鄂西北山区农村居民健康状况调查--武当山镇农村的调查报告

目的：调查该镇农村居民健康状况，为卫生管理部门决策提供依据。方法：采用分层整群抽样方法，对该地区的808例居民进行问卷调查。结果：武当山镇农村居民两周患病率及慢性病患病率分别为17．1％和11．8％，调查人群两周患病率高，是全国农村的1．71倍。影响武当山镇农村居民健康的疾病主要是消化系病、呼吸系病、运动系病和损伤与中毒。两周就诊率是全国农村平均水平的1．2倍。结论：与全国农村相比，武当山镇农村居民具有医疗高需要量、门诊服务低利用的特点，且生物医学模式的疾病谱在该地区占主导地位。     

安庆市郊区农村卫生服务调查分析

目的：了解安庆市郊区农村卫生服务的基本状况。方法：采取分层整群抽样的方法，调查安庆市郊区农民2266人。结果：两周患病率、慢性病患病率、两周就诊率均高全国农村平均水平。两周末就诊率、年住院率与全国农村平均水平接近。就诊单位构成比基本与各级医疗机构功能吻合。医疗服务费用高于全国农村平均水平。结论：农民健康状况不容乐观，医疗需要量大，医疗费用较高，加重了病人的负担，因此推行合作医疗势在必行，同时要完善健全三级医疗网。     

安庆市郊区农民医疗需要和卫生服务利用研究

目的 :了解安庆市郊区农民医疗卫生需要量及卫生服务利用的基本情况和特点。方法 :通过分层整群抽样 ,访谈安庆市郊区农民 2 2 6 6人。结果 :慢性病患病率 ,尤其是男性的慢性病患病率高于全国农村平均水平 (P<0 .0 5 ) ,两周患病率与全国农村平均水平相比有很大差距。两周就诊率也高于全国农村平均水平。两周未就诊率、年住院率与全国农村平均水平接近。就诊单位构成比基本与各级医疗机构功能吻合 ,仍有 1/ 5的病人因经济困难而未就诊。医疗服务费用高于全国农村平均水平 ,给农民带来了一定的经济负担。结论 :安庆市郊区农民的健康状况不容乐观 ,与全国农村平均水平相比 ,医疗需要量大 ,医疗费用较高 ,加重了病人的负担 ,因此推行合作医疗势在必行 ,同时要完善健全三级医疗网。     

四川省农村15岁及以上居民两周患病未治疗的影响因素探讨

目的：了解四川省农村15岁及以上居民两周患病未治疗的影响因素，为制定相应政策提供客观科学的依据。方法：利用第3次国家卫生服务调查西部扩充点四川省的资料，对农村15岁及以上居民两周患病未治疗的可能影响因素，在单因素分析的基础上进行非条件logistic回归。结果：四川省农村居民两周患病率和慢性病患病率分别为220．54‰和167．84‰(以人次计)，均高于本次调查的全国平均水平(139．5‰和120．5‰)两周患病未就诊率低于全国水平，未住院率高于全国水平。非条件logistic回归结果表明：性别、人均年收入、是否愿意获得保健知识和因病卧床天数对四川省农村15岁及以上居民两周患病未治疗有统计学意义。结论：四川省农村居民对卫生服务的需要量较高，现有卫生服务利用不充分。性别、人均年收入、是否愿意获得保健知识和因病卧床天数是四川省农村15岁及以上居民两周患病未治疗的主要影响因素。     

江苏省卫生服务利用状况分析

一、卫生需求与卫生服务利用比较１．两周患病率。１９９８年与１９９３年的两周患病率比较 ,江苏从１２４．２‰上升至１３７．７‰（全国从１４０．１‰升至１４９．８‰），江苏上升１３．１个千分点，其中江苏城市平均从１７０．９‰下降至１５１．０‰（全国城市从１７５．２‰升至１８７．２‰），农村平均从１０８．７‰上升至１３１．８‰（全国农村从１２８．２‰升至１３７．１‰）。２．两周未就诊率、未住院率。１９９８年调查地区两周内患病未就诊人次数占两周患病人次数的比例为３３．３３%。其中城市 (４２．６６% )明显高于…     

中国居民健康及卫生服务利用现状与变化趋势

目的 探讨我国居民健康及服务利用现状及变化趋势,为相关决策部门提供参考.方法 采用多阶段分层整群抽样的方法,实际调查住户9.41万,调查人口25.63万.结果 居民两周患病率和慢性病患病率增加,且农村增长超过城市,高血压、糖尿病成为居民最主要的慢性疾病.居民两周就诊率、年住院率呈上升趋势.结论 居民卫生服务需要量持续增...     

