城市化发展对蜚蠊群落结构的影响及其防制对策研究

目的了解城市化发展对室内蜚蠊群落的影响。方法粘捕盒法。结果2004-2005年,苏州市城区室内蜚蠊平均密度为0.53只/(盒.夜),德国小蠊、美洲大蠊和黑胸大蠊的构成比分别为80.30%、17.04%和2.66%;1997-2001年为0.05只/(盒.夜),3种蜚蠊的构成比依次为86.69%、7.37%和5.95%,两个时间段蜚蠊密度与构成比差异均有统计学意义(u=15.19,P<0.05;P<0.01)。2004-2005年,老城区蜚蠊平均密度为0.49只/(盒.夜),德国小蠊、美洲大蠊和黑胸大蠊的构成比分别为75.71%、22.31%和1.98%,新建城区平均密度为0.58只/(盒.夜),3种蜚蠊的构成比依次为84.52%、12.19%和3.28%,老城区与新建城区的密度和构成比差异同样具有统计学意义(u=7.66,P<0.01)。结论城市化发展包括城区改造、面积扩大和人口增长,对蜚蠊群落结构和数量有较大影响。     

Child health and the environment: the INMA Spanish Study

The INMA (INfancia y Medio Ambiente [Environment and Childhood]) is a population-based cohort study in different Spanish cities, that focuses on prenatal environmental exposures and growth, development and health from early fetal life until childhood. The study focuses on five primary areas of research: (1) growth and physical development; (2) behavioural and cognitive development; (3) asthma and allergies; (4) sexual and reproductive development; and (5) environmental exposure pathways. The general aims of the project are: (1) to describe the degree of individual prenatal exposure to environmental pollutants, and the internal dose of chemicals during pregnancy, at birth and during childhood in Spain; (2) to evaluate the impact of the exposure to different contaminants on fetal and infant growth, health and development; (3) to evaluate the role of diet on fetal and infant growth, health and development; and (4) to evaluate the interaction between persistent pollutants, nutrients and genetic determinants on fetal and infant growth, health and development. Extensive assessments will be carried out on 3100 pregnant women and children. Data will be collected by physical examinations, questionnaires, interviews, ultrasound and biological samples. Pregnant women are being assessed at 12, 20 and 32 weeks of gestation to collect information about environmental exposures and fetal growth. The children will be followed until the age of 4 years.     

Influence of dietary iodine on the iodine content of pork and the distribution of the trace element in the body

Background Millions of people worldwide still suffer from iodine deficiency disorders. Besides salt iodination, iodine is added to animal feed to concentrate it in food of animal origin (milk, eggs, meat). Otherwise possible adverse effects of high supplementation should be avoided. Aim of the study The objective of the study was to evaluate the iodine content of pork at various feed iodine concentrations to estimate its contribution to human iodine supply. Furthermore the handling of low and high iodine dosages by the organism should be investigated using the pig as a model for the human. Methods Seventy pigs (live weight period 27–115 kg), divided into five groups, were fed diets supplemented with 0 (group 1), 0.5 (group 2), 1 (group 3), 2 (group 4) and 5 (group 5) mg iodine per kg diet. Iodine was determined in the thyroid and in the fractions innards/blood, bones and muscle/fat of four pigs of each group by ICP-MS. Results Rising iodine supplementation of feed significantly increased (P < 0.05) the iodine content of the muscle/fat fraction [3.9 (group 1), 6.0 (group 2), 8.5 (group 3), 10.8 (group 4) and 17.1 (group 5) μg I/kg]. Carry over (of supplemented iodine) into muscle/fat varied between 0.10 and 0.24%. The highest tested iodine dosage (5 mg I/kg diet) caused a 3.6-fold iodine concentration of the total body (calculated from the contents of the fractions), and a significantly increased thyroid weight compared to the group without supplementary iodine. Iodine supplementation increased iodine content in thyroid and bones significantly (P < 0.05) but not in innards/blood. On an average of the groups, the thyroid contained 80% of the body’s iodine, innards/blood 14%, muscle/fat 5% and bones 1%. Conclusions The iodine content of pork, and consequently its contribution to human iodine supply (∼1%), is very low, even at high supplementation of feed. The total body iodine content (empty body) is determined by the iodine intake. Irrespective of the iodine dosage, the thyroid contains about 4/5 of the body iodine. Bones represent a very low iodine concentration, even at a strongly increased iodine intake. The increase of the thyroid weight as an adverse effect of iodine supplementation requires further research with high dietary iodine.     

