秦皇岛市16-18岁青少年血三酰甘油检测结果分析

目的 了解秦皇岛市16～18岁青少年血三酰甘油水平,分析高三酰甘油的危险因素,为儿童青少年代谢综合征的早期预防提供依据.方法 通过分层整群随机抽样,测定秦皇岛市2 395名16～18岁青少年身高、体重、腰围、血压、空腹血糖、血三酰甘油(TG)和高密度脂蛋白胆固醇(HDL-C)水平.结果 血三酰甘油的分布P95为1.75 mmol/L.高三酰甘油血症的检出率为5.8%,男、女生高三酰甘油血症检出率分别为6.9%和4.7%,差异有统计学意义(χ2=5.160,P＜0.05).对血三酰甘油的影响因素进行多元线性回归分析显示,男生组最佳模型引入HDL-C(β=-0.511,P＜0.01)和腰围(β=0.009,P＜0.01),女生组最佳模型引入HDL-C(β=-0.426,P＜0.01)和腰围身高比(β=1.77,P＜0.01).结论 青少年高三酰甘油血症患病率较高,中心性肥胖和低高密度脂蛋白胆固醇是引发青少年高三酰甘油血症的主要危险因素.     

老年非酒精性脂肪性肝病患者γ-谷氨酰转移酶、丙氨酸氨基转移酶与代谢综合征相关因素的研究

目的 探讨老年非酒精性脂肪性肝病患者代谢综合征相关因素的聚集情况及其与γ-谷氨酰转移酶(GGT)、丙氨酸氨基转移酶(ALT)变化的关系.方法 依据超声影像学检查诊断的非酒精性脂肪性肝病患者216例,以GGT或ALT＜50 U/L者为观察组,以GGT或ALT≥50 U/L且≤200 U/L者作为对照组.检测两组患者GGT、ALT、空腹血糖、血脂、血压及腰围,并进行统计分析.结果 与对照组比较,观察组腰围、收缩压、空腹血糖、三酰甘油均低,高密度脂蛋白-胆固醇高,差异有统计学意义(P＜0.01).GGT与腰围、空腹血糖、三酰甘油呈正相关,ALT与三酰甘油呈正相关.结论 老年非酒精性脂肪性肝病患者GGT、ALT与腰围、血压、空腹血糖及血脂紊乱相关,其中GGT敏感度较高.     

糖尿病诊断中生物化学检验的应用意义评估

目的:评估糖尿病诊断中生物化学检验的应用意义.方法:选择我院2014年1月～2016年12月收治的76例糖尿病患者作为研究对象,对76例糖尿病患者实施空腹血糖、糖耐受、血清三酰甘油等化学检测,分析各项生物化学检验结果.结果76例糖尿病患者的空腹血糖平均(8.8±5.5)mmol/L,2h平均糖耐受值(12.5±6.4) mmol/L,血清三酰甘油水平值平均(2.20±1.20) mmol/L;分析76例糖尿病患者的空腹血糖、糖耐受、血清三酰甘油等化学指标均比正常值高.结论:糖尿病患者诊断生物化学检验在临床诊断中具有重要意义,通过对这三方面的数值检测,可以了解患者疾病情况,对患者临床诊断治疗具有重要意义,值得推广应用.     

平顶山市区239名中小学生血脂谱影响因素分析

目的 了解平顶山市儿童血脂谱水平及其影响因素,为筛查血脂异常儿童提供参考指标.方法 对平顶山市239名中小学生进行体格检查、血脂测定及影响因素问卷调查.结果 血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平女生依次为(3.44±0.84),(0.91±0.33),(1.12±0.26),(1.68±0.49)mmol/L,男生依次为(3.65±0.63),(1.02±0.30),(1.18±0.23),(1.88±0.68) mmol/L,女生各项指标显著高于男生;饮食、运动和体格状况与血脂水平有不同程度的相关性.结论 不良饮食习惯、活动量小、肥胖和血压偏高可作为筛查血脂异常高危儿童的参考指标.     

