煤工尘肺患者血清铜蓝蛋白活性与微量元素Cu、Zn相关性的探讨

目的和方法 为探讨煤工尘肺的发病机理,用火焰原子吸收法对48名煤工尘肺患者及40名健康对照者血清微量元素Cu、Zn进行了测定,同时用对苯对苯二胺盐酸盐法测定了血清铜蓝蛋白活性,并对两者进行相关分析。结果 煤工尘肺患者血清铜蓝蛋白活性、血清Cu、Cu/Zn明显高于对照组（P＜0．01）,而血清Zn则明显低于对照组（P＜0．05）。随着煤工尘肺病程的不同,测试指标均有明显改变（P＜0．05）。结论 长期接触煤尘可使血清含铜酶活性改变,且该酶活性改变与体内某些微量元素密切相关。     

煤工尘肺患者血清中可溶性Fas和FasL水平及临床意义

目的探讨煤工尘肺患者血清中可溶性Fas（sFas）和可溶性FasL（sFasL）水平及意义。方法用酶联免疫吸附双抗体夹心法检测52例矽肺患者（矽肺组）、57例煤工尘肺患者（煤工尘肺组）、46例井下健康工人（井下对照组）及40例井上健康人（井上对照组）血清中sFas和sFasL水平。结果分别与井上对照组、井下对照组比较，矽肺和煤工尘肺患者血清中sFas和sFasL水平均明显增高，差异均有统计学意义（P〈0．01）；井下对照组sFas、sFasL均明显高于井上对照组，差异有统计学意义（P〈0．01）；与矽肺组比较，煤工尘肺患者血清中sFas水平升高，差异有统计学意义（P〈0．01），而sFasL水平虽也升高，但无统计学意义（P〉0．05）。矽肺组、煤工尘肺组与单纯Ⅰ期比较，Ⅰ期并发肺气肿、单纯Ⅱ＋Ⅲ期患者血清sFas水平均增高，差异均有统计学意义（P〈0．01），而sFasL水平按尘肺相关指标分组比较均无明显改变。不同接尘时间比较，矽肺和煤工坐肺患者血清中sFas和sFasL水平均无明显改变。sFas、sFasL在矽肺中无相关性，而在煤工尘肺中呈正相关关系。结论矽肺和煤工尘肺患者血清中sFas和sFasL水平异常，sFas和sFasL与尘肺发牛发展过程有关，sFas水平的变化可能预示着尘肺病情的发展变化，检测sFas对鉴别矽肺和煤工尘肺有一定参考价值。     

煤工尘肺患者646例肺通气功能分析

目的探讨煤工尘肺患者肺通气功能的损害情况。方法对646例男性煤工尘肺患者和320例男性接尘工人进行肺通气功能测量并比较。结果各期煤工尘肺患者的肺活量（VC）、用力肺活量（FVC）、第1秒用力呼气容积（FEV1.0）、FEV1.0、FVC百分比、25％呼气中期流速（MEF75％）、50％呼气中期流速（MEF50%）、75％呼气中期流速（MEF25%）、最大呼吸中期流速（MMEF）、最大通气量（MVV）均明显低于对照组，差异有统计学意义（P〈0．01），Ⅰ、Ⅱ、Ⅲ期煤工尘肺患者肺通气功能异常率分别为77．78％、88．54％和100．00％，明显高于对照组，差异有统计学意义（P〈0．01）；Ⅰ、Ⅱ期煤工尘肺患者肺通气功能损害类型主要为阻塞性和混合性，Ⅲ期煤工尘肺患者肺功能损害以混合性为主。结论各期煤工尘肺患者的肺通气功能损伤明显，尘肺患者肺通气功能随尘肺期别增加而降低。     

煤工尘肺患者抑郁焦虑症状分析

目的了解抑郁、焦虑症状在煤工尘肺患者中的发病情况，给予相应的干预治疗，以提高煤工尘肺患者的生命质量。方法通过采用症状自测量表（SCL-90）测评煤工尘肺患者的心理健康状况，从中找出抑郁、焦虑组症候群因子，利用SPSS软件，与对照组及全国常模对比分析。结果煤工尘肺患者抑郁焦虑发病率分别为73．0％和52．0％，明显高于对照组的发病率44．0％和28．0％（均P〈0．01）；煤工尘肺患者抑郁焦虑症状因子（因子4和5）分明显高于对照组和国内常模组，差异有统计学意义（均P〈0．01。结论煤工尘肺患者存在严重心理健康问题，应加强对煤工尘肺患者的心理健康教育和指导及必要的心理治疗。     

