沈阳市女性肺癌危险因素的病例对照研究

对沈阳市区１９９１年４月至１９９４年１２月的３１３例、年龄３５～６９岁的女性肺癌患者进行了按年龄配比１：１的病例对照研究。结果显示，女性肺癌的危险因素为吸烟、烹饪油烟暴露，其ＯＲ值与９５％可信限分别为１．８６（１．３４～２．５７）和４．３１（３．０７～６．０５），其ＰＡＲ％分别为２２％与４６％。吸烟与油烟对肺癌的发生有交互作用，其相对超额危险度为３．１２。肺癌以腺癌为主，而吸烟仅与鳞癌有关。肺结核、慢性支气管炎增加肺癌发生危险性，但无显著意义。     

南京市肺癌环境危险因素的病例对照研究

目的探讨近年来南京市肺癌发生的环境危险因素.方法对南京市63例原发性肺鳞癌和89例原发性肺腺癌进行1:1配对病例-对照研究,并用条件Logistic回归模型分析危险因素.结果慢性支气管炎史、吸烟指数是肺鳞癌发生的环境危险因素,其OR值分别为8.55,2.35;人群归因危险度分别为18.22%,58.80%;综合人群归因危险度为0.6871.慢性支气管炎史、肺结核史、不良烹调习惯、煤炉使用年限、家族肿瘤史是肺腺癌发生的环境危险因素,OR值分别为5.16,4.12,2.91,2.02,2.59;人群归因危险度分别为8.15%,11.91%,27.30%,29.98%,10.35%;综合人群归因危险度为0.630 6.结论肺鳞癌、腺癌的发病分别与多种环境因素有关,应积极控制环境危险因素,以减少肺癌的发生率.     

广东省肺癌危险因素病例对照研究

对广东省３９０例肺癌作１：１病例对照研究，比较不同性别、不同病理类型肺癌的危险因素。女性肺癌的流行特征、病理类型、危险因素与男性肺癌不尽相同。２９１例男性肺癌以肺鳞癌多见（鳞癌：腺癌＝１：０．５），９９例女性肺癌以肺腺癌为主（鳞癌：腺癌＝１：２．７）；女性肺癌诊断时年龄明显比男性小（Ｐ〈０．００１）。单因素Ｌｏｇｉｓｔｉｃ回归分析发现，家族肿瘤史、家族肿癌史、慢支／肺气肿病史、肺结核史、其他肺疾患     

橡胶职业暴露与肝癌关系的病例—队列研究

为研究橡胶职业暴露与肝癌之间的关系，应用标化死亡率和病例队列研究对上海某橡胶厂轮胎和胶鞋制造工人进行了２３年（１９７３～１９９５）的随访调查，结果表明，全队列人群总的死亡率低于普通人群，但按工种分组分析，发现男性胶鞋工种肝癌死亡超额明显［ＳＭＲ为１０（２／２．０），９５％ＣＩ＝２．４３～１０８．３］；病例—队列准似然多因素分析表明，胶鞋和机修工种的肝癌危险度较高，但无统计学显著性；非职业因素中，家庭燃煤肝癌危险度增高（ＲＲ＝３．０５，９５％ＣＩ：１．２８～７．２８）。认为，橡胶工人总的肝癌危险度稍低于普通人群，但某些工种的肝癌ＲＲ增高，分析可能与滑石和溶剂暴露有关     