广州市白云区“城中村”人群健康及卫生服务现况调查

目的：了解广州市城中村人群健康和卫生服务现况，为构建和谐社会，发展城市社区卫生服务提供依据。方法：多阶段分层整群随机抽样，在辖区城中村内抽取3个社区的部分居民进行问卷调查。结果：被调查人群两周患病率为117．2‰，慢性病患病率为107．2‰、两周就诊率为71．8‰、两周未就诊率为45．4‰、住院率为4．2‰，卫生服务需求和利用水平下降。结论：城中村人群卫生服务需要量隐性增加，对医疗服务需求和利用呈下降趋势，有效需求呈多极化。     

农村居民门诊服务利用分析

目的通过对顺义区4镇农村居民卫生服务利用情况进行分析,了解农村地区居民的门诊服务利用状况．为制定卫生政策提供数据支持和理论依据。方法采用分层随机抽样的方法抽取样本,利用SPSS软件对调查人口的社会经济学特征、家庭状况、两周患病情况,两周就诊情况等进行分析。结果两周患病率为209．8‰,千人口两周患病天数为2262天。两周就诊率为138．8‰,两周未就诊率为33．5％。顺义区农村居民的平均门诊费用为525．8元,门诊费用中位数为120元。结论顺义区4镇农村居民卫生服务需要程度高于全国平均水平,卫生服务利用情况低于全国平均水平,在选择就诊医疗机构时侧重于基层机构,选择原因侧重于便捷程度和技术能力。     

贵州省农村卫生服务公平性研究

目的:通过对贵州省农村地区卫生服务公平性状况的分析,研究影响卫生服务公平性的因素,为建立健全可行的医疗制度提供参考依据.方法:通过多阶段分层整群随机抽样.访谈贵州省贫困地区农村居民2 943人,以入户询问方式获取相关定量资料,进行卫生服务公平性评价.结果:贵州省在农村居民健康、卫生服务提供、卫生服务可及性及卫生服务筹资等方面都存在着不同程度的不公平.慢性病患病率是全国农村平均水平的2.14倍.两周患病率是全国农村平均水平的1.77倍,两周就诊率接近全国农村平均水平.结论:贵州省农村地区卫生服务状况呈现卫生服务需要大、卫生服务利用低和卫生筹资不公平的特点.     

上海市私营企业职工医疗服务需求和利用分析

对上海市私营企业职工抽样调查结果表明，私营企业职工健康情况较一般人群好，以自费医疗（占40．4％）和合作医疗（26．8％）为主。两周患病率、住院率、慢性病患病率均低于全国城市平均水平；他们的卫生服务利用水平也低于全国水平，两周就诊率很低，两周未就诊率、未住院率接近或低于全国平均水平。经济困难是未就诊、未住院的主要原因。扩大上海市城镇职工社会医疗保险对私营企业从业人员的覆盖面，保障其基本医疗，是政府和医保部门当前面临的重要任务。     

A Comparison of Finger 2D:4D by Self-Report Direct Measurement and Experimenter Measurement from Photocopy: Methodological Issues

The ratio of 2nd and 4th digit length (2D:4D) is sexually dimorphic and may be a correlate of prenatal sex steroids. 2D:4D is often calculated from measurements of photocopies of fingers. However, 2D:4D from photocopies is lower than 2D:4D from direct measurements of the fingers. A new and promising source of 2D:4D measures is self-reports from Internet studies. This necessitates self-report of direct finger measurements and such measurements may be unreliable. In the present study, we compared 2D:4D from self-reported finger lengths measured directly from the fingers (S-R 2D:4D) and experimenter-measured finger lengths from photocopies of the fingers (photo 2D:4D). There were 329 participants (77 men, 252 women) recruited from a first-year undergraduate psychology pool. Compared to photo 2D:4D, (1) S-R 2D:4D tended to include some extreme values; (2) S-R 2D:4D was higher; (3) S-R 2D:4D showed weak similarities which increased when extreme values of S-R 2D:4D were removed; (4) photo 2D:4D and S-R 2D:4D showed lower values for males compared to females but the dimorphism was significant for the former but not for the latter. We conclude that, insofar as S-R 2D:4D has similarities to 2D:4D from Internet studies, the 2D:4D from Internet studies will show extreme values which should be removed, mean 2D:4D will be higher than from photocopy studies, and the sexual dimorphism will be weaker than in photo 2D:4D. We suggest that large samples are necessary in Internet studies of 2D:4D because measurement error will reduce effect sizes.     

