吉林市儿童青少年超重肥胖流行现状

目的分析吉林市儿童青少年超重、肥胖的流行状况,为制定相应的防治策略和干预措施提供科学依据。方法选取2011-2015年吉林市学生体质健康监测资料,对吉林市5~18岁学生196 454名进行体格检查,利用中国肥胖问题工作组(WGOC)和国际肥胖工作组(IOTF)推荐的BMI标准筛查超重、肥胖。结果吉林市5~18岁儿童青少年男生肥胖率为20.2%,女生肥胖率为10.4%;男生超重率为19.0%,女生超重率为13.8%;‘超重+肥胖’:男生39.1%,女生24.2%;男生超重率、肥胖率均显著高于女生,差异有统计学意义(均P0.05)。结论吉林市儿童青少年男性比女性超重、肥胖情况更严重,均高于国内其他城市水平。吉林市超重、肥胖有一定的流行趋势,因此需采取有效干预措施降低发生率。     

杭州市儿童青少年腰围特征及肥胖分析

目的分析杭州市儿童青少年腰围分布特征和肥胖状况。方法通过杭州市学生健康监测与预警管理信息平台,收集21所中小学27 967名7~18岁2015学年儿童青少年健康检查资料,分析腰围(WC)、腰围身高比(WHt R)的分布特征,采用中国肥胖工作组(WGOC)颁布的中国儿童青少年超重、肥胖体质指数筛查分类标准和我国7~18岁青少年腰围的P_(90)分析肥胖流行状况。结果杭州市儿童青少年的WC随年龄增长逐渐增加,WHt R受年龄影响较小,WC和WHt R与BMI均呈正相关,且WC与BMI的关系比WHtR更紧密(WC:男生r_s=0.868,P0.01;女生r_s=0.780,P0.01;WHtR:男生r_s=0.631,P0.01;女生r_s=0.578,P0.01);杭州市儿童青少年肥胖率为7.29%,中心性肥胖率为17.69%,肥胖率和中心性肥胖率随学段升高呈下降趋势(P0.01),男生高于女生(P0.01)。结论杭州市儿童青少年肥胖状况较为严峻,应重点关注低学段学生和男生。     

1993-2009年7~18岁中国学龄儿童超重肥胖和腹型肥胖率变化趋势

【目的】 探讨1993-2009年7~18岁中国学龄儿童超重肥胖率和腹型肥胖率变化趋势。【方法】 选取1993、1997、2000、2004、2006和2009年“中国健康与营养调查”6次横断面调查数据,研究对象为7~18岁中国11 592名学龄儿童。研究内容包括性别、年龄、地区、身高、体重和腰围等。【结果】 7~18岁中国学龄儿童体质指数增加0.6 kg/m²(趋势P<0.001),腰围增加1 cm(趋势P<0.001);超重肥胖率从8.1%增加到18.0%(趋势P<0.001);腹型肥胖率从15.3%增加到28.9%(趋势P<0.001)。学龄儿童超重肥胖率及腹型肥胖率在不同性别、年龄及地区均显示出逐年增加的趋势(趋势P<0.001)。【结论】 17年来中国学龄儿童BMI、腰围、超重肥胖及腹型肥胖逐年增长,腹型肥胖的增加速度更为显著。因此,控制儿童肥胖迫在眉睫。     

