舟山市高血压流行病学调查及危险因素分析

目的探讨海岛地区高血压的流行特点及危险因素.方法对舟山市定海(城市)、普陀(农村)二地区15岁以上的自然人群1174人进行高血压患病和危险因素调查.结果高血压总患病率31.69%,标化率14.96%.高血压患病率随年龄递增,40岁始患病率明显增高;高血压危险因素为年龄、超重、高血糖、高血脂、高血压家族史、心脑血管病史及饮酒;血压与性别、吸烟、食盐摄人量无相关性.高血压患者服药率为34.95%,血压控制率为11.02%.结论舟山市高血压患病率呈快速上升趋势,患病年龄有提前趋势.超重、高血糖,高血脂是目前海岛高血压的最主要危险因素.     

海岛居民高血压流行病学基线调查结果分析

[目的]对舟山市人群高血压基线抽样调查,掌握高血压流行现状,为综合防治、评价防治效果提供依据。[方法]于2005年6月采用整群随机抽样,抽取定海区两社区,以当地居民,年龄≥35岁的常住人群,以浙江省社区主要慢性病基线调查表进行问卷调查,并进行体格和实验室检查。[结果]高血压总患病率41.9%,性别、年龄、职业、文化程度以及婚姻状况均有意义,危险因素为年龄、超重、腰围、高血糖、高血脂、高血压家族史及饮酒;血压与吸烟、烹调用油无相关性。高血压知晓率为62.9%;患者中有63.5%不进行正规降压治疗,控制率仅18.3%,有81.7%患者的血压未控制到目标水平。[结论]海岛高血压患病率呈快速上升趋势,患病年龄有提前趋势,超重、高血糖和高血脂是主要危险因素,患者服药率和血压控制率均有待提高。     

嘉兴市城乡高血压流行病学调查

目的通过对嘉兴市社区人群高血压抽样调查,及时掌握我市高血压流行现状,为进一步加强高血压社区综合防治、评价防治效果提供科学依据。方法于2003年9-10月在嘉兴市随机抽取1 5岁以上人群进行高血压流行病学调查。结果高血压患病率为29.67%,标化率为17.49%, 其中城市患病率为25.40%(标化率为11.84%),农村患病率为32.60%(标化率为20.74%):男性患病率为33.33%(标化率为20.50%),女性患病率为27.72%(标化率为15.92%):血压与年龄有显著相关, 相关系数为0.453;糖尿病史、高血糖、超重、高甘油三酯、高胆固醇、高血压家属史、饮酒为高血压重要危险因素,其比值比(OR)分别为14.61,6.02,2.90,2.89,2.57,1.78,1.49; 高血压患者服药率为42.11%,血压控制率为9.74%。结论与1990年比较,高血压患病率明显上升;农村患病率高丁城市;患病率随年龄增长而增长,男性发病高峰比女性早10年;高血糖、超重、高血脂是我市人群高血压的最主要危险因素;服药率和控制率两者均是城市高于农村。     

高血压、高血压前期、低血压的流行特征及与常见慢性病的关系

目的了解人群高血压、高血压前期和低血压的流行特征和影响因素，为进一步研究和防治提供依据。方法采用随机抽样的方法，随机抽取哈尔滨市城区2019人进行测量血压和相关因素调查。结果高血压、高血压前期、低血压的标化患病率分别为24．04％、16．91％、3．88％。高血压和高血压前期的流行特征相似，低血压的流行特征与高血压相反，高血压使糖尿病、冠心病、脑血管病、高血脂、肾脏疾病、肝脏疾病的患病危险增高，高血压前期使冠心病、脑血管病的患病危险增高，低血压对其他慢性病的患病无影响。结论该地区高血压的患病率高于全国平均水平，低血压患病率低于全国平均水平。高血压和高血压前期的流行特征相似，低血压与之相反，控制高血压、高血压前期可降低其他慢性病的发生。     

河南省南阳市农村中老年人高血压流行病学现况调查

目的 探讨河南省南阳市农村中老年居民高血压发病情况及相关因素的关系，为制定该病的防治策略提供参考依据。方法 采用整群抽样的方法在南阳市宛城区辛店乡抽取长期在该地区生活居住的40岁以上居民6151人，对其进行高血压患病情况及年龄、性别、体质指数等相关因素的调查研究。结果 在6151名调查对象中血压处于正常高值者797人，占13.0%；高血压患者2943例，患病率为47.8%，且随年龄增高高血压患病率呈明显增高趋势。在各年龄别中，女性患病率高于男性。在超重和肥胖人群中，高血压患病率高达61.3%，其中男性为57.4%，女性为63.7%。在高血压人群中以轻度高血压（Ⅰ级高血压）患者居多，占总患病人数的74.7%，中度高血压（Ⅱ级高血压）和重度高血压（Ⅲ级高血压）患者仅占25.3%。结论 调查地区高血压患病率之高正成为非常突出的公共卫生问题之一。年龄和体擀指数升高是高血压患病的主要危险因素，且存在性别差异，女性高于男性。Ⅰ级高血压患者及血压处于正常高值的人群应当成为健康教育和实施干预措施的重点人群。     

深圳特区常住人口糖尿病流行特征研究

目的　了解深圳市常住人口糖尿病患病及其有关影响因素。方法　对深圳市 2 0岁以上常住人口 82 0 0人进行糖尿病流行病学调查 ,采用葡萄糖氧化酶法测定血糖。结果　按WHO糖尿病 (DM )诊断标准 ,DM患病率为 4.2 3% ,糖耐量减低 (IGT)患病率为 11.94%。DM、IGT患病率随年龄增长呈上升趋势。肥胖、有DM家族史人群DM和IGT患病率明显增高 ,DM和IGT人群多伴有甘油三酯、总胆固醇、尿酸、肌酐的升高和高密度脂蛋白一胆固醇 (HDL)的降低。结论　家族史、高龄、超重及高血脂是糖尿病的危险因素     

