贲门癌危险因素病例对照研究

目的：探讨贲门癌发生的危险因素，为深入进行病因学研究提供线索。方法：对福州市6所医院2000年和2001年4月至7月的住院病人603例进行多组病例对照研究。贲门癌组为病理、手术和胃镜确诊的贲门癌191例，非贲门部胃癌190例，健康对照组为与肿瘤病例同期住院的骨科、泌尿外科的非肿瘤病人222例。采用统一调查表进行床边询问，对资料进行单因素及多因素Logistic分析。结果：贲门癌的主要危险因素有一一级亲属患肿瘤（OR＝4．286 95％CI：2．431－7．554）、进食速度快（OR＝2．028 95％ CI：1．142－2．912）、三餐不按时吃（OR＝1．909 95％ CI：1．396－2．610）、饮用井水（OR＝1．741 95％CI：1．042－2．910）每日吸烟量多（OR＝1．347 95％CI：0．989－1．835）。主要保护 因素有：常吃新鲜水果（OR＝0．645 95％CI：0．439－0．945）、使用冰箱年数长（OR＝0．731 95％CI：0．536－0．997）、化程度高（OR＝0．468 95％CI：0．276－0．74）。结论： 贲门癌与非贲门部胃癌可能有不同的危险因素，值得进一步研究。     

福建省贲门癌病例对照研究

目的：探讨贲门癌发生的危险因素,为病因学研究提供线索。方法：对福州市6所大医院2000年4－7月的住院病人进行多组病例对照研究,其中男性287例（82．5％）,女性61例（17．5％）,病例组为经病理,手术或胃镜确诊的贲门癌病例93例,非贲门部胃癌病例85例及非消化道肿瘤病例73例,对照组为与肿瘤病例同期住院的骨,泌尿外科的非肿瘤病例97例,采用统一调查表进行床边询问,内容包括一般人口学特征,身高,体重体,吸烟,饮酒,饮食状况,既往疾病史,家族肿瘤史等,对资料进行单因素及多因素Logistic分析。结果：贲门癌的危险因素有每日吸烟量（OR＝1．76,95％CI：1．19－2．58）,10年前食用猪油（OR＝4．24,95％CI：2．01－8．92）,父母患胃癌（OR＝3．78,95％）,CI：1．06－13.41）,胃部疾病史（OR＝3。19,95％CI：1．46－6．96）,常吃新鲜蔬菜（OR＝0．21,95％CI：0．07－0．62）,豆及豆制品（OR＝0．29,95％CI：0．09－0．92）为保护因素。结论：贲门癌与非贲门部胃癌可能有不同的危险因素,值得进一步研究。     

男性不育症危险因素的病例对照研究

目的：探讨男性不育症的危险因素，方法：对94对病例和对照1：1配比进行病例对照研究。结果：长期大量吸烟（OR＝3．45，95％ CI：1．95－6．10）、婚外性生活史（OR＝7．29，95％CI：2．54－20．89）、高温大棚蔬菜种植（OR＝6．73，95％CI：1．91－23．69）、苯类化学品接触（OR＝20．53，95％CI：4．67－90．25），解脲支原体感染（OR＝5．55，95％CI：2．8－13．533）与男性不育症有关联，为其危险因素，结论：男性不育症是由多种因素长期反复作用的结果，其预防应从整治环境污染，加强职业防护，提高自我防护能力，改变不良工作生活习惯等方面做起。     

恶性淋巴瘤影响因素病例对照研究

目的探讨恶性淋巴瘤（ML）发生的危险因素。方法采用以医院病例为基础的1：2配比病例对照研究方法，对从江苏省南通市4家医院收集的72例经组织病理学确诊的恶性淋巴瘤（ML）患者及144例其他肿瘤和非肿瘤对照进行问卷调查。采用多分类结局Logistic回归分析模型拟合的方法，单因素和多因素分析ML的相关因素。结果住所周围环境污染（OR=2．747，90％CI：1．216～6．204）、经常接触有机溶剂（OR=4．310，90％CI=1．079～17．219）、经常接触化肥农药（OR=2．648，90％CI=1．188～5．903）、本人其他肿瘤史（OR=7．586，90％CI=1．202～47．890）、家族肿瘤史（OR=5．268，90％CI=2．054～13．515）等5个因素可能增加ML的危险性；而经常吃淡水鱼虾（OR=0．456，90％CI=0．246～0．842）可降低ML的危险性。结论恶性淋巴瘤影响因素较为复杂，环境污染、化学毒物接触及家族史是主要危险因素。     