Effects of dietary cis 9, trans 11-18:2, trans 10, cis 12-18:2, or vaccenic acid (trans 11-18:1) during lactation on body composition, tissue fatty acid profiles, and litter growth in mice

Cis 9, trans 11 (c 9, t11)-18:2 and trans 10, cis 12 (t10, c12)-18:2 are the major conjugated linoleic acid (CLA) isomers in dietary supplements which reduce milk fat content in nursing women. The present study evaluated the effects of each CLA isomer or vaccenic acid on body composition and tissue fatty acids during lactation in mice. Dams were fed 30 g rapeseed oil (control)/kg diet or 20 g control plus 10 g 18:0, trans 11-18:1 (t11-18:1), c 9, t11-18:2, or t10, c12-18:2. Dietary t10, c12-18:2 reduced food intake by 18 % and carcass fat weight of the dams by 49 % compared with the other treatments. Milk fat percentage ranked by treatment was 18:0>t11-18:1=c 9, t11-18:2>t10, c12-18:2. The sum of saturated 12:0 to 16:0 in milk fat was lower when c 9, t11-18:2 was fed compared with the control, 18:0, or t11-18:1 treatments. Dietary t10, c12-18:2 caused further reductions in milk fat 12:0 to 16:0. The proportion of CLA isomers was 3-fold greater in milk fat than in the carcasses of the dams. The pups nursing from the dams fed t10, c12-18:2 had the lowest body weights and carcass fat, protein, and ash contents. Nursing from the dams fed c 9, t11-18:2 also resulted in lower carcass fat compared with the 18:0 or t11-18:1 treatments. The ratios of cis 9-16:1:16:0 or cis 9-18:1:18:0, proxies for Delta(9)-desaturase activity, were markedly lower in the carcasses of the dams and pups fed t10, c12-18:2. The ratio of 20:4n-6:18 : 2n-6, a proxy for Delta(6)- and Delta(5)-desaturase and elongase activity, in the liver of the dams and pups fed t10, c12-18:2 also was lower. Dietary t11-18:1 enhanced the content of c 9, t11-18:2 in milk fat and carcasses. As in previous studies, the reduction in food intake by t10, c12-18:2 could not entirely account for the marked decrease in carcass fat content and milk fat concentration. T10, c12-18:2 probably had a negative effect on Delta(9)-desaturase and mammary de novo fatty acid synthesis. Although these effects need to be confirmed in lactating women, the results suggest that the consumption of supplements containing t10, c12-18:2 should be avoided during the nursing period.     

A case-control study of gastric cancer and nutritional factors in Marseille,France

A case-control study was conducted in Marseille (France) to investigate the relationship between usual diet and risk of gastric cancer. Patients with histologically confirmed gastric adenocarcinoma were identified in 8 major centres for gastric surgery. Controls were selected in specialized medical centres from patients undergoing functional reeducation for injuries or trauma, according to the age and sex distributions of the cases. The study involved 92 cases and 128 controls who were interviewed with a dietary history questionnaire on their usual diet during the year preceding first symptoms for cases, or preceding interview for controls. Odds ratios for specific foods were calculated after adjustment for age, sex, occupation and energy intake. A reduced risk was observed for consumption of raw vegetables (OR2: 0.55; OR3: 0.41 for the second and third tertiles, respectively), fresh fruit (OR2: 0.63; OR3: 0.50), vegetable oil (OR2: 0.60; OR3: 0.52), pasta and rice (OR2: 1.06; OR3: 0.50) whereas consumption of cakes and pastries (OR2: 1.02; OR3: 2.96), sugar and confectionery (OR2: 0.96; OR3: 1.68) was associated with an increased risk. An increased risk was found for intake of saturated fat (OR2: 1.49; OR3: 1.67), simple sugars (OR2: 1.18; OR3: 1.78) and calcium (OR2: 1.84; OR3: 2.57). A decreased risk was observed with intake of fiber (OR2: 0.49; OR3: 0.59), fibre from vegetables and fruit (OR2: 0.83; OR3: 0.53) and iron (OR2: 0.70; OR3: 0.41).     

