辽宁省一般人群血和尿中铅水平研究

目的调查辽宁省一般人群血和尿中铅水平,分析其分布特点。方法采用整群随机抽样方法,2009—2010年在辽宁省东部、西部和中部抽取2105名6~60岁人群为调查对象,分别采集血液和尿液样品,应用电感耦合等离子体质谱法检测血和尿液中铅水平,并分析年龄、性别和区域对血和尿中铅水平的影响。结果辽宁省一般人群全血中铅的几何均数为29.04μg/L,男性和女性分别为35.11、24.33μg/L(Z=-18.5,P0.01),东、中、西部人群分别为30.59、27.27和29.43μg/L(χ2=21.58,P0.01),吸烟和不吸烟人群分别为42.28、27.46μg/L(Z=-11.52,P0.01),饮酒和不饮酒人群分别为40.39、27.89μg/L(Z=-8.82,P0.01);一般人群尿铅的几何均数为3.22μg/L,男性和女性分别为3.37、3.08μg/L(Z=-1.96,P=0.05);东、中、西部人群分别为3.21、2.22和4.74μg/L(χ2=297.71,P0.01)。结论辽宁省一般人群血铅和尿铅水平存在性别及地区差异,并与吸烟和饮酒有关。     

辽宁省一般人群血和尿中镉水平研究

目的调查辽宁省一般人群血和尿中镉水平,分析其分布特点。方法采用整群随机抽样方法,2009—2010年在辽宁省东部、西部和中部抽取2105名6~60岁人群为调查对象,分别采集血液和尿液样品。应用电感耦合等离子体质谱法检测血和尿液中镉水平,并分析年龄、性别和区域对血和尿中镉水平的影响。结果辽宁省一般人群全血中镉的几何均数为0.45μg/L;男性和女性分别为0.58、0.35μg/L(Z=-6.32,P0.01);东、中、西部人群分别为0.41、0.31和0.77μg/L(χ2=160.63,P0.01);吸烟和不吸烟人群分别为3.7、0.31μg/L(Z=-20.95,P0.01);饮酒和不饮酒人群分别为2.25、0.36μg/L(Z=-13.52,P0.01)。一般人群尿镉几何均数为0.44μg/L;男性和女性分别为0.46、0.43μg/L(Z=-1.88,P0.05);东、中、西部人群分别为0.38、0.40和0.56μg/L(χ2=61.72,P0.01);吸烟和不吸烟人群分别为0.60、0.41μg/L(Z=-5.82,P0.01);饮酒和不饮酒人群分别为0.64、0.41μg/L(Z=-5.73,P0.01)。结论辽宁省一般人群血镉和尿镉水平存在性别及地区差异,并与吸烟和饮酒有关。     

辽宁省一般人群全血和尿液中砷水平分布的研究

目的了解辽宁省一般人群全血和尿液中砷水平的分布,并分析其流行分布特点。方法采用整群随机抽样的方法,于2009—2010年在辽宁省东、中、西部3个城市的区县中,抽取2 105名6~60岁人群作为调查对象,进行血、尿样品采集和问卷调查。应用电感耦合等离子体质谱法检测样品中砷水平,分析在不同性别、年龄、地区和生活方式中砷水平分布情况。结果调查对象血砷几何均数为3.68μg/L,95%CI为3.55~3.80μg/L,男性血砷几何均数(3.90μg/L)高于女性(3.46μg/L)(P0.01)。各年龄组血砷的几何均数差异具有统计学意义(P0.01),其中46~60岁年龄组血砷最高(为5.07μg/L),17~20岁年龄组血砷最低(为2.19μg/L)。辽宁省东、中、西部地区人群血砷几何均数分别为5.06、2.67和3.15μg/L(P0.01)。调查对象尿砷几何均数为21.27μg/L,95%CI为20.37~22.25μg/L。男性尿砷几何均数(22.76μg/L)显著高于女性(19.85μg/L)(P0.01)。不同年龄组人群尿砷几何均数差异有统计学意义(P0.01),其中13~16岁年龄组尿砷最低(为14.97μg/L),31~45岁年龄组尿砷最高(为32.04μg/L);辽宁省东、中、西部地区人群尿砷几何均数分别为25.81、17.34和21.40μg/L(P0.01)。在吸烟、饮酒和摄食海鲜人群中血砷、尿砷均增高(P0.01)。辽宁省一般人群血砷水平与尿砷水平呈正相关(r=0.189,P0.01)。辽宁省一般人群血砷几何均数(3.68μg/L)高于全国一般人群(2.33μg/L)(P0.01);辽宁省尿砷几何均数(21.27μg/L)高于全国(13.72μg/L)(P0.01)。结论辽宁省一般人群血砷和尿砷水平在性别、年龄、区域和生活方式特征中均存在差异。辽宁省一般人群血砷和尿砷水平显著高于全国一般人群水平。     

