老年甲状腺结节特征与甲状腺功能关系研究

目的研究老年人群中甲状腺结节的发病情况,了解结节特征及其与甲状腺功能的关系。方法对150例65岁以上老年人行甲状腺B超检查,同时测定甲状腺功能(T3、T4、TSH)。结果 150例老年人中,检出甲状腺结节62例,检出率为41.3%。其中65～70岁检出28例,占检出者45.2%;70岁以上检出34例,占检出者54.8%。70岁以上组检出率明显高于65～70岁组(P<0.05)。女性检出结节30例,检出率44.8%;男性检出结节32例,检出率38.6%,女性甲状腺结节检出率明显高于男性(P<0.05)。检出结节以多发(59.8%)、直径≤1.0cm的小结节(67.3%)为主。20例患者手术后病理证实:12例为甲状腺腺瘤、7例为甲状腺囊肿、1例为甲状腺乳头状癌。结节组与未检出结节组相比较,甲状腺功能测定差异无统计学意义(P>0.05)。结论老年人甲状腺结节发病率高,随年龄增长发病率增加,女性发病率高于男性。甲状腺结节不引起严重的甲状腺功能异常,应重视老年人甲状腺结节的早期诊断及治疗。     

关于35495名健康体检人员甲状腺结节检出情况分析

目的分析健康体检人群甲状腺结节检出情况,为甲状腺疾病的防治提供科学依据。方法对2011年1月1日至12月31日期间在我院健康管理中心健康体检并进行甲状腺超声检查的35495名人员甲状腺结节检出情况进行卡方检验、两独立样本的秩和检验和卡方趋势检验统计分析,比较不同年龄、不同性别结节检出率、结节大小、结节数目之间的差异。结果35495名人员甲状腺结节总检出率为33．87％,男性女性检出率分别为29．68％、41．76％,女性明显高于男性,女性检出年龄早于男性,检出率随年龄增长而增加;单发结节检出率随着年龄的增长而减少,多发结节检出率随着年龄的增长而增加,单发结节检出率男性多于女性,多发结节反之;小结节、中等结节和大结节的检出率男性分别为77．49％、18．19％、4．32％;女性分别为72．57％、21．59％、5．84％;检出甲状腺结节的人群中,甲状腺癌检出率为4万。结论甲状腺结节患病率已是我国健康体检人群常见及多发的病症之一,我们应加强甲状腺疾病的防治。随着高分辨率超声探头及彩色多普勒超声等技术的应用,以及在健康体检中甲状腺检查的普及,超声诊断甲状腺疾病的诊断率将逐步提高。     

健康体检人群甲状腺结节检出情况调查

目的了解健康体检人群甲状腺结节检出情况,为甲状腺疾病的防治工作提供依据。方法选取2015年1-12月在武汉某医院行健康体检的人群作为研究对象,共3 124人,采用彩色多普勒超声诊断仪行甲状腺检查。结果研究对象甲状腺结节检出率为42.22%,其中,男性甲状腺结节检出率为29.10%,低于女性的53.00%,差异有统计学意义(P0.05)。20~29岁年龄组、30~39岁年龄组、40~49岁年龄组、50~59岁年龄组、60岁及以上年龄组研究对象的甲状腺结节检出率分别为21.07%,36.80%,42.65%,47.20%及57.50%,不同年龄组研究对象甲状腺结节检出率的差异有统计学意义(P0.05),且研究对象的甲状腺结节检出率随年龄增长而呈上升趋势。各年龄组研究对象中,女性甲状腺结节检出率均高于男性,且差异均有统计学意义(P0.05)。研究对象中,术后病理证实甲状腺癌34例(1.09%),不同性别研究对象甲状腺癌的检出率差异无统计学意义(P0.05)。结论甲状腺结节在健康体检人群中的检出率较高,因该病患者常无明显的自觉症状,故极易被忽视,应将甲状腺彩色多普勒超声检查纳入常规体检项目,以期尽早发现病灶并进行干预。此外,女性应尽早关注甲状腺问题。     

