钢铁企业男性职工打鼾流行病学调查

目的：研究钢铁企业男性职工打鼾症状的发生率，探讨打鼾发生的影响因素。方法：采用整群抽样方法抽取不同车间不同工种的当班作业工人1224人，采用自填问卷法，调查打鼾情况，吸烟、饮酒、职业紧张等，同时测量血脂、身高、体重等。结果：（1）该钢铁企业男性职工习惯性打鼾（HS）的发生率为14．1％，偶尔打鼾的发生率为55．3％；HS随年龄的增长，发生率增加，50岁以后略有下降；（2）用多因素logistic回归分析控制年龄的影响后，习惯性打鼾的危险因素为超重和肥胖调整OR，OR 95％可信区间，P值分别为2．108、1．608～2．764、P〈O．001；吸烟20支及以上为1．917、1．315～2．793，P=O．001；曾经饮酒或每天饮酒，特别是饮酒10年以上且每天或几乎每天饮酒为1．374，1．058～1．785，P=0．017）、重体力劳动为1．641，1．173～2．294，P=0．004；职业紧张为1．459，1．208～1．761，P〈0．001；夜班和两班轮转为1．574，1．217～2．037，P=0．001；高脂血症为1．802、1、287～2．524、P=O．001；特别是混合型高脂血症为2．207、1．309～3．723、P=O．003。结论：男性打鼾的影响因素除了年龄外，与超重和肥胖、吸烟20支以上、饮酒、重体力劳动、职业紧张、夜班或两班轮转、高脂血症等因素有关。     

马钢企业男性职工生活方式疾病及其影响因素的调查

目的：调查钢铁企业职工生活方式疾病的患病情况及其影响因素。为职业人群生活方式疾病的预防和控制提供理论依据。方法：采用整群抽样方法抽取不同车间不同工种的当班作业工人1181人，采用自填问卷法。同时测量血压、血脂、身高、体重等。用多因素Logistic回归分析生活方式疾病的影响因素。结果：钢铁企业男性职工高血压患病率17．7％，高脂血症的检出率为31．2％。慢性支气管炎的流行率为9％。肥胖率为5．2％。超重率为43．2％。该钢铁企业生活方式疾病的影响因素有年龄和肥胖超重。另外吸烟饮酒、职业因素(间断噪声合并高温。轮班和职业紧张)和饮食因素与生活方式疾病关系密切。结论：生活方式疾病对职业人群健康的影响不容忽视，特别注意超重肥胖、吸烟、职业因素的预防。应采用多因多果的综合预防措施。     

南海城乡结合地区居民高血压患病率及其影响因素分析

目的了解南海城乡结合地区高血压患病率,分析其患病的影响因素。方法采用分层随机抽样的方法,由经过培训合格的调查员进行面对面问卷调查和体格检查。结果实际调查18岁以上常住居民8168人,高血压患者为1542人,患病率为18．88％,标化率为12．44％,其中男性为13．62％,女性为11．43％,男女患病率之间差异具有统计学意义（P＜0．05）。高血压患病率随年龄增加而升高（P〈0．05）。年龄（OR=1．623～21．332）、吸烟（OR=1．350）、BMI（OR=1．623～6．083）和糖尿病（OR=3．155）是高血压的独立危险因素,文化程度（OR=0．720～0．358）是保护因素。结论该地区高血压患病率较高,年龄、文化程度、吸烟、BMI和糖尿病是影响该地区高血压患病的主要因素。     

中老年鼾症与高血压的相关性研究

目的 探讨中老年鼾症与高血压的关系.方法 选取年龄≥40岁的非脑卒中和心肌梗死患者375例,对其进行有关鼾症的问卷调查,并对高血压的相关危险因素进行非条件Logistic回归分析.结果 在375例患者中,不打鼾169例、偶尔打鼾86例、经常打鼾120例,三者高血压患病率分别为33.7％(57/169)、39.5％(34/86)、49.2％(59/120),三者比较差异有统计学意义(P＜0.05).影响高血压的非条件Logistic回归分析结果:校正其他因素后,经常打鼾为中老年人发生高血压的危险因素,其OR值为2.124(95％CI 1.189～ 3.796);按性别分层后,经常打鼾仍为女性发生高血压的危险因素,其OR值为3.993(95％ CI 1.259～ 12.663),而不是男性发生高血压的危险因素.结论 经常打鼾与高血压的患病率增加有关,是高血压的危险因素.     

