月经规律女性抗缪勒氏管激素与基础卵泡刺激素关系的研究

目的 探讨月经规律女性抗缪勒氏管激素(AMH)随年龄变化规律及其与基础卵泡刺激素(bFSH)之间的关系.方法 以89例月经规律女性为研究对象,按年龄分为5组(20 ～24岁组,25 ～29岁组,30 ～ 34岁组,35 ～ 39岁组,40～44岁组),应用全自动电化学发光法测定血清中AMH及bFSH水平,分析AMH及bFSH随年龄的变化规律及其相互间的关系.结果 AMH水平与年龄呈负相关(r=-0.847,P＜0.001);bFSH与年龄呈正相关(r=0.296,P=0.005);除第2、3组间AMH无明显差异外(P=0.091),其余各组间均有显著性差异(P1∶2＜0.001,P1∶3＜0.001,P1∶4＜0.001,P1∶5＜0.001,P2∶4＜0.001,P2∶5＜0.001,P3∶4 =0.003,P3∶5 ＜0.001,P4∶5＜0.001);血清AMH水平与bFSH呈负相关(r=-0.406,P＜0.05).结论 月经规律女性AMH水平随年龄增加逐渐下降,其与年龄相关性优于bFSH,且AMH水平可预测bFSH水平,在评价卵巢功能中起重要作用.     

南京市2岁以内儿童骨强度状况研究

[目的]了解南京市2岁以内儿童骨强度水平,分析对比采用亚洲儿童和中国儿童两种标准数据库评价结果的差异. [方法]选取2 024例0～2岁常规健康体检儿童,采用超声骨强度测定仪测定其骨强度,以骨骼超声波传播速度(SOS)的数量表示,并记录采用亚洲儿童和中国儿童两种标准数据库分别进行评价后的Z-score,对两者(ZA、ZC)进行分析比较.每个儿童均进行体格检查,记录并分析相关数据. [结果] SOS随着儿童年龄的增加而增高(r=0.870,P＜0.001);以Z≤-1为判断骨强度异常的界值,则ZA异常儿童占20.4%,ZC异常儿童达66.9%,两者之间差异有非常显著的统计学意义(P＜0.001);且ZA＞-l(t=39.357,P＜0.001),ZC＜-1(t=-17.501,P＜0.001);SOS与婴儿的体重和身长均呈正相关(r=0.680和r=0.810,P＜0.001),与体质指数(BMI)呈负相关(r=-0.256,P＜0.001). [结论]2岁以内儿童骨强度随着年龄的增加而增高;肥胖儿童更容易发生骨强度不足;以亚洲儿童数据库评价南京市儿童的骨强度状况,标准相对宽松,而用中国儿童数据库则过于严格,因此应尽早建立针对本地区儿童的标准数据库.     

5～14岁儿童的体格发育与骨密度的相关性分析

目的 研究5～14岁儿童身高、体重及身体质量指数对骨密度的影响及其相关性.方法 选择2010年4月至2011年6月就诊于沈阳市儿童医院儿保门诊的1 219名健康儿童为研究对象,进行身高和体重的测量,计算身体质量指数,采用DPX NT型双能X线骨密度仪测量全身骨密度,并对数据进行分析.结果 各年龄组的骨密度随年龄的增加而递增,其与年龄(r=0.694)、身高(r=0.757)、体重(r=0.775)、身体质量指数(r=0.593)呈正相关,均P<0.01;骨密度在部分年龄组(5～8岁)不同性别间存在差异,且有统计学意义(均P<0.05).结论 儿童时期的骨密度是一个连续累积的过程,其受身高、体重及身体质量指数等多因素的影响,因此在评价过程中,应该考虑体格发育等因素的影响.     