甲状腺彩超在健康体检中的应用研究

目的探讨甲状腺彩超检查在健康体检中的必要性。方法对2011年1-12月在某院体检中心参加健康体检的人群中接受甲状腺高频彩超检查者1 620人进行分析。结果甲状腺检查结果异常例数为422人,阳性检出率为26.05%,其中男性检出率为19.00%(210/1 105),女性检出率为41.35%(213/515),女性明显高于男性(χ2=419.78,P0.05);在各个年龄段女性甲状腺检查异常率均明显高于男性;不同年龄段甲状腺异常率呈现明显上升趋势(χ2=218.46,P0.05);随访发现甲状腺癌12例,甲状腺癌人数占甲状腺检查异常率的2.84%,占受检人数的0.74%。结论甲状腺彩超对甲状腺疾病的早期发现具有重要意义,应作为健康体检的常规检查项目,尤其对于35岁以上年龄段女性,具有重要的健康意义。     

2728例体检人群甲状腺结节的流行病学调查

目的了解2728例体检人群甲状腺结节发病情况。方法选择2011年1月至2011年9月杭州市20岁以上,在我院作甲状腺物理和超声检查的健康体检人群2728人,分析其甲状腺检出率情况,并比较物理和超声检查甲状腺的检出率。结果受检人群物理检查出甲状腺结节82例,检出率3℅,其中男性检出17人(1℅),女性检出65人(6%);超声检查检出490例,检出率17.96%,其中男性检出237人(14.29%),女性检出253人(23.67%);女性显著高于男性(P<0.001),且检出率随年龄的增加而增高(P<0.001)。超声检查较物理检查可有效提高检出率(P<0.05)。结论体检人群中甲状腺结节检出率较高,且随年龄的增加而增高,女性高于男性;超声检查可有效提高检出率。     

黄骅市体检人群甲状腺结节检出情况的调查分析

目的了解黄骅市健康体检人群甲状腺结节的检出情况及流行病学特点。方法统计分析2012年1月至2014年12月黄骅市某些单位进行甲状腺超声检查健康体检人群的甲状腺检查资料。结果超声检查2012年甲状腺结节总检出率17.42%,其中男性16.27%,女性21.53%;2013年检出率22.07%,男性20.78%,女性27.24%;2014年检出率30.32%,男性29.02%,女性35.79%。甲状腺结节总检出率连续三年逐年持续升高,差异有统计学意义(χ2=36.836,P0.05),且随着年龄增加呈上升趋势,差异有统计学意义(χ2=26.986,P0.05),女性检出率明显高于男性,但男女检出率差异无统计学意义(χ2=134.81,P0.05)。连续三年受检人群甲状腺结节直径0.3~0.5cm的检出率低于结节直径0.5cm的检出率,甲状腺结节中单发结节的检出率低于多发结节的检出率,二者间比较差异有统计学意义(χ2=403.52,P0.01)。结论黄骅市健康体检人群中甲状腺结节的检出率较高,呈逐年持续升高,且与年龄和性别有关,需有针对性采取预防措施。     