吸烟在睡眠呼吸暂停低通气综合征患病率流行病学研究中的意义

目的了解吸烟对睡眠呼吸暂停低通气综合征（SAHS）患病率的影响。方法按照随机整群抽样法，对承德市双桥区部分30岁以上居民进行人户调查，共调查1168人，对部分2级及2级以上打鼾者进行整夜睡眠呼吸监测。结果吸烟组打鼾率（69．09％）显著高于非吸烟组（45．07％，P=0、000）。男性吸烟组打鼾率（69、72％）显著高于非吸烟组（60．80％，P=0．033）；女性吸烟组打鼾率（61.80％）显著高于非吸烟组（39．70％，P=0．011）。男性非吸烟组打鼾率（60．80％）明显高于女性非吸烟组（39．70％，P=0、000）。男、女性吸烟组打鼾率差异无统计学意义（P=0．927）。logistic多元回归分析显示，吸烟指数为影响打鼾的独立危险因素（P=0．003）。在对127名≥2级打鼾人群进行便携式多导睡眠初筛仪监测后，以AHI≥5，ESS评分≥3、6、9为标准判断有无SAHS，SAHS患病率吸烟组显著高于非吸烟组（P〈0．001）。结论吸烟与打鼾和SAHS的关系密切；吸烟可以使不同性别人群打鼾和SAHS患病率升高。     

2型糖尿病病人急性心肌梗死危险因素的病例-对照研究

目的 通过回顾性病例—对照研究，分析2型糖尿病人急性心肌梗死的危险因素。方法 选择在娄底市3家医院出院诊断为2型糖尿病人1137例，以合并急性心肌梗死者72例作为病例组，无合并急性心肌梗死者1065例作为对照组，比较两组间危险因素的差异。结果 住院2型糖尿病人急性心肌梗死的患病率6．33％。多因素Logistic分析显示，控制血糖用药不规则(OR1．78，95％可信区间1．07～2．97)、血糖控制欠佳(OR 1．89，95％可信区间1．15～3．11)、高血压(OR 1．68，95％可信区间1．01～2．81)、甘油三酯≥2．82mmol／L(OR 2．26，95％可信区间1．37～3．72)、体质指数≥25kg／m^2(OR 1．79，95％可信区间1．06—3．02)是2型糖尿病人急性心肌梗死的独立危险因素。结论 血糖控制欠佳、用药不规则、高血压、高甘油三酯血症、肥胖等因素的控制对预防2型糖尿病人的急性心肌梗死具有重要意义。     

新乡市城乡居民高血压流行现状及相关因素调查

目的了解新乡市居民高血压流行现状及影响因素,为高血压疾病的干预提供科学依据。方法采用多阶段分层随机抽样方法,对2个县1个区的6个村（居委会）15岁以上居民1856人进行问卷调查、体格检查,并进行高血压相关因素的单因素x。检验和多因素logistic回归分析。结果新乡市15岁以上居民高血压患病率为25．59％,标化率为27．01％,男性高血压患病率（29．24％）高于女性（23．31％）,差异有统计学意义（x^2=11．651,P=0．001）;随年龄的增长,患病率有升高趋势,并与文化程度、职业、人均收入、吸烟、体质指数（BMI）有关。高血压知晓率、服药率分别为36．42％和26．53％。多因素非条件logistic回归分析显示,高血压的危险因素为≥35岁、肥胖、不常食用新鲜水果、吸烟OR值分别为2．446（95％C1：1．40—4．27）、4．581（95％CI：1．95—10．78）、1．817（95％CI：1．16～2．84）和1．264（95％CI：1．07～1．49）];人均收入是保护因素（OR=0．894,95％CI：0．81-0．99）。结论新乡市居民高血压患病率较高,需加强综合干预工作,实施35岁以上人群首诊测血压制度和开展健康促进活动。     