螺内酯对糖尿病肾病患者尿8-异前列腺素F2α的影响

目的 了解螺内酯对糖尿病肾病患者尿8-异前列腺素F2α(8-iso-PGF2α)的影响.方法 将78例糖尿病肾病患者按随机数字表法分为试验组(40例)和对照组(38例),对照组采用常规治疗,试验组在常规治疗的基础上加用螺内酯20 mg/d,均治疗3个月.分别观察治疗前后收缩压、舒张压、空腹血糖、餐后2h血糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、糖化血红蛋白、尿白蛋白/尿肌酐、尿8-iso-PGF2.血钾、血钠等.结果 两组治疗前后空腹血糖、餐后2h血糖、收缩压、舒张压、糖化血红蛋白、三酰甘油、LDL-C、血钠比较差异无统计学意义(P＞0.05).对照组治疗前后ACR、8-iso-PGF2α比较差异无统计学意义(P＞0.05),试验组治疗后ACR、8-iso-PGF2α较治疗前和对照组治疗后均明显降低[(44.55±46.82) mg/g比(85.42±59.46) mg/g和(110.02±110.65) mg/g、(251.07±424.64) ng/L比(438.84±505.23) ng/L和(465.21±544.08)ng/L,P＜0.05].对照组和试验组治疗后TC均较治疗前明显降低[(4.63±0.87) mmol/L比(5.14±0.98) mmol/L和(4.56±0.80)mmol/L比(4.98±0.98) mmol/L,P＜0.05],但两组间比较差异无统计学意义(P＞0.05).试验组治疗后血钾较治疗前明显升高[(4.10±0.46) mmol/L比(3.82±0.46) mmol/L,P＜ 0.05].结论 螺内酯对糖尿病肾病具有独立的抗氧化和降低ACR的保肾作用.     

妊娠期糖尿病合并妊娠高血压综合征孕妇血清高密度脂蛋白表达特征及预测妊娠结局价值

目的:探索妊娠期糖尿病合并妊娠高血压综合征孕妇血清高密度脂蛋白表达特征以及对妊娠结局的预测意义。方法:选取2014—2016年本院确诊的妊娠期糖尿病合并妊娠高血压综合征孕妇95例为观察组,产前检查健康孕妇100例为对照组,测定空腹血糖和口服葡萄糖试验,高密度脂蛋白水平,测量血压,对观察组血清高密度脂蛋白表达与妊娠结局进行关联分析。结果:妊娠28周时观察组空腹血糖(5.64±0.79mmol/L)高于对照组(4.46±0.50mmol/L),餐后1h、2h血糖水平高于对照组,收缩压和舒张压(156.68±13.94mmHg、7.66±9.07mmHg)高于对照组,血清高密度脂蛋白(1.36±0.29mmol/L)低于对照组(1.80±0.33 mmol/L),低密度脂蛋白、甘油三酯和胆固醇水平均高于对照组(P0.05)。观察组中高密度脂蛋白水平小于正常值孕妇顺产比例(51%)低于正常水平孕妇,产后出血发生率(8.1%)高于正常水平者(0.0%)(P0.05),但阴道助产、剖宫产及新生儿窒息和死胎发生率与高密度脂蛋白水平高低未差异。多因素回归分析显示,高密度脂蛋白水平异常减低,空腹血糖水平、低密度脂蛋白水平及收缩压异常增高等均与不良妊娠发生有关。结论:妊娠期糖尿病合并妊娠高血压综合征孕妇血清高密度脂蛋白异常降低,且与顺产及产后出血发生存在关联,值得临床关注。     

不同糖耐量人群的相关临床指标检测的临床价值研究

目的 对不同糖耐量人群有关指标检测的临床意义进行探讨。方法 将2020年2月-2021年2月来惠州市第六人民医院产科门诊治疗的10266例2型糖尿病患者、糖耐量降低患者、体检正常者列为研究对象,例数均为3422例,依次列为耐量高组、糖耐量降低组、正常组,三组研究对象均进行血糖指标检测、血脂指标检测,并对三组检测结果进行分析对比。结果 糖耐量高组的空腹血糖、餐后2小时血糖、糖化血红蛋白水平分别为(10.48±1.67)mmol/L、(15.32±3.53)mmol/L、(9.99±2.53)%,显著高于糖耐量降低组和糖耐量正常组;耐糖量高组的总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇水平分别为(4.78±0.74)mmol/L、(2.58±0.44)mmol/L、(2.98±0.54)mmol/L、(0.98±0.13)mmol/L,显著高于糖耐量降低组和糖耐量正常组,组间差异有统计学意义,P<0.05。结论 糖代谢能力越差,血糖水平越高,脂质代谢能力越差,应对糖耐量异常人群进行有关临床指标检测,及时了解患者身体状况。     

