超重和肥胖人群血清脂联素水平变化与高血压病的关系

目的研究血清脂联素水平与超重、肥胖及与高血压病的关系。方法对深圳地区21岁~60岁人群共21578人进行体重指数(BM I),腰围(WC),腰臀围比(WHR)及血压(HP)测量,按体重指数(BM I)将其分成三大组:正常非肥胖组(BM I≤24kg/m2)共14817人;超重组(2495 cm的人群为133‰。(χ12=821.26,P<0.005),(χ22=500.16,P<0.005)。血清脂联素浓度在肥胖人群及高血压病肥胖患者均显著低于正常人群[脂联素:单纯性肥胖组(7.16±1.41)mg/L,高血压病肥胖组(7.18±1.45)mg/L vs.正常非肥胖组(9.22±0.61)mg/L,F=3.217,P<0.05]。血清脂联素浓度在超重人群与正常人群之间无显著性差异[脂联素:超重组(7.71±1.73)mg/L vs.正常非肥胖组(9.22±0.61)mg/L,P=0.097>0.05]。在高血压病肥胖患者中,脂联素浓度与体重指数、腰围、腰臀围比、、收缩压之间呈显著负相关。结论脂联素水平下降与肥胖、血压之间存在一定的相关性;保持BM I和WC在正常范围,是预防高血压病发生的有效措施之一。     

新疆牧民超重和肥胖的现况调查

目的　了解新疆牧区以高脂饮食为特征的哈萨克人和蒙古人的体重指数水平。　方法　采用整群抽样的方法进行流行病学调查。　结果　 (1)BMI的平均值男性组为 (2 4.98± 3 .98)kg/m2 ,女性组为 (2 4.87± 4.5 1)kg/m2 ,总人群为 (2 4.91± 4.3 1)kg/m2 。 (2 )调查人群超重和肥胖的患病率为 5 1.66%。　结论　新疆牧区超重和肥胖的患病率处在全国较高的水平     

腹型肥胖与社区中老年人糖尿病关系的调查

目的了解本社区中老年人群腹型肥胖和糖尿病(DM)的现患率,分析腹型肥胖与糖尿病的关系。方法对1130名45岁以上的中老年人进行问卷调查和身高、体重、腰围(WC)、臀围、腰臀比(WHR)及血糖的检测,比较腹型肥胖组和正常体型组人群糖尿病患病率的差异。结果本社区45岁以上中老年人群腹型肥胖现患率达59.47%(WC标准)、66.55%(WHR标准),糖尿病现患率达12.83%。腹型肥胖组糖尿病患病率高于正常体型组。WC、WHR和BMI均与空腹血糖(FBG)呈正相关,r值的大小和显著性是WHR>WC>BMI。结论肥胖,尤其是腹型肥胖,是糖尿病的重要危险因素,WHR与糖尿病的相关性优于WC和BMI。     

北京市成人体质指数、腰围、腰臀比与肾小球滤过率的相关性研究

目的 探讨北京市自然人群体质指数(BMI)、腰围、腰臀比与肾小球滤过率的相关性.方法 2007年9月至2008年10月在北京地区抽样调查了4 510例人群的身高、体重、腰围(WC),计算BMI及腰臀比(WHR);测血肌酐,估算肾小球滤过率(eGFR).采用t检验或单因素方差分析进行组间均值的比较,采用X2检验进行组间率的比较,指标的相关性研究应用直线相关进行统计分析.结果 男性的BMI、WC、WHR水平高于女性(P＜0.05).女性的eGFR水平高于男性(P＜0.05),随着年龄增长,男性和女性的eGFR水平均逐渐降低.超重与肥胖人群eGFR水平低于正常人群,中心性肥胖人群eGFR水平低于非中心性肥胖人群,差别有统计学意义(P＜0.05),肥胖及中心性肥胖人群CKD的检出率高于正常与非中心性肥胖人群(P＜0.05).男性BMI、WC、WHR与eGFR均呈负相关(P＜0.01),女性BMI、WC与eGFR呈负相关(P＜0.01),而WHR与eGFR没有相关性(P=0.85),BMI较WC与eGFR的相关性更强.结论 肥胖和中心性肥胖与肾小球滤过率成呈相关,其中BMI的相关性最强.     