苏州市居民糖尿病流行现状及危险因素分析

目的了解苏州市居民糖尿病流行现状及影响因素,寻找早期干预措施。方法采用多阶段整群随机抽样的方法,抽取苏州市20岁以上的居民30578名,进行吸烟、饮酒等行为危险因素的问卷调查及测量血压、血糖、身高、体重等。结果苏州市居民糖尿病患病率为8.12%,糖尿病患病率有随年龄增高而上升的趋势;城市的糖尿病患病率高于农村,但50岁以下年龄则是农村高于城市,差异均有统计学意义(P﹤0.01)。糖尿病知晓率、治疗率、控制率分别为73.22%、73.91%、44.99%。Logistic回归分析显示,糖尿病患病的危险因素有高血压、超重与肥胖、饮酒、口味偏甜、睡眠质量差和生活紧张;保护因素为经常体育锻炼、饮食节制。结论苏州地区的糖尿病患病率较高,对糖尿病的防治应采取针对多种危险因素的综合干预措施。     

湖北省35岁以上人群高血压病流行现况调查

目的了解湖北省高血压病的流行现状,为开展高血压人群防治和采取有效的干预措施提供科学依据。方法横断面调查湖北省10个县市13865名35岁以上人群高血压现患和相关危险因素情况。结果湖北省35岁以上人群高血压总患病率为25.1%,男性和女性分别为25.9%和24.4%,农村、城镇、城市分别为32.0%、21.5%和23.6%。超重、肥胖、高血压认知差、年龄增长、中心性肥胖、食用动物油、睡眠时间不足、不参加体育锻炼和农村地区是高血压患病的危险因子。结论高血压防治重点应放在农村地区,防治对象重点是超重、肥胖者、文化程度低的农民和大年龄组的女性人群。     

湖北省35～75岁居民高血压、糖尿病、高血脂患病及共病影响因素分析

目的探讨35～75岁居民高血压、糖尿病、高血脂("三高")患病和共病流行现状及主要影响因素,并提出有关对策和建议。方法从2015—2016年国家心血管病高危人群早期筛查与综合干预项目的湖北项目点中,选择具有代表性的6个项目点作为研究现场,以自然村或者社区为基本抽样单位,采用整体随机抽样的方法,抽取35～75岁居民为研究对象,使用项目标准调查表对研究对象进行问卷调查并收集基本信息,并进行体格检查和生化指标的检测。用统计学软件SPSS 20.0进行x~2检验和多因素logistic回归分析。结果本研究共调查35～75岁城乡居民64 151人,男性23 282人,女性40 869人。高血压、糖尿病、高血脂患病率分别为50.9%、 22.2%和49.5%,高血压并糖尿病的患病率为14.3%,高血压并高血脂的患病率为27.6%,糖尿病并高血脂的患病率为13.2%,高血压并糖尿病并高血脂的患病率为8.9%。不同性别人群高血压、糖尿病、高血脂、高血压合并糖尿病以及高血压合并高血脂的患病率差异均有统计学意义(P0.001);不同年龄组人群高血压、高血糖和高血脂的患病率以及共患率差异均有统计学意义(P0.001)。在高血压、糖尿病和高血脂患者中,至少有50%以上的患者合并患有其他二种疾病。高血压、糖尿病、高血脂的患病和共病的多因素logistic回归分析结果均表明,年龄增长、农村地区、超重和肥胖、打鼾均为危险因素(OR1.00),其中肥胖者(BMI28.0)、超重BMI (24.0～27.9)相对正常体重(BMI 18.5～23.9)人群的OR值(95%CI)分别为4.33 (4.01-4.68)和2.16 (2.07-2.26);而体重过低(BMI18.5)为保护因素OR值(95%CI)为0.54 (0.45-0.66)。结论湖北省35～75岁居民"三高"慢性病率较高,超重和肥胖是影响"三高"患病和共病的最主要危险因素。慢性病预防策略是进行"三高"共管,即对高血压、糖尿病和高血脂的各种危险因素进行综合干预,而远离"三高",体重管理是关键。     

深圳市高血压患病及主要危险因素变化趋势分析

目的通过分析1997-2009年深圳市成年居民高血压患病情况及主要危险因素时间变化趋势,为制定高血压的防控策略提供科学依据。方法以深圳市1997年和2009年两次慢性病及其相关危险因素流行病学调查为基础,分析危险因素改变对高血压患病的影响,并对危险因素归因危险度的时间趋势进行分析。结果 1997-2009年,深圳市成年居民高血压标化患病率由13.23%上升至15.33%,差异有统计学意义(χ2=3.96,P<0.01),相对于1997年,人群45~50岁、60~70岁年龄段患病明显升高。超重和肥胖、血脂异常、高血压家族史、糖尿病、饮酒和吸烟的暴露率分别由30.66%、21.64%、16.84%、4.20%、7.72%和15.42%上升到38.05%、41.12%、36.30%、5.20%、21.40%和16.47%。超重和肥胖、血脂异常、糖尿病、饮酒和吸烟为深圳市居民高血压患病增高的主要危险因素,高血压患病率升高归因于行为危险因素的比例呈上升趋势。结论高血压危险因素效应随时间的变化有升高趋势,血脂异常、超重和肥胖、糖尿病、饮酒和吸烟为高血压升高持续稳定的危险因素。     

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.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.