橡胶职业暴露与肠癌和胰腺癌关系的病例—队列研究

对上海某橡胶厂轮胎和胶鞋制造工人进行了２３年（１９７３～１９９５年）的随访调查。应用病例－队列方法，对橡胶职业暴露与肠癌和胰腺癌之间的关系进行了研究。准似然多因素分析表明，除内胎工种外，其它五类工种的肠癌相对危险度均升高，胶鞋和机修工种尤为明显，这种作用独立于与肠癌可能的非职业危险因素，如年龄、性别、饮茶、吸烟、饮酒、经济状况等。认为橡胶化合物中的亚硝胺（ＲＲ＝２．４３，９５％ＣＩ＝０．６５～９．１２）和碳黑（ＲＲ＝２．３０，９５％ＣＩ＝０．６４～８．２６）暴露可能与肠癌有关。与胰腺癌有关的橡胶化合物可能是溶剂（ＲＲ＝３．８４，９５％ＣＩ＝０．４６～３２．２０）和亚硝胺（ＲＲ＝２．７１，９５％ＣＩ＝０．６２～１１．９１）。结论认为，虽然本次研究的病例数较少，与职业相关变量的相对危险度增高未有统计学显著性，但所揭示的橡胶职业与这两种疾病的关系值得注意和进一步研究。     

橡胶职业暴露与多种疾病间关系的分别分析

对某橡胶厂工人进行了２３年（１９７３￣１９９５）的随访调查,应用多因素分析方法,在控制可能的混杂因素下,分别估计了肺癌,肠癌,胰腺癌,缺血性心脏病和脑血管疾病的危险度。结果显示,亚硝胺的肺癌危险增高有统计学显著性（ＲＲ＝２．７１,９５％,ＣＩ＝１．３２￣５．５７）;与肠癌有关的橡胶化合物可能是亚硝胺（ＲＲ＝２．４３,９５％ＣＩ＝０．６５￣９．１２）和碳黑（ＲＲ＝２．３０,９５％ＣＩ＝０．６４￣８．     

上海及全国一些地区胰腺炎流行病学调查

目的试用胰腺炎／胃癌住院病例比例和胃癌发病率,推测胰腺炎发病率。方法收集上海９家,其他地区９家医院共７９８３例胰腺炎住院病例。结果（１）上海市（１９８８～１９９５年）胰腺炎估计发病率为１８．６／１０万,男性１７．０／１０万,女性２３．０／１０万;（２）上海市（１９８８～１９９５年）胰腺炎占总住院比重３．８‰,其他地区７．４‰,为上海市的２倍;成都地区比重高达９．６‰;（３）性别分布：发病率女＞男;（４）年龄分布：男性年龄中位数为４９．５岁;女５７．０岁;（５）临床分型,胆源性占６３．１％,酒精性占１２．１％,不同于西方;（６）病前有暴食史者占１６．６％。结论胰腺炎的病因、诱因、危险因素虽不完全清楚,但与胆道疾病如胆结石、感染、饮酒、暴食、性别、年龄等有关。     

2型糖尿病遗传病因的流行病学研究

对３６３例２型糖尿病先证者家系及２９１例人群对照家系进行了以人群为基础的遗传流行病学病例－对照研究。结果显著的：糖尿病先证者一级亲属（父母、同胞、子女）的累积发病率为３．９４％,对照组一级亲属１．０９％,相对危险度（ＲＲ）为３．６２,差异有非常显著性意义（χ２＝３６．５４,Ｐ＜０．００１）;无论男性或女性一级亲属,先证者组的累积发病率均非常显著地高于人群对照组;诊断时年龄＜５５岁先证者的一级亲属,其糖尿病累积发病率和相对危险度均显著高于诊断年龄＞５５岁组。二项分布显示先证者一级亲属中２型糖尿病的分布呈明显的家庭聚集性,先证者一级亲属的遗传度为４０．４％（男性４２．６％,女性３８．６％）;２型糖尿病在同胞中的分离比为０．０３２,显著低于０．２５,不符合单基因遗传的特征。     

闽北农村居民吸烟,饮酒与慢性病关系的研究

为了解闽北农村居民吸烟、饮酒等因素与患慢性病的关系，抽样调查了闽北建阳、顺昌两县（市）１０５４７名农村居民。结果：慢性病总患病率为１０．２％；≥１５岁农村居民７７７４人，其中吸烟者２１２１人，吸烟率２７．３％，饮酒者１５５０人，饮酒率１９．９％；男性吸烟、饮酒率均显著高于女性；慢性病患病率１３．４％（１０３８／７７７４），男性１４．４％（５７０／３９５７），女性１２．３％（４６８／３８１７）。应用相对危险度、归因危险度、多元协方差、交互作用和Ｌｏｇｉｓｔｉｃ回归等方法分析，结果均提示吸烟和过量饮酒是农村居民患慢性病的重要因素。     

