过氧化物酶体增殖物激活受体多态性及基因-基因交互作用对脉压的影响

目的 探讨过氧化物酶体增殖物激活受体（PPAR）单核苷酸多态性（SNP）以及基因-基因交互作用对脉压差的影响。方法 基于江苏省代谢综合征和多代谢异常综合防治研究（PMMJS）队列,采用单纯随机抽样方法随机抽取其中研究对象820例,选取3个PPARα、2个PPARδ和5个PPARγ的SNP位点并进行检测,运用广义多因子降维法（GMDR）模型检测10个SNP的基因-基因交互作用与高血压的关联。结果 PPARγ的rs1805192的突变基因型（PA+AA）携带者与野生型（PP）相比,脉压差水平显著变化（1.341 mmHg,95% CI：0.431~2.252 mmHg）。GMDR模型分析显示,在脉压差≥ 30 mmHg的亚组中,PPARα基因的rs135539、PPARδ的rs2016520、PPARγ的rs10865710、rs1805192、rs709158、rs3856806组成的六阶模型平均检验准确度为0.577,交叉验证一致性为10/10,为最优模型。而在脉压差≤ 40 mmHg的亚组中,二阶交互作用模型与脉压差显著相关,平均检验准确度为0.628,交叉验证一致性为10/10。结论 PPARγ的rs1805192多态性与脉压差水平有关联,PPARα基因的rs135539、PPARδ的rs2016520和PPARγ的rs10865710、rs1805192、rs709158、rs3856806六个SNP间基因-基因交互作用与脉压差间具有显著性关联。     

2015—2017年中国城市居民对肿瘤防治知识的需求、获取途径及相关因素分析

目的分析2015—2017年中国城市居民对肿瘤防治知识的需求情况、获取途径及相关因素。方法采用横断面调查的方法,于2015—2017年以2015年度城市癌症早诊早治项目覆盖的16个项目省份为研究现场,采用整群及方便抽样的方法,将年龄≥18岁、能够理解调查程序的居民纳入研究,共32257名,社区居民、癌症风险评估/筛查干预人群、现患癌症患者及职业人群分别有15524、8016、2289、6428名。采用自制的调查问卷收集一般人口学特征、肿瘤防治知识需求情况、获取途径及影响其态度的原因等资料。以χ2检验分析不同特征研究对象肿瘤预防知识需求率的差异;采用logistic回归模型分析肿瘤防治知识的相关因素。结果研究对象整体对肿瘤防治知识的需求率为79.5%,在肿瘤患病的诱因、症状表现、诊断方法防治知识方面,职业人群的需求率最高(P值均<0.001),分别为66.8%、71.0%、20.8%,在治疗方法和治疗费用防治知识方面,现患癌症患者的需求率最高,分别为45.9%和21.9%。肿瘤防治知识获取途径排在前三位的分别为"广播或电视(69.5%)""书报、海报或宣传册(44.7%)"和"家人朋友(33.8%)"。与事业单位人员/公务员、未婚/同居/离婚/丧偶及其他、2014年家庭年收入<2.0万元人民币、东部地区、未被诊断过癌症、自评有患癌风险人群相比,企业人员/工人、已婚、2014年家庭年收入6.0万~14.9万元、中部地区、患有癌症、自评不清楚自身是否有患癌风险的人群对肿瘤防治知识需求意愿相对较高(P值均<0.05)。结论2015—2017年我国城市居民肿瘤防治知识需求率较高,肿瘤防治知识主要获取途径为广播或电视;职业、婚姻状况、家庭年收入、区域、健康状态、患病风险是肿瘤防治需求情况的主要相关因素。     

《天津市控制吸烟条例》实施十周年控烟监测结果分析

目的评估《天津市控制吸烟条例》实施10周年后各类公共场所的实施效果, 调查人群的烟草暴露和危害认知情况, 为控烟政策和措施的落实提供依据。方法数据源于2012和2021年天津市控烟调查。调查采用现场观察法记录天津市各类公共场所内各项控烟措施的落实情况, 并采用拦截面对面调查方式收集天津市≥15岁常住居民二手烟暴露和烟草相关知识数据。结果 2012-2021年天津市医疗卫生机构禁烟标志张贴率处于较高水平(100.0%), 教育机构、政府办公机构上升至100.0%, 出租车下降幅度较大。医疗卫生机构、公共交通等候场所、互联网上网服务营业场所、公交车的控烟宣传资料摆放率下降, 其他场所均上升。除出租车外, 其他调查场所在观察期间发现有人吸烟的现象均下降。非吸烟人群公共场所和工作场所的二手烟暴露率从43.2%下降至26.6%。公众对吸烟导致中风的知晓率上升11.3%、导致心脏病、肺癌的知晓率分别下降7.7%和7.2%;二手烟导致成年人心脏病、儿童肺部疾病、成年人肺癌的知晓率分别下降21.8%、22.1%、9.1%。结论《天津市控制吸烟条例》实施以来, 二手烟暴露情况得到改善, 但禁烟场所的环境...     

