喂养方式与1～3月龄婴儿血清锌铜含量的观察

本文比较了母乳和牛乳两种不同喂养方式的1～3月龄婴儿的血清锌铜含量。86名成都市区婴儿(1～3月)经配对后分为母乳喂养组和牛乳喂养组。两组婴儿生后一直采用同一种方式喂养。结果母乳组婴儿血清锌含量为15.47±3.95μmol/L,血清铜为17.27±6.36μmol/L。牛乳组血清锌为13.57±4.21μmol/L,明显低于母乳组(P<0.05);血清铜为17.21±6.20μmol/L,与母乳组差异无显著性(P>0.05)。母乳组锌摄入量(mg/d)从1～3月分别为2.35±0.71,1.47±0.61,0.86±0.17,均低于牛乳组(3.82±1.22);母乳组铜摄入量(mg/d)从1～3月分别为0.29±0.11,0.18±0.07,0.15±0.04均高于牛乳组(0.10±0.07)。两组婴儿的血清锌铜含量与乳汁锌铜摄入量间无相关性。结果提示:婴儿早期的锌营养状况与喂养方式有关。母乳喂养儿的锌营养状况优于牛乳喂养儿,可能与母乳锌的生物利用度较好有关。而婴儿早期的铜营养状况与喂养方式关系不大,可能主要依赖于体内的铜储存量及其动用。     

喂养方式对婴儿早期碘营养状态的影响

【目的】了解不同喂养方式对婴儿早期碘营养状态的影响。【方法】在非碘缺乏地区的上海随机选取68名母乳喂养儿和54名配方乳喂养儿进行观察性研究。分别于婴儿日龄42 d和90 d时测定其母乳或配方乳中的碘浓度,以及婴儿尿中的碘浓度,对乳母进行48 h回顾性膳食问卷调查。【结果】①母乳和配方乳喂养婴儿在42 d和90 d日龄时的尿碘浓度(中位数)分别为197.9、115.4μg/L和219.2、140.1μg/L;②母乳和配方乳的乳碘浓度(中位数)分别为109.14μg/L和88.9μg/L(P<0.01);③乳母膳食碘摄入量(中位数)为194.05μg/d,<200μg/d的占52.2%;④乳母膳食碘摄入量与母乳碘浓度呈正相关(r=0.558,P=0.000)。【结论】①母乳喂养婴儿的碘营养状态优于配方乳喂养的婴儿,积极鼓励母乳喂养;②母乳中的碘含量高于配方乳中的碘含量;③部分乳母膳食碘摄入不足。     

肥胖儿童血浆瘦素水平与早期喂养方式关系的研究

【目的】观察学龄前肥胖儿童血浆瘦素水平与婴儿早期喂养方式之间的关系。【方法】用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)对40例3~6岁的单纯性肥胖儿童及按性别、年龄1∶1配对的40例正常儿童进行了血浆瘦素水平检测,并通过查询儿保门诊记录及询问母亲或主要扶养人确定婴儿6个月内喂养方式及断奶月龄。【结果】肥胖儿童血浆瘦素水平[(2 2.2 6±2.3 0)μg/L]显著高于正常儿童[(3.3 6±0.2 3)μg/L](P<0.001);肥胖组儿童在婴儿早期的母乳及混合喂养率(30.0%)明显低于正常组(80.0%)(P<0.001)。喂养方式与血浆瘦素的关系显示,母乳及混合喂养组血浆瘦素水平[(10.22±1.56)μg/L和(11.30±1.28)μg/L]均较人工喂养组[(15.19±1.15)μg/L]降低(P<0.05),母乳喂养持续时间与儿童体质指数(body mass index,BMI)及血浆瘦素水平之间均呈显著负相关。【结论】婴儿期母乳喂养可以降低儿童期血浆瘦素水平,有助于预防肥胖的发生。     

