂直传播的分界点。结论　父血清HBV-DNA阳性、父HBeAg阳性、精液HBV-DNA阳性是HBV父婴垂直传播的危险因素;父血清HBV-DNA载量>10⁵ copies／ml、精液HBV-DNA载量>10³ copies／ml时,增加父婴HBV垂直传播的阳性率。     

血清钙离子水平与肝硬化发病风险相关性研究

目的探讨成年人血清钙离子水平与肝硬化发病风险间的关系。方法在河南省林县食管癌营养干预试验队列中开展巢式病例对照研究。利用全自动生物化学分析仪和酶联免疫法检测281名肝硬化病例和562名对照个体的基线血清钙浓度以及HBsAg、抗一HBc、抗一HCV,采用调查问卷收集研究对象相关基线特征信息。研究对象血钙水平以三分位分组并使用多因素logistic回归模型计算各组肝硬化发病OR值及其95％C／。结果病例组血清钙离子水平为(1．81±0．84)mmol／L,高于对照组(1．65±0．79)mmol／L,f=一2．640,P=0．008。血清钙的不同取值水平与肝硬化发病率有关(X²=6．888,P=0．0319)。血钙浓度最高组患肝硬化的风险约为最低组的2倍(OR=2．261,95％CI：1．497～3．416,P=0．002),且血钙水平与肝硬化风险呈正相关(X²=6．842,P=0．0089)。结论 中国人群中高血清钙水平可能作为肝硬化发生一项独立的危险因素,其机制尚需进一步研究。     

中学生体育锻炼行为的阶段变化与心理因素分析

目的　了解中学生体育锻炼现状及影响因素,为进一步完善健康教育和健康促进措施提供科学依据。方法　采用多阶段随机抽样方法利用心理测定量表调查3个城市3600名中学生体育锻炼行为,采用t检验、X²检验分析中学生体育锻炼频率、体育锻炼行为变化阶段相关性,对体育锻炼行为的心理因素采用单因素方差分析。结果　中学生每周锻炼时间为（2．66±1．801）d,81．4％的学生锻炼时间<4 d。5个行为阶段中37．3％的学生处于体育锻炼行为的前意向阶段,23．6％的学生处于意向阶段,20．5％的学生处于准备阶段,仅有18．6％的学生处于行动阶段和维持阶段,并随着变化阶段的提高学生体育锻炼时间有所增加;5个行为阶段间的改变策略（F=77．442,P<0．001）、决策平衡正向效应（F=29．498,P<0．001）、负向效应（F=14．784,P<0．001）和自我效能（F=135．544,P<0．001）得分的差异均有统计学意义;从前意向阶段到维持阶段改变策略、决策平衡正向效应、自我效能得分随着变化阶段的提高而增加,而决策平衡负向效应随着变化阶段的提高而减少。结论　中学生每周体育锻炼时间不足,其锻炼行为存在阶段性差异,但大多数学生处于初级阶段;心理因素在不同变化阶段发挥作用不同,提示对不同体育锻炼阶段的学生采取不同的健康教育和心理干预措施,以提高健康促进效果。     

辽宁省大棚作业农民慢性阻塞性肺疾病危险因素分析

目的 探讨大棚作业人群慢性阻塞性肺疾病(COPD)患病危险因素.方法 2006-2009年采用随机、分层、整群抽样方法,对辽宁省800余个大棚从事作业的农民进行统一问卷调查、体格(血常规、血气分析、胸部X线及肺功能)检查,COPD确诊按照中华医学会呼吸病学分会制定的《慢性阻塞性肺疾病诊治指南》(2007年修订版)诊断标准.结果 共调查从业人员5880人,有效应答者5420人,有效应答率92.18％.年龄(x²＝32.530,P=0.000)、棚内日劳作时间(x²=21.311,P=0.000)、大棚通风频率(x²=9.79l,P=0.007)及大棚面积(x²=73.645,P=0.000)危险因素存在地区差异.logistic回归分析提示,吸烟(OR=1.976,95％CI:1.672～2.334)、年龄(OR=4.188,95％CI:3.718 ～ 4.718)、菌棚(相对于蔬菜棚,OR=1.302,95％CI:1.016 ～ 1.669)、花卉棚(相对于蔬菜棚,OR=1.503,95％CI:1.201～1.880)为大棚作业农民COPD的危险因素;从业年限(OR=0.684,95％CI:0.609 ～ 0.767)是大棚作业农民COPD的保护因素.结论 辽宁省大棚作业农民COPD的发生与多种因素相关,应重视其防治.     

北京市某社区老年人多次跌倒发生率 及相关因素的随访研究

目的调查北京市某社区老年人多次跌倒的发生情况,并探讨跌倒相关因素。方法 以北京市某社区为调查现场,2009年抽取472名老年人采用面对面询问方式进行人户调查,通过 单因素及多因素logistic回归分析多次跌倒的影响因素。结果472名老年人中,跌倒>---2次共29 名,多次跌倒发生率为6．1％。多因素logistic回归分析显示,家庭月收入高(OR----1．39,95％CI： 0．67～2．16)、担心跌倒(OR=2．23,95％CI：1．47。3．85)、静态平衡异常(OR=2．48,95％CI：1．84～ 4．05)是老年人多次跌倒的危险因素,楼梯台阶宽度合适(OR=0．49,95％CI：0．21．1．12)、日常用品 易于取放(OR=0．41,95％CI：0．14—1．16)是多次跌倒的保护因素。结论北京市某社区老年人多 次跌倒发生率高,跌倒发生与多种因素有关,应采取综合性措施预防老年人跌倒。     

美沙酮维持治疗门诊HIV阳性服药人员 吸毒过量死亡的影响因素分析

目的分析影响美沙酮维持治疗(MMT)门诊HIV阳性服药人员吸毒过量死亡的因 素。方法采用1：l配对病例对照研究方法,对1lO例因吸毒过量死亡的服药人员与相应对照 (与病例同性别、同门诊、首次入组时间相近)的社会人El学、吸毒行为、服药行为等特征进行比 较。结果 多因素logistic回归模型分析表明,人组前3个月共用针具(OR=5．19,95％CI：1．39。 19．33)、经注射吸毒感染HIV(OR=3．08,95％CI：1．16—8．21)、终点前脱失(OR=2．54,95％CI： 1．23—5．23)是吸毒过量死亡的危险因素,而治疗依从性好(OR=O．31,95％CI：0．10．0．95)为保护 l因素。结论应采取综合措施提高MMT门诊服药病例的依从性,并对曾共用针具的病例展开重 点干预,从而减少死亡。     

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.     

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.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

The risk of heat exhaustion at a deep underground metalliferous mine in relation to surface temperatures

The risk of heat exhaustion at a deep underground metalliferous mine was assessed in relation to thermal conditions prevailing on the surface. For each day of a 1-year prospective case series of heat exhaustion, surface 24-h mean wet and dry bulb temperatures were recorded. From this data, 24-h mean wet bulb globe temperatures were derived using certain assumptions. The three surface temperature variables were significantly higher on those days on which heat exhaustion occurred, compared to those days on which it did not occur (P < 0.001). The relative risk of heat exhaustion on days when the 24-h mean wet bulb globe temperature was in the range 26.0-28.0 degrees C was 4.82 (95% confidence interval 2.12-10.96). Surface temperature data could be used at this mine to warn miners about the risk of heat exhaustion.