呼吸机相关肺炎病原微生物来源相关性研究

目的探讨呼吸机相关肺炎(VAP)的感染途径,为制定VAP的预防及治疗措施提供依据。方法采用目标性监测方法,探寻使用呼吸机患者口咽部、胃液及呼吸机的湿化器、冷凝器、螺纹管的微生物污染或携带与VAP患者痰液中病原微生物之间的关系。结果VAP发病率为61.02%(36/59);60.71%(34/56)的VAP病原微生物是革兰阴性(G-)杆菌,23.22%(13/56)是革兰阳性(G )球菌,16.07%(9/56)是真菌。51.79%的VAP患者痰液阳性结果与咽拭子阳性结果一致;26.79%的VAP患者痰液阳性结果与胃液阳性结果一致;分别有7.14%,19.64%,12.50%VAP患者痰液培养出病原微生物与呼吸机湿化器、冷凝器、螺纹管标本的阳性培养结果一致。结论VAP病原菌以G-杆菌为主;口咽部微生物定植、气道内病原微生物易位是VAP发生的重要原因。胃液微生物携带以及呼吸机管路微生物污染在VAP发生过程中的作用还有待进一步证实。     

对讲机微波辐射强度的调查分析

目的　对 2个品牌 4种型号的对讲机微波辐射进行测定研究。方法　使用已校正的国产ML 91型微波漏能测试仪 ,测定 4种型号 199台对讲机的微波辐射强度。结果　发射状态下距离对讲机天线部 5cm处和各部位 5cm处微波漏能平均功率密度分别为 (1316 .0± 14 4 .3)、(971.0± 131.6 )μW/cm2 ,均明显高于待机状态 [分别为 (14 .4± 5 .3)、(13.2± 4 .9) μW/cm2 ],差异有显著性 (P <0 .0 1)。在发射状态下距离对讲机不同部位 5 0cm处微波漏能平均功率密度为 (35 7.3± 2 7.8) μW/cm2 。 4种型号对讲机在发射通话状态下 ,对持机者的头、胸、腹部接触微波漏能平均功率密度日总计量为(94 5 .5±4 4 7.1) μW·h/cm2 ,超过国家作业场所微波辐射卫生标准的日总计量 (40 0 μW·h/cm2 )。结论　对讲机在发射状态的微波漏能明显高于待机状态。对讲机微波漏能以天线部最高。对讲机在发射状态 ,对持机者的头、胸、腹部微波漏能大部分超过国家作业场所微波辐射卫生标准 ,对持机者健康可造成潜在的影响 ,应做好防护工作。     

中文版老年人自我护理能力量表多中心信效度分析和验证

目的 对中文版老年人自我护理能力量表（SASE-CHI）进行多中心信效度分析,以检测其在多地区是否具有良好的信效度。方法 采用方便抽样的方法对7个地区的2551例老年人进行调查,运用SPSS21.0和AMOS21.0对数据进行统计分析。 结果 SASE-CHI平均得分为61.65±8.52; Cronbach’s α为0.863,重测信度各条目组内相关系数（ICC）为0.88～0.99（均P＜0.001）,总分ICC为0.99 (95%CI: 0.99～1.00,P＜0.001)。各条目-总分相关系为0.267～0.784（均P＜0.001）。内容效度指数（CVI）为0.98;探索性因子分析（EFA）提取3个公因子,累计方差为72.69%,各条目共同度为0.60～0.92;验证性因子分析（CFA）得到各拟合指标卡方/自由度（〖XC小五号.EPS;P〗/df）为1.76、拟合优度指数（GFI）为0.91、调整拟合优度指数（AGFI）为0.87、残差均方和平方根（RMR）为0.02、渐进残差均方和平方根（RMSEA）为0.06、标准拟合指数（NFI）为0.93、增值拟合指数（IFI）为0.97、非规范拟合指数（TLI）为0.96、比较拟合指数（CFI）为0.97。结论 SASE-CHI在多个地区测量中具有良好的信效度,可广泛用于评价我国老年人自护能力状况。     