Meal-Planning Practices with Individuals in Health Disparity Zip Codes

ObjectiveThis study identified perceptions of family meal benefits and family meal preplanning patterns among African Americans (AAs) living in health disparity zip codes in the Deep South.DesignSurveys that included demographic information, perceptions about family meal benefits, and preplanning behaviorsResultsStudy participants with limited meal preplanning practices were less likely to participate in family meals.ConclusionsThis study provides a greater understanding of some of the specific practices related to the time and the number of family meals planned by individuals in this population that may contribute to the low number of family meals they experience.     

Type 2 diabetes management in nurse-led primary healthcare settings in urban and rural Cameroon

AimsTo implement a protocol-driven primary nurse-led care for type 2 diabetes in rural and urban Cameroon.MethodsWe set-up three primary healthcare clinics in Yaounde (Capital city) and two in the Bafut rural health district. Participants were 225 (17% rural) patients with known or newly diagnosed type 2 diabetes, not requiring insulin, referred either from a baseline survey (38 patients, 17%), or secondarily attracted to the clinics. Protocol-driven glucose and blood pressure control were delivered by trained nurses. The main outcomes were trajectories of fasting capillary glucose and blood pressure indices, and differences in the mean levels between baseline and final visits.ResultsThe total duration of follow-up was 1110 patient-months. During follow-up, there was a significant downward trend in fasting capillary glucose overall (p < 0.001) and in most subgroups of participants. Between baseline and final visits, mean fasting capillary glucose dropped by 1.6 mmol/L (95% CI: 0.8–2.3; p ≤ 0.001). Among those with hypertension, blood pressure also decreased significantly for systolic and marginally for diastolic blood pressure. No major significant change was noticed for body weight.ConclusionsNurses may be potential alternatives to improve access to diabetes care in settings where physicians are not available.     

中国淮安地区2009年至2011年恶性肿瘤的发病率及死亡率分析

Objective

The aim of the study was to investigate the cancer incidence and mortality in Huai’an area, China, from 2009 to 2011.

Methods

The data about cancer incidence and mortality were provided by Huai’an Cancer Registry, China. Incidence and mortality rates, and standardized rates were calculated by age, gender, areas (urban and rural areas of Huai’an) and cancer sites.

Results

The crude incidence rate for all cancer sites was 205.60/10⁵ and the standardized incidence rate was 166.22/10⁵. Both the crude and standardized rates were higher in urban area than in rural area for both sexes. The incidence rates increased in people aged 40 and over, and the peak ages of incidence were between 70–75 in both males and females. The crude mortality rate for all cancer sites was 153.88/10⁵ and the standardized mortality rate was 122.14/10⁵. Both the crude and standardized rates were similar in urban and rural areas for both men and women. The mortality rates were at low level under the age 50 in both sexes, but increased after the age 50, reaching the peak at the ages of 80–85 in both males and females. The top 10 most common cancer sites in rank were esophagus, stomach, lung, liver, colon-rectum, breast, pancreas, cervix uteri, brain and central nervous system, and leukemia, accounting for 87.56% of all cancers. The top 10 most leading causes of cancer death in order were cancers of esophagus, lung, liver, stomach, colon-rectum, pancreas, brain and central nervous system, leukemia, breast and lymphoma, accounting for 90.53% of all cancer deaths.

Conclusion

Cancer is one kind of major diseases threatening people’s health in Huai’an area, China. Cancer prevention and control should be enhanced, especially for esophageal cancer.     

