溃疡性结肠炎发病相关因素Meta分析

目的了解溃疡性结肠炎(UC)发病的相关因素,为疾病防治提供循证依据。方法检索国内CNKI、万方和维普数据库,纳入含病例对照研究的国内相关文献,采用双录入法提取数据并进行Meta分析。结果纳入8篇相关文献研究,累计病例1 610例、对照1 664例。Meta分析表明,各因素合并OR值(95%CI)分别为:精神紧张1.55(0.71～3.39)、肠道感染史4.09(2.18～7.68)、慢性腹泻/炎性肠病家族史4.90(1.41～16.98)、牛奶3.06(1.80～5.20)、油炸食品/西餐3.09(2.31～4.12)和吸烟0.75(0.66～0.85)。结论肠道感染史、慢性腹泻/炎性肠病家族史、牛奶、油炸食品/西餐可能为UC发病的危险因素;吸烟可能为保护因素。     

脑梗死复发相关危险因素分析及干预

目的 分析脑梗死复发的相关危险因素及干预方法.方法 对比分析53例复发性脑梗死患者(复发组)及202例首次发生脑梗死患者(对照组)的临床资料,分析年龄、性别、原发性高血压、高胆固醇血症、糖尿病、吸烟、颈动脉粥样硬化斑块等在脑梗死复发中的作用.结果 复发组患者年龄>60岁、男性、原发性高血压、高胆固醇血症、糖尿病、吸烟、颈动脉粥样硬化斑块的比例明显高于对照组,差异均有统计学意义.结论 高龄,男性,合并原发性高血压、糖尿病、吸烟、高胆固醇血症、颈动脉粥样硬化斑块均为脑梗死复发的危险因素,加强对这些因素的干预有助于预防脑梗死复发.     

中国人群吸烟与胃癌发病关系的Meta分析

目的 探索中国人群胃癌和吸烟的关系,并对不同性别和吸烟量进行亚组分析.方法 所有数据来自中国期刊网全文数据库、维普数据、万方数据库、Science Direct和Pubmed医学数据库.统一制定文献评价标准,由两位研究者独立检索文献,独立对文献进行质量评价和提取信息.利用软件STATA中的Meta analysis模块进行统计分析.结果 共纳入文献51篇(11260例病例).在合计人群中,吸烟是胃癌发病的危险因素(OR=1.66,95%CI:1.47～1.87).在男性中,吸烟是胃癌的危险因素(OR=1.93,95%CI:1.35～2.76),但在女性中却并未发现吸烟是胃癌的危险因素(OR=1.05,95%CI:0.67～1.64).按吸烟量的不同,把吸烟分为轻度吸烟、中度吸烟、重度吸烟,通过Meta回归得到:LnOR=0.404×group-0.361,说明吸烟量每增加-个等级,胃癌的发病率会变为原来的1.5倍.结论 吸烟是中国人群胃癌的危险因素之一,但在女性这种关系还需进一步研究.吸烟量不同对胃癌的发病率会产生影响.     

国内新生儿缺氧缺血性脑病产科危险因素的系统评价

目的系统评价国内新生儿缺氧缺血性脑病发病的主要危险因素,为预防决策提供依据。方法计算机检索万方数据库、中国生物医学文献数据库(CBM)、中国学术期刊全文数据库(CNKI)、中文科技期刊数据库(VIP)的同时利用百度、谷歌等搜索引擎全面收集与新生儿缺氧缺血性脑病发病危险因素有关的所有病例—对照研究。采用meta分析方法对所纳入的研究结果进行定量综合分析,并通过Rev Man 5. 3软件对研究结果进行异质性检验以及OR值的合并及95%CI的计算。结果共纳入12篇文献,病例组1 288例,对照组1 335例。Meta分析结果显示国内新生儿缺氧缺血性脑病大的产科危险因素有:妊娠期高血压、高龄妊娠、妊娠贫血、妊娠合并糖尿病、脐带异常、产程异常、胎盘异常、羊水污染、胎膜早破、宫内窘迫(P<0. 01)。结论现有证据表明,国内新生儿缺氧缺血性脑病的产科危险因素有:妊娠期高血压、高龄妊娠、妊娠贫血、妊娠合并糖尿病、脐带异常、产程异常、胎盘异常、羊水污染、胎膜早破、宫内窘迫。     

糖尿病与原发性肝癌关系的病例对照研究Meta分析

目的评价糖尿病(DM)在导致原发性肝癌(HCC)的危险因素中所起的作用,探讨DM和HCC的关系。方法通过制定检索策略,计算机检索Cochrane Library、PubMed、EMbase、Ovid、中国生物医学文献、维普中文科技期刊和清华同方等数据库;检索时间均从建库至2008年12月。纳入所有研究DM和HCC病因相关性的病例-对照研究,并对纳入的文献进行评价。采用Revman5.0软件对同质研究进行Meta分析。结果最终有14篇病例-对照研究纳入系统评价。在纳入的14篇病例-对照研究中,12篇纳入Meta分析,HCC组与对照组的人群比较Meta分析结果显示,合并效应量OR=2.0,95%CI=1.42~2.81,表明暴露DM发生HCC的危险性是未暴露DM的2.0倍。结论 DM与HCC存在正关联,提示DM可能是HCC的一个独立致病危险因素。     

