武汉市婴幼儿呼吸道感染与家人吸烟的关系

为了分析武汉市婴幼儿 (0～ 3岁 )呼吸道感染与家人吸烟的关系 ,探讨婴幼儿被动吸烟、母亲孕期、哺乳期被动吸烟对婴幼儿呼吸道感染的影响 ,采用非匹配的病例对照研究 ,于 2 0 0 2年 6～ 7月在武汉市 5家医院儿科门诊随机抽取病例及对照 3 0 9名 (病例组 15 0名 ,对照组 15 9名 ) ,由培训过的调查员采用调查问卷进行调查 ,收集到的资料采用卡方检验 ,非条件的 L ogistic回归进行分析。结果 :家人有无吸烟 (P<0 .0 0 0 1)、家人吸烟对幼儿的回避程度 (P=0 .0 0 18)、母亲怀孕期间被动吸烟 (P<0 .0 0 0 1)及母亲哺乳期间被动吸烟 (P<0 .0 0 0 1)对幼儿的呼吸道感染有显著的不良影响 ,趋势检验有显著性 (P<0 .0 0 0 1) ,对 1岁以内的幼儿的影响要大于 1岁以上 3岁以内的幼儿。提示 :幼儿被动吸烟以及其母亲怀孕、哺乳期间的被动吸烟对幼儿的呼吸道感染均有显著的不良影响 ,尤其对 1岁以内幼儿的影响更为明显     

队列研究中对照组的选择问题

职业流行病学调查时，对照组是非常重要的，因为使用不同折对照组将得到不同的结果。为了选择一个较好的有可比性的对照组，本文调查了某煤矿工人死亡率，调查对象共２５８９例生矿工，追踪２１年（１９７２年１月１日￣１９９２年１２月３１日），采用５个对照组，即内对照、工厂组、３个居民组（当地、某城区和全国）进行分析，探讨队列研究中如何选择恰当对照，使其结果更能反映客观事实。结果表明：不同对照其结果不同。分析了各     

儿科治疗急性上呼吸道感染应用抗菌药物现状分析

目的 调查儿科门诊治疗急性上呼吸道感染(URI)的抗菌药物应用现状，分析滥用的原因，提出避免滥用的对策。方法 于2002年3—6月，随机抽查本院儿科门诊就诊病历607份，就诊次数1000例次，对在治疗URI过程中抗菌药物的应用情况进行统计、分析。结果 本院儿科门诊1000例次就诊病人，诊断为URI病人862例次，占就诊人次的86．20％；URI抗菌药物使用819例，使用率95．01％；使用二联以上抗菌药物357例，占抗菌药物使用的43．59％；治疗URI常用抗菌药物，前三位为头抱一代、青霉素类、头孢二代。结论 URI为儿科门诊常见病，多为病毒感染引起，因此进行合理使用抗菌药物的再教育和提高医生诊疗水平可减少门诊抗菌药物的滥用。     

Smoking habits, exposure to passive smoking and attitudes to a non-smoking policy among hospital staff

A survey was carried out into the smoking habits and exposure to passive smoking among health staff in the hospitals of Faenza, Forli and Rimini (Emilia-Romagna, Northern Italy). 2453 subjects answered anonymously a 41 question questionnaire. 53% of the subjects were professional nurses, 16% doctors, 15% maintenance staff, 10% ancillary staff, 1% non-medical graduates, 2% were administrators and 3% were assigned to the category ‘others’.Of the subjects answering the questionnaire 39% were smokers, 19% ex-smokers and 42% non smokers. The highest number of smokers was found among women (41%) compared to men (37%) and among ancillary staff (48%) compared to nurses (41%) and doctors (31%). The males were mostly heavy smokers (≥20 cigarettes/d) and smoked strong cigarettes (≥12 mg/cig condensate content). The females were mostly light smokers (<10 cigarettes/d) and smoked light cigarettes (1–6 mg/cig condensate content). A high percentage of subjects (87%) smoked at work especially in areas reserved for staff. 43% and 26% of shift workers and non-shift workers tended not to modify their habit when on morning or afternoon shifts. During night shifts the majority of them increased their tobacco consumption.Around 87% of hospital employees stated they were exposed to passive smoking inside the hospital especially in cooking areas, at information desks and corridors. Nurses, ancillaries and maintenance staff were those most exposed and for a greater number of hours per day compared to doctors. Almost all subjects were aware of the harm caused by passive smoking. 56% of smokers, 65% of ex-smokers and 72% of non smokers said they were willing to participate in future campaigns to limit smoking in their hospitals.     

