农村居民体质指数、腰围与血压变化趋势分析

目的 研究山东省居民体质指数（BMI）、腰围与血压的关系。方法 采用多阶段随机抽样的方法抽取样本，对确定的调查人群进行问卷调查，测量身高、体重、腰围、臀围和血压，并计算出体质指数和腰臀比。用描述性流行病学方法进行分析。结果 当体质指数（kg／m2）在18．5～23．9，24～27．9，≥28时，血压均值分别是123．5／76．1，128．8／80．0，134．5／85．6mmHg，高血压的患病率分别是15．65％，26．38％和43．78％。当体质指数≥24和／或腰围≥85cm（女性≥80cm），血压增长的速度明显加快，高血压的患病率也明显上升。结论 血压均值和高血压的患病率随着体质指数和腰围的增加而上升．二者是高血压的主要危险因素。     

声门上型喉癌颈廓清术34例临床观察

目的探讨声门上型喉癌不同颈廓清术方法及其预后。方法对34例声门上型喉癌进行颈廓清术治疗,其中20例选用传统根治性颈廓清术,14例采用区域选择性颈廓清术治疗。结果根治性颈廓清术两年复发率为25%,5年生存率为60%;区域选择性颈廓清术分别为28.5%和57.1%,两组情况相似(P>0.05)。前组并发症为40%,后组为14.3%,前组明显较高(P<0.05)。结论声门上型喉癌行区域选择性颈廓清术能够保证治疗的疗效,并减轻传统治疗模式所带来的不良反应。     

Contribution of Cardiorespiratory Fitness to the Obesity Paradox

Until recently, cardiorespiratory fitness (CRF) has been overlooked as a potential modifier of the inverse association between obesity and mortality (the so-called obesity paradox), observed in patients with known or suspected cardiovascular (CV) disease. Evidence from five observational cohort studies of 30,104 patients (87% male) with CV disease indicates that CRF significantly alters the obesity paradox. There is general agreement across studies that the obesity paradox persists among patients with low CRF, regardless of whether adiposity is assessed by body mass index, waist circumference, or percentage body fat. However, among patients with high CRF, risk of all-cause mortality is lowest for the overweight category in some, but not all, studies, suggesting that higher levels of fitness may modify the relationship between body fatness and survival in patients manifesting an obesity paradox. Further study is needed to better characterize the joint contribution of CRF and obesity on mortality in diverse populations.     

Temporomandibular joint related painless symptoms,orofacial pain,neck pain,headache, and psychosocial factors among non-patients

The aims of this study were to assess the prevalence of temporomandibular joint related (TMJ) painless symptoms, orofacial pain, neck pain, and headache in a Finnish working population and to evaluate the association of the symptoms with psychosocial factors. A self-administered postal questionnaire concerning items on demographic background, employment details, perceived general state of health, medication, psychosocial status, and use of health-care services, was mailed to all employees with at least 5 years at their current job. The questionnaire was completed by 1339 subjects (75%). Frequent (often or continual) TMJ-related painless symptoms were found in 10%, orofacial pain in 7%, neck pain in 39%, and headache in 15% of subjects. Females reported all pain symptoms significantly more often than men (P < 0.001). Frequent pain and TMJ-related symptoms were significantly associated with self-reported stress, depression, and somatization (P < 0.001). Perceived poor general state of health (P < 0.001), health care visits (P < 0.001), overload at work (P < 0.001), life satisfaction (P < 0.05), and work satisfaction (P < 0.05) were also significantly associated with pain symptoms, but the work duty was not (P > 0.05). Our findings are in accordance with earlier studies and confirm the strong relationship between neck pain, headache, orofacial pain, TMJ-related painless symptoms, and psychosocial factors. Furthermore, TMJ-related symptoms and painful conditions seem to be more associated with work-related psychosocial factors than with type of work itself.     

Abdominal obesity has the highest impact on metabolic profile in an overweight African population

Aim: The aim of this study was to determine the association between different anthropometric parameters and metabolic profile in an overweight, adult, black Kenyan population.

