饮酒频率与心血管病高危风险的关联分析

目的探索饮酒频率对心血管病(CVD)高危风险的影响,为限制饮酒预防CVD高危风险提供研究依据。方法本研究数据来源于2016年中国心血管病高危人群筛查与综合干预项目江苏省数据库,采用倾向性得分匹配的最近邻匹配法为每个CVD高危对象匹配一个倾向性得分相近的非CVD高危对象。问卷调查人口社会学信息、饮酒频率和CVD风险因素,并进行体格检查和生化指标测定。采用SPSS 23.0进行t检验、χ~2检验和多因素logistic回归分析。结果共31 605例对象纳入本研究,其中CVD高危对象15 948例,非CVD高危对象15 657例。多因素logistic回归分析结果显示,饮酒将增加CVD高危风险(OR=1.06,95%CI:1.04～1.08);不同饮酒频率比较发现,与从不饮酒相比,饮酒≤1次/月可降低CVD高危风险(OR=0.89,95%CI:0.79～1.00),饮酒2～3次/周(OR=1.14,95%CI:1.00～1.29)和≥4次/周(OR=1.30,95%CI:1.21～1.41)可增加CVD高危风险,均有统计学意义(P0.05,P0.01)。分层分析结果显示,饮酒是男性CVD高危的危险因素(OR=1.05,95%CI:1.03～1.07),却是女性的保护因素(OR=0.87,95%CI:0.82～0.92)。异质性检验结果显示,饮酒频率与CVD高危的关联性在不同性别间存在异质性(P0.01)。交互作用结果显示,饮酒频率与性别在对CVD高危作用中存在交互作用,有统计学意义(P0.01)。结论不同饮酒频率人群的CVD高危发生率呈"U"型分布。性别是饮酒频率致CVD高危的效应修饰因素;饮酒频率与性别在对CVD高危作用中存在交互作用。     

北京市顺义区35～75岁居民心血管病高危人群检出情况及高危预测模型建立

目的 了解北京市顺义区35～75岁居民心血管病(CVD)高危人群检出情况并建立CVD高危预测模型,为CVD的预防控制提供参考依据.方法 于2017年3月-2019年10月采用分层随机抽样方法在北京市顺义区抽取16 520名35～75岁居民进行问卷调查和体格检查,分析CVD高危人群检出情况;应用多因素logistic回归...     

上海市居民心血管疾病高危人群的流行病学特征

【目的】分析上海市8个区的心血管疾病(CVD)高危人群比例、不同高危类型聚集情况及影响因素,为CVD防控提供科学依据。【方法】基于上海市2016—2021年8个国家项目区开展的“心血管病高危人群早期筛查与综合干预项目”资料,纳入35～75岁104 685名常住居民为研究对象。运用R 3.6.1软件进行χ²检验、趋势χ²检验、多因素二元logistic回归分析、多因素无序多分类logistic回归分析。【结果】CVD高危人群占比为19.17%,高血压型、血脂异常型、CVD病史型和WHO评估患病风险≥20%型高危人群占比分别为8.65%、6.33%、5.58%和2.69%。多因素logistic回归分析结果显示,高龄、农民、非在婚者、家庭年收入<5万元、吸烟、饮酒、中心性肥胖、超重、肥胖与CVD高危高风险相关(均P<0.05),高文化程度与CVD高危低风险相关(P<0.01)。CVD高危类型聚集情况方面单独1种、聚集2种和≥3种者分别占81.34%、16.13%和2.54%。无序多分类logistic回归分析结果显示,高龄、农民...     