辽宁省一般人群尿中2,5-己二酮水平研究

目的调查辽宁省一般人群尿中2,5-己二酮水平,分析其人群分布特点。方法将辽宁省划分为东、中、西部地区,采用多阶段分层整群随机抽样的方法,于2009—2010年从东、中、西部三个地区抽取1373名对象进行问卷调查,并采集尿液样品,采用气相色谱-离子阱二级质谱法对尿中2,5-己二酮的含量进行检测,统计分析一般人群尿中2,5-己二酮的分布水平。结果辽宁省一般人群尿中2,5-己二酮几何均数为0.18μg/L,男性和女性尿中2,5-己二酮几何均数分别为0.19μg/L、0.18μg/L(Z=-2.87,P0.01)。结论辽宁省一般人群尿中2,5-己二酮水平存在性别及地区差异。     

辽宁省一般人群血和尿中硒水平的分布

采用整群随机抽样方法，在辽宁省3个不同地区抽取3个代表性城市的2 105名调查对象，进行问卷调查并采集血液和尿液。采用电感耦合等离子质谱法（ICP-MS）对血液和尿液样品分别进行硒含量的检测。结果显示，辽宁省一般人群血硒几何均数为210.57μg/L，男性和女性血硒几何均数分别为215.18、205.98μg/L（Z=—4.54，P<0.01）；尿硒几何均数为6.58μg/L，男性和女性尿硒几何均数分别为7.94、5.44μg/L（Z=—8.87，P<0.01）。提示辽宁省不同地区、性别、年龄的一般人群血硒和尿硒水平存在差异。     

辽宁省一般人群尿中铜、锌水平研究

目的调查辽宁省一般人群尿中铜、锌水平,分析其人群分布特点。方法将辽宁省划分为东、中、西部地区,采用多阶段分层整群随机抽样的方法,于2009—2010年辽宁省东、中、西部抽取1691名对象进行问卷调查,并采集尿液样品。用电感耦合等离子体质谱法检测尿中铜、锌含量,通过统计分析研究一般人群尿中铜、锌的分布水平。结果调查对象尿铜几何均数(95%CI)为10.59μg/L,中位数(P50)为10.70μg/L;男性尿铜几何均数显著高于女性(P0.01);不同年龄组人群尿铜几何均数差异具有统计学意义(P0.01),其中17~20岁年龄组尿铜最高,21~30岁年龄组尿铜最低;辽宁省东、中、西部地区人群尿铜几何均数差异有统计学意义(P0.01),分别为10.69、8.71和12.73μg/L;吸烟与饮酒特征中人群尿铜几何均数差异均有统计学意义(P0.01)。尿锌95%CI为77.26μg/L,P50为85.09μg/L;男性尿锌几何均数显著高于女性(P0.01);不同年龄组人群尿锌几何均数差异具有统计学意义(P0.01),其中6~12岁年龄组尿锌最高,31~45岁年龄组尿锌最低;辽宁省东、中、西部地区人群尿锌几何均数差异具有统计学意义(P0.01);吸烟与饮酒特征中人群尿锌几何均数差异均有统计学意义(P0.05)。结论辽宁省一般人群尿中铜、锌水平在不同性别、年龄、区域特征中均存在差异。     

辽宁省一般人群全血和尿液中铬水平分析

目的了解2009—2010年辽宁省一般人群全血和尿液中铬水平(以下简称血铬、尿铬),分析其流行病学特点。方法 2009—2010年采用整群随机抽样方法,从辽宁省内东、中、西部3个城市抽取2 105名6~60岁一般人群作为研究对象,对其生活环境和健康状况问卷调查,并分别采集2 105份静脉抗凝血和1 691份尿样,应用电感耦合等离子体质谱法检测血铬、尿铬水平,分析不同年龄、性别和区域人群的分布情况。结果辽宁省一般人群血铬几何均数为0.53μg/L,中位数为0.3μg/L,P95为2.92μg/L;男性和女性几何均数分别为0.49、0.58μg/L(P0.01);6~12、13~16、17~20、21~30、31~45、46~60岁年龄组血铬几何均数分别为0.38、0.57、0.66、0.55、0.57和0.52μg/L(P0.01);东、中、西部地区人群血铬几何均数分别为0.32、1.23、0.42μg/L(P0.01)。辽宁省一般人群尿铬几何均数低于检出限0.42μg/L,对不同特征中尿铬高于检出限人数分布比较结果显示,不同年龄、地域人群尿铬水平差异有统计学意义(P0.01)。结论辽宁省血铬、尿铬水平均低于全国一般人群血铬、尿铬水平,本研究为进一步开展铬的生物监测、鉴别排除职业禁忌症等研究提供了基础数据。     

