石家庄市高血压患病现状及防治策略研究

[目的]了解2008年石家庄市15～69岁居民高血压患病现状及其主要危险因素,为制定高血压防治策略提供科学依据。[方法]采用分层整群随机抽样方法调查石家庄市23个县(市)、区中抽取的9个县(市)区的7668名15～69岁常住居民,调查方法包括问卷调查、体格测量和实验室检查。[结果]高血压患病率为27.2%(标化率25.8%),居各类慢性病首位;男性高血压患病率为26.3%,女性为27.8%,男女间差异无统计学意义(P﹥0.05);高血压患病率随年龄的增长而升高(P﹤0.01);城市高血压患病率(37.4%)高于农村(25.9%,P﹤0.01);高年龄、向心性肥胖、糖尿病、精神因素是高血压的主要危险因素,高文化程度是高血压的保护因素。[结论]石家庄市居民高血压患病率较高,应采取以全人群健康教育为主,个体干预为辅的综合防治措施,提高全人群高血压防治知识水平,提高高血压知晓率、治疗率、控制率,进而达到预防心脑血管理疾病的目的。     

国际航行船舶外来医学媒介生物传入风险的判别分析

[目的]探索国际航行船舶外来医学媒介生物传入的风险评估方法。[方法]采用1︰4频数匹配的分析性流行病学研究方法,在2007年来港国际航行船舶中选择外来媒介阳性船舶170艘,随机选择对照船舶680艘进行调查,以Bayes判别分析法筛选及判定与媒介检出相关的风险因素,并建立二次型判别函数。[结果]总吨位、曾检出外来媒介生物、到达季节、装货种类、免予除鼠证书签发日期、船舶类型等6项指标对判别分析具有统计学意义,据此建立二次型判别函数作为外来媒介检出的风险分析模型,总正确率达83.25%。[结论]贝叶斯判别分析将船舶携带外来医学媒介生物的风险表达为数字,具有直观、定量、针对个体的优点,为国际航行船舶外来媒介生物风险评估及预警系统的建立提供理论基础。     

2007年蓬莱市农村居民生活危险因素及相关慢性病患病情况调查

[目的]了解蓬莱市农村居民生活危险因素及相关慢性非传染性疾病（慢性病）患病情况,为制定慢性病防治政策和干预措施提供科学依据。[方法]2007年10月,在蓬莱市抽取部分15-59岁农村居民进行调查。[结果]调查320人（男性162人,女性158人）,每日摄取食盐（11.69±5.35）g,油脂（45.68±15.58）g;每日静坐时间男性为（2.90±1.87）h,女性为（3.00±2.15）h;男性吸烟率为51.85%,饮酒率为60.49%。肥胖率男性为17.28%,女性为32.91%（P〈0.01）;超重率、中心性肥胖率男性分别为32.71%、52.46%,女性分别为28.48%、62.66%（P〉0.05）;高血压患病率男性为33.33%,女性为36.71%（P〉0.05）。[结论]蓬莱市农村居民高血压患病率与肥胖罹患率较高,高油、高盐饮食者较多,饮酒率、吸烟率较高,运动时间较少。     

2011年济南市疾病预防控制机构慢性病防制卫生资源调查

[目的]了解济南市疾病预防控制机构慢性非传染性疾病的卫生资源配置和慢性病防制工作开展情况。[方法]2011年12月,对济南市及11个县（市、区）疾病预防控制机构的慢性病防制工作进行调查。[结果]济南市市级和11个县（市、区）疾病预防控制中心都有1名副主任分管慢性病防制工作;8个单位有独立的慢性病防制科;慢性病防制工作人员共34人,28人为专职人员,所学专业为预防医学的14人;12个单位全部配有微机、打印机,有专人负责日常死因监测上报工作;11个县（市、区）疾控中心开展了多种形式的健康教育与健康促进工作,并选择性的开展了部分干预工作。[结论]济南市慢性非传染性疾病的卫生资源严重不足,初步开展了慢性病防制工作,迫切需要各级政府给予关注和扶持。     

安徽省某乡镇社区居民高血压患病率及危险因素研究

[目的]了解农村社区居民高血压患病率及主要危险因素,探讨农村社区高血压疾病的综合防制措施。[方法]整群抽样安徽省某乡镇9个农村社区年龄35岁以上、居住时间超过1年的居民进行高血压普查及其危险因素调查。[结果]安徽某乡镇社区35岁以上农民高血压患病率为23.29%,男女患病率相当。高血压的主要影响因素有:年龄、BMI、家族史、蛋类摄入、高血压知识了解情况、职业等。[结论]本地区农村居民高血压防制形势不容乐观,应加强对高血压疾病的社区干预。     

泰兴市35岁以上居民原发性高血压患病情况及其危险因素研究

[目的]了解泰兴市居民原发性高血压患病情况及其危险因素。[方法]2000年以村（居委会）为单位，抽样调查35岁以上居民20548人，调查原发性高血压的患病情况及其危险因素。[结果]调查对象中，高血压忠现率为37.5%；高血压患者的高血压知晓率、治疗率和控制率分别为19.6%、12.7%、8.8%；多因素非条件Logistic回归分析结果，高血压发病的主要危险因素为年龄、BMI、吸烟、高血压家族我、口味偏咸、睡眠时间少，蔬菜、油脂摄入量为保护性因素。[结论]泰兴市高血压患病人数众多，亟需开展社区高血压的综合防治，普及防治知识，做好查、治、管工作。     