EFFECTS OF LIFESTYLE, COPING AND WORK-RELATED STRESS ON BLOOD PRESSURE IN OFFICE WORKERS

1. The relative importance of perceived stress compared with coping behaviours and ‘lifestyle’ characteristics known to influence blood pressure were studied in 337 male and 317 female office workers. 2. Males had significantly higher mean systolic (P<0.01; t-test, 652 d.f.) and diastolic (P<0.01; t-test, 652 d.f.) blood pressure and unhealthier lifestyles than females, particularly in the areas of alcohol intake (P<0.01; t-test, 653 d.f.) and diet (P= 0.01; t-test, 663 d.f.). 3. In males drinking alcohol was correlated to job and home/work stress (P<0.05), and eating more atherogenic foods was correlated to home/work stress (P<0.05). 4. Coping by food and drug consumption was correlated with job and home/work stress (P <0.05) in males; avoidance/ denial coping was correlated with job stress in both males and females (P<0.001) and to home/work stress (P<0.001) in males only. Blood pressure was not correlated with stress in males or females. 5. In age-adjusted regression analyses body mass index (BMI) and lifestyle (physical inactivity, alcohol consumption and diet) made significant contributions to systolic (P= 0.02) and diastolic (P<0.01) blood pressure and, in separate analyses, coping contributed significantly to diastolic blood pressure (P<0.01) in males. Stress made no additional contribution to blood pressure in either analysis. 6. After including age, BMI, lifestyle and coping in males ‘lifestyle’ still contributed to systolic and diastolic blood pressure and coping made a significant additional contribution to diastolic blood pressure. Neither lifestyle or coping contributed significantly to blood pressure in females. 7. Thus obesity, alcohol, physical activity and diet had dominant effects on blood pressure; while any effects of job stress were indirect and related to maladaptive coping, particularly in males.     

Smoking and Obesity in Relation to the Etiology and Disease Progression of Prostate Cancer in Japan

Background:
Various risk factors have been investigated concerning the etiology of prostate carcinoma, but many questions about the significance of the risk factors remain unanswered. To evaluate the relationship between smoking and obesity in prostate cancer, a case-control study was performed.
Methods:
Between 1986 and 1995, 329 patients with untreated prostate cancer and 188 patients with benign prostate hyperplasia (control patients) were evaluated according to their smoking habits and the degree of obesity. Also, the progression of prostate cancer in relationship to smoking and obesity was examined.
Results:
Smoking and obesity were not risk factors for the development of prostate cancer (odds ratio, 0.986, 0.836; 95% confidence interval, 0.69-1.41, 0.57-1.24, respectively). Nor were smoking or obesity a risk factor for survival in stage D2 patients, however, in stage B1-D1 patients, obese men had a tendency for disease progression.
Conclusion:
This study demonstrated that neither smoking nor obesity increase the risk of developing prostate cancer, or the risk of disease progression in prostate cancer patients. However, obese men have a tendency for progression of stage B1-D1 prostate cancer although further studies are necessary to confirm this finding.     

