学龄前儿童哮喘的发病危险因素病例对照研究

目的调查分析学龄前儿童哮喘发生的危险因素，为制订干预对策与措施提供依据。方法采用回顾性病例对照研究，对58例学龄前哮喘患儿患病的危险因素进行调查。结果哮喘组与健康对照组在儿童过敏史、特应性体质、2年内有严重的呼吸道感染史、家族哮喘史、父母吸烟、接触宠物和母乳喂养等因素中差异有统计学意义。结论过敏史、特应性体质、2年内有严重的呼吸道感染史、家族哮喘史、父母吸烟、接触宠物是学龄前儿童哮喘的危险因素，控制这些危险因素对儿童的影响，对儿童哮喘的预防与控制具有重要的临床实际意义。     

被动吸烟与儿童哮喘关系的病例对照研究

【目的】探讨被动吸烟与儿童哮喘的关系。【方法】应用1：1配对的病例对照研究方法，调查和分析儿童及其母亲在孕期被动吸烟情况与儿童哮喘的关系。【结果】131对对照病例，经条件Logistic回归分析，父亲吸烟、吸烟年限、吸烟量与子女的哮喘有关，并随着吸烟年限及吸烟量的增加，子女哮喘的危险性增加，父亲既吸烟又饮酒增加儿童哮喘的危险性。在母亲孕期父亲是否在孕妇面前吸烟，都会增加子女哮喘的危险性，且随着吸烟频度及吸烟量的增加，子女哮喘的危险性也增加。提示孕妇及儿童暴露于香烟烟雾环境，都会增加儿童哮喘的危险性。【结论】向父母宣传被动吸烟对哮喘儿童的危害性，争取家庭合作，控制被动吸烟对预防儿童哮喘意义重大。     

滕州市城区2～14岁儿童哮喘危险因素的病例对照研究

[目的]探讨滕州市城区儿童哮喘病发病的危险因素,为制订干预对策与措施提供依据。[方法]2004年9～10月,选择城区2～14岁儿童哮喘病人106例进行1∶1配对病例对照研究。[结果]进入多因素条件Logistic回归模型的有儿童呼吸道感染史、家族哮喘史、儿童过敏史、儿童特应性体质和家庭同居人口吸烟,5个变量的OR值分别为22.087、18.211、17.116、9.098和3.842。[结论]即有儿童呼吸道感染史、家族哮喘史、儿童过敏史、儿童特应性体质和家庭同居人口吸烟是儿童哮喘的危险因素。     

儿童哮喘危险因素的Meta分析及归因危险度百分比的探讨

目的:分析儿童哮喘发病相关危险因素,为临床早期干预提供依据.方法；收集国内1995年1月～ 2012年11月公开发表的关于儿童哮喘发病危险因素的研究文献进行Meta分析及人群归因危险度百分比,查找儿童哮喘发病危险因素.结果:个人过敏史、特应性体质、家族哮喘史、一二级家族过敏史、感冒、呼吸道感染、环境因素包括异味、吸烟、吸人物等是发生儿童哮喘的危险因素,母乳喂养是保护因素.危险因素权重估计分别为个人过敏史11.15％,特应性体质14.29％,家族哮喘史19.17％,一二级家族过敏史21.44％,诱因1感冒、呼吸道感染26.22％,诱因2环境异味、吸烟、吸入物等7.73％.结论:对于特应性体质儿童提倡母乳喂养,尽量避免呼吸道感染,避开常见吸人性过敏原或可预防儿童哮喘发生.     

儿童哮喘发病的相关危险因素分析

目的:探讨儿童哮喘发病的相关危险因素,为预防儿童哮喘提供理论依据。方法:选择2008年12月～2011年12月120例哮喘患儿为病例组,同时选择无呼吸道疾病的儿童240例为对照组,采用单因素和多因素非条件Logistic回归分析法,分析儿童哮喘发病的危险因素。结果:过敏史、特应性、家族有哮喘史、家族有过敏史、近期有严重的呼吸道感染和父母一方吸烟是儿童哮喘发病的相关危险因素。结论:对于有哮喘危险因素的患儿,应预防呼吸道感染,减少过敏原的接触,防止被动吸烟。     

云浮市城区儿童哮喘危险因素1∶1病例对照分析

目的探讨云浮市城区儿童哮喘的危险因素。方法应用1∶1配对病例-对照研究方法 ,对城区152例哮喘儿童(病例组)和152例非哮喘儿童(对照组)的哮喘危险因素进行调查,并进行单因素和多因素条件Logistic回归分析。结果儿童过敏史、家族哮喘史、急性呼吸道感染史、被动吸烟及接触粉尘和有害气体是本城区儿童哮喘的危险因素。结论儿童哮喘是遗传和环境双重因素共同作用导致的一种复杂疾病,但可通过预防呼吸道感染、减少过敏原接触等方面来进行儿童哮喘防治。     

