中国18岁及以上人群血脂异常流行特点研究

目的 掌握我国城乡及不同地区居民血脂异常及高胆固醇血症、高甘油三酯血症、低高密度脂蛋白血症流行情况及其差异。方法 调查时间为2002年8至12月。采用酶法对49252名调查对象空腹血浆总胆固醇、甘油三酯、高密度脂蛋白胆固醇进行测定。结果 按年龄和地区调整后,我国18岁及以上成人血脂异常患病率为18．6％,18-44岁、45-59岁和≥60岁人群的患病率分别为17．0％、22．9％和23．4％;男性为22．2％,女性为15．9％;城市为21．0％,农村为17．7％。我国18岁及以上成人高胆固醇血症患病率为2．9％,胆固醇边缘性升高率为3．9％;高甘油三酯血症患病率为11．9％;低高密度脂蛋白血症患病率为7．4％。结论 血脂异常已成为威胁我国人民健康的重要危险因素;18岁及以上人群血脂异常以高甘油三酯、低高密度脂蛋白胆固醇血症为主;中、老年人血脂异常患病率相近,城乡差别不大。作好人群早期综合防治工作十分重要。     

中国9省/自治区成年居民膳食胆固醇摄入与高胆固醇血症关系的前瞻性研究

目的 探讨成年居民膳食胆固醇摄入与高胆固醇血症的关系. 方法 利用“中国健康与营养调查”数据,本研究中纳入的研究对象为同时参加2004年和2009年2轮调查、且在2009年调查时年龄为25～65岁、血样检测和膳食调查数据完整的成年居民,共4 244人.以《中国成人血脂异常防治指南2007》为标准,血清TC≥6.22 mmol/L时,判定为高胆固醇血症.采用非条件logistic回归方法,研究膳食胆固醇摄入与高胆固醇血症的关系.结果 2009年成年居民平均血清TC水平为4.9 mmol/L,高胆固醇血症患病率为9.6%.2004－2009年膳食胆固醇摄入量总体呈大幅增长,尤其是低摄入量组的增幅最大.男性成年居民中2004年膳食胆固醇摄入中低水平者和2009年膳食胆固醇摄入高水平者,高胆固醇血症患病风险增加.女性膳食胆固醇摄入与高胆固醇血症之间未见统计学关联.结论 膳食胆固醇摄入与高胆固醇血症的关系具有性别差异.膳食胆固醇摄入水平升高,可增加男性居民发生高胆固醇血症的危险性.     

文成县居民2013年血脂异常患病情况及相关因素调查

目的 研究文成县社区居民血脂异常患病情况的现状及其主要危险因素,为制定干预策略提供科学依据。 方法 2013年采用多阶段随机抽样方法抽取文成县4 003名18岁及以上常住居民为调查对象。进行问卷调查(一般情况、吸烟、饮酒、体力活动、膳食及精神因素等)、体格检查(体重、身高和血压的测量)及血生化检测(甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白、总胆固醇和血糖的检测),采用χ²检验分析血脂异常的人群分布,采用多因素非条件 logistic 回归分析探讨血脂异常的危险因素。 结果 文成县18岁及以上居民血脂异常患病率为45.32％,男女性血脂异常患病率为40.12％、48.86％。以2000年中国人口构成进行标化后血脂异常标化患病率为44.21%:男为39.43%,女为46.40%。女性显著高于男性(χ²=29.76,P=0.000),居民血脂异常患病率随着年龄的增加而增加(χ²_趋势=29.25,P=0.000)。高甘油三酯血症、高低密度脂蛋白胆固醇、高胆固醇血症、低高密度脂蛋白血症患病率分别为22.2％、14.9%、12.4%、8.9％。多因素非条件 logistic 回归分析结果表明,血脂异常与性别(OR=1.317,95%CI:1.115~1.554, P=0.001)、年龄(OR=1.010,95%CI:1.005~1.016, P=0.000)、职业(OR=1.053,95%CI:1.021~1.086, P=0.001)、文化程度(OR=1.146,95%CI:1.055~1.246, P=0.001)、高血压(OR=13.094,95%CI:11.053~15.512, P=0.000)、超重(OR=1.220,95%CI:1.022~1.457, P=0.028)、肥胖(OR=2.376,95%CI:1.524~3.704, P=0.000)有关。 结论 文成县社区居民18 岁及以上人群血脂异常患病率已经达到较高水平,血脂异常与性别、年龄、职业、文化程度、高血压、超重和肥胖有关。     

