Cadmium in kidneys in Swedes measured in vivo using X-ray fluorescence analysis

An X-ray fluorescence (XRF) technique using plane polarized X-rays for excitation was used for in vivo measurements of cadmium in the kidney cortex among non-occupationally exposed members of the general population in southern Sweden. The measured concentrations of cadmium in the kidney cortex of smokers (median 28 g/g, n = 10) were significantly higher (P = 0.0036) as compared to those in non-smokers (median 8 g/g, n = 10), and so were the cadmium concentrations in blood and urine. The results show that smoking considerably increases the cadmium concentration in the kidney cortex and that smoking is a major source of cadmium exposure in the general population of Sweden. Except in the presence of very deeply situated kidneys, where the minimum detectable concentration is high, non-invasive in vivo XRF analysis of kidney cadmium should be a useful tool for evaluating the effects of long-term low-level exposure to cadmium and the risk of kidney damage.     

我国消除丙型肝炎的普通人群HCV检测策略的成本效果分析

目的 分析我国消除丙型肝炎（丙肝）的普通人群HCV检测策略的成本效果,明确最佳成本效果的HCV检测年龄。方法 运用TreeAge pro 2019软件构建决策树马尔科夫模型,以1年为周期,模拟10万名20~59岁各年龄组人群HCV检测和治疗结果,以全社会角度分析策略间比较的成本效果和效益。效果指标为增量成本效果比（ICER）,效益指标为净货币效益（NMB）,以我国2022年人均国内生产总值（85 698元）为意愿支付阈值。通过单因素敏感性分析和概率敏感性分析评估结果可靠性。结果 在20~59岁人群HCV检测有成本效果,在40~49岁年龄组进行HCV检测成本效果最佳。20~59岁年龄组人群HCV检测策略与未HCV检测策略比较,增量成本为161.24元/人,增量效用为0.003 6质量调整寿命年（QALYs）/人,ICER为45 197.26元/QALY,ICER小于意愿支付阈值,具有成本效果。各年龄组人群HCV检测策略与未HCV检测策略比较,ICER为42 055.06~53 249.43元/QALY,NMB为96.52~169.86元/人,其中40~49岁年龄组的ICER最低,NMB最高。单因素敏感性分析结果显示,贴现率、丙肝抗体（抗-HCV）检测成本、人群抗-HCV阳性率和直接抗病毒药物治疗成本对经济学评价影响较大,但改变参数取值,结论不变。概率敏感性分析结果表明模型分析结果稳定。结论 医疗机构探索动员20~59岁普通人群进行HCV检测具有较好的成本效果,以40~49岁年龄组人群的HCV检测成本效果最佳。在我国普通人群中实施HCV检测的“愿检尽检”策略,能降低人群丙肝疾病负担。     

职业人群不健康行为生活方式与高尿酸血症的关系及高血压、血脂异常的效应修饰作用

目的 探索不健康行为生活方式与高尿酸血症的关系,以及高血压、血脂异常的效应修饰作用,为预防高尿酸血症提供理论依据。方法 采用横断面调查研究设计,基于2021年10-12月来自四川省、贵州省28个地级市和重庆市33个区（县）中国铁路成都局集团有限公司的西南职业人群队列基线数据,通过问卷调查、体格测量及实验室生化检测收集研究对象的人口学特征、行为生活方式、慢性非传染性疾病患病情况。不健康行为生活方式得分根据吸烟、饮酒、膳食模式、体力活动和低体重/超重状况进行评分,分值越高不健康行为生活方式越多。采用多因素logistic回归模型分析不健康行为生活方式评分、吸烟状况、饮酒状况等与高尿酸血症的关系,采用分层分析探索高血压等疾病对不健康行为生活方式与高尿酸血症之间关系的修饰效应。结果 共纳入11 748名研究对象,高尿酸血症患病率为34.4%。多因素logistic回归分析显示,现在吸/既往吸烟、现在饮/既往饮酒及BMI异常是高尿酸血症患病的危险因素,不健康行为生活方式对高尿酸血症患病风险呈现累积效应,随着得分的升高,高尿酸血症患病风险升高,OR值由1.64（95%CI：1.34~2.00）上升至2.89（95%CI：2.39~3.50）。分层分析结果显示,在高血压及血脂异常人群中,不健康行为生活方式对高尿酸血症患病风险影响更大。结论 多种不健康行为生活方式的共存会升高高尿酸血症患病风险,这一效应在高血压、血脂异常人群中更明显。及时纠正不健康行为生活方式,并控制高血压和血脂异常,降低患高尿酸血症的风险。     

对贫困人口实施医疗救助

本文在分析了我国城乡居民收入分配中的公平性加重、医疗保障水平降低、医疗费用大幅度上涨、个人负担比例增加和卫生保健等筹资的“供方投入”模式的不合理性以及贫困人口较差的健康状况和卫生服务利用水平、贫困人口的主要健康问题、“需方投入”模式对供方的激励作用的基础上,认为对贫困人口实施医疗救助不仅符合公平原则,而且符合效率原则。医疗救助计划应该成为我国目前正在步步深入的卫生改革的重要组成部分。作者分别以我国     

