陕西省麟游县大骨节病家庭聚集性病例对照家系研究

目的:探讨大骨节病(Kashin-Beck Disease,KBD)的家族聚集性及其相关的环境因素与遗传因素.方法:采用以人群为基础的病例和对照家系设计,运用条件logistic回归模型对陕西省麟游县212例KBD患者家系和212例对照家系数据进行拟合,以AIC值最小作为判断拟合优度的标准.结果:饮用河水是KBD家庭聚集性的危险因素,饮用自来水是保护因素;父母表型与子女KBD发病相关.结论:KBD的发生是环境因素与遗传因素多种因素作用的结果.饮用河水可能是引起陕西省麟游地区KBD家庭聚集性的主要原因.     

淮安地区食管癌遗传流行病学研究

[目的]了解遗传因素在淮安地区食管癌发病中的作用及食管癌的遗传模式.[方法]采用以人群为基础的病例对照家系研究,收集97对淮安当地原发性食管癌患者及其对照的家系资料,调查这些家系所有一级亲属的肿瘤发病率;应用多因素非条件Logistic回归估计食管癌家族史的发病风险,Li-Mantel-Gart法计算食管癌的分离比,Penrose法估计遗传模式,Falconer法计算遗传度.[结果]淮安地区食管癌先证者与对照的食管癌家族史差异有统计学意义,先证者家系的一级亲属食管癌患病风险显著高于对照家系,其同胞分离比为0.026(95%CI:0.0003～0.028),Ⅰ级亲属食管癌的遗传度为(24.769±7.038)%.[结论]淮安地区食管癌具有明显的家族聚集性,遗传因素在淮安地区食管癌病因中占一定比重,其遗传模式呈现多基因遗传方式.     

河南省开封县肝癌危险因素的病例对照研究

[目的]探讨河南省开封县原发性肝癌发病的危险因素.[方法]对开封县149例肝癌患者进行1∶1配对的病例对照研究.[结果]影响当地肝癌发病的危险因素有肝炎病史、好生闷气(OR=14.13,95%CI:3.07～65.00)、直系亲属疾病史(OR=18.47,95%CI:3.05～111.85)、家族肿瘤史(OR=309.67, 95%CI:8.42～11 385.05).[结论]原发性肝癌危险因素的研究发现可为今后开封县肝癌的预防与监测工作提供参考.     

福建省原发性肝癌遗传因素分析

为了探讨遗传因素与福建省原发性肝癌的关系,应用多种对照配对的病例对照研究方法,对100个原发性肝癌和200个对照家系进行了遗传流行病学分析。结果显示,原发性肝癌先证者一、二级亲属患病率明显高于对照组患病率,分离比为0.04146～0.08654,遗传度加权均值为63.52±4.22％。提示原发性肝癌系多基因遗传病,遗传易感性是原发性肝癌的危险因素之一,原发性肝癌的发生是遗传和环境多种因素共同作用的结果。     

224例原发性肝癌病因危险性分析

[目的]探讨原发性肝癌的致病因素及病因危险性.[方法]收集2005年10月～2007年4月在中国医科大学附属第一医院介入科住院的原发性肝癌患者224例和同期住院的其他非肝病患者290例进行病例对照研究.[结果]两组间年龄、民族和职业分布无差别.HBV感染者发生肝癌的危险性是非感染者的27.4倍,原发性肝癌人群归因危险度为77.437%, HBV感染在两性分布无差别.单因素logistic回归分析提示HBV和HCV感染、既往肝硬化史、乙肝病史、性别(男性是危险因素)、饮酒、家族肝炎史和家族肝癌史与肝癌的发病有关.经多因素回归分析后剔除了饮酒和家族肝炎史,模型的拟合优度为88.4%.[结论]HBV慢性感染是原发性肝癌的一个主要危险因素,此外还和HCV感染、肝硬化等有关,此类病人定期迸行检查是早期发现肝癌的主要手段.     

