井下煤矿工人肠易激综合征患病现状分析

目的探讨煤矿井下工人肠易激综合征的患病现状及患病的危险因素,为煤矿工人胃肠疾病的研究提供流行病学资料。方法采用单纯随机抽样问卷方法进行肠易激综合征相关症状调查,根据结果决定是否进行结肠镜检查。结果肥城矿区井下作业煤矿工人肠易激综合征患病率为22.69%,矿区附近一般人群患病率为15.04%。两组患病率比较,差异有显著性(P<0.05)。结论井下作业煤矿工人肠易激综合征患病率高于一般人群。井下作业环境、心理障碍及不良生活习惯是患病的危险因素。     

Differences between fixed day shift workers and rotating shift workers in gastrointestinal problems: a systematic review and meta-analysis

This study comprised a review and compilation of literature to gain an in-depth understanding of the impact of rotating shift work on gastrointestinal health. PubMed, CINAHL, and the Cochrane Library were searched for studies published between January 1, 1985, and June 30, 2020. Fixed day shifts were defined as work shifts that began between 7:00 and 9:00 in the morning. Shifts beginning at any other time were classified as rotating shifts. A meta-analysis was performed using Comprehensive Meta-Analysis Software (CMA) version 3. In the end, 16 studies were included in the meta-analysis. An odds ratio (OR) of 1.56 (95% confidence interval (CI): 1.24–1.95), indicating that gastrointestinal problems are more common in rotating shift workers than in fixed day shift workers. Four gastrointestinal problems, namely, irritable bowel syndrome, constipation, indigestion, and peptic ulcers, were then analyzed separately. Significant differences between rotating shift workers and fixed day shift workers were found only for indigestion and peptic ulcers. For indigestion, the OR was 1.72 (95% CI: 1.28–2.30). For peptic ulcers, the OR was 1.66 (95% CI: 1.19–2.30). Thus, research indicates that rotating shift work may increase the risk of gastrointestinal problems, particularly indigestion and peptic ulcers.     

肠易激综合征患者胃肠运动功能的临床研究

目的：对16例肠易激综合征（IBS）患者胃肠运动功能进行临床分析,为临床研究肠易激综合征的发病机制及临床药物治疗提供理论依据。方法：对16例肠易激综合征患者进行食管动态pH监测、胃电检测和呼吸氢试验分析。结果：肠易激综合征患者进餐前、后胃电变化较对照组明显（t＝-8.437,t＝-7.126;P〈0.01）,胃电变异指数、肠道传递时间与对照组有显著性差异（t＝-2.312,t＝-1.694,t＝-9.163,t＝-7.894;P〈0.01）。结论：肠易激综合征患者消化吸收及肠道运动功能异常可能是由于肠道电生理活动异常而引起。     

Adult-onset asthma and wheeze among irritant-exposed bleachery workers

BACKGROUND: Whether new-onset asthma is associated with irritant exposure is unclear. The aim was to investigate if occupational exposure to irritant gases, especially repeated peak exposure (gassings), increased the risk of obstructive airways disease. METHODS: Data on airway symptoms and exposure among bleachery (n = 101) and paper department workers (n = 314) were collected by a questionnaire. Incidence rates and hazard ratios (HR) (Cox regression) were calculated. Non-responders were interviewed by telephone. RESULTS: The incidence rate for adult-onset physician-diagnosed asthma among bleachery workers reporting gassings giving rise to respiratory symptoms was 7.6/10(3) person-years and for those without gassings 2.2/10(3) person-years, compared to 1.0/10(3) person-years for paper workers. In a Cox regression model for asthma (n = 12), stratified for sex, HR for gassings were 5.6 (95% confidence intervals (CI) 1.6-20), for hay fever 3.0 (95% CI 0.8-11), and for ever smoking 0.7 (95% CI 0.2-2.4). The same model for adult-onset wheeze gave HR of 5.2 (95% CI 2.2-12), 1.7 (95% CI 0.6-5.4), and 1.1 (95% CI 0.5-2.7), respectively. CONCLUSIONS: Repeated peak exposure to irritant gases, here studied as gassings in the pulp industry, increased the risk for both adult-onset asthma and wheeze.     

