内皮型一氧化氮合酶基因与年龄、吸烟的交互作用

目的 探讨内皮型一氧化氮合酶（eNOS）基因第7外显子G894T（Glu298 Asp）变异与年龄、吸烟之间交互作用在冠心病患病中的意义。方法用病例一病例研究设计，以新诊断的冠心病患者为研究对象，用聚合酶链反应-限制性片段长度多态性分析法（PCR-RFLP）检测eNOS基因G894T变异，运用单因素及多因素Logistic回归分析eNOS基因G894T变异与年龄、吸烟之间的交互作用。结果eNOS基因G894T变异与年龄之间在冠心病的患病中存在显著的相乘模型交互作用，且该交互作用具有显著的剂量-反应关系；eNOS基因G894T变异与吸烟之间在冠心病的患病中无显著的相乘模型交互作用。其交互作用也无显著的剂量-反应关系。结论eNOS基因G894T变异可增加低年龄者冠心病的患病的患病危险性；且年龄越低，eNOS基因G894T变异对冠心病的患病危险性越高。     

内皮型一氧化氮合酶基因G894T变异与超重和高血压的关系

目的 探讨内皮型一氧化氮合酶(eNOS)基因第7外显子G894T变异与超重在高血压患病中的意义。方法 在人群中筛检出未经药物系统治疗的116例高血压患者及136名血压正常者为研究对象;运用PCR-限制性片段长度多态性检测G894T变异;用相加模型分析G894T变异与超重之间的交互作用;用人群归因危险度百分比(PAR％)反映人群中的病因分值。结果 G894T变异与超重对高血压患病具有正交互作用;归因交互效应为1．99;归因交互效应百分比为30．76％;纯因子间归因交互效应百分比为36．38％。用多元logistic回归分析调整年龄、性别、吸烟指数及饮酒指数后,G894T变异与超重对高血压患病仍具有正交互作用。调整上述混杂因素后,归因交互效应为2．85;归因交互效应百分比为39．97％;纯因子间归因交互效应百分比为46．49％。在给定条件下计算的PAR％约为15％。结论 eNOS基因第7外显子G894T变异与超重之间的交互作用在该研究人群高血压患病中具有重要意义;在仅仅对具有G894T。变异与超重同时存在的部分人群中控制超重可明显降低一般人群高血压的患病率。     

高血压患者eNOS基因变异与饮酒间交互作用

目的：探讨丙皮型一氧化氮合成酶（eNOS)基因第7外显子G894T（Glu298Asp)变异与饮酒之间交互作用在高血压患病中的意义。方法：以某工厂人群中筛检出的、未经药物系统治疗的116名高血压患及136名血压正常对研究对象；运用PCR－限制性片段长度多态性检测G894T变异；用相加模型分析G894T变异与饮酒之间的交互作用；用人群归因危险度百分比计算人群中的病因分值。结果：G894T变异与饮酒之间对高血压患病具有正交互作用；归因交互效应为3．69；归因交互效应百分比为48．68％；纯因子间归因交互效应百分比为56．08％。用多元Logistic回归调整年龄、性别、吸烟、体重指数后，G894T变异与饮酒之间对高血压患病仍具有正交互作用。调整上述混杂因素后，归因交互效应为1．13；归因交互效应百分比为19．09％；纯因子间归因交互效应百分比为22．97％。在给定条件下计算的人群归因危险度百分比约为10％－15％。结论：eNOS基因G894T变异与饮酒之间交互作用在该研究人群高血压患病中具有重要意义；在仅仅对具有G894T变异与饮酒同时存在的这一小部分人群中控制饮酒可明显降低一般人群高血压患病危险。     

