青少年身材偏矮关联因素探讨

目的　探讨青少年身体偏矮的相关因素。　方法　从 32 4 0名初中学生中筛选矮身材青少年 96例作为研究对象 ,同时选正常身高青少年 96例作为对照 ,进行问卷调查。　结果　矮身材检出率为 3.2 1% ;矮身材组父或母身材矮小者占 35 .4 % ,而对照组父或母身材矮小者占 7.3% ,差异有极显著意义 (P <0 .0 1) ;矮身材组出生时有难产史例数显著多于对照组 (P <0 .0 5 ) ,出生体重显著低于对照组 (P <0 .0 1)、偏食、不常参加体育活动者均显著高于对照组 (P <0 .0 5和P <0 .0 1)。　结论　青少年矮身材与出生时难产、低出生体重、偏食、体育锻炼少和父母身材偏矮有一定关系     

儿童矮身材病因及其骨龄发育情况374例分析

目的 分析儿童矮身材的病因及骨龄发育情况,为该类患儿的诊断及治疗提供有价值的参考.方法 收集2012年3月至2014年3月于西安交通大学第二附属医院内分泌门诊和陕西省榆林市儿童医院就诊的374例矮小儿童的病史,测量身高、体重,检查第二性征的发育,并行骨龄、生长激素激发试验、甲功、垂体核磁共振成像(MRI)等相关检查.结果 374例患儿中,生长激素缺乏症(GHD)206例(55.08％),其次分别为特发性矮小(ISS) 100例(26.74％),小于胎龄儿(SGA) 23例(6.15％),甲状腺功能减低20例(5.35％),Turner综合征16例(4.28％);不同病因的矮小患儿间年龄及骨龄平均落后程度均存在显著性差异(F值分别为7.841和9.724,均P＜0.05).结论 GHD和ISS是儿童矮身材的常见病因,不同病因矮小患儿骨龄落后程度存在差异,矮身材儿童早发现、早确诊对治疗非常重要.     

矮身材儿童血清微量元素分析

目的 了解儿童血清铜、锌、钙、铗、铁对身高发育的影响.方法 测定符合矮身材诊断标准的儿童血清中铜、锌、钙、镬、铁的含量并与正常对照组比较分析.结果 矮身材组儿童血清铜、锌、钙、铗、铁分别为17.65±4.02μmol/L、70.62±18.82μmol/L、1.53±0.13mmol/L、1.37±0.08mmol/L、7.20±0.94mmol/L;除血清铜外,其余4种元素明显低于正常对照组,经比较有非常显著性差异(t值分别为6.317、9.254、14.036、9.035,均P<0.001).矮身材组儿童血清锌、铁、钙低于正常值下限的百分率分别为45.65%、30.43%、41.30%,明显高于正常对照组,经比较有显著性差异(X2分别为8.527、2.826、5.158,均P<0.05).不同性别矮身材儿童血清5元素低于正常值百分率经比较无显著性差异(P>0.05).结论 血清锌、钙、镁、铁影响儿童的生长发育,对矮身材儿童应在明确病因的同时检测及补充缺乏的微量元素.     

学龄前肥胖儿童体质指数与血清瘦素、胰岛素及性激素水平的关系

[目的]研究学龄前肥胖儿童体质指数与血清瘦素、胰岛素及性激素水平的关系. [方法]对122例学龄前肥胖儿童及61例健康正常儿童的瘦素(Leptin)、胰岛素(Ins)、胰岛素样生长因子-Ⅰ(IGF-Ⅰ)、胰岛素样生长因子结合蛋白-3(IGF-BP3)、雌二醇(E2)和睾酮(T)水平进行测定,测量其身高、体重.计算其体质指数(body mass index,BMI),并分析BMI与各激素的相互关系. [结果]①肥胖组儿童BMI及血清Leptin、Ins、IGF-Ⅰ、IGF-BP3和E2水平明显高于正常组,且差异有显著性(P值均<0.001),而两组睾酮水平差异无显著性(P>0.05);相关分析显示肥胖儿童BMI与血清Leptin和Ins水平有明显正相关(r=0.412,r=0.336.P值均<0.001);②正常组儿童BMI与血清Leptin、Ins、IGF-Ⅰ、IGF-BP3、E2和睾酮水平均无相关性(P值均>0.05),③BMI与血清Leptin和Ins水平的相关系数肥胖男童大于肥胖女童,且肥胖女童BMI与血清E2水平有显著正相关(P<0.05),而肥胖男童则无显著相关性(P>0.05);④多元线性回归分析显示肥胖儿童血清Leptin和Ins水平是影响BMI的重要因素(P值均<0.001). [结论]BMI对儿童肥胖的早期诊断、早期干预是非常有意义的.     