尿石症危险因素人群病例对照研究

目的 探索尿石症发病的危险因素，为人群预防提供依据。方法 选取深圳市尿石症现况调查发现的334例患者为病例组，721名健康者为对照组，进行尿石症危险因素人群病例对照研究；采用非条件logistic回归对34个变量进行分析，采用Falconer回归法估算遗传变。结果 尿石症病例组和对照组配比条件均衡可比，单因素logistic回归分析共有17个变量有统计学意义，但最终进入模型的因素有10个，其中4个变量为尿石症发病危险因素，OR值大小依次为既往泌尿系慢性炎症史（OR＝4.09,95%CI:1.38-12.14)，一级亲属尿石症史（OR＝2.61,95%CI:1.70-4.01)和多食动物蛋白质（OR＝2．14，95％CI：1．71－2．69），暴露日照时间长（OR＝1．39，95％CI：1．16－1．66）；而较高文化程度（OR＝0．46，95％CI：0．29－0．73），日引水量多（OR＝0．59，95％CI：0．48－0．72），饮果汁（OR＝0．41，95％CI：0．18－0．94），多食奶及奶制品（OR＝0．82，95％CI：0．68－0．99），多食蔬菜（OR＝0．70，95％CI：0．55－0．91）和多食水果（OR＝0．78，95％CI：0．64－0．94）6个变量为尿石症发病的保护因素。一级亲属尿石症患病率病例组高于对照组，尿石症分离比为0．0109，95％CI：0．0050－0．0168，一级亲属尿石症的遗传度为28．48％，男，女分别为32．06％和24．60％。结论 尿石症主要受饮食习惯影响，尿石症家族史和社会经济状况也与发病有关。     

胃腺癌危险因素的病例对照研究

目的 探讨与胃癌有关的危险因素。方法 对天津市区1998－1999年的189例新发胃癌病人进行1：1配对病例对照研究,采用条件Logistic回归分析。结果 烟熏食品OR＝2．34,OR95％CI＝1．60－4．98;吸烟量OR＝6．07,OR95％CI＝1．26－7．16;喜食重盐饮食OR＝1．95,OR95％CI＝1．27－3．23;过量摄入动物肉类OR＝1．46,OR95％CI＝1．05－2．02。结论 经常食用烟熏食品、吸烟量大、重盐饮食、过量摄入动物肉类等可能是胃癌的危险因素。     

泰兴市胃癌危险因素病例对照研究

目的：探讨胃癌的危险因素。方法：对泰兴市439例胃癌进行1：1配比病例对照研究,通过条件Logistic回归单因素和多因素分析筛选主要危险因素,计算各因素的比值比和95％可信限。结果：胃慢性疾病史、文化程度差、人均收入低、吸烟、不良饮食习惯、情绪较差均与胃癌有明显关系。其中胃慢性疾病史与胃癌发生最为密切（OR＝22．01,95％CL为10．39－46．62）为主要危险因素。结论：应针对上述危险因素采取预防措施。     

非胰岛素依赖型糖尿病视网膜病变危险因素的探讨

目的：采用1：1配比的病例对照研究对DR患病的危险因素进行了初步探讨。方法：采用条件Logistic回归分析程序对105名DR病例和对照进行分析。结果：单因素分析显示：糖尿病病程,糖尿病诊断年龄,高血压,SBP,尿蛋白,使用胰岛素治疗与糖尿病视网膜病变有关。经多因素分析进入主效应模型的因素为病程,其OR＝2．32（95％CI：1．32－4．5）;SBP,其OR＝4．78（95％CI：1．83－12．52）;尿蛋白,其OR＝1．9％（95％:1．21－2．99）;胰岛素使用量,其OR＝1．98（95CI：1．05－3．74）。吸烟,饮酒,饮茶,运动锻炼,社会经济状况,看书时间,社会心理因素以及BMI与DR无关。结论：在糖尿病人群中,DR发生的危险因素为病程长,使用胰岛素治疗,尿蛋白增高和SBP增高。     

