口腔医生工效学负荷和工作相关肌肉骨骼疾患的研究

目的 评估口腔医生工效学负荷水平，探讨其与工作相关肌肉骨骼疾患（WMSDs）的相关性。方法 采用《中国肌肉骨骼疾患问卷》调查口腔医生WMSDs的患病情况，采用快速上肢评估（RULA）法进行现场工效学评估，并分析其相关性。结果 口腔医生WMSDs患病率为56.1%，各部位患病率差异有统计学意义（X2=62.400，P<0.01），颈部最高；女性患病率高于男性（X2=16.020，P<0.01）。RULA法评估口腔医生工效学负荷平均得分为5.6±1.1，82.4%的口腔医生工效学负荷等级Ⅲ～Ⅳ级。多因素Logistic回归分析显示，工效学负荷Ⅲ级和Ⅳ级（OR=2.413、14.700）、女性（OR=3.670）、中级职称（OR=2.479）、身高<160 cm或≥175 cm（OR=3.708）均为WMSDs的危险因素。WMSDs患病率与工效学负荷之间存在相关性（P<0.05），患病率随工效学负荷的增加而递增。结论 工效学负荷是WMSDs的危险因素；口腔医生WMSDs患病率高，工效学负荷水平高，需予以关注并尽快加以改善。     

基于BRIEF、PLIBEL和RULA方法的制鞋工人工作相关肌肉骨骼疾患工效学危险评估

目的 对制鞋生产中存在的工作相关肌肉骨骼疾患(WMSDs)工效学危害因素进行识别和危险评估。方法 选择18家制鞋企业53个重点岗位884名工人作为研究对象,采用美国工效学基本因素检查表(BRIEF)和瑞典工效学因素识别表(PLIBEL)两种方法识别作业人员作业过程中WMSDs罹患部位及不良工效学危害因素,并采用快速上肢评估(RULA)法进行WMSDs危险等级评估。结果 BRIEF识别结果显示,作业工种/岗位普遍存在手/腕部、肘部、颈部、肩部和背部的WMSDs危害因素,52个工种/岗位(98.11%)存在颈部和右腕部WMSDs危害因素;PLIBEL识别发现,存在≥6个WMSDs危害因素的工种/岗位有18个(33.96%)、有5个危害因素的14个(26.42%)、4个危害因素的有16个(30.19%)、3个危害因素的有5个(9.43%);RULA评估制鞋业生产工人WMSDs危险等级为Ⅱ～Ⅳ级,其中,Ⅱ级工种/岗位14个(26.42%)、Ⅲ级37个(69.81%)、Ⅳ级2个(3.78%),其主要得分源为不良姿势。结论 制鞋作业普遍存在中高风险的不良工效学危害因素,集中在颈部、手/腕部、肩部和...     

汽车装配工人肌肉骨骼疾患的不良工效学因素

目的探讨汽车装配工人工作相关肌肉骨骼疾患(WMSDs)的发生情况及相关不良工效学因素。方法应用经适当修订的《美国危险区域检查表》和《北欧肌肉骨骼疾患调查问卷》形成综合调查问卷,对某汽车制造公司总装车间498名男性装配工人进行问卷调查。采用Logistic回归分析WMSDs发生的不良工效学因素。结果总人群中WMSDs的年发生率为84%,其中肩部(50.6%)最为严重,其次为颈部(49.7%)、下背部(43.4%)、手腕和小腿(均为38.4%)。Logistic回归分析显示,影响颈部的不良工效学因素有颈前曲45°和单手捏紧4.5 kg以上伴腕部不良姿势;影响肩部的因素有跪姿作业、每天搬举的物体超过34 kg和背前曲30°;影响下背部的因素有跪姿作业、搬举的物体超过4.5kg,且每分钟超过2次和背前曲45°;影响腕部的因素有单手捏紧4.5 kg以上伴腕部不良姿势。结论汽车装配工人WMSDs高发,可能与其接触的不良工效学因素有关。     

工作相关肌肉骨骼疾患研究现状及进展

<正>工作相关肌肉骨骼疾患(work-related musculoskeletal disorders,WMSDs)是一类由接触工作场所中的危险因素(如重复操作、不良姿势、负荷、振动等)所引起的肌肉、骨骼、神经及局部血液循环系统的损伤~([1])。国际劳工组织(ILO)早在1960年就已将WMSDs列为职业病~([2])。WMSDs患病率高,涉及行业和人群广泛,不仅影响劳动者的工作效率和健康,也给国家造成了巨大的经济损失,因而关于WMSDs易发职业     