Irritable bowel syndrome correlates with increased risk of Parkinson’s disease in Taiwan

This study investigated whether an association exists between irritable bowel syndrome (IBS) and the risk of Parkinson’s disease. This is a retrospective cohort study using the dataset of the Taiwan National Health Insurance Program from 2000 to 2010. We identified 23,875 patients (aged 20 years or older) with newly diagnosed IBS as the IBS group and 95,500 subjects without IBS as the non-IBS group for comparison. The main outcome was incident Parkinson’s disease compared between both groups by the end of 2010. We measured the hazard ratio (HR) to evaluate the association between IBS and Parkinson’s disease. The overall incidence of Parkinson’s disease in the IBS group was 1.76-fold higher than that in the non-IBS group (16.4 vs. 9.33 per 10,000 person-years). The multivariable Cox proportional hazards regression analysis revealed that the adjusted HR of Parkinson’s disease associated with IBS was 1.48 (95 % CI 1.27, 1.72), compared with the non-IBS group. Age, women, hypertension, dementia, cerebrovascular disease and depression were also significantly associated with Parkinson’s disease. Patients with irritable bowel syndrome are at an increased risk of developing Parkinson’s disease. Further studies are required to explore the pathophysiological connection between these disorders.     

Radioactive iodine therapy and breast cancer. A follow-up study of hyperthyroid women

A follow-up study of 1,762 hyperthyroid women who were treated at the Massachusetts General Hospital Thyroid Unit between 1946 and 1964 was conducted. The average length of follow-up was 17.2 years. A 1978 mailing address or a death certificate was located for 92% of the women, and 88% of 1,058 living patients responded to a mail questionnaire. The standardized mortality ratio (SMR) for all causes of death was 1.3 (95% confidence interval (CI) 1.2-1.4). The standardized mortality ratios for all malignant neoplasms and for breast cancer were 0.9 (95% CI 0.7-1.1) and 1.3 (95% CI 0.8-1.9), respectively. More deaths than expected were observed from endocrine and metabolic diseases (SMR = 1.8, 95% CI 1.2-2.7), circulatory system diseases (SMR = 1.4, 95% CI 1.3-1.6), and respiratory system diseases (SMR = 1.9, 95% CI 1.3-2.6). The standardized incidence ratios (SIR) for all malignant neoplasms and for breast cancer were 0.9 (95% CI 0.8-1.1) and 1.2 (95% CI 0.9-1.5), respectively. A nonsignificant excess breast cancer risk was observed 10 years after the onset of thyroid symptoms and was present at the end of 30 years of observation. A statistically significant excess number of pancreatic cancer cases (SIR = 2.0, 95% CI 1.0-3.7) and a nonsignificant excess of brain cancer cases (SIR = 2.3, 95% CI 0.7-5.3) were observed. Eighty per cent of the women were treated with radioactive iodine. When age at treatment and year of treatment were controlled, women who were ever treated with radioactive iodine had a standardized rate ratio for breast cancer of 1.9 (95% CI 0.9-4.1), compared with those who were never treated with radioactive iodine. Women who developed hypothyroidism as a result of their treatment for hyperthyroidism did not have an increased risk of developing breast cancer (SIR = 1.1, 95% CI 0.8-1.6).     

Pediatric functional gastrointestinal disorders

Functional gastrointestinal disorders continue to be a prevalent set of conditions faced by the healthcare team and have a significant emotional and economic impact. In this review, the authors highlight some of the common functional disorders seen in pediatric patients (functional dyspepsia, irritable bowel syndrome, functional abdominal pain) as well as one of the more intriguing (cyclic vomiting). The most recent Pediatric Rome Working Group has modified the definitions of functional gastrointestinal disorders. Current studies have used these categorizations to understand better the epidemiology, etiology, and treatment options for these disorders. As more data are available, children and their families will be offered a better understanding of the conditions and more effective treatments to overcome them. The importance of making an accurate diagnosis of a functional gastrointestinal disorder cannot be overemphasized.     

