2306例孕妇糖耐量筛查及影响因素分析

目的:了解妊娠期糖代谢异常的发生率,探讨其相关因素,为制定干预措施提供科学依据。方法:对2 306例孕妇进行50 g葡萄糖筛查试验(GCT),50 g GCT结果≥7.8 mmol/L再行口服葡萄糖耐量试验(OGTT)明确诊断,将临床资料进行统计分析。结果:妊娠期50 g GCT阳性率20.77%。其中葡萄耐量降低发生率4.16%,妊娠期糖尿病(GDM)检出率3.64%。高龄、孕前肥胖及糖尿病家族史为妊娠期糖代谢异常的相关因素。结论:GDM母儿并发症多,50 g GCT对GDM的及时发现和管理具有重要的意义。妊娠期糖耐量异常的发生率与孕妇的年龄、孕前体重指数及糖尿病家族史相关。做好孕前保健工作,按时对孕妇进行50 g GCT检测,特别是对GDM高危孕妇的筛查与管理有非常重要的临床意义。     

江阴地区5100例妊娠期糖尿病筛查结果分析

目的 研究江阴地区妊娠期糖尿病的患病情况,同时评价妊娠期糖尿病筛查的临床意义.方法 回顾性分析江阴地区2010年1月至2011年12月在江阴人民医院产科门诊进行产前检查的5100例孕妇的50g葡萄糖筛查试验结果,阳性者进一步行75g葡萄糖耐量试验.采用统一编制的调查表对每个受试孕妇进行调查,根据结果 把受试者分为高危组和非高危组两组,而高危组人群根据糖筛查时间的先后按孕龄分成:孕周<24W组(A组),孕24～28W组(B组),孕周≥28W组(C组),按三组进行统计学分析.同时将心理焦虑因素也列入了研究范围,研究心理焦虑因素对妊娠期糖尿病(GDM)的影响.结果 江阴地区妊娠期糖尿病的发病率为3.57%,高危组孕妇妊娠期糖尿病发病率明显高于非高危组(χ2=50.82,P<0.05);有心理焦虑因素孕妇的糖筛异常情况较无心理焦虑因素孕妇高(χ2分别为27.91、8.40、5.39,均P<0.05).结论 江阴地区妊娠期糖尿病发生率较高,高危因素者可在初诊时即行糖尿病筛查,从而指导临床,降低并发症,心理焦虑因素也是妊娠期糖尿病的重要影响因素之一.     

孕期50g葡萄糖筛查在妊娠期糖尿病诊断中的临床意义

目的：通过1 012例孕妇孕期50g葡萄糖筛查结果分析,了解孕妇妊娠期糖尿病的发病情况,评价50g葡萄糖筛查的临床应用价值,为防治妊娠期糖尿病及妊娠糖耐量受损提供科学依据。方法：对2009年4月1日至2010年9月30日间自愿在景宁县妇幼保健所行50g葡萄糖筛查的1 012例孕妇的筛查结果进行回顾性分析,对阳性者（血糖≥7.8mmol/L）进一步行75g葡萄糖耐量试验。结果：妊娠期糖尿病发生率为2.08%,妊娠期糖耐量受损的发生率为5.53%。糖耐量异常总数发生率为7.61%。结论：通过在孕中期50g葡萄糖筛查,对异常者行糖耐量试验,可以提高妊娠期糖尿病的检出率,为尽早对糖代谢异常妊娠妇女进行干预提供理论依据,减少该病给母儿带来的危害,促进母婴健康。     

妊娠期糖尿病早期筛查与妊娠结局

目的探讨孕妇妊娠期糖尿病(GDM)的发生率,以及妊娠期有糖尿病相关高危因素者与无高危因素者葡萄糖耐量试验异常的关系及对胎儿、新生儿的影响.方法对孕中、晚期孕妇进行口服50 g葡萄糖筛查(50 g GCT),血糖≥7.8 mmol/L者做正规糖耐量试验(OGTT)以明确诊断,并对诊断妊娠期糖耐量降低(GIGT)及GDM给予早期治疗,观察其妊娠结局.结果50 gGCT阳性率为10.65%,GIGT及GDM发病率分别为3.80%及3.48%.经早诊断、早治疗的孕妇,妊娠并发症、巨大儿、围产儿窒息、围产儿死亡率明显降低.结论对所有孕妇进行早期50 g GCT筛查,并对GIGT、GDM进行早治疗,伴有高危因素的孕妇重点监测,减少了母儿的病死率.     

妊娠期糖尿病早期筛查与妊娠结局

目的:探讨孕妇妊娠期糖尿病(GDM)的发生率,以及妊娠期有糖尿病相关高危因素者与无高危因素者葡萄糖耐量 试验异常的关系及对胎儿、新生儿的影响。方法:对孕中、晚期孕妇进行口服50 g葡萄糖筛查(50 g GCT),血糖≥7.8 mmol／L者做 正规糖耐量试验(OGTT)以明确诊断,并对诊断妊娠期糖耐量降低(GIGT)及GDM给予早期治疗,观察其妊娠结局。结果:50 g GCT阳性率为10.65％,GIGT及GDM发病率分别为3.80％及3.48％。经早诊断、早治疗的孕妇,妊娠并发症、巨大儿、围产儿窒息、 围产儿死亡率明显降低。结论:对所有孕妇进行早期50 g GCT筛查,并对GIGT、GDM进行早治疗,伴有高危因素的孕妇重点监测, 减少了母儿的病死率。     