辽宁省一般人群全血中铜和锌水平分布的研究

目的了解辽宁省一般人群血中铜、锌水平的分布,并分析其分布特点。方法采用整群随机抽样的方法,于2009—2010年在辽宁省东、中、西部3个城市的区县中,抽取了2 105名6~60岁人群作为调查对象,进行问卷调查及血液样品采集。应用电感耦合等离子体质谱法检测样品中铜、锌水平,分析探讨在不同性别、年龄、地区以及生活方式中铜、锌水平分布情况。结果调查对象血铜几何均数为783μg/L,95%CI为775~791μg/L,P5、P50和P95分别为555、785和1 059μg/L。男性血铜几何均数(778μg/L)低于女性(788μg/L)(P0.01)。不同年龄组人群血铜几何均数差异有统计学意义(P0.01),其中6~12岁年龄组血铜最高(为853μg/L),13~16岁年龄组血铜最低(为649μg/L);辽宁省东、中、西部地区人群血铜几何均数分别为706、852和837μg/L,差异有统计学意义(P0.01);在吸烟与饮酒特征中人群血铜几何均数差异均无统计学意义(P0.05)。调查对象血锌几何均数为4 158μg/L,95%CI为4 115~4 201μg/L,P5、P50和P95分别为2 657、4 243和5 931μg/L。男性血锌几何均数(4 258μg/L)显著高于女性(4 058μg/L)(P0.01);不同年龄组人群血锌几何均数差异具有统计学意义(P0.01),其中,6~12岁年龄组血锌最低(为3 574μg/L),31~45岁年龄组血锌最高(为4 593μg/L);辽宁省东、中、西部地区人群血锌几何均数分别为4 315、3 811和4 286μg/L,差异有统计学意义(P0.01);吸烟和饮酒人群血锌高于不吸烟、不饮酒人群,差异均有统计学意义(P0.01)。辽宁省一般人群血铜几何均数(783μg/L)低于全国一般人群血铜(795μg/L)(P0.01)。辽宁省一般人群血锌几何均数(4 158μg/L)高于全国一般人群血锌(3 996μg/L)(P0.01)。结论辽宁省一般人群血液中铜、锌水平在不同性别、年龄、区域特征中均存在差异。辽宁省一般人群血铜水平显著低于全国一般人群,而辽宁省血锌水平显著高于全国一般人群水平。     

辽宁省一般人群血和尿中钴、钼水平研究

目的调查辽宁省一般人群血和尿中钴、钼水平,分析其分布特点。方法采用多阶段分层整群随机抽样的方法,于2009—2010年在辽宁省东、中、西部三个地区抽取2105名对象进行问卷调查,并采集血液和尿液样品。采用电感耦合等离子体质谱法对血样和尿样进行钴、钼含量的检测,通过统计分析研究一般人群血液中钴、钼的分布水平。结果辽宁省一般人群血中钴、钼几何均数为0.153μg/L和0.38μg/L,尿中为0.516μg/L和23.88μg/L;在不同年龄和区域特征中差异均有统计学意义。结论辽宁省一般人群血和尿中钴、钼水平在不同年龄和区域特征中均存在差异。     

我国8省市一般人群尿中镓、铟、铊水平分布的研究

目的了解我国一般人群尿中镓、铟、铊水平,分析其人群分布特征。方法于2009—2010年,在我国东部、西部和中部8个省(市、自治区)的24个地区,采用分层整群随机抽样的方法抽取了18 120名(6~60)岁人群为研究对象,对其生活习惯和健康状况进行了问卷调查,并采集其尿液样品。应用电感耦合等离子体质谱法对尿样进行镓、铟、铊含量检测,统计分析性别、不同年龄人群尿中镓、铟、铊水平的分布。结果我国一般人群尿镓第50百分位数LOD(0.08μg/L);第95百分位数为1.72μg/L;男性和女性尿镓第50百分位数均LOD(0.08μg/L),男性和女性人群尿镓检出率分别为26.5%,21.6%(χ~2=43.478,P0.01)。一般人群尿铟第50百分位数为LOD(0.03μg/L),第95百分位数为0.61μg/L;男性和女性尿铟第50百分位数均为LOD(0.03μg/L),男性和女性人群尿铟检出率分别为16.3%,18.1%(χ~2=5.234,P0.05);一般人群尿铊几何均值为(0.17±0.01)μg/L,第50百分位数为0.27μg/L,第95百分位数为1.37μg/L。男性和女性尿铊几何均值分别为(0.18±0.01)μg/L、(0.16±0.01)μg/L(Z=4.86,P0.01);男性和女性人群尿铊检出率分别为84.0%,83.0%(χ~2=2.577,P0.05)。结论本研究报道了我国2009—2010年一般人群尿中镓、铟、铊的含量和分布水平,为进一步开展镓、铟、铊的生物监测等研究提供基础数据。     

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.     

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.     

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.     

Bacteriology and constitutional health--genomics and proteomics: concepts in medicine and concepts in health insurance in the past and future

Future discussions on health issues on the individual or society level will be fundamentally linked to genetic dispositions. This genetic world will become reality in the same way the world of hygiene and bacteriology has become real for everyone. Approaches of molecular medicine for public health issues have not yet been created so far. The secret dreams of molecular eugenics must be made public and critically discussed. Up to now only a few monogenetically recessive hereditary diseases can be detected by screening. This kind of screening should be carefully considered. However, for the sciences, for medicine and thus for the physicians in practice, for health care sciences as well as for public health care, new tasks will emerge from genetics and molecular medicine. In individual as well as public health these new tasks will at first mainly turn in on the sphere of diagnosis and specific screening as well as health education and consultation. With regard to the considerable social implications the public health care sector should be aware of the coming issues of molecular medicine in time.     

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