内皮型一氧化氮合成酶基因G894T变异与早发冠心病的关系

目的 探讨内皮型一氧化氮合成酶基因第7外显子G894T变异(Glu298Asp)与早发冠心病之间的关系。方法 以医院为基础的病例对照研究，选择新诊断的冠心病患者为研究对象。男性55岁以前及女性65岁以前患冠心病为早发冠心病。以132例早发冠心病患者为病例组，172例迟发冠心病患者为对照组。运用PCR-限制性片段长度多态性检测G894T变异。结果 G894T变异基因型频率早发冠心病组(TT、GT、GG频率分别为6.06％、20．45%、73．48%)显著高于迟发冠心病组(TT、GT、GG频率分别为1.74％、11.63％，86.63％)(P=0.01)。T等位基因频率早发冠心病组(16．29％)也显著高于迟发冠心病组(7．56%)(P=0.001)，OR=2.38，95％CI：1.38～4.16。在α=0.05显著性水平上，用多元逐步非条件logistic回归调整性别、吸烟、饮酒、超重后，G894T变异对早发冠心病仍具有显著影响(P=0.01)，OR=2.25，95％CI：1.19～4.26。结论 eNOS基因G894T变异可能是早发冠心病发病的重要危险因素之一。     

基因与环境因素的交互作用对老年高血压患病的影响

目的探索KCNMB1 E65K、eNOS G894T及BDKRB2-58T/C 3个基因型与环境因素对老年人群原发性高血压的影响,为防治提供依据。方法对病例组与对照组进行问卷调查,对DNA基因型检测结果进行分析。结果超重、肥胖、高血压家族史以及eNOS基因G894T多样性,是高血压病患病的影响因素,其中BMI与高血压病家族史间存在相加交互作用,BMI与eNOS基因G894T多样性间对高血压病的患病存在相加交互作用。结论合并多个危险因素的老年人群,更应注意日常行为习惯,以便早期预防高血压病。     

超重肥胖及年龄对高血压患病的交互作用分析

目的 探讨超重肥胖及年龄与高血压患病的关系，以及两者对高血压患病的交互作用。方法 采用χ²检验和logistic回归模型，探讨超重肥胖及年龄与高血压患病的关系；采用相加交互作用模型，通过相加交互超额相对危险度(the relative excess risk of interaction, RERI)、归因比(the attributable proportion due to interaction, AP)和交互作用指数(the synergy index, SI),探讨两者对于高血压患病的交互作用及其强度。结果 本研究纳入1 215名调查对象，高血压患病率为33.17%,其中≥60岁人群为67.85%。对相关因素进行调整后，年龄≥60岁的高血压患病风险是<60岁的8.56倍(95%CI:6.39～11.47),超重肥胖者的高血压患病风险是非超重肥胖者的2.13倍(95%CI:1.64～2.76)。在调整相关混杂因素后，<60岁超重肥胖、≥60岁非超重肥胖、≥60岁超重肥胖人群的高血压患病风险，分别是<60岁非超重肥胖人群的3.14倍(95%...     

高血压家族史和受教育程度交互作用对高血压患病的影响

目的探究高血压家族史与受教育程度交互作用对高血压患病的影响。方法采用多阶段整群随机抽样方法,于2016年对昆山市18~69岁常住居民进行问卷调查与体格检查。样本数据通过复杂加权后估计高血压患病率。采用非线性混合模型估计交互作用指数(Synergy Index,S)、交互作用相对超额危险度(Relative Excess Risk of Interaction,RERI)及归因交互效应百分比(The Attributable Proportion Due to Interaction,AP)来评价相加交互作用。结果有效调查8 529人,加权后高血压患病率为16.28%(95%CI:15.18%~17.37%),其中男性为19.47%(95%CI:17.72%~21.22%),女性为13.59%(95%CI:12.21%~14.97%)。不仅有高血压家族史(OR=1.12,95%CI:1.11~1.14)和低教育程度(OR=1.09,95%CI:1.07~1.12)与高血压患病存在统计学关联;且两者相乘交互效应的参数估计值有统计学意义(P=0.0002)。未发现低教育程度和有高血压家族史相加交互作用与高血压患病有统计学关联(RERI=-0.636,95%CI:-1.236~-0.037;AP=-0.333,95%CI:-0.712~0.046;S=0.589,95%CI:0.331~1.048)。结论昆山市常住居民中高血压较为流行,有高血压家族史和低教育程度与高血压患病存在关联,未发现两者相加交互作用与高血压患病有统计学关联。     