海岛老年人甲状腺癌TI-RADS系统筛查结果分析

目的高频超声在甲状腺检查中应用逐步普及,甲状腺癌发病率呈上升趋势,而对良恶性甲状腺结节的鉴别,是甲状腺癌早发现早诊断关键,针对海岛地区甲状腺癌高发情况,本研究探讨甲状腺影像报告和数据系统(thyroid imaging reporting and data system,TI-RADS)在海岛老年人甲状腺癌筛查中应用价值。方法选取2018-09-11-2018-12-14普陀山镇>60岁居民及高血压慢性病管理居民进行甲状腺超声检查。本次甲状腺超声检查共发现591个结节均给予TI-RADS分类,对恶性结节的极低回声、微钙化、纵横比>1、边缘不清和异常肿大淋巴结进行评级,将TI-RADS分为5级。结果进行甲状腺超声检查共有430人,甲状腺结节269例,检出率为62.5%。男性甲状腺结节检出率为51.6%(80/155),女性检出率为68.7%(189/275),男女比为1∶1.33,女性甲状腺结节发生率高于男性,差异有统计学意义,χ~2=5.68,P=0.017。女性甲状腺结节恶性率为4.4%(20/453),高于男性的2.9%(4/138),差异无统计学意义,P>0.05。结论 TI-RADS系统筛查对于海岛老年人甲状腺癌筛查有指导作用。     

南京市26 788名体检人群甲状腺结节检出率及影响因素分析

目的 通过对大样本健康体检人群进行甲状腺超声检查,分析甲状腺结节的检出率及其危险因素,以期对甲状腺癌的早期防范提供线索。方法 收集2018年1月至2020年5月于南京某医院体检中心行甲状腺超声检查的体检者临床资料,采用单、多因素方法进行分析。结果 26 788例体检者中检出甲状腺结节6 965例,总体检出率为26.0%,其中男性检出率为21.7%,女性检出率为41. 4%,女性检出率明显高于男性（χ²=919.785,P<0.01）。随着年龄的增长甲状腺结节检出率显著增加（P<0.01）。多因素Logistic回归分析显示女性（OR=3.075）、年龄越大（OR=1.066）、空腹血糖异常（OR=1.136）、血压异常（OR=1.151）为罹患甲状腺结节的影响因素。结论 女性、高龄、血糖异常、血压异常是甲状腺结节的危险因素,甲状腺结节的发病可能与代谢异常有关,对代谢异常人群早期筛查可尽早发现甲状腺结节并采取防治措施。     

杭州市余杭区居民甲状腺结节异常情况调查

目的：了解余杭区居民人群中甲状腺结节的异常率及结节特征。方法：采用分层整群随机抽样方法确定调查对象,对1 105名常住居民进行甲状腺高分辨率超声检查、问卷调查,对检出甲状腺结节患者采血,进行甲状腺功能七项的检测。结果：甲状腺结节检出率为27.42%,女性检出率明显高于男性,结节检出率随年龄增长呈增加趋势。甲状腺结节以直径不到1cm的小结节为主,检出结节的人群中甲状腺功能指标异常率为28.71%。结论：甲状腺结节在人群中检出率较高,以单发的小结节为主,女性高于男性,结节患病率随年龄增长而增加。检出结节的人群中甲状腺功能指标异常率为28.71%。     

丽水市农村健康人群甲状腺结节的超声诊断及分析

目的：了解浙江省丽水市农村健康人群甲状腺结节的发病情况;探讨甲状腺结节的高频超声声像图和彩色多普勒血流特征,评估其对甲状腺良、恶性结节鉴别诊断的临床应用价值。方法：结合新型农村合作医疗健康体检工作,应用高频彩色超声对丽水市莲都区638例既往无甲状腺疾病史的健康农民进行超声普查;并对甲状腺结节的超声声像图和彩色多普勒血流特征进行分析。结果：638例受检者中有245例患甲状腺结节疾病,患病率为38.4%。其中,女147例,患病率为46.1%,男98例,患病率为30.2%。女性患病率明显高于男性,两者比较,差异有统计学意义（P〈0.01）。245例甲状腺结节患者中发现甲状腺癌12例（均经手术后病理诊断证实）。不同性质的甲状腺结节有各自不同的声像图特点和血供表现。结论：浙江省丽水市农村健康人群甲状腺结节患病率相对较高,今后应将甲状腺超声检查作为常规体检项目。超声结合彩色多普勒血流显像可对甲状腺结节做出一定程度上的鉴别诊断,对甲状腺癌的早期筛查具有重要的临床价值。     

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.     

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.