上海市2000-2014年中小学生体质量指数变化趋势

了解2000-2014年上海市学龄儿童青少年体质量指数(BMI)的变化趋势,为儿童青少年超重、肥胖判别标准研制及预防干预提供参考.方法 选取2000,2005,2010,2014年4次全国学生体质与健康调研中7~18岁儿童青少年作为研究对象.应用最小均方(Least Mean Square,LMS)法探讨不同性别、年龄组儿童青少年BMI的变化趋势.结果 14年间学生BMI P85低年龄组差异比较小,随年龄增加差异逐渐增大,青春期后有减小的趋势,男生平均增加2.1百分点,女生平均增加1.3百分点.学生BMI增长主要集中在中等和高百分位数,尤其是P90后,差值逐渐增大.7~11,12~15岁男生在P5o后差值均逐渐增大,P95分别达2.0,3.2百分点,其中12岁男生从23.4 kg/m2增加到26.8 kg/m2,14岁女生从24.0 kg/m2增加到25.9 kg/m2.与WGOC标准相比,2014年男生BMI P85,P95均较高,而女生BMI P85 10岁之前高于WGOC标准,从11岁开始与WGOC标准基本相一致.2014年上海市7~18岁儿童青少年超重、肥胖检出率分别为15.4%,9.1%,较2000年总体均呈上升趋势,分别上升6.4,5.2百分点.结论 BMI分布高百分位的个体比低百分位个体的变化更大.在肥胖防治工作中,加强对群体BMI曲线的监测分析,对适时调整宏观调控战略意义重大.     

2009-2014年上海市宝山区中小学生超重肥胖流行趋势分析

目的分析上海市宝山区中小学生超重、肥胖现况,探讨流行趋势,为卫生和教育部门开展防治工作提供科学依据。方法利用2009-2014年学生健康监测数据,计算BMI,根据《中国学龄儿童青少年超重、肥胖筛查BMI分类标准》判定是否超重肥胖,计算分年龄段和性别的超重率、肥胖率。结果 2009-2014年中小学生男生超重率为16.97%~19.15%、肥胖率为11.28%~15.29%,男生超重率、肥胖率随年份呈先升后降趋势。各年龄男生超重率较为稳定,肥胖率则随年龄增长有下降趋势。女生超重率为9.68%~14.89%、肥胖率为4.20%~7.63%,女生超重率、肥胖率随年份呈上升趋势(χ2=24.35、20.87,均P<0.01)。女生超重率随年龄增长稍有下降趋势,肥胖率随年龄增长下降趋势明显。各年龄段男生超重率、肥胖率高于女生(均P<0.05)。结论宝山区中小学生超重肥胖发生情况存在性别、年龄差异,男生超重肥胖较为严重但趋于稳中有降,女生超重肥胖呈上升趋势,男、女生均存在年龄越小肥胖率越高现象,可采取有针对性措施防治中小学生超重肥胖发生。     

中国6~17岁儿童青少年超重肥胖流行特征

目的 分析我国6~17岁儿童青少年超重肥胖流行情况,为制定肥胖防治策略提供科学依据。方法 利用"2010-2012年中国居民营养与健康状况监测"中6~17岁儿童青少年调查资料,分析我国儿童青少年超重肥胖现状。6岁儿童采用WHO 2007年推荐的分年龄性别BMI超重肥胖判定标准判定超重肥胖,7~17岁儿童青少年采用《中国学龄儿童青少年超重和肥胖预防与控制指南》中的分年龄、性别的BMI超重肥胖判定标准进行判定。结果 6~17岁儿童青少年超重率和肥胖率分别为9.6%和6.4%,其中城市儿童青少年超重率和肥胖率分别为11.0%（男生：12.8%,女生：9.0%）和7.7%（男生：9.7%,女生：5.5%）,农村儿童青少年超重率和肥胖率分别为8.4%（男生：9.3%,女生：7.4%）和5.2%（男生：6.2%,女生：4.1%）。按家庭经济收入水平分,高、中和低家庭收入儿童青少年的超重率分别为12.3%、10.7%和8.2%,肥胖率分别为8.6%、7.2%和5.7%。结论 2012年,我国6~17岁儿童青少年超重肥胖表现为城市高于农村,男生高于女生;患病率与家庭经济收入水平有关。     