慢性阻塞性肺疾病危险因素病例对照研究

目的探讨慢性阻塞性肺疾病（COPD）发病的相关危险因素，为开展COPD的一级预防提供依据。方法采用按年龄±3岁进行1：1配比的病例一对照研究方法，对435例来源于2003年1月-2006年4月某市级医院的COPD患者及其对照者应用条件Logistic回归进行危险因素分析。结果单因素分析结果显示，性别（OR=1．802，95％CI：1．385--2．346）、药物过敏史（OR=4．346，95％CI：2．838～6．657）、吸烟（OR=2．857，95％CI：2．145～3．807）、吸烟年限〉10a（OR=2．719。95％CI：2．041～3．621）、日吸烟量〉10支（OR=2．250，95％CI：1．601～3．161）、开始吸烟年龄≤20岁（0R=1．909，95％CI：1．140。3．198）、吸烟指数大于300年支（OR=2．241，95％CI：1．645-3．054）和高血糖（OR=2．469，95％CI：1．772～3．441）为COPD的危险因素。多因素分析结果显示，性别（OR=1．595，95％CI：1．124～2．264）、药物过敏史（OR=4．029，95％（CI：2．411～6．735）、吸烟（OR：2．635，95％CI：1．844～3．764）和高血糖（OR=2．390，95％CI：1．632-3．502）为COPD的危险因素。结论男性、药物过敏史、吸烟和高血糖为COPD的主要危险因素。     

沈阳农村60岁以上人群良性前列腺增生危险因素的病例对照研究

目的：探讨各种危险因素与良性前列腺增生（BPH）的关系。方法：采用以人群为基础的病例对照研究，病例组为沈阳市某郊区农村60周岁以上BPH患者，对照组为无前列腺增生（排除前列腺癌、前我腺炎等疾病）的老年男性，病例与对照各100例，单因素分析采用χ^2检验，多因素分析利用非条件logistic回归分析。结果：多因素非条件logistic回归分析显示BPH发病与下列5种因素有关：患前列腺炎（OR＝5．577，95％CI：2．147－14．482）；20世纪80年代初每月肉类摄入量（OR＝4．930，95％CI：2．404－10．111）；舒张压（OR＝1．050，95％CI：0．480－0．881）。结论：患前列腺炎、80年代初每月过多摄入肉类、舒张压高可能是BPH的危险因素；吸烟量大、饮酒量大可能是BPH保护因素。     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.     

The reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

Function of the protein RPE65 in the visual cycle

A protein called RPE65 performs a key role in the trans-cis isomerization of retinol in the retinal pigment epithelium of the eye. The palmitoylation of RPE65 serves to switch off the visual cycle in darkness and to switch it on in the light.     

Acute symptoms following work with pesticides

BACKGROUND: Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms. AIM: To explore the frequency, nature and determinants of acute symptoms following work with pesticides. METHODS: A postal survey of men in three rural areas of England and Wales provided data on occupational use of five categories of pesticide, occurrence of 12 specified symptoms within 48 h of using pesticides and tendency to somatize. Risk factors for pesticide-related symptoms were assessed by modified Cox regression. RESULTS: Of 10 765 responders (response rate = 31%), 4108 had at some time used pesticides occupationally, including 935 (23%) who reported symptoms following such work on at least one occasion. In two areas, acute symptoms were most frequent following use of sheep dip (29 and 32% of users), but in the third area the rate was significantly lower (13% of users). The relative frequency of symptoms was similar for all five categories of pesticide, and flu-like symptoms did not cluster unusually among users of sheep dip. Risk of pesticide-related symptoms increased with somatizing tendency (prevalence ratio for highest versus lowest category 2.4, 95% confidence interval 2.0-3.0) and was higher in men who had used pesticides most often or handled concentrate. CONCLUSION: Acute symptoms are common following work with pesticides, but in many cases the illness may arise through psychological rather than toxic mechanisms.     