焦炉作业与代谢综合征的相关性研究

[目的]探讨焦化厂焦炉作业与代谢综合征之间的相关性。[方法]以焦炉作业工人为研究对象,选取男性焦炉作业工人432名,其中炉顶工208名、炉侧工161名和炉底工63名。112名对照选自机电车间工人。检测所有研究对象的身高、体重、血压、血糖、高密度脂蛋白以及三酰甘油水平,按照中华医学会糖尿病分会(CDS)建议的标准诊断代谢综合征。[结果]采用多元Logistic回归分析对各组间年龄、工龄、吸烟和饮酒状况等因素进行校正后,发现炉顶组及炉侧组与对照组相比患代谢综合征的危险度升高,调整OR值分别为3．33(95％可信区间为1．07-10．34)和3．43 (95％可信区间为1．13-10.37);且炉顶组及炉侧组高血压患病率也显著高于对照组(P<0．05),而炉底组危险度未见升高。[结论]炉顶和炉侧作业可增加该作业人群患代谢综合征的危险度。     

高校教职工脂肪肝患病情况及其相关因素

目的了解高校教职工脂肪肝患病情况及其相关因素，为预防和治疗脂肪肝提供依据。方法问卷调查某高校教职工性别、年龄、病史、饮食和行为习惯等，测量身高、体重、血压，同时进行腹部B超、血糖、血脂的检查。结果1348名高校教职工中，脂肪肝患病率为16．69％，男性（19．67％）高于女性（13．09％），差别有统计学意义（χ^2=10．40，P〈0．01），45～64岁男性患病率高于女性（P〈0．05），女性随年龄增长患病率有增高的趋势。经多因素Logistic回归分析，脂肪肝的患病率与体质指数（χ^2=13．471，OR=I．841，95％CI：1．232～2．748）、糖尿病（χ^2=8．326，OR=I．622，95％CI：1．050～2．504）、高脂血症（X2=26．312，OR=3．161，95％cf：2．101—4．754）、高血压（χ^2=11．392，OR=I．748，95％CI：1．171—2．611）、饮酒（χ^2=14．574，OR=I．867，95％CI：1．251～2．789）等因素密切相关。结论高校教职工脂肪肝患病率较高，应针对肥胖、糖尿病、高脂血症、高血压、饮酒等危险因素加强预防和治疗。     

吸烟、饮酒与食管癌关系的Meta-分析

目的 探讨我国吸烟、饮酒与食管癌的关系。方法 应用Meta—分析方法对国内有关吸烟、饮酒与食管癌的关系7个研究结果进行定量综合分析。用随机效应模型(D—L法)计算合并比值比(0R)及其95％的可信区间(95％C1)。结果 吸烟、饮酒的合并OR分别为1．84〔95％CI：1．50一2．25)和1．50(1．22一1．85)，它们相应的归因危险度百分比分别为23．21％和16．41％。结论 吸烟、饮酒是我国食管癌的危险因素。     

Lunasin is prevalent in barley and is bioavailable and bioactive in in vivo and in vitro studies

Lunasin, a unique 43-amino acid peptide found in a number of seeds, has been shown to be chemopreventive in mammalian cells and in a skin cancer mouse model. To elucidate the role of cereals in cancer prevention, we report here the prevalence, bioavailability, and bioactivity of lunasin from barley. Lunasin is present in all cultivars of barley analyzed. The liver and kidney of rats fed with lunasin-enriched barley (LEB) show the presence of lunasin in Western blot. Lunasin extracted from the kidney and liver inhibits the activities of HATs (histone acetyl transferases), yGCN5 by 20% and 18% at 100 nM, and PCAF activity by 25% and 24% at 100 nM, confirming that the peptide is intact and bioactive. Purified barley lunasin localizes in the nuclei of NIH 3T3 cells. Barley lunasin added to NIH 3T3 cells in the presence of the chemical carcinogen MCA activates the expression of tumor suppressors p21 and p15 by 45% and 47%, decreases cyclin D1 by 98%, and inhibits Rb hyperphosphorylation by 45% compared with the MCA treatment alone. We conclude that lunasin is prevalent in barley, bioavailable, and bioactive and that consumption of barley could play an important role of cancer prevention in barley-consuming populations.     