广东地区肺鳞癌和肺腺癌危险因素对比分析

运用ＡＳＲＳ单因素、多因素分析方法，对广东地区１６９例肺鳞癌和１３５例肺腺癌进行了１：１配比病例对照研究。比较分析显示：主动吸烟与肺鳞癌的联系更为密切。被动吸烟在肺腺癌中则可能有相对较高的病因地位。多变量分析表明粉尘类职业、印染化工类职业、肺结核、慢支以及吸烟指数（≥１９，≥３７）为广东地区重要的危险因素，综合人群归因危险度为８２．２１％；肺腺癌的重要危险因素则是家庭被动吸烟年数、吸烟指数（≥２６）、慢支，综合人群归因危险度为６８．９２％。为广东地区肺鳞癌和肺腺癌的病因防治提出了重点。     

Rural-urban differences in sociodemographic,social network and lifestyle factors related to mortality of middle-aged Japanese men from the Komo-Ise cohort study

To examine rural-urban differences in the relationships of sociodemographic, social network, and lifestyle factors to mortality in middle-aged men, we used the data from a community based prospective cohort study, the Komo-Ise study. The subjects were all men aged 40-69 years living in Komochi Village, the rural group (n=2,295), or the downtown district of Isesaki City, the urban group (n=3,334), as of 1993. They completed a self-administered questionnaire in 1993 and were followed for all-cause deaths until 2000. The Cox proportional hazards model was used to compute relative risks (RRs) with 95% confidence intervals (CIs). Low educated men and men without a spouse in the rural group had an increased risk of mortality (RR=4.4; 95%CI: 1.1-18.2, RR=2.4; 95%CI: 1.2-4.5). Men who did not enjoy good fellowship with their neighbors in the rural group had a decreased risk of mortality (RR=0.58; 95%CI: 0.35-0.97). Mortality risks were significantly higher in urban men not participating in hobbies, club activities or community groups (RR=1.6; 95%CI: 1.1-2.4). These variables remained significant risk factors, even after controlling for all sociodemographic, social network, lifestyle, and health status variables. Educational level, marital status and relation to neighborhoods showed significant rural-urban differences.     

中国成年人体质指数和腰围与高血压关系的四年随访研究

目的探讨中国成年人体质指数(BMI)和腰围(WC)的增加与高血压发病危险的关系。方法利用“中国居民健康与营养调查”资料,以4552例18~60岁参加2000年调查、当时无高血压等慢性病并且2004年调查被随访到者为研究对象,考察基线BMI和WC对高血压的预测作用,以及BMI和WC4年间的变化与高血压发病之间的关系。结果男性和女性随访4年高血压发病率分别为20.01%和13.52%。随着基线肥胖程度的增加,高血压的发病危险增加。与BMI和WC均不肥胖者相比,BMI超重/肥胖并且WC肥胖者发生高血压的危险最高(男性,RR=2.840,95%CI:2.139~3.771;女性,RR=2.734,95%CI:2.050~3.647)。调整了其它协变量后,4年中BMI每增加一个单位,男性和女性患高血压的危险分别增加0.141和0.109倍;WC每增加1cm,男性和女性患高血压的危险分别增加0.038和0.035倍。结论体质指数和腰围的增加均能增加高血压发病的危险,体质指数和腰围联合使用可增强对高血压发病的预测作用。     

Risk factors for proximal humerus, forearm, and wrist fractures in elderly men and women: the Dubbo Osteoporosis Epidemiology Study

