Cor pulmonale and silicosis: a necropsy based case-control study.

The presence of cor pulmonale at death in relation to other factors such as emphysema, silicosis, and thromboembolism was analysed in a case-control study of 732 South African gold miners. Marked emphysema was the highest risk factor with an odds ratio of 21.32 (95% confidence interval (95% CI) 5.02-90.7), then extensive silicosis (OR 4.95, 95% CI 2.92-8.38) and thromboembolic disease (OR 1.92, 95% CI 1.37-2.69). Age and smoking were not significant predictors of cor pulmonale.     

Continued exposure to silica after diagnosis of silicosis in Brazilian gold miners

BACKGROUND: There is a paucity of studies analyzing the effect of continued silica exposure after the onset of silicosis with regard to disease progression. The present study investigates differences in clinical and radiological presentation of silicosis among former workers with a diagnosis of silicosis, and compares workers who continued to be exposed to silica with those who stopped silica exposure after having received their diagnosis. METHODS: A sample of 83 former gold miners with a median of 21 years from the first diagnoses of silicosis, had their clinical and occupational histories taken and underwent both chest radiography (International Labor Organization standards) and spirometry. Their silica exposure was assessed and an exposure index was created. The main outcome was the radiological severity of silicosis and tuberculosis (TB). The statistical analysis was done by multiple logistic regression. RESULTS: Among the 83 miners, 44 had continued exposed to silica after being diagnosed with silicosis. Continuation of silica exposure was associated with advanced radiological images of silicosis (X-ray classification in category 3, OR = 6.42, 95% CI = 1.20-34.27), presence of coalescence and/or large opacities (OR = 3.85, CI = 1.07-13.93), and TB (OR = 4.61, 95% CI = 1.14-18.71). CONCLUSIONS: Differential survival is unlikely to explain observed differences in silicosis progression. Results reinforce the recommendation that silica exposure should be halted at an early stage whenever X-ray is suggestive of the disease.     

Genetic polymorphisms in alveolar macrophage response-related genes, and risk of silicosis and pulmonary tuberculosis in Chinese iron miners

Alveolar macrophages (AMs) play a prominent role in influencing the development of lung inflammation and injury. The aim of this study is to investigate the roles of AMs response-related genes TNF-alpha, iNOS, and NRAMP1 (SLC11A1) in susceptibility to silicosis and pulmonary tuberculosis (PTB), and to analyze the interaction of dust exposure and genetic susceptibility to silicosis, interactions of TNF-alpha-308 and Natural Resistance-associated Macrophage Protein 1 (NRAMP1) INT4, D543N polymorphisms to PTB. Several epidemiological designs were used: retrospective investigations on dust exposure, case-control studies of 184 silicosis cases and 111 miners occupationally exposed to silica dust, and 1:2 matched case-control studies of 61 PTB cases and 122 PTB-free miners. The miners and controls were recruited from an iron mining operation in Anhui province, China. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was applied to detect single nucleotide polymorphisms. Despite the recruitment of high dust exposure among the controls, silicosis patients still had significantly higher dust exposure than controls (242.6 +/- 98.8 vs. 217.6 +/- 100.7 mg a/m(3)). The mutation of iNOS Ser608Leu is associated with protection against silicosis and against severity of silicosis in the miners. There is a 0.47-fold (95% CI: 0.28-0.79) decrease in risk of silicosis for individuals with C/T, T/T genotype compared with the wild-type homozygous (C/C) individuals after adjustment for occupational exposure, smoking, and drinking. The protection effect of the iNOS polymorphism was particularly detected in the > or = 150 mg a/m(3) exposure group (OR: 0.44, 95% CI: 0.22-0.91). However, no interaction of dust exposure with the iNOS polymorphism was observed. Furthermore, the variant NRAMP1 INT4 genotype is significantly associated with PTB in miners. No association of other polymorphisms (NRAMP1 D543N, TNF-alpha-308) and susceptibility to silicosis or PTB in Chinese miners was found. Our data showed a 3.26-fold (95% CI: 1.47-7.23) increased risk of PTB for miners carrying both the NRAMP1 D543N G/G and NRAMP1 INT4 G/C+C/C genotypes. Additionally, in miners with TNF-alpha-308 G/G genotype, the risk of PTB increased 2.38-fold if they carry the NRAMP1 INT4 G/C+C/C genotype (95% CI: 1.14-4.98). In conclusion, the C>T mutation of iNOS Ser608Leu may be an important protective factor to miners. On the other hand, the variant NRAMP1 INT4 may play a role in the development of PTB in Chinese miners. Therefore, the novel information can be used as guideline for further mechanistic investigations and for strengthening specific protection protocols for workers.     