成都市2144名中小学生超重肥胖现状分析

分析成都市7~15岁学龄儿童青少年超重肥胖现状,为预测该地区超重肥胖发展趋势提供依据.方法 采用分层整群抽样法,共获得成都市中、小学各2所7~15岁儿童青少年有效数据2 144份.测量儿童青少年的身高、体重,计算体质量指数(BMI).分别采用中国肥胖问题工作组(WGOC)推荐的“中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准”以及国际肥胖工作组(IOTF)推荐的“儿童青少年超重肥胖筛查标准”评价超重和肥胖.结果 根据WGOC标准和IOTF标准,成都市7~15岁儿童青少年的超重率和肥胖率分别为10.68%,12.92%和6.53%,3.17%.不同性别学生超重率差异无统计学意义,男生肥胖率高于女生(P<0.05);男生超重率和肥胖率最高的年龄段分别为10~12岁和7~9岁,而女生超重率和肥胖率最高的年龄段均为10~12岁.结论 成都地区儿童青少年的肥胖问题男生较女生更为严重,且超重和肥胖出现低龄化.     

上海市虹口区小学生超重肥胖及家庭环境影响因素分析

近年来,随着社会经济发展和物质水平的提高,人们社会生活产生了诸多变化,肥胖人数日益增多,儿童青少年肥胖率亦逐年增高[1].近20年来,7~18岁中国儿童青少年体质量指数(body mass index,BMI)增加了0.6 kg/m2,腰围增加了1 cm,超重肥胖率从8.1%上升到18.0%,腹型肥胖率从15.3%上升到28.9%[2].肥胖已成为我国经济发达地区儿童青少年最突出的营养问题[3-4].肥胖严重影响了儿童青少年的身心健康,肥胖儿童青少年原发性高血压、脂代谢异常、糖尿病的检出率高于体重正常的儿童青少年,且随着超重的程度增加,检出率亦呈上升趋势[5-6].此外,儿童青少年时期肥胖也是成年人罹患高血压、高血脂、脑血管疾病、糖尿病等慢性病的危险因素[7].     

中国7~17岁儿童青少年1993-2011年血压偏高变化趋势分析

了解中国7~17岁儿童青少年1993-2011年血压水平和血压偏高检出率变化趋势,为我国儿童青少年血压偏高防治提供基础数据.方法 基于1993,2000和2011年3次中国健康和营养调查(CHNS)横断面数据,选取具有性别、年龄、身高、体重、腰围和血压完整资料的4 715名7~17岁的儿童青少年作为研究对象,采用Logistic回归模型分析儿童青少年血压偏高的影响因素.结果 1993-2011年儿童青少年SBP和DBP水平分别增长3.4和1.5 mmHg,其中男生、7~12岁和城市儿童增长幅度较大.血压偏高、单纯收缩压偏高和单纯舒张压偏高检出率分别从1993年的10.0%,2.1%和9.3%增加到2011年的12.9%,3.0%和11.7%,分别增长2.9,0.9和2.4百分点.儿童青少年超重、肥胖和腹型肥胖检出率分别从1993年的4.8%,1.4%和4.9%增加到2011年的10.8%,8.8%和19.7%,分别增长6.0,7.4和14.8百分点(x2值分别为61.4,132.7,229.7,P值均<0.05).相对于男生,女生血压偏高的OR值为0.79(95% CI=0.66~ 0.95);与正常体重儿童相比,超重儿童青少年血压偏高的OR值为2.11(95%CI=1.57~2.84),肥胖OR值为3.14(95%CI=2.15~ 4.59);与正常腰围相比,腹型肥胖OR值为1.65(95%CI=1.22~2.22).结论 1993-2011年中国儿童青少年血压水平、血压偏高、超重、肥胖和腹型肥胖检出率均呈增加趋势.儿童青少年血压偏高防治形势依然严峻,肥胖是儿童青少年血压偏高的重要危险因素.     

