肥胖青少年血清脂联素水平与胰岛素抵抗关系

目的 研究青少年肥胖与血清脂联素水平与胰岛素抵抗的关系.方法 中学生健康体检时选择47名体质指数(BMI)在同年龄、同性别第95百分位数或以上的中学生为肥胖组,对照组为50名健康学生.检测血压、血糖、血脂、胰岛素和脂联素等指标,计算胰岛素抵抗指数(HOMA-IR),并采用双能x线吸收检测体脂含量.结果 肥胖组血压高于对照组(P＜0.05),BMI、HOMA-IR和躯干部体脂百分比高于对照组(均P＜0.01),而血清脂联素水平显著低于对照组(P＜0.05).多元逐步回归分析显示,总体脂百分比、躯干部体脂百分比和HOMA-IR是血清脂联素独立相关因素,呈负性相关.结果 肥胖青少年存在显著低脂联素血症.血清脂联素与体脂含量和胰岛素抵抗呈显著负相关.     

脂联素基因多态性与青少年肥胖的相关性分析

目的研究脂联素基因第+45位点单核苷酸多态性与青少年肥胖的相关性,为青少年肥胖防治提供依据。方法选择台州市第二中学初中二年级健康体检时肥胖中学生47名为肥胖组,选择体重正常中学生50名为对照组,检查血压、血糖、血脂、胰岛素、脂联素和体脂含量。采用聚合酶链反应-单链构象多态性(PCR-RFLP)检测+45位点单核苷酸多态性。结果肥胖组血压、BMI、HOMA-IR、躯干部体脂百分比均高于对照组,而血清脂联素水平低于对照组。多元逐步回归分析显示,总体脂百分比、躯干部体脂百分比和HOMA-IR是血清脂联素的独立相关因素,为负性相关。2组学生+45位点基因型频率差异无统计学意义,等位基因频率差异也无统计学意义。结论青少年肥胖存在低脂联素血症,血清脂联素与体脂含量和胰岛素抵抗呈负相关,未发现脂联素基因第+45位点单核苷酸多态性及其与青少年肥胖相关。     

血浆抗素水平与胰岛素抵抗的关系研究

目的:探讨血浆抗素(resistin)与肥胖、胰岛素抵抗及糖尿病之间的关系。方法:对型糖尿病(DM)组122例、糖耐量低减组(IGT)56例、糖耐量正常对照组(NGT)122例,采用争性酶联免疫分析法检测空腹血浆抗素浓度;同时测定血脂水平、空腹血浆葡萄糖浓度(FPG)和浆胰岛素浓度(FINS);测量身高、体重、腰围、血压(SBP、DBP),计算体质指数(BMI)、体脂百比(%Fat)、稳态模型胰岛素抵抗指数(HOMA-IR)。结果:与糖耐量正常组比较,糖尿病组体脂百分比甘油三酯(TG)、总胆固醇(TC)、血浆抗素水平、胰岛素抵抗指数较高(P<0.05)。相关分析显示浆Resistin水平与体质指数、体脂百分比、腰围、总胆固醇、胰岛素、血糖、胰岛素抵抗指数呈正关,调整BMI、年龄后,血浆抗素水平仍与胰岛素、血糖、胰岛素抵抗指数呈正相关。结论:Ⅱ型尿病患者血浆抗素水平较高,血浆抗素水平与胰岛素、空腹血糖水平及胰岛素抵抗指数相关,提示素是胰岛素抵抗发生的一个重要危险因素,在胰岛素抵抗与糖尿病之间建立联系。     

2型糖尿病患者血清脂联素与胰岛素抵抗相关性研究

目的探讨2型糖尿病（T2DM）患者血清脂联素与胰岛素抵抗（IR）的关系。方法收集初诊T2DM患者86例（T2DM组），另选门诊体检健康者50例（对照组），检测所有研究对象空腹状态下血清脂联素、血脂、尿酸、空腹血糖及胰岛素水平，采用稳态模型评估法计算IR指数（HOMA—IRI），同时计算体重指数（BMI）和腰臀比（WHR）。结果T2DM组脂联素显著低于对照组（P〈0．01），HOMA—IRI显著高于对照组（P〈0．05）。脂联素与BMI、WHR、空腹血糖、空腹胰岛索、HOMA—IRI、低密度脂蛋白一胆固醇、甘油三酯呈负相关，与高密度脂蛋白一胆固醇呈正相关，与总胆固醇、尿酸无相关性。WHR、BMI、脂联素和空腹血糖是影响IR最显著的因素。结论2型糖尿病患者存在IR、低脂联素血症，低脂联索血症可能影响T2DM患者IR的程度。     

