浙江省城市居民膳食营养素与代谢综合征关系研究

目的从膳食营养素的角度探讨浙江省城市居民代谢综合征(MS)患病的致病因素。方法采用病例对照研究方法,随机选择浙江省四城区MS病例390例,对照393例,进行医学体检和3日24 h膳食调查,将每一种膳食摄入量折算成20种营养素的日均摄入量并使用非条件Logistic回归法分析营养素与MS发生关系。结果调整研究人群基本信息因素和总能量等混杂因素干扰后,钠的摄入在男性组为MS的危险因素(OR=1.77),女性组脂肪、碳水化合物、胆固醇的摄入是MS患病的危险因子;维生素C在男性组为MS的保护性因素(OR=0.78);女性组蛋白质、维生素A、核黄素、钙、磷、钾为MS的保护性因素,OR值均小于1(趋势检验P<0.10)。结论 MS患病的致病因素可能存在性别差异。高能量、高脂、高碳水化合物、高胆固醇及高盐膳食可能是MS发生的危险因素;而高蛋白、抗氧化维生素、膳食纤维、磷、钾、钙可能是其保护因素。[营养学报,2014,36(1):17-21]     

肺癌危险因素及交互作用研究

目的探讨肺癌的影响因素及其交互作用。方法采用病例对照研究设计,收集781例肺癌病例,并按性别、年龄(±3岁)进行1:1匹配,通过调查问卷获取生活饮食习惯等信息。构建决策树及非条件Logistic回归模型,计算OR值及其95%CI,分析影响因素间的交互作用。结果肺癌的危险因素有吸烟(轻度吸烟OR=1.67,重度吸烟OR=7.27)、被动吸烟(轻度被动吸烟OR=2.63,重度被动吸烟OR=6.25)、居住地污染(吸烟者OR=2.26,不吸烟者OR=1.72)、肺癌家族史(吸烟者OR=15.94);保护因素有常吃水果(吸烟者OR=0.69,不吸烟者OR=0.44)、锻炼(吸烟者OR=0.50)、饮茶(不吸烟者OR=0.57)。吸烟与居住地污染、肺癌家族史存在交互作用,重度吸烟与不锻炼存在交互作用。结论吸烟、被动吸烟、居住地污染、肺癌家族史可增加肺癌风险,常吃水果、锻炼、饮茶有助于预防肺癌。肺癌影响因素间的协同作用应予重视。     

营养素摄入量与高脂血症的关系

目的探索各类营养素摄入量与高胆固醇血症、高甘油三酯血症之间的关系。方法用现况调查结合病例对照研究的方法，随机抽取271名调查对象，按血脂检测结果分为病例组和对照组。用食物模型和流行病学问卷调查表的方法，调查研究对象1年中各种食物摄人量，按食物成分表换算成17类营养素的摄入量，比较病例组和对照组间各类营养素摄入量的差异。结果单因素检验结果显示，病例组每天能量、蛋白质、碳水化合物及粗纤维的摄入量（分别为13193KJ，111．91g，606．31g，10．53g）大于对照组（分别为10904．77KJ，97．23g，427．80g，8．75g），单不饱和脂肪酸的摄入量低于对照组（分别为10．28g和13．97g）。因子分析结果显示，高胆固醇血症病例能量因子得分高于对照组；高甘油三酯血症病例能量因子得分高于对照组，脂肪因子得分低于对照组。结论能量摄入过多是高胆固醇血症和高甘油三酯血症发病的危险因素，不饱和脂肪酸摄入不足是高甘油三酯血症发病的危险因素。     

膳食胡萝卜素对肺癌发病危险的影响

通过１５６对１：１配比病例对照研究，分析了武汉地区肺癌患者及其一般疾病住院对照的膳食主要营养素摄入情况。结果表明，病例组膳食胡萝卜素、维生素Ｃ、纤维素摄入水平显著低于对照。作者还分析了膳食胡萝卜素摄入量与肺癌各病理类型发病危险的关系，按吸烟因素分层进行ＯＲ趋势检验，发现膳食胡萝卜素水平与肺腺癌病理类型的ＯＲ趋势无统计显著性差异，但与肺鳞癌及它肺癌病理类型发病存在暴露剂量－反应关系。     

肺癌的营养流行病学研究

通过膳食调查，对沈阳市区１９９１年４日至１９９４年１２月的２９０例原发性肺癌进行１：１按年龄配对的病例对照研究，探讨营养素摄入与肺癌的关系。结果显示，病例组和对照组每天摄入胡萝卜素、视黄醇、纤维素、抗坏血酸的量有显著差异（Ｐ〈０．０５）。上述营养素能减少患肺癌的危险性，其ＯＲ值分别为０．８４，０．７６，０．４６，０．７５，且随摄入量的增加，患肺癌的危险性下降，呈剂量反应关系，调整吸烟因素后，这些营养素降低患肺癌的危险性的联系依然存在。     

食物频率问卷法评估人群能量和营养素摄入量的准确性

目的：研究分析食物频率问卷法评估人群能量和营养素摄入量的准确性,为理论研究提供参考依据。方法收集保定市2012年1月-2014年1月期间130例成人摄入食物的相关资料,进行回顾性分析,使用WFR和食物频率问卷两种方法计算能量以及营养素摄入量,并且将两种方法检测结果进行比较分析。结果 WFR计算出130例入选对象每天摄入能量9.5MJ、脂肪87.3g、蛋白质82.2g、碳水化合物268.9g。使用食物频率问卷计算出的130例入选对象每天摄入能量9.69MJ、脂肪112.6g、蛋白质88.1g、碳水化合物247.9g。关于蛋白质和能量测量数据两种方法的计算结果均无显著差异（P＆gt;0.05）。食物频率问卷法计算的脂肪摄入量明显偏高,而碳水化合物摄入量偏低,矿物质和维生素摄入量计算高于WFR计算所得的摄入量,但个别例如铁、维生素E等的摄入量与WFR相比偏低。食物频率问卷法评估得到的能量和营养素的摄入量除维生素C以及胡萝卜素等以外,与WFR相比均成正相关关系,调整年龄和膳食摄入量后,食物频率问卷对钠、脂肪等的评估与WFR相比不存在相关性。结论食物频率问卷法可用于评估能量、碳水化合物、蛋白质、钾、钙、锌、维生素A等的摄入量,不适用于评估脂肪、维生素C、E以及钠铁、胡萝卜素等的摄入量。     