应用简易体脂参数估测男性2型糖尿病患者腹内型肥胖的可靠性评价

[目的]评价体重指数(BMI)、腰围(WC)、腰臀比(WHR)估测男性2型糖尿病患者腹内型肥胖的最佳临界点、敏感度及特异度.[方法]应用CT对91例男性2型糖尿病患者在腰椎4-5间隙水平进行腹腔内脏器脂肪含量(VA)的测量,同时测量其体重(BW)、身高(H)、腰围(WC)、臀围(HC)、并计算体重指数(BMI)和腰臀比(WHR).以受试者工作特性(ROC)曲线评价简易体脂参数对男性2型糖尿病患者腹内型肥胖的诊断价值.[结果]②经CT诊断,超重及肥胖者中89.80%、正常体重者中47.62%呈腹内型肥胖(VA≥100 cm2);③BMI、WC、WHR与腹内脂肪面积呈正相关关系,尤以BMI、WC的相关性为好;③简易体脂参数估测男性2型糖尿病患者腹内脂肪积聚的最佳切割点为BMI:25 kg/m2,WC:90 cm,WHR:0.93;④当BMI≥28 kg/m2,100%的患者为腹内型肥胖,当WC≥95cm时,91.90%的患者为腹内型肥胖.[结论]BMI、WC及WHR都可估测男性2型糖尿病患者腹内型肥胖,但以BMI、WC的准确率为高.     

不同肥胖测量指标在代谢综合征评估中的意义

目的了解不同肥胖测量指标在代谢综合征(metabolic syndrome,Met S)评估中的意义。方法选取某铁路公司6 703名职工的体格检查资料,计算体质量指数(BMI)、腰围(WC)、腰臀比(WHR)、腰围/身高比值(WHt R)等不同肥胖测量指标,筛查研究人群Met S及组分患病率。结果 6 703名铁路职工Met S总患病率为21.6%,男性及女性患病率分别为23.4%、10.1%;Met S患病率随着年龄增长而增加,男性大于女性;Met S在不同肥胖测量指标的检出率由低到高依次为WHR(78.1%)、WC(90.3%)、WHt R(94.2%)、BMI(14.5%+81.2%),差异均有统计学意义(P0.05)。结论综合评价分析,WHt R、WC、BMI可作为筛查评估Met S的理想指标。     

1661名农村中老年人健康状况调查的分析

目的调查了解农村中老年人的健康状况并对相关测量指标的应用进行分析。方法随机抽取青岛市某农村1661名中老年人（男612人,女1049人）进行体格检查,包括身高、体重、腰围、臀围、血压、血糖、血红蛋白等指标。结果 1661名农村中老年人高血压患病率为63.4%,高血糖检出率为23.8%,贫血患病率为35.3%。中老年女性体质指数（BMI）、腰围（WC）、腰围/身高比值（WHtR）均高于男性（P〈0.05）,男性腰围/臀围比（WHR）高于女性（P〈0.05）。65岁之前BMI、WC均较高（BMI〉25kg/m^2,WC〉85cm）,65岁以后随年龄升高BMI、WC有逐渐降低的趋势（P〈0.05）。BMI、WC、WHR、WHtR4者与收缩压、舒张压、血糖的正相关系数均为WHtR最大（P〈0.01）。结论农村中老年人高血压、高血糖、贫血患病率均较高,中老年女性超重和肥胖率高于男性,比男性更易发生高血糖,同时45～65岁中老年人超重和肥胖的发生率也较高;WHtR与BMI、WC、WHR、收缩压、舒张压和血糖的相关性均较强,可以作为有效的腹型肥胖指标和预测高血糖与高血压的有效指标。     

