2010—2013年南京市成年居民代谢综合征患病情况及流行特征

目的了解南京市成年居民代谢综合征(MS)的患病情况以及流行特征。方法 2010—2013年,采用多阶段分层与人口成比例的整群随机抽样的方法,共调查南京市成年居民4918人。对调查对象进行问卷调查、体格检查和实验室检查,收集调查对象的基本情况、个人健康情况以及身高、体重、腰围、血压、空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇等相关指标。MS患者的筛查采用2009年国际联合暂定声明(JIS)诊断标准。结果 4918名调查对象中有1627人患MS,粗患病率为33.1%,年龄标化患病率为26.3%,男性MS年龄标化患病率为29.0%,女性为24.8%,不同性别之间的年龄标化患病率差异无统计学意义(χ~2=1.352,P=0.245)。不同年龄段(χ~2=132.557,P<0.001)、职业(χ~2=87.572,P<0.001)、文化程度(χ~2=26.077,P<0.001)的调查对象MS患病率间差异均有统计学意义。有高血压(χ~2=26.582,P<0.001)、糖尿病(χ~2=16.013,P<0.001)家族史的调查对象MS患病率更高。结论 2010—2013年南京市成年居民代谢综合征患病率较高。     

昆明市糖尿病流行现状及其特征分析

[目的]了解昆明地区居民糖尿病(DM)患病现状及其特征,探讨糖尿病预防控制策略.[方法]采用多阶段随机抽样方法,随机抽取20岁及以上常住居民5 381人,进行糖尿病流行病学调查,包括问卷调查、体格检查和临床检验,调查居民糖尿病患病情况及其危险因素情况.[结果]调查人群糖尿病患病率为5.76%,按2007年昆明市城乡居民人口构成进行标化,昆明地区20岁及以上人群糖尿病标化患病率为3.99%;其中,男性患病率为6.30%(标化率为3.99%),女性患病率为5.44%(标化率为3.69%),男女性患病率间差异无统计学意义(x2=1.620,P=0.203),不同人群患病率存在差异,主要受年龄、职业、文化程度、经济条件和体重指数的影响.[结论]应根据昆明市不同类型人群特点,开展糖尿病健康教育和预防控制工作.     

北京市海淀区老年人代谢综合征患病现况

[目的]了解海淀区老年人代谢综合征患病现况。[方法]采用等比例多阶段整群随机抽样的方法抽取海淀区60岁以上常住居民440人进行询问调查、体格检查及血液生化指标的测定。[结果]海淀区老年人代谢综合征患病率29.09%,男女性患病率分别为30.32%、28.42%,二者差异无统计学意义(χ2=0.176,P=0.675)。文化程度、体重、血压、血脂水平与代谢综合征患病率有关。糖尿病、高血压、血脂异常患者代谢综合征患病率明显高于非慢性病者。[结论]海淀区老年人代谢综合征患病率较高,积极控制慢性病及其危险因素有助于遏制代谢综合征快速增长的趋势。     

上海市长宁区社区居民代谢综合征患病率调查

目的了解上海市长宁区社区居民代谢综合征患病情况。方法利用2010年全国居民营养与健康状况监测资料,采用多阶段分层与人口比例的整群随机抽样方法,对抽取的上海市长宁区1 104名居民进行医学体检和问卷调查。成人(≥18岁)代谢综合征采用美国国家胆固醇教育计划指南修订(NCEPATPⅢ)定义,儿童与青少年(≤17岁)代谢综合征则采用国际糖尿病联合会(IDF)定义。结果居民代谢综合征粗患病率与标化患病率分别为18.21%、12.02%。男、女标化患病率分别为13.91%、11.22%。在5个代谢综合征指标中,高血压或服用降压药、高空腹血糖或服用降糖药、高甘油三酯、腹型肥胖、低高密度脂蛋白胆固醇的检出率分别为40.94%、35.14%、33.33%、24.12%和11.14%。代谢综合征的患病率随年龄增长有增高的趋势(趋势分析χ2=111.4,P<0.001),30岁以上患病率开始明显增高。结论代谢综合征是影响社区居民健康的重要共公卫生问题,特别是年龄超过30岁的居民。     

重庆市社区居民代谢综合征相关危险因素分析

目的 了解重庆市社区居民代坩综合征(Metabolic Syndrome,MS)的患病情况及主要危险因素,为MS的防治措施提供依据.方法 通过分层整群抽样对9 727名15岁～人群进行调查,计算MS患病率和标化患病率,比较不同年龄、性别的MS及各种代谢异常患病率,应用Logistic回归分析进行MS的危险因素分析.结果 重庆市社区居民MS患病率为9.44%(标化患病率10.12%),男性8.25%(标化率9.03%),女性为10.50%(标化率10.96%),随着年龄的增长患病率呈增加趋势;血脂紊乱、高血压、超重肥胖、高血糖分别为34.95%,22.34%,19.56%和7.09%.多因素Lo-gistic回归分析结果表明,性别(DR=1.40)、年龄增加(OR=1.64)、吸烟(OR=1.39)、经常参加体育锻炼(OR=0.70)、高血压家族史(OR=2.13)、糖尿病家族史(OR=3.20)是MS独立的危险因素.结论 MS已成为重庆市社区居民患病的主要疾病之一,应尽早针对相关危险因素采取预防控制措施.     

