某铁路公司员工吸烟饮酒与代谢综合征的相关性

目的了解某铁路公司员工吸烟饮酒与代谢综合征(MetS)的相关性,为制订铁路员工的健康指导方案提供科学依据。方法采用SPSS 20.0软件进行统计学分析,不同性别MetS的患病率及吸烟、饮酒人群检出率的比较采用卡方检验。不同年龄MetS、组分患病率及吸烟、饮酒人群检出率变化趋势采用卡方趋势检验。吸烟、饮酒与研究人群MetS患病率的相关性采用分层卡方检验。结果 6703例铁路职工MetS患病率为21.6%;不同年龄组和不同性别吸烟、饮酒状况的比较差异均有统计学意义;MetS及组分患病率随着年龄增长而增加,且男性高于女性;吸烟是MetS的危险因素(RR=1.371),饮酒是45岁男性MetS的危险因素(RR=1.405)。结论吸烟、饮酒与MetS密切相关。     

职业接触噪声与高胆固醇血症关系的初探

目的探讨噪声对血胆固醇浓度的影响。方法以噪声所致高频听力损失值(4000Hz)为噪声接触水平的特异性暴露指标,利用多因素非条件logistic回归对血胆固醇浓度的影响因素进行分析。结果1171名噪声岗位员工中,血清胆固醇均值为(4.84±0.92)mmol/L,高胆固醇血症的患病率为33.22%。高胆固醇血症患病率:不同年龄组间差异有统计学意义(χ^2=59.480,P<0.001),以40~岁组患病率最高,为42.33%;不同性别间差异无统计学意义(χ^2=0.560,P=0.454);BMI指数异常高于正常组,差异有统计学意义(χ^2=12.726,P<0.001);吸烟组高于不吸烟组,差异有统计学意义(χ^2=7.888,P=0.005);饮酒与不饮酒组差异无统计学意义(χ^2=2.510,P=0.113);高频听损组高于无高频听损组,差异有统计学意义(χ^2=5.564,P=0.018);不同工龄组间差异有统计学意义(χ^2=47.529,P<0.001),其中工龄>10年组最高,为40.81%。多因素非条件logistic回归分析显示,年龄(OR=1.34,95%CI:1.13~1.58)、BMI指数(OR=1.38,95%CI:1.07~1.79)、工龄(OR=1.41,95%CI:1.06~1.88)是高胆固醇血症的危险因素,高频听损对血胆固醇浓度未见明显影响。结论噪声在职业接触噪声人群中并不是高胆固醇血症的主要危险因素。     

青海省居民高血压患病率及危险因素分析

目的 了解青海省高血压流行状况及相关危险因素,为制定高血压防治对策提供依据.方法 2008年6月～2009年5月,多阶段分层整群随机抽样对青海4个经济类型县(区)的2633名18岁以上人群进行调查.结果 青海省18岁以上居民高血压患病率为20.81％,男性患病率22.25％,女性患病率19.63％(x2=2.726、P=0.099),随年龄的增加患病率显著升高(x2=403.845、P=0.000),不同经济类型地区间高血压患病率差异有统计学意义(x2=16.999、P=0.001),随着体质指数的增加高血压患病率也随之增加(x2=181.38、P=0.000),有高脂血症者高血压患病率(28.16％)明显高于无高脂血症者高血压患病率(19.52％) (x2=11.058、P=0.001),有糖尿病者高血压患病率(34.85％)明显高于无糖尿病者高血压患病率(20.60％) (x2=7.69、P=0.006).不同职业性体力活动者高血压患病率差异有统计学意义(x2=60.679、P=0.000).有高血压家族史的高血压患病率(26.58％)明显高于无高血压家族史的患病率(19.10％) (x2=15.740、P=0.000),有冠心病家族史的高血压患病率(25.42％)与无冠心病家族史的患病率(20.36％)间差异无统计学意义(x2=3.34、P=0.067);有脑卒中家族史的高血压患病率(35.20％)明显高于无脑卒中家族史的患病率(20.10％) (x2=16.482、P=0.000).结论 青海省城乡居民高血压患病率处于较高水平,应控制肥胖、糖尿病和血脂异常,进行适当的体育锻炼,从而防治高血压.     

