北京市小学生BMI、腰围与代谢综合征的关系研究

目的 探讨儿童肥胖与代谢综合征(MS)的关系,分析体重指数(BMI)和腰围与MS组分的关系.方法 在北京市海淀区的8所学校选取1 928名7～14岁小学生,测量其身高、体重和各MS组分,分析不同营养状况小学生MS组分的差异.采用多元线性回归和Logistic回归模型,分析BMI、腰围与MS组分的关系.结果 除空腹血糖外,血压、血脂、腰围在不同营养状况小学生之间差异有统计学意义(P＜0.05),表现为肥胖组＞超重组＞体重正常组.不同营养状况小学生高SBP、高TG、低HDL-C、中心性肥胖的检出率差异均有统计学意义(P＜0.01),随BMI增加异常率增高.多元线性回归发现BMI和腰围均与除中心性肥胖外的其他MS组分有独立的相关性;除TC外, “腰围”对于其他MS组分的标化回归系数绝对值略大于“BMI”.除DBP外,对于其他MS组分,BMI与腰围同时升高(超重/肥胖且腰围≥P90)的OR值＞BMI和腰围有且仅有一项偏高(超重/肥胖或腰围≥P90)＞体重正常且腰围正常.结论 儿童肥胖与代谢综合征关系密切,联合应用腰围和BMI有利于评估MS风险.     

北京市密云区6～14岁儿童青少年肥胖及相关代谢异常情况

目的调查北京市密云区6~14岁儿童青少年肥胖及相关代谢异常情况,为改善学生营养健康状况,保障儿童健康成长提供指导。方法采用分层多阶段整群随机抽样法,抽取本地区6~14岁中小学生558人作为研究对象进行问卷调查,测定身高、体重、腰围、血糖、血脂等,计算BMI指数,分析肥胖及代谢异常情况。结果本地区558名中小学生检出肥胖110名,肥胖检出率为19.7%。一年级学生肥胖检出率最高,达到26.7%,且男童多于女童;肥胖儿童血脂的异常检出率为34.5%,远高于正常儿童;腰围水平不仅与血清甘油三酯水平呈显著正相关,也与血清高密度脂蛋白胆固醇呈显著负相关,且差异均具有统计学意义(P<0.05)。超重与肥胖儿童每日膳食能量、脂肪的摄取量超标率远远高于正常儿童。结论密云区中小学生肥胖发生率较高,肥胖儿童与脂类代谢异常相关性大,应进行综合干预,制定营养改善策略。     

儿童肥胖的综合干预效果评价与成本效益分析

目的探讨儿童肥胖营养健康教育+运动综合干预的效果,并进行成本效益分析。方法 8所学校1507名小学生分为干预组(n=749)和对照组(n=758),干预措施为营养健康教育+运动的综合方法,干预1年后比较干预前后学生的肥胖相关形态学指标和血生化指标的变化,并进行干预成本效果和成本效益分析。结果干预后干预组男生肥胖检出率较干预前显著下降,干预组腰围、腰围身高比(WHR)、低密度脂蛋白水平显著低于对照组(均P<0.05),超重肥胖学生干预前的腰高比、低密度脂蛋白显著高于正常体重组学生(P<0.05),干预后无统计学差异。成本效益分析表明每下降1kg/m2(BMI)的成本为每人245.01元。结论营养健康教育和增加学生身体活动的综合干预方法可显著降低少年儿童肥胖的发生率,并获得收益。     

北京市小学生膳食营养健康教育效果评价

目的了解北京市小学生膳食营养健康教育的效果,为提出有效的营养干预模式提供理论依据。方法对随机整群抽取的1 242名学生(干预组756名,对照组486名)实施为期1 a的膳食营养干预,并于干预前后进行营养相关知信行调查及身体指标测量。结果干预组学生腰围、腰围/身高比增长低于对照组(P值均<0.05),干预组营养知识、态度得分均高于对照组(P值均<0.05);在营养相关行为中,干预组早餐种类多于对照组,在外就餐次数少于对照组,但差异均无统计学意义(P值均>0.05)。结论以学校为基础的膳食营养健康教育效果明显。     

应用膳食质量指数评价浦东新区部分小学生营养干预效果

[目的]引入膳食质量指数(DQI)评价并改善浦东新区小学生膳食模式,为探讨改善小学生营养状况的方法提供依据。[方法]抽取浦东新区城区和乡镇地区小学各2所小学生1493人,按所在的地域分别分为干预组和对照组,对干预组开展为期1年的营养干预,并对干预效果进行评估。[结果]营养干预后,干预组和对照组比较,城区干预前后油、盐、零食DQI均值,DQI-HB和DQI-DIS均值降低幅度差异有统计学意义。乡镇地区干预前后盐、油DQI均值降低幅度差异有统计学意义。城乡地区干预组小学生营养不良得到改善;城区干预组小学生超重和肥胖得到控制;乡镇地区干预组小学生超重和肥胖上升趋势较对照组有所减缓。[结论]DQI方法能改善小学生膳食模式,控制学生超重及肥胖人数比例。     

延边地区汉族学生肥胖类型与代谢综合征相关性分析

了解青少年肥胖类型与代谢综合征(MS)及其组分的相关性,为有效预防儿童青少年肥胖及相关疾病提供依据.方法 选取2009年延边地区安图县汉族高中毕业生1 095名,全部测量身高、体重、腰围及血压.以人体质量指数(BMI)和腰围身高比值(WHtR)作为不同类型肥胖指标,测定空腹血清三酰甘油、高密度脂蛋白胆固醇及血糖.结果 超重肥胖组的腹型肥胖、高血压、高血糖及MS检出率高于正常组(P值均<0.01),腹型肥胖组的超重及肥胖、高血压、高血糖、高TG及MS检出率高于正常组(P值均<0.05).超重肥胖合并腹型肥胖组的高血压、高血糖及MS患病危险性高于任何单一类型肥胖组,腹型肥胖组的高血压、高血糖、高TG和MS患病危险性高于超重肥胖组.结论 超重肥胖合并腹型肥胖显著增加高血压、高血糖及MS的患病危险,腹型肥胖组的高血压、高血糖、高TG和MS患病危险高于超重及肥胖.联合应用BMI与WHtR可提高对MS及其组分的预测效应.     