胃肠起搏在功能性胃肠病中的应用

功能性胃肠病是临床上最常见的消化系统疾病之一,其发病机制涉及多方面的因素,部分患者对于常规内科治疗不能获得满意效果,严重影响患者生活质量。近年来,胃肠起搏在功能性胃肠病治疗中的作用引起许多学者的关注,目前已应用于胃轻瘫综合征、功能性消化不良、肠易激综合征和胃食管反流病的治疗,并取得了良好的疗效。对近年来胃肠起搏在功能性胃肠病治疗中的应用进行简要综述,为临床应用提供一定的理论基础。     

Mental health among university students with eating disorders and irritable bowel syndrome in France

BackgroundUniversity students are subject to stress due to academic pressure, empowerment and transition from adolescence to adulthood. This young population may have a higher risk of functional disorders as eating disorders (ED) and irritable bowel syndrome (IBS). Our objective was to determine the prevalence of ED, IBS and both and the associated behaviours.MethodsA cross sectional study was conducted in Rouen University (France). Participating students filled an anonymous self-questionnaire with items on socio-demographics, depression (Duke score), stress (Cohen score), emotional exhaustion (Maslach Inventory), insomnia (Insomnia Severity Index), cyberaddiction (Internet Addiction Test), ED (SCOFF-F test) and IBS (Rome III).ResultsThis study included 731 students (male/female ratio = 0.43). The prevalences of ED, IBS and co-existing ED-IBS were respectively 16.7%, 7.8% and 2.7%. ED and IBS were more common in female students. Depression, stress, emotional exhaustion, insomnia and cyberaddiction were significantly associated with ED and IBS or both. Students with ED had a higher risk of having IBS (Adjusted Odds Ratio (AOR) = 2.42, 95% CI: 1.30–4.51), and conversely students with IBS had a higher risk of having ED (AOR = 2.46, 95% CI: 1.32–4.55) and were more likely to be in the third year of academic study or above (AOR = 2.95, 95% CI: 1.50–5.76).ConclusionStudents (female especially) suffer from ED and IBS, with a significant risk of co-existing ED-IBS. ED and IBS are related to multiple mental health symptoms, which could lead to negative academic consequences. Screening, using simple and quick tests as SCOFF questionnaire and ROME IV criteria (update of ROME III in 2016), is essential in this population of university students.     

黛力新联合培菲康治疗腹泻型肠易激综合征疗效观察

[目的]观察黛力新联合培菲康对腹泻型肠易激综合征患者的疗效,探讨选择性胃肠道钙通道拮抗剂与抗焦虑、抗抑郁在腹泻型肠易激综合征患者中的作用。[方法]将60例腹泻型肠易激综合征患者随机分为两组,治疗组30例给予黛力新联合培菲康治疗,对照组30例给予培菲康治疗,比较治疗后疗效。[结果]黛力新联合培菲康治疗组总有效率90%,单用培菲康对照组总有效率70%,差异有统计学意义。[结论]黛力新联合培菲康能有效改善腹泻型肠易激综合征患者的临床症状。     

The burden of acute gastrointestinal illness in Ontario, Canada, 2005-2006

A retrospective, cross-sectional telephone survey (n=2090) was conducted in Ontario, Canada, between May 2005 and April 2006, to determine the burden of acute gastrointestinal illness in the population. The 4-week prevalence was 8.56% (95% CI 7.36-9.76); in households with more than one resident, 35% of cases reported someone else in their household had similar symptoms at the same time. The annual adjusted incidence rate was 1.17 (95% CI 0.99-1.35) episodes per person-year, with higher rates in females, rural residents, and in the winter and spring. Health care was sought by 22% of cases, of which 33% were asked to provide a stool sample. Interestingly, 2.2% of cases who did not visit a health-care provider reported self-administering antibiotics. Overall, acute gastrointestinal illness appears to pose a significant burden in the Ontario population. Further research into the specific aetiologies and risk factors is now needed to better target intervention strategies.     

温州地区7～16岁中小学生抽动障碍的现况调查

目的 了解温州地区中小学生抽动障碍(TD)的流行病学特征。方法 采用分层整群抽样方法,对温州地区9742名7～16岁的中小学生进行TD横断面调查。结果 TD总患病率为104/万;短暂性抽动障碍、慢性运动或发声抽动障碍、发声与多种运动联合抽动障碍的患病率分别为34/万、27/万、43/万;男性TD患病率为166/万,女性为29/万,男性高于女性(X~2=43.96,P<0.001,患病率比为5.7,95％CI:3.20～10.30),TD三种临床亚类型的患病率均表现为男性高于女性;平均发病年龄为(8.5±2.8)岁,发病高峰在6～10岁,各年龄组患病率以9～10岁组为最高(X~2=15.51,P<0.01).小学生TD患病率显著高于初中生(X~2=11.33,P<0.01,患病率比为2.2,95％CI:1.37～3.43);延迟诊断率69.3％,延迟诊断时间(中位数)为1.0年。结论 TD在温州地区儿童少年中较多见,疾病早期漏诊现象严重,应提高临床医生及社会公民对该病的认识,做到早发现早治疗。     