Risk factors for overweight in children from Southern Brazil

Risk factors for overweight were investigated in a cross-sectional survey of children aged 12-59 months in the Southern Brazilian city of Porto Alegre (n = 2,660). Odds ratios (OR) for overweight, defined by weight/height > 2 z-scores of the NCHS standards, were estimated for socioeconomic and demographic conditions, social environment, and childhood health events. Prevalence of overweight was 6.5%. In the multivariate model, the odds of overweight were positively associated with maternal education (schooling > 12 years, OR = 2.36; 95%CI: 1.21-4.60; 9-11 years, OR = 2.07; 95%CI: 1.16-3.70) and family income per capita > 2 times the minimum wage (OR = 1.86; 95%CI: 1.13-3.08) and negatively associated with maternal work (OR = 0.72; 95%CI: 0.52-0.99). Odds were higher for children born large-for-gestational-age (OR = 2.29; 95%CI: 1.36-3.85) and lower for children born small (OR = 0.57; 95%CI: 0.33-0.99), as compared to those born with adequate birth weight for gestational age. Paternal schooling, parental occupation, and maternal age at the child's birth were associated with overweight in the unadjusted model only. Programs are needed to prevent overweight during childhood, with special attention to families and children at increased risk.     

Estimation of the degree of acclimatization to high altitude by a rapid and simple physiological examination

The recent expansion in the geographical areas open to human activity has made it desirable to have an objective method to evaluate the degree of high-altitude acclimatization. In this study, we measured the arterial oxygen saturation value at rest and just after exercise in healthy high-altitude trekkers using a transportable pulse oximeter. During a 100-day stay at high altitude (around 4000 m), the degree of arterial hemoglobin saturation measured at rest was relatively stable. However, shortly after arrival at high altitude, even light exercise induced an acute reduction in the degree of arterial hemoglobin saturation; this reduction was ameliorated as the trekkers became acclimatized to the high altitude. Preliminary short trekking to high altitudes does not appear sufficient to induce this response. It is suggested that this rapid and simple physiological examination, the measurement of arterial oxygen saturation value after light exercise, could be a convenient means of estimating the level of high-altitude acclimatization among healthy subjects.     

铀矿工GSTP1基因多态与MGMT基因和p16基因甲基化的关系

目的探讨氡职业暴露人群谷胱甘肽S-转移酶P1(GSTP1)基因多态与痰细胞6-氧-甲基嘌呤-DNA甲基转移酶(MGMT)和p16基因甲基化的关系。方法用聚合酶链反应-限制性片段长度多态性法(PCR-RFLP)确定70例氡职业暴露人群GSTP1的基因型;用聚合酶链反应-甲基化特异性法(MSP)确定痰细胞中MGMT和p16基因的甲基化与非甲基化状态。结果在70名铀矿工中,GSTP1基因A105G位点的纯合子(Ile/Ile)42例,杂合子(Ile/Val)25例和纯合子(Val/Val)3例。MGMT、p16基因甲基化率和总甲基化率分别为14.2%、8.6%和18.6%。与携带Ile/Ile人群相比,携带异常等位基因(Ile/Val与Val/Val)的人群MGMT基因甲基化和总甲基化率增加[P=0.037,OR=4.8,95%CI(1.1~21.0);P=0.016,OR=5.1,95%CI(1.4~19.6)];p16基因甲基化率差异无统计学意义[P=0.057,OR=4.6,95%CI(0.8~29.2)]。结论GSTP1(A105G)基因多态性与氡致MGMT基因甲基化和总甲基化的易感性有关。     