广西壮族自治区居民精神分裂症流行病学调查

目的 了解广西壮族自治区≥15岁居民精神分裂症的患病水平和分布特征.方法采用多阶段分层整群随机抽样方法对在广西壮族自治区抽取的6个地级市和10个县共18 219名≥15岁常住居民进行流行病学调查.结果广西壮族自治区居民精神分裂症时点患病率和标化率分别为8.29‰和8.32‰,终生患病率和标化率分别为9.77‰和9.90‰;时点患病率在不同年龄(x2=15.458,P=0.017)、不同文化程度(x2 =8.545,P＜0.001)、不同婚姻状况(x2=75.518,P＜0.001)间差异均有统计学意义;终生患病率在不同年龄(x2=26.293,P=0.001)、不同文化程度(x2=11.614,P=0.009)、不同婚姻状况(x2 =86.947,P＜0.001)间差异均有统计学意义;不同性别、民族和地区居民时点患病率、终生患病率间差异均无统计学意义(P＞0.05).结论广西壮族自治区居民精神分裂症患病率较高,不同年龄、文化程度和婚姻状况居民患病率不同.     

宜春市社区人群代谢综合症流行病学调查分析

[目的]了解宜春市社区20岁及以上居民代谢综合症（MS）的患病情况和流行趋势,为预防和控制MS提供科学依据。[方法]采用分层整群抽样方法对研究对象进行问卷调查和体格检查,并检测血清胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、空腹血糖（FPG）和测量身高、体重、血压。[结果]宜春市社区20岁及以上人群中高血压、高血糖、超重/肥胖和血脂异常的标化患病率分别为18.85%、7.76%、24.60%、30.06%;59.89%的常住居民有MS组分异常,32.88%有MS组分聚集现象,MS的患病率是12.82%;代谢异常患病率均随着年龄的增大患病率逐渐升高,具有两种和两种以上代谢异常者在50岁以上人群中大幅上升,60岁年龄组达到高峰。[结论]代谢异常的患病和MS组分的聚集在本市社区居民中比较普遍,在人群中早期筛检并发现高危人群,及时给予生活行为方式的干预是防治MS的重要手段。     

北京市海淀区居民慢性非传染性疾病患病现况及相关危险因素调查

目的了解北京市海淀区居民慢性非传染性疾病(以下简称慢性病)相关危险因素的现状及主要发生发展趋势。方法采用等比例多阶段整群随机抽样、集中调查和入户调查相结合的方法,调查海淀区18岁以上常住居民的慢性病患病情况及危险因素。结果本次调查共回收有效问卷2 698份,高血压患病率为34.5%(标化率为28.4%),血脂异常患病率为56.4%(标化率为47.7%),糖尿病患病率为9.7%(标化率为7.6%),男、女性各慢性病患病率差异均有统计学意义(均P(0.01),各年龄组患病率差异均有统计学意义(均P(0.01),随年龄组的升高患病率增高。慢性病危险因素水平:肥胖率为17.4%,吸烟率为22.6%,饮酒率为27.3%,缺乏锻炼率为28.4%。结论北京市海淀区居民慢性病患病率较高。应开展全人群的慢性病综合防治和健康教育,在全面监测的基础上进行慢性病规范化管理,使海淀区慢性病患病率及危险因素水平得到有效控制。     

广西城乡居民代谢综合征流行病学特征分析

目的了解广西城乡居民MS患病及其流行病学特征,为制订防治MS对策提供依据。方法采取多阶段随机抽样方法,分别抽取广西4个城市和4个农村共计2 991名15岁及以上城乡居民进行调查,内容包括基本情况问卷调查,对调查对象进行健康体检和实验室生化指标检测。结果代谢综合征(MS)病例100人,城乡居民总体粗患病率为3.3%,标化率为2.1%,其中城市居民MS患病率为5.0%,标化率为3.1%,农村MS患病率为1.8%,标化率0.8%,城市居民患病率显著高于农村(P<0.01);城乡居民均随着年龄增长MS患病率呈上升趋势,其中男性从35岁开始上升,女性从45岁开始上升;35~44岁农村男性MS患病率4.6%,与城市同年龄组男性患病率几乎一致,而且高于农村45岁以上中老年男性居民MS患病率3.3%;城市男女MS患病无明显差异,而农村男性MS患病率显著高于女性(P<0.01);汉族女性居民MS患病率4.4%,显著高于壮族等少数民族1.1%(P<0.01)。结论根据城乡15岁及以上居民MS标化率估计,广西有66.49万MS病人,其中城市32.46万,农村34.03万,MS防治和农村男性青壮年MS高发问题应当引起重视。     

南京市栖霞区2020―2022年≥65岁老年人代谢综合征患病率变化趋势

目的 了解南京市栖霞区≥65岁老年人代谢综合征(metabolic syndrome, MS)患病率的变化趋势及其相关影响因素,为采取针对性的干预措施提供参考依据。方法 采用分层随机抽样,选择2020―2022年在南京市栖霞区参与体检的≥65岁人群为研究对象,分析其MS患病率变化趋势及相关影响因素。结果 2020―2022年南京市栖霞区≥65岁人群的MS总患病率分别为36.72%、35.17%、33.80%,标化患病率分别为36.60%、35.11%、33.67%,呈下降趋势(趋势χ²=41.021,P<0.001);城乡分层后,城市≥65岁人群MS患病率呈下降趋势(趋势χ²=95.499,P<0.001);农村≥65岁人群MS患病率呈上升趋势(趋势χ²=16.237,P<0.001)。结论 南京市栖霞区≥65岁人群MS总患病率2020―2022年虽然呈下降趋势,但依然较高,尤其是农村地区MS患病率呈上升趋势,农村地区女性MS患病率增幅快,应重点关注。     

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.     

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.     

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.     

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.     

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.     

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.