北京市海淀区1985-2010年中小学生肥胖变化趋势分析

目的 了解北京市海淀区1985 -2010年中小学生超重、肥胖及体质量指数(BMI)变化趋势,为儿童青少年肥胖干预政策的制定提供科学依据.方法 使用1985 -2010年中国学生体质与健康调研北京市海淀区资料,根据身高和体重计算BMI,应用中国肥胖工作组(WGOC)“中国学龄儿童青少年超重、肥胖筛查BMI分类标准”判定超重和肥胖,比较7 ～18岁学生各年度超重与肥胖检出率,分析各百分位数BMI( P25,P50,P75,P90,P95)变化趋势.结果 1985 -2010年7～18岁男生肥胖率分别为1.0％,4.0％,6.5％,15.2％,女生分别为0.5％,2.1％,2.8％,5.2％.各年龄组男、女生超重、肥胖率以及各百分位数BMI值均随年度不断上升(P值均＜0.01).1985 -2010年各百分位数BMI增长表现为男生增速高于女生,较高百分位BMI值增速高于较低百分位BMI值,各年龄组高百分位BMI值全面大幅上升.2000-2010年以来10～15岁男、女生BMI增速明显.结论 北京市海淀区1985 -2010年学生超重、肥胖检出率以及BMI水平持续增长,10～15岁学生是下一步肥胖防控的重点对象.     

Salmonellas in pigs and animal feeding stuffs in England and Wales and in Denmark

A comparison has been made between the incidence of salmonellas in pigs and feeding stuffs in England and Wales and in Denmark. In Denmark there is veterinary legislation requiring the sterilization of imported and home produced feed ingredients of animal origin. There is no such legislation in England and Wales. In Denmark 0·3% of resterilized imported meat and bone meal was contaminated with salmonellas. This compared with 23% of meat and bone meal in England and Wales and 20-27% of other ingredients of animal origin. In England and Wales salmonellas were isolated from 7% of caecal samples and 6% of lymph node samples, while in Denmark they were isolated from 3% of caecal samples and 4% of lymph node samples. In England and Wales 25 serotypes were found in both pigs and feeds and these included nearly all the most prevalent human pathogens. In Denmark four of the six serotypes in pigs had been found in resterilized feed. One notable difference between the two studies was the very wide range of serotypes found in pigs in England and Wales and the narrow range in Denmark. A second was that Salmonella typhimurium formed 15% of all Salmonella strains isolated from pigs in England and Wales, and 60% of those in Denmark.     

Lunasin is prevalent in barley and is bioavailable and bioactive in in vivo and in vitro studies

Lunasin, a unique 43-amino acid peptide found in a number of seeds, has been shown to be chemopreventive in mammalian cells and in a skin cancer mouse model. To elucidate the role of cereals in cancer prevention, we report here the prevalence, bioavailability, and bioactivity of lunasin from barley. Lunasin is present in all cultivars of barley analyzed. The liver and kidney of rats fed with lunasin-enriched barley (LEB) show the presence of lunasin in Western blot. Lunasin extracted from the kidney and liver inhibits the activities of HATs (histone acetyl transferases), yGCN5 by 20% and 18% at 100 nM, and PCAF activity by 25% and 24% at 100 nM, confirming that the peptide is intact and bioactive. Purified barley lunasin localizes in the nuclei of NIH 3T3 cells. Barley lunasin added to NIH 3T3 cells in the presence of the chemical carcinogen MCA activates the expression of tumor suppressors p21 and p15 by 45% and 47%, decreases cyclin D1 by 98%, and inhibits Rb hyperphosphorylation by 45% compared with the MCA treatment alone. We conclude that lunasin is prevalent in barley, bioavailable, and bioactive and that consumption of barley could play an important role of cancer prevention in barley-consuming populations.     