云南省中学生身体素质现况及影响因素分析

目的 了解云南省中学生身体素质现况及其影响因素,为提高中学生体质健康水平提供参考依据。方法 采用分层随机整群的抽样方法选取2019年云南学生体质与健康调研中13～18岁中学生11 946名,测量不同性别、年龄、民族的学生各项身体素质相关指标及计算合格率,对弱势项目（肺活量、男生引体向上、女生仰卧起坐）应用多因素logistic 回归分析。结果 2019年云南省中学生体质测试中整体合格率由高到低的项目依次为耐力跑（99.9%）、50m跑（96.4%）、坐位体前屈（96.4%）、立定跳远（86.1%）、肺活量（76.8%）、引体向上/仰卧起坐（52.5%）。不同民族间比较发现肺活量合格率最高为汉族（85.6%）,最低为傣族（47.4%）;引体向上/仰卧起坐合格率最高为佤族（81.9%）,最低为纳西族（41.3%）。多因素 logistic 回归分析显示:肺活量项目中,超重肥胖（OR = 0.56,95%CI:0.49～0.64）、学校不挤占体育课（OR = 0.88,95%CI:0.81～0.97）、一周中肌肉力量锻炼≥4次（OR = 0.67,95%CI:0.58～0.77）体测合格率更高,而低体重（OR = 3.78, 95%CI:3.31～4.56）体测合格率更低;引体向上/仰卧起坐项目中,上体育课时感觉出汗（OR = 0.87,95%CI:0.76～0.99）、学校不挤占体育课（OR = 0.87,95%CI:0.80～0.93）、每天上课间操次数超过两次（OR = 0.76,95%CI:0.67～0.88）体测合格率更高,而低体重（OR = 2.10,95%CI:1.73～2.55）、超重肥胖（OR = OR=1.25,95%CI:1.13～1.38）、每天体育锻炼不超过1 h（OR = 1.11,95%CI:1.02～1.20）体测合格率更低。结论 引体向上和肺活量是云南省中学生身体素质弱势项目,今后政府、学校、家庭应加强合作,积极鼓励青少年参与体育锻炼,确保学生身体素质水平均衡发展。     

潍坊市成人居民主要慢性病患病现状及其影响因素分析

目的 了解潍坊市成人居民慢性病患病现状及其影响因素,为慢性病预防与控制提供理论依据。方法 采用分层随机抽样方法在潍坊市抽取5 156名≥18岁成人居民进行问卷调查,利用logistic回归分析主要慢性病患病影响因素。结果 潍坊市成人居民高血压、血脂异常及糖尿病患病率分别为35.16%、34.60%、9.39%;对其影响因素进行logistic回归分析,多因素结果显示男性（OR = 1.391,95%CI:1.164～1.661）、年龄大（OR = 13.568,95%CI:8.215～22.408）、饮酒（OR = 1.270,95%CI:1.060～1.520）、肥胖（OR = 9.644,95%CI:5.203～17.878）、高盐（OR = 1.020,95%CI:1.000～1.041）、自评健康状况差（OR = 3.006,95%CI:1.694～5.335）、锻炼（OR = 0.834,95%CI: 0.725～0.959）是高血压的影响因素;男性（OR = 1.268,95%CI:1.032～1.558）、年龄大（OR = 6.049,95%CI:2.420～15.117）、肥胖（OR = 18.227,95%CI:2.471～134.480）、自评健康状况差（OR = 3.664,95%CI:1.093～12.277）、锻炼（OR = 0.719,95%CI:0.587～0.880）是糖尿病的影响因素;年龄大（OR = 2.209,95%CI:1.522～3.206）、自评健康状况好（OR = 0.859,95%CI:0.743～0.993）、已婚（OR = 0.599,95%CI:0.402～0.893）、肥胖（OR = 6.239,95%CI:3.868～10.062）、吸烟（OR = 1.281,95%CI:1.076～1.526）、高盐（OR = 1.024,95%CI:1.006～1.043）、高油（OR = 1.208,95%CI:1.007～1.014）是血脂异常的影响因素。结论 高血压、血脂异常和糖尿病是潍坊市成人居民的主要健康问题,其患病率随年龄呈上升趋势,应加强对老年人、超重和肥胖居民的健康管理,同时大力倡导低盐饮食,戒烟限酒,适度锻炼,提高居民生存质量。     