超重、肥胖男青少年血清脂联素与转氨酶关系

目的分析超重、肥胖男青少年血清脂联索水平与肝转氨酶活性的关系。探讨脂联索对肝脏脂代谢异常疾病的影响。方法随机抽选132名14～16岁超重、肥胖男中学生，测量身高、体重和血压，检测血脂、血清脂联紊、胰岛索和转氨酶水平。结果转氨酶增高组与正常组体质指数（BMI）、腰围（WAIST）、低密度脂蛋白胆固醇（LDL—C）、甘油三酯（TG）、胰岛素抵抗指数（HOMA—IR）和脂联索水平差异有统计学意义（P〈0．05）。脂联索与转氨酶（ALT）对数呈显著负相关（r=-0．209，P〈0．05），校正BMI、WAIST后相关性差异无统计学意义。结论低脂联紊血症可引发与脂代谢异常有关的肝脏疾病；这一损害受体成分和脂肪分布的影响。     

超重肥胖儿童血脂、血压、胰岛素抵抗与C反应蛋白相关性调查

目的探讨超重、肥胖对儿童血压、血脂、胰岛素抵抗与C-反应蛋白(CRP)的相关关系。方法在哈尔滨市随机抽取6所小学,对432名7~11岁健康儿童进行体格、血压测量及血脂、血糖、胰岛素和C反应蛋白(CRP)检测。结果超重肥胖儿童的检出率为35.64%,在对年龄性别修正后,超重肥胖儿童与正常儿童相比血压、胰岛素抵抗指数(HOMA-IR)、甘油三酯(TG)和胆固醇(TD)显著升高,偏相关分析显示CRP与体质指数(BMI)、腰高比(WHt R)和HOMA-IR相关,偏相关系数分别是0.183(P<0.05)、0.319(P<0.01)和0.171(P<0.01)。结论超重肥胖可引起儿童脂代谢紊乱和高血压,且在超重肥胖儿童体内BMI、WHt R、体脂率和胰岛素抵抗(IR)与CRP存在一定相关关系。     

肥胖人群糖脂代谢、体脂水平与胰岛素抵抗的关系

目的观察肥胖人群糖脂代谢、体脂水平与胰岛素抵抗的关系。方法将社区人群中体重指数(BMI)>25kg/m2者96例纳入本研究,测量血压、身高、体重、腰围、臀围、体脂含量及重量,并抽血检测空腹及口服75g葡萄糖2h后血糖(FBS,2hPBS)、胰岛素水平(Fins,2hIns),采用稳态模型评估法(HO-MA)中的HOMA-IR公式评价胰岛素抵抗程度;空腹检测血脂、尿酸及糖化血红蛋白(HbAlc)水平。结果①本组肥胖人群64.0%存在胰岛素抵抗,糖、脂代谢异常,高血压和高尿酸血症者分别为31.2%、74.4%、44.8%及43.2%;②存在糖代谢异常者HOMA-IR和(或)2hIns、WHR、TG高于糖代谢正常组;血脂或尿酸水平异常者WHR大于正常组;高血压组HDL水平低于血压正常组;胰岛素抵抗组WHR、体脂重量、体脂含量、FBS、TC及BMI高于非胰岛素抵抗组;③HOMA-IR指数与体脂重量和TG呈正相关(r=0.448,p=0.000;r=0.411,p=0.000)。结论本组肥胖人群存在糖脂代谢异常、体脂水平增高及胰岛素抵抗,对于肥胖患者应尽早进行相关代谢指标的筛查。     

