杭州市某社区老年高血压患者脉压差对血压影响的相关调查

目的调查社区老年高血压患者脉压差对血压的相关影响。方法对杭州市下城区天水武林社区所辖老年高血压413例进行调查,根据脉压差是否大于60 mmHg分为两组,比较两组患者肾功能不全、脑卒中和冠心病的发生情况,及两组患者体重、年龄、家族史等情况。结果脉压差大于60 mmHg的患者中发生肾功能不全、脑卒中及冠心病的比例显著高于脉压差小于60 mmHg的患者(P0.05),脉压差大于60 mmHg的患者中存在家族史、体重指数超过26及年龄超过75均显著高于脉压差小于60 mmHg的患者(P0.05)。结论脉压差增大的高血压患者更易出现肾功能不全、脑卒中及冠心病等并发症,有高血压家族史、体重指数超标、年龄偏大是脉压差增高的危险因素,应提高临床重视,重点进行预防干预。     

脉压对心脑血管疾病的影响

目的　探讨高血压病患者脉压对心脑血管疾病的影响。方法　收集 94 1例高血压病患者临床资料 (包括年龄、性别、脉压、合并心脑血管疾病的情况 ) ,进行统计学分析。结果　 (1)在≥ 6 0岁年龄组 :脉压 >4 0mmHg合并高血压心脏病 (CHD)的百分比小于脉压≤ 4 0mmHg组 ,P <0 .0 5 ;(2 )在 <6 0岁年龄组 :脉压 >4 0mmHg合并脑出血的百分比大于脉压≤ 4 0mmHg组 ,P <0 .0 1,而合并高心病的百分比小于脉压≤ 4 0mmHg组 ,P <0 .0 5。结论　脉压可作为预测高血压病患者心脑血管事件 (如高心病、脑出血、冠心病 )的危险因素     

缺血性和出血性脑卒中危险因素分析

目的分析缺血性和出血性脑卒中发病的危险因素。方法回顾性分析2014年5月至2016年5月该院收治的脑卒中患者120例的临床资料,将出血性脑卒中患者设为观察组(n=60)、缺血性脑卒中患者设为对照组(n=60)。对比两组临床指标、影响因素分布,分析其发病的独立危险因素。结果观察组舒张压(SBP)、收缩压(DBP)、纤维蛋白原(FIB)、尿酸高于对照组,甘油三酯(TG)、高密度脂蛋白(HDL-C)低于对照组,差异均有统计学意义(均P0.05);观察组高血压、高血糖比例分别为85.00%、21.67%,高于对照组的61.67%、6.67%,差异均有统计学意义(均P0.05);观察组年龄60岁、脉压增大、吸烟、肥胖、高尿酸血症、高FIB血症、高TG血症、高胆固醇血症、低密度脂蛋白(LDL-C)胆固醇血症、HDL-C胆固醇血症、房颤、脑卒中史比例低于对照组,差异均有统计学意义(均P0.05);经Logistic回归分析,年龄60岁、高血压、肥胖、高尿酸、高TG、脉压增大、房颤、脑卒中史为脑卒中发病的独立危险因素(P0.05),其中与出血性脑卒中显著相关的因素为高血压,与缺血性脑卒中显著相关的因素为房颤、肥胖、高甘油三酯、脑卒中史、脉压增大、年龄60岁、高尿酸。结论出血性脑卒中与缺血性脑卒中危险因素存在一定差异,临床应根据患者具体病情采取适当预防措施,缓解疾病发作。     

原发性高血压及高血压脉压差增大患者肱动脉血管内皮依赖性舒张功能超声研究

目的探讨原发性高血压及高血压脉压差增大患者血管内皮舒张功能的改变.方法采用彩色多普勒高频超声对45例原发性高血压患者(A组)、45例高血压脉压差增大患者(B组)及45例正常血压(C组)的血管内皮舒张功能,进行检测并对比分析.结果A组 B组和C组比较差异有非常显著性(P＜0.01),A组与B组间亦有统计学意义(P＜0.05).结论高血压患者存在血管内皮舒张功能受损,高血压脉压差增大时内皮功能受损进一步加重.     

脑卒中合并高血压患者社区护理干预的效果观察

目的:分析社区护理干预在脑卒中合并高血患者中的应用效果.方法:挑选76例2016年1月~2017年7月收治的脑卒中合并高血压患者,分为两组,对照组给予常规护理干预,研究组实施社区护理干预,观察两组护理效果.结果:研究组干预后舒张压为(78.1±4.5)mmHg,收缩压为(125.3±5.7)mmHg,与对照组的(89.6±5.3)mmHg和(138.2±6.4)mmHg比较,具有显著性差异(P<0.05).研究组与对照组护理满意度分别为94.74%和73.68%,P<0.05,差异有统计学意义.结论:在脑卒中合并高血压患者中实施社区护理干预,能够有效降低患者血压水平,改善患者生活质量,提升患者满意度,可推广应用.     

