建德市肾综合征出血热Ⅰ型灭活疫苗随机对照现场中对照组人群隐性感染定群研究

目的：用定群血清流行病学方法研究ＨＦＲＳ疫苗效果考核现场对照组人群隐性感染情况及感染后抗体水平的变化。方法：采用ＩＦＡＴ检测血清中ＨＦＲＳＩｇＧ抗体,分析不同性别和年龄的隐性感染及感染后抗体水平变化情况。结果：对照组３６０人随访４０个月（１９９４年７月至１９９７年１１月）,ＨＦＲＳ年感染率２９３％,不同性别和年龄组未见显著差异;３２名隐性感染者ＨＦＲＳ抗体转阴率４６８８％,也可见ＨＦＲＳ抗体上升率达２５００％,在不同ＨＦＲＳ抗体滴度、性别和年龄组中未见显著差异。结论：此研究结果将为疫苗现场效果评价提供一些背景资料     

铸造工人肺癌死亡队列研究

以三个工厂３ ２７９名铸钢、铸铁工为暴露组, 以同厂１ １７６ 名机加、修机工为非暴露组, 对１９７２ 年１ 月１ 日在册的队列成员进行了回顾性队列研究。观察期自１９７２ 年１ 月１ 日至１９９２ 年１２ 月３１ 日。结果表明, 铸造工肺癌粗死亡率４６－４４／１０ 万, 占恶性肿瘤死亡的３０－１０ ％ , 在恶性肿瘤死亡中居首位。以一般人群作参比标准时, 铸工标化死亡比（Ｓｔａｎｄａｒｒｉｚｅｄ Ｍｏｒｔａｌｉｔｙ Ｒａｔｉｏ, ＳＭＲ） 为１－５６ , １－８３ （ Ｐ＜ ０－０５）。男性尘肺患者肺癌死亡率高于男性非尘肺患者, ＳＭＲ 为２－１５ （χ２ ＝ ６－９２） , 相对危险度（ＲＲ） 为３－４０ （χ２ ＝ ６－９６） , 年龄分层处理后总的相对危险度（Ｒｅｌａｔｉｖｅ Ｒｉｓｋ Ｔｏｔａｌ ＲＲＴ） 为１－６９ （χ２ＭＨ＝ １－１９）。结果表明,该队列铸造工肺癌死亡超量, 尘肺患者尤为明显。     

建德市肾综合征出血热Ⅰ型灭活疫苗试验现场对照组人群隐性感染定群研究

用定群血清流行病学方法观察ＨＦＲＳ疫苗效果考核现场对照组人群隐性感染情况。采用ＩＦＡＴ检则血清中ＨＦＲＳＩｇＧ抗体,分析不同性别和年龄人群的隐性感染及感染后抗体水平变化情况。结果,ＨＦＲＳ年感染率为２２９％,在不同性别和年龄组中未见显著差异;３２名隐性感染者ＨＦＲＳ抗体转阴率４６８８％,ＨＦＲＳ抗体上升率达２５００％,在不同ＨＦＲＳ抗体滴度、性别和年龄组中未见显著差异。此观察结果为疫苗现场效果评价提供一些背景资料。     

The effect of smoking at different life stages on bone mineral density in elderly men and women

To assess the effect of smoking on bone mineral density (BMD) at different life stages, to examine whether the effect of smoking differs between men and women, and to discover whether its effect in women differs according to history of estrogen use, a cohort study was carried out with single cross-section measurement of BMD by single and dual photon absorptiometry. The setting was the Framingham Study, a population-based cohort study with over 40 years prospectively collected data on smoking. Subjects (n=1164) consisted of cohort members participating in the 20th biennial Framingham examination (1988–1989). The measurements included in the study were BMD measured at the hip, spine and radius, smoking history ascertained at all Framingham Study examinations since 1948, and other factors affecting BMD (age, weight, estrogen use, caffeine use, alcohol use and physical activity). Neither current smoking, recent (last 10 years) smoking, nor early adulthood smoking resulted in significantly lower BMD at any skeletal site among women who had not taken estrogen. Among women who had taken estrogen, BMD at most sites was lower among current or recent smokers, although the small numbers of smokers made it difficult to find significant differences at all skeletal sites. Among men, a consistently lower BMD at all skeletal sites was observed for smokers regardless of when in their life they smoked (4–15.3% lower), although the effect of smoking during early adulthood was of a lesser magnitude (4–8% lower). Former male smokers who had quit <10 years ago had lower BMD than men who had quit 10 years ago. In conclusion, in women who had used estrogen, BMD was lower in current or recent smokers than it was in non-smokers. In men, smoking at any stage of life had adverse effects on the skeleton that was independent of weight, alcohol or caffeine use, implying other mechanisms for smoking's effect on bone.     

极低出生体重儿的临床干预和并发症的发生率及病死率研究

目的　探讨极低出生体重儿主要并发症的特点及影响其存活率的相关因素 ,以便改进干预措施 ,进一步降低其病死率。　方法　对 1996年 1月～ 2 0 0 1年 12月于生后 2 4 h内转入 NICU的 12 2例极低出生体重儿的临床资料进行回顾性分析 ,并按出生体重分 3组 ,对其并发症的发生率、转归、主要死因、肠道喂养开始时间及体重变化情况等进行分析比较。　结果　导致极低出生体重的主要原因有多胎妊娠 (30 % )、妊娠合并症 (2 1% )、羊膜早破 (15 % )和原因不明 (30 % )等。所有患儿均有一种或多种并发症 ,主要为高血糖 (5 7% ) ,缺氧缺血性脑病 (46 % ) ,呼吸窘迫综合征 (33% ) ,感染(30 % ) ,低体温 (2 5 % ) ,呼吸暂停 (2 4 % ) ,脑室内出血 (18% )和动脉导管未闭 (18% )等。由于采取预防性干预措施 ,大多数并发症的发生率在不同体重组间的差异无显著性。本组极低出生体重儿存活率为 84 % ,若排除因经济困难或担心后遗症而放弃治疗后死亡的病例 ,则存活率为 91% ;其中出生体重≤ 10 0 0 g者为 5 9%。死亡的主要原因为呼吸窘迫综合征、感染和先天畸形。存活者能耐受经口胃管喂养开始时间为 (6± 4 ) d,不同出生体重之间差异无显著性 (F=1.36 ,P>0 .0 5 ) ;自行吸吮开始时间为 (2 3± 14 ) d,且随出生体重增加而     