重庆市某区居民高血压流行病学特征及危险因素分析

目的分析和探讨重庆某区居民高血压流行病学特征及其主要危险因素。方法采用分层多阶段抽样法,对重庆市某区18岁及以上的常住居民(居住6个月及以上者)进行调查。利用Epidata软件建立数据库并采用双人双遍录入并校对,SPSS18.0软件进行描述性分析和危险因素分析。结果共调查1 200人,其中有193名高血压患者,患病率为16.8%。60岁及年龄组高血压患病率比小于60岁各年龄组患病率高(χ2=114.212,P0.05);未接受正规学校教育人群的高血压患病率(34.8%)较其他组高(χ2=51.978,P0.05);丧偶人群的患病率(41.46%)高于其他组(χ2=49.022,P0.05);超重、肥胖人群的高血压患病率高于偏瘦和正常人群患病率(χ2=47.150,P0.05)。在本次调查中男女性别、饮酒与否、吸烟与否与高血压患病率无统计学差异。结论本地区高血压的患病率无性别差别,但年龄、职业、文化程度及婚姻状况的不同高血压的患病率有所不同。高龄,低文化程度、丧偶人群的高血压患病率较高。吸烟与饮酒不是本区高血压患病的危险因素,肥胖是本区高血压的危险因素。     

贵州省某县毛南族与汉族老年人高血压对照研究

[目的]了解毛南族、汉族老年人高血压患病的流行现状和主要危险因素,为农村地区防治制订合理的防治措施.[方法]对平塘县593名农村老年人进行分层随机抽样.[结果]老年人高血压患病率为24.96%,男女间差异无统计学意义(χ2=1.752,P=0.209);毛南族与汉族间差异无统计学意义(χ2=3.336,P=0.072).男女之间各级高血压患病无差异(χ2=0.926,P=0.629);民族内部男、女之间各级高血压患病无差异(χ2=0.899,P=0.638;χ2=1.176,P=0.555).单纯收缩期高血压的患病率为7.59%,两民族各年龄组之间单纯收缩期高血压患病率差异有统计学意义(χ2=18.337,P=0.000).本民族内部各年龄组之间单纯收缩期高血压患病率差异有统计学意义(χ2=15.681,P=0.000;χ2=14.561,P=0.001);毛南族汉族体质指数、吸烟、烹调用油的种类、职业、劳动强度与高血压患病率差异均有统计学意义(χ2=19.227,6.814,16.313,14.506,12.510;P=0.000 0,0.009 0,0.000 0,0.000 0,0.002).[结论]高血压是影响农村老年人健康的主要疾病之一,重视农村老年人高血压病的管理,提高人群对高血压病的预防意识,改善生活方式,是降低高血压病患病率的主要途径.     

南昌市某社区脑卒中高危人群筛查结果分析

目的了解南昌市东湖区江铃社区40岁及以上居民脑卒中高危人群危险因素暴露情况,为脑卒中预防和干预提供依据。方法按照整群抽样方法,对江铃社区4 349例常住居民进行筛查,采用x2检验等方法分析社区居民脑卒中危险因素的暴露情况。结果本研究共筛查出562例脑卒中高危者,检出率为12.9%。居前5位危险因素分别为高血压、缺乏运动、血脂异常、吸烟和明显超重或肥胖。不同性别居民吸烟、明显超重或肥胖和糖尿病差异有统计学意义(P0.05);不同年龄组居民高血压、吸烟、明显超重或肥胖、糖尿病及房颤或脉搏不齐差异有统计学意义(P0.05)。结论针对不同性别、不同年龄组居民脑卒中高危者进行有针对性干预,降低脑卒中发病率、死亡率和致残率。     

青岛成人抑郁症和2型糖尿病患病率双向关联研究

目的 评估青岛成人抑郁和2型糖尿病的患病率以及相关危险因素,为社区开展早期慢性病危险因素预防提供科学依据.方法 研究对象来自青岛市2006年建立的横断面研究数据,通过分层随机抽样抽取6 100名35～74岁常住居民(居住时间≥5年).用Zung自评量表进行抑郁的筛检,标准2h糖耐量试验诊断糖尿病.结果 2 974名调查者纳入本研究,抑郁和2型糖尿病的患病率分别为10.1％和16.4％.多因素校正Logistic回归分析中,糖尿病增加抑郁患病风险,农村居民、高密度脂蛋白降低抑郁的风险(均有P ＜0.05);年龄、抑郁、体质指数、甘油三酯、高血压、糖尿病家族史、未婚与2型糖尿病患病率增长均呈正相关(均有P ＜0.05);空腹血糖与抑郁(x2=12.32,OR=1.366,95％ CI:1.151～1.622)、2h血糖与抑郁(x2=11.35,OR=1.212,95％ CI:1.081～1.358)皆存在剂量-反应关系.结论 抑郁和2型糖尿病互为两者患病率增加的独立危险因素.早期开展社区心理干预能够预防抑郁和糖尿病的发生.     

