上海市某社区老年人体质指数与代谢异常关系的调查

[目的]了解上海市湖南社区老年人体质指数(BMI)的分布情况及与高血压、高血糖、血脂紊乱、高尿酸、代谢综合征等患病情况的关系,以便更好地进行干预。[方法]对社区中60岁以上老人进行体检,询问病史,测定身高、体重、血压、空腹血糖、血脂、血尿酸等。[结果]639名资料齐全的老人平均BMI为24.15±3.38,其中男性为24.11±3.15,女性为24.18±3.53。超重、肥胖比例达51.64%,高于体重正常组,男性60～69岁组肥胖比例最高。60岁以上老人高血压检出率在超重和肥胖人群中高达83.40%和87.01%,明显高于体重正常组。血脂紊乱检出率在超重和肥胖人群中高达67.98%和75.33%,高于低体重组和正常体重组;正常体重组女性血脂紊乱检出率高达66.86%,高于同组男性的50.42%。代谢综合征检出率在超重、肥胖人群中分别为35.97%、61.04%,明显高于低体重组和正常体重组。高尿酸血症在肥胖组中达36.36%,高于另3组。高血糖检出率以超重和肥胖组为高。[结论]应加强健康教育,提前控制体重等心脑血管疾病危险因素,以利提高老年人的生存质量。     

某高校教师高血压检出情况及相关因素分析

目的了解高校教师高血压发病情况及其影响因素。方法对全校2 605名教职工进行体检,了解血压、血脂、血糖、体质指数等情况并进行统计分析。结果高血压检出率19.76%,随着年龄增加高血压检出率增高。高血压组血脂异常、肥胖及高血糖的检出率均明显高于血压正常组,差异有统计学意义(P<0.01)。结论高校教师高血压检出率高于全国平均水平,其原因可能与高校教师工作压力、生活方式及代谢综合征有关。     

门诊体检人群代谢综合征检出人员相关特征分析

目的探讨门诊体检人群中代谢综合征患者的发病特征。方法对参加健康体检的101例代谢综合征（根据国际糖尿病联盟全球共识定义诊断代谢综合征标准）患者进行身高、体重、血压、血脂、血糖等指标检测,并与非代谢综合征组相关检测指标进行比较分析。结果代谢综合征组与对照组比较,年龄、收缩压、体质指数、空腹血糖、总胆固醇、低密度脂蛋白明显升高,高密度脂蛋白明显降低,差异有统计学意义（P〈0．05）。两组比较甘油三脂和舒张压无统计学差异。体质指数异常、血糖异常和血压异常在老年组与中青年组间有统计学差异（P〈0．01）。以代谢综合征为因变量,进行非条件多因素Logistic回归分析显示,代谢综合征与年龄、体质指数、空腹血糖3个变量呈正相关,高密度脂蛋白与代谢综合征的危险度呈负相关。结论高龄、体质指数升高、空腹血糖升高是老年患者代谢综合征的危险因素,高密度脂蛋白则是保护因素。     

四川省西昌市汉族人群代谢综合征及其影响因素的病例对照研究

目的探讨四川省西昌市汉族居民代谢综合征及其影响因素,为代谢综合征的防治提供依据。方法采用病例对照研究的方法,以确诊的120例代谢综合征患者为病例组,按照年龄与性别频数匹配确定120例非代谢综合征者为对照组,采用多因素非条件Logistic回归分析代谢综合征的影响因素。结果代谢综合征病例组中代谢异常组分检出率从高到低依次是血脂紊乱(98.3%)、高血压(92.5%)、超重或肥胖(90.0%)和高血糖(33.3%)。文化程度是代谢综合征的独立保护因素(OR=0.461,95%CI:0.234～0.908),而相关疾病家族史是代谢综合征的独立危险因素(OR=3.287,95%CI:1.722～6.275)。结论凉山彝族自治州西昌市汉族人群代谢综合征最常见的组合类型是超重或肥胖+高血压+血脂紊乱,文化程度与相关疾病家族史是代谢综合征的影响因素。     

代谢综合征临床特点及相关因素分析

目的研究成人体检中发现的代谢综合征临床特点及相关影响因素。方法对连云港市第一人民医院体检中心的体检资料进行分析，将研究对象分为对照组和代谢综合征组，通过2组人群体重指数、血液生化指标等比较，用logistic回归分析代谢综合征的影响因素。结果代谢综合征组的患者体重指数、血压、血糖、胆固醇、甘油三酯、低密度脂蛋白明显增高、高密度脂蛋白明显降低。差异有统计学意义（P〈0．05）。logistic回归提示，肥胖、高血压、高血糖、血脂代谢紊乱是代谢综合征危险因素。结论通过体检可发现代谢综合征患者存在不同程度的血压和各项代谢指标的异常，充分说明体检和保健的必要性。     