某校大学生饮食习惯对肠易激综合征的影响

目的 了解饮食对肠易激综合征的影响。方法 对2018年10月—2019年4月来校医院就诊的1 207名在校本科生进行问卷调查,问卷依据罗马Ⅳ诊断标准,数据分析采用SPSS 22.0卡方检验、单因素分析、Logistic多因素回归分析。结果 来校医院就诊的在校大学生中,肠易激综合征的患病率为5.1%(60/1207)。在单因素分析中,进食生冷(P=0.070)、高纤维(P=0.367)、乳制品(P=0.414)、果蔬(P=0.784)与肠易激综合征的患病差异无统计学意义。进食辛辣(P=0.002)、高脂饮食(P<0.001)与肠易激综合征的患病差异有统计学意义。进一步Logistic多因素回归分析显示,高频率进食高脂食物比低频率(≤1次/周)进食高脂食物更容易引起肠易激综合征。P值为0.003,OR:1.545。结论 本调查样本中,肠易激综合征的患病率为5.1%。肠易激综合征的患病与进食辛辣、高脂饮食有关。高频率的进食高脂食物是肠易激综合征患病的危险因素。基层医生应着重做好相关病人的饮食指导,尽量减少肠易激综合征被诱发。     

Prevalence and incidence of HIV-1 infection among employees of a large textile business and their wives in Kinshasa, 1991-1996

BACKGROUND: The Democratic Republic of Congo has been experiencing a critical economic situation for several years, resulting in a favorable context for the spread of HIV-infection. A study was performed in a large textile factory in Kinshasa, to determine prevalence and incidence of HIV-infection among employees and their wives. METHODS: From February to November 1996, a cross-sectional study was conducted among 2010 employees (1859 males, 151 females) of the factory and their 1198 female partners. Participants responded to a structured questionnaire and HIV testing was performed after an informed consent was obtained in a pre-test counselling session. Using a reconstituted population of 1580 employees (1502 males, 78 females) and their 806 female partners (all HIV-seronegative in 1990), we determined the HIV incidence between 1990 and 1996. Employees included manual workers, middle managers and senior managers. RESULTS: Overall prevalence and incidence rates were 2.1% (95% CI=1.6%-2.6%) and 0.16/100 persons-years (95% CI=0.09-0.22) respectively. Reported condom use was associated with HIV infection in men (OR=2.5; 95% CI=1.2-5.3) and their spouces (OR=1; 95% CI=0.02-10.7) and with a history of urethral discharge in men (OR=4.1; 95% CI=1-30.1). The HIV incidence between 1990 and 1996 was 0,2/100 person-years (95% CI=0.1-0.2). The seroconversion risk increased from manual workers to senior managers (chi-square for linear trend=12.9; p<0.001). CONCLUSIONS: Despite the deterioration of health services and the economical instability in Kinshasa, HIV prevalence and incidence rates in this factory were much lower than rates observed in factories in same East and Southern African countries. Comparative prospective studies using a similar methodology are needed to better understand the reasons for these differences.     

来源于谷物的膳食纤维对肠道运动及症状影响的Meta分析

目的研究摄入来源于谷物的膳食纤维对肠道运动及症状的影响。方法检索国内外医学期刊2013年7月前公开发表的来源于谷物的膳食纤维对肠道运动及症状研究的随机对照试验,由2位研究者根据纳入与排除标准独立进行文献筛选、资料提取及质量评价,采用Rev Man 5.2软件进行Meta分析。结果 13个研究共739名观察对象纳入分析。Meta分析显示膳食纤维组与对照组相比排便频率增加(WMD=0.10,95%CI 0.02~0.18,P<0.05)、肠道通过时间减少(WMD=-6.36,95%CI-11.53~-1.20,P<0.05)、粪便湿重增加(WMD=51.52,95%CI31.00~72.04,P<0.05)、且不增加胃肠道副反应(SMD=0.06,95%CI-0.04~0.16,P=0.267),采用符合方案集分析时,功能性肠道障碍症状缓解率增加(RR=1.20,95%CI 1.00~1.44,P=0.05),意向性分析时功能性肠道障碍症状缓解率无明显增加(RR=1.16,95%CI 0.95~1.41,P=0.14)。结论来源于谷物的膳食纤维对肠道运动具有促进作用,且不增加胃肠道副反应,但对功能性肠道障碍症状缓解作用不明确。     