贵州省成年居民血脂异常患病现状及危险因素分析

目的了解贵州省成年居民血脂异常患病现状及其危险因素,为血脂异常的预防控制提供参考依据。方法于2011年8—12月采用多阶段分层整群随机抽样方法对在贵州省抽取的9 280名≥18周岁成年居民进行问卷调查、体格检查和实验室检测。结果贵州省成年居民血脂异常者患病率为58.1%,高总胆固醇血症、高甘油三酯血症、高低密度脂蛋白胆固醇血症和低高密度脂蛋白胆固醇血症患病率分别为11.9%、18.9%、9.6%和37.4%;贵州省成年居民对血脂异常诊断的知晓率为3.9%,男性和女性居民知晓率分别为3.7%和4.1%,城市和农村居民知晓率分别为4.2%和3.8%,18~44、45~59和≥60岁居民知晓率分别为1.9%、5.7%和6.3%,居民血脂异常诊断知晓率随着年龄增长呈增高趋势(χ2=58.253,P0.001);多因素非条件logistic回归分析结果显示,居住在农村、吸烟、饮酒、红肉摄入过多、谷薯类摄入不足、高血压、糖尿病和超重/肥胖是贵州省成年血脂异常患病的危险因素。结论贵州省成年居民血脂异常患病率较高,且对血脂异常诊断的知晓率较低;居住地及是否吸烟、饮酒、红肉摄入过多、谷薯类摄入不足、高血压、糖尿病、超重/肥胖为该地区成年居民血脂异常患病的主要危险因素。     

我国中老年人群高胆固醇血症的膳食影响因素分析

目的 分析我国中老年人群高胆固醇(TC)血症的膳食影响因素.方法 利用2002年中国居民营养与健康状况调查的资料,根据区域分布特点和饮食习惯,抽取东南沿海地区、西南内陆地区和中部内陆地区共23个省的45岁及以上人群17 545名,分析高TC血症和TC正常组的膳食模式差异,并采用logistic回归分析模型分析高TC血症的膳食影响因素.根据2007年<中国成人血脂异常防治指南>中推荐的标准,TC≥6.22 mmol/L为高TC血症.结果 中老年人群高TC血症组的肉类、蛋类摄入量分别为146.2 g/d和26.3 g/d,均为TC正常组的1.3倍.高TC血症组的粮谷类食物摄入量和碳水化合物供能比分别为352.9 g/d和52.9%,TC正常组的粮谷类食物摄入量和碳水化合物供能比分别为411.5 g/d和57.7%,均高于高TC血症组(粮谷类食物摄入量:t=6.51,P＜0.01;碳水化合物供能比:t=7.18,P＜0.01).肉类消费＜50 g、50～99 g、100 g～组高TC血症患病率分别为1.6%、2.2%和2.5%(组间趋势性检验,x2=14.4,P＜0.01);蛋类消费＜50 g、50～99 g、100 g～组高TC血症患病率分别为1.9%、2.8%和2.7%(x2=8.6,P=0.007);动、植物摄人量比＜0.2、0.2～0.39、0.4～组高TC血症患病率分别为1.5%、2.2%和3.6%(x2=59.4,P＜0.01);脂肪供能比＜20%、20%～、40%～组高TC血症患病率分别为1.3%、2.0%和3.1%(x2=26.7,P＜0.01).粮谷类消费＜300 g、300～499 g、500 g～组高TC血症患病率分别为3.4%、1.8%和1.3%(x2=58.3,P＜0.01);碳水化合物供能比＜40%、40%～、60%～组高TC血症患病率分别为3.5%、2.4%和1.4%(x2=37.3,P＜0.01).在控制年龄、性别、城乡、地区、热能摄入、看电视时间、BMI和吸烟后,肉类摄入量(β=0.16,P＜0.01)、动植物摄入量之比(β=0.11,P＜0.01)与高TC血症正相关,碳水化合物供能比与高TC血症负相关(β=-0.28,P＜0.01).结论 高脂、高胆同醇的动物性食物是高TC血症的重要危险因素,而粮谷类食物则具有保护性作用.高TC血症的高危人群和患者应尽量减少动物性食物摄入量,在控制总能量的前提下适当增加粮谷类食物摄入量.     

常熟市成年居民血脂异常流行病学研究

目的了解常熟市成人居民的血脂异常现状,分析饮食习惯和生活方式对血脂水平的影响,为城乡居民血脂异常防治工作提供科学的依据。方法采用随机整群抽样的方法,于2007年9-10月,对常熟市1 708名18周岁及以上的城乡居民进行现况调查,检测血清总胆固醇、甘油三酯、高密度脂蛋白胆固醇。结果调查对象血脂异常率为37.1%,血脂异常率与年龄、性别有关,男性高于女性(P<0.01),异常率先随着年龄的增高而增加,到60岁后有所下降;Logistic回归分析结果显示,性别、体质指数为血脂异常的非膳食相关因素;血脂异常与脂肪摄入呈正相关,与膳食纤维和蔬菜水果摄入呈负相关(P<0.05)。结论常熟市成年居民血脂异常率较高,故应采取综合干预措施,对高脂血症患者加强健康干预,教育其注意饮食平衡,养成良好生活习惯,减少血脂异常及心血管疾病的发生。     

