中国城镇化与健康相关行为关系分析:一项基于CHARLS数据的实证研究

目的: 探讨中国城镇化与居民健康相关行为的关系,理清城镇化对健康行为的影响。方法: 基于中国健康与养老追踪调查(China Health and Retirement Longitudinal Study, CHARLS)在2011、2013和2015年均被追踪到的数据构建个体面板,采用面板数据固定效应模型分析城镇化水平对戒烟、饮酒、睡眠质量和锻炼行为的影响,利用人口密度、人均国内生产总值(gross domestic product, GDP)、第二三产业产值占比代表城镇化水平。结果: 2011—2015年中国城镇化水平呈增加趋势,表现为人口密度、人均GDP和第二三产业产值占比的逐年增长。戒烟率随人均GDP水平、第二三产业产值占比水平的增加均有所提高。饮酒率以低水平为对照,人均GDP水平在45 000元以上的地区饮酒率提高2.49%,第二三产业产值占比为80%~85%的地区饮酒率降低2.48%,人口密度的差异无统计学意义。睡眠质量随人均GDP水平的增加而降低,人均GDP在93%以上的地区睡眠质量好的比低水平降低3.71%,人口密度水平和第二三产业产值占比的差异无统计学意义。锻炼率以低水平为对照,人口密度在400~600人/平方公里和800人/平方公里以上的地区锻炼率分别降低5.2%和7.7%,人均GDP在25 000~35 000元和45 000元以上的地区锻炼率分别降低3.26%和3.73%,第二三产业产值占比在93%以上的地区锻炼率降低10.68%。结论: 城镇化不同维度对不同健康行为的影响不同,戒烟率随城镇化水平增加而上升,与人均GDP和第二三产业产值占比有关;锻炼率随城镇化的增加而降低,与三个维度均有关系;睡眠质量好的概率随城镇化水平的增加而降低,与人均GDP关系更为密切;饮酒率与城镇化水平无明显相关趋势,还需要进一步研究。     

Malaria vectors and urbanization in the equatorial forest region of south Cameroon

Entomological surveys were carried out in the town of Mbalmayo and in the nearby rural village of Olama, within the equatorial forest zone of Cameroon. Mosquitoes were captured when landing on human volunteers and by pyrethrum spray catches. Malaria vectors captured were Anopheles gambiae Giles (M and S forms) and A. moucheti Evans in both areas, together with A. funestus Giles in Mbalmayo. One A. marshallii (Theobald) specimen infected by Plasmodium falciparum was found in Olama. Anopheles moucheti was the most abundant anopheline species caught in Olama, while A. gambiae was the most abundant in Mbalmayo. All these vectors were highly anthropophilic as indicated by the fact that only 5 of 201 blood meals analysed had been taken from non-human hosts. Plasmodium falciparum was the only malaria parasite species found in Mbalmayo, while P. malariae was also found in Olama. The annual entomological inoculation rate was estimated at 129 infective bites/person/year in Mbalmayo and 322 in Olama. Comparison with data published in 1955 from Mbalmayo, before expansion of the town, showed the impact of urbanization on the composition of the vector system and malaria transmission dynamics. Such changes should be considered when implementing sustainable control measures.     

城市对海口市南渡江的微生物群落及其毒力因子与抗生素耐药基因组的影响

目的探讨河流流经海口市前后河水中细菌菌群结构、抗生素耐药基因组和病原菌毒力基因组的变化, 及其传播扩散模式。方法从流经海口市前的南渡江上游至南渡江入海口划分前、中、后段3个研究区域, 每个区域选择3个采样点, 每个采样点平行采集6份样本并混合为1份, 每份3 L。通过宏基因组测序和16S rRNA基因全长测序获得相关生物信息数据, 分析前、中、后3段水体中微生物群落结构以及耐药基因、毒力因子和可移动遗传元件信息。运用主坐标分析、普氏分析和曼特尔检测等方法分析样本间菌群分布差异以及传播模式相关性。结果随着河水流经海口市, 微生物的α多样性呈现逐渐降低趋势。其中变形菌门在前、中、后段的细菌群落中均占据主导地位, 中、后段变形菌门相对丰度高于前段。抗生素耐药基因、毒力因子及可移动遗传元件的多样性和丰度在前段均处于较低水平, 流经海口市后, 均明显升高。同时, 可移动遗传元件介导的水平传播在抗生素耐药基因和毒力因子扩散中发挥较大作用。结论城市化对河流中的微生物及其携带的耐药基因、毒力因子和可移动遗传元件产生显著影响。在海口市南渡江, 河流流经城市受纳了人群排出的抗生素耐药菌和病原相关细菌, 同...     