浅谈医患关系"寒冷期"的形成原因与对策

医患关系是一种特殊的社会人际关系，其好坏程度直接影响社会的稳定，由于种种原因，此关系目前进入了一个相对的“寒冷期”，严重影响着医患双方的行为，进而影响卫生事业的发展和人民群众的生命健康。该文初步探讨了其形成原因有：（1）医者的支配地位与患者自我保护意识增强之间的矛盾。（2）医疗的高风险性与患者高期望值之间的矛盾。（3）医疗费用上涨过快与患者经济承受能力低下之间的矛盾。（4）传统价值观与现实之间的矛盾。（5）新闻媒体的炒作起着推波助澜的作用。针对上述原因，应采取的对策有：（1）加强信息交流，提高医患双方的风险意识。（2）服务到位，心理相融，建立新型服务关系。（3）增加收费透明度，切实减轻患者经济负担。（4）加强职业修养。（5）明确卫生政策定位，政府增加投入。     

污灌区居民健康状况的调查研究

为观察污灌区居民健康状况，抽样调查了一个自然村内长住５年以上居民１８４５人（男９０９人，女９３６人），结果表明血液，呼液与尿液免疫球蛋均低于非污灌对照区居民。污灌区居民询问调查的患病率（４．５５３％）高于对照区居民（３．５２４％），Ｐ〈０．０１。污灌区居民年标化发病率（２．３６３％），癌标化发病率（０．２１７％）高于对照区居民（分别为２．０９３％与０．１２１％）。污灌区居民年标化死亡率（０．６７２     

经阴道尿道中段线性悬吊术治疗压力性尿失禁的疗效评价

目的评估经阴道尿道中段线性悬吊术治疗压力性尿失禁(stress urinary incontinence,SUI)的疗效和安全性。方法回顾性分析四川省妇幼保健院2010年8月至2015年11月收治的46例采用经阴道尿道中段线性悬吊术治疗的SUI患者的临床资料,术后平均随访(33.04±19.56)月。采用手术时间、术中出血量、保留尿管时间、术后残余尿量、手术前后ICI-Q-SF评分以及并发症发生情况作为评估手术效果的指标。结果 46例患者手术均顺利,手术时间(82.93±30.48)min,术中出血量(111.30±78.81)mL,保留尿管(5.26±1.25)d,术后残余尿量(34.61±45.18)mL;治愈42例(91.3%),症状改善3例(6.5%),总有效率97.8%;术前ICI-Q-SF评分(12.41±3.57)分,术后(4.28±1.64)分,手术前后生活质量评分差异有统计学意义(P0.05),无明显并发症发生。结论采用经阴道尿道中段线性悬吊术治疗SUI安全、经济、微创、有效。     

A dosimetric approach for relating the biological response of the lung to the accumulation of inhaled mineral dust

Results from studies of the retention of contrasting mineral dusts inhaled by rats (for periods of up to three months) and the resultant changes in the phagocyte defence system of the deep lung were examined. The dusts used were titanium dioxide (relatively innocuous) and quartz (relatively toxic). The parameters assessed included the accumulation of material in the lung and lymph nodes during chronic exposure and the associated leukocyte response as assessed by broncho-alveolar lavage. The principal findings were that: (a) low level exposure to titanium dioxide produced no measurable inflammation (as indicated by neutrophil recruitment) but higher concentrations (30, 50, and 90 mg/m3) caused the transfer of dust to lymph nodes and first evidence of inflammation; and (b) for quartz, there was a more prominent response and earlier transfer of material to the lymph nodes. The suggested relation between changes in the neutrophil population and dust accumulation is discussed in terms of a quantitative dosimetric model, from which implications for assessing and managing human exposures emerge.     