北京市东城区14～16岁学生代谢综合征相关症状分析

目的分析北京市14-16岁学生代谢综合征（MS）及流行情况，为成年期疾病的早期预防提供依据。方法选择北京市2042名14～16岁学生，测量身高、体重、腰围和血压并检测血脂和血糖。按照NCHS超重、肥胖BMI分类标准和美国国家胆固醇教育计划成人MS判定标准，观察不同体重组代谢综合征及相关症状流行情况。结果男、女生MS流行率肥胖组（男为12．3％，女为12．0％）显著高于超重组（男为0．6％，女为3．1％），正常体重组无MS发生。男生以中心性肥胖和高血压、女生以中心性肥胖和高密度脂蛋白降低最常见。结论伴随体重增加，MS及各成份异常显著增加。加强对超重肥胖青少年MS指标监测已成为预防心血管疾病的必要措施。     

不同营养状况儿童代谢综合征发生情况分析

目的了解超重、肥胖儿童代谢综合征及其组分的发生情况，为预防儿童肥胖和代谢综合征提供依据。方法选择北京市3所中学和2所小学，根据2005—2006年中小学生身高、体重体检结果进行体重正常、超重和肥胖学生的筛选，对自愿参加的1042名7～15岁学生进行身高、体重、腰围、血压的测量，并采集空腹肘静脉血测定血清总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）和空腹血糖（FPG）。结果除TC在不同体重组女生间差异无统计学意义外（P〉0．05），MS各组分均数在不同体重组男、女儿童间差异均具有统计学意义（P值均〈0．01）。SBP，DBP，WC，LDL—C，TG及FPG水平均为肥胖儿童〉超重儿童〉体重正常儿童，HDL—C水平为肥胖儿童〈超重儿童〈体重正常儿童。除高血糖检出率在不同体重组女生间差异无统计学意义外（P〉0．05），MS及MS各组分异常检出率在不同体重组男、女儿童间差异均有统计学意义（P值均〈0．05），检出率均为肥胖儿童〉超重儿童〉体重正常儿童。结论超重和肥胖儿童较体重正常儿童存在明显的血压、血脂和血糖异常等MS表现。应加强对超重和肥胖儿童MS各组分的检测，防治儿童肥胖，减少MS的发生。     

广州市中小学生超重肥胖与代谢综合征关联性

了解广州市儿童青少年代谢综合征(MS)的流行现况,探讨儿童青少年超重和肥胖与MS的关系.方法 采用整群随机抽样的方法在广州市区抽取7所中小学共1 242名10~17岁的中小学生为研究对象,进行身高、体重、腰围、血压的测量和血液中MS组分的检测,比较不同体质量指数(BMI)组儿童青少年MS组分的水平及异常情况,计算MS患病率.结果 超重和肥胖组儿童青少年的腰围(WC)、收缩压(SBP)、舒张压(DBP)和三酰甘油(TG)水平均高于正常体重组,高密度脂蛋白(HDL-C)水平低于正常体重组,差异均有统计学意义(P值均<0.05).肥胖组的WC,SBP,DBP,TG和HDL-C异常检出率均最高,而正常体重组最低(P值均<0.05).广州市10~17岁儿童青少年MS患病率为2.9%,其中正常体重、超重和肥胖儿童青少年MS检出率分别为1.0%,13.7%和32.4%.结论 超重和肥胖儿童青少年MS患病率显著高于正常体重组,且随BMI增加而增加,预防和控制儿童青少年肥胖和代谢综合征的发生势在必行.     

上海嘉定区中小学生营养知识健康教育干预效果评价

目的 了解嘉定区中小学生营养知识健康教育干预效果,为改善中小学生营养状况提供依据.方法 以简单随机和整群抽样相结合的方法,随机抽取上海市嘉定区13所中学和13所小学学生970名作为研究对象进行干预,干预形式为专题培训,讲座,健康教育大课堂、发放宣传资料、版面巡展、知识竞赛等,0.5a内相同宣传重复2次,2010年2月进行干预前基线调查,2010年9月进行干预的评估调查.结果 膳食指南相关知识知晓率小学生干预前为66.46％,干预后为72.22％;中学生干预前为74.29％,干预后74.02％.小学生平衡膳食与膳食宝塔相关知识知晓率干预前为67.52％,干预后为74.02％;中学生干预前为71.70％,干预后为74.42％;合理营养相关知识知晓率小学生干预前为68.09％,干预后为73.59％;中学生干预前为73.46％,干预后为74.78％.干预后与干预前比较,相关营养知识总知晓率小学生从62.75％上升到69.67％,差异有统计学意义(u=117.87,P=0.000);中学生从70.04％上升到70.27％,差异无统计学意义(u=0.158,P=0.691).结论 宣传、开展健康知识竞赛、下发宣传手册等干预手段,对中小学生膳食营养知识的提高是有效的.中学生干预效果相对小学生较差,是今后健康教育的重点干预方向.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.