汽车维修工人工作相关肌肉骨骼疾患的工效学评估

目的 对汽车维修行业中存在的工作相关肌肉骨骼疾患（work-related musculoskeletal disorders,WMSDs）相关的工效学危险因素进行识别和危险评估。方法 2018年1月—2020年12月,采用整群抽样方法,选取重庆市23家汽车维修企业的作业人员作为研究对象,采用美国《工效学基本因素检查表》（baseline risk identification of ergonomic factors,BRIEF）和瑞典《工效学因素识别表》（method for the identification of musculoskeletal stress factors which may have injurious effects,PLIBEL）识别汽车维修作业过程中的不良工效学危险因素,并采用快速全身评估法（rapid entire body assessment,REBA）进行姿势负荷等级评估。结果 本研究共对193名作业工人进行了工效学评估,其中维修工86人、喷漆工60人和钣金工47人。BRIEF识别结果显示,维修工、喷漆工和钣金工的颈部、背部、手腕为WMSDs...     

2011-2020年我国工作相关肌肉骨骼疾患研究文献分析

目的 通过对近10年我国工作相关肌肉骨骼疾患(WMSDs)文献的统计分析,概要了解我国WMSDs的总体发病情况及不同职业、工种的患病情况,从而为该领域后续研究及WMSDs的防治提供参考.方法 对2011年1月—2020年12月中华医学会电子期刊数据库、中国知网资源总库、万方数据知识服务平台、维普中文科技期刊数据库和台湾...     

电子制造业工人工作相关肌肉骨骼疾患研究进展

电子制造业的兴起使其人力资源需求增大,劳动者的职业健康问题值得关注。工作相关肌肉骨骼疾患(WMSDs)是一种常见的工作相关疾病,在许多国家已列为职业病。本文概述了电子制造业工人WMSDs患病情况,探讨影响电子制造业工人WMSDs的危险因素,为有效控制职业性肌肉骨骼损伤提供帮助。     

某公立口腔医院医生工作相关肌肉骨骼疾患影响因素分析

采用整群抽样方法,选择《北欧肌肉骨骼疾患问卷(修改版)》对某公立口腔医院157名医生工作相关肌肉骨骼疾患(work-related musculoskeletal disorders,WMSDs)进行流行病学调查。结果显示,口腔医生任一部位WMSDs发生率70.7%(111/157),各部位发生率从高到低依次为颈部(65.6%)、肩部(55.4%)、上背部(39.5%)、下背/腰部(30.6%)、手/腕部(16.6%)。Logistic回归分析显示,工作姿势不舒服是发生颈、肩、上背部WMSDs的危险因素;每分钟多次重复操作是颈、上背部 WMSDs的危险因素; 颈部大幅前倾是肩和背部WMSDs的危险因素;手腕长期处于弯曲状态是肩和腕部WMSDs的危险因素;经常加班是上背部WMSDs的危险因素。与同事轮流完成工作是背部WMSDs的保护因素;体育锻炼是颈部、下背/腰部、手/腕部的保护因素。建议采取针对性的措施,降低口腔医生罹患WMSDs的风险。     

妇产科医务人员工作相关肌肉骨骼疾患发病现状及姿势负荷

目的调查分析妇产科医务人员工作相关肌肉骨骼疾患(WMSDs)的现状,并对其姿势负荷进行评价。方法以某市各级医院妇产科医务人员928人为研究对象,采用自主研发的肌肉骨骼问卷调查其WMSDs状况,在928人中随机选取51人,利用快速暴露检查法(QEC)和工作姿势与负荷分析(OWAS)评估法对其进行姿势负荷评价。结果妇产科医务人员的一个或多个部位的周患病率和年患病率分别为61.7%和85.5%,患病率排在前三位的身体部位分别为颈、肩、下背。QEC的工作负荷评价结果显示,背部负荷得分高于中等以上的人数占总人数的54.9%,肩臂占70.6%,手腕占49.0%,颈部占94.1%。OWAS的评价结果,损害较轻的占23.5%,明确损害的占7.8%。结论妇产科医务人员具有较高的WMSDs患病率,其姿势负荷较为突出,可以从推广坐位接生或手术、改善设备用品、培训正确工作姿势等方面进行姿势负荷的干预。     