老年住院患者吞咽障碍及膳食质量评价

目的 了解老年住院患者吞咽障碍以及其膳食质量,为吞咽障碍患者营养管理措施提供科学依据。方法 65岁以上老年住院患者通过中文版吞咽障碍指数量表(Chinese-Dysphagia Handicap Index, C-DHI)自查吞咽障碍情况,分为吞障风险组和无吞障风险组; 采用中国膳食平衡指数(Diet Balance Index-16,DBI-16)分析两组膳食质量。结果 本研究共收集对象306人,吞障碍风险124人(40.5%),无吞障风险182人(59.5%); 吞障风险组年龄较大(χ²=12.172,P<0.001),且两组营养状况不同(χ²=6.001,P=0.05); 吞障风险组存在中度的摄入不足和中度摄入失衡,膳食模式以模式C(严重的摄入不足)、E(中度摄入不足和摄入过量)、H(严重的摄入过量伴随中度的摄入不足)为主,分别为31.5%、20.2%和16.9%; 吞障组粮谷类摄入量(96.73±73.5)和肉类食物摄入量(65.9±36.9)均低于无风险组(P<0.05)。结论 对于有吞障风险的老年人尽早调整膳食结构和食物质构,以提高老年人健康水平和生活质量。     

Accuracy of the Actiheart for the assessment of energy expenditure in adults

BACKGROUND/OBJECTIVE: The Actiheart (Mini Mitter, Sunriver, OR, USA) uses heart rate (HR) and activity data to predict activity energy expenditure (AEE). Currently, the Actiheart has only been tested during laboratory conditions. Therefore, the objective of this study was to validate the Actiheart prediction method against indirect calorimetry during a wide range of activities in a field setting. SUBJECTS/METHODS: Forty-eight participants (age: 35+/-11.4 years) were recruited for the study. Eighteen activities were split into three routines of six activities and each routine was performed by 20 participants. During each routine, the participants wore an Actiheart and simultaneously, AEE was measured with a Cosmed K4b(2) portable metabolic system. The manufacturer's HR algorithm, activity algorithm, and combined activity and HR algorithm were used to estimate AEE. RESULTS: The mean error (and 95% prediction intervals) for the combined activity and HR algorithm, HR algorithm, and activity algorithm versus the Cosmed K4b(2) were 0.02 kJ kg(-1) min(-1) (-0.17, 0.22 kJ kg(-1) min(-1)), -0.03 kJ kg(-1) min(-1) (-0.24, 0.18 kJ kg(-1) min(-1)), and 0.14 kJ kg(-1) min(-1) (-0.12, 0.40 kJ kg(-1) min(-1)), respectively. CONCLUSION: The Actiheart combined activity and HR algorithm and HR algorithm provide similar estimates of AEE on both a group and individual basis.     

Impact of the daily variations of the air pollution on the ambulatory emergency health services activity. Study in the urban area of Rouen (France)

BACKGROUND: The aim of this study was to evaluate feasibility of using both the emergency phone calls (SAMU) and medical interventions (SMUR) related to ambulatory emergency services for local epidemiological surveillance of health impact of air pollution. METHODS: A temporal ecological study was performed at Rouen area (France) (380,000 inhabitants) for 1990-1997 (SAMU) and 1990-1996 (SMUR). The pollutants tested were: Sulphur dioxide (SO(2)), Particles (PM13), and Nitrogen dioxide (NO(2)), as collected routinely by a local automated network. For each phone call (SAMU) or emergency interventions (SMUR), the date, medical reason for calling (SAMU) or diagnosis after interventions (SMUR) (classified as respiratory, cardiovascular or other diseases) have been extracted from a specific information system. A statistical analysis based on time series analysis associated to a Poisson regression was conducted, taking into account temporal trend, seasonal variations, influenza, days of the week, holiday and meteorological data. RESULTS: An association was observed between ambulatory emergency services activity for cardiovascular diseases, and the daily variations of both SO(2) (relative risk=1.008 [1.001-1.016] for SAMU with an increase of 10 microg/m(3)) and NO(2) (relative risk=1.018 [1.008-1. 030] for SAMU, relative risk=1.016 [1.001-1.032] for SMUR with an increase of 10 microg/m(3)). No association could be observed with the respiratory diseases for these pollutants. CONCLUSION: The ambulatory emergency services activity data could contribute to an epidemiological surveillance of the health impact of the air pollution, but a better quality of data collected (concerning both procedures and codification) is requested. The interest of an epidemiological surveillance, rather than usual pollutant monitoring, remains to evaluate.     