Formation of 8,11,14-octadecatrienoic acid (18:3 n-4) from naturally occurring unique fatty acid, 9,12-hexadecadienoic acid (16:2 n-4), in animal cell cultures.

9,12-Hexadecadienoic acid (16:2 n-4), present in small amounts in fish oils as a naturally occurring unique fatty acid, was incorporated into the phospholipids in rat liver BRL-3A cells to a similar extent as linoleic acid (18:2 n-6). 11,14-Octadecadienoic acid (18:2 n-4) and 8,11,14-octadecatrienoic acid (18:3 n-4) were detected in the cellular lipids of BRL-3A cells when incubated in a medium supplemented with 16:2 n-4 methyl ester. The cellular levels of these acids increased in parallel with 16:2 n-4 methyl ester added to the medium. These compounds were probably formed through conversion from 16:2 n-4 to 16:3 n-4 by delta 6 desaturation, and then 18:3 n-4 was produced by elongation, and part of the surplus 16:2 n-4, not desaturated to 16:3 n-4, elongated to 18:2 n-4. These results suggested that 16:2 n-4 was desaturated by delta 6 desaturase in vitro. It was also shown that 16:2 n-4 inhibited arachidonic acid synthesis from exogenous linoleic acid in BRL-3A cells as efficiently as alpha-linolenic acid (18:3 n-3).     

Accumulation and apparent oxidation of cis,trans-18 : 2 isomers relative to linoleic acid in rats

Dietary cis,trans-18 : 2 isomers impair desaturation and elongation of linoleic acid (Delta9cis,12cis-18 : 2), but little is known of their proportional partitioning between accumulation and oxidation. The present study was therefore designed to assess the accumulation and apparent oxidation of cis,trans-18 : 2 isomers compared with that of trans-18 : 1 isomers and Delta9cis,12cis-18 : 2 in rats. Accumulation is defined as whole-body increase in a fatty acid during a given period (i.e. final body content-initial body content). The apparent oxidation (disappearance) is defined as whole-body utilization of a fatty acid relative to its intake for a given period (intake-excretion-accumulation-longer-chain products)/intakex100). The animals were fed on a diet containing 15 % (w/w) partially hydrogenated rapeseed oil with 1.72 % energy as cis,trans-18 : 2 isomers and varying amounts of Delta9cis,12cis-18 : 2. The apparent oxidation of total cis,trans-18 : 2 isomers (72-76 % dietary intake) was greater than that of Delta9cis,12cis-18 : 2 (38-51 % dietary intake) but it was similar to that of total trans-18 : 1 isomers (78-82 % dietary intake). Among the four isomers, the apparent oxidation of Delta9trans,12trans-18 : 2 was greater than that of the other isomers including Delta9trans,12cis-18 : 2, Delta9cis,12trans-18 : 2 and Delta9cis,13trans-18 : 2. Accumulation of Delta5cis,8cis,11cis,15trans-20 : 4 and Delta5cis,8cis,11cis,14trans-20 : 4 derived from chain-elongation and desaturation of Delta9cis,13trans-18 : 2 and Delta9cis,12trans-18 : 2 was decreased when the dietary Delta9cis,12cis-18 : 2 supply was increased.     