Lack of effect of hormonal treatment and smoking on cytokeratin expression in buccal mucosa

Differences in cytokeratin expression of clinically normal buccal mucosa were studied in 50 healthy women by indirect immunofluorescence staining with monoclonal antibodies. The subjects were divided into four groups: control group (N= 18), smokers (N=8), oral contraceptive users (N=8) and smokers receiving oral contraceptives (N=16). Our findings indicate that cytokeratin expression in non-cornified stratified epithelium is not influenced by smoking or oestradiol/progesterone treatment. Only cytokeratin No. 19 showed variable patterns of expression but the differences could not be ascribed to smoking or contraceptives. Cytokeratin No. 19 gave a positive reaction in the basal and suprabasal layers in 34 subjects (68%). In 9 (18%) specimens, the staining was positive in the basal cells and showed a positive heterogeneous cytoplasmic reaction in the suprabasal cells. Interestingly, cytokeratin No. 7 was recognized in all epithelial cells except the basal cells. Our results suggest that changes in the serum oestradiol levels do not affect the cytokeratin pattern in buccal mucosa.     

疾病家庭聚集性研究中对照的选择及其影响

本文讨论了疾病家庭聚集性研究中不同对照的特点。揭示在没有混杂因素作用的情况下，两种对照的任一种都可以通过与病例组比较，对疾病的家庭聚集性作出检验。但用指示对照有关的个体组成的对照具有较大的检验效能。若存在混杂因素，需采用分层分析方法或者标准化法对其进行控制，然后通过病例组与对照组的比较，对疾病的家庭聚集性作出推断。     

Smoking as a Risk Factor for Injury Death: A Meta-Analysis of Cohort Studies

Background.Injury and tobacco effects represent one-quarter of the global burden of disease. Understanding the causes of injury and the effects of smoking may help reduce those burdens. Some smokers have high risks of injury. We provide an initial meta-analysis of cohort associations between smoking and fatal injury.Methods.Three authors independently searched MEDLINE, and bibliographies of the pertinent studies found, for cigarette smoker-specific injury death data which allowed estimation of an appropriate relative risk (RR) and 95% confidence interval (CI). Relative risks and dose response were summarized by fixed effects and Poisson modeling, respectively.Results.Six studies covering 10 pertinent cohorts were located. Associations between smoking and injury death have been significant after adjustment or, in effect, stratification for age, race, sex, country, and, respectively, alcohol, marriage, education, and body mass; job and time period; job, alcohol, and exercise; etc. Summary-dose response trends were significantly positive (P< 0.00005). Cigarette smoking predicted summary injury death crude RRs of 1.61 (CI 1.44–1.81) vs never smokers and 1.39 (CI 1.25–1.55) vs ex-smokers.Conclusions.Smoking has significant, consistent, dose-response, often strong and independent, prospective associations with injury death, internationally.     

Responses of the cerebellar fastigial neurones to tilt

Summary The activity of units located in the rostral portion of the fastigial nucleus has been recorded in decerebrate, unanaesthetized cats in response to tilt. The responses consisted of steady variation of the discharge rates when the animal was tilted in the median plane. The majority of the units exhibited a frequency increase on ipsilateral tilt and a frequency decrease on contralateral tilt. Some units displayed an opposite type of response, while some others responded with a frequency increase on tilt in both directions. It was possible to establish a relationship between the amount of the response and the degree of tilt. Some units exhibited a dynamic response during the movement of the tilt table and the amount of this dynamic response was related to the velocity of the movement. It was not possible to demonstrate a convergence of macular input on these dynamic units. The responses did not depend on proprioceptive feed-back since they persisted after deep curarization of the animal. Since the rostro-fastigial neurones project on the dorsal ipsilateral Deiters' nucleus the existence of a cerebellar fastigial loop through which macular information may reach Deiters' nucleus has been postulated. This loop may be of relevance in the cerebellar and vestibular control of postural activities.This investigation was supported by Public Health Service Research Grant NS 07685-05 from the National Institute of Neurological Diseases and Blindness, N.I.H., Public Health Service, U.S.A. and by a Research Grant from the Consiglio Nazionale delle Ricerche, Italy.