膳食钠和钾摄入量与非酒精性脂肪肝发病关系病例对照研究

目的了解膳食钠和钾摄入量与非酒精性脂肪肝(NAFLD)发病的关系,为NAFLD的综合防治提供流行病学依据。方法采用以医院为基础的病例对照研究方法,对2015年4月—2017年8月在福建医科大学附属南平市第一医院体检中心经腹部彩超确诊的541例NAFLD新发病例作为病例组及按病例组同性别、年龄(±5岁)频数匹配的同期在福建医科大学附属南平市第一医院体检中心进行腹部彩超检查的541名非NAFLD体检者作为对照组进行问卷调查。结果病例组NAFLD患者和对照组非NAFLD体检者膳食钠、钾摄入量分别为(818.39±417.60)和(742.27±407.08)mg/d、(1 597.10±686.25)和(1 638.96±660.89)mg/d;2组人群比较,病例组NAFLD患者膳食钾摄入量低于对照组非NAFLD体检者(t=–3.929,P 0.001),2组人群膳食钠摄入量差异无统计学意义(P0.05)。在调整了性别、年龄、文化程度、职业、家庭人均月收入、吸烟情况、饮酒情况、体育锻炼时间、慢性病病史及膳食能量、蛋白质、胆固醇、脂肪、碳水化合物、钙、铁和钾等混杂因素后,多因素条件logistic回归分析结果显示,膳食钠摄入量第三五分位数和第四五分位数女性人群NAFLD的发病风险分别为最低五分位数女性人群的0.42倍(OR=0.42,95%CI=0.18～0.96)和0.28倍(OR=0.28,95%CI=0.12～0.66)。在调整了性别、年龄、文化程度、职业、家庭人均月收入、吸烟情况、饮酒情况、体育锻炼时间、慢性病病史及膳食能量、蛋白质、胆固醇、脂肪、碳水化合物、钙、铁和钠等混杂因素后,多因素条件logistic回归分析结果显示,膳食钾摄入量第二五分位数、第三五分位数、第四五分位数和最高五分位数人群NAFLD的发病风险分别为最低五分位数人群的0.63倍(OR=0.63,95%CI=0.43～0.94)、0.45倍(OR=0.45,95%CI=0.29～0.69)、0.36倍(OR=0.36,95%CI=0.22～0.58)和0.31倍(OR=0.31,95%CI=0.16～0.58),膳食钾摄入量第三五分位数、第四五分位数和最高五分位数男性人群NAFLD的发病风险分别为最低五分位数男性人群的0.38倍(OR=0.38,95%CI=0.23～0.65)、0.30倍(OR=0.30,95%CI=0.16～0.57)和0.30倍(OR=0.30,95%CI=0.13～0.67)。结论全人群和男性人群膳食钾摄入量较高及女性人群膳食钠摄入量较高是NAFLD发病的保护因素。     

人群血清胆固醇水平与膳食营养的关系

本文利用一项国家“八·五”攻关研究中不同地区１３个人群心血管病危险因素调查资料，分析膳食营养对人群血清胆固醇水平的影响。通过多元回归分析（调整性别及人群的平均体重指数）发现：人群平均动物蛋白质、脂肪、饱和脂肪酸、膳食胆固醇、膳食脂质分值（Ｋｅｙｓ分值）等营养因素的摄入量以及肉类、蛋类及糕点类的平均食用量分别与人群血清总胆固醇均值正关联；人群平均碳水化合物的摄入量与人群血清总胆固醇均值负关联。本结果支持：在血清总胆固醇及膳食脂质相对较低的人群间，膳食脂质仍是影响人群血清总胆固醇水平的重要因素；适当控制肉类和蛋类食物的摄入量可预防人群血清胆固醇水平升高     

膳食宏量营养素与血脂对妊娠期糖尿病的影响

目的 探讨膳食宏量营养素与血脂对妊娠期糖尿病发病的影响。方法 选择中期妊娠诊断为妊娠期糖尿病的孕妇47例（GDM组）,正常孕妇58例（正常妊娠组）为调查对象,进行24 h回顾性膳食调查,并比较2组孕妇膳食结构中宏量营养素每日摄入量及血清中甘油三酯和总胆固醇的变化。结果 糖尿病组孕妇每日摄入总热卡,碳水化合物、脂肪和蛋白质摄入量以及总胆固醇和甘油三酯均高于正常妊娠组。结论 孕前体重指数高、孕妇摄入碳水化合物、脂肪和蛋白质过多,血甘油三酯和总胆固醇上升,可能是妊娠期糖尿病发病的原因之一。     

微波烹调的营养与食品卫生相关问题的研究

本文总结近年来国内外学者对微波烹调的研究成果,综述微波烹调对食品中徽量营养素、蛋白质、脂肪、碳水化合物及天然植物化学物的影响。对食品农药、兽药残留的作用,对微波食品包装及烹调容器的化学污染,对食品中杂环胺、N-亚硝基化合物、二噁英及其他化学污染物的影响,对食品中微生物的作用,以及微波烹调过程中微波对机体健康的影响等安全性问题。     

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.