广州市中老年人体脂率与常规肥胖指标相关性及其对应值的研究

目的 探讨广州市中老年人体脂率（BFP）与BMI、腰围（WC）和腰臀比（WHR）等常规肥胖指标的相关性,并推算BFP相应切点值。方法 基于“广州生物库队列研究”（GBCS）平台,选择3 490名50岁及以上相对健康者随机分成两组,一组用于曲线拟合分析,确定BFP与BMI、WC和WHR间的相关方程,然后再引入性别、年龄、体力运动、吸烟、饮酒等因素进行逐步回归分析,建立预测方程,进而推算反映肥胖程度的BMI、WC、WHR各切点值对应的BFP切点值,然后与另一组进行验证。结果 BFP随BMI、WC和WHR的增加而增加,与WC、WHR相比,BMI能更好预测BFP,其回归方程为BFP=（-23.47-8.87×性别）+2.94×（BMI）-0.024×（BMI）²,决定系数R²=0.805。根据回归方程,超重（24 kg/m²≤BMI < 28 kg/m²）对应的BFP分别男性为24.3%≤BFP < 31.1%,女性为33.2%≤BFP < 40.0%。与WC、WHR对应的BFP判定肥胖的一致性相比,BMI所对应的BFP判定肥胖的一致性较好,其ROC曲线下面积最大,男性为0.909,女性为0.919,灵敏度和特异度分别男性为70.3%、85.5%;女性为75.2%、93.0%。结论 BFP与BMI的相关性较好。广州市中老年人BFP对应于超重/肥胖（BMI≥24 kg/m²）的切点值男性为24.0%,女性为33.0%。     

贵州侗族30岁以上人群肥胖与骨质疏松关联性的性别分析

目的 比较贵州侗族30岁以上人群肥胖与骨质疏松之间关联的性别差异,为人群骨质疏松危险分层提供参考依据。方法 采用现况调查设计,问卷调查对象的基本情况、疾病史、吸烟、饮酒等情况,并进行体格检查,骨密度检测,比较不同性别的肥胖类型、肥胖指标,骨质疏松的患病率及关联。结果 此次共调查贵州侗族30岁以上人群5362人,男性超重率为34.9%、肥胖率为9.9%;女性超重率为34.3%、肥胖率为10.7%。骨质疏松的患病率为2.9%,男性为6.1%,女性为1.3%。采用logistic回归分析,以非肥胖为参比,男性中心性肥胖、全身性肥胖、复合型肥胖的OR（95%CI）分别为2.368（1.595~3.515）、4.819（0.486~47.807）、3.014（1.800~5.048）;女性中心性肥胖和复合型肥胖的OR（95%CI）分别为0.630（0.333~1.193）和1.446（0.605~3.460）。进一步将BMI、WHR、WHtR、WC 按四分位数分组后,男性随BMI、WHR、WHtR、WC水平增高其骨质疏松患病率也增高（Ptrend 分别为0.002、0.003、0.001、0.002）,患病危险性也增高;女性无统计学意义（Ptrend分别为0.173、0.851、0.836、0.405）。结论 贵州侗族人群骨质疏松与肥胖有关联存在性别差异,男性肥胖为骨质疏松的高危人群。     

某高校教职工体质指数及腰臀比与血压关系

目的 探讨体质指数(BMI)和腰臀比(WHR)对教职工血压水平和高血压患病率的影响。方法 对郑州大学2008年健康体检的2 668名教职工体检资料进行统计分析,采用Logistic回归分析相关危险因素。结果 教职工总体人群高血压患病率为17.2%,男性为21.0%,女性为15.8%,男性高于女性(P=0.000);随着年龄的增加,总体人群平均血压水平和高血压检出率均明显升高(P<0.01);与BMI、WHR正常人群比较,超重及肥胖组、腹型肥胖人群血压水平均明显升高(P<0.01),且高血压检出率均升高(P<0.01);多因素Logistic回归分析结果显示,WHR、BMI、年龄是高血压的独立危险因素,相对危险度分别为94.291(95%CI=8.147~1 091.264),1.216(95%CI=1.170~1.264),1.051(95%CI=1.041~1.060)。结论 教职工人群WHR及BMI水平与高血压密切相关。     

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.     

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.     

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.     

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.     

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.