Effects of sodium bicarbonate, caffeine, and their combination on repeated 200-m freestyle performance

The purpose of this study was to investigate the effects of sodium bicarbonate (NaHCO(3)), caffeine, and their combination on repeated 200-m freestyle performance. Six elite male freestyle swimmers ingested NaHCO(3) (0.3 g/kg; B), caffeine (6.2 +/- 0.3 mg/kg; C), a combination of both (B+C), and placebo (P) on 4 separate occasions before completing 2 maximal 200-m freestyle time trials (TT1 and TT2) separated by 30 min. No significant differences (p = .06) were observed for performance in TT1 (B 2:03.01 +/- 0:03.68 min, C 2:02.42 +/- 0:03.17 min, B+C 2:01.69 +/- 0:03.19 min, P 2:03.77 +/- 0:03.21 min) or TT2 (B 2:02.62 +/- 0:04.16 min, C 2:03.90 +/- 0:03.58 min, B+C 2:01.70 +/- 0:02.84 min, P 2:04.22 +/- 0:03.75 min). The drop-off in performance time from TT1 to TT2, however, was significantly greater when C was ingested than with B (-1.5%, p = .002) or B+C (-1.2%, p = .024). This is likely because of the lower blood pH and slower recovery of blood HCO(3) post-TT1 after C ingestion. These findings suggest that the ergogenic benefit of taking C alone for repeated 200-m swimming performance appears limited. When combined with NaHCO(3), however, its negative impact on repeated maximal exercise performance is reversed.     

Aqueous photolysis of 8:2 fluorotelomer alcohol

The 8:2 fluorotelomer alcohol (8:2 FTOH) was photodegraded in aqueous hydrogen peroxide solutions, synthetic field water (SFW) systems, and Lake Ontario (Canada) water samples. It was found to undergo indirect photolysis, with the data suggesting that the hydroxyl radical was the main degradation agent and that nitrate promoted photolysis whereas dissolved organic carbon inhibited it. The half-lives of 8:2 FTOH were 0.83 +/- 0.20 h (10 mM H2O2), 38.0 +/- 6.0 h (100 microM H2O2), 30.5 +/- 8.0 to 163.1 +/- 3.0 h (SFW systems), and 93.2 +/- 10.0 h (Lake Ontario). No significant loss of the parent compound by direct photolysis could be observed. The major monitored products were the 8:2 fluorotelomer aldehyde, the 8:2 fluorotelomer acid (8:2 FTCA), and perfluorooctanoate (PFOA); the minor monitored products were the 8:2 fluorotelomer unsaturated acid (8:2 FTUCA) and perfluorononanoate (PFNA). The intermediates, 8:2 FTCA and 8:2 FTUCA, were photodegraded to verify the degradation pathway, and a mechanism for the photolysis was proposed whereby the end products of the photolysis pathway were PFOA (major) and PFNA (minor).     

A lower proportion of dietary saturated/monounsaturated/polyunsaturated fatty acids reduces the expression of adiponectin in rats fed a high-fat diet

The role for the amount of different dietary fatty acids in regulating expression of adiponectin and metabolism of glucose and lipids has been implicated, but the optimal amount has not been established yet. To address this issue, we fed male Wistar rats with either chow diet or various high-fat diets (HFDs) for 12 weeks. The HFDs contained the same percentage of fat (35% energy from fat) but had different proportions of saturated/monounsaturated/polyunsaturated (S/M/P) (1:1.7:1.2, 1:1:1, 2:1.5:1, 1:2:1, or 1:1:2) fat. Glucose and lipid metabolism and adiponectin expression were subsequently examined. In comparison with chow diet, HFD with any proportion of S/M/P increased energy intake but had no obvious effect on body weight gain. The HFD with the S/M/P proportion at 1:1:1 or 1:1:2 significantly decreased the serum triglyceride level and increased the serum level of high-density lipoprotein cholesterol in comparison with the HFD with the S/M/P proportion at 1:1.7:1.2, 2:1.5:1, or 1:2:1. The HFD containing the highest level of saturated fatty acids (S/M/P proportion at 2:1.5:1) increased levels of total cholesterol, low-density lipoprotein cholesterol, and blood glucose. Levels of serum insulin and the homeostasis model assessment of insulin resistance index were significantly increased by HFD with S/M/P proportions at 1:1.7:1.2, 1:1:1, 2:1.5:1, or 1:2:1 but not by the HFD with the S/M/P proportions at 1:1:2 (containing the highest level of polyunsaturated fatty acids). Levels of adiponectin messenger RNA in subcutaneous and visceral adipose tissues were reduced by the HFD with the S/M/P proportion at 1:1.7:1.2 or 1:1:1 but increased by the HFD with the S/M/P proportion at 1:1:2. These changes in expression of adiponectin were inversely associated with those in levels of triglyceride, insulin, and homeostasis model assessment of insulin resistance. Together, the proportion of different fatty acids in diets plays an important role in expression of adiponectin and metabolism of glucose and lipids. Specifically, the proportion of S/M/P at 1:1:2 can promote expression of adiponectin, improve metabolism of glucose and lipids, and increase insulin sensitivity.     