Management of pregnancy and childbirth in England and Wales and in France

This paper reviews national data on obstetric and neonatal practices in England and Wales, and in France between 1970 and 1980. The data have been derived from national statistics and surveys on national samples of births in 1970, 1975 and 1980 in England and Wales, and 1972, 1976 and 1981 in France. The analysis shows that there was no major difference in pregnancy outcome, but wide variations in medical practices, and their trend over time. The main differences were: in England and Wales a higher number of antenatal visits, a higher percentage of inpatient admissions during pregnancy, a higher rate of induction, more episiotomies, a higher rate of resuscitation at birth, and admission to neonatal special care units; in France, a higher rate of caesarean sections before and during labour, some evidence of a more active management of labour, and a longer hospital post-natal stay. These differences in practice reflect differences in objectives and assessment of the effectiveness of care between the two countries: they point out the need for better monitoring and evaluation of obstetric and neonatal practices.     

Research and teaching in social and preventive medicine and in public health

Summary Both public health and social and preventive medicine are characterised by the common goal of promoting, maintaining and improving health and preventing disease, and both are concerned with a population-related, preventive and environmental perspective. But whereas public health is interdisciplinary and goes far beyond the medical focus, social and preventive medicine is medically based and forms a bridge between public health and medical practice. Research in a department of social and preventive medicine serves to support preventive and medico-social activities in medical practice as well as in public health. This is illustrated by results from research conducted at the author's department during the last twenty years. Examples are research in support of smoking cessation activities, and research used for the planning of care for the elderly. Both the research and the teaching activities of the department take into account the population focus of public health as well as the focus on individual medicine in clinical practice.

---

Forschung und Lehre in Sozial-und Präventivmedizin und öffentlicher Gesundheit

Zusammenfassung Sowohl das Gebiet der öffentlichen Gesundheit als auch dasjenige der Sozial-und Präventivmedizin sind durch das Ziel der Förderung, Erhaltung und Verbesserung der Gesundheit sowie der Krankheitsvorbeugung gekennzeichnet, und beide beschäftigen sich mit einer bevölkerungsbezogenen, präventiven und umweltbezogenen Perspektive. Aber während die öffentliche Gesundheit stark interdisziplinär ist und weit über den medizinischen Fokus hinausreicht, ist die Sozial-und Präventivmedizin ein medizinisches Fach und stellt eine Brücke zwischen der öffentlichen Gesundheit und der ärztlichen Praxis dar. Die Forschung in einem Institut für Sozial-und Präventivmedizin dient der Förderung präventiver und sozialmedizinischer Tätigkeiten in der ärztlichen Praxis wie auch in der öffentlichen Gesundheit. Dies wird durch die Forschungstätigkeit des Instituts des Autors aus den letzten 20 Jahren illustriert, wobei Beispiele aus den Gebieten der Förderung der Raucherentwöhnung und der Betreuung behinderter Betagter dargestellt werden. Sowohl in den Forschungs-als auch in den Lehrtätigkeiten des Instituts finden der Bevölkerungsbezug der öffentlichen Gesundheit wie auch der individualmedizinische Ansatz der ärztlichen Praxis ihren Ausdruck.

---

La recherche et l'ensignement en médecine sociale et préventive et en santé publique

Résumé La santé publique aussi bien que la médecine sociale et préventive sont caractérisées par le but commun de promouvoir, maintenir et améliorer l'état de santé et de prévenir les maladies, et elles s'orientent vers une perspective de population, de prévention et environnementale. Mais la santé publique est interdisciplinaire et va loin au-delà de la médecine, tandis que la médecine sociale et préventive est basée sur la médecine et représente le lien entre la santé publique et la pratique médicale. La recherche d'un institut de médecine sociale et préventive sert à appuyer les activités préventives et médico-sociales au cabinet médical aussi bien qu'en santé publique. Cela est illustré par des résultats de recherches conduites dans les vingt années passées à l'institut de l'auteur, et les exemples sont tirés de la recherche en appui de la promotion de la cessation de fumée et de la planification de la prise en charge des personnes âgées et handicapées. Les activités de recherche et de l'enseignement de l'institut tiennent compte de la perspective de population cacactéristique de la santé publique, aussi bien que de la dimension de médecine individuelle caractéristique de la pratique clinique.