Urbanization and systolic/diastolic blood pressure from a gender perspective: Separating longitudinal from cross-sectional association

There has been a generally negative view of the impact of urbanization on a rising burden of non-communicable diseases including cardiovascular disease. However, the evidence on the relationship between urbanization and cardiovascular health has remained inconclusive. A comprehensive picture of the relationship is lacking, given an implicit assumption that the longitudinal association between changes in cardiovascular health and an increasingly urbanized environment is similar between less and more urbanized communities, men and women. We used the longitudinal data on adults (18–64 years) from the China Health and Nutrition Survey (1991–2015) and employed within-between random-effects models to disaggregates the longitudinal and cross-sectional associations between urbanization and systolic/diastolic blood pressure (SBP/DBP) and examined heterogeneities in the longitudinal association by average urbanization level and gender. We found that the positive longitudinal association of urbanization with SBP/DBP was stronger in less urbanized than more urbanized communities. The cross-sectional association between urbanization and SBP was negative and significant, although the cross-sectional association between urbanization and DBP was of no statistical significance. Moreover, the positive longitudinal association between urbanization and DBP was stronger among men than women, although the gender heterogeneity in the longitudinal association of urbanization with SBP was not significant.     

Comparison of three perioperative fluid regimes for laparoscopic donor nephrectomy

Background Pneumoperitoneum (PP), as used for laparoscopic procedures, impairs stroke volume, renal blood flow, glomerular filtration rate and urine output. This study investigated whether perioperative fluid management can abolish these negative effects of PP on hemodynamics. Methods Twenty-one patients undergoing laparoscopic donor nephrectomy (LDN) were randomized into three groups: group 1 received overnight infusion and received a bolus of colloid before induction of anesthesia, followed by a bolus just before PP; group 2 received overnight infusion and a colloid bolus before anesthesia; group 3 served as controls and received only infusion during operation. All three groups received the same total amount of crystalloids and colloids until nephrectomy. Data analysis of the donor included; mean arterial pressure (MAP), stroke volume (SV), left ventricular ejection time (LVETc), perioperative urine output and renal function measured as the creatinine clearance (CrCl) until one-year post-operative. Results SV was significantly higher in group 1 compared to controls for all measurements. In the control group SV significantly decreased after changing from the supine to lateral position whereas there was no change in SV in both pre-hydrated groups. In all groups, MAP decreased after induction of anesthesia, and restored to pre-anesthetic values during PP. CrCl decreased in the control group during PP, but not in the other groups. From two days postoperative, CrCl was comparable between the three study groups. Conclusion Overnight infusion and a bolus of colloid just before PP attenuate hemodynamic compromise from PP. This study was performed at the Department of Anesthesiology, Erasmus University Medical Center Rotterdam and was financially supported by this Department     

Epidemiological aspects of cutaneous leishmaniasis in the Iguazú falls area of Argentina

Over the last three decades the incidence of American cutaneous leishmaniasis (ACL) has increased sharply in Argentina and throughout the world. In the Iguazú Falls area, on the border between Brazil and Paraguay, the incidence of human ACL has risen since 2004. Most of the 36 cases of human ACL reported until 2005 have involved males over 15 years old (75%) infected during deforestation to establish individual farms. Captures carried out in primary forest, periurban areas, and deforested land sites yielded 18,438 sand flies belonging to 13 species; the most prevalent species were Lutzomyia (Nyssomyia) whitmani (87.4%) and Lutzomyia (Mygonemyia.) migonei (7.6%). Cluster analysis was used to group traps according to species and abundance of sand flies. The group of traps located in recently deforested places, in pig and chicken dwellings of houses where ACL cases had been reported in the past, and at one house with an active ACL case, had the highest abundance of Lu. whitmani and Lu. whitmani + Lu. migonei as well as the highest ratio of Lu. whitmani/Lu. migonei. Leishmania sp. infections, both in Lu. whitmani, in Lu. quinquefer, and in smears from human cases were detected by DNA kinetoplast amplification using a generic PCR protocol. The risk of ACL outbreak in the Iguazú Falls area is still associated with economic and leisure activities in primary-secondary forest, including deforestation, rural settlements, fishing, hunting, and ecotourism. In addition, the risk of periurban transmission seems likely, and this is discussed within the framework of surveillance and prevention strategies.     

