医学院校高血压控制状况调查分析

目的了解院校高血压患者的血压控制状况与其它心脑血管病危险的关系,为有效防治高血压提供依据.方法对160 例高血压患者进行随访调查,按照<中国高血压防治指南>和Holloway 的脑血管病循证医学达标模式进行比较.结果参照国家指南标准,经治疗后血压达标率为45%,55%的患者治疗后未达到目标血压;高血脂治疗达标率仅为5.2%,94.8%的患者经过治疗血脂仍超标;高血压患者均伴有不同程度的其它心脑血管病危险,其排列顺序为高血脂、高血糖、高尿酸、冠心病、糖尿病、脑卒中;不能有效降低血压的患者心脑血管病危险明显高于有效降压组,尤其显著高于血压降至理想组.结论有效降血压可明显降低心脑血管病的危险,应严格按相关指南防治高血压.     

医务人员高血压患者治疗的依从性与健康教育

目的：了解医务人员高血压患者的血压控制状况与治疗依从性．以完善健康教育措施。方法：对160例高血压患者进行血压控制与相关心脑血管病危险的随访,并与160例正常对照组共同进行高血压认知和健康生活方式问卷调查。结果：高血压控制率为45％．高血压合并高血脂、高血糖、高血尿酸、肥胖的患者没有得到适当治疗．高血压的认知和掌握健康生活方式调查显示,高血压组逊于对照组。结论：医务人员迫切需要提高自身高血压防治水平。     

内蒙古大学教职工高血压患病情况调查分析

目的了解内蒙古大学教职工群体高血压现状，为该病的防治工作提供科学依据。方法对此特殊人群的高血压患病率、并发并存痰病情况和相关因素以及生活质量进行调查分析。结果该人群高血压患病率为26．02％．高于全国的抽样普查结果；高血压组并发的心脑血管病以及并存的糖尿病、高血脂都高于非高血压组；高血压组的生活质量显著低于非高血压组。结论内蒙古大学教职工高血压患病率较高，重视高血压痛的防治．提高教职工相关的健康知识很有必要。     

199例社区高血压患者规范化管理的效果观察

目的研究高血压患者规范化管理效果。方法根据《中国高血压防治指南2010））对199例高血压患者进行分层分级管理,分别在管理前、管理3年后进行效果观察。结果高血压患者管理3年后与管理前相比,患者的部分危险因素改善明显,具有统计学意义（P〈0．05）,血压分级情况有统计学意义（P〈0．05）。结论对社区高血压患者实施规范化管理,是降低可变危险因素、降低血压级别和提高血压达标率的有效方法。     

高血压、高血脂对颈动脉内膜-中膜厚度改变的影响

目的：探讨高血压、高血脂对颈动脉内膜-中膜厚度改变的影响。方法：将中国人民解放军第二一一医院神经内科2013年收治的患者（共90例）依据中国高血压防治指南2010（修订版）分为高血压组和对照组；依据中国成人血脂异常防治指南（2007）分为高血脂组和对照组。并应用GELOGIQE9型彩色诊断仪进行颈动脉内膜-中膜厚度检查。结果：高血压组IMT增厚或斑块出现情况明显高于正常对照组，具有统计学差异；高血脂组IMT增厚或斑块出现情况也明显高于正常对照组，具有统计学差异。结论：高血压和高血脂确为IMT病理改变最终导致动脉粥样硬化出现的高危因素，提示我们应密切关注自身血压达标情况和血脂情况，定期体检，将心脑血管类疾病的发病风险将至最低。     

中西医结合抗击高血压——独具特色的优势

卫生部2002年的调查表明，我国成年人高血压发病率为18．8％。据此分析我国现有高血压患者超过1．6亿。高血压是心脑血管病最重要的危险因素．而心脑血管病是我国近二十年来死因中的首位。所憾我国在制定有关高血压治疗指南中尚未提及中医或中西医结合的诊治。面对如此严峻形势，对高血压及其相关疾病的防治．     

