高血压矿工血浆血管紧张素Ⅱ水平的分析

[目的]探讨井下作业对高血压矿工血浆血管紧张素Ⅱ（AngⅡ）水平的影响。[方法]对地面与井下作业的煤矿工人进行问卷调查和血压、身高、体重的测量，用放射免疫测定法测定研究对象的血浆AngⅡ水平。[结果]高血压组矿工血浆AngⅡ水平显著高于非高血压组（P〈0．01），矿工平均动脉血压与血浆AngⅡ水平呈一定的正相关（r=0．359，P〈0．01）。在高血压矿工中，井下作业组血浆AngⅡ水平显著高于地面作业组（P〈0．01），且井下作业组中又以安装维修组最高（F=10．677，P〈0．01）；高盐饮食组血浆AngⅡ水平显著高于正常饮食组（P〈0．01），而年龄、工龄、家族史、体重指数、吸烟和酗酒等因素对高血压矿工血浆AngⅡ水平均未见显著性影响。[结论]煤矿井下作业作为一种应激刺激，在高盐饮食协同作用下，可能通过AngⅡ介导引发矿工高血压的发病。     

高血压矿工血浆肾素、血管紧张素Ⅱ、醛固酮和皮质醇水平的分析

目的　对煤矿工人血浆肾素活性 (PRA)、血管紧张素Ⅱ (AngⅡ )、醛固酮 (ALD)和皮质醇 (CORT)水平进行分析 ,探讨矿工高血压发病的因素和机制。方法　对地面与井下作业的煤矿工人进行问卷调查和血压、身高、体重的测量 ,用放射免疫测定法测定研究对象的血浆PRA、AngⅡ、ALD和CORT水平。结果　高血压组血浆PRA、AngⅡ和ALD水平显著高于非高血压组 (均P <0 0 1) ,矿工平均动脉血压与血浆PRA、AngⅡ和ALD水平呈显著正相关 (r =0 3 71、r =0 412和r =0 3 5 2 )。在高血压患者中 ,井下作业组血浆PRA、AngⅡ、ALD和CORT水平显著高于地面作业组 (均P <0 0 1) ,且井下作业组中又以安装维修组最高 ,CORT与AngⅡ水平呈显著正相关 (r =0 5 89) ;高盐饮食组血浆PRA、AngⅡ和ALD水平显著高于正常饮食组 (均P <0 0 1) ,而年龄、工龄、家族史、体重指数、吸烟和饮酒等因素对高血压患者血浆PRA、AngⅡ和ALD水平均无显著性影响。结论　煤矿井下作业可能作为一种应激刺激 ,在高盐饮食协同作用下 ,通过肾素 血管紧张素 醛固酮系统介导引发矿工高血压的发病。     

高血压矿工血浆内皮素水平的分析

目的通过分析高血压矿工血浆内皮素(ET)水平,探讨ET在矿工高血压发病中的作用。方法对地面与井下作业的煤矿工人进行问卷调查和血压、身高、体重的测量,用放射免疫测定法测定高血压(HP)与非高血压(NHP)矿工血浆ET水平。结果高血压矿工血浆ET总体水平高于非高血压矿工(P>0.05),而临床高血压患者血浆ET水平更高,并显著高于高血压矿工(P<0.01)。在地面作业的矿工中,HP组血浆ET水平明显高于NHP组(P<0.01),且主要是超体重的高血压矿工,矿工血浆ET水平与体重指数(BMI)呈正相关(P<0.01)。相反,在井下作业的矿工中,HP组血浆ET水平反而低于NHP组(P<0.01),并显著低于地面作业的HP组矿工(P<0.01),矿工血浆ET水平与BMI呈负相关。结论ET水平与矿工高血压的发病及严重程度有重要关系。超体重者血浆ET水平较高,而井下作业可能降低了高血压矿工血浆ET水平。     

煤矿井下作业对高血压矿工血浆血管紧张素Ⅱ水平的影响

采用放射免疫测定法对煤矿工人进行血浆血管紧张素Ⅱ(AⅡ)测定.结果显示,井下作业高血压矿工血浆AⅡ水平显著高于地面作业高血压矿工(P＜0.05),且井下作业矿工平均动脉血压与血浆AⅡ水平显著相关(r＝0.558,P＜0.01).提示井下作业因素可能是引起井下高血压矿工血浆AⅡ水平升高的原因.     