Dyspepsia in general practice: incidence, risk factors, comorbidity and mortality

BACKGROUND: Many individuals consulting their GP with upper abdominal symptoms are initially classified as having dyspepsia. Few studies have described the incidence of dyspepsia or the comorbidities, risk factors or prognosis associated with this diagnosis. METHODS: We used the UK General Practice Research Database to find patients with a new diagnosis of dyspepsia in 1996 (n = 6,913) and a control cohort (n = 11,036). We determined the incidence of dyspepsia, potential risk factors and comorbidity, and the risk of new onset morbidity in the year following the index date. RESULTS: The incidence of dyspepsia was 15.3 per 1,000 person-years. An increased probability of a dyspepsia diagnosis was associated with chest pain [odds ratio (OR): 2.4], general pain (OR: 1.8), sleep disorders (OR: 1.5), angina (OR: 1.5), osteoarthritis/rheumatoid arthritis (OR: 1.4) and smoking (OR: 1.2). There was only a borderline association with obesity (OR: 1.1). Patients with dyspepsia had an increased likelihood of a diagnosis of irritable bowel syndrome (IBS) (OR: 264), gastroesophageal reflux disease (GERD) (OR: 62.8) or peptic ulcer disease (PUD) (OR: 27.2) during the following year. CONCLUSIONS: The commonest diagnosis to emerge after an initial consultation for dyspepsia was IBS, followed by GERD and PUD.     

Health surveillance for asthma in the US Navy: experience of 9,185,484 person-years

PURPOSE: To measure trends and demographic risk factors for hospitalization for asthma. METHODS: Time trends and demographic risk factors, for hospitalized asthma (1CD-9-CM Code 493) were analyzed by measuring age-specific and age-adjusted first hospitalization rates in a defined population of active-duty enlisted members of the US Navy worldwide during 1980-1999, consisting of 9,185,484 person-years. RESULTS: There were 3911 patients first hospitalized for asthma, including 2916 men and 995 women. The age-adjusted incidence rate of first hospitalization for asthma was three times higher in women than men, 110 per 100,000 person-years (95% confidence interval [CI], 104-117), compared with 35 per 100,000 person-years (95% CI, 33-37), respectively (p < 0.0001). The rate in black women was twice as high as in white women, 186 per 100,000 person-years, compared with 99 per 100,000 person-years, respectively (p < 0.001). The rate in black men was higher than in white men, 45 per 100,000, compared with 34 per 100,000 (p < 0.001). Age-adjusted rates in women doubled from 73 per 100,000 in 1980-1983 to 159 in 1997-1999 (p for trend < 0.01), while those in men remained stable. CONCLUSIONS: Age-adjusted incidence rates of first hospitalization for asthma were three times as high in women as in men, and doubled during the period between 1980 and 1999. The rates in black women were twice as high as in white women. The reasons are unknown.     

Prevalence of musculoskeletal disorders in union ironworkers

The prevalence of musculoskeletal disorder (MSD) symptoms and doctor-diagnosed musculoskeletal disorders (DDMDs) were estimated among union construction ironworkers by a telephone-administered questionnaire. Of 1996 ironworkers eligible, 1566 were contacted and 981 were interviewed. The prevalence of self-reported MSD symptoms was high for the lower back (56%), wrist/hands/fingers (40%), knees (39%), and shoulders (36%). The most common DDMDs were tendonitis (19%), ruptured disk in the back (18%), bursitis in the shoulder (15%), and carpal tunnel syndrome (12%). Generally, the prevalence of DDMDs and MSD symptoms increased with duration of employment. In age-adjusted logistic regression analyses, those who worked 25 to 35 years were more likely to have tendonitis (odds ratio [OR] 7.1, 95% confidence interval [CI] 3.116.6), shoulder bursitis (OR 13.7, 95% CI 3.160.4), knee bursitis (OR 5.1, 95% CI 1.025.1), and ruptured intervertebral back disk (OR 6.7, 95% CI 2.617.5). The effect of prior injury was also consistently high (upper extremities, OR 4.6; lower extremities OR 5.1; lower back, OR 6.0). Among workers without prior injuries, MSD symptoms were more frequent for the lower back in structural ironwork (OR 1.7, 95% CI 1.12.6), and for the upper extremity in concrete reinforcement ironwork (OR 1.9, 95% CI 1.22.9). These findings suggest that some musculoskeletal morbidity in construction ironworkers may be work related and thus preventable.     