Fractures of the proximal humerus, forearm, and wrist account for approximately one third of total osteoporotic fractures in the elderly. Several risk factors for these fractures were evaluated in this prospective study of 739 men and 1,105 women aged > or =60 years in Dubbo, Australia. During follow-up (1989-1996), the respective incidences of humerus and of forearm and wrist fractures, per 10,000 person-years, were 22.6 and 33.8 for men and 54.8 and 124.6 for women. Independent predictors of humerus fracture were femoral neck bone mineral density (FNBMD) (relative risk (RR) = 2.3, 95% confidence interval (CI): 1.2, 4.5) in men and FNBMD (RR = 2.4, 95% CI: 1.7, 3.5) and height loss (RR = 1.1, 95% CI: 1.0, 1.2) in women. For forearm and wrist fractures, risk factors were FNBMD (men: RR = 1.5, 95% CI: 1.0, 2.3; women: RR = 1.5, 95% CI: 1.2, 1.9) and height loss (men: RR = 1.2, 95% CI: 1.0, 1.3; women: RR = 1.1, 95% CI: 1.0, 1.2). In addition, dietary calcium (men: RR = 2.0, 95% CI: 1.0, 3.6) and a history of falls (women: RR = 1.9, 95% CI: 1.4, 2.6) were also significant. These data suggest that elderly men and women largely share common risk factors for upper limb fractures and that FNBMD is the primary risk factor.     

中国人群主动吸烟与慢性阻塞性肺病关系的Meta分析

目的 通过meta分析探究中国人群慢性阻塞性肺病（COPD）的危险因素,为制定中国控烟政策及评估中国烟草带来的疾病负担提供必要的参数。方法 在PubMed、Web of science、Embase、中国知网、维普、万方数据库中检索从建库至2021年6月31日发表的所有吸烟相关疾病的中、英文队列或病例对照研究文献,筛选并提取相关信息。 使用Stata 16.0进行meta分析,探究吸烟与慢性阻塞性肺病发病/死亡的关联。结果 最终纳入16篇文献,其中队列研究10篇,病例对照6篇。Meta分析结果显示,吸烟是COPD的重要危险因素,曾吸烟者较不吸烟者COPD患病/死亡风险更大,RR值为2.64（95%CI:1.74～4.00）,其中男性RR为1.74（95%CI:1.44～2.09）,女性RR为4.06（95%CI:2.53～6.52）,女性显著高于男性。亚组分析结果显示,除男性曾吸烟者病例对照研究（RR: 2.22,95%CI:1.68～2.95)和队列研究（RR:1.33,95%CI:1.19～1.49）RR可信区间无交叠,差异有统计学意义外,其他不同类别的各亚组间RR值差异没有统计学意义。结论 虽然与西方国家相比,中国人群RR值偏低,但吸烟仍是COPD的重要危险因素,其中女性较男性危险度更高。为减轻COPD造成的疾病负担,应进一步加强控烟相关措施。同时,作为一篇只针对于中国人群的研究,本篇文献将为制定中国控烟政策及评估中国烟草带来的疾病负担提供相关依据。     

妇女既往孕次及产次对新生儿出生体重影响的队列研究

目的 探讨妇女既往孕次及产次对新生儿出生体重的影响。方法 基于东莞市免费婚前健康检查和孕前优生健康检查项目,获取受检对象检查结果,追踪随访获取其妊娠结局情况。采用无序多分类logistic回归探讨妇女既往孕次及产次与小于胎龄儿（SGA）、大于胎龄儿（LGA）、低体重出生儿（LBWI）及巨大儿发生率的关系。结果 共有17 783名对象参与;调整相关混杂因素后,妇女既往孕次＞1次是分娩LGA（RR = 1.59,95%CI:1.36～1.85）和巨大儿（RR = 1.87,95%CI:1.49～2.35）的危险因素,但可降低分娩SGA（RR = 0.70,95%CI:0.60～0.81）和LBWI（RR = 0.73,95%CI:0.60～0.89）的风险;妇女既往产次＞1次增加分娩LGA（RR = 1.74,95%CI:1.40～2.17）和巨大儿（RR = 1.98,95%CI:1.45～2.71）的风险,但可降低分娩SGA（RR = 0.70,95%CI:0.54～0.90）和LBWI（RR = 0.63,95%CI:0.44～0.91）的风险。结论 妇女既往孕次、产次对新生儿出生体重有影响,应做好产前保健和健康教育工作。     