几种改进的漂浮颗粒剂灭中华按蚊和致倦库蚊的效果

目的：比较几种改进的漂浮颗粒剂灭中华按蚊和致倦库蚊幼虫的效果。方法：现场试验。结果：室内生物测定,Ｂ．ｔ．ｓ－１８７漂浮颗粒剂（荷叶型）ＬＤ５０为０．４０８７μｇ／ｍｌ,Ｂａｃｔｉｍｏｓ颗粒剂（荷叶型）ＬＤ５０为０．９３４４μｇ／ｍｌ,Ｂ．ｓ－Ｃ３－４１漂浮颗粒剂（荷叶型）ＬＤ５０为０．０５９９μｇ／ｍｌ。稻田灭中华按蚊幼虫的效果显示：两种Ｂ．ｔ．ｓ漂浮颗粒剂（荷叶型）０．８１ｇ／ｍ２剂量时,２４ｈ灭蚊效果均可达１００％。１８７漂浮颗粒剂持效可达１１ｄ,Ｂａｃｔｉｍｏｓ漂浮颗粒剂持效为８ｄ。１８７颗粒剂和Ｂ．ｓ－Ｃ３－４１颗粒剂现场灭致倦库蚊的效果显示：在０．６８ｇ／ｍ２剂量时,２４ｈ蚊幼密度下降率分别为１００％和９９．１％,持效分别为９ｄ和８ｄ。结论：采用荷叶粉为主要载体,在自然界中易于分解,不造成污染,而且灭蚊即效和持效均较好。     

合肥市1993—1997年城区居民恶性肿瘤死亡分析

本文对合肥市１９９３—１９９７年城区居民恶性肿癌死亡进行了分析,结果显示恶性肿瘤死亡率居该市死因第一位,死亡居前的是肺癌、胃癌、肝癌、食管癌,５０—６９岁年龄段人群恶性肿瘤死亡率成倍增长,７０—８０岁年龄段癌症死亡率最高,分析表明老年人是暴露恶性肿癌危险因素高危人群,是癌症防治的重点人群。     

Effect of distance and population size on patient trips in a prefecture of Japan: Application of a transportation distribution model to the demand for and supply of health services

The gravity model, a method for analyzing transportation distribution in transportation engineering, was used to explain patient trips between ten health service regions in a Japanese prefecture. The OD (Origin-Destination) tables were constructed with zoning by regions, distinguishing between out- and inpatients. The observed trips were determined from the data of a survey conducted in 1992 that reported the locations of patient residences and chosen medical facilities. The base values used in the model calculations were the population size of each region and the road distance between the centers of regions. Problems of intrazonal trip were avoided by setting a mean intrazonal movement distance. This model was calibrated by the linear regression method with simultaneous validation by the index of correlation coefficients. The model was found to accurately simulate the effect of distance on the choice of medical facilities and the differences between the characteristics of in- and out-patients. The population value in use showed the relation not only with demand but also the supply of clinical services. It was suggested that the model presented here was useful in the allocation of medical resources and would help explain the relationship between suppliers and consumers of medical services.     

海南省流动儿童计划免疫现况分析

为更好地了解流动儿童计划免疫管理现况,１９９７年海南省组织了专题调查,发现流动儿童以县内流动为主,流动儿童上卡率为７６．６％,五苗接种率分别为卡介苗６９．４％,脊灰糖丸６５．１％,百白破６３．６％,麻疹５９．９％,ＨＢＶ５６．９％,均远未达到目标要求,脊达抗体ＧＭＴ流动儿童为１：１５３．２０,常住儿童为１：２４３．６１,两者有显著性差异,这表明,加强流动儿垢计划免疫管理,最今后计免工作的重点和难点     

Polymorphism analysis of the VNTR locus D17S5 in Central Spain

The fragment length polymorphism YNZ22 (D17S5) was analysed for a sample of 207 unrelated individuals living in Madrid (Spanish Caucasians) using PCR-methodology and high resolution separation. Hardy-Weinberg expectations (HWE) were calculated after pooling alleles into four groups. No deviations from HWE were detectable using the conventional ²-test. The power of discrimination was estimated as 0.96 and the mean paternity exclusion chance as 0.7587. A comparison of the allele frequency distribution with those of other Caucasian groups revealed no major differences.     

Single neurons are differently involved in stimulus-specific oscillations in cat visual cortex

Synchronised oscillatory population events (35–80 Hz; 60–300 ms) can be induced in the visual cortex of cats by specific visual stimulation. The oscillatory events are most prominent in local slow wave field potentials (LFP) and multiple unit spikes (MUA). We investigated how and when single cortical neurons are involved in such oscillatory population events. Simultaneous recordings of single cell spikes, LFP and MUA were made with up to seven microelectrodes. Three states of single cell participation in oscillations were distinguished in spike triggered averages of LFP or MUA from the same electrode: (1) Rhythmic states were characterised by the presence of rhythmicity in single cell spike patterns (35–80 Hz). These rhythms were correlated with LFP and MUA oscillations. (2) Lock-in states lacked rhythmic components in single cell spike patterns, while spikes were phase-coupled with LFP or MUA oscillations. (3) During non-participation states LFP or MUA oscillations were present, but single cell spike trains were neither rhythmic nor phase coupled to these oscillations. Stimulus manipulations (from optimal to suboptimal for the generation of oscillations) often led to systematic transitions between these states (from rhythmic to lock-in to non-participation). Single cell spike coupling was generally associated with negative peaks in LFP oscillations, irrespective of the cortical separation of single cell and population signals (0–6 mm). Our results suggest that oscillatory cortical population activities are not only supported by local and distant neurons with rhythmic spike patterns, but also by those with irregular patterns in which some spikes occur phase-locked to oscillatory events.