The Life Events Inventory: re-scaling based on an occupational sample.

The objective of this study was to compare the validity of the original weightings used by the Life Events Inventory (LEI) with those obtained from a contemporary occupational sample. Fifty male and 62 female manufacturing employees (age range 16-55 years) assigned scores to each item on a slightly modified version of the LEI scale. The current sample consistently assigned higher weights to events/items than did the original sample, but there was high agreement in terms of item ranking. Some distinct age and gender differences in scoring were apparent, and are discussed further. It was concluded that when separate weightings are employed for age and gender groups, the LEI remains a useful tool for quantifying background levels of stress in both workplace stress audits and epidemiological studies where statistical control for non-occupational sources of stress is required.     

Maxillofacial injuries related to work accidents: a new concept of a hospital-based full electronic occupational trauma surveillance system

The objective of this study was to investigate the occurrence of occupational maxillofacial injuries using a newly installed relational database. Twenty-six injuries were identified out of 28,624 patients admitted to the emergency unit during a 12 month period. Falls from height or being struck by moving objects were common causes of these injuries. Two-thirds of those identified were construction workers. This paper demonstrates the power of modern databases to identify specific occurrences that may provide the basis for prevention in the future.     

Rôles physiologiques des endocannabinoïdes dans le contrôle de l’homéostasie énergétique

Endocannabinoids are endogenous lipids which modulate the release of neurotransmitters and activate different signaling pathways, through the binding to cannabinoïd receptors, CB1 and CB2. Endocannabinoids are involved in the control of a variety of behavioural and neuroendocrine functions, including feeding behaviour. In the central nervous system, they essentially modulate the expression of orexigen or anorexigen neuropeptides thus resulting in the stimulation of food intake. Their peripheral targets are mainly the liver and the white adipose tissue where they stimulate lipogenesis, through the modulation of several enzymes and proteins expressions. Cannabinoïd receptor agonists are nowadays prescribed to improve appetite of people suffering from cancer or AIDS. In the same way, CB1 antagonist, such as Rimonabant, could provide efficient treatment of obesity.     

Stress in police officers: a study of the origins,prevalence and severity of stress-related symptoms within a county police force

BACKGROUND: High levels of stress-related illness are causing concern across industry. Against a background of impending legislative moves to try to improve this situation, there is a need to identify key work-related stressors. Police work tends to be regarded as inherently stressful because of the personal risk of exposure to confrontation and violence and the day-to-day involvement in a variety of traumatic incidents. As a result, high levels of stress-related symptoms might be expected in this population. OBJECTIVE: To examine the sources of stress-related symptoms within police officers and measure the prevalence of significant associated mental ill-health. METHOD: A cross-sectional questionnaire survey of a population of 1206 police officers was performed to assess levels of strain associated with a series of potential home and work related stressors. Participants were then split into low and high scoring groups on the basis of a General Health Questionnaire (GHQ) threshold score in order to identify those stressors most associated with mental ill-health effects. RESULTS: Occupational stressors ranking most highly within the population were not specific to policing, but to organizational issues such as the demands of work impinging upon home life, lack of consultation and communication, lack of control over workload, inadequate support and excess workload in general. The high scoring group constituted 41% of the population and differed significantly from those with low scores in perception of all stressors, ranking both personal and occupational stressors more highly, and from personality constraints appeared significantly more 'stress-prone'. A significant association between gender and mental ill-health was found, with females more likely to score more highly on the GHQ than males. CONCLUSION: This study confirms previous findings of organizational culture and workload as the key issues in officer stress. Given that the degree of symptomatology appears to be worsening, management action is required. Further research is indicated within the police population into a possible increased susceptibility in female officers.