城市社区人群Ⅱ型糖尿病危险因素的病例对照研究

目的：探讨城市社区Ⅱ型糖尿病的危险因素，为该类社区人群II型糖尿病干预对策与措施的制定提供依据。方法：用71例Ⅱ型糖尿病患者进行1：1配对病例对照研究。结果：条件Logisitic回归模型显示，糖尿病家族史，父系遗传系数（OR＝3．831）和腰臂比（OR＝2．105）为Ⅱ型糖尿病的危险因素。结论：对具有糖尿病家族史特别是具有父系遗传史者与中心型肥胖者应加强干预工作。     

松江地区Ⅱ型糖尿病人群危险因素的病例对照研究

目的　探讨松江地区Ⅱ型糖尿病的危险因素 ,为该类地区人群Ⅱ型糖尿病干预对策与措施的制定提供依据。方法　用 1 5 0例Ⅱ型糖尿病患者进行 1 :1配对病例对照研究。结果　条件Logistic回归模型显示 ,糖尿病家族史 (OR =4 1 3 )、高血压 (OR =1 87)、高血脂 (OR =3 0 3 )和腰臀比 (OR =2 1 7)为Ⅱ型糖尿病的危险因素。结论　对具有糖尿病家族史、高血压、高脂血症和肥胖者应加强干预工作。     

不同人群非胰岛素依赖型糖尿病危险因素的病例对照研究

[目的 ]了解不同人群非胰岛素依赖型糖尿病 (NIDDM)的危险因素 ,为该病适宜的社区干预对策与措施的制订提供科学依据。 [方法 ]1 996～ 1 998年以同一方法对城市 (济南市、滨州市 ) 1 1 5例、农村 (东平、安丘、莘县、长清县 ) 1 0 9例、沿海 (日照、长岛、威海、莱州市 ) 1 0 1例NIDDM患者分别进行 1∶2配比病例对照研究。 [结果 ]糖尿病家族史、体重超重、高血压为三人群NIDDM共有的危险因素 ,但作用强度各异 ,合计人群病因分值 (PARP )分别为5 8 5 2 %、6 5 91 %、6 3 5 8% ;低体力活动为城市特有的危险因素 (OR =1 6 88,PARP =2 8 31 % ) ,喜荤食为农村特有的危险因素 ( OR =2 473,PARP =1 7 78% ) ,喜素食为沿海人群的保护因素 ( OR =0 445 ,PARP =-2 0 5 2 % )。 [结论 ]应针对不同人群的共有与特有的危险因素制订NIDDM的社区干预对策与措施。     

2型糖尿病发病危险因素探讨

[目的]探讨糖尿病的危险因素以及心理因素与糖尿病发生的关系。[方法]于2004年3～11月选择164例社区的糖尿病病例和62例社区的正常人群的病例对照研究,并采用Zung抑郁自评量表、Zung焦虑自评量表测量研究对象的心理状况。[结果]多元Logistic回归分析结果表明,糖尿病家族史OR为1.180(1.042～1.335),饮酒OR为2.748(1.132～6.668),食用油OR为3.398(1.467～7.873),甜食OR为3.045(1.446～6.414),饮用茶OR为2.551(1.213～5.361),抑郁OR为3.848(1.675～8.840)和焦虑OR为15.759(1.706～145.566)。[结论]糖尿病家族史、饮酒、食油、甜食、饮用茶是2型糖尿病的危险因素,心理状况与2型糖尿病有一定相关性,但尚不明确其因果关系。     

某社区女性居民糖尿病与空腹血糖损害现状及影响因素研究

[目的]探讨上海某社区女性居民糖尿病与空腹血糖损害现状及影响因素。[方法]采用现况研究方法,由经培训的调查员用统一的调查表进行面对面调查,于1999年12月~2000年2月在该社区20岁以上女性居民中开展研究。同时对所有研究对象进行体格检查(身高、体重、血压、脉搏、腰围、臀围、空腹血糖)。对数据进行多元无序多分类Logistic回归分析。[结果]1 989名女性社区居民糖尿病和空腹血糖损害(IFG)标化患病率分别为4.1%和3.0%。进一步分析表明,年龄(OR=1.034,95%可信限:1.016~1.052)、腰臀比(OR=14.984,95%可信限:1.175~191.028)、高血压(OR=2.448,95%可信限:1.550~3.865)、饮酒史(OR=4.646,95%可信限:1.670~12.982)、体质指数(OR=1.123,95%可信限:1.061~1.188)和糖尿病家族史(OR=5.312,95%可信限:2.664~10.589)是女性社区居民糖尿病可能的独立危险因素;体质指数(OR=1.096,95%可信限:1.026~1.172)和糖尿病家族史(OR=3.292,95%可信限:1.399~7.745)也是IFG可能的独立危险因素。[结论]该社区女性居民的糖尿病和IFG患病率水平较高,应该加强对较胖(特别是中心性肥胖)、有糖尿病家族史、年龄较大(50岁以上)、有高血压及有饮酒史的女性高危人群的监测与干预。     