Prevalence and Risk Factors of Work-Related Musculoskeletal Disorders in Massage Practitioners

INTRODUCTION: Massage practitioners are at high risk for work-related musculoskeletal disorders (WMSDs). We investigated the prevalence and risk factors. METHODS: We randomly selected 161 visually impaired practitioners. Demographics, musculoskeletal symptoms, and working postures were analyzed with multivariate logistic regression. RESULTS: Results indicated that about 71.4% had at least one WMSD in 12 months. Prevalence rates were finger or thumb, 50.3%; shoulder, 31.7%; wrist, 28.6%; neck, 25.5%; arm or elbow, 23.6%; forearm, 20.5%; and back, 19.3%. Working duration >20 years had an adjusted odds ratio (OR) for finger or thumb 4.0-4.5 with 95% confidence interval (CI) 1.5-13.8, client contact >4 h/day (adjusted OR for finger = 3.2, 95% CI=1.3-8.1), and < or =7-kg pulp-pinch strength (adjusted OR for upper extremity = 2.9-3.2, 95% CI=1.2-8.3). Adjusted ORs for lower-back symptoms were 3.1 (95% CI=1.3-7.8) and 3.6 (95% CI=1.4-9.6), respectively, for lack of neutral neck posture and for inappropriate working-table height. CONCLUSION: WMSDs were prevalent among massage practitioners.     

北京市海淀区社区居民胃食管反流病的流行病学调查

目的 了解北京市海淀区胃食管反流病(GERD)及其相关症状的分布情况,探讨可能的危险因素,并分析其与既往疾病的相关关系.方法 2008年6-9月,采用多阶段抽样法,对海淀区18～80岁的2615名常住居民进行问卷调查,内容包括基本信息、伴发疾病及反流性疾病问卷.结果 海淀区人群GERD的患病率为8.4%(220/2615),单纯胃灼热、单纯反流、两个症状均有的现患率分别为1.0%(25/2615),6.2%(163/2615)和1.2%(32/2615).多因素分析发现,GERD的可能危险因素有生活在农村(OR=2.237,95%CI:1.422～3.517)、女性(OR=1.456,95%CI:1.085～1.955)、高学历(OR=1.242,95%CI:1.001～1.542)、工作生活压力大(OR=1.277,95%CI:1.089～1.497)、精神状态差(OR=1.320,95%CI:1.046～1.665)和有胃肠病家族史(OR=1.594,95%CI:1.075～2.365);胃灼热症状的危险因素有居住在农村(OR=2.481,95%CI:1.278～4.818)、女性(OR=1.747,95%CI:0.902～3.386)、饮酒(OR=1.838,95%CI:0.916～3.690)、不运动(OR=2.091,95%CI:1.131～3.867)和精神状态差(OR=1.657,95%CI:1.123～2.446);反流症状的可能危险因素有生活在农村(OR=2.171,95%CI:1.326～3.556)、女性(OR=1.505,95%CI:1.102～2.056)、高学历(OR=1.347,95%CI:1.063～1.706)、工作生活压力大(OR=1.317,95%CI:1.113～1.558)、精神状态差(OR=1.266,95%CI:0.992～1.616)和有胃肠病家族史(OR=1.739,95%CI:1.163～2.600).GERD、胃灼热和反流症状与既往病史如焦虑症、抑郁症、消化性溃疡、胃炎、炎症性肠病、肾病有较强的关联.结论 GERD及其相关症状在该地区有一定程度的流行,它与不健康的生活方式、精神心理问题等相关,需要在社区开展有效的干预措施.