新生儿血清瘦素水平与喂养方式间的关系研究

目的:测定母乳及配方乳中瘦素含量,比较不同喂养方式对足月新生儿血清瘦素水平的影响。方法:采用放射免疫分析法测定足月新生儿血清、母乳及配方乳中的瘦素水平。结果:①66例健康足月儿生后第3、7、28天其母乳中的瘦素水平分别为(1.31±0.67)μg/L、(1.33±0.14)μg/L、(1.26±0.98)μg/L,产后不同日龄母乳中瘦素水平差异无统计学意义(F=1.78,P>0.05)。配方乳中瘦素水平为0。②母乳喂养组新生儿生后第3、7、28天血清中瘦素水平分别为(2.45±1.04)μg/L、(3.38±1.54)μg/L、(4.98±2.16)μg/L;人工喂养组新生儿生后第3、7、28天血清中瘦素水平分别为(1.23±0.67)μg/L、(1.91±0.31)μg/L、(2.63±1.19)μg/L;两组间血清瘦素水平差异显著(t=1.113,t=3.176,t=2.152,P<0.05)。结论:①母乳中含有一定浓度的瘦素,初乳与成熟乳之间瘦素水平无显著差异,配方乳中未检测到瘦素。②母乳喂养儿血清瘦素水平明显高于人工喂养儿,母乳喂养有利于维持新生儿期血中较高的瘦素水平。     

配方奶和母乳喂养儿第一年瘦素水平和体格发育指标的比较

【目的】研究中国婴儿配方奶喂养和母乳喂养时第一年血清瘦素水平和体格发育指标的差异。【方法】选取配方奶喂养儿45人(其中男24人,女21人),母乳喂养儿51人(其中男27人,女24人)进行对照研究,分别检查6个月和1岁时的血清瘦素浓度和体格发育指标。【结果】①配方组婴儿6个月时身高、体重和体质指数(body massindex,BMI)高于母乳组,但差异无显著性(P>0.05),瘦素浓度则明显低于母乳组(P<0.05);配方组婴儿1岁时体重和BMI较母乳组高,差异且有显著性(P<0.05);配方组身高稍高于母乳组,但差异无显著性(P>0.05),而瘦素浓度在配方组仍明显低于母乳组(P<0.05),但差别有所缩小。【结论】中国婴儿配方奶喂养和母乳喂养时第一年血清瘦素水平和体格发育指标的差异明显。     

母乳前列腺素E_2含量与婴儿生理性腹泻关系及其治疗研究

母乳喂养婴儿常见生理性腹泻,为探索母乳与生理性腹泻的关系,我们应用放射免疫分析法测定了320例产后4个月内健康母乳前列腺素E_2(PGE_2)含量,其均值为0.623±0.417μmol/L,腹泻组143例母乳PGE_2为0.823±0.409μmol/L;非腹泻组177例母乳PGE_2含量为0.375±0。219μmol/L,两者相比P<0.001。提示母乳PGE_2含量过高可能是婴儿生理性腹泻的重要原因。母乳PGE_2含量个体差异明显(0.046～2.823μmol/L),婴儿腹泻次数与母乳PGE_2含量呈正相关(r=0.75,P<0.01)。本文对102例母乳PGE_2含量高婴儿又有明显生理性腹泻者用随机分组法进行治疗观察,治疗组52例哺乳妇女口服消炎痛25mg每日2次,7～10天为1疗程,治疗前母乳PGE_2含量为0.950±0.449μmol/L,治疗后母乳PGE_2为0.409±0.173μmol/L,两者相比P<0.001,有高度显著性差异,同时见婴儿腹泻治愈46例,好转4例,总有效率96.15％。治疗中婴儿无任何副作用;哺乳妇女2例轻微副作用在停药后迅速消失。而安慰剂组50例用药后母乳PGE_2含量及婴儿腹泻均无改变。     

沈阳市工业区儿童体内汞含量调查及分析

【目的】　了解我市儿童体内汞含量并进行国际间比较。　【方法】　铁西区 5 8名 4岁儿童及其母亲尿样、发样 ,采用原子吸收方法检测尿中及发中汞含量。　【结果】　我市工业污染区儿童尿汞全距为 0～ 0 .0 2 1μmol/L ;平均值 ( 0 .0 0 35± 0 .0 0 48) μmol/L ;成人尿汞全距为 0～ 0 .0 2 3μmol/L ,平均值为 ( 0 .0 0 32± 0 .0 0 34) μmol/L ;均低于国内其他城市监测值 ,也低于日本、美国等发达国家的检测值。　【结论】　沈阳市儿童及成人体内汞含量处于正常水平 ;沈阳市工业汞处理达到了国际发达国家水平。     