Factors associated with liver biopsy performance in HCV-HIV coinfected injecting drug users with HCV viremia: Results from a five-year longitudinal assessment

The last international consensus conference about hepatitis C virus (HCV) treatment emphasized the importance of treatment for persons coinfected with HCV and human immunodeficiency virus (HIV). As liver biopsy precedes treatment, we aimed to identify factors associated with the performance of liver biopsy among HIV-HCV coinfected drug users during a 5-year follow-up to study their access to HCV treatment. Of the 296 patients followed in the HIV hospital departments of Nice and Marseilles and with retrievable records about HCV diagnosis and care, 166 were eligible for analysis having had detectable HCV RNA at least once during the study period. Overall, 45.2% of patients underwent liver biopsy during follow-up. Using proportional hazard models, predictors of having had a liver biopsy were high social support, complete abstinence from drug injection, and lack of immunosuppression as well as male gender, no history of multiple incarcerations, more recent onset of drug use, and an increase of liver enzyme levels. These results suggest that specific efforts should be devoted to HIV-HCV coinfected drug users to assist with stabilizing these patients to optimize their access to HCV care whenever possible. The MANIF 2000 study group includes C. Boirot, A. D. Bouhnik, M. P. Carrieri, J. P. Cassuto, M. Chesney, P. Dellamonica, P. Dujardin, S. Duran, J. G. Fuzibet, H. Gallais, J. A. Gastaut, G. Lepeu, D. A. Loundou, C. Marimoutou, D. Mechali, J. P. Moatti, J. Moreau, M. Nègre, Y. Obadia, I. Poizot-Martin, C. Pradier, D. Rey, C. Rouzioux, A. Sobel, B. Spire, F. Trémolières, and D. Vlahov.     

职业接尘及吸烟致呼吸系统疾病死亡危险度比较的队列研究

目的 比较接尘、吸烟对呼吸系统疾病死亡的影响.方法 在1989年至1992年广州建立职业健康监护档案的基础上对30岁以上、职业接触粉尘和无粉尘接触的80 987名工人进行前瞻性队列研究.结果 （1）队列平均年龄43.5岁,职业性粉尘接触率16.3%,吸烟率43.7%,饮酒率33.5%.（2）队列平均随访8年,35人失访,失访率0.04%,总死亡1 593人中,219人死于肺癌,90人死于非恶性肿瘤性呼吸系统疾病.（3）调整相关因素后,相对于不吸烟者,吸烟者肺癌死亡相对危险度（RR）为3.32,是粉尘接触者相对于无粉尘接触者肺癌死亡RR（1.53）的2.2倍.粉尘接触者非恶性肿瘤性呼吸系统疾病死亡RR为2.41,是吸烟者（1.89）的1.28倍.尤其是矽尘接触者,其非恶性肿瘤性呼吸系统疾病死亡RR为5.72,是吸烟者的3.03倍.既接触粉尘又吸烟,呼吸系统疾病死亡RR增加更明显.（4）男性吸烟者呼吸系统疾病死亡危险分别随日吸烟量、烟龄的增加而增加.结论 职业接触粉尘和吸烟均可引致超额的呼吸系统疾病死亡,两者存在协同作用.吸烟致肺癌死亡RR高于接尘,而致非恶性肿瘤性呼吸系统疾病死亡RR则低于接尘.吸烟与呼吸系统疾病死亡危险存在明显的剂量-效应关系.     

红点黄本对城市小学生远视力保护效果的追踪观察

目的探讨红点黄本对小学生远视力的保护作用,为学生用簿本标准的制订提供依据。方法整群抽取大连市某小学二年级学生131名为试验组6、35名为对照组,追踪观察3 a。观察指标为受试者的双眼远视力。结果试验组远视力以保持“不变”为主(43.9%),比对照组(21.2%)多1倍;远视力下降3~5行的,对照组(合计20.3%)各分别比试验组约多1倍;下降6行及以上者,试验组为0,而对照组占4.5%。试验组的右眼远视力3 a间平均下降0.034 4,而对照组下降0.095 1(t=3.731,P=0.000);试验组的左眼远视力平均下降0.044 3,而对照组下降0.081 1(t=2.247,P=0.025)。结论红点黄本对城市小学生的远视力有保护作用。     

海门市原发性肝细胞癌高发危险因素的队列研究

目的探讨海门市原发性肝细胞癌（HCC）高发的主要危险因素，为HCC防制决策提供依据。方法1993年在HCC高发区海门市建立了一支83794人的HCC研究队列，对每一研究对象进行一项流行病学调查，并采集外周静脉血标本作相关检测，每年随访1次，至2001年终止。运用COX比例风险模型对HBsAg、肝炎感染史、HCC家族史、职业史、饮酒史、饮茶史、吸烟史、饮水类型、主食类型等9个变量在HCC发生中的作用作了分析。结果HBsAg（＋）是海门市HCC高发的最主要危险因素（男性HR=22.3，女性HR=37．2）。结论HBV感染，HCC家族史及职业均为HCC高发的危险因素。