高原作业对于钻探人员职业紧张的影响探究

目的 探究高原作业是否为钻探人员职业紧张的危险因素及其影响规律,为降低高原作业者职业紧张情况提供参考。 方法 使用付出-回报失衡问卷（Effort-Reward Imbalance,ERI）调查某钻井公司76名高原作业钻探人员和118名非高原作业钻探人员,利用t检验和χ2分析比较两组间基线数据的差异,用卡方分析确定混杂因素,利用二元logistic回归排除混杂因素的干扰衡量高原作业因素的影响。结果 高原作业组ERI问卷平均得分为（1.31±0.21）,高原作业组中有73.68%员工处于职业紧张状态;对照组员工ERI问卷平均得分为（1.18±0.37）,有66.95%的员工处于职业紧张状态。两组间ERI得分有差异有统计学意义。 “高原作业”对职业紧张影响所对应的OR值为2.029（95%CI:1.481～3.248）,职业紧张的其他影响因素为“工龄”（OR = 0.917,95%CI: 0.867～0.969）、“学历”(OR = 1.227,95%CI: 1.149～1.785)与“运动习惯”(OR = 0.724,95%CI: 0.510～1.078)。结论 高原作业组职业紧张程度高于对照组,高原作业是钻探作业人员职业紧张的危险因素。相关部门应该针对影响因素设置防护措施。     

Respiratory outcomes among South African coal miners at autopsy

BACKGROUND: Studies of dose-response relationships between respiratory outcomes at autopsy and coal dust exposure are limited. The Pathology Automation System (PATHAUT) database of South African miners, is one of the largest autopsy databases of occupational lung disease. This study described the prevalence of respiratory outcomes among South African coal miners at autopsy, and determined whether dose response relationships existed between emphysema and exposure. METHODS: Autopsies conducted from 1975 to 1997 on coal miners with exclusive coal mining exposure and having exposure duration information (n = 3,167) were analyzed from PATHAUT. Logistic regression was used to determine relationships between exposure and outcomes, controlling for race, smoking and age on a subset for whom smoking history was available (n = 725). RESULTS: The mean duration of exposure was 11.0 years. Most were black miners (75.3%) with significant differences in the mean ages of black and white miners (37.9 and 55.3 years, respectively). Only 22.9% of cases had information on smoking. The prevalence of silicosis, tuberculosis (TB), coal workers' pneumoconiosis (CWP), and moderate and marked emphysema were 10.7%, 5.2%, 7.3%, and 6.4%, respectively. All diseases, except TB, were associated with exposure duration. Black miners had 8.3 and 1.2 fold greater risks for TB and CWP, respectively, than white miners. White miners had an increased risk of 1.4 and 5.4 for silicosis and moderate to marked emphysema, respectively. In models unadjusted for age, and including smoking, moderate to marked emphysema was strongly associated with exposure duration (OR = 3.4; 95% CI = 1.9-5.9 for highest tercile of exposure duration). Exposure-related risk estimates were reduced when age was introduced into the model. However, age and duration of exposure were highly correlated, (r = 0.68) suggesting a dilution of the exposure effect by age. CONCLUSIONS: There were significant dose related associations of disease, including emphysema, with coal dust exposure.     

长春市脱发大学生抑郁情绪及相关因素分析

目的 了解长春市脱发大学生抑郁情绪水平,探讨影响脱发大学生抑郁情绪的相关因素。方法 选取长春中医药大学附属医院2019年11月—2021年6月收治的275名脱发大学生作为调查对象,利用流调用抑郁量表、一般人口学问卷进行调查,对可能的影响因素进行二元Logistic回归分析。结果 脱发大学生中发生抑郁情绪者121名,检出率为44.0%。女生(OR=2.26,95%CI=1.22～4.20)、26～30岁(OR=2.43,95%CI=1.01～5.85)、自评睡眠质量很差(OR=13.63,95%CI=4.09～45.42)、自评人际关系受较大影响(OR=3.56,95%CI=1.57～8.06)、感知到重度压力(OR=3.73,95%CI=1.35～10.30)与脱发大学生发生抑郁情绪呈正相关,每周锻炼1～2次或3～5次及>5次[OR值(95%CI)分别为0.17(0.05～0.61),0.14(0.04～0.52),0.03(0.01～0.14)],与脱发大学生发生抑郁情绪呈负相关(P值均<0.05)。结论 脱发大学生的抑郁情绪发生率较高,年龄、性别、睡眠质量、人际关系困扰...     

