Dioxins and medical-genetic indices of health of residents of the town of Chapayevsk]

The paper presents the results of an integrated medical genetic survey carried out in the town of Chapayevsk. The survey included an estimation of the incidence of congenital malformations (CMF), congenital morphogenetic options (CMGO), evaluation of the frequency of chromosomal mutations of various types and micronuclei in human somatic cells. The incidence of CMF among newborn infants corresponds to that in Russia, but such forms of CMF as congenital hydrocephalus and agenesia and disgenesis of the kidney were more common in the town. The study ascertained that the average number of CMGO per child was on the increase. Cytogenetic findings unambiguously demonstrate that there was a spatial gradient within the town (from the plant to remote districts), higher rates of chromosomal aberrations. Further studies of the effects of dioxins on genetic health are required to assess the actual genetic risk due to its human contact.     

Monetary value of breast milk in Bolivia]

OBJECTIVE: To estimate the volume of breast milk consumed by Bolivian children under 36 months of age, and the monetary value of replacing that volume of breast milk with commercial substitutes. METHODS: The analysis took into account the distribution of the infant population by age groups, the prevalence of breast-feeding practices (exclusive or partial) in every age group, the average volume of breast milk consumed by the infants of a given age group, and the cost of breast milk production and replacement. RESULTS: Bolivian infants annually consume more than 161 million liters of breast milk, which represents an average volume of 573 mL/day per infant under 1 year of age. The monetary value of breast milk consumed by the Bolivian infants amounts to US$ 274 million annually. The average cost of replacing breast milk with commercial substitutes for an infant adequately breast-fed for the first year of life would be US$ 407. DISCUSSION: For the formulation and consolidation of policies and programs to protect, promote, and support breast-feeding to become a reality, it is necessary that the political leaders of Bolivia be aware of the enormous monetary value of breast milk.     

Relationship between breast milk and atopic dermatitis in children]

OBJECTIVE: To determine whether or not dioxins and furans in breast milk have a role in the prevalence of atopic dermatitis among children. METHODS: The target population of the study was all children participating in health check-up program for 3-year-old children in Tochigi Prefecture in September and October 1997. Using a questionnaire, information on nutrition in infants (breast milk only, bottled milk only, or mixed), parity, mothers' age at birth, and a history of atopic dermatitis was obtained. Besides, data on potential confounding factors were obtained. RESULTS: Questionnaires from 2,968 children (85.3% of those who were to participate in the programs, and 90.2% of children who participated them) were analyzed. The risk of atopic dermatitis was higher among children with breast milk (odds ratio [OR] = 1.37 with 95% confidence interval [CI] 1.02-1.83) and those with mixed nutrition (OR = 1.21, 95% CI: 0.94-1.57) in comparison with children with only bottled milk. Mothers' age at birth (OR for those who were more than 30 years or older in comparison with those who were younger than 30 years = 1.27; 95% CI, 1.01-1.62) and those with second or later parity orders (OR = 1.32, 95% CI; 1.04-1.67) were also risk factors of the dermatitis after the adjustment for some potential confounding factors. CONCLUSION: Breast milk elevates the risk of atopic dermatitis slightly; the risk is, however, higher in children in second or later parity orders. If the PCDDs and PCDFs in breast milk cause the dermatitis, this would contradict the assumed metabolism of these chemicals in human bodies.     

婴儿血铅与母亲血铅和乳铅等因素的相关性研究

目的了解婴儿血铅与母亲血铅和乳铅等因素的相关关系,为防治儿童铅中毒提供参考依据。方法2002年11至12月,采用石墨炉原子吸收光谱法,测定厦门市177名0～11个月的婴儿及其母亲的血铅,并对小儿出生情况及其母亲、家庭环境等相关因素进行问卷调查。结果177例婴儿血铅的几何均值为(0.37±0.15)μmol/L,范围为0.12～1.36μmol/L,≥0.48μmol/L者46例(占25.99%);母亲血铅的均值为(0.50±0.14)μmol/L,范围为0.21～2.38μmol/L;177例中有160例为母乳喂养儿,其中105例采集出乳汁,乳铅的几何均值为(0.17±0.08)μmol/L,婴儿血铅与母亲的血铅和乳铅密切相关,表明母体的铅可以通过乳汁影响到婴儿血铅水平。旧商业区婴儿的血铅、婴儿母亲乳铅水平均高于其他地区,婴儿血铅水平主要与母亲血铅、婴儿月龄和母亲在职等呈正相关关系,而与母亲身高等因素呈负相关关系。结论母乳喂养儿的血铅水平除了与母亲血铅水平相关外,还与乳铅密切相关,因此在婴儿喂养方式的选择和家庭抚育行为方面须引起重视。     