吸烟与宫颈癌关系的Meta分析

目的:探讨吸烟与宫颈癌之间的相互关系。方法:采用Meta分析专用软件ReviewManger4.2对国内外13篇关于吸烟与宫颈癌关系文献的病例对照研究结果进行随机效应模型的Meta分析。结果:吸烟与宫颈癌之间关联明显(Z=10.58,P=0.000),合并计算的OR值为1.98,OR的95%CI为1.74～2.25。结论:吸烟是宫颈癌发生的一个危险因素。     

脑梗死复发危险因素分析

目的探讨脑梗死复发危险因素,为脑梗死防治提供理论依据。方法分析48例复发脑梗死患者和124例初发脑梗死患者的年龄、性别、吸烟、酗酒及高血压、糖尿病、冠心病、TIA病史等危险因素;测定血小板聚集率,筛选阿司匹林抵抗者,并统计分析两组危险因素差异性。结果单因素卡方检验显示阿司匹林抵抗、高血压、糖尿病、高脂血症和男性是脑梗死复发的重要危险因素。Logistic回归分析显示高血压、糖尿病、高脂血症和男性与脑梗死复发关系密切。OR值分别为6.981、4.952、2.945和2.525。结论高血压、糖尿病、高脂血症和男性是脑梗死复发的重要独立危险因素,此外阿司匹林抵抗可能也是脑梗死复发的独立危险因素。     

被动吸烟与宫颈癌关系的Meta分析

目的 利于Meta分析的方法系统评价被动吸烟与宫颈癌的关系.方法 检索2000～2009年Elsevier、中国期刊网、万方数据知识平台等已经发表的关于被动吸烟和宫颈癌关系研究的文献.纳入标准为涉及被动吸烟和宫颈癌关系的病例对照研究,各文献研究方法相似,有综合的统计指标.剔除不符合纳入标准,且重复研究报告及数据不完整的文献.利用Review Manager 4.2软件进行统计分析.结果 将14个研究结果加权合并,累计病例2 612例,累计对照3 050例,被动吸烟与宫颈癌有关联(Z=4.34,P<0.0001),合并计算的OR=1.62,其95%CI:1.30～2.01.结论 被动吸烟是宫颈癌发生的一个危险因素.     

中国居民高血压的危险因素Meta分析

摘要:目的　综合评价中国居民高血压的主要危险因素,为高血压的一级预防提供循证依据。方法　检索收集国内2003-2012年发表的高血压危险因素病例对照研究文献,应用Lichtenstein量表进行文献质量评估,采用Meta分析方法进行定量综合分析,绘制森林图,计算危险因素合并OR值及其95%置信区间,通过绘制漏斗图和计算失安全系数Nfs控制偏倚。结果　纳入文献37篇,各危险因素合并OR值（95% CI）由高到低依次为:糖尿病史OR＝2.76（2.24,3.39）;超重OR＝2.61（2.19,3.11）;高血压家族史OR＝2.56（2.35,2.79）;高盐饮食OR＝1.47（1.16,1.85）;饮酒OR＝1.15（1.07,1.24）;吸烟OR＝1.14（1.05,1.23）。结论　糖尿病史、超重、高血压家族史、高盐饮食、饮酒、吸烟均为中国居民高血压的危险因素。     

糖尿病与原发性肝癌队列研究的Meta分析

目的 探讨糖尿病与原发性肝癌发病风险的关系.方法 利用中国学术期刊全文数据库、万方全文数据库及Medline数据库,检索1989年1月到2010年2月国内外公开发表的关于糖尿病与肝癌关系的队列研究文献,共收集到28篇文献.利用固定效应模型及随机效应模型计算检索文献的合并RR值及其95%CI值,并根据入选文献的研究人群来源、性别、地域差别,以及入选文献质量评分的高低进行亚组分析.结果 纳入Meta分析的文献共14篇,随访队列总人数为3 672 248例(名),累计肝癌患者3800例.经Meta分析,与未患糖尿病者相比,糖尿病患者肝癌发病的RR值为3.33(95%CI值:1.82～6.10),提示糖尿病与肝癌的发生有较密切的关系;亚组资料分析显示,研究对象为一般人群和已患某种疾病的患者的各个研究合并RR值(95%CI值)分别为3.76(1.69～8.38)和2.41(1.34～4.32);男性经Meta分析综合后糖尿病的RR值(95%CI值)为2.32(1.70～3.17),女性为1.63(1.08～2.47).结论 糖尿病与肝癌的发生有一定的关联,可能是原发性肝癌的危险因素之一.     

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.     

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.     

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.     

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.     

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.