Salmonellas in pigs and animal feeding stuffs in England and Wales and in Denmark

A comparison has been made between the incidence of salmonellas in pigs and feeding stuffs in England and Wales and in Denmark. In Denmark there is veterinary legislation requiring the sterilization of imported and home produced feed ingredients of animal origin. There is no such legislation in England and Wales. In Denmark 0·3% of resterilized imported meat and bone meal was contaminated with salmonellas. This compared with 23% of meat and bone meal in England and Wales and 20-27% of other ingredients of animal origin. In England and Wales salmonellas were isolated from 7% of caecal samples and 6% of lymph node samples, while in Denmark they were isolated from 3% of caecal samples and 4% of lymph node samples. In England and Wales 25 serotypes were found in both pigs and feeds and these included nearly all the most prevalent human pathogens. In Denmark four of the six serotypes in pigs had been found in resterilized feed. One notable difference between the two studies was the very wide range of serotypes found in pigs in England and Wales and the narrow range in Denmark. A second was that Salmonella typhimurium formed 15% of all Salmonella strains isolated from pigs in England and Wales, and 60% of those in Denmark.     

Management of pregnancy and childbirth in England and Wales and in France

This paper reviews national data on obstetric and neonatal practices in England and Wales, and in France between 1970 and 1980. The data have been derived from national statistics and surveys on national samples of births in 1970, 1975 and 1980 in England and Wales, and 1972, 1976 and 1981 in France. The analysis shows that there was no major difference in pregnancy outcome, but wide variations in medical practices, and their trend over time. The main differences were: in England and Wales a higher number of antenatal visits, a higher percentage of inpatient admissions during pregnancy, a higher rate of induction, more episiotomies, a higher rate of resuscitation at birth, and admission to neonatal special care units; in France, a higher rate of caesarean sections before and during labour, some evidence of a more active management of labour, and a longer hospital post-natal stay. These differences in practice reflect differences in objectives and assessment of the effectiveness of care between the two countries: they point out the need for better monitoring and evaluation of obstetric and neonatal practices.     

Research and teaching in social and preventive medicine and in public health

Summary Both public health and social and preventive medicine are characterised by the common goal of promoting, maintaining and improving health and preventing disease, and both are concerned with a population-related, preventive and environmental perspective. But whereas public health is interdisciplinary and goes far beyond the medical focus, social and preventive medicine is medically based and forms a bridge between public health and medical practice. Research in a department of social and preventive medicine serves to support preventive and medico-social activities in medical practice as well as in public health. This is illustrated by results from research conducted at the author's department during the last twenty years. Examples are research in support of smoking cessation activities, and research used for the planning of care for the elderly. Both the research and the teaching activities of the department take into account the population focus of public health as well as the focus on individual medicine in clinical practice.

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Forschung und Lehre in Sozial-und Präventivmedizin und öffentlicher Gesundheit

Zusammenfassung Sowohl das Gebiet der öffentlichen Gesundheit als auch dasjenige der Sozial-und Präventivmedizin sind durch das Ziel der Förderung, Erhaltung und Verbesserung der Gesundheit sowie der Krankheitsvorbeugung gekennzeichnet, und beide beschäftigen sich mit einer bevölkerungsbezogenen, präventiven und umweltbezogenen Perspektive. Aber während die öffentliche Gesundheit stark interdisziplinär ist und weit über den medizinischen Fokus hinausreicht, ist die Sozial-und Präventivmedizin ein medizinisches Fach und stellt eine Brücke zwischen der öffentlichen Gesundheit und der ärztlichen Praxis dar. Die Forschung in einem Institut für Sozial-und Präventivmedizin dient der Förderung präventiver und sozialmedizinischer Tätigkeiten in der ärztlichen Praxis wie auch in der öffentlichen Gesundheit. Dies wird durch die Forschungstätigkeit des Instituts des Autors aus den letzten 20 Jahren illustriert, wobei Beispiele aus den Gebieten der Förderung der Raucherentwöhnung und der Betreuung behinderter Betagter dargestellt werden. Sowohl in den Forschungs-als auch in den Lehrtätigkeiten des Instituts finden der Bevölkerungsbezug der öffentlichen Gesundheit wie auch der individualmedizinische Ansatz der ärztlichen Praxis ihren Ausdruck.