Evaluation of data quality in the cancer registry: Principles and methods. Part I: Comparability,validity and timeliness

The value of the modern cancer registry and its ability to carry out cancer control activities rely heavily on the underlying quality of its data and the quality control procedures in place. This two-part review provides an update of the practical aspects and techniques for addressing data quality at the cancer registry. This first installment of the review examines the factors influencing three of the four key aspects, namely, the comparability, validity and timeliness of cancer registry data. Comparability of cancer data may be established through a comprehensive review of the registration routines in place. Validity is examined via numerical indices of that permit comparisons with other registries, or, within a registry, over time, or with respect to specified subsets of cases. There are no international guidelines for timeliness at present, although specific standards for the abstraction and reporting of registry have been set out by certain organisations.     

Sex differences in cardiovascular risk factors of children and adolescents with type 1 diabetes mellitus: A role for diet?

Background and aimsCardiovascular disease is the leading cause of morbidity and mortality in individuals with type 1 diabetes mellitus (T1DM). Cardiovascular risk is higher in women with diabetes than in men. With this study, we wanted to determine whether female children and adolescents with T1DM are more prone to cardiovascular risk factors (CVRFs) and an atherogenic diet than boys.Methods and resultsFor this cross-sectional study, anthropometric, clinical, biochemical, and dietary intake data of 314 children with diabetes (3–18 years; 178 boys) were analysed according to age and sex. Linear and binary logistic regression was performed to test independent associations between sex, dietary intake, and CVRFs.Low-density lipoprotein -cholesterol (LDL-c), triglyceride (TG), fibre, monounsaturated fatty acid levels (all p < 0.01), and lipid (p = 0.022) intake were higher in the girls than in the boys. Multiple regression analysis showed that LDL was associated with sex, glycated haemoglobin (HbA1c), and lipid intake percentage (R (Kannel, 1979) [2] = 0.130; p = 0.0004) independent of age, pubertal stage, body mass index (BMI), duration of diabetes, energy, and fibre intake. Logistic regression analysis showed that high LDL-c levels were present more often in girls [odds ratio, OR; confidence interval, CI = 2.569 (1.178–5.604); p = 0.018] who had a higher dietary lipid intake percentage [OR (CI) = 1.089 (1.011–1.173); p = 0.025].ConclusionsGirls with diabetes have higher LDL-c levels associated with higher dietary lipid intake. Our findings suggest that young people with diabetes, especially girls, may benefit from early dietary interventions to reduce their cardiovascular risk.     

1998-2010年哈尔滨市市区慢性病流行趋势分析

目的 分析哈尔滨市区1998-2010年慢性病流行状况及发病趋势,为制定适合本地的慢性病防治措施提供科学依据.方法 收集哈尔滨市1998-2010年慢性病报告资料,采用描述性流行病学的方法分析哈尔滨市慢性病的流行趋势.结果 1998-2010年哈尔滨市区慢性病年报告发病率呈逐年上升趋势,年均报告发病率为1 273.91/10万,发病率居前5位的慢性病分别为脑卒中、肿瘤、高血压、糖尿病和冠心病,5种慢性病发病有明显的性别差异,冠心病、脑卒中发病有明显的季节性差异.2010年的慢性病发病率高于1998年,差异有统计学意义( P＜0.001).市区男性年均报告发病率(1 452.02/10万)高于女性(1 093.69/10万),差异有统计学意义(P＜0.001).慢性病报告发病率随年龄的增长而升高(Z=1 034.97,P＜0.001).结论 慢性病发病呈逐年上升趋势,预防和控制男性及老年人慢性病发病是今后卫生防病工作的重点,应采取针对性措施,有效的控制慢性病发病.     

Carbon monoxide … the silent killer with an audible solution

Carbon monoxide (CO) is responsible for more poisoning fatalities each year than any other toxic agent. The often insidious nature of the symptom progression and its ability to imitate many common illnesses may result in the failure to diagnose a potentially fatal outcome. CO detectors equipped with an audible alarm can alert potential victims of CO poisoning before toxic sequelae develop. A study was conducted in which all calls to 911 concerning a CO detector in alarm or regarding possible CO poisoning were investigated by a paramedic crew; 101 possible CO exposures were investigated. CO detectors with audible alarms were the genesis of 59.4% of the calls. Detectable CO levels were found in 69.3% of the investigations, and 80% of the homes with detectors had verifiable CO concentrations. The mean CO concentration in homes with detectors was 18.6 ppm, compared with 96.6 ppm when no detector was available; 63.4% of the victims with no alarm were symptomatic, compared with 13.3% of victims with alarms. CO detectors with audible alarms were effective in alerting the potential victims of CO poisoning to its presence. Persons with CO detectors were less likely to become symptomatic from a CO exposure than those who did not have CO detectors.