参与式工效学在预防工作相关肌肉骨骼疾患中的应用

工作相关肌肉骨骼疾患是一种慢性非致死性疾病,是职业人群常见的健康问题,尤其在劳动密集型行业。在国外,参与式工效学已广泛应用于工作场所中肌肉骨骼疾患的预防。本文依据参与式工效学的组织、实施及其影响因素和特点,介绍参与式工效学在预防肌肉骨骼疾患中的应用。参与式工效学方式可帮助工人识别作业过程中的危险因素并制定相应的干预方案。企业可通过开展参与式工效学项目改善工作条件、减少肌肉骨骼疾患相关危险因素的暴露及预防相关疾患的发生,以促进职工健康。     

肠道产甲烷菌与肠道疾病的关系研究进展

肠道产甲烷菌是一类将氢气和二氧化碳生成甲烷的厌氧菌,研究证实其与人体肠道疾病密切相关,因此深入探索肠道产甲烷菌在肠道疾病中的作用机制具有重要意义。本文就肠道产甲烷菌的特点、种类、定植特征,及其与肥胖、肠易激综合征、炎症性肠病、结直肠癌、憩室病等疾病之间的关系进行综述,着重梳理肠道产甲烷菌在这些疾病中可能发生的机制,为人体肠道疾病的预防、诊断和治疗提供一定的新思路。     

Gut Microbiota in Non-Alcoholic Fatty Liver Disease Patients with Inflammatory Bowel Diseases: A Complex Interplay

The intestinal microbiota represents the microbial community that colonizes the gastrointestinal tract and constitutes the most complex ecosystem present in nature. The main intestinal microbial phyla are Firmicutes, Bacteroidetes, Actinobacteria, Proteobacteria, Fusobacteria, and Verrucromicrobia, with a clear predominance of the two phyla Firmicutes and Bacteroidetes which account for about 90% of the intestinal phyla. Intestinal microbiota alteration, or dysbiosis, has been proven to be involved in the development of various syndromes, such as non-alcoholic fatty liver disease, Crohn’s disease, and ulcerative colitis. The present review underlines the most recurrent changes in the intestinal microbiota of patients with NAFLD, Crohn’s disease, and ulcerative colitis.     

Effect of Microalgae and Macroalgae Extracts on Non-Alcoholic Fatty Liver Disease

The present review aims to gather scientific evidence regarding the beneficial effects of microalgae and macroalgae extracts on non-alcoholic fatty liver disease (NAFLD). The described data show that both microalgae and macroalgae improved this alteration. The majority of the reported studies analysed the preventive effects because algae were administered to animals concurrent with the diet that induced NAFLD. The positive effects were demonstrated using a wide range of doses, from 7.5 to 300 mg/kg body weight/day or from 1 to 10% in the diet, and experimental periods ranged from 3 to 16 weeks. Two important limitations on the scientific knowledge available to date are that very few studies have researched the mechanisms of action underlying the preventive effects of microalgae on NAFLD and that, for the majority of the algae studied, a single paper has been reported. For these reasons, it is not possible to establish the best conditions in order to know the beneficial effects that these algae could bring. In this scenario, further studies are needed. Moreover, the beneficial effects of algae observed in rodent need to be confirmed in humans before we can start considering these products as new tools in the fight against fatty liver disease.     

Perinatal High-Salt Diet Induces Gut Microbiota Dysbiosis,Bile Acid Homeostasis Disbalance,and NAFLD in Weanling Mice Offspring

A perinatal high-salt (HS) diet was reported to elevate plasma triglycerides. This study aimed to investigate the hypothesis that a perinatal HS diet predisposed offspring to non-alcoholic fatty liver disease (NAFLD), the hepatic manifestation of abnormal lipid metabolism, and the possible mechanism. Female C57BL/6 mice were fed a control diet (0.5% NaCl) or HS diet (4% NaCl) during pregnancy and lactation and their offspring were sacrificed at weaning. The perinatal HS diet induced greater variation in fecal microbial beta-diversity (β-diversity) and increased bacteria abundance of Proteobacteria and Bacteroides. The gut microbiota dysbiosis promoted bile acid homeostasis disbalance, characterized by the accumulation of lithocholic acid (LCA) and deoxycholic acid (DCA) in feces. These alterations disturbed gut barrier by increasing the expression of tight junction protein (Tjp) and occludin (Ocln), and increased systemic lipopolysaccharide (LPS) levels and hepatic inflammatory cytokine secretion (TNF-α and IL-6) in the liver. The perinatal HS diet also inhibited hepatic expression of hepatic FXR signaling (CYP7A1 and FXR), thus triggering increased hepatic expression of pro-inflammatory cytokines (TNF-α and IL-6) and hepatic lipid metabolism-associated genes (SREBP-1c, FAS, ACC), leading to unique characteristics of NAFLD. In conclusion, a perinatal HS diet induced NAFLD in weanling mice offspring; the possible mechanism was related to increased bacteria abundance of Proteobacteria and Bacteroides, increased levels of LCA and DCA in feces, and increased expressions of hepatic FXR signaling.     