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La recherche et l'ensignement en médecine sociale et préventive et en santé publique

Résumé La santé publique aussi bien que la médecine sociale et préventive sont caractérisées par le but commun de promouvoir, maintenir et améliorer l'état de santé et de prévenir les maladies, et elles s'orientent vers une perspective de population, de prévention et environnementale. Mais la santé publique est interdisciplinaire et va loin au-delà de la médecine, tandis que la médecine sociale et préventive est basée sur la médecine et représente le lien entre la santé publique et la pratique médicale. La recherche d'un institut de médecine sociale et préventive sert à appuyer les activités préventives et médico-sociales au cabinet médical aussi bien qu'en santé publique. Cela est illustré par des résultats de recherches conduites dans les vingt années passées à l'institut de l'auteur, et les exemples sont tirés de la recherche en appui de la promotion de la cessation de fumée et de la planification de la prise en charge des personnes âgées et handicapées. Les activités de recherche et de l'enseignement de l'institut tiennent compte de la perspective de population cacactéristique de la santé publique, aussi bien que de la dimension de médecine individuelle caractéristique de la pratique clinique.

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Paper presented at a symposium on The Public Health Perspective of Social and Preventive Medicine, in celebration of the 20th anniversary of the Department of Social and Preventive Medicine, University of Berne, 25 June 1992 in Berne.     

Eggs enriched in omega-3 fatty acids and alterations in lipid concentrations in plasma and lipoproteins and in blood pressure

Effects of dietary eggs enriched with omega-3 fatty acids on lipid concentrations in plasma and lipoproteins and blood pressure were determined in 11 men and women in two groups. Group 1 consumed four omega-3 eggs per day during the first 4-wk period and four control eggs for the second 4-wk period. Group 2 ate the same number of eggs in the reverse order. Mean plasma cholesterol concentration was significantly increased by control eggs (P less than 0.01) but unchanged by omega-3 eggs. Mean plasma triglyceride concentration was decreased by omega-3 eggs but increased by control eggs. Both systolic and diastolic blood pressures were significantly lowered by omega-3 eggs in group 1 whereas only systolic pressure was significantly decreased on omega-3 eggs in group 2. The control eggs did not change blood pressure. In conclusion, the omega-3 eggs may be more healthful than the control eggs.     

Selenium levels in human blood and tissues in health and in disease.

The levels of selenium in human sera and pancreatic, hepatic and synovial tissues were measured. An attempt was made to correlate the selenium level with certain disease states. Selenium was determined by nerutron activation analysis, using the 17.4 second half-life isotope 77mSe with a sensitivity of 2ppb. Serum-bound selenium was determined in normal individuals and individuals with various malignancies, and medical and surgical disorders. Tissue selenium was assayed in diseased and normal pancreases, livers, and synovial membranes. A wide variation was observed both in the serum selenium content of patients with a malignancy and in postmoren pancreatic and synovial showing histopathological changes. Significantly lower selenium values were observed in sera from cancer patients than from normal individuals. Higher values were generally observed in patients with primary neoplasms of the reticuloendothelial system. Higher tissue concentrations were obtained in synovia from patients with rheumatoid arthritis and in pancreatic tissues associated with histopathological changes.     

Prevalence and Trends in Overweight in Mexican-American Adults and Children

Overweight and obesity have been increasing in many countries. Our objective is to describe the trends in overweight and obesity occurring in the Mexican-American population in the United States. Data on measured height and weight for Mexican Americans come from the following surveys: the Hispanic Health and Nutrition Examination Survey (HHANES, 1982–84), the Third National Health and Nutrition Examination Survey (NHANES III, 1988–94), and NHANES 1999–2002. In 1999–2002, 73% of Mexican-American adults were overweight and 33% were obese. Obesity increased between NHANES III and NHANES 1999–2002, from 24% to 27% for men and from 35% to 38% for women. Increases were also seen for children and adolescents. The Mexican-American population in the United States, both children and adults, is showing trends in overweight and obesity over time that are similar to those seen in other segments of the U.S. population and indeed in many countries