妊娠期糖尿病的产前筛查

目的:了解南宁市妊娠期糖尿病的发病率及高危因素,评价50g葡萄糖筛查的应用价值。方法:对2324例孕24～28周的孕妇进行50g糖筛查,1h血糖≥7.8mmol/L者再行OGTT检测。结果:2324例中妊娠期糖尿病(GDM)的发生率为2.67%,妊娠期糖耐量减低(GIGT)发生率为2.15%;高危因素有巨大儿、肥胖、异常孕产史、反复霉菌性阴道炎、糖尿病家族史、反复尿糖阳性等。结论:对妊娠期所有孕妇进行50g糖筛查可减少GDM漏诊,对伴有高危因素的孕妇应重点监测。     

妊娠期糖尿病早期筛查与妊娠结局

目的：探讨孕妇妊娠期糖尿病(GDM)的发生率，以及妊娠期有糖尿病相关高危因素者与无高危因素者葡萄糖耐量试验异常的关系及对胎儿、新生儿的影响。方法：对孕中、晚期孕妇进行口服50g葡萄糖筛查(50gGCT)，血糖≥7.8mmol／L者做正规糖耐量试验(OGTT)以明确诊断，并对诊断妊娠期糖耐量降低(GIGT)及GDM给予早期治疗，观察其妊娠结局。结果：50gGCT阳性率为10．65％，GIGT及GDM发病率分别为3．80％及3．48％。经早诊断、早治疗的孕妇，妊娠并发症、巨大儿、围产儿窒息、围产儿死亡率明显降低。结论：对所有孕妇进行早期50g GCT筛查，并对GIGT、GDM进行早治疗，伴有高危因素的孕妇重点监测，减少了母儿的病死率。     

妊娠期糖代谢异常相关因素调查分析

目的：探讨妊娠期糖代谢异常发病的高危因素,为制定有效干预措施提供科学依据。方法采用前瞻性对照研究方法,收集2011年4至9月在珠海市妇幼保健院产科门诊行产前检查诊断的糖代谢异常孕妇（研究组）共108例,其中妊娠期糖尿病（GDM）75例、妊娠糖耐量异常（GIGT）33例;收集同期糖代谢正常孕妇91例（对照组）,对两组孕妇的临床资料进行单因素及多因素回归分析,探讨各因素对妊娠期糖代谢异常发病的影响。结果一般情况分析显示,糖代谢异常孕妇年龄、孕前身体质量指数（ BMI）、孕期体重增长、孕次及产次均大于正常孕妇（ t 值分别为-6．567、-4．818、-1．929、-3．231、-3．270,均P＜0．05）;糖代谢异常孕妇高中以下文化程度的比例较对照组高,差异有统计学意义（χ^2＝5．642,P＜0．05）。单因素分析发现,孕次、产次、文化程度、年龄≥30岁、孕前BMI≥24kg/m^2、糖尿病家族史、不良孕产史、高脂血症、反复发生霉菌性阴道炎（ VCC）、孕期大量甜食、孕期大量水果、孕期锻炼等因素与糖代谢异常的发生相关。多因素Logistic回归分析表明,孕期大量甜食、孕期大量水果、糖尿病家族史、孕前BMI≥24kg/m^2、VCC、年龄≥30岁、孕期锻炼7个因素进入主效应模型,其中孕期锻炼为保护性因素,其他为危险因素。结论不合理饮食、糖尿病家族史、孕前超重、年龄≥30岁、反复发生霉菌性阴道炎为影响妊娠期糖代谢异常发生的高危因素,孕期锻炼为保护性因素。对存在高危因素的妇女在产前检查时应加强监护和指导。     

妊娠期糖尿病高危孕妇重复糖筛查的价值

目的:评价妊娠期糖尿病高危孕妇首次糖尿病筛查结果正常时再次筛查异常结果发生率及相关因素。方法:2005年4月～2007年4月期间在本院进行产前检查有患糖尿病高危因素的600例孕妇,且于孕24周前行50g糖筛查结果均小于7.8mmol/L。所有研究对象在孕28～32周再次接受糖筛查实验并进行随访。结果:600例孕24周前首次糖筛查结果正常的孕妇被纳入研究。513例接受了二次糖筛查实验,其中165例(32.2%,95%CI:28.2%～36.3%)在二次糖筛查中结果异常,20例(3.9%)被诊断为糖尿病。妊娠妇女年龄≥30岁或首次糖筛查结果≥7.2mmol/L者再次筛查的异常发生率较高。结论:有患糖尿病高危因素的孕妇于孕24周前糖筛查结果正常时,仍需建议在孕28～32周时再次接受筛查实验,再次筛查结果异常的高危因素为年龄≥30岁和50g糖筛查结果≥7.2mmol/L。     

妊娠期糖尿病产前筛查的意义

目的探讨50 g糖筛查及葡萄糖负荷试验（OGTT）在产前检查运用价值。方法回顾性分析行产前检查并分娩的单胎孕妇1235例，孕24-28周，行50g糖筛查≥7.8 mmol/L为异常，再行OGTT实验，检测异常及妊娠期糖尿病（GDM）患者。结果1235例孕妇中50克糖筛查异常者392例，占31.74%；75 g OGTT中糖耐量异常（IGT）者36例，占2.91%；GDM者40例占3.24%。高危因素有DM家族史，既往有流产及新生儿不明原因死亡史，此次妊娠反复发作真菌性阴道炎及肥胖等。结论对妊娠期孕妇实行糖尿病筛查是有必要的，特别是对有高危因素的患者，必要时重复筛查或直接行OGTT实验。     

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.