山东泰安地区两个自然村人群血脂状况调查

目的:调查了解山东泰安地区农村人群的血脂水平,为该地区农民心脑血管疾病的预防提供基础数据。方法:实验于2006-06随机选取泰安市两个自然村650人进行健康检查,男270人,女380人,年龄2～88岁。①650人均于早晨空腹采集静脉血3mL,静置凝固后,2h内分离血清,采用全自动生化分析仪常规测定患者血脂指标总胆固醇、三酰甘油水平。②总胆固醇>5.2mmol/L判定为高胆固醇血症,三酰甘油>1.7mmol/L判定为高三酰甘油血症。结果:650人全部完成血样采集与血脂指标检测。①不同性别血脂水平比较:被检人群男性三酰甘油水平显著高于女性[(1.16±1.47),(0.95±0.84)mmol/L,P<0.05];男女总胆固醇水平基本相似(P>0.05)。②不同年龄段血脂水平比较:8人因具体年龄段不祥被排除,剩余642人分为3个年龄段:2～30岁、31～50岁、51～88岁。结果31～50岁人群三酰甘油水平显著高于2～30岁人群[(1.14±1.47),(0.88±0.70)mmol/L,P<0.05],略高于51～88岁人群(P>0.05);51～88岁人群总胆固醇水平>31～50岁人群>2～30岁人群,相邻年龄段间比较差异均有显著性意义(P<0.001)。③各年龄段男女间血脂水平比较:2～30岁人群和51～88岁人群三酰甘油水平性别间差异均无显著性意义(P>0.05),但总胆固醇水平女性均显著高于男性[(2.38±1.47),(1.85±1.26)mmol/L,P<0.05;(4.48±0.92),(4.18±0.76)mmol/L,P0.01]。31～50岁人群男性三酰甘油水平显著高于女性[(1.51±2.06),(0.90±0.80)mmol/L,P<0.01],总胆固醇水平基本相似(P>0.05)。④各年龄段男女高血脂症构成比:31～50岁人群高三酰甘油血症构成比显著高于2～30岁、51～88岁人群(23.1%,5.5%,9.3%,P<0.01);随着年龄增高,各年龄段高胆固醇血症构成比逐渐升高,相邻年龄段间差异均有显著性意义(2.7%,8.6%,15.6%,P<0.01)。31～50岁人群男性高三酰甘油血症、高胆固醇血症的构成比显著高于女性(P<0.01);2～30岁、51～88岁人群男女间高血脂症的构成比基本相似(P>0.05)。结论:①山东泰安地区农村人群高三酰甘油血症,31～50岁年龄段患病率最高;高胆固醇血症患病率随年龄增长逐步上升,提示中年人健康体检尤为重要。②高脂血症应从青少年开始加大预防和保健力度,进行广泛和反复的健康教育,倡导健康的生活方式和生活行为。     

The impact of foodborne calicivirus disease: the Minnesota experience

The first outbreaks of Norwalk virus gastroenteritis in Minnesota were confirmed in 1982. Since then, Norwalk-like caliciviruses have been recognized to be the most common cause of foodborne disease outbreaks, accounting for 41% of all confirmed foodborne outbreaks in Minnesota from 1981-1998. Although laboratory confirmation of caliciviruses in stool samples was not attempted in most of these outbreaks, all conformed to epidemiologic criteria for defining outbreaks of Norwalk virus. Since 1996, the availability of polymerase chain reaction testing at the Minnesota Department of Health has allowed for the confirmation of calicivirus infection among patients involved in epidemiologically defined outbreaks of viral gastroenteritis. Results have confirmed the usefulness of characterizing foodborne disease outbreaks by epidemiologic criteria and also confirmed the importance of human caliciviruses as the leading cause of foodborne disease outbreaks in Minnesota.     

Where's the beef? The role of cross-contamination in 4 chain restaurant-associated outbreaks of Escherichia coli O157:H7 in the Pacific Northwest

BACKGROUND: From March through August 1993, outbreaks of Escherichia coli O157:H7 occurred at 4 separate Oregon and Washington steak and salad bar restaurants affiliated with a single national chain. OBJECTIVE: To determine the cause of outbreaks of E coli O157:H7 at 4 chain restaurants. METHODS: Independent case-control studies were performed for each outbreak. Available E coli O157:H7 isolates were subtyped by pulse-field gel electrophoresis and by phage typing. RESULTS: Infection was not associated with beef consumption at any of the restaurants. Implicated foods varied by restaurant but all were items served at the salad bar. Among the salad bar items, no single item was implicated in all outbreaks, and no single item seemed to explain most of the cases at any individual restaurant. Molecular subtyping of bacterial isolates indicated that the first 2 outbreaks, which occurred concurrently, were caused by the same strain, the third outbreak was caused by a unique strain, and the fourth was multiclonal. CONCLUSIONS: Independent events of cross-contamination from beef within the restaurant kitchens, where meats and multiple salad bar items were prepared, were the likely cause of these outbreaks. Meat can be a source of E coli O157:H7 infection even if it is later cooked properly, underscoring the need for meticulous food handling at all stages of preparation.     