ERCC1基因多态性与肝癌易感性研究

目的 研究ERCCl基因多态性与福州地区人群肝癌易感性之间关系,及其与环境因素交互作用对肝癌发生的影响.方法 采用病例对照研究收集病例和对照暴露信息,采用聚合酶链反应限制性片段长度多态性(PCR-RFLP)技术对ERCCl-C8092A基因多态性进行检测;通过广义线性模型模拟ERCC1-C8092A基因多态性与肝癌主要环境危险因素交互作用的结构模型.结果 以ERCC1-C8092ACC作为参照,ERCC1-C8092ACA/AA基因型可以增加原发性肝癌的发病危险性(OR=3.789,95%CI:2.792～5.142);ERCCl-C8092A突变与饮沟塘水、乙型肝炎病毒感染的联合作用最适模型均为超相加模型,与霉变食品联合作用为超相乘模型.结论 ERCC1-C8092A多态可能与肝癌遗传易感有关,并与肝癌主要环境因素间存在协同作用.     

肝癌遗传模式与危险因素病例-对照研究

目的探讨肝癌的危险因素及遗传模式,为肝癌的预防提供科学依据。方法采用病例-对照研究,以98例肝癌病例和196名健康对照作为研究对象,询问其暴露史;采用Penrose法、简单分离分析和Falconer法对98例原发性肝癌家系资料进行遗传流行病学研究。结果乙肝病史、亲属肿瘤史、食用盐腌食品史、肝硬化病史、饮用地表水与浅井水、饮酒等因素的比值比分别为5.18,8.40,2.16,9.33,2.56,2.61;单基因显性简单分离分析(分离比1/2)χ2=219.44,P<0.01;单基因隐性简单分离分析(分离比1/4)χ2=67.74,P<0.01;应用Penros法计算同胞肝癌发生率,一般人群肝癌发生率(s/q)接近1/q1/2;先证者一级亲属的遗传度为(58.74±5.43)%。结论乙肝病史、亲属肿瘤史、食用盐腌食品史、肝硬化病史、饮用地表水与浅井水、饮酒等是武威市肝癌发病的危险因素;先证者肝癌遗传不符合单基因显性和隐性遗传而是属于多基因遗传,遗传因素对肝癌的发病具有一定的贡献,约占整个危险因素的3/5。     

原发性肝癌遗传与环境因素的病例对照研究

在１５２例原发性肝癌病人和１：１配对的对照中调查了与肝癌有关的危险因素，及家族中二系三级亲属肝癌的累积死亡情况。结果显示：病例组亲属肝癌的累积死亡率（０．４６％）明显高于对照组亲属（０．０７％）；病例组有血缘关系亲属中肝癌的累积死亡率（０．５５％）显著高于无血缘关系者（０．０８％）；而在有血缘关系的亲属中，随着血缘关系的疏远，肝癌的累积死亡率呈规律性的下降。用多元回归和分层分析法将遗传因素与其他环境因素综合分析后，仍可见到遗传因素的作用。这一结果为研究遗传因素与肝癌发病的联系提供了理论依据。     

Ⅱ型糖尿病家族聚集性的流行病学研究

目的探讨遗传因素与Ⅱ型糖尿病之间的关系。方法通过遗传流行病学病例对照研究方法,对常州市350个家系（184个Ⅱ型糖尿病先证家系和166个对照家系）进行了Ⅱ型糖尿病的遗传流行病学研究。结果病例和对照家系有良好的均衡可比性,病例组一级亲属总的患病率为3．47％,与对照组的1．03％相比,差异有非常显著性（X2=17．66,P＜0．005）,不论其父母、同胞或子女,均以病例亲属的患病率显著高于对照,二项分布显示,Ⅱ型糖尿病家族中实际发病数超过其二项分布的理论概率范围,即Ⅱ型糖尿病的分布呈明显的家族聚集性,单因素和多因素Logistic回归模型拟合也提示,遗传因素在Ⅱ型糖尿病发病中占有重要地位。结论遗传因素与Ⅱ型糖尿病的发生有一定的关系。     

核心家系中删失性状遗传方差分量模型的研究

目的研究核心家系资料中删失性状的遗传方差分量模型,评价环境因素和遗传因素对删失性状的影响。方法应用多变量脆弱模型研究删失性状的遗传方差分量,基础模型选用Cox比例危险模型,MCMC方法用于参数估计,原发性肝癌核心家系发病年龄资料的分析说明了该方法的实际应用。结果实例分析结果符合专业解释,该模型对生存时间分布没有要求因而有更广泛的适用性。结论基于Cox回归模型的遗传方差分量模型可用于家系资料,研究生存时间资料的遗传和环境因素的作用。     

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.