双水平无创正压通气治疗煤工尘肺合并呼吸衰竭临床观察

目的 观察双水平无创正压通气（BiPAP）对煤工尘肺合并呼吸衰竭的治疗作用。方法 将56例煤工尘肺合并呼吸衰竭的患者随机分成治疗组（32例）和对照组（24例），比较两组治疗前后血气分析指标及临床症状改善情况。结果 治疗组经无创正压通气治疗后临床症状及血气分析指标恢复正常，呼吸频率下降，心率下降，辅助呼吸肌活动明显减轻和消失，与对照组的血气分析指标及临床疗效比较，差异有显著性（P〈0．01）。结论 双水平无创正压通气在煤工尘肺合并呼吸衰竭的治疗中依从性强，解除呼吸肌疲劳，纠正呼吸衰竭，疗效肯定。     

胃癌患者血清中五种微量元素含量的分析

目的 了解血清中微量元素与胃癌的关系。方法 采用比色法检测54例胃癌患者血清中Cu、Fe、Zn、Ca、Mg等5种微量元素的含量，并与40例正常人及30例胃良性疾病患者进行比较。结果 胃癌患者血清Zn低于正常对照组（P〈0．05），血清Cu、Fe（P〈0．01）明显高于正常对照组，血清Ca、Mg的变化与正常人差别不大（P〉0．05）。结论 胃癌的发生与发展与血清中微量元素的变化有密切关系。     

视力低下中学生头发微量元素含量测定

目的探讨中学生视力低下与体内微量元素含量之间的关系，为预防中学生视力低下提供依据。方法选取视力低下（实验组）和视力正常（对照组）中学生各30名，采用原子吸收分光光度法测定其枕发中锌（Zn）、铁（Fe）、铜（Cu）、钙（Ca）、镁（Mg）、镉（Cd）含量。结果与对照组相比，视力低下者发中Zn，Fe，Ca，Mg含量明显较低，差异有非常显著性（P〈0．01）；Cu含量虽然低于对照组，但差异无显著性（P〉0.05）；Cd含量明显较高，差异有非常显著性（P〈0．01）。结论视力低下与体内Zn，Fe，Ca，Cu，Mg含量偏低有关。     

微量元素与血脂和血糖的相关性

目的研究上海地区成年人全血微量元素与血脂和血糖的关系。方法选择上海地区2个社区18岁以上成年调查对象245名,测定其体内铁（Fe）、锌（zn）、铜（Cu）、镁（Mg）、铅（Pb）、锰（Mn）、镉（cd）等各种元素含量及体重指数（BMI）、腰臀比（WHR）和血压水平,分析上述指标与血脂和血糖之间的关系。结果与正常对照组相比,高脂血症组全血Fe、Mn水平显著降低,Zn、Zn／cu水平显著升高（P〈0．05或P〈0．01）;高血糖组全血Zn、Zn／Cu和Mn水平显著降低,cu和Pb水平显著升高（P〈0．05或P〈0．01）;在高脂血症和高血糖组均存在低Mg高Cd趋势,但差异无统计学意义（P〉0．05）。结论高脂血症和高血糖患者体内大多数微量元素都存在代谢异常,及时纠正微量元素代谢紊乱对高脂血症和高血糖的防治和转归可能具有一定价值。     

糖尿病患者血中相关指标及微量元素改变的研究

目的测定糖尿病患者外周血中CD62p、CD63、CD42a、CD4、CD8、CD3、CDl6＋56和微量元素锌（Zn）、铬（Cr）含量。方法应用流式细胞术测定CD62p、CD63、CIM2a、CD4、CD8、CD3、CD16＋56；用原子吸收光谱法测定Zn、Cr。结果糖尿病患者CD4、CD3、CD16＋56、Zn、Cr水平显著低于正常对照组（P〈0．01），而CD62p、CD63、CD42a、CD8水平则显著高于正常对照组（P〈0．01）。结论糖尿病患者血小板膜糖蛋白（CD62p、CD63、CD42a）和免疫功能指标（CD4、CD8、CD3、CD16＋56）及微量元素、锌（Zn）、铬（Cr）的含量在糖尿病病情观察、临床诊断治疗中可能起着一定的作用。     