深圳市社区高血压患者治疗达标情况分析

目的 分析深圳市20家社区健康服务中心管理、随访的高血压患者的治疗达标情况,为临床治疗提供依据. 方法采用纵向前瞻的、有对照的流行病学试验研究方法,通过对社区患者抗高血压治疗2年后血压值的变化,并对患者治疗达标情况进行相关分析. 结果共分析接受社区管理、随访的原发性高血压患者1 000例,其中500例入试验组-规范化治疗管理组(A组),另500例入对照组-常规治疗管理组(B组).2年管理、随访后所有患者的达标率(血压＜140/90 mmHg)达到了47.26%;其中A组患者血压达标率为54.0%;B组患者为40.6%(P＜0.01). 结论遵循"中国高血压防治指南",对高血压患者实施规范化治疗管理-健康教育、生活方式干预和规律用药,对提高社区高血压患者血压达标率有重要意义.     

老年高血压患者健康管理的效果分析

目的通过对老年高血压患者的健康管理,提高高血压患者的血压控制达标率,减少心脑血管事件的发生率及死亡率。方法对高血压患者进行信息化管理,建立健康档案,找准危险因素,进行危险分层,制定个体化的健康计划,实施针对性地健康教育、合理膳食、适量运动、戒烟限酒、心理调适与循证药物治疗等规范化管理,并跟踪随访。结果（1）本人群的高血压患病率为68．15％,其中65．07％为单纯收缩期高血压;（2）通过3年健康管理,观察组高血压患者血压控制达标率提高了10．65％（P〈0．01）,对照组血压达标率差异无统计学意义（P〉0．05）;（3）高血压患者治疗率达到96．68％;经合理调整用药,尼群地平、血管紧张素转换酶抑制剂（ACEI）或血管紧张素Ⅱ受体拮抗剂（ARB）和利尿剂的服用率分别提高了31．25％、32．61％和104．39％（P〈0．01）,硝苯地平服用率下降了66.35％,传统复方制剂服用率下降了36．17％（P〈0．01）;（4）心脑血管事件发生率下降了54．40％．死亡率下降了32．16％。结论通过健康管理,能有效控制老年高血压患者的血压水平,提高血压控制达标率。改善生活质量,降低心脑血管事件的发生率与死亡率。     

中医利水法配合治疗高血压的临床分析

目的：探讨中医利水法对高血压患者治疗的有效性及安全性，为临床治疗提供依据。方法对我院收治的146例高血压患者，参照随机数字表，将患者分为西医治疗组和中医利水组。西医治疗组单纯服用西药降压药进行治疗；中医利水组在服用西药降压药的同时加入中医利水疗法。对146例患者，均进行为期8周的治疗，并在治疗前和治疗后测量血压，记录数值，计算血压降压幅度，并用统计学方法对其进行处理运算。结果治疗后中医利水组的收缩压下降幅度大于西医治疗组（P＜0．05），具有统计学意义。中医利水组显效50人（68．5％），有效21人（28．8％），无效2人（2．7％），总有效率97．3％；西医治疗组显效29人（39．7％），有效39人（53．4％），无效5人（6．8％），总有效率93．2％，中医利水组总有率高于西医治疗组（P＜0．05），具有统计学意义。结论中医利水法配合治疗高血压，可以有效降低血压，维持患者血压的正常值。     

农村高血压患者用药与血压控制分析

目的 了解农村高血压患治疗用药和血压控制情况。方法 问卷调查。结果 患初次确诊用药率为71．3％。半年后停药率达83．96％，只有6．64％坚持长期用药；药物使用以单药为主，复方制剂33．02％，钙拮抗剂22．64％，单药合计55．66％，组合用药占44．34％；用药后一月有记录测血压为41．41％，血压控制达标率59．43％，测当日血压达标率仅为27．36％。结论 农村高血压患坚持用药率和血压控制达标率远低于城市。     

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.