2018年四川省成人糖尿病流行现状及其影响因素分析

目的 了解四川省成人常住居民糖尿病患病情况及其影响因素,为有效预防糖尿病,降低发病风险提供科学的依据。方法 2018年采用多阶段分层整群随机抽样的方法,抽取四川省18岁及以上常住居民进行身体测量、问卷调查、实验室检测。采用SAS 9.4分析四川省成人糖尿病流行情况和患病影响因素。结果 2018年四川省成人糖尿病患病率12.94%,其中男性患病率为13.09%,女性患病率为12.79%,差异无统计学意义(χ²=3.964,P=0.460); 年龄增长(与18～44岁组相比,75岁及以上OR=6.070,95%CI:3.792～9.716)、职业(与农业生产人员相比,离退休人员OR=1.781,95%CI:1.277～2.484)、锻炼频率(与每周0次相比,每周1～3次OR=0.439,95%CI:0.281～0.686)、血脂异常(OR=2.069,95%CI:1.693～2.528)、中心性肥胖(OR=1.938,95%CI:1.619～2.320)、高血压(OR=2.031,95%CI:1.583～2.606)、糖尿病家族史(OR=2.825,95%CI:1.658～4.813)是糖尿病患病的影响因素。结论 四川省糖尿病患病率处于较高水平,每周锻炼1～3次是预防糖尿病的保护因素,年龄增加、离退休人员、血脂异常、中心性肥胖、高血压、糖尿病家族史是糖尿病患病的危险因素,应进一步开展针对性的预防干预措施。     

福建省城乡人群恒牙龋病流行病学抽样调查报告

目的：了解福建省居民口腔健康状况及流行趋势,为今后进行口腔健康教育、开展口腔保健项目提供依据。方法：采用多阶段、分层、整群随机抽样的方法对福州市、泉州市、南平市的5,12,15,18,35－44及65－74岁年龄组的城乡人群12792人（男女各半）进行口腔检查。结果：随着年龄的增大,龋均、患龋率、充填率呈上升趋势（P＜0．01）。35－44岁、65－74岁年龄组龋均、患龋率城市高于农村（P＜0．01）,其他年龄组城乡之间差别无显著性（P＞0．05）。各年龄组充填率城市均高于农村（P＜0．01）。福建省城乡居民的恒牙患龋率、龋均高于全国平均水平。结论：应从小进行口腔健康教育,增强口腔健康意识,加大实施口腔预防保健措施的力度。     

关于中药新药用饮片取样法的探讨

从药材及饮片（植物药）的包件取样、包件内取样及试验样品制备等方面对《中国药典》（Chinese Pharmacopoeia,ChP）、《欧洲药典》（European Pharmacopoeia,EP）、《英国药典》（British Pharmacopoeia,BP）及《美国药典》（United States Pharmacopoeia,USP）进行对比,结合新药用饮片检验的要求,就中药新药用饮片取样法存在的问题进行探讨,并提出以下建议：（1）相关部门组织专家起草中药新药用饮片取样的指导原则或技术要求。（2）暂时参照EP、BP的取样法对中药新药用饮片进行研究,并关注饮片取样对检验结果的影响。（3）根据试验样品的特点研究确定其处理方法。如饮片的不同药用部位或位置的质量差异大,可采用分层抽样的方法,减少取样误差。（4）加强药材的源头管理,减少药材质量差异。（5）在新药用饮片的生产过程中采用混合步骤提高同批饮片的同质性。（6）在ChP“中药材及饮片取样办法”中增加：待检批次饮片应具有较好的同质性;有些样品或试验需要采用更严格的取样方法,包括更多取样包件数或包件内取样量;此外,可对包件内抽取的位...     

1702例早孕绒毛细胞培养及细胞遗传学分析

目的探讨早孕期绒毛活检及细胞遗传学分析在产前诊断中的应用。方法回顾性分析2002年4月至2019年9月在北京协和医院产前诊断中心进行早孕期绒毛活检及细胞遗传学检测的1702例患者的临床资料,统计培养成功率及染色体异常率,并对其诊断指征进行分析。结果1702例绒毛组织标本中,培养成功1602例,成功率为94.12%。穿刺的临床指征中以高龄妊娠(43.60%)和单基因病史(29.14%)为多见。检出染色体核型异常共161例,异常率10.05%,其中纯合型异常核型有153例,嵌合型异常核型有8例,包括21-三体53例、18-三体39例、13-三体10例、性染色体异常31例、其他常染色体数目异常9例、染色体结构异常17例、多倍体2例。染色体异常发生率最高的是夫妻染色体异常组,染色体异常率39.13%(9/23);其次是早孕期超声异常组,染色体异常率35.14%(110/313);单基因病产前诊断的464例样本中,检出6例染色体异常。1702例绒毛样本中取材后胎儿丢失5例,流产率0.29%。结论早孕期绒毛活检及核型分析能够有效提前产前诊断时间,尤其适用于单基因病孕史及早孕期超声异常的产前诊断。绒毛组织培养可以获得较高的培养成功率,失败原因多见于样本量少及细胞活性欠佳。绒毛染色体嵌合时要警惕胎儿与胎盘染色体不一致的情况。     