性别与高血压交互作用对铁路企业职工空腹血糖受损的影响

目的 探究性别与高血压交互作用对铁路企业职工空腹血糖受损(impaired fasting glucose,IFG)的影响。方法 以甘肃省某铁路企业59 112名有2020年健康检查数据的职工为研究对象，采用2×4叉生分析表获得性别与高血压对IFG各自主效应及交互效应，基于相加模型计算交互作用相关指标，包括交互作用超额相对危险度(RERI)、交互作用归因比(AP)和交互作用指数(S)，通过交互项哑变量二元logistic回归获得协方差矩阵，输入Andersson编制的公式进行假设检验。结果 该企业检出IFG职工3 772例，总检出率为6.38%，男性检出率为7.3%，女性为2.8%，性别对IFG的单独效应OR01(95%CI)为2.444(2.137～2.795)；高血压对IFG的单独效应OR₁₀(95%CI)为3.326(2.554～4.332)；性别与高血压对IFG的联合效应OR₁₁(95%CI)为6.208(5.408～7.125)，性别与高血压对IFG存在相加交互作用，RERI(95%CI)为1.437(0.586～2.288);S(...     

长链非编码RNA及与环境因素交互作用对冠心病患病的影响

目的探讨外周血白细胞长链非编码RNA(long noncoding RNA,lncRNA)和环境因素在冠心病患病中的作用。方法采用病例-对照研究的方法,利用分层随机抽样的方法于2015年3月至2017年12月在福州市某医院收集冠心病病例和健康对照,进行问卷调查、健康体检和实验室检测。采用实时荧光定量PCR方法检测lncRNA(NR_027032、NR_047116和NR_104181)在病例组和对照组中的表达情况。采用多因素Logistic回归模型、叉生分析等分析环境因素和lncRNA在冠心病患病中的联合及交互作用。结果病例组外周血白细胞中NR_027032、NR_047116和NR_104181的表达水平低于对照组(P0.05);多因素Logistic回归分析结果显示,NR_027032、NR_047116和NR_104181低表达可增加冠心病患病风险。叉生分析结果显示,超重与NR_047116低表达同时存在时冠心病患病风险是非超重且无NR_047116低表达的19.053倍(95%CI 5.159～70.361)。超重与NR_047116低表达基于相加模型的交互作用有统计学意义(U=1.999,P=0.046),各评价指标:S=0.598,AP=10.070,RERI=0.629。结论冠心病是环境因素和遗传因素共同作用的结果,NR_047116低表达与超重的联合作用及相加交互作用可增加冠心病的患病风险。     

内皮型一氧化氮合酶基因G894T突变与冠心病危险因素的关系

内皮型一氧化氮合酶 (eNOS)基因G894T突变与冠心病患病风险有关[1 5 ]。我们应用聚合酶链反应 限制性片段长度多态性 (PCR RFLP)分析 ,检测了一组浙江地区冠心病患者eNOS基因G894T突变 ,并调查冠心病经典危险因素 ,旨在探讨eNOS基因G 894T突变和冠心病危险因素的关系。1.对象与方法 :( 1)研究对象 :冠心病患者 10 6例 ,选自 2 0 0 0年 4月至2 0 0 1年 1月浙江大学医学院附属第二医院心内科病房。病例符合 1979年WHO关于缺血性心脏病的命名和诊断标准。本组冠心病患者年龄为 ( 65± 10 )岁 ( 3 9～ 86岁 ) ;男 74例 ,女3 2例 ;其…     

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.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.