飞行人员高血压及其相关因素研究

目的 调查飞行人员高血压发病情况，探讨引起飞行人员高血压的危险因素。方法采用整体抽样的方法抽取民航飞行学院598名飞行人员的体检资料，同时进行问卷调查，所有资料采用SPSS 13．0软件，进行方差分析及t检验。结果 飞行人员收缩压为（114．45±10．10）mmHg（1mmHg-0．133kPa），舒张压为（72．81±8．90）mmHg，大多分布在正常血压组和正常高值血压组。其中，正常组346例，占57．86％；正常高值血压组225例，占37．63％；高血压组27例（1级23例，2级4例），检出率为4．51％，多为单纯收缩期高血压，无3级高血压。根据危险因素与各组对照分析发现，超重、中心性肥胖及缺乏锻炼对飞行人员血压的影响存在显著差异（p〈0．01）。结论 超重、中心性肥胖及缺乏锻炼是飞行人员高血压的主要危险因素。建议对飞行人员中的高危人群加强高血压健康知识教育，通过改变他们的生活方式，进而达到减缓飞行人员血压偏高者向高血压发展的趋势。     

民航飞行人员体质指数及腹围与血压的关系调查

[目的]了解民航飞行人员体质指数(BMI)、腹围(WC)与血压的关系。[方法]采取整群抽样方法抽取民航飞行人员861名的体检资料,所有资料采用SPSS13.0软件进行方差分析,均方差估计采用LSD法。[结果]本组民航飞行人员BMI正常者571名,占66.32%;超重者257名,占29.85%;肥胖者33名,占3.83%。WC正常者635名,占73.75%;腹型肥胖者226名,占26.25%。超重、肥胖及腹部肥胖均随着年龄增长而增长。血压水平随着BMI的增高而升高,差异具有统计学意义(P﹤0.01)。收缩压随WC增加而升高,差异具有统计学意义(P﹤0.01),但舒张压与WC无明显相关性(P﹥0.05)。高血压组的BMI及WC均明显高于正常高值血压组和正常血压组,差异具有统计学意义(P﹤0.01)。缺乏锻炼是导致飞行人员超重及腹部肥胖,尤其是腹部肥胖的危险因素,同时,也是影响飞行人员血压水平的危险因素。[结论]超重、腹部肥胖及缺乏锻炼影响血压水平,对于BMI达到超重或肥胖标准及腹部肥胖者,尤其是腹型肥胖者,应加强锻炼,限制体重,以达到预防、延缓高血压进展的目的。     

正常高值血压飞行人员心脏及血管结构的变化

目的了解正常高值血压飞行人员心脏及血管结构的变化。方法选择军事飞行人员126名,根据血压水平分为正常血压组、正常高值血压组和高血压组,调查吸烟情况,测量并比较3组人员心脏结构指标、颈动脉内-中膜厚度(CA-IMT)、体质量指数(BMI)、腰围(WC)、血脂及空腹血糖(FPG)。结果正常高值血压组低密度脂蛋白(LDL)、三酰甘油(TG)、BMI水平、血脂异常率、超重肥胖检出率明显高于正常血压组(P0.05)。正常高值血压组WC明显高于正常血压组,但低于高血压组(P0.05)。3组间吸烟者比率差异无统计学意义(P0.05)。正常高值血压组左心室质量指数、CA-IMT明显高于正常血压组,二尖瓣口舒张早期与晚期血流速度峰值比(E/A比值)明显低于正常血压组(P0.05)。正常高值血压组左心室间隔厚度、左心室后壁厚度与正常血压组差异无统计学意义,但明显低于高血压组(P0.05)。结论正常高值血压飞行人员较正常血压者存在更多的心血管病危险因素,并可能存在心脏和血管结构的异常变化,需要加强监测和干预。     

南宁市大中院校教师高血压流行现状及其危险因素分析

目的 了解南宁市高校教师高血压患病情况及其相关危险因素,探讨高校教师人群高血压的防制措施.方法 对南宁市2 528名大中院校教师进行问卷调查与健康体检,收集个人一般资料、病史、行为习惯,并进行身高、体重、血压、血糖、血脂等项目检测.结果 2 528名教师的平均舒张压水平为(75±9)mm Hg,收缩压水平为(121±18)mm Hg;高血压检出率为23.34%,血压正常高值检出率为37.06%;多因素非条件Logistic回归分析显示,年龄、高血压家族史、超重和肥胖、糖尿病、血脂异常、向心性肥胖是高血压的危险因素,体育锻炼是高血压的保护因素.结论 南宁市高校教师群体高血压患病率较高.应针对其高血压危险因素特点,干预重点在于改变其生活方式.     