Risk of pulmonary tuberculosis relative to silicosis and exposure to silica dust in South African gold miners [published erratum appears in Occup Environ Med 1999 Mar;56(3):215-6]

OBJECTIVES: To investigate the following questions. (1) Is silica dust on its own, without the presence of silicosis, associated with an increased risk of pulmonary tuberculosis (PTB) in workers exposed to silica dust? (2) In the absence of silicosis is the excess risk dose related? (3) What is the predominant chronological sequence between the development of PTB and the development of silicosis after the end of exposure to dust? METHODS: A cohort of 2255 white South African gold miners has been followed up from 1968 to 1971, when they were 45-55 years of age, to 31 December 1995 for the incidence of PTB. During the follow up 1592 (71%) men died. Of these, 1296 (81%) had a necropsy done at the National Centre for Occupational Health (NCOH) to determine the presence of silicosis and PTB. The incidence of PTB in the cohort was studied relative to cumulative exposure to dust and the onset of silicosis. For the miners with necropsy, the incidence for PTB was studied relative to the severity of silicosis found at necropsy. RESULTS: There were 115 subjects who developed PTB. The total person- years of follow up was 39,319. For the whole cohort, the factors associated with increased risk of PTB were cumulative exposure to dust (mg/m3.y) (the adjusted rate ratio (RR) 1.07; (95% confidence interval (95% CI) 1.04 to 1.10)), silicosis diagnosed radiologically (3.96 (2.59 to 6.06)), and tobacco pack-years (1.02 (1.01 to 1.03)). The RR (95% CI) for PTB increased with increasing quartiles of cumulative exposure to dust 1.0, 1.51 (0.78 to 2.91), 2.35 (1.28 to 4.32), and 3.22 (1.75 to 5.90). In miners who did not have radiologically diagnosed silicosis (n = 1934, PTB = 74), the adjusted RR (95% CI) for PTB and cumulative exposure to dust was 1.10 (1.06 to 1.13), and increased with quartiles of cumulative exposure to dust as 1.00, 1.46 (0.70 to 3.03), 2.67 (1.37 to 5.23), and 4.01 (2.04 to 7.88). For the subjects who had a necropsy (n = 1296, PTB = 70), the adjusted RR (95% CI) for PTB increased with the severity of silicosis found at necropsy; 1.0 for no silicosis, 1.88 (0.97 to 3.64) for negligible, 2.69 (1.35 to 5.37) for slight, and 2.30 (1.16 to 4.58) for moderate or marked silicosis. For subjects who had a necropsy and no silicosis (n = 577, PTB = 18), the adjusted RR (95% CI) increased slightly with quartiles of cumulative dust 1.0, 1.11 (0.31 to 4.00), 1.42 (0.43 to 4.72), and 1.38 (0.33 to 5.62). CONCLUSION: Exposure to silica dust is a risk factor for the development of PTB in the absence of silicosis, even after exposure to silica dust ends. The risk of PTB increases with the presence of silicosis, and in miners without radiological silicosis, with quartiles of exposure to dust. The severity of silicosis diagnosed at necropsy was associated with increasing risk of PTB and even < 5 nodules--that is, undetectable radiologically--was associated with an increased risk of PTB. The diagnosis of PTB was on average 7.6 years after the end of exposure to dust, at around 60 years of age. The onset of radiological silicosis preceded the diagnosis of PTB in 90.2% of the cases with PTB who had silicosis. The results have implications for medical surveillance of workers exposed to silica dust after the end of exposure.       

遵义地区脑卒中患者生活方式和饮食习惯现状调查及危险因素分析

目的 调查遵义地区脑卒中患者的生活方式和饮食习惯现状,探讨该地区脑卒中的危险因素。方法 采用病例对照研究方法,以在遵义市第一人民医院住院的患者为研究对象,于2017年1月- 2019年1月期间收集280对病例对照,研究遵义地区脑卒中患病的危险因素。结果 遵义地区脑卒中患病的危险因素有超重或肥胖（OR = 2.782,95%CI = 1.742～4.442）、高血压（OR = 3.124,95%CI = 1.689～5.778）、吸烟（OR = 2.456,95%CI = 1.543～3.912）、饮酒（OR = 2.324,95%CI = 1.288～4.191）、缺乏运动（OR = 1.873,95%CI = 1.108～3.168）、高盐（OR = 3.074,95%CI = 2.069～4.568）、高脂（OR = 2.421,95%CI = 1.381～4.242）、尿酸（OR = 2.547,95%CI = 1.582～4.100）、空腹血糖（OR = 2.032,95%CI = 1.300～3.177）、TG（OR = 1.928,95%CI = 1.340～2.770）和LDL - C（OR = 1.903,95%CI = 1.202～3.010）（P＜0.05）,保护因素为摄入充足的蔬菜（OR = 0.438,95%CI = 0.221～0.866）（P＜0.05）。结论 遵义地区脑卒中患病的危险因素众多,应根据上述危险因素对该地区的高危人群提出有针对性地干预措施,以达到有效预防脑卒中发生的目的。     