煤矿井下作业与井下矿工高血压病相关性研究

为了解煤矿井下作业对井下矿工高血压发病的影响 ,采取整群随机抽样 ,对地面作业和井下作业 (-2 5 0m～ -4 5 0m)的矿工进行问卷调查和血压、心率、身高、体质量的测量 ,经统计学处理 ,分析矿工高血压发病的原因。结果青壮年 (年龄≤ 40岁 )矿工中 ,井下作业组高血压检出率明显高于地面作业组 (P <0 0 5 ) ,且井下工龄越长 ,高血压检出率越高 ,矿工平均动脉血压 (ABP)与井下累计作业时间呈正相关 (P <0 0 5 )。     

煤矿井下作业与井下矿工高血压症相关性研究

为了解煤矿井下作业对井下矿工高血压发病的影响,采取整群随机抽样,对地面作业和井下作业（－２５０ｍ￣－４５０ｍ）的矿工进行问卷调查和血压、心率、身高、体质量的测量,经统计学处理,分析矿工高血压发病的原因。结果青壮年（年龄≤４０岁）矿工中,井下作业组高人出率明显高于地面作业组（Ｐ〈０．０５）,且井下工龄越长,高血压检出率越高,矿工平均动脉血压（ＡＢＰ）与井下累计作业时间呈正相关（Ｐ〈０．０５）。     

宜宾市珙县男性煤矿工人高血压流行病学调查

目的了解井下矿工高血压患病情况及相关知识知晓率,为制定防治对策与有效预防提供依据。方法以宜宾市珙县所有男性煤矿工人为研究对象,对地面作业和井下作业的矿工进行问卷调查和血压、心率、身高、体重测量,描述矿工高血压患病率与知识知晓率。结果矿工中井下作业组高血压患病率为37．62％,地面作业组为12．57％,差异有统计学意义（P〈0．05）;高血压检出率随井下工龄增长升高（P〈0．05）;有吸烟、饮酒、肥胖、高脂血症、低钾血症、高血压家族史等因素的井下矿工高血压患病率为65．16％,无上述因素者为17．24％;初中以上文化组对高血压与相关疾病知识知晓率及高血压患病危险因素知晓率为87．43％,初中以下组为39．47％。结论井下煤矿工人高血压患病率高于地面作业人员,高血压病井下工作时间有关,与吸烟、饮酒、肥胖、高脂血症、低钾血症、有高血压家族史和高血压病知识知晓情况等有关。     

东湖区高血压社区管理效果评估研究

[目的]探讨社区综合干预措施对血压认知和行为改变以及高血压控制的影响。[方法]对东湖区565名社区高血压患者进行综合干预,比较干预前后血压控制、血压、知晓率及行为的改变率。[结果]综合干预措施后,高血压知晓率明显提高,规律服药人数增加(P﹤0.001),血压平均水平明显下降(P﹤0.01),高血压控制率显著提高,由18.23%到48.85%(P﹤0.01),有不良行为和危险因素如过量饮食、缺乏体力活动体重指数和盐摄入量的患者比例下降(P﹤0.01)。[结论]在社区实施高血压综合干预防治,对高血压患者的血压控制是一种比较有效的管理模式。     

老年性高血压病患者社区健康教育效果研究

[目的]评价中小城市社区高血压自我管理模式的实施效果。[方法]在河北保定市区选择3个社区的60岁以上高血压患者为研究对象,其中两个社区为干预组,一个为对照组。对干预组进行高血压自我管理健康教育综合干预,并在干预前后对干预组和对照组均进行高血压相关行为、血压控制情况等调查,评价干预效果。[结果]干预组干预前调查110人,干预后99人;对照组干预前调查99人,干预后81人。干预组干预前后血压下降较对照组显著(P﹤0.01),体重指数降低程度显著大于对照组(P﹤0.05),遵医嘱服药率提高程度明显高于对照组(P﹤0.01),经常监测血压的比例提高程度也明显高于对照组(P﹤0.01)。[结论]高血压自我管理健康教育模式在中小城市具有很高的有效性和可行性。     

超敏C反应蛋白和高血压相关性及意义探讨

[目的]以C反应蛋白观察指标,探讨炎症反应在高血压发生、发展的作用及相互关系。[方法]按入选标准纳入高血压患者64人入试验组,门诊就诊的正常患者30人入对照组。将高血压组分为两个亚组:A组(无左室肥厚)37例,男21例,女16例;B组(伴左室肥厚)27例,男17例,女10例。比较试验组、对照组以及试验组各亚组间C反应蛋白水平差异。[结果]高血压两个亚组血清hsCRP浓度显著高于对照组(P﹤0.05);B组(伴左室肥厚)hsCRP浓度比A组(无左室肥厚)组高(P﹤0.05);血浆CRP水平与个体平均动脉压显著相关(P﹤0.01),血浆CRP水平越高,个体的血压值也越高。[结论]炎症在高血压的发生、维持与复发过程中起到了重要作用,CRP水平可以作为高血压病情评估的一个重要指标。     

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.