体质指数与高血压关系Meta分析

目的估计成年人体质指数与高血压患病之间的关系。方法通过文献检索收集1990年以来的国内体质指数与高血压患病关系的现况调查,经质量评估最终23篇入选并进行Meta分析。结果通过固定效应模型估算20岁以上体质指数≥24与体质指数≥25人群患高血压的相对危险度分别为2.93和2.96。结论较高的体质指数是高血压的重要危险因素。     

肥胖对高血压、高血糖的预测作用分析

目的探讨体质指数、腰围及腰臀比对高血压、高血糖的预测作用。方法采用分层整群抽样法调查20岁以上,在深圳居住5年及以上8 207名常住社区居民高血压、糖尿病患病与肥胖相关数据,进行偏相关分析、交互作用分析,并在体质指数、腰围及腰臀比各切点上进行相对危险度、归因危险比、人群归因危险比分析。结果按性别分层,控制年龄进行相关分析显示血压、血糖与BMI、WC、臀围、WHR呈正相关(P(0.0001)。交互作用分析提示,BMI与WC、BMI与WHR 对高血压、高血糖、二者聚集有交互作用。BMI、WC取不同切点,各自对高血压、高血糖及二者聚集的人群危险度及归因比分析提示,BMI切点在25及以上者约占23%,控制此切点,可改善总人群 34%的高血压,23%的高血糖,44%的危险因素聚集。而男性WC切点在85cm及以上,女性WC切点在 80cm及以上者占总人群的29%,控制此因素可改善总人群45%的高血压,33%的高血糖,59%的危险因素聚集。结论结合分析偏相关系数,高血压、糖尿病的危险度,及人群预防的公共卫生意义,筛选深圳市该类疾病高危人群适当的界点是:高血压取BMI≥25cm,高血糖取男性WC≥85cm, 女性WC≥80c...     

超重肥胖及年龄对高血压患病的交互作用分析

目的 探讨超重肥胖及年龄与高血压患病的关系，以及两者对高血压患病的交互作用。方法 采用χ²检验和logistic回归模型，探讨超重肥胖及年龄与高血压患病的关系；采用相加交互作用模型，通过相加交互超额相对危险度(the relative excess risk of interaction, RERI)、归因比(the attributable proportion due to interaction, AP)和交互作用指数(the synergy index, SI),探讨两者对于高血压患病的交互作用及其强度。结果 本研究纳入1 215名调查对象，高血压患病率为33.17%,其中≥60岁人群为67.85%。对相关因素进行调整后，年龄≥60岁的高血压患病风险是<60岁的8.56倍(95%CI:6.39～11.47),超重肥胖者的高血压患病风险是非超重肥胖者的2.13倍(95%CI:1.64～2.76)。在调整相关混杂因素后，<60岁超重肥胖、≥60岁非超重肥胖、≥60岁超重肥胖人群的高血压患病风险，分别是<60岁非超重肥胖人群的3.14倍(95%...     

血脂异常和腹型肥胖的交互作用对糖尿病患病的关系研究

目的探讨血脂异常和腹型肥胖交互作用对糖尿病患病的影响,为糖尿病的防治提供科学依据。方法采取多阶段分层随机抽样对贵州省8个县/区的居民进行调查。采用Logistic回归分析影响糖尿病患病主要危险因素。采用Logistic回归相加尺度分析血脂异常和腹型肥胖交互作用对糖尿病患病的影响。结果贵州省成年居民糖尿病患病率6. 4%,调整年龄、城乡等混杂因素后,血脂异常和腹型肥胖均与糖尿病患病存在统计学关联(P 0.01)。交互作用分析显示,血脂异常和腹型肥胖与糖尿病患病存在协同的相加交互作用(RERI=1.74;95%CI:0.57~2. 90)。分层交互作用分析显示,仅在正常体质指数人群中,血脂异常和腹型肥胖与糖尿病患病存在协同的相加交互作用(RERI=2. 21; 95%CI:0.22~4. 20)。同时患有腹型肥胖与血脂异常的居民患糖尿病的风险更高(OR=4. 49, 95%CI:2.79~7. 21)。结论正常体质指数人群中血脂异常和腹型肥胖存在交互作用致使糖尿病患病风险显著提升,加强对居民特别是正常体质指数居民血脂和腰围的控制会有效降低糖尿病的患病风险。     

深圳市居民体质指数,腰臀围比与糖尿病的关系研究

采用分层整群抽样方法,研究了深圳市５ 个行政区年龄在２０ 岁以上,在深圳居住５ 年及以上８２００ 名常住社区居民肥胖与糖尿病的关系结果表明,深圳居民体质指数（ＢＭＩ） ≥２５ 的人群糖尿病患病率和ＩＧＴ 患病率明显高于体质指数（ＢＭＩ） ＜２５ 的人群,肥胖人群糖尿病患病率和ＩＧＴ 患病率分别是非肥胖人群的２．６ 倍和２３ 倍。随腰围、臀围及两者之比的升高,糖尿病患病率和ＩＧＴ患病率升高;腰臀围比≥１ 和＜１人群糖尿病患病率和ＩＧＴ 率之比分别为１：５ 和１：２５。研究结果还表明,随腰围的增加两率增加更加明显,腰围平均每增加１ｃｍ 糖尿病患病率增加０５％ ,ＩＧＴ 患病率增加１０％     