Releasing pre-adoption birth records: a survey of Oregon adoptees

OBJECTIVE: In June 2000, Oregon implemented a citizen-initiated ballot measure that grants adult adoptees access to their birth records, which contain their birth parents' identifying information. Because other states are considering similar policy changes, the authors explored whether Oregon's new law is meeting the information needs of adoptees. METHODS: Birth records were abstracted for a 9% (221/2,529) random sample of adoptees who obtained their records from June 20, 2000, to July 20, 2000, to describe the population and the information they obtained. Telephone interviews documented their motivations, expectations, and whether they considered the birth record useful. RESULTS: The mean age of the adoptees was 41 years, 64% were female, and 97% were white. Virtually all received information about their birth mother; however, only one-third received information about their birth father. Of the 221 sampled, 123 (59%) participated in the telephone survey, 12 were ineligible, 84 could not be reached, and 2 refused. The most common motivations for requesting records were to find birth parents (29%) and to obtain medical information (29%). Twenty-nine percent received less information than they expected, with many expecting, but not receiving, birth father information. Thirty-three (47%) of the 70 adoptees who tried to find their birth mother were successful. The records were considered "very" useful by 52% of respondents, "somewhat" or "a little" useful by 42%, and "not at all" useful by 6%. CONCLUSIONS: The results indicate that many adoptees received less information than they expected, and many did not meet their goals of finding birth parents or obtaining medical information. Nonetheless, the majority considered their birth records useful and important.     

Effets tardifs des radiations ionisantes sur les tissus de la sphère otorhinolaryngologique

Numerous structures are included in the irradiated volume of patients presenting with head and neck cancer: skin, mucosa, bone, teeth, cartilage, muscles, salivary glands, etc. Curative intent treatment of such tumours requires aggressive approach which can lead to severe sequellae. These sequellae are in most cases dose-dependent and volume-dependent. However, an appropriate technique might decrease the severity of such sequellae. Details of these late changes are presented, including their pathophysiology, clinical syndromes, potential treatment, and prevention.     

Ambulatory blood pressure monitoring

Ambulatory blood pressure monitoring (ABPM) in adults is proving to be useful. The aim of this study was to determine if ABPM is accurate in the lower blood pressure range encountered in children and, equally important, whether it is acceptable to children. Thirty one children, between the ages of 6 and 18 years, were assessed using an ambulatory blood pressure monitor that uses an auscultatory method. Blood pressure was measured in the contralateral arm with a mercury sphygmomanometer and an oscillometric device at the beginning and end of the study for comparison. Over a blood pressure range of 90-130 mm Hg systolic and 40-80 mm Hg diastolic, a close agreement was found with the sphygmomanometer; the limits of agreement (+/- 2 SD) were 11.6 mm Hg for systolic blood pressure and 13.6 mm Hg for diastolic blood pressure. The bias was less than 1.0 mm Hg. The ambulatory device was worn by all patients for at least 16 hours with an average of 52 recordings per patient. The majority found the device comfortable to wear and were not woken from sleep.     

The STR system in the human phenylalanine hydroxylase gene: true fragment length obtained with fluorescent labelled PCR primers

We present a simple, fast, non-radioactive method for the analysis of the polymorphic short tandem repeat (STR) system in the human phenylalanine hydroxylase gene. Previously, sizing of the STR marker involved radiolabelling of PCR amplified fragments and resolution on denaturing polyacrylamide gels using M13 sequencing ladder as a standard. However, this method consistently gave sizes 2 bp longer than the known sequence. The fluorescent method presented here employs internal lane standards and enables accurate sizing of the fragments. To avoid confusion, we suggest that the true fragment lengths are used as reference values in the future. The analysis of STR alleles is valuable for population genetic studies and for targeted mutation screening in phenylketonuria (PKU). It can replace RFLP-based haplotype analysis for carrier detection, and we report its use for prenatal diagnosis in a Northern Irish family with PKU. The analysis of 250 Northern Irish chromosomes, including 128 PKU alleles, showed no significant difference between normal and PKU alleles, with fragment lengths of 238 and 242 bp most common in both groups.