Non-Alcoholic Fatty Liver Disease in Children: Focus on Nutritional Interventions

With increasing prevalence of childhood obesity, non-alcoholic fatty liver disease (NAFLD) has emerged as the most common cause of liver disease among children and adolescents in industrialized countries. It is generally recognized that both genetic and environmental risk factors contribute to the pathogenesis of NAFLD. Recently, there has been a growing body of evidence to implicate altered gut microbiota in the development of NAFLD through the gut-liver axis. The first line of prevention and treatment of NAFLD in children should be intensive lifestyle interventions such as changes in diet and physical activity. Recent advances have been focused on limitation of dietary fructose and supplementation of antioxidants, omega-3 fatty acids, and prebiotics/probiotics. Convincing evidences from both animal models and human studies have shown that reduction of dietary fructose and supplement of vitamin E, omega-3 fatty acids, and prebiotics/probiotics improve NAFLD.     

Impact of COVID-19 Lockdown on Non-Alcoholic Fatty Liver Disease and Insulin Resistance in Adults: A before and after Pandemic Lockdown Longitudinal Study

Background: Non-alcoholic fatty liver disease is a chronic disease caused by the accumulation of fat in the liver related to overweight and obesity, insulin resistance, hyperglycemia, and high levels of triglycerides and leads to an increased cardiovascular risk. It is considered a global pandemic, coinciding with the pandemic in 2020 caused by the “coronavirus disease 2019” (COVID-19). Due to COVID-19, the population was placed under lockdown. The aim of our study was to evaluate how these unhealthy lifestyle modifications influenced the appearance of metabolic alterations and the increase in non-alcoholic fatty liver disease. Methods: A prospective study was carried out on 6236 workers in a Spanish population between March 2019 and March 2021. Results: Differences in the mean values of anthropometric and clinical parameters before and after lockdown were revealed. There was a statistically significant worsening in non-alcoholic fatty liver disease (NAFLD) and in the insulin resistance scales, with increased body weight, BMI, cholesterol levels with higher LDL levels, and glucose and a reduction in HDL levels. Conclusions: Lockdown caused a worsening of cardiovascular risk factors due to an increase in liver fat estimation scales and an increased risk of presenting with NAFLD and changes in insulin resistance.     

谷氨酰胺在肝损伤中的应用研究进展

肝是人体重要的解毒器官.化学性肝损伤、缺血-再灌注损伤和菲酒精性脂肪性肝病都存在不同程度的肝功能受损.谷氨酰胺(Gln)作为条件必需氨基酸,在维持肠道的正常结构和功能中发挥着重要的作用.最近研究发现,Gln可通过提高抗氧化能力抑制炎性反应、减少肝细胞凋亡、减轻化学性肝损伤、肝缺血-再灌注损伤和非酒精性脂肪肝.此外,Gln还能改善胰岛素抵抗,而胰岛素抵抗与非酒精性脂肪肝密切相关.Gln作为一个多功能氨基酸,在辅助治疗肝损伤方面具有一定潜力.     

营养干预在代谢相关性脂肪肝疾病进展中的作用机制研究进展

代谢紊乱相关性脂肪肝(Metabolic-associated fatty liver disease, MAFLD)被认为是一种包括遗传、生理和环境因素在内的多因素疾病,其中不同的因子在各种通路重叠,导致代谢损伤和肝损伤。MAFLD的主要危险因素是超重/肥胖、胰岛素抵抗/2型糖尿病、高甘油三酯血症和相关的饮食行为诱因,主要是果糖饮料的摄入,坚持地中海饮食是MAFLD患者肝脏脂肪含量变化的重要预测因素。越来越多的证据表明,为MAFLD患者开具已被证明具有保肝作用的特定补充剂或营养保健品处方,以加速改善肝酶和肝脂肪变性的程度,或可预防或延缓MAFLD疾病进展。