肺癌危险因素──在日本大坂进行的追踪研究

在日本大坂进行了以人群为基础的环境因素与肺癌关系的追踪研究，研究对象为24489名年龄在40岁以上的居民。基本调查了1985年开始，以调查对象本人所填写的问卷为基础，在已进行的10年追踪中，有161例为新发现的肺癌病例（男120，女41）。分析了各种环境因素与肺癌的关系，结果发现吸烟与肺癌有病因学联系（目前吸烟者男性的RR＝5.72，95％CI＝2．5～13．08，女性的RR。2．05，95％CI=0.97～4.32）。其他的环境因素除了男性饮用咖啡的RR值略高（aRR＝2．02，95％CI＝1.34～3．05）和女性食用黄绿色蔬菜RR值有所降低（aRR＝0．47，95％CI＝0.23~0.94）外．其他均无统计学意义。     

Resting heart rate is a risk factor for cardiovascular and noncardiovascular mortality: the Chicago Heart Association Detection Project in Industry

In a prospective cohort study, associations of resting heart rate with risk of coronary, cardiovascular disease, cancer, and all-cause mortality in age-specific cohorts of black and white men and women were examined over 22 years of follow-up. Participants were employees from 84 companies and organizations in the Chicago, Illinois, area who volunteered for a screening examination. Participants included 9,706 men aged 18-39 years, 7,760 men aged 40-59 years, 1,321 men aged 60-74 years, 6,928 women aged 18-39 years, 6,915 women aged 40-59 years, and 1,151 women aged 60-74 years at the baseline examination in 1967-1973. Vital status was ascertained through 1992. For fatal coronary disease, multivariate-adjusted relative risks associated with a 12 beats per minute higher heart rate (one standard deviation) were as follows: for men aged 18-39 years, relative risk (RR) = 1.27 (95% confidence interval (CI) 1.08-1.48); for men aged 40-59 years, RR = 1.13 (95% CI 1.05-1.21); for men aged 60-74 years, RR = 1.00 (95% CI 0.89-1.12); for women aged 40-59 years, RR = 1.21 (95% CI 1.07-1.36); and for women aged 60-74 years, RR = 1.16 (95% CI 0.99-1.37). Corresponding risks for all fatal cardiovascular diseases were similar to those for coronary death alone. Deaths from cancer were significantly associated with heart rate in men and women aged 40-59 years. All-cause mortality was associated with higher heart rate in men aged 18-39 years (RR = 1.11, 95% CI 1.01-1.20), men aged 40-59 years (RR = 1.16, 95% CI 1.11-1.21), and women aged 40-59 years (RR = 1.20, 95% CI 1.13-1.27). Heart rate was not associated with mortality in women aged 18-39 years. In summary, heart rate was a risk factor for mortality from coronary disease, all cardiovascular diseases, and all causes in younger men and in middle-aged men and women, and for cancer mortality in middle-aged men and women.     

体力活动与结肠癌关系前瞻性研究的Meta分析

目的 索体力活动与结肠癌发生的病因学联系.方法 集和整理1979-2009年国内外公开发表的体力活动与结肠癌关系的队列研究文献,开展Meta分析.其中,各文献RR值的合并采用倒方差法或DerSimonian-Laird method(D-L)法,剂量-反应关系的评价采用方差加权的最小二乘法.结果 入Meta分析的文献共28篇.与低体力活动者相比,男、女性高体力活动者结肠癌RR值分别为0.75(95%CI:0.66～0.86)、0.85(95%CI:0.76～0.95).高质量文献分析显示体力活动与结肠癌,男性RR=0.74(95%CI:0.61～0.90)、女性接近统计学意义的RR=0.99(95%CI:0.95～1.02).男、女性中均未观察到明显的剂量-反应关系,趋势检验分别为P=0.142和P=0.417.结肠亚部位分析结果显示,增加体力活动与男性近端(右侧)结肠癌与远端(左侧)结肠癌发生均有关联,合并RR值分别为0.62(95%CI:0.45～0.85)和0.74(95%CI:0.56～0.99).结论 增加体力活动可以降低结肠癌发生的危险性.     