云南省35～76岁居民心血管病高危风险与健康生活方式的关联分析

目的 分析云南省心血管病(cardiovascular disease, CVD)高危风险的人群特征，并探讨其与健康生活方式的关联，为相关部门制定CVD防控措施提供数据参考。方法 2021年1—12月在云南省“2020年中国居民心血管病及其危险因素监测项目”的现场调查数据，纳入年龄为35～76岁的居民。分析云南CVD高危对象特征及各种类型(WHO评估高风险型、CVD病史型、高血压型、血脂异常型)的分布情况。将7种健康生活方式(不吸烟、不饮酒、蔬菜水果摄入充足、体力活动充足、体重正常、非中心性肥胖、睡眠充足)计1分进行量化，以得分越高为越健康。采用多因素非条件logistic回归模型检验CVD高危人群与健康生活方式得分的关系。结果 共检出CVD高危1 255人(26.3%)。其中高血压型616人(12.9%)、血脂异常型457人(9.6%)、WHO评估高风险型385人(8.7%)、CVD病史型83人(1.7%)。CVD高危人群检出率随着健康生活方式得分的增加而减小(均P趋势<0.001),0～2分的CVD高危人群比例达43.2%(主要为WHO评估高风险型及血脂异常型)。多因素log...     

福建省35～75岁居民心血管病高危人群特征及影响因素

目的 了解福建省心血管病(CVD)高危人群特征及其影响因素,为CVD防控提供依据。方法 2017—2020年采取方便抽样法在福建省10个CVD高危人群早期筛查与综合干预项目点选取35～75岁常住居民120 458人为研究对象,开展问卷调查、体格检查和实验室检测,比较不同特征人群CVD高危检出率并分析其影响因素。结果 研究对象平均年龄56.7±9.8岁,CVD高危检出率为21.4%(25 728/120 458),标化检出率18.5%。Logistic多因素回归分析结果显示,居住地为农村(OR=1.37)、年龄大(≥45岁,OR=2.81)、吸烟(OR=1.09)、饮酒(OR=1.14)和超重/肥胖(BMI≥24.0 kg/m²,OR=2.38)是CVD高危的危险因素;女性(OR=0.91)、文化程度≥高中(OR=0.90)、家庭年收入≥5万元(OR=0.96)和有医保(OR=0.87)为其保护因素。结论 福建省35～75岁居民CVD高危人群检出率21.4%,应关注重点人群并采取针对性干预措施,减少CVD事件发生。     

广州市老城区心血管病高危人群检出情况及其影响因素分析

目的了解广州市老城区心血管病(CVD)高危人群流行情况及其影响因素,为CVD高危人群干预提供参考依据。方法于2017—2018年采取整群抽样方法在广东省广州市某老城区开展35～75岁常住居民心血管病高危人群筛查,包括问卷调查、体格检查和实验室检测并进行心血管病高危人群判定,采用单因素及多因素logistic回归分析高危人群检出的影响因素。结果 4 892名调查对象心血管病高危总标化检出率为15.17%,心血管病史、血压高、血脂异常、WHO10年心血管病患病风险≥20%型标化检出率分别为2.13%、6.68%、6.82%、1.69%。多因素logistic回归分析显示,年龄55～、65～75岁组心血管病高危检出风险高于35～岁组[OR(95%CI)=1.74(1.20～2.53)、2.67(1.82～3.92)],BMI超重、肥胖、现在吸烟、过去12个月饮酒均为心血管病高危检出的危险因素[OR(95%CI)=1.36(1.16～1.60)、1.80(1.43～2.26)、1.35(1.07～1.71)、1.24(1.05～1.47)];而BMI偏瘦为心血管病高危检出的保护因素[OR(95%CI)=0.61(0.38～0.98)]。结论应重点针对社区中老年人群采取体重管理、不良生活方式及血脂异常干预,做好心血管病防控工作。     