煤工尘肺患者血清MMP9与TIMP1的表达

[目的]了解基质金属蛋白酶9（MMP9）及其组织抑制因子1（TIMP1）与煤工尘肺发生的关系。[方法]用酶联免疫吸附试验（ELISA）检测对照组、接尘组及病例组血清中MMP9、TIMP1的含量，计算相应的MMP9/TIMP1值。采用多因素回归对年龄和接尘工龄校正后进行分析。[结果]与对照组比较，接尘组血清中MMP9、TIMP1均有增加，尤其是MMP9增加较为明显（P〈0．05），而TIMP1的差异没有统计学意义（P〉0．05），各期煤工尘肺患者的MMP9、TIMP1浓度呈增加趋势，而MMP9/TIMP1值呈下降趋势，且与对照组相比，差异有统计学意义（P〈0．05）；经接尘工龄校正，与接尘组比较，Ⅰ期煤工尘肺的TIMP1升高（Х^2=8．80）以及Ⅲ期的MMP9、TIMP1升高（Х^2=12．18，8．20）。MMP9／TIMP1随煤工尘肺患者的晋期增加呈下降趋势（Х^2=13．42），差异均有统计学意义（P〈0．05）。[结论]MMP9和TIMP1的平衡可能与煤工尘肺的发生与发展有关。     

企业职工高尿酸血症与血压、血脂、血糖的相关性研究

目的探讨企业职工高尿酸血症（HUA）与血压、血脂、血糖的相关性,为企业进行健康管理提供依据。方法以中国石油长庆油田公司各下属企业为抽样单位,整群随机抽取2个单位,每个单位中所有的HUA者作为HUA组,共720人;同时在尿酸水平正常者中随机选取620人为正常组。通过Logistic回归分析HUA与年龄、性别、血压、血脂、血糖的关系。结果HUA合并高血压、高血脂、空腹m糖受损任意一项、两项、三项的比例均远高于正常组（OR值分别为：4．036,2．562,4．174）。多因素Logistic回归发现：男性、收缩压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇是HUA的危险因素（OR值分别为7．736,2．309,1．721,2．761,1．411）;高密度脂蛋白胆固醇为HUA的保护因素（OR值为0．211）。结论HUA存在性别差异,且与血压、血脂密切相关。企业对职工的健康管理应充分考虑多危险因素的综合作用,全面的进行健康教育及干预。     

癌缺氧病因及预防和治疗

目的 探讨癌及安阳林州市食管癌高发原因及癌病因预防和治疗措施.方法 对林州市食管癌等疾病现场进行调查,在进行10余年统计分析基础上,综合分析了全国156篇文献成果.结果 提出癌缺氧病因学说,使用制氧机、按摩器、饮用纯净水治疗恶性肿瘤,取得良好效果,改水能够大幅降低林州市居民食管癌发病率、死亡率.结论 癌可能是由于机体长...     

Recruitment and retention challenges and successes

Objective: Addressing health disparities requires well designed, culturally adapted research. However, recruiting/retaining minority participants has often been challenging. We present strategies used to successfully recruit and retain rural Hispanic women during a breastfeeding education intervention.

Design: This study involved a two-group repeated measures quasi-experimental design with assessments at seven intervals between enrollment and 6 months postpartum. Participants (Hispanic women?≥?15 years old) were recruited through a regional hospital.

Results: We successfully met our recruitment goals, most women contacted were enrolled (46 of 58), and 100% completed the study.

Discussion: Research staff with ties within the community helped establish trust. Using bilingual study materials, simple language, and an interpreter addressed language/literacy concerns. Phone assessments facilitated participation as transportation was an issue. Accommodating requests to deliver or mail study materials and providing incentives were important. Extra effort was needed to maintain contact when phone service was disrupted or participants moved. Keys to success were persistence, flexibility, and alleviating barriers to participation.     