诱发儿童哮喘的家庭环境危险因素分析

目的:分析儿童哮喘发病家庭环境的危险因素。方法:选择2009年1月～2011年1月在医院门诊及住院诊断为哮喘患儿400例,以同时期来医院治疗的非呼吸道疾病患儿403例为对照,采用问卷调查法调查与儿童哮喘有关的因素。结果:单因素分析显示,家族哮喘史、家族过敏史、过敏性体质、饲养动物、被动吸烟、使用空调、接触花粉、父母的受教育程度、经常情绪低落的比例哮喘组明显高于对照组,差异有统计学意义(P<0.01)。多因素非条件Logisitc回归分析显示家族哮喘史、过敏史、父母的受教育程度、被动吸烟、饲养动物5个因素差异有统计学意义(P<0.05)。结论:家族哮喘史、过敏史、父母的受教育程度、被动吸烟、饲养动物是儿童哮喘的危险因素,提示平时及时控制纠正与哮喘发生或发作的相关危险因素对儿童哮喘的预防与控制具有重要的实际意义。     

宜昌地区0～6岁儿童支气管哮喘相关危险因素分析

目的 分析0～6岁儿童支气管哮喘的相关危险因素,为临床及家庭预防哮喘的急性发作提出对策。方法 选取宜昌市中心人民医院门诊就诊的0～6岁儿童哮喘病人110 例(观察组) 和同期来院的无喘息发作史的0～6岁儿童110 例(对照组) 进行研究分析。结果 单因素分析显示,影响0~6岁儿童哮喘的变量包括性别、食物过敏史、吸入性过敏史、呼吸道感染、家族过敏史、湿疹史、过敏性鼻炎史和被动吸烟(P＜0.05)。多因素Logistic回归分析结果发现食物过敏史、呼吸道感染、家族过敏史、湿疹史、过敏性鼻炎史、被动吸烟是0～6岁儿童哮喘发作的危险因素(P＜0.05)。结论 食物过敏史、呼吸道感染、家族过敏史、湿疹史、过敏性鼻炎史、被动吸烟均是0～6岁儿童哮喘急性发作的危险因素,患儿家属及临床工作者重视这些危险因素,同时采取相应的有效措施干预,对于哮喘急性发作的预防具有重要意义。     

儿童反复呼吸道感染危险因素的Meta分析

目的探讨儿童反复呼吸道感染的危险因素。方法检索数据库建库至2020年6月国内外公开发表的儿童反复呼吸道感染危险因素的病例对照或队列研究文献,使用Stata 15.1及Review Manager 5.3软件进行数据统计分析。结果共纳入20篇符合文献,儿童反复呼吸道感染相关危险因素的合并OR值(95%置信区间)分别为:户外活动2 h/d 3.62(2.87,4.56)、挑食偏食3.47(2.68,4.48)、入学入托3.45(2.49,4.78)、抗菌药物使用次数多3.00(2.41,3.74)、父亲/母亲文化程度低3.00(1.36,6.64)、微量元素缺乏(锌缺乏)2.94(2.23,3.89)、慢性呼吸道疾病暴露史2.84(1.97,4.07)、父母过敏史或过敏体质2.08(2.05,2.11)、被动吸烟1.72(1.43,2.08);母乳喂养0.58(0.46,0.74)、足期产0.35(0.27,0.44)。结论户外活动2 h/d、挑食偏食、入学入托、抗菌药物使用次数多、父亲/母亲文化程度低、微量元素缺乏(锌缺乏)、慢性呼吸道疾病暴露史、父母过敏史或过敏体质及被动吸烟是儿童反复呼吸道感染的危险因素;缺乏户外活动对儿童反复呼吸道感染发病的危险程度最高,其次是挑食偏食及入学入托。母乳喂养、足期产是儿童反复呼吸道感染的保护因素。     

儿童哮喘发病危险因素的logistic分析

目的探讨儿童哮喘发病的危险因素,为制定干预对策与措施提供依据。方法 2009年3月—2010年10月间,采用多因素logistic回归分析,对滕州市中心人民医院确诊的2～14岁96例哮喘儿童进行病例对照调查。结果有儿童呼吸道感染史、家族哮喘史、儿童过敏史、儿童特异性体质4个变量进入模型,OR值依次为22.31、14.89、13.65及8.23。结论有儿童呼吸道感染史、家族哮喘史、儿童过敏史、儿童特应性体质是该人群哮喘发病的危险因素。     

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.     

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.     

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.     

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.