代谢综合征组分对2型糖尿病的预测作用及调控意义

目的探讨社区居民糖尿病患病情况及代谢综合征组分对2型糖尿病的预测作用与调控意义。方法采用分层整群抽样方法对徐州市社区20岁以上成人糖尿病及代谢综合征的患病情况进行研究,SPSS16.0软件进行统计分析。结果社区人群糖尿病、代谢综合征患病率分别为4.4%、10.3%,代谢综合征中糖尿病患病率高于一般人群(P﹤0.05)。排除血糖后,代谢综合征单组分中体质指数(OR=1.692,95%CI 1.139～2.515),血压(OR=4.152,95%CI 2.814～6.126)是糖尿病的独立预测因子。代谢综合征多组分组合中体质指数合并高血压和高甘油三酯组(OR=3.218,95%CI 2.037～5.082,P﹤0.01)对糖尿病的预测作用最强。结论代谢综合征单组分体质指数和高血压是2型糖尿病的独立预测因素,体质指数合并高血压和高甘油三酯聚合体对2型糖尿病有较强预测作用。对代谢综合征组分的综合调控可能对糖尿病及心脑血管疾病的预防具有公共卫生意义。     

心血管病高危人群腰围和体质指数变化与空腹血糖水平变化关系纵向数据分析

目的 探讨心血管病高危人群腰围和体质指数变化与空腹血糖水平变化的关系,为糖尿病和心血管病的防治提供理论参考依据。方法 于2015年9月—2016年6月基于“中国心血管病高危人群早期筛查与综合干预项目”在江苏省徐州市、连云港、盐城市等8个项目点招募71 758名≥35岁常住居民进行基线调查,对筛查出的12 369名初筛血糖水平记录完整的心血管病高危人群分别于2017、2018和2019年每年进行1次随访调查,采用广义估计方程分析心血管病高危人群腰围和体质指数变化与空腹血糖水平变化的关系。结果 江苏省完成3次随访且随访血糖水平完整的9 952名心血管病高危人群中,正常腰围、中心性肥胖前期和中心性肥胖分别有3 045人(30.6%)、2 130人(21.4%)和4 777人(48.0%),体重过轻、正常体重、超重和肥胖分别有56人(0.6%)、2 669人(26.8%)、4 540人(45.6%)和2 687人(27.0%)。在调整了性别、年龄、文化程度、居住地、吸烟情况、饮酒情况、是否高血压、是否糖尿病、是否血脂异常、基线腰围、基线体质指数和随访次序等混杂因素后,广义估计方程分析结果显示,...     

华泾镇干部人群2型糖尿病糖耐量低减与肥胖的关联

目的探讨2型糖尿病、糖耐量低减与肥胖的关系。方法根据1997年美国糖尿病协会（ADA）糖尿病诊断标准，采用随机抽样的方法进行横断面调查研究。随机选取具有干部工作经历的215人开展流行病学调查，针对肥胖因素进行单因素分析。结果该人群总体2型糖尿病的患病率为3．26％，糖耐量低减的患病率为15．35％。体重指数高（BMI≥25）的人群糖尿病的患病率为5．80％，糖耐量低减的患病率为23．2％；肥胖人群中腰臀比大者即向心性肥胖者（男性≥0．9，女性≥0．85）；2型糖尿病的患病率为8．20％，糖耐量低减的患病率为31．15％。结论糖尿病与肥胖相关联，体重指数和腰臀比的增大，可增加2型糖尿病的发病危险性。     

孕妇体质指数与妊娠期糖尿病关系

目的探讨孕期体质指数增长速度与妊娠期糖尿病（GDM）发病率的关系。方法通过流行病学调查和产检测量获得一般资料；通过实验室检查确诊妊娠期糖尿病。采用非条件Logistic回归分析孕期体质指数增加与妊娠期糖尿病的关系。结果多因素回归分析显示，孕期体质指数（BMI）增加大（OR=89．1274，95％CI=6．2574～95．1757）、孕前体质指数大（OR=8．1826，95％CI=7．1804～41．3126）、有糖尿病家族史（OR=4．1254，95％CI=4．0247～27．2024）、年龄大（OR=2．4322，95％CI=2．2815～15．2251）均增加孕妇发生妊娠期糖尿病的风险；未发现身高与妊娠期糖尿病发病有关。排除孕前体重干扰后，孕期体重增长速度越快，发生妊娠期糖尿病的风险越大。结论孕期体质指数增长过快是妊娠期糖尿病的独立危险因素。     

上钢社区部分居民血糖异常情况的调查与分析

目的通过对社区482例社区居民的现况调查,了解上钢社区糖尿病患病情况,从而有针对性地开展预防和干预。方法随机选择上钢社区2个居委,按5％的比例随机抽取20岁以上的居民482人,通过糖尿病现况问卷调查,统计分析现在糖尿病患者的基本情况。结果上钢社区的糖尿病患病率为17．84％,IGT患病率为7．8％。40岁以上人群是体质指数超标和血糖异常的主要患者。结论应当加强社区40岁以上人群的糖尿病筛查工作,特别是餐后血糖的筛查。     

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.