Childhood leukaemia and socioeconomic status: fact or artefact? A report from the United Kingdom childhood cancer study (UKCCS)

BACKGROUND: It is widely believed that children of high socioeconomic status (SES) are more likely than those of low SES to develop acute lymphoblastic leukaemia (ALL). Such observations have led to wide-ranging speculations about the potential aetiological role of factors associated with affluence and modernization. METHODS: Children (0-14 years) newly diagnosed with cancer in the UK between 1991 and 1996 were ascertained via a rapid hospital-based case finding system (n = 4430, of which 1578 were ALL). Children without cancer (controls) were randomly selected from primary care population registries for comparative purposes (n = 7763). Area-based deprivation scores were assigned as markers of SES at two time points - birth and diagnosis. An individual-based marker of SES - social class - was assigned using father's occupation as recorded on the child's birth certificate. RESULTS: No differences in area-based measures of deprivation were observed between cases and controls at time of diagnosis, either for all cancers combined [n = 4430, odds ratio (OR) = 1.00 (95% confidence intervals (CI) 0.98-1.01)] or for ALL alone (n = 1578 OR = 0.99, 95%CI 0.96-1.01). Findings were similar at time of birth (all cancers, OR = 0.99 95%CI 0.98-1.01, ALL OR = 0.98, 95%CI 0.96-1.00). In addition, no case-control differences were observed when an individual-based measure of SES - social class - based on father's occupation at time of birth was used. CONCLUSIONS: The comprehensive nature of the data, coupled with complete case-ascertainment and representative population-based controls suggests that SES in the UK is not a determinant of ALL in children. We believe the small effects reported for SES in some past studies may be artefactual.     

广州市中小学生运动伤害危险因素的配对病例对照分析

目的 探讨中小学生运动伤害的危险因素.方法 按性别、年龄、班级1:1配对原则,通过样本量计算选择349对运动伤害病例和对照,采用单因素和多因素条件logistic回归分析.结果中小学生发生运动伤害的危险因素是:鞋底磨损大(OR=7.20,95%CI:2.37～21.84)、疲倦(OR=14.34,95%CI:2.29～89.66)、带病时参加运动的频率高(OR=1.96,95%CI:1.29～3.06)和既往伤害史(OR=2.11,95%CI:1.41～3.96).运动伤害的保护因素:体育训练时有老师指导动作(OR=0.46,95%CI:0.26～0.79)、运动时做防护措施(OR=0.36,95%CI:0.20～0.64)和运动前热身运动的频率高(OR=0.31,95%CI:0.14～0.67).结论 中小学生运动伤害与个人因素、家庭因素和社会因素有关;应提高学生和老师的安全运动意识,减少运动伤害危险行为的发生.     

深圳市中小学生近视影响因素分析

目的了解深圳市中小学生近视影响因素,为开展学生近视防控工作提供参考。方法采取分层整群抽样的方法在深圳市选取2个区,每个区选小学、初中和普通高中各1所,职业高中1所,共计对14所学校3 073名学生开展近视及影响因素调查。结果对于小学生,每天用电脑2~<3 h(OR=2.23,95%CI=1.19~4.20),不上体育课(每周2节:OR=0.34,95%CI=0.13~0.91;每周4节:OR=0.23,95%CI=0.08~0.62;每周5节及以上:OR=0.33,95%CI=0.11~0.97)与近视呈正相关;课间休息或放学时老师不拖堂(偶尔:OR=1.99,95%CI=1.51~2.63;经常:OR=2.07,95%CI=1.29~3.30),在近距离用眼时0.5~<1 h休息1次眼睛("1~<2 h"OR=1.33,95%CI=1.03~1.70;"≥3 h"OR=1.87,95%CI=1.17~3.00),父母均不近视(一方近视:OR=1.69,95%CI=1.32~2.17;双方近视:OR=2.13,95%CI=1.50~3.02)与近视呈负相关。对于初中生,父母均不近视(一方近视:OR=3.27,95%CI=2.17~4.94;双方近视:OR=5.38,95%CI=2.78~10.42)与近视呈负相关。对于高中生,男性(女性OR=1.52,95%CI=1.07~2.14),每天在校做2次眼保健操(OR=0.41,95%CI=0.23~0.75),每天白天累计户外活动时间≥2 h(OR=0.70,95%CI=0.49~1.00)与近视呈负相关。结论深圳市不同学段学生近视危险因素不尽相同,对具有高危因素的学生应重点防控。     