初产妇与经产妇焦虑抑郁状态分析及干预

目的：分析初产妇、经产妇心理状态特点,以便采取更有效的干预措施。方法筛选2014年6月至2015年1月在咸阳市旬邑县妇幼保健院产科门诊产前检查的健康初产和经产妇各60名,孕周为28~40周。入组时用焦虑自评量表( SAS)、抑郁自评量表(SDS)对两组孕妇进行心理评定,并给1次支持性心理干预(40~60分钟),1周后再次用SAS、SDS对两组孕妇进行评定分析。结果经产妇干预前SAS(50.73±3.45)、SDS(49.13±3.86)评分明显高于初产妇SAS(42.45±2.08)、SDS(41.77±2.21),差异均有统计学意义(t值分别为-15.921、-12.817,均P<0.01);干预后两组SAS、SDS评分均比干预前明显降低,差异均有统计学意义(t值分别为14.999、15.413;15.724、15.832,均P<0.01);干预后经产妇 SAS(38.61±5.02)、SDS(39.10±3.03)评分明显高于初产妇SAS(34.88±3.31)、SDS(32.01±4.27),差异均有统计学意义(t值分别为-4.805、-10.489,均P<0.01)。结论初产妇和经产妇均伴有焦虑、抑郁情绪,干预前后经产妇抑郁、焦虑情绪均较初产妇明显,支持性心理干预能有效改善孕妇的不良情绪。     

Continuity and change in neighborhood disadvantage and adolescent depression and anxiety

We used data from the Fragile Families and Child Wellbeing Study which includes a sample of adolescents of age 15 at the most recent wave (between 2014 and 2017) from mainly low-income urban families in the United States, to examine the association between neighborhood poverty entries and exits and adolescent depression and anxiety. In addition, we examined whether these associations differed by gender. Adolescents who consistently lived in disadvantaged neighborhoods had the highest level of depression and anxiety. Those who entered poor neighborhoods were more depressed than those who never lived in poor neighborhoods. Those who exited poor neighborhoods showed no significant difference in depression and anxiety compared to those never lived in poor neighborhoods. Furthermore, these associations applied to adolescent girls only and were not statistically significant for boys. The results suggest that neighborhood poverty has cumulative negative impacts on adolescent mental health and disproportionally affects adolescent girls. Reducing neighborhood poverty would substantially improve the health of adolescents, especially girls, which would reduce health disparities.     

Enabling positive change: Progress and setbacks in HIV and sexual and reproductive health and rights

At a point in history when the future of sexual and reproductive health including HIV looks particularly uncertain, it is helpful to recognise that many of the challenges currently faced are neither new nor insurmountable. Reflecting on past achievements and lessons learned helps us to have confidence that positive change is feasible. This paper reflects on some of the changes observed in countries like India and Mozambique and identifies a range of factors which need to coalesce to enable these developments, along with specific contextual factors. It is the combination of these influences rather than any one of them alone that brought about the change in the three instances described – fostering a positive political response to HIV in its early years in India; bringing about policy reform on abortion in Mozambique; and increasing contraceptive prevalence and age at marriage in some districts in Bihar, India. Change is always fragile and susceptible to setbacks, but change-seekers can learn in the process and gain renewed hope that progress can and often does take place if they persevere.     

儿童青少年超重肥胖评价方法及SPSS和SAS实现

超重肥胖已成为世界各国儿童青少年面临的重大公共卫生问题之一。现行的儿童青少年超重肥胖筛查标准不统一,逐条评价或自行编写程序容易出错且效率较低。本研究以中国学龄儿童青少年超重与肥胖筛查标准为例,详细介绍了国际和中国共四种评价儿童青少年超重肥胖的方法和步骤,结合具体案例详细介绍其应用方法,同时编制SPSS和SAS程序包和解...     

Car ownership and the association between fruit and vegetable availability and diet

Objective

Nearly all research on the food environment and diet has not accounted for car ownership — a potential key modifying factor. This study examined the modifying effect of car ownership on the relationship between neighborhood fruit and vegetable availability and intake.

Methods

Data on respondents' (n = 760) fruit and vegetable intake, car ownership, and demographics came from the 2008 New Orleans Behavioral Risk Factor Surveillance System. Shelf space data on fresh, frozen, and canned fruits and vegetables were collected in 2008 from a random sample of New Orleans stores (n = 114). Availability measures were constructed by summing the amount of fruit and vegetable shelf space in all stores within defined distances from respondent households. Regression analyses controlled for demographics and were run separately for respondents with and without a car.

Results

Fruit and vegetable availability was positively associated with intake among non-car owners. An additional 100 m of shelf space within 2 km of a residence was predictive of a half-serving/day increase in fruit and vegetable intake. Availability was not associated with intake among car owners.

Conclusions

Future research and interventions to increase neighborhood healthy food options should consider car ownership rates in their target areas as an important modifying factor.