唐山市居民糖尿病患病情况调查

目的　调查唐山地区居民糖尿病的流行特点.方法　采用整群随机抽样调查的方法,通过问卷及检测空腹血糖对研究对象进行调查,并对调查结果进行统计分析.结果 唐山市居民糖尿病患病率为6.15％.男性患病率为5.40％,女性患病率为6.73％,不同性别人群糖尿病的患病率差异无统计学意义(x2=1.747,P＞0.05).不同年龄段居民的糖尿病患病率差异有统计学意义(x2=30.701,P＜0.05),70岁以上居民患病率为9.54％,30岁以下居民患病率为0.50％.城市居民患病率为7.10％,乡镇居民患病率为4.92％,差异有统计学意义(x2=4.612,P＜0.05).文化水平越高患病率越低,差异有统计学意义(x2=14.117,P＜0.05).体重过低人群患病率3.73％,肥胖人群患病率9.61％,差异有统计学意义.结论 不同年龄、地区、文化水平、体重指标人群糖尿病的患病率不同,应根据不同人群特点开展糖尿病防控工作.     

北京市顺义区居民饮酒现状及影响因素分析

目的分析北京市顺义区社区居民饮酒行为及其影响因素。方法采用按人口规模大小成比例的概率抽样方法 (PPS)抽取顺义区18~80岁常住居民3840人,去除数据缺失者后为3810人,其中男性1708人,女性2102人。采用自行设计的调查问卷对调查对象进行面对面问卷调查。结果顺义区成年居民过去12个月饮酒率为37.5%,标化率为37.7%;男性饮酒率为69.9%,女性为11.1%,女性饮酒率显著低于男性(χ~2=1389.143,P0.05);顺义区居民总体饮酒率在各年龄组间变化不大,各年龄组男性饮酒率均显著高于女性;男性饮酒率最高的年龄组为50~59岁,为76.5%,女性饮酒率最高的年龄组为18~29岁,为15.5%;各职业间饮酒率差异有统计学意义(χ~2=166.465,P0.05),各职业中以工人饮酒率最高,为54.5%(276/506);婚姻状况中未婚者的饮酒率最高,为44.0%,且不同婚姻情况的居民饮酒率差异有统计学意义(χ~2=14.030,P0.05);吸烟居民的饮酒率明显高于不吸烟居民的饮酒率,差异具有统计学意义(χ~2=854.127,P0.05);不同饮酒频率组中男性和女性的饮酒频率差异有统计学意义(χ~2=176.498,P0.01)。结论顺义区社区居民的饮酒率高于全国居民的饮酒率,男性和吸烟人群是目前限酒干预的重点对象,我们应加强对顺义区居民健康饮酒宣教,避免和减少饮酒相关疾病和伤害的发生。     

影响陕南山区消防官兵功能性消化不良发生率及相关因素分析

目的 调查陕南山区消防官兵功能性消化不良(FD)的患病的发生率及分析其相关因素.方法 采用国际功能性胃肠病罗马诊断标准设计的FD症状量表,通过问卷方式对生活在海拔1 000～2 200 m的200名消防官兵进行调查,对可能的相关危险因素进行单因素和多因素Logistic回归分析.结果 调查的消防官兵中被诊断为FD的有61例,患病率为30.5％,该61例FD患者临床症状表现为上腹部疼痛13例(21.3％)、饱胀感15例(24.6％)、烧灼感11例(18.0％)、早饱9例(14.8％)、反酸5例(8.2％)、恶心3例(4.9％)以及嗳气者5例(8.2％);FD组和健康组在躯体化、抑郁、焦虑及精神病性4个项目上比较,差异有统计学意义(P＜ 0.05);单因素分析结果,消防官兵吸烟(x2=4.236)、饮酒(x2=3.983)、喜进生冷食物(x2=3.319)、焦虑(x2=3.271)、参加灭火和抢险(x2=3.493)5个因素是影响消防官兵发生FD的危险因素(P＜0.05);多因素Logistic回归分析结果,吸烟(OR=6.358)、焦虑(OR=5.472)、参加灭火和抢险(OR=5.253)是影响FD发生的高危因素,差异有统计学意义(P＜0.05).结论 山区消防官兵中FD的发生率较高,吸烟、喜进生冷食物,饮酒、焦虑和经常参加灭火和抢险是引发FD的危险因素.     