广西居民正常高值血压流行现状及相关危险因素分析

目的 了解广西居民正常高值血压流行状况及相关危险因素,为广西高血压防控工作提供数据支持。方法 2013年在广西10个监测点,采用多阶段整群随机抽样方法抽取5 987名18岁及以上居民,采用问卷调查、身体测量及实验室检测等方法进行调查。剔除有变量缺失及已诊断高血压1 547例,对4 440名研究对象进行分析,采用多因素非条件logistic回归探索正常高值血压及高血压的相关危险因素。结果 人群正常高值血压检出率为36.5%,男性（43.8%）高于女性（30.0%）,男性18～34岁组、35～44岁组检出率分别为44.2%、44.7%。调整年龄、性别后,多因素 logistic 回归分析显示,相对于正常血压,肥胖（OR = 2.356,95%CI:1.609～3.451）、中心性肥胖（OR = 1.594,95%CI:1.364～1.861）、高低密度脂蛋白胆固醇血症（OR = 2.160,95%CI:1.710～2.726）、高血糖（OR = 1.455,95%CI:1.190～1.779）是正常高值血压的危险因素;相对于正常高值血压,肥胖（OR = 2.419,95%CI:1.743～3.357）、中心性肥胖（OR = 1.250,95%CI:1.021～1.529）、高低密度脂蛋白胆固醇血症（OR = 1.312,95%CI:1.023～1.683）、高血糖（OR = 1.600,95%CI:1.291～1.982）也是高血压的危险因素。结论 广西人群正常高值血压检出率接近全国平均水平,并且存在多种危险因素。应加大正常高值血压的筛查,尤其是中青年男性,控制体重,加强多种危险因素的综合干预。     

河北省机关事业单位干部人群血压及相关危险因素分析

[目的]了解河北省机关事业单位干部人群高血压患病状况,探讨血压与血脂、血糖、超重肥胖等因素的关系. [方法]整群抽取河北省机关事业单位干部人群1 503例,进行身高、体重、腰围、臀围、血压测量和空腹血糖、血脂检测. [结果]1 503名研究对象,高血压患者410人,高血压患病率27.3%.1、2、3级高血压分别占76.8%、19.3%、3.9%.高血压患病率男性(39.5%)高于女性(14.6%).随着年龄的增长,高血压患病率有上升趋势(χ2=324.988,P<0.01).收缩压(119.5±19.5)mmHg,舒张压,77.8±10.9,mmHg,男性高于女性;血清总胆固醇(TC)、甘油三酯(TG)及空腹血糖受损(IFG)和糖尿病患者的高血压患病率和血压正常高值检出率均高于正常者(χ2值分别为36.220,128.746,12.953,37.254,均P<0.01).超重胆胖者高血压患病率和血压正常高值检出率均高于正常者(χ2值分别为49.924,47.284,P<0.01),中心性肥胖者高血压患病率和血压正常高检出率均高于正常考(χ2值分别为190.539,184.546,P<0.01). [结论]河北省机关事业单位干部高血压患病率较高,TC、TG、IFG、糖尿病、超重肥胖者高血压患病率明显高于正常者,应加强高血压的综合防治.     

原发性高血压合并2型糖尿病的影响因素分析

目的分析原发性高血压患者合并2型糖尿病的影响因素,为采取相应预防措施提供依据。方法从上海市居民高血压健康管理信息系统导出原发性高血压患者资料,按是否合并2型糖尿病分组,比较两组人口学特征、生活方式、家族史和血压等情况,采用Logistic回归模型分析高血压患者合并2型糖尿病的影响因素。结果纳入原发性高血压患者4 258例,其中高血压合并2型糖尿病患者95例,占2.23%。高血压合并2型糖尿病患者的平均收缩压及脉压差分别为(162.37±11.26)和(70.43±11.23)mmHg,均高于单纯高血压患者的(156.14±12.30)和(64.83±12.12)mmHg(P0.05)。Logistic回归分析结果显示,缺乏体力活动(OR=1.767,95%CI:1.171~2.667)、超重(OR=3.085,95%CI:1.615~5.892)和肥胖(OR=2.673,95%CI:1.352~5.285)是高血压合并2型糖尿病的危险因素。结论高血压合并2型糖尿病患者的收缩压和脉压差均高于单纯高血压患者,缺乏体力活动、超重和肥胖是高血压合并2型糖尿病的危险因素。     