---

---

Paper presented at a symposium on The Public Health Perspective of Social and Preventive Medicine, in celebration of the 20th anniversary of the Department of Social and Preventive Medicine, University of Berne, 25 June 1992 in Berne.     

Eggs enriched in omega-3 fatty acids and alterations in lipid concentrations in plasma and lipoproteins and in blood pressure

Effects of dietary eggs enriched with omega-3 fatty acids on lipid concentrations in plasma and lipoproteins and blood pressure were determined in 11 men and women in two groups. Group 1 consumed four omega-3 eggs per day during the first 4-wk period and four control eggs for the second 4-wk period. Group 2 ate the same number of eggs in the reverse order. Mean plasma cholesterol concentration was significantly increased by control eggs (P less than 0.01) but unchanged by omega-3 eggs. Mean plasma triglyceride concentration was decreased by omega-3 eggs but increased by control eggs. Both systolic and diastolic blood pressures were significantly lowered by omega-3 eggs in group 1 whereas only systolic pressure was significantly decreased on omega-3 eggs in group 2. The control eggs did not change blood pressure. In conclusion, the omega-3 eggs may be more healthful than the control eggs.     

Bacteriology and constitutional health--genomics and proteomics: concepts in medicine and concepts in health insurance in the past and future

Future discussions on health issues on the individual or society level will be fundamentally linked to genetic dispositions. This genetic world will become reality in the same way the world of hygiene and bacteriology has become real for everyone. Approaches of molecular medicine for public health issues have not yet been created so far. The secret dreams of molecular eugenics must be made public and critically discussed. Up to now only a few monogenetically recessive hereditary diseases can be detected by screening. This kind of screening should be carefully considered. However, for the sciences, for medicine and thus for the physicians in practice, for health care sciences as well as for public health care, new tasks will emerge from genetics and molecular medicine. In individual as well as public health these new tasks will at first mainly turn in on the sphere of diagnosis and specific screening as well as health education and consultation. With regard to the considerable social implications the public health care sector should be aware of the coming issues of molecular medicine in time.     

成人社区及医院获得性肺炎病原菌及耐药性差异

 目的 比较非呼吸机相关医院获得性肺炎（NV-HAP）、呼吸机相关肺炎（VAP）与社区获得性肺炎（CAP）感染病原菌分布及耐药性。方法 回顾性调查2017年10月-2019年9月某院肺炎患者病历资料,按NV-HAP、VAP、CAP定义将患者分别列为NV-HAP组、VAP组、CAP组。收集三组患者痰、支气管肺泡灌洗液、血标本培养病原菌及药敏试验结果,分析三组患者感染病原菌构成和耐药性差异。结果 共纳入肺炎患者4 391例,NV-HAP组1 080例,VAP组126例,CAP组3 185例,各组分别检出病原菌841、191、1 440株,均以革兰阴性（G^-）菌为主,依次占72.77%、84.82%和61.18%,三组患者检出病原菌分布比较,差异有统计学意义（χ²=64.037,P<0.001）。鲍曼不动杆菌对头孢吡肟、头孢哌酮/舒巴坦、亚胺培南、庆大霉素、妥布霉素、左氧氟沙星、环丙沙星和复方磺胺甲口恶唑耐药率,铜绿假单胞菌对头孢哌酮/舒巴坦和亚胺培南耐药率,肺炎克雷伯菌对常用抗菌药物耐药率,三组比较差异均有统计学意义（均P<0.05）;金黄色葡萄球菌对红霉素、克林霉素和环丙沙星的耐药率比较,CAP组高于NV-HAP组（P<0.05）。结论 NV-HAP、VAP和CAP在病原菌分布及细菌耐药性方面均存在差异,在制定临床治疗方案时,要区别对待不同感染类型的肺炎。