中老年人血压水平与脑卒中患病率及患病风险的相关性研究

目的 研究中老年人群中血压水平与脑卒中患病率及患病风险之间的关系。方法 采用分层整群抽样方法,对扬州市广陵区40岁及以上常住居民开展问卷调查、体格检查和实验室检查。通过对年龄分层,采用单因素和多因素logistic回归分析不同年龄组血压与脑卒中患病率及患病风险的关系。结果 3 999例有效样本中,男性1 904例（47.61%）,女性2 095例（52.39%）;其中脑卒中243例（6.08%）,高血压1 900例（47.51%）,糖尿病929例（23.23%）,血脂异常943例（23.58%）,高血压患者中脑卒中211例（86.83%）。男性（χ2 = 9.539,P = 0.002）、高龄（t = - 13.683,P＜0.001）、缺乏运动（χ2 = 15.568,P＜0.001）、吸烟史（χ2 = 40.799,P＜0.001）、高血压（t = - 9.149,P＜0.001）、高血糖（t = - 6.832,P＜0.001）、低高密度脂蛋白胆固醇（t = 3.509,P＜0.001）、肥胖（t = - 4.964,P＜0.001）均是脑卒中重要危险因素。随着年龄和血压的增加,脑卒中的患病率增加。对年龄进行分层,并对危险因素进行校正,60岁以下人群中脑卒中患病风险随血压升高而显著增加;收缩压≥160 mm Hg脑卒中患病风险是收缩压＜130 mm Hg的8.13倍;舒张压≥110 mm Hg脑卒中患病风险是舒张压＜80 mm Hg的28.54倍。60岁及以上人群中收缩压≥150 mm Hg脑卒中患病风险开始增加;收缩压≥160 mm Hg脑卒中患病风险是收缩压＜130 mm Hg的2.12倍;舒张压与脑卒中患病风险之间无显著相关性。结论 高血压是脑卒中的重要危险因素,根据不同的年龄,设定相应的降压目标是有效预防脑卒中的重要途径。     

重庆市计划妊娠夫妇高血压危险因素聚集对高血压患病的影响

目的：分析重庆市计划妊娠人群高血压危险因素聚集状况及其与高血压患病之间的关系。方法于2013年4—12月,采用按比例多阶段分层整群随机抽样方法抽取了重庆市19个区（县）的11953对计划妊娠夫妇,对其进行问卷调查、体格检查和血糖检测。采用多因素二分类非条件logistic回归方法,分析危险因素聚集与高血压之间的相关性,高血压患病风险采用OR（95%CI）值表示。根据重庆市第6次人口普查数据对高血压患病率进行标化。结果重庆市计划妊娠人群高血压标化患病率为15.6%（95%CI：15.1%～16.0%）,丈夫标化患病率为16.7%（95%CI：16.0%～17.4%）,妻子标化患病率为14.2%（95%CI：13.6%～14.9%）。调查对象暴露比例较高的3项危险因素为经济压力（95.1%,22732/23906）、家族遗传史（24.9%,5950/23906）、超重和肥胖（22.3%,5341/23906）。丈夫组,具有家族遗传史、超重肥胖、吸烟、饮酒、有经济压力者患高血压风险分别是无家族遗传史、体重正常、不吸烟、不饮酒、无经济压力者的2.49（1.88~3.31）、1.85（1.68~2.03）、1.29（1.22~1.37）、1.16（1.11~1.23）、1.09（1.03~1.16）倍。妻子组,具有家族遗传史、高血糖、饮酒、有经济压力者患高血压风险是无家族遗传史、血糖正常、不饮酒、无经济压力者的3.07（2.43~3.89）、2.92（2.52~3.38）、1.28（1.12~1.49）、1.21（1.05~1.39）、2.52（1.40~4.53）倍。随着高血压危险因素聚集项数的增加,丈夫和妻子高血压患病风险升高：丈夫组危险因素聚集2~5项者高血压患病风险是危险因素聚集0项者的3.45（1.41~8.46）、5.68（2.32~13.93）、9.61（3.92~23.59）和15.20（6.10~37.87）倍;妻子组聚集2~4项者是危险因素聚集0项者的3.85（1.41~10.52）、6.18（2.23~17.15）和9.30（3.15~27.48）倍。结论家族遗传史、超重肥胖、吸烟、饮酒、有经济压力是重庆市计划妊娠夫妇高血压的主要危险因素;随着危险因素聚集项数的增加,高血压患病风险升高。     

苍南县沿海居民高血压危险因素的logistic回归分析

[目的]了解苍南县沿海居民高血压患病情况及高血压危险因素,为综合防治提供参考。[方法]随机抽取4个沿海乡镇8个村,对15岁以上常住居民进行血压测量和可疑危险因素调查,用SPSS10.0软件包对可疑危险因素进行多因素logistic回归分析。[结果]调查1721人,高血压标化患病率为17.1%;年龄、体质指数（BMI）、高血压家族史、日均食盐消耗量和文化程度等是高血压发病的主要危险因素。[结论]降低BMI、减少日均食盐消耗量是沿海居民预防高血压的重要措施。     

攀枝花市成人高血压患病率及相关因素分析

摘要:目的　了解攀枝花市成人高血压患病情况及相关危险因素,为当地制定防控措施和策略提供依据。方法　采用多阶段分层随机抽样的方法,对全市所有县（区）、乡镇（街道）18岁以上成年人进行调查,包括问卷调查和身体测量;利用EpiData3.1建立数据库,利用SPSS 17.0进行统计分析。结果　攀枝花市成人高血压患病率为20.02%,标化患病率为15.58%;影响高血压患病的主要因素有性别、年龄、文化程度、体重指数、饮食口味、体育锻炼、家族史等,即男性、年龄越大、受教育程度越低、体重指数越高、口味偏重、缺乏体育锻炼,具有高血压家族史的人群患高血压的风险更高。结论　攀枝花市成人高血压患病率水平低于全国水平;改变生活方式应是高血压防控关注的重点之一。     

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.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.