扩散法采集环境空气中氨

目的探讨采集氨的新方法方法采用扩散法将空气中氨采集在磷酸—甘油浸渍的无纺布吸收层上。结果采样速率为（１３７．６±８．４）ｍｌ／ｍｉｎ,与动力采样法现场对比测定,总不确定度为±１９．３％。结论采样器体积小、无噪声、操作方便,适于个体接触量与室内空气污染监测。     

郑州市4123名中学生吸烟状况调查

目的：了解郑州市中学生吸烟状况。方法：采用问卷法对６所中学４１２３名学生进行吸烟状况调查。结果：中学生总吸烟率为４５１６％（１８６２／４１２３）。其中,高中组吸烟率（５０４９％）高于初中组（３９４９％）,男生吸烟率（７０１９％）明显高于女生（３１５％）,且中学生吸烟的严重性随年龄的增加而增加;父母的文化程度、周围人群的吸烟情况与学生吸烟率有密切关系。结论：中学生吸烟问题较重,为保护中学生的身心健康应大力开展卫生宣教。     

Characterization of AUCs from Sparsely Sampled Populations in Toxicology Studies

Purpose. The objective of this work was to develop and validate blood sampling schemes for accurate AUC determination from a few samples (sparse sampling). This will enable AUC determination directly in toxicology studies, without the need to utilize a large number of animals. Methods. Sparse sampling schemes were developed using plasma concentration-time (Cp-t) data in rats from toxicokinetic (TK) studies with the antiepileptic felbamate (F) and the antihistamine loratadine (L); Cp-t data at 13–16 time-points (N = 4 or 5 rats/time-point) were available for F, L and its active circulating metabolite descarboethoxyloratadine (DCL). AUCs were determined using the full profile and from 5 investigator designated time-points termed critical time-points. Using the bootstrap (re-sampling) technique, 1000 AUCs were computed by sampling (N = 2 rats/point, with replacement) from the 4 or 5 rats at each critical point. The data were subsequently modeled using PCNONLIN, and the parameters (k_a, k_e, and V_d) were perturbed by different degrees to simulate pharmacokinetic (PK) changes that may occur during a toxicology study due to enzyme induction/inhibition, etc. Finally, Monte Carlo simulations were performed with random noise (10 to 40%) applied to Cp-t and/or PK parameters to examine its impact on AUCs from sparse sampling. Results. The 5 time-points with 2 rats/point accurately and precisely estimated the AUC for F, L and DCL; the deviation from the full profile was ~10%, with a precision (%CV) of ~15%. Further, altered kinetics and random noise had minimal impact on AUCs from sparse sampling. Conclusions. Sparse sampling can accurately estimate AUCs and can be implemented in rodent toxicology studies to significantly reduce the number of animals for TK evaluations. The same principle is applicable to sparse sampling designs in other species used in safety assessments.     

Exposure to soluble barium compounds: an interventional study in arc welders

Summary Soluble barium (Ba) compounds are well-known toxicants. Intoxications are mainly known in an acute form from casual or suicidal oral ingestion. No scientifically based data are available on possible health effects of inhalative exposure to soluble Ba salts at the workplace. Therefore, we investigated 18 welders in an interventional study over 1 week. They performed welding of Ba-containing stick electrodes and self-shielded flux cored wires under conditions similar to real working conditions. The welding fumes contained 31%–37% Ba, more than 90% of which was soluble in acids. Without appropriate preventive measures, a high rate of measurements exceeded the TLV values for total welding fumes of 5 mg/m³ and for soluble Ba of 0.5 mg/m³. The median fume concentrations were 13.2 mg/m³ in stick electrode welding and 12.3 mg/m³ in flux cored wire welding. The median Ba concentrations were 4.4 and 2.0 mg/m³ respectively. An integrated exhaust system built into the gun proved to be efficient in flux cored wire welding. The internal exposure to Ba reached median urine levels up to 101.7 g/l (normal: below 20 g/l) and median plasma concentrations of up to 24.7 g/l (normal: below 8 g/l). No health impact on the welders could be proven, but hypokalemia may have occurred as a result of the Ba exposure.