深圳市某企业员工脂肪肝患病情况分析

目的探讨广东省深圳市企业员工脂肪肝患病情况及其影响因素。方法对深圳市某企业1 612名员工的健康体检资料进行t检验、χ2检验和Logistic回归分析。结果深圳市某企业员工的脂肪肝患病率为32.5%,脂肪肝组体重指数(27.83±3.53)kg/m2、腰围(92.09±8.64)cm、收缩压(128.99±13.73)mmHg、舒张压(82.49±11.39)mmHg(1 mmHg=0.133kPa)、总胆固醇(5.41±1.00)mmol/L、甘油三酯(2.53±2.20)mmol/L、低密度脂蛋白(3.43±0.81)mmol/L、空腹血糖(5.28±1.31)mmol/L、谷丙转氨酶(45.83±31.07)U/L和尿酸(453.51±89.39)μmol/L等指标高于非脂肪肝组,高密度脂蛋白(1.06±0.21)mmol/L低于非脂肪肝组(P均<0.01)。结论深圳市企业员工脂肪肝患病率较高,影响因素较多,有必要采取一系列综合性防治措施。     

2型糖尿病合并非酒精性脂肪性肝病患者的临床特征及相关危险因素分析

目的 探讨2型糖尿病合并非酒精性脂肪性肝病(NAFLD)患者的临床特征,并对本病可能的相关危险因素进行分析.方法 选取住院的96例2型糖尿病患者,根据是否合并NAFLD将其分为合并NAFLD组(40例)和无NAFLD组(56例),测量记录两组身高、体重、腰围、臀围,以及两组丙氨酸氨基转移酶、天冬氨酸氨基转移酶、血脂以及空腹血糖、胰岛素水平,计算体质指数、腰臀比、稳态模型胰岛素抵抗指数(HOMA-IR),并对结果数据进行统计学分析.结果 合并NAFLD组体质指数、腰臀比、三酰甘油、总胆固醇、低密度脂蛋白胆固醇、HOMA-IR分别为(26.18±2.68)kg/m2、0.95±0.04、(2.68±0.94) mmol/L、(5.75±1.23) mmol/L、(3.63±0.74)mmol/L、1.58±0.39,较无NAFLD组的(21.41±2.37)kg/m2、0.91±0.03、(1.52±0.78]mmol/L、(4.46±1.02)mmol/L、(3.11±0.89)mmol/L、1.12±0.43均显著升高,合并NAFLD组高密度脂蛋白胆固醇为(1.06±0.27)mmol/L,较无NAFLD组的(1.31±0.31)mmol/L显著降低,差异均有统计学意义(P＜0.01).结论 肥胖以及胰岛素抵抗、脂肪代谢紊乱等危险因素可能会增加2型糖尿病发生NAFLD的危险性.     

非乙醇性脂肪肝患者血脂、血糖与肝功能检验情况评价

目的:研究非乙醇性脂肪肝患者血脂、血糖与肝功能检验情况.方法:本次选取的研究对象为2015年11月1日～2016年10月31日期间在我院进行治疗的非乙醇性脂肪肝患者35例(疾病组)和同期在本院进行体检的健康人群35例(健康组),将两组检验后的血脂、血糖以及肝功能情况进行比较.结果:疾病组的血糖水平、血脂水平依次为(7.11±1.24mmol/L)、三酰甘油(3.29±0.85mmol/L)、总胆固醇(5.76±1.18mmol/L)、低密度脂蛋白胆固醇(3.76±1.23mmol/L)、高密度脂蛋白胆固醇(2.38±0.31mmol/L),肝功能水平分别为天门冬氨酸氨基转移酶(41.28±6.47U/L)、丙氨酸氨基转移酶(43.52±8.38U/L)、谷酰转肽酶(51.60±9.52U/L),数据与健康组相比,明显是疾病组更高(P<0.05).结论:诊断非乙醇性脂肪肝时血脂、血糖与肝功能指标的检验结果均具有较高的医学价值.     

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.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.