病毒性心肌炎患儿血清一氧化氮与微量元素锌的变化及临床意义

目的:探讨一氧化氮(NO)和微量元素锌(Zn)在病毒性心肌炎(VMC)中的作用及临床意义。方法:采用比色法、原子吸收分光光度分析法测定42例VMC患儿及23例正常健康儿的血清NO、Zn水平。结果:急性期VMC患儿血清NO含量为(61.35±18.92)μmol/L,较对照组(23.81±5.37)μmol/L、恢复期(33.95±8.86)μmol/L患儿明显升高(P<0.01);而急性期VMC患儿血清Zn浓度为(76.81±11.05)μmol/L,较对照组(116.28±11.76)μmol/L、恢复期(89.75±9.90)μmol/L患儿降低(P<0.01);VMC患儿急性期NO与Zn呈高度负相关(P<0.05)。结论:血清NO、Zn含量变化与VMC的发生发展有关。     

婴儿血铅与母亲血铅和乳铅等因素的相关性研究

目的了解婴儿血铅与母亲血铅和乳铅等因素的相关关系,为防治儿童铅中毒提供参考依据。方法2002年11至12月,采用石墨炉原子吸收光谱法,测定厦门市177名0～11个月的婴儿及其母亲的血铅,并对小儿出生情况及其母亲、家庭环境等相关因素进行问卷调查。结果177例婴儿血铅的几何均值为(0.37±0.15)μmol/L,范围为0.12～1.36μmol/L,≥0.48μmol/L者46例(占25.99%);母亲血铅的均值为(0.50±0.14)μmol/L,范围为0.21～2.38μmol/L;177例中有160例为母乳喂养儿,其中105例采集出乳汁,乳铅的几何均值为(0.17±0.08)μmol/L,婴儿血铅与母亲的血铅和乳铅密切相关,表明母体的铅可以通过乳汁影响到婴儿血铅水平。旧商业区婴儿的血铅、婴儿母亲乳铅水平均高于其他地区,婴儿血铅水平主要与母亲血铅、婴儿月龄和母亲在职等呈正相关关系,而与母亲身高等因素呈负相关关系。结论母乳喂养儿的血铅水平除了与母亲血铅水平相关外,还与乳铅密切相关,因此在婴儿喂养方式的选择和家庭抚育行为方面须引起重视。     

0～6岁儿童骨密度与血清锌、铜、血铅关系的研究

【目的】　探讨 0～ 6岁儿童低骨密度与血清锌、铜、血铅的关系 ,为临床儿童低骨密度的预防提供依据。　【方法】　在本院儿保门诊 ,随机抽取己排除影响骨代谢性疾病的 0～ 6岁儿童 2 0 4名 ,用超声骨密度仪测胫骨中段骨密度 ,根据同年龄、同性别骨密度值的百分位数分成低骨密度组与正常对照组 ,同时测定血清锌、铜及全血铅。　【结果】　低骨密度组平均血清锌水平 ( 12 70 .5± 14 6.0 ) μmol/L低于对照组 ( 13 2 2 .1± 166.0 ) μmol/L ,差异有显著性(P <0 .0 5 ) ;锌缺乏患病率 ( 3 0 %)高于对照组 ( 18%) ,差异有显著性 (P <0 .0 5 ) ;低骨密度组平均血清铜值 ( 14 98.6±2 16.8) μmol/L ,稍低于对照组 ( 15 3 4.4± 2 3 0 .6) μmol/L ,但差异无显著性 (P >0 .0 5 ) ;两组铜缺乏患病率、血铅值、铅中毒患病率差异无统计学意义 (P >0 .0 5 )。　【结论】　 0～ 6岁儿童低骨密度的发生与锌缺乏有关 ,应加强儿童锌缺乏症的预防和治疗 ,以降低儿童低骨密度的发生。     

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.