矮身材原因及防治对策

对１８９名低于同性别、同年龄身高均值减２个标准差的儿童青少年进行了一般体格检查及骨龄拍片。部分做Ｔ３、Ｔ４和生长激素（ＧＨ）测定，以确定矮身材原因。属病理性矮身材者仅１４人；非病理性矮身材１７２人，其中１８名为家庭性矮身材，８名为体质性生长迟缓；其余皆为正常身材儿童。饮食调查表明：矮身材学生蛋白质、热能等营养素摄入普遍不足，有些不吃肉、不爱吃青菜，不少有挑食偏食习惯，说明在青少年身高发育方面，营养     

血清睾酮、生长激素对青少年矮身材及骨龄的影响

目的　探讨血清睾酮 (T)、生长激素 (GH)对青少年矮身材及骨龄的影响 ,以便有针对性地开展治疗和指导工作。方法　采用病例对照的研究方法 ,把低于当地同年龄、同性别平均身高 2个标准差以下者定为矮身材组 (观察组 ) ,再选取同学校、同年级、同民族、同性别、同年龄身高位于x～ (x± 2s)范围的学生作为对照组。对所有被选学生进行T、GH放免测定 ,同时进行体格检查与骨龄评定。结果　观察组血清T(x=54 .53μg/L)明显低于对照组 (x=1 57.1 9μg/L) (P <0 .0 0 1 ) ;观察组儿童骨龄 (1 1 .0 5± 0 .76)岁也明显低于对照组 (1 1 .94±0 .69)岁 (P <0 .0 0 1 ) ,年龄骨龄差高于对照组 ,且T与身高 (r=0 .462 ,t=0 .530 )、骨龄 (r=0 .444 ,t=0 .493)呈明显正相关关系 (P <0 .0 0 1 ) ;GH与身高、骨龄的相关差异无显著性 (P >0 .0 5)。结论　T ,GH含量高低与青少年生长发育有关系 ,且T较GH影响大。     

父母身高对7岁以下儿童身高影响效应的研究

目的 分析父母身高对7岁以下儿童身高的影响效应,为个体儿童生长评估提供参考依据。方法 以“2015年中国九市7岁以下儿童体格发育调查”中父母身高信息完整的161 297名儿童为分析对象,参照中国儿童身高标准计算儿童身高、父亲身高、母亲身高和父母身高中值的Z分值,采用Spearman方法分析儿童身高与父身高、母身高、父母身高中值的相关性,并按父母身高分组,比较各组儿童身高的差异。 结果 1)儿童身高与父身高、母身高和父母身高中值正相关(r=0.13~0.42,P<0.05),且与父母身高中值的相关系数最高;2)按父母身高中值分为矮身材、偏矮、中等偏下、中等偏上、较高、高身材6组,各组儿童平均身高依次递增,父母矮身材组儿童身高比父母高身材组低1.9~14.7 cm,年龄越大差值越大;3)父母身高偏矮组子女身高第3百分位(P₃)比中国儿童身高标准P₃低0.6~4.8 cm,而父母较高身材组P₃则比身高标准P₃高0.6~4.7 cm;4)父母矮身材、偏矮、中等偏下、中等偏上、较高和高身材组的儿童身高Z分值与父母身高中值Z分值差值依次为1.27±0.99、0.61±0.92、0.18±0.89、-0.19±0.90、-0.61±0.93、-1.17±0.92。结论 7岁以下儿童身高与父母身高正相关;矮身材父母的子女身高明显低于高身材父母子女;矮身材父母子女身高高于家庭遗传身高;个体儿童身高评估和解释时,不可忽视父母身高的影响作用。     