江苏省22083名心血管病高危人群健康生活方式的现状分析

  目的  了解江苏省城乡居民心血管病(cardiovascular disease, CVD)高危人群的健康生活方式的分布特征。  方法  在2015-2018年度全国CVD高危人群筛查与综合干预项目江苏省研究数据基础上,分析全省CVD高危人群的健康生活方式状况及其三间分布。  结果  22 083名CVD高危人群中,当前不吸烟、不过量饮酒、健康饮食、积极体力活动、健康体重和健康体脂等健康生活方式的比例分别为79.85%、91.55%、8.31%、25.02%、24.41%和28.24%。全部研究对象健康生活方式评分为(2.57±1.05)分,84.96%的对象同时具有2~4种健康生活方式因素,但所有生活方式因素均健康的个案所占比例仅0.20%。相比而言,女性、低年龄组、农村地区、高文化程度者同时具备≥4项健康生活方式的比例更高(均有P < 0.05)。4种高危类型中,血压高型高危人群的健康生活方式评分最高,为(2.58±1.04)分,CVD患病风险≥20%型的健康生活方式评分最低,仅(2.38±1.04)分。  结论  江苏省CVD高危人群中相关生活方式均健康的比例很低,健康生活方式存在人群和城乡差异,应对高危人群采取有针对的综合干预措施,阻止其由“高危”向“患病”状态转变。     

社区人群综合干预对心血管病高危人群健康状况的影响

目的 评估社区综合干预措施对心血管病（CVD）高危人群心血管健康状况以及CVD相关危险因素的影响。方法 从常州市天宁区红梅街道社区随机抽取257例CVD高危人群纳入干预组,根据年龄、性别进行1∶1匹配,将最终符合条件的257例CVD高危人群作为对照组。比较两组干预前后以及干预后两组间CVD危险因素和心血管病风险评分（LS7）变化情况。结果 本研究共纳入514例CVD高危人群,干预组和对照组各纳入257例,2组CVD高危人群中,年龄、性别、BMI、WC、SBP、DBP、FPG、TC、TG、LDL-C和LS7评分均值差异无统计学意义（均P>0.05）;对照组HbA1c均值低于干预组、HDL-C均值高于干预组（均P<0.01）。干预组对象干预后的BMI、SBP、FPG、HbA1c、TG、LDL-C的均值均低于干预前,HDL-C值和LS7评分高于干预前（P<0.05或P<0.01）。对照组对象常规干预后仅SBP和HbA1c平均水显著低于干预前（P<0.05或P<0.01）;干预后干预组对象的BMI、SBP、DBP、FPG、TC均值均低于对照组（P<0....     

通江县35～75岁居民心血管疾病高危人群调查

目的 分析通江县35～75岁居民不同类型心血管疾病(CVD)高危人群检出情况及影响因素,为制订综合干预策略提供依据.方法 采用多阶段分层整群随机抽样法,于2018-2019年按乡镇、村(居)委会、家庭户分层抽取35～75岁常住居民为调查对象.采用国家心血管病中心编制的电子问卷收集调查对象基本信息,测量身高、体重、腰围和...     

北京市某回族聚居社区成人心血管病高危风险的流行特征分析

目的 评价北京市某回族聚居社区心血管病(CVD)高危风险的流行特征和治疗情况,识别与CVD高危风险相关的个体特征。方法 本研究基于国家心血管病高危人群早期筛查与综合干预项目,在北京市某回族聚居社区于2017-02-22-2019-08-29,使用方便采样的方式纳入年龄在35～75岁的常住居民,调查其CVD高危人群的比例、个体特征以及他汀类、阿司匹林的使用等情况。使用χ²检验比较不同特征人群中CVD高危比率,并对人群中的4种高危类型(心血管病史型、高血压型、高血脂型、预测高危型)进行分析。采用logistic回归模型进行多因素分析评估人群的流行特征与CVD高危风险之间的关系。结果 1 830名调查对象中,平均年龄(60.6±8.6)岁,其中女性1 158名(63.3%),回族559名(30.5%)。CVD高危率为20.8%(381/1 830),标化高危率为18.0%。男性(χ²=14.20,P<0.001)、≥65岁(χ²=22.80,P<0.001)人群高危率增高;接受高等教育(χ²=...     

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.