以照顾家人为目的城乡来源流动老年人健康及锻炼行为比较分析

目的 分析比较以照顾家人为目的城乡来源的流动老年人的健康及锻炼行为。 方法 在“2015年全国流动人口卫生计生动态监测调查数据”中获取研究对象3 175名。采用logistic回归分析城乡老年人自评健康及锻炼行为的影响因素。 结果 以照顾家人为目的的流动老年人自评健康和锻炼时长普遍较高,但城乡来源老年人存在差异。二项logistic回归发现,未患高血压/糖尿病、共同居住、本地朋友数量多是城乡老年人自评健康状况好的共性因素,而城市老年人中个人经济独立（OR=1.62, 95%CI: 1.08~2.44）、农村老年人中家庭人均收入更高（OR=1.74, 95%CI : 1.38~2.18）与自评健康状况好相关。有序logistic回归表明,朋友数量多是城乡老年人锻炼时间长的共性因素,而城市老年人经济独立（OR=1.63, 95%CI : 1.08~2.45）和独立居住（OR=1.56, 95%CI : 1.08~2.22）、农村老年人患高血压/糖尿病（OR=1.35, 95%CI : 1.10~1.65）和健康自评好（OR=1.32, 95%CI : 1.11~1.56）与锻炼时间长相关。结论 城乡来源的流动老年人自评健康和锻炼行为及影响因素既有共性也存在差异,需要关注流动老年人群的异质性,同时需要加强社会支持和家庭支持以促进流动老年人健康。     

Television viewing, leisure-time exercise and acute coronary syndrome in transitional Albania

OBJECTIVE: To assess the association of leisure-time exercise and television (TV) viewing, a sedentary marker, with acute coronary syndrome (ACS) in Albania, a transitional country in Southeast Europe. METHODS: A population-based case-control study was conducted among Tirana residents in 2003-2006. Information on leisure-time exercise (transformed into kilocalories of energy expenditure) and daily hours of TV viewing was obtained by interviewer-administered questionnaire. 460 non-fatal ACS patients (368 men, 92 women) and 628 coronary heart disease-free controls (413 men, 215 women) were studied. RESULTS: Adjusted for socio-demographic characteristics, conventional coronary risk factors and leisure-time exercise, TV viewing was associated with ACS in women (OR=1.66, 95%CI=1.12-2.46 per hour/day viewing), but not in men (OR=0.93, 95%CI=0.81-1.07; P for sex-interaction=0.02). A low level of leisure-time exercise (adjusted also for TV viewing) was associated with ACS similarly in men and women (pooled sexes OR=2.03, 95%CI=1.29-3.22 for bottom vs top tertile of energy expenditure). CONCLUSIONS: Leisure-time inactivity is confirmed as an important risk factor for ACS also in Southeastern Europe. TV viewing may be an informative coronary risk marker in transitional societies, especially in women.     

儿童饮食运动行为干预中手机APP使用的依从性及影响因素

  目的  研究儿童饮食运动行为干预中手机应用程序(APP)使用的依从性及其影响因素,为未来提高干预依从性提供科学依据。  方法  基于在北京、山西长治和新疆乌鲁木齐3座城市开展的一项儿童饮食运动行为干预项目,通过整群随机对照试验,调查干预组694名儿童和家长在干预过程中手机APP使用情况,通过APP点击次数评估APP使用依从性,通过Logistic回归模型分析可能影响APP使用依从性的因素。  结果  手机APP在知识传播、行为监测、家庭作业上传和评估反馈4个部分使用次数M(P₂₅, P₇₅)分别为10(5, 21)、20(14, 26)、7(4, 10)、26(15, 53)次。多因素Logistic回归分析发现,长治地区(OR=1.67,95%CI=1.12~2.48)和主要照顾者为母亲(OR=1.55,95%CI=1.09~2.22)的研究对象对APP使用的依从性较好,而母亲有工作者(OR=0.47,95%CI=0.31~0.74)对APP使用的依从性较差(P值均 < 0.05)。  结论  儿童饮食运动行为干预中手机APP使用依从性较好,地区、主要照顾者是否为母亲、母亲是否工作可能影响依从性的因素。