Health of children born to medical radiographers.

OBJECTIVES: To develop a reliable method for collecting information on reproductive outcome in an occupational setting; and to investigate the health of children born to medical radiographers. METHODS: The study population comprised 6730 members of the College of Radiographers who were, at the time of survey; aged between 30 and 64 years, on the current membership file of the College, and were resident in Britain. RESULTS: The postal method developed proved to be reliable, with around 87% of questionnaires being returned. The observed frequencies of reproductive events were broadly in line with findings from other studies: of the 9208 pregnancies reported, 83% were livebirths, 12% were miscarriages (gestational age < 20 weeks), 1% were stillbirths (gestational age > or = 20 weeks), and 1% were other rarer spontaneous adverse events (ectopic pregnancy, blighted ovum, and hydatidiform mole). There was little difference between men and women in the frequency of adverse reproductive events reported, with the exception that male radiographers reported fewer medical terminations, the proportions being 3.1% and 1.4% for women and men respectively. Among children, the overall risks of major congenital malformation (RR 1.0, 95%CI 0.9-1.2), chromosomal anomaly (RR 1.4, 95%CI 0.8-2.3), and cancer (RR 1.2 95%CI 0.7-2.0) were as expected based on general population rates. Borderline excesses of chromosomal anomalies other than Down's syndrome in the children of female radiographers (RR 3.9, 95%CI 1.3-9.0, based on five observations), and cancer in the children of male radiographers (RR 2.7, 95%CI 0.9-6.5, based on five observations) were noted. The numbers on which these risks are based are small and the findings should be interpreted cautiously. CONCLUSIONS: The postal methods developed for obtaining information about reproductive events and child health proved to be reliable in men, as well as in women. Overall, the findings for medical radiographers are reassuring. Dose-response relations could not, however, be examined as long term dose records of radiographers are not routinely kept in an accessible form.     

Skinfold thickness, body mass index, and fatal coronary heart disease: 30 year follow up of the Northwick Park heart study

STUDY OBJECTIVE: To examine the effect of baseline body mass index (BMI) and skinfold thickness (ST) on fatal coronary heart disease (CHD) and all cause mortality after 30 years of follow up. DESIGN: Prospective cohort study. SETTING: Northwick Park heart study (NPHS) designed to investigate the role of haemostatic variables on CHD. PARTICIPANTS: 1511 men and 691 women enrolled in NPHS aged 40 to 64 years at entry. MAIN RESULTS: Baseline BMI (kg/m(2)) and forearm, triceps, subscapular, and suprailiac skinfolds ST (mm) were measured. Cox regression was used to calculate hazard ratios for fatal CHD and total mortality for each standard deviation unit increase in obesity adjusting for age, smoking status, total cholesterol, systolic blood pressure, fibrinogen, and factor VII activity. Subjects experienced 250 fatal CHDs and 819 all cause deaths over 30 years (median: 26 years; IQR: 22-28 years). Among men, only BMI (RR = 1.29, 95%CI = 1.12 to 1.49) significantly increased the risk of fatal CHD. Among women, BMI (RR = 1.48, 95%CI = 1.07 to 2.06), as well as, subscapular (RR = 1.65, 95%CI = 1.19 to 2.30), forearm (RR = 1.46, 95%CI = 1.08 to 1.97), and triceps (RR = 1.63, 95%CI = 1.12 to 2.39) skinfolds were predictive of fatal CHD. None of the estimates for all cause mortality were significant except for subscapular skinfold in women (RR = 1.20, 95%CI = 1.02 to 1.42). There was no evidence of interaction between obesity and sex for fatal CHD or all cause death. The effect of obesity on fatal CHD or all cause deaths does not seem to be mediated substantially by cholesterol, systolic blood pressure, or haemostatic variables. CONCLUSIONS: BMI is an important risk factor for fatal CHD where its prognostic significance remains after up to 30 years of follow up.