Methods: An opportunity sample of 245 overweight adult Kenyans (body mass index (BMI) ≥ 25 kg/m²) was analysed. A score of metabolic profile (metabolic Z-score) was constructed on the basis of levels of plasma lipids, blood pressure, blood glucose and serum insulin. Linear regressions using metabolic Z-score as outcome and six anthropometric variables (waist circumference (WC), hip circumference, visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue, arm fat area and arm muscle area) separately as independent variables were carried out.

Results: Mean age of study participants was 42.1 years (SD = 9.6) and 26.5% of the participants were men. The median BMI was 28.6 kg/m² (Q1 = 26.3; Q3 = 31.3). Of the six anthropometric variables tested, WC and VAT thickness had the strongest negative association with the metabolic profile (β = 0.17 (0.09; 0.24) and 0.15 (0.08; 0.23), respectively).

Conclusions: WC and VAT thickness were the strongest anthropometric predictors for the metabolic profile in overweight adult Kenyans. WC is useful in clinical practice for the diagnosis of metabolically unhealthy fat accumulation in an African setting.     

Immediate effects of the central posteroanterior mobilization technique on pain and range of motion in patients with mechanical neck pain

Purpose.?To determine the immediate effects of the central posteroanterior (PA) mobilization technique on both pain and active cervical range of motion in patients with mechanical neck pain presenting with central or bilateral symptoms.

Methods.?A randomized controlled trial was conducted in 60 patients who were randomly allocated into either ‘central PA’ or ‘random’ mobilization group. Two physical therapists and one assessor participated. Outcome measures included neck pain at rest, pain on the most painful movement, and active cervical range of motion taken before and immediately 5?min after the mobilization treatment.

Results.?Significant reductions in pain at rest and on the most painful movement were noted within-group comparisons (p?<?0.001). However, the ‘central PA’ mobilization group obtained a significantly greater reduction in pain on the most painful movement than the ‘random’ mobilization group (p?<?0.05). Both mobilization techniques had no effects on the active cervical range of motion. However, the differences in the means of pain reduction between both mobilization techniques were modest (<10?mm).

Conclusion.?The clinical recommendation regarding the selection of the central PA mobilization technique for treating patients with central or bilateral mechanical neck pain is therefore arguably.     

Treating the N0 neck in early stage oral cancer: a pause for re-assessment?

The incidence of metastases following neck dissection in the apparent lymph node negative neck in oral cancer is between 7% and 33%; early resection of cervical metastases may well increase survival. Modern imaging techniques can reduce the yield of previously undiagnosed metastatic nodes in elective neck dissection (END). An audit of 112 consecutive cases was conducted to determine the proportion of undiagnosed nodal metastases, after END. There were neck metastases in 10 cases (9%), which were mainly (but not all) micrometastic. The 20% likelihood of nodal metastases was only apparent in primary tumours greater than 6 mm thick. The length of inpatient stay was increased from 3.7 to 16.5 days with free vascularised transfer. There were complications including cranial nerve damage. There were two peri-operative deaths. No ipsilateral neck failures occurred, median follow up was 937 days. To reduce unnecessary END, resection can be undertaken as a prior procedure, subsequently only carrying out END on tumours greater than 6 mm, or with unfavourable tumour characteristics.     

Hip Hip Hurrah! Hip size inversely related to heart disease and total mortality

During the past decade a series of published reports have examined the value of studying the relation between hip circumferences and cardiovascular end points. Specifically, in a series of recent studies the independent effects of hip circumference have been studied after adjustment for general obesity and/or waist circumference. These studies have been remarkable in terms of their consistency, and in the unexpected finding of an adverse effect of small hip size, after statistically correcting for differences in general and abdominal size. The hazard related to a small hip size may be stronger for women than men, but is evident in both genders. In this ‘viewpoint’, we wish to draw attention to the emerging body of evidence and to encourage researchers to continue collecting measures of lower body size in their surveys.