2型糖尿病患者三酰甘油脂肪酶水平与肥胖及其胰岛素抵抗的关系

目的探讨2型糖尿病（T2DM）患者体质指数（BMI）、稳态模型胰岛素抵抗指数（HOMA—IR）、腰围、腰臀比（WHR）与血浆中三酰甘油脂肪酶（adipose triglyceride lipase,ATGL）水平之间的关系。方法选择T2DM患者131例,根据BMI分为正常体质量组（A组）、超重组（B组）和肥胖组（c组）,采用酶联免疫吸附法（ELISA）分别检测三组空腹血浆ATGL水平,同时测定各组血糖、血脂、空腹胰岛素水平,计算WHR、HOMA—IR,分析各指标与ATGL的关系。结果三组中A组空腹ATGL水平[（56．74±21．46）ng／ml]明显高于B组[（21．92±6．12）ng／ml],P〈0．01;B组ATGL水平[（21．92±6．12）ng／ml]高于C组[（8．90±2．28）ng／ml],P〈0．01;空腹ATGL与BMI、三酰甘油（TG）、空腹胰岛素（Fins）、HOMA—IR呈负相关,r值分别为-0．828,-0．739,-0．674,-0．570,P〈0．01。以ATGL为因变量,BMI、空腹血糖（FPG）、餐后2h血糖（2hPG）、Fins、HOMA—IR等为自变量进行多元线性逐步回归分析,结果显示,BMI是ATGL的独立影响因素。结论T2DM患者血清ATGL水平与肥胖密切相关,与胰岛素抵抗也具有一定的相关性。     

肥胖伴隐性高血压患者动态动脉硬化指数与胰岛素抵抗的关系

目的探讨肥胖伴隐性高血压（MH）患者动态动脉硬化指数（AASI）与胰岛素抵抗的关系。方法选择诊所血压正常的肥胖患者80例和体质指数正常的健康体检者40例作为对照组,均行24h动态血压（ABP）监测,并测定空腹血糖（FPG）、血浆胰岛素（FINS）和血脂水平。根据ABP结果计算AASI,采用稳态模型评估法计算胰岛素抵抗指数（HOMA—IR）,分析MH组的AASI水平与HOMA—IR的相关性。结果MH组的AASI最高（0．51±0．09）,对照组和肥胖组的AASI分别为0．41±0．05和0．43±0．05,与MH组比较,差异均有统计学意义（P〈0．01）。MH组的HOMA—IR（4．70±0．96）高于肥胖组（2．46±0．65）,肥胖组（2．46＋0．65）高于对照组（1．98±0．42）,差异均有统计学意义（P〈0．01,P〈0．05）。Pearson相关分析显示,MH组AASI与HOMA—IR呈正相关（r=0．497,P〈0．01）。结论肥胖患者存在高胰岛素血症,胰岛素抵抗与肥胖伴MH患者的动脉硬化程度有关。     

济南市7岁儿童BMI及体成分与血压水平的相关性分析

目的阐明儿童期BMI及体成分指数与血压水平的相关性,为成年期疾病的早期预防提供相关依据。方法对济南市910名7岁儿童进行身高、体重、血压和皮褶厚度测量,采用回归方程推算体脂比(BF%),计算脂肪组织指数(FMI)和非脂肪组织指数(FFMI)。结果 BMI,BF%,FMI,FFMI与收缩压和舒张压均呈一定程度正相关(P值均0.05),血压与FMI的相关性高于FFMI。高BMI、BF%百分位数组儿童的血压水平均显著高于低百分位数组(P值均0.05)。血压偏高的检出率为肥胖组超重组正常组消瘦组。结论儿童BMI及体成分指数与血压水平有显著的相关性。预防儿童高血压应从控制体脂肪、预防肥胖做起。     

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 human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

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.     

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.     

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.     

The risk of heat exhaustion at a deep underground metalliferous mine in relation to surface temperatures

The risk of heat exhaustion at a deep underground metalliferous mine was assessed in relation to thermal conditions prevailing on the surface. For each day of a 1-year prospective case series of heat exhaustion, surface 24-h mean wet and dry bulb temperatures were recorded. From this data, 24-h mean wet bulb globe temperatures were derived using certain assumptions. The three surface temperature variables were significantly higher on those days on which heat exhaustion occurred, compared to those days on which it did not occur (P < 0.001). The relative risk of heat exhaustion on days when the 24-h mean wet bulb globe temperature was in the range 26.0-28.0 degrees C was 4.82 (95% confidence interval 2.12-10.96). Surface temperature data could be used at this mine to warn miners about the risk of heat exhaustion.