Lunasin is prevalent in barley and is bioavailable and bioactive in in vivo and in vitro studies

Lunasin, a unique 43-amino acid peptide found in a number of seeds, has been shown to be chemopreventive in mammalian cells and in a skin cancer mouse model. To elucidate the role of cereals in cancer prevention, we report here the prevalence, bioavailability, and bioactivity of lunasin from barley. Lunasin is present in all cultivars of barley analyzed. The liver and kidney of rats fed with lunasin-enriched barley (LEB) show the presence of lunasin in Western blot. Lunasin extracted from the kidney and liver inhibits the activities of HATs (histone acetyl transferases), yGCN5 by 20% and 18% at 100 nM, and PCAF activity by 25% and 24% at 100 nM, confirming that the peptide is intact and bioactive. Purified barley lunasin localizes in the nuclei of NIH 3T3 cells. Barley lunasin added to NIH 3T3 cells in the presence of the chemical carcinogen MCA activates the expression of tumor suppressors p21 and p15 by 45% and 47%, decreases cyclin D1 by 98%, and inhibits Rb hyperphosphorylation by 45% compared with the MCA treatment alone. We conclude that lunasin is prevalent in barley, bioavailable, and bioactive and that consumption of barley could play an important role of cancer prevention in barley-consuming populations.     

Salmonellas in pigs and animal feeding stuffs in England and Wales and in Denmark

A comparison has been made between the incidence of salmonellas in pigs and feeding stuffs in England and Wales and in Denmark. In Denmark there is veterinary legislation requiring the sterilization of imported and home produced feed ingredients of animal origin. There is no such legislation in England and Wales. In Denmark 0·3% of resterilized imported meat and bone meal was contaminated with salmonellas. This compared with 23% of meat and bone meal in England and Wales and 20-27% of other ingredients of animal origin. In England and Wales salmonellas were isolated from 7% of caecal samples and 6% of lymph node samples, while in Denmark they were isolated from 3% of caecal samples and 4% of lymph node samples. In England and Wales 25 serotypes were found in both pigs and feeds and these included nearly all the most prevalent human pathogens. In Denmark four of the six serotypes in pigs had been found in resterilized feed. One notable difference between the two studies was the very wide range of serotypes found in pigs in England and Wales and the narrow range in Denmark. A second was that Salmonella typhimurium formed 15% of all Salmonella strains isolated from pigs in England and Wales, and 60% of those in Denmark.     

Management of pregnancy and childbirth in England and Wales and in France

This paper reviews national data on obstetric and neonatal practices in England and Wales, and in France between 1970 and 1980. The data have been derived from national statistics and surveys on national samples of births in 1970, 1975 and 1980 in England and Wales, and 1972, 1976 and 1981 in France. The analysis shows that there was no major difference in pregnancy outcome, but wide variations in medical practices, and their trend over time. The main differences were: in England and Wales a higher number of antenatal visits, a higher percentage of inpatient admissions during pregnancy, a higher rate of induction, more episiotomies, a higher rate of resuscitation at birth, and admission to neonatal special care units; in France, a higher rate of caesarean sections before and during labour, some evidence of a more active management of labour, and a longer hospital post-natal stay. These differences in practice reflect differences in objectives and assessment of the effectiveness of care between the two countries: they point out the need for better monitoring and evaluation of obstetric and neonatal practices.     

Research and teaching in social and preventive medicine and in public health

Summary Both public health and social and preventive medicine are characterised by the common goal of promoting, maintaining and improving health and preventing disease, and both are concerned with a population-related, preventive and environmental perspective. But whereas public health is interdisciplinary and goes far beyond the medical focus, social and preventive medicine is medically based and forms a bridge between public health and medical practice. Research in a department of social and preventive medicine serves to support preventive and medico-social activities in medical practice as well as in public health. This is illustrated by results from research conducted at the author's department during the last twenty years. Examples are research in support of smoking cessation activities, and research used for the planning of care for the elderly. Both the research and the teaching activities of the department take into account the population focus of public health as well as the focus on individual medicine in clinical practice.

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Forschung und Lehre in Sozial-und Präventivmedizin und öffentlicher Gesundheit

Zusammenfassung Sowohl das Gebiet der öffentlichen Gesundheit als auch dasjenige der Sozial-und Präventivmedizin sind durch das Ziel der Förderung, Erhaltung und Verbesserung der Gesundheit sowie der Krankheitsvorbeugung gekennzeichnet, und beide beschäftigen sich mit einer bevölkerungsbezogenen, präventiven und umweltbezogenen Perspektive. Aber während die öffentliche Gesundheit stark interdisziplinär ist und weit über den medizinischen Fokus hinausreicht, ist die Sozial-und Präventivmedizin ein medizinisches Fach und stellt eine Brücke zwischen der öffentlichen Gesundheit und der ärztlichen Praxis dar. Die Forschung in einem Institut für Sozial-und Präventivmedizin dient der Förderung präventiver und sozialmedizinischer Tätigkeiten in der ärztlichen Praxis wie auch in der öffentlichen Gesundheit. Dies wird durch die Forschungstätigkeit des Instituts des Autors aus den letzten 20 Jahren illustriert, wobei Beispiele aus den Gebieten der Förderung der Raucherentwöhnung und der Betreuung behinderter Betagter dargestellt werden. Sowohl in den Forschungs-als auch in den Lehrtätigkeiten des Instituts finden der Bevölkerungsbezug der öffentlichen Gesundheit wie auch der individualmedizinische Ansatz der ärztlichen Praxis ihren Ausdruck.