基于职工满意度的公立医院托管效果研究

目的:调查托管背景下医院职工的工作满意度及托管认可度,找出医院托管后存在的问题。方法:采用明尼苏达满意度问卷短式(MSQ)量表与自制量表进行问卷调查。结果:医院职工工作满意度(3.80±0.86)及托管认可度(3.95±0.77)整体均较高,托管认可度最高的为医院的文化内涵(84.8%)、管理理念(82.8%),总体满意度最低的为收入与工作量(53.7%)、工作条件与环境(55.3%)。行政后勤人员满意度高于医务人员(P=0.001)。结论:托管后医院已取得一些成绩,但在很多方面仍需加强,医院应关注职工的需求,提升医院职工满意度,推进医院持续发展。     

Estimating the burden and cost of infectious intestinal disease in the Maltese community

The aim of this study was to estimate the burden of infectious intestinal disease (IID) and cost of illness at the community level from a societal aspect. A retrospective, age-stratified cross-sectional telephone study was carried out in Malta in 2004-2005. The number of cases, resources used and cost of resources were computed. The resources involved direct costs (health-care services, stool culture tests, medicines and personal costs) and indirect costs (costs from lost employment by cases and caregivers). This study estimated 0.421 (95% CI 0.092-0.771) separate episodes of IID per person per year in Malta which corresponds to 164 471 (95% CI 35 941-301 205) episodes of IID per year or 450 (95% CI 98-825) episodes of IID each day. The largest proportion of cost is due to provision of health-care services with euro10 454 901 [Maltese liri (Lm) 4 558 970] per year; followed by euro963 295 (Lm 2 209 393) in lost productivity; euro1 286 286 (Lm 561 078) in medicines; euro152 335 (Lm 66 452) in stool culture testing and euro71 487 (Lm 31 183) in personal costs, giving a total cost of illness of over euro16 million (7 million Lm) per year. The burden and cost of IID are high enough to justify efforts to control the illness. Such estimates are important to assess the cost-effectiveness of proposed specific interventions.     

Role of the endocannabinoid system in the development of tolerance to alcohol

The present review evaluates the evidence that the endocannabinoid system plays in the development of tolerance to alcohol. The identification of a G-protein-coupled receptor, namely, the cannabinoid receptor (CB(1) receptor), which was activated by Delta(9)-tetrahydrocannabinol (Delta(9)-THC), the major psychoactive component of marijuana, led to the discovery of endogenous cannabinoid agonists. Until now, four fatty acid derivatives identified to be arachidonylethanolamide (AEA), 2-arachidonylglycerol (2-AG), 2-arachidonylglycerol ether (noladin ether) and virodhamine have been isolated from both nervous and peripheral tissues. Both AEA and 2-AG have been shown to mimic the pharmacological and behavioural effects of Delta(9)-THC. The role of the endocannabinoid system in the development of tolerance to alcohol was not known until recently. Recent studies from our laboratory have implicated for the first time a role for the endocannabinoid system in development of tolerance to alcohol. Chronic alcohol treatment has been shown to down-regulate CB(1) receptors and its signal transduction. The observed downregulation of CB(1) receptor function results from the persistent stimulation of the receptors by AEA and 2-AG, the synthesis of which has been shown to be increased by chronic alcohol treatment. The enhanced formation of endocannabinoids may subsequently influence the release of neurotransmitters. It was found that the DBA/2 mice, known to avoid alcohol intake, have significantly reduced CB(1) receptor function in the brain, consistent with other studies in which the CB(1) receptor antagonist SR 141716A has been shown to block voluntary alcohol intake in rodents. Similarly, activation of the CB(1) receptor system promoted alcohol craving, suggesting a role for the CB(1) receptor gene in excessive alcohol drinking behaviour and development of alcoholism. Ongoing investigations may lead to a better understanding of the mechanisms underlying the development of tolerance to alcohol and to develop therapeutic strategies to treat alcoholism.     