5~14岁儿童屈光不正与年龄、眼轴长度及角膜表面形态的关系

目的 探讨5～14岁儿童屈光不正与年龄、眼轴长度及角膜表面形态改变的关系.方法 回顾性分析2017年3月—2019年12月在大连市某医院眼科门诊就诊的121例(242眼)儿童临床资料,根据年龄分为5～7岁组[48例(96眼)]、8～10岁组[43例(86眼)]、11～14岁组[30例(60眼)].比较不同年龄及不同屈光度儿童的眼轴长度(AL)、角膜曲率,分析各年龄组屈光度与AL、角膜曲率的相关性.结果 3组儿童眼睛角膜曲率比较,差异均无统计学意义(P＞0.05);3组儿童眼睛屈光度比较,5～7岁组＞8～10岁组＞11～14岁组,差异均有统计学意义(P＜0.05);3组儿童眼睛AL比较,5～7岁组＜8～10岁组＜11～14岁组,差异均有统计学意义(P＜0.05);Pearson相关分析发现,年龄与屈光度呈负相关(r=-0.687,P＜0.05),年龄与AL呈正相关(r=0.426,P＜0.05).不同年龄组不同屈光度儿童眼睛角膜曲率比较,差异均无统计学意义(P＞0.05);各年龄组不同屈光度儿童眼睛AL比较,均为近视＞正视＞远视,差异均有统计学意义(P＜0.05);Pearson相关分析发现,各年龄组儿童眼睛屈光度与AL均呈负相关(P＜0.05).结论 随着年龄增加、眼轴增长,儿童屈光度逐渐降低,近视深度增加.临床应采取措施延缓儿童眼轴增长,以改善儿童屈光不正状态.     

血清杀菌试验和酶联免疫吸附试验测定C群脑膜炎奈瑟菌血清抗体滴度比较

目的 比较血清杀菌试验(SBA)和酶联免疫吸附试验(ELISA)测定两种C群脑膜炎奈瑟菌(Nm)疫苗免疫后血清抗体滴度的差异.方法 采用SBA测定75名未免疫健康成年人(40～70岁)血清、143名3～8月龄婴儿及194名3～5岁儿童NmA和C群结合疫苗或A+C群多糖疫苗免疫前后血清中Nm杀菌抗体水平,然后用ELISA测定相应血清的Nm特异性IgG含量,并利用线性相关与回归分析两种测定结果的相关性.结果 未免疫健康成年人血清中Nm杀菌抗体水平和特异性IgG含量之间的相关性较高(r=0.814 33,P＜0.001);3～8月龄婴儿和3～5岁儿童接种结合/多糖疫苗前,Nm杀菌抗体水平和特异性IgG含量之间相关性较差(3～8月龄:r=0.140 64,P＞0.l00/r=0.2899,P＜0.05;3 ～5岁:r=0.540 40,P＜0.05/r=0194 36,P＜0.05),接种1剂结合疫苗后,杀菌抗体水平和特异性IgG含量之间的相关性较好(r=0.809 38,P＜0.001和r=0.837 23,P＜0.001);接种多糖疫苗后,杀菌抗体水平和特异性IgG含量之间的相关性较差(r＜0.500 00).结论 健康成年人血清和结合疫苗免疫后的婴幼儿血清中特异性C群Nm IgG含量可以间接反映血清杀菌抗体水平,ELISA方法可以替代SBA.但ELISA检测方法不适用于3～8月龄婴儿多糖疫苗免疫后的效果评价.     

天津市20041名3～6岁入托儿童血脂水平分析

目的 了解天津市3～6岁儿童血脂水平和血脂异常检出率.方法 采集天津市48所幼儿园20041名3～6岁儿童末梢血,采用东芝120全自动生化分析仪检测血浆总胆固醇(TC)和甘油三酯(TG)水平.结果 20 041名入托儿童TC和TG分别为(4.17±0.69) mmol/L和(0.86±0.44) mmol/L;血脂异常总检出率为11.4％,其中TC异常检出率为7.1％,TG为4.9％,两项均异常的检出率为0.6％.不同性别儿童TC异常检出率女童高于男童,差异有统计学意义(x2=51.77,P＜0.001).不同年龄组儿童TC和TG异常检出率的差异均有统计学意义(x2=10.29,P=0.016;x2=10.93,P=0.012),但未见明显的年龄变化趋势.不同肥胖程度儿童TC异常检出率的差异无统计学意义,TG异常检出率差异有统计学意义(x2=211.8,P＜0.001),肥胖儿童TG异常检出率明显高于正常和超重儿童.城乡地区儿童TC和TG异常检出率差异均有统计学意义(x2=22.09,P＜0.001;x2=11.26,P=0.001),TC异常检出率城市儿童高于农村,TG异常检出率农村儿童高于城市.结论 天津市3～6岁儿童血脂异常率较高,且存在性别、年龄、肥胖程度、地区差异,应有针对性开展儿童血脂异常筛查与干预.     