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La recherche et l'ensignement en médecine sociale et préventive et en santé publique

Résumé La santé publique aussi bien que la médecine sociale et préventive sont caractérisées par le but commun de promouvoir, maintenir et améliorer l'état de santé et de prévenir les maladies, et elles s'orientent vers une perspective de population, de prévention et environnementale. Mais la santé publique est interdisciplinaire et va loin au-delà de la médecine, tandis que la médecine sociale et préventive est basée sur la médecine et représente le lien entre la santé publique et la pratique médicale. La recherche d'un institut de médecine sociale et préventive sert à appuyer les activités préventives et médico-sociales au cabinet médical aussi bien qu'en santé publique. Cela est illustré par des résultats de recherches conduites dans les vingt années passées à l'institut de l'auteur, et les exemples sont tirés de la recherche en appui de la promotion de la cessation de fumée et de la planification de la prise en charge des personnes âgées et handicapées. Les activités de recherche et de l'enseignement de l'institut tiennent compte de la perspective de population cacactéristique de la santé publique, aussi bien que de la dimension de médecine individuelle caractéristique de la pratique clinique.

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Paper presented at a symposium on The Public Health Perspective of Social and Preventive Medicine, in celebration of the 20th anniversary of the Department of Social and Preventive Medicine, University of Berne, 25 June 1992 in Berne.     

Eggs enriched in omega-3 fatty acids and alterations in lipid concentrations in plasma and lipoproteins and in blood pressure

Effects of dietary eggs enriched with omega-3 fatty acids on lipid concentrations in plasma and lipoproteins and blood pressure were determined in 11 men and women in two groups. Group 1 consumed four omega-3 eggs per day during the first 4-wk period and four control eggs for the second 4-wk period. Group 2 ate the same number of eggs in the reverse order. Mean plasma cholesterol concentration was significantly increased by control eggs (P less than 0.01) but unchanged by omega-3 eggs. Mean plasma triglyceride concentration was decreased by omega-3 eggs but increased by control eggs. Both systolic and diastolic blood pressures were significantly lowered by omega-3 eggs in group 1 whereas only systolic pressure was significantly decreased on omega-3 eggs in group 2. The control eggs did not change blood pressure. In conclusion, the omega-3 eggs may be more healthful than the control eggs.     

Selenium levels in human blood and tissues in health and in disease.

The levels of selenium in human sera and pancreatic, hepatic and synovial tissues were measured. An attempt was made to correlate the selenium level with certain disease states. Selenium was determined by nerutron activation analysis, using the 17.4 second half-life isotope 77mSe with a sensitivity of 2ppb. Serum-bound selenium was determined in normal individuals and individuals with various malignancies, and medical and surgical disorders. Tissue selenium was assayed in diseased and normal pancreases, livers, and synovial membranes. A wide variation was observed both in the serum selenium content of patients with a malignancy and in postmoren pancreatic and synovial showing histopathological changes. Significantly lower selenium values were observed in sera from cancer patients than from normal individuals. Higher values were generally observed in patients with primary neoplasms of the reticuloendothelial system. Higher tissue concentrations were obtained in synovia from patients with rheumatoid arthritis and in pancreatic tissues associated with histopathological changes.     

Prevalence and Trends in Overweight in Mexican-American Adults and Children

Overweight and obesity have been increasing in many countries. Our objective is to describe the trends in overweight and obesity occurring in the Mexican-American population in the United States. Data on measured height and weight for Mexican Americans come from the following surveys: the Hispanic Health and Nutrition Examination Survey (HHANES, 1982–84), the Third National Health and Nutrition Examination Survey (NHANES III, 1988–94), and NHANES 1999–2002. In 1999–2002, 73% of Mexican-American adults were overweight and 33% were obese. Obesity increased between NHANES III and NHANES 1999–2002, from 24% to 27% for men and from 35% to 38% for women. Increases were also seen for children and adolescents. The Mexican-American population in the United States, both children and adults, is showing trends in overweight and obesity over time that are similar to those seen in other segments of the U.S. population and indeed in many countries