中小学教师职业紧张干预研究

目的评价中小学教师的职业紧张和工作能力状况,采取有针对性的综合干预措施,以便降低他们的职业紧张水平并提高工作能力,同时评价干预效果。方法采用整群随机抽样的方法选择四川省某市的9所中小学学校,以其中5个学校为干预组,其他4个学校为对照组,对该9所学校的教师进行职业紧张程度的调查和工作能力的检测,对干预组教师进行职业紧张的健康教育等综合措施,1年后以同样量表对该两组教师再次进行问卷调查和测量,从而评价干预效果。结果(1)干预后在职业任务问卷6个子项中,干预组教师的任务过重、任务冲突、责任感和工作环境4个子项得分较干预前降低,差异有统计学意义(P<0·05),且干预后任务过重、任务冲突和工作环境3个子项平均得分也低于对照组教师,差异有统计学意义(P<0·05);(2)干预后在个体紧张反应问卷4个子项中,干预组教师的人际紧张反应子项得分在干预后显著降低(P<0·05),且业务紧张反应和人际紧张反应2个子项的平均得分也低于对照组,差异有统计学意义(P<0·05);(3)干预后在个体应对资源问卷4个子项中,干预组教师在娱乐休闲、自我保健和理性处事3个子项上的平均得分显著高于干预前水平和对照组教师,差异均有统计学意义(P<0·05);(4)干预后,干预组教师的工作能力得分显著高于干预前和对照组教师(P<0·05)。结论干预措施能够有效降低中小学教师的职业紧张程度,缓解紧张反应,增强应对紧张的能力并提高他们的工作能力。     

Intra- and inter-individual variations in diets of the middle-aged and the elderly]

This study was conducted to examine intra- and inter-individual variations in diets of the middle-aged and the elderly (40 years or older, 46 men and 42 women). The coefficients of variations for intakes of nutrients and food groups were computed from four 4-day weighed dietary records performed at 3-month intervals from June 1996. The results were as follows: a) The highest intra-individual variation (%) for nutrient intake was observed in retinol (men 293.5, women 283.8) and the lowest in carbohydrate (men 17.7, women 22.1). b) The highest inter-individual variation (%) was found in retinol (58.2) in men, and in carotene (56.7) in women. The lowest inter-individual variation (%) was observed in magnesium (17.0) in men, and in carbohydrate (14.4) in women. c) Nuts and seeds showed the highest intra-individual variation (%) for food group intake (men 291.5, women 391.8), while rice presented the lowest (men 30.5, women 38.9). d) The highest inter-individual variation for food group intake (%) was seen in milk and dairy products (111.7) in men and in alcoholic beverages (162.3) in women. The lowest inter-individual variation was observed in potatoes and starches (20.7) in men and in pulses (26.0) in women. e) The number of days necessary to estimate true average nutrient intake was much longer for such vitamins as retinol and carotene (over 50 days) than for macronutrients (3-5 days) except for fat. More than one year was required to estimate intake of nuts and seeds in both sexes and alcoholic beverages or seaweeds in women, whereas only 9-15 days for intake of rice. In conclusion, energy, protein and carbohydrate can be estimated by short-period dietary recalls or records, since their intra-individual variations were relatively small. On the other hand, many days, were found to be required to estimate usual dietary intake of such vitamins as retinol or carotene and that of each food group except for rice. It would therefore be very difficult to estimate usual intake of these nutrients and food groups by short-period dietary recalls or records.     

Study of the ultraviolet emission of the electrode coatings of arc welding

The optical emission properties of several minerals components employed in electrode coatings of arc welding have been investigated. The X-ray diffraction analysis shows that the composition of 14 commercial electrode coatings collected from different countries (Spain, France, UK, Poland, Argentina and Germany), consists of quartz, calcite, sodium and potassium rich feldspars, muscovite and rutile. The natural thermal stimulated luminescence (TSL) of these mineral phases, measured in the range of 200-800 nm at different temperatures (from room temperature to 400 degrees C) displays UV-A (wavelengths of 320 nm to 400 nm) and UV-B (from 280 nm to 320 nm) emissions, with the exception of rutile. The UV-B radiation, commonly described as the most dangerous form of radiation to human life, is here associated with structural defects in the crystallographic lattice of the mineral components of electrode coatings.