煤工尘肺患者脉压与心脑血管疾病的关系

目的探讨煤工尘肺患者脉压(PP)与心脑血管疾病的关系。方法选择2016年1月—2018年12月在国家卫生健康委职业安全卫生中心职业病治疗中心住院的260例煤工尘肺患者作为尘肺组,随机抽取262例某集团井下作业无尘肺工人为对照组,调查职业史、既往史、工龄、年龄、吸烟、饮酒、家族史,同时测量血压、检查心电图、心脏超声。脉压(PP)≥60 mm Hg为增大。结果尘肺组舒张压[(75.62±9.83)mm Hg]水平低于对照组[(83.16±10.29)mm Hg];脉压[(55.86±13.96)mm Hg]水平高于对照组[(51.09±14.79)mm Hg]。两组舒张压、脉压比较,差异均有统计学意义(均P0.05),两组收缩压比较差异无统计学意义(P0.05);尘肺组高血压(44.6%)、冠心病(71.9%)、脑卒中(70.8%)患病率均高于对照组(均P0.05);尘肺组脉压异常率(48.5%)高于对照组(30.5%),差异有统计学意义(P0.05);PP60 mm Hg或PP≥60 mm Hg比较,尘肺组心脑血管发病情况均高于对照组,差异均有统计学意义(均P0.05);PP60 mm Hg或PP≥60 mm Hg比较,尘肺组和对照组患高血压病、冠心病的危险性均随PP水平的增加而增加,尘肺组中不同PP水平尘肺患者脑卒中患病情况比较,差异无统计学意义(P0.05),对照组中不同PP水平工人脑卒中患病率比较,差异有统计学意义(P0.05)。结论煤工尘肺患者PP高于一般群体,且随着PP值水平的增高,高血压病、冠心病的发病率有增加的趋势。     

脉压及年龄与心肌梗死间相互影响的探讨

目的　探讨脉压 (PP)及年龄与心肌梗死间的相互影响。方法　将 4 16例高血压合并 或心肌梗死患者分为 3组 :A组 (10 6例 )为高血压病合并心肌梗死组 ,B组 (14 3例 )为单纯心肌梗死组 ,C组 (16 7例 )为单纯高血压病组 ,并选取同期体检人员作为对照组D组 (96例 ) ,分析 4组人员的PP水平分布状况和对各年龄分组的PP进行比较。结果　 (1)PP最大分布区域 :A组 >70mmHg,占 32 1% ,B、D组均在 4 0～ 4 9mmHg ,分别占 38 5 %和 39 6 % ,C组在 5 0～ 5 9mmHg ,占 31.1%。 (2 )年龄增大 ,PP亦增大 ,6 0岁以上各年龄分组PPA组明显大于B、C组 (P <0 .0 1) ;6 9岁以下C组则明显大于B组 (P <0 .0 1)。结论　 (1)只有高血压病者 (尤其老年人 )的PP独立于其他血压指标与心肌梗死有关 ,且当PP >70mmHg时 ,发生心肌梗死的频率明显增加。 (2 )血压正常者与高血压者心肌梗死时 ,PP范围不同 ,前者的心肌梗死不一定只与高血压及PP有关 (尤其非老年人 )。 (3)增龄与高血压是引起PP增大的主要因素。     

104例脉压与脑卒中关系分析

高血压是脑卒中最主要的独立危险因素[1 ] ,脑卒中危险与血压升高成正比[2 ] 。但脉压与脑卒中关系却鲜见报道。近年来 ,关于脉压与脑血管关系的流行病学调查和临床随访逐渐引起重视[3] 。本研究从脑卒中高血压患者与非脑卒中高血压患者的收缩压、舒张压、脉压来分析脉压与脑卒中的关系。对象与方法1　对象　患者组 :高血压脑卒中随访患者 10 4例。年龄 4 7～ 84 (6 6± 11 4 )岁 ;男性 4 6例 ,女性 5 8例。均经两次以上头颅ＣＴ证实。对照组 :非脑卒中高血压随访患者 (除影响脉压的疾病患者外 ) 90例。年龄 4 5～ 80 (6 3± 13 1)岁 ;男性 …     

高血压病患者动态脉压与左心室肥厚的相关性研究

目的探讨高血压病患者动态脉压和主动脉根部内径(AOD)与左心室肥厚(LVH)之间的相互关系。方法对240例高血压病患者分别进行24 h动态血压监测和超声心动图检查。根据左心室心肌质量指数(LVMI),男>120 g/m2、女>110 g/m2作为左心室肥厚的标准,分为左心室肥厚组(94例)和无左心室肥厚组(146例)。结果24 h平均脉压、白昼平均脉压、夜间平均脉压和AOD在高血压左心室肥厚组和无左心室肥厚之间差异均有统计学意义(P<0.05)。经多元回归分析结果显示:夜间平均脉压和AOD与LVMI的关系最密切(P<0.001)。结论AOD和脉压、尤其是夜间平均脉压增大在LVH中起主要决定因素。     

海捷亚对原发性高血压患者脉压及左室重量的影响

目的探讨海捷亚对原发性高血压患者脉压及左心室重量的影响。方法68例原发性高血压患者随机分为两组治疗组给予海捷亚每日1片治疗;对照组给予依那普利10mg,每日1次。治疗前后通过24h动态血压(ABPM)及超声心动图分别检测两组患者脉压(PP)及左室重量指数(LVMI),对比其治疗前后的变化。结果治疗后两组患者脉压(PP)及左室重量指数(LVMI)均较治疗前降低(P<0.05)。治疗组与对照组比较,两者有显著性差异(P<0.05)。结论海捷亚能显著降低原发性高血压病患者的脉压及左室重量指数。     

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.