2型糖尿病危险因素的病例对照研究

目的探讨2型糖尿病的危险因素,为制定干预措施提供依据。方法将203例确诊的2型糖尿病患者作为研究对象,1∶1配对进行病例对照研究。通过条件Logistic回归分析筛选主要危险因素。结果糖尿病家族史（OR=3.540）、高血脂（OR=3.420）、工作紧张度（OR=3.174）、腰臀比（OR=2.173）、高血压史（OR=2.033）、嗜甜食（OR=1.751）是2型糖尿病的主要危险因素。结论 2型糖尿病与遗传等因素有关,针对高危人群应采取合理膳食、保持良好心理状态、控制体重和血压等综合干预措施。     

福州市鼓山镇老年2型糖尿病患病状况及其危险因素分析

目的 了解城乡结合部老年2型糖尿病的患病状况,为社区糖尿病干预提供基线数据.方法 2007年7-11月,采用随机整群抽样方法,抽取福州市城乡结合部鼓山镇14个行政单位60岁及以上常住居民4 653人进行2型糖尿病筛查.结果 鼓山镇老年2型糖尿病患病率为11.21%,经多因素非条件Logistic回归分析显示,年龄、职业、月收入(OR=1.42,95%CI:1.13～1.77)、糖尿病家族史(OR=6.49,95%CI:4.62～9.10)、向心性肥胖(OR=1.47,95%CI:1.15～1.88)是糖尿病患病的独立危险因素.结论 鼓山镇老年2型糖尿病患病率较高,今后应加强对有糖尿病家族史、向心性肥胖人群的健康教育及不良行为的干预,大力开展社区干预工作.     

村人群非胰岛素依赖型糖尿病危险因素的条件Logistic回归分析

目的 ]了解东平县农村人群非胰岛素依赖型糖尿病 (NIDDM )的危险因素 ,为该病适宜的社区干预对策与措施的制订提供科学依据。 [方法 ]对东平县医院 1997年 1～ 12月新诊断的 48例农村NIDDM患者进行 1∶2配比病例对照研究 ,对NIDDM的危险因素采用条件Logistic回归分析。[结果 ]糖尿病家族史、高血压史、喜甜食、喜荤食、体重指数为NIDDM的危险因素 ,OR值分别为 13 0 0、5 62、3 10、6 3 1和 1 16。 [结论 ]在该县农村应开展有关糖尿病危险因素的干预工作     

乌鲁木齐市维吾尔族居民糖尿病及糖调节受损危险因素病例对照研究

目的 探讨维吾尔族40岁以上居民2型糖尿病及糖调节受损的危险因素,为制定有针对性的干预策略及措施提供依据.方法 采用整群抽样的方法,调查乌鲁木齐市维吾尔族居民较集中的6个社区40岁以上常住居民529人,按照WHO 1999年糖尿病的诊断标准确诊2型糖尿病及糖调节受损患者.以筛检的2型糖尿病92人及糖调节受损患者40A为病例组,选取血糖正常者59人为对照组,采用病例-对照研究方法,对相关因素进行单因素及多因素非条件Logistic回归分析.结果 有糖尿病家族史(OR=2.577)、高血压(OR=2.115)、高血脂(OR=2.236)、腰臀比(OR=2.018)是糖尿病发病的独立危险因素,家族史(OR=2.954)、高血脂(0R=3.410)、喜油腻(OR=2.656)是糖调节受损发病的危险因素.结论 社区维吾尔族居民应建立健康的生活方式;加强血压、血脂和体重的控制,倡导低脂饮食,是预防2型糖尿病发生的重要措施.     

2型糖尿病危险因素病例对照研究

目的 探讨人群2型糖尿病(DM)的危险因素,为制定相关干预政策及措施提供依据.方法 采用病例对照研究方法,病例为在深圳市3间医院就诊及住院的295例2型糖尿病患者, 糖尿病诊断按照1999年世界卫生组织(WHO)和国际糖尿病联盟的标准;对照为同期在门诊进行健康体检的214例非糖尿病人群.用统一调查表调查研究对象的人口学特征、环境行为心理学特征(包括吸烟饮酒史、体力活动情况、脑力强度、体育锻炼情况、社会心理因素、膳食营养因素等)、既往病史、家族史等内容,并检测其身高、体重、血压、空腹及餐后2h血糖及血脂等指标.对以上研究因素进行单因素及多因素非条件logistic回归分析. 结果多因素非条件logistic回归分析结果表明,年龄(OR=3.119)、工作压力(OR=2.202)、高血脂(LDL-C:OR=5.337)、DM家族史(OR=5.243)是2型糖尿病的危险因素;而文化程度(OR=0.283)、运动锻炼(OR=0.701)是保护因素. 结论 2型糖尿病是遗传因素与环境因素共同作用的结果.对糖尿病的防治应采取综合措施,尤其对于具有糖尿病家族史者以及中老年人群,更应控制各种危险因素.     

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.     

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.