北方地区儿童超声骨密度值与儿童年龄及季节的关系

【目的】 了解北方部分地区儿童骨密度现状,探讨儿童骨密度与年龄、性别及季节的关系。 【方法】 对2008-2009年度本科5 971名正常儿童骨密度检测值与年龄、性别、季节的相关性进行分析。 【结果】 北方儿童骨密度值呈正态分布,并随年龄增长而增加(P<0.001)。不同年龄段儿童骨密度差异有统计学意义(P<0.001)。青春期前儿童骨密度值与性别无关(P>0.05);而青春期女童骨密度较男童高(P<0.000 1)。学龄组(6~12岁)儿童骨密度值Z分数差异有统计学意义(P=0.008 5),其余组四季骨密度差异不显著,婴儿组秋季偏低,与冬季差异显著;学龄前组夏季偏低,与冬季差异显著(P均＜0.05)。 【结论】 北方地区儿童骨密度值随年龄而增加并受性别影响。青春期儿童应注重钙制品及维生素D的补充。儿童在夏秋季也应根据户外接受日照情况等因素适量添加维生素D。     

中国北方五市儿童功能性便秘流行病学特征现况调查

目的 对中国北方城市儿童排便习惯进行调查,探讨儿童功能性便秘(FC)的患病率和流行病学特征.方法 应用分层、整群随机抽样方法对中国北方5市(北京、天津、沈阳、长春和哈尔滨)4～14岁常住儿童进行问卷调查和普查,根据普查结果按国际通用的儿童RomeⅢ标准(H3a)判断的FC检出率,再对筛出的部分儿童进行全面检查(包括结肠传输试验、钡灌肠造影、肌电图、消化道测压)以排除结肠器质性疾病,并分析儿童FC的地域、年龄和性别分布.结果 北方5市调查的19286名儿童中FC患病率为4.73%.北京地区儿童患病率(5.02%)明显高于其他地区(分别为4.82%、4.76%、4.27%和4.40%),差异有统计学意义(P＜0.001);4～6岁为最常见的患病年龄段.分层研究表明不同地区相同年龄段儿童FC的患病率不同,差异有统计学意义(P＜0.001),基本与总体分布接近,FC分布具有地域差异;相同地区不同年龄段儿童FC患病率不同,差异有统计学意义(P＜0.001),基本与总体分布接近,FC分布具有年龄差异.结论 儿童FC是常见病多发病,好发于4～6岁儿童,患病率有地区差异.     

深圳市儿童超声骨密度测定结果

目的:了解深圳地区0～1 5岁儿童少年超声骨密度状况;建立其超声骨密度正常参考值。方法:选择0～1 5岁深圳出生和/或居住的正常儿童少年为检测对象,用定量超声骨密度仪(QUS)测定受检者足跟部骨密度(BMD)值,同时测量受检者体重、身高。结果:0～72个月龄男童与女童之间BMD无差异(P >0.0 5 ) ;6～1 2岁男童与女童之间BMD存在差别(r =0 73.2 ,P <0.0 0 1 ) ,但经体重校正后差异无显著性(P >0 .0 5 ) ,1 3～1 5岁少年BMD与性别有关;0～1 5岁儿童少年BMD值与身高增长快慢有关。结论:胎儿期储备、合理膳食、体重、运动、雌激素对BMD有影响     

合肥市4551名0～3岁健康儿童超声骨密度检测结果分析

目的研究0~3岁不同性别、不同年龄组儿童骨密度状况,为监测儿童钙营养和骨健康提供依据。方法随机抽取在儿童保健门诊进行健康体检的的4551名0~3岁健康儿童进行超声骨密度检测,根据同年龄、同性别骨密度Z值的评分数分为正常、轻度不足、中度不足、重度不足。结果男童骨密度Z值高于女性,骨密度不足检出率女童高于男童,不同性别间比较差异有统计学意义(χ2=102.11,P0.001);年龄越小,骨密度不足检出率越高。不同年龄组儿童骨密度值比较差异有显著性(χ2=595.35,P0.001)。结论 1岁之内的婴儿是防治骨密度不足的主要人群,生后6个月婴儿是防治骨密度不足的关键期。     

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.