长江经济带建设战略下血吸虫病防治工作思考

长江经济带建设已纳入国家战略,其目的不仅仅是提高全民经济水平,更是以经济性、均衡性、生态性和公平性共同发展,建设一个绿色生态廊道。长江经济带作为血吸虫病流行的主要地区,在进行经济建设时更应严格做好血吸虫病防治工作,促进血吸虫病消除目标顺利实现。本文对长江经济带区域血吸虫病流行现况,以及长江经济带建设对血吸虫病防治工作可能造成的影响进行剖析,并对今后该区域内的血吸虫病防治工作提出一些建议。     

Unexpected spatiotemporal abundance of infected Culex restuans suggest a greater role as a West Nile virus vector for this native species

Difficulties in correctly differentiating Culex restuans mosquitoes from Culex pipiens have left the spatiotemporal mechanisms underlying the epidemiology of West Nile virus (WNV) in the northeastern United States largely unresolved. We performed weekly surveys across a natural to urban gradient of sites in central New Jersey (USA) and used a rapid and cheap DNA extraction and a species-specific PCR assay to create single species pools for WNV testing. To assess seasonal trends we combined these results with WNV surveillance records generated from grouped Cx. restuans/Cx. pipiens pools tested in 2011–2012. Cx. restuans was found to be highly abundant within all sites and reached especially high abundance in urban wetland habitats greatly disturbed by human action. In contrast, the seasonal presence of Cx. pipiens was greatest in residential and urban habitats and its presence in natural areas was minimal throughout the season. WNV infection rates in both species were similar but Cx. restuans was consistently found infected first and more frequently, even as early as May, whereas WNV was first detected in Cx. pipiens in late July. WNV activity peaked during the month of August when WNV was commonly isolated from both species. The peak in WNV activity in August observed for both species was consistent with data from 2011 to 2012 when Cx. restuans and Cx. pipiens were grouped, although analyzing single species pools increased overall predicted infection levels. Our results support the preeminence of Cx. restuans as an enzootic vector of WNV and strongly suggest this species has become a “native invasive” exploiting human modified habitats and reaching very high abundance there. Importantly, high infection rates in disturbed wetland sites with high populations of Cx. restuans suggest this species may enable the introduction of WNV to urbanized environments where both Culex contribute to transmission potentiating disease risk.     

Urban social exclusion and mental health of China's rural-urban migrants – A review and call for research

China's internal rural-urban migrants experience social exclusion that may have significant mental health implications. This has historically been exacerbated by the hukou system. Echoing recent calls for interdisciplinary research on the interdependencies of urbanization and mental health, this review examines evidence of rural-urban migrants’ mental health status in comparison with nonmigrants and its association with various dimensions of social exclusion. We found conflicting evidence on the mental health status of migrants in comparison with nonmigrants, but strong evidence that social exclusion is negatively associated with migrants’ mental health: limited access to full labour rights and experience of social stigma, discrimination and inequity were the most significant factors. We discuss the limitations of current social epidemiological research and call for an attempt to use close-up, street-level ethnographic data on the daily experience of being a migrant in the mega-city, and describe our aim to produce a new sociological deep surveying instrument to understand migration, urban living, and mental health.     

Permanent Hearing Loss among Professional Spice Grinders in an Urban Community in Southwest Nigeria

This study set out to determine the pattern and predictors of noise-induced hearing loss (NIHL) among small-scale and self-employed chili pepper grinders in Lagos, Southwest Nigeria. Audiological evaluation was conducted for all participants after noise level measurement. Of 136 studied, 85 (62.5%) were confirmed with slight-to-moderate NIHL. Mean age was 40.2 years, mean years spent as grinders was 9.3 years and mean hours spent daily at work was 13.3 hours. The mean age of those with NIHL was significantly higher than those without. Spending over 10 years in commercial grinding and working ≤12 hours daily were predictive of NIHL. Questionnaire-based screening using symptoms of NIHL was associated with a sensitivity of 44.7%, specificity of 62.7%, and positive predictive value of 66.7%. In conclusion, pepper grinding is associated with high/excessive noise levels and NIHL. Hearing conservation program incorporating engineering modification of locally fabricated grinders is warranted in this and similar populations in developing countries.