生命网在代谢综合征干预中的应用

目的评估代谢综合征对心血管事件的影响，探讨生命网模式干预的应用价值。方法将266例患者分为干预组和对照组，干预组运用生命网干预，观察血糖、血压、糖化血红蛋白等危险因素的转归。结果入网1、3、6个月、1a随访，血糖、血压、血脂、体质指数等经干预治疗后明显改善，具有统计学意义（P〈0．05）。结论生命网干预是有效控制肥胖、高血糖、血脂紊乱、高血压等危险组分的治疗模式。     

紫云社区65岁以上老年人代谢综合征患病情况分析

目的分析紫云社区65岁以上老年人代谢综合征(metabolic syndrome,MS)患病情况,为社区居民健康水平的提高提供指导。方法运用中华医学会糖尿病分会(CDS)建议代谢综合征诊断标准对720名65岁以上人群体检结果(体重指数、血压、血糖、血脂)进行分析。计量资料比较采用t检验,计数资料比较采用χ~2检验,P0.05为差异有统计学意义。结果所有研究对象总患病率为18.3%;其中65~69岁组患病率(20.6%)最高,75~79岁组患病率(16.7%)最低,不同年龄组间差异无统计学意义(P0.05);三种相关疾病患病率:高血压(56.9%)高血糖(47.4%)血脂紊乱(34.2%),高血压有随年龄增高的趋势,不同年龄组间差异有统计学意义(P0.01);男性患病率(18.0%)低于女性(18.5%),差异无统计学意义(P0.05);结论社区老年人代谢综合征的防制应引起重视,从控制体重和血压入手,改变不良生活方式,调整膳食结构,降低其患病率。     

某社区代谢综合征相关指标测定分析

目的探讨代谢综合征相关危险因素。方法选取某社区35岁以上居民为研究对象,以问卷调查的形式,调查了解有关血压、空腹血糖、总胆固醇、甘油三酯、体质指数等指标。结果代谢综合征组的血压、空腹血糖、总胆固醇、甘油三酯、体质指数的异常率均明显高于非代谢综合征组(P<0.01)。结论代谢综合征的发生与高血压、高血糖、高胆固醇、高甘油三酯、肥胖(或超重)等因素密切相关。     

中国中老年人群高血压患病影响因素分析

目的了解中国中老年人群高血压患病的影响因素,为采取相应的干预措施提供参考依据。方法收集2015年中国健康与养老追踪调查(CHARLS)中6 366名中老年人群的数据资料,应用多因素非条件logistic回归模型分析中老年人群高血压患病的影响因素。结果调查的6 366名中老年人群中,非高血压者3 622人(56.90%),高血压者2 744例(43.10%);多因素非条件logistic回归分析结果显示,年龄较大、有高血脂史、有高血糖史、中心性肥胖和体质指数较高为中国中老年人群高血压患病的危险因素,女性、在婚、每周有体力活动和每月有社交活动为中国中老年人群高血压患病的保护因素。结论肥胖、超重、有高血脂史和有高血糖史是中国中老年人群高血压患病的主要影响因素。     

老年人肥胖与主要慢性病的关系

目的 分析南京市老年人肥胖与高血压、糖尿病、冠心病、高血脂的关系。方法 2013年4月~12月利用整群随机抽样法抽取南京市某区1 927名60岁及以上的老年人;对其进行问卷调查、体格检查和实验室检测,获取信息,得到完整有效资料1 808份;肥胖用体质指数（body mass index,BMI）和腰围（waist circumference,WC）诊断,采用SPSS 19.0软件进行方差分析、χ2检验、非条件Logistic回归分析,探讨肥胖与血压、血糖、血脂以及主要慢性病的关系。结果 1 808名老年人中慢性病患病人数为1 276（70.6%）人,主要慢性病为高血压、糖尿病、冠心病、高血脂;超重人数为668人,占36.9%,肥胖人数为150人,占8.2%。中心肥胖人数为406人,占比22.5%;肥胖与收缩压、舒张压、空腹血糖、总胆固醇、甘油三脂、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇密切相关（均有P<0.05）;BMI和WC对高血压患病情况有影响（均有P<0.05）。结论 老年人肥胖增加主要慢性病患病风险,肥胖与血压、血糖、血脂密切相关,控制体重是提高老年人健康水平的有效方法。     

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.