体育运动对青少年矮身材及骨龄的影响

目的　探讨体育运动对青少年矮身材及骨龄的影响。　方法　采用病例对照研究的方法 ,把低于当地同年龄、同性别平均身高的 2个标准差者定为观察组 ,再选取同学校、同年级、同民族、同性别、同年龄身高位于 x～ x+ 2s范围内的儿童作为对照组 ,作 1∶1配对。进行问卷调查、体格检查、骨龄评定。　结果　观察组儿童在经常参加体育运动方面明显低于对照组儿童 (P <0 .0 5 ) ;经常运动组骨龄明显高于不经常运动组 (P <0 .0 0 1) ,而年龄与骨龄差经常运动组明显低于不经常运动组 (P <0 .0 0 1) ;运动时间长短对青少年身高的影响观察组和对照组间差异无显著意义 (P >0 .0 5 )。　结论　经常参加体育运动对儿童青少年的生长发育及骨骼发育有积极的影响。     

阳江市阳春地区矮身材儿童病因及骨龄调查结果分析

目的分析阳江市阳春地区矮身材儿童病因及骨龄调查结果。方法选取2017年10月-2018年10月户籍在阳江市阳春地区的矮身材儿童共80例作为研究对象,收集所有研究对象的一般临床资料,并行常规实验室检查和骨龄检查,采用化学发光法检测IGF-1、IGFBP-3水平。结果 80例矮身材儿童中,特发性矮身材(ISS)、生长激素缺乏性矮身材(GHD)、营养缺乏性矮身材(ND)、家族性矮身材、宫内发育迟缓是矮身材儿童的前5位病因;ISS、GHD及ND三种不同病因的矮小患儿的IGF-1、IGFBP-3水平与骨龄落差程度差异有统计学意义(P0.05)。结论 ISS、GHD及ND是阳江市阳春地区矮小症儿童的主要病因,且不同病因的IGF-1、IGFBP-3水平与骨龄落差程度存在差异,对于矮小症患儿的治疗具有重要意义。     

儿童体格发育家庭影响因素分析

目的 了解不同家庭背景儿童生长发育水平,探讨家庭因素对儿童生长发育的影响.方法 随机整群抽样调查54 633名健康儿童,按照人体标准测量方法测量其身高体重.采用调查问卷了解儿童家庭情况并进行家庭多因素分析.结果 城区儿童体重、身高均值分别高于农村儿童0.68 kg、0.87 cm,差异有统计学意义(P<0.01).处于不同家庭类型的同性别儿童体重和身高指标差异有统计学意义(P<0.01);主干家庭的儿童平均体重与身高(12.45 kg、85.99 cm)分别低于核心家庭儿童(14.33 kg、93.11 cm).外婆或奶奶与保姆为主抚养的男童平均体重与身高(13.15kg、84.80 cm)及女童平均体重与身高(12.57 kg、88.17 cm)明显低于母亲抚养组的男童(14.44 kg、92.89cm)与女童(13.80 kg、91.76 cm)(P<0.01).抚养人文化程度高,儿童体重、身高均值有增高趋势,差异有统计学意义(P<0.01).父母文化程度和不同职业对儿童体重影响差异无统计学意义(P>0.05),但父母是大学/大专文化程度的儿童平均身高(92.65 cm)高于其他组(90.61 cm),干部、军人、文教卫生与科技职业父母其儿童平均身高(94.16cm)高于其他组(90.84 cm),差异有统计学意义(P<0.05).结论 不同生活环境的儿童生长发育水平存在差异,家庭因素对儿童身长(高)的影响比体重更为明显.文化程度较低的儿童抚养人是儿童保健健康教育的重点人群.     

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.