天津市社区正常高值血压居民合并已知高血压危险因素的分析

目的调查天津市社区40~70岁正常高值血压居民合并已知高血压危险因素的聚集情况,为高血压和相关心血管疾病的防治提供依据。方法采用自然抽样方法,对天津市6个区年龄40~70岁的未明确患高血压的常住人口进行调查,收集人口统计学、生活方式资料,测量血压、身高、体重和腰围,并检测血糖、血脂等生化指标。按血压水平分为正常高值血压组[120 mm Hg≤收缩压≤139 mm Hg和(或)80 mm Hg≤舒张压≤89 mm Hg]和正常血压组(收缩压120 mm Hg和舒张压80 mm Hg)。多因素logistic回归分析正常高值血压组合并已知高血压危险因素的聚集情况。结果共调查1 176人,正常高值血压组592人,正常血压组584人,40~70岁不同年龄段正常高值血压组的体质指数、腰围、甘油三酯、男性比例及饮酒比例方面均高于正常血压组,差异均有统计学意义(P0.05,P0.01),不同年龄段两组糖尿病史比例、吸烟比例和低密度脂蛋白胆固醇水平差异均无统计学意义(P0.05),年龄≥50岁正常高值血压组的空腹血糖水平高于正常血压组,差异有统计学意义(P0.05)。正常高值血压组有0项和1项危险因素(摘自中国高血压防治指南中已知的吸烟、饮酒、超重或肥胖、血脂异常和高血糖这5种高血压危险因素)者所占比例低于正常血压组,有3项、4项和5项危险因素者所占比例高于正常血压组,差异均有统计学意义(P0.01)。40~70岁居民危险因素个数为1项、2项、3项、4项和5项者合并正常高值血压的危险性是个数为0项者的1.76倍、2.32倍、3.55倍、3.52倍和22.18倍。结论天津市社区40~70岁正常高值血压居民存在已知高血压危险因素聚集的现象,应对正常高值血压人群进行合理的控制。     

英德市农村居民慢性病相关危险因素流行病学调查

目的 了解英德市农村居民慢性病相关危险因素,为开展农村基本公共卫生服务提供科学依据.方法 采用多阶段整群随机抽样方法抽取4个镇16个村,对1014名15～69岁农村居民进行问卷调查和体格测量,使用Epidata 3.0建立数据库,SPSS 17.0软件统计分析.结果 超重、肥胖、向心性肥胖、高血压粗患病率分别为18.71%、3.56%、22.77%和27.12% 现在吸烟率和饮酒率分别为31.85%和36.98%.居民休闲锻炼性活动占15.88%,静坐活动平均时间为5.30 h/d 规律早餐的占91.33%,每天摄入鱼类、禽肉类、奶类、薯类和杂粮的频率均明显不足.Logistic回归分析,超重、向心性肥胖、高血压均与年龄呈正相关,高盐饮食、饮酒和肥胖等是致高血压的主要危险因素,休闲锻炼活动是防止超重、向心性肥胖、高血压的保护因素.结论 英德市农村居民存在膳食结构不合理和不良饮食习惯,现在吸烟率和饮酒率较高,缺乏规律锻炼等不良生活方式,高血压、肥胖症等慢性病患病率偏高,应加大农村居民慢性病健康教育与相关危险因素的干预.     

中青年男性体重指数与血压、血脂、血糖关系的分析

目的：调查体检人群体重指数（BMD与血压、血脂、血糖水平的关系。方法：对2005年我院健康管理中心2112例中青年男性体检资料进行分析，根据BMI分为超重肥胖组和对照组，分别比较两组之间血压、血脂、血糖水平以及高血压、血压正常高值、血脂异常、糖尿病、空腹血糖受损发生率等指标。结果：超重肥胖组的血压、血脂及空腹血糖的水平均显著高于对照组（P〈0．001），且高血压、血压正常高值、血脂异常、糖尿病及空腹血糖受损的发生率显著增高（P〈0．005）；BMI与血压、血脂、血糖之间存在正相关关系（P〈0．001）。结论：超重肥胖影响血压、血脂、血糖，与心血管疾病危险因素密切相关。     

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.