天津市成年居民血脂异常流行特征及影响因素分析

目的了解天津市成年居民血脂异常流行特征及其影响因素,为血脂异常的预防控制提供参考依据。方法于2012年1—12月采用分层随机抽样方法对在天津市抽取的8 968名≥18周岁成年居民进行体格检查和实验室检测。结果天津市成年居民血脂异常患病率为28.88%,标化患病率为26.70%;男性血脂异常患病率为34.63%,高于女性的19.98%(χ2=223.5,P=0.000);18~29、30~39、40~49、50~59、60~69和≥70岁成年居民血脂异常患病率分别为17.55%、24.49%、31.33%、37.40%、32.35%和28.36%,血脂异常患病率随着年龄增加先增高后降低(χ2趋势=105.4,P=0.000);天津市成年居民甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)分别为(1.53±1.23)、(4.91±1.10)、(1.43±0.37)和(2.86±0.80)mmol/L;天津市成年居民高TG血症、高TC血症、高LDL-C血症和低HDL-C血症患病率分别为15.16%、8.95%、6.50%和12.61%,标化患病率分别为14.05%、7.42%、5.36%和12.65%。多因素非条件logistic回归分析结果显示,年龄≥30岁、超重、肥胖、高血压、糖尿病和高尿酸血症是天津市成年居民血脂异常和高TG血症的危险因素,女性和体重过轻是天津市成年居民血脂异常和高TG血症的保护因素;女性、年龄≥30岁、超重、肥胖、高血压、糖尿病和高尿酸血症是天津市成年居民高TC血症的危险因素;女性、年龄≥40岁、超重、肥胖和高血压是天津市成年居民高LDL-C血症的危险因素;超重、肥胖、糖尿病和高尿酸血症是天津市成年居民低HDL-C血症的危险因素,女性和体重过轻是天津市成年居民低HDL-C血症的保护因素。结论天津市成年居民血脂异常患病率较低,但性别、年龄差异较大;性别、年龄、体质指数(BMI)、血压、血糖和血尿酸是天津市成年居民血脂异常的主要影响因素。     

天津市居民膳食结构及与血脂异常的关系

目的了解天津居民膳食结构及膳食营养水平,分析主要膳食因素与血脂异常患病的风险。方法采用2002年全国营养与健康状况调查统一方法,抽取天津城区常住人口1080户,对其中部分人群进行膳食调查及血生化检测。结果天津居民膳食结构中存在着钙、镁、锌、钾、硫胺素、核黄素、纤维素和视黄醇等摄入不足;钠、脂肪、维生素E等超过参考摄入量;与膳食平衡宝塔比较,天津居民蔬菜、水果、奶类及豆制品等食物摄入偏低,而油脂和食盐摄入过量;脂肪、蔬菜水果、膳食纤维摄入与血脂异常的患病风险密切相关,膳食脂肪的供能比≥30/是血脂异常的危险因素,OR为2.22;蔬菜水果摄入量≥500g/d是血脂异常的保护因子,OR为0.47;每人每天膳食纤维摄入量≥20g是血脂异常的保护因素,OR为0.24。结论天津市居民膳食结构与营养水平影响着天津居民的健康状况,与血脂异常的患病密切相关。     

藏族与汉族中老年人膳食模式的差异对血脂的影响

目的了解西藏地区居住的藏、汉两族中老年人及居住在汉族地区的汉族中老年人的膳食模式与血脂异常的关系。方法应用移民流行病学的方法,调查35岁以上居住在藏族地区的藏族、汉族和居住在汉族地区的汉族中老年人共572人的膳食和血脂状况,分析其特征和差异。结果藏民摄入较多为粗粮[（219.8±123.3）g/d]、肉类[（226.2±210.1）]g/d,饮酒较多[（580.8±1049.0）g/d],蔬菜、水果摄入量较低[（217.8±160.4）g/d];藏民的高甘油三酯血症（TG,5.0%）、低高密度脂蛋白胆固醇血症患病率（HDL-C,3.1%）低于其他两组人群（藏区汉族居民22.5%,10.7%;汉族地区汉族居民14.7%,8.4%）,差别有统计学意义（P〈0.05）;藏族地区汉族人群饮食结构类似汉族地区汉族居民,其高TG血症患病率较高（22.5%）,低HDL-C血症患病率（10.7%）与汉族地区汉族居民（8.4%）接近,高于藏民（3.1%）,差别有统计学意义（P〈0.05）;高胆固醇血症（TC,2.7%）、高低密度脂蛋白胆固醇血症患病率（LDL-C,1.6%）低于汉族地区汉族居民（7.6%,4.0%）。结论藏区藏族居民高TC血症、高LDL-C血症患病率较低。藏区藏族居民高脂膳食对高TC血症发病有一定不良影响。     

江苏省18岁以上人群血脂异常流行特点分析

目的掌握江苏省城乡及不同地区居民血脂异常及高胆固醇血症、高甘油三酯血症、低高密度脂蛋白血症流行情况及其差异。方法采用酶法对2907名调查对象空腹血浆总胆固醇、甘油三酯、高密度脂蛋白胆固醇进行测定。结果江苏省18岁及以上成人血脂异常患病率为21.1%;男性为23.3%,女性为19.1%;城市为31.1%,农村为17.7%。结论血脂异常已成为威胁江苏省人民健康的重要危险因素;江苏省18岁及以上人群血脂异常以高甘油三酯为主;中、老年人血脂异常患病率相近。     

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.