Evaluation of recombinant adenovirus vectors and adjuvanted protein as a heterologous prime-boost strategy using HER2 as a model antigen

Induction of strong antigen-specific cell-mediated and humoral responses are critical to developing a successful therapeutic vaccine. Herein, using HER2 as a model antigen, we aim to evaluate a therapeutic vaccine protocol that elicits anti-tumor antibody and cytotoxic T cells to HER2/neu antigen. Replication-competent (ΔPS AdV) and non-replicating recombinant adenoviral vectors (AdV) expressing a rat HER2/neu (ErbB2) oncogene, were generated and compared for four different doses and over four time points for their ability to induce antigen-specific T and B cell responses in mice. Although ΔPS AdV:Her2 vector was shown to induce more durable antigen-specific CD8⁺ T cell responses, overall, the AdV:Her2 vector induced broader T and B cell responses. Hence the AdV:Her2 vector was used to evaluate a heterologous prime-boost vaccination regimen using rat HER2 protein encapsulated in archaeosomes composed of a semi-synthetic glycolipid (sulfated S-lactosylarchaeol, SLA; and lactosylarchaeol, LA) (SLA/LA:HER2enc) or admixed with archaeosomes composed of SLA alone (SLA:HER2adm). We first tested AdV:Her2 using a prime-boost approach with SLA/LA:HER2enc, and thereafter evaluated a sub-optimal AdV:Her2 dose in a heterologous prime-boost approach with SLA:HER2adm. A single administration of AdV:Her2 alone induced strong cell-mediated immune responses, whereas SLA/LA:HER2enc alone induced strong antigen-specific IgG titers. In mice primed with a suboptimal dose of AdV:Her2, strong CD8⁺ T-cell responses were observed after a single dose which were not further augmented by protein boost. AdV:Her2 induced CD4⁺ specific T-cell responses were augmented by SLA:HER2adm. Homologous vaccination using SLA:HER2adm induced strong antigen-specific antibody responses. However, the overall magnitude of the responses was similar with three doses of SLA:HER2adm or Ad:HER2 prime followed by two doses of SLA:HER2adm.We demonstrate that AdV:Her2 is capable of inducing strong antigen-specific CD8⁺ T cell responses, even at a low dose, and that these responses can be broadened to include antigen-specific antibody responses by boosting with SLA adjuvanted proteins without compromising CD8 T cell responses elicited by AdV priming.     

Increased risk of infection in patients with diabetes mellitus type 1 or 2

OBJECTIVE: To determine the risk of common infections in patients with diabetes mellitus type 1 (DM1) or type 2 (DM2). DESIGN: Prospective controlled study. METHODS: In a 12-month prospective cohort study as part of the Second Dutch National Survey of General Practice, 705 adult DM1 and 6,712 DM2 patients were compared with 18,911 control patients who had hypertension without diabetes. Outcome measures were medically-attended episodes of infections of the respiratory tract, urinary tract, skin and mucous membranes. Multivariate and multinomial logistic regression analysis was applied to determine independent risks of infections and their recurrence in patients with diabetes compared to controls. RESULTS: Upper respiratory-tract infections were as common in diabetes patients as in controls. Diabetes patients had a higher risk of lower respiratory-tract infections (DM2: odds ratio (OR): 1.30; 95% CI: 1.11-1.52), urinary-tract infections (DM1: OR: 1.56; 95% CI: 1.13-2.15; DM2: OR: 1.21; 95% CI: 1.07-1.38), bacterial skin or mucous-membrane infections (DM1: OR: 1.48; 95% CI: 1.01-2.15; DM2: OR: 1.32; 95% CI: 1.13-1.55) and mycotic skin or mucous-membrane infections (DM2: OR: 1.41; 95% CI: 1.24-1.61). The risk of recurrence of these common infections was seen to be increased. CONCLUSIONS: Patients with type-1 and type-2 diabetes are at increased risk of lower respiratory-tract infections, urinary-tract infections and skin or mucous-membrane infections.