海岛地区居民高血压患病现状及影响因素分析

目的了解福建省霞浦县海岛乡居民高血压患病率及相关危险因素,为制定适合于海岛地区的高血压干预措施提供依据。方法采用问卷及体格检查形式调查海岛乡4个村1 408名≥30岁居民的高血压患病率和相关危险因素情况,应用χ²检验及logistic回归分析方法分析该地区居民高血压患病因素。结果海岛地区居民高血压患病率为38.5%,标化患病率为28.4%;多因素logistic回归分析结果表明,海岛地区居民高血压患病的危险因素为年龄高、大量饮酒和体质指数高,保护因素为重度体力活动。结论福建省海岛地区居民高血压患病率较高,减少饮酒、控制肥胖、适当增加体力活动有助于高血压的防治。     

母血、脐血、母乳铅、钙水平配对分析

[目的]了解母血、脐血、母乳之间铅、钙含量的相关性,尝试降低人体铅含量的途径. [方法]对56名正常产妇进行母血、脐血、母乳铅、钙含量进行配对分析. [结果]各样本中铅含量呈母血＞脐血(P＜0.05),钙含量呈母乳＞脐血＞母血(P＜0.01),母血铅与脐血铅含量、母乳铅含量均呈显著正相关,分别为(r=0.375,P＜0.05;r=0.511,P＜0.01).母血铅与母血钙含量呈负相关(r=-0.468,P＜0.01). [结论]脐血、母乳铅含量受母血铅水平的影响,铅可通过血液进入乳汁,母亲通过授乳可将铅传递给新生儿.血钙水平降低会导致血铅升高.     

城镇居民主要腹泻病原菌现状研究

〔目的〕掌握我省城镇居民的主要腹泻病原菌 ,为建立食源性疾病主动监测体系 ,提供必要的监测数据。〔方法〕采集监测点腹泻门诊腹泻患者粪便 (或肛拭 )标本 ,分离沙门菌、志贺菌、霍乱、肠出血性大肠O157∶H7及副溶血性弧菌 5种病原菌。〔结果〕15 70份标本共分离各类病原菌 2 2 3株 (14 .65 % ) ,其中 ,以副溶血性弧菌检出率为最高 ,占总检出率的 85 .65 % ,志贺菌、沙门菌的检出率分别为 3 .14 %和 0 .45 % ,霍乱、肠出血性大肠O157∶H7未检出 ;女性患者病原菌检出率显著高于男性患者 (P <0 .0 1) ;60 .0 9%的患者年龄集中在 2 0～ 40岁 (P <0 .0 0 1) :副溶血性弧菌流行的血清型主要为O3 血清型。〔结论〕我省城镇居民主要致泻病原菌为副溶血性弧菌且仍为O3 血清型 ,患者主要为中青年。     

城乡居民健康素养比较研究

目的了解我国城乡居民的健康素养状况,为有针对性的开展健康素养干预提供依据。方法采用多阶段分层抽样的方法,选取吉林、浙江、广东、甘肃、湖北、云南6省18～69岁的城乡居民11759人进行问卷调查。结果在知识性健康素养方面,农村居民对慢性病和传染病知识知晓率较低,特别是慢性病知识（〈60．8％）。城市居民对这两类知识的掌握显著高于农村居民。城市居民对基本的营养与食品卫生相关知识掌握较好（〉72．2％）,而农村居民对这些知识的掌握则不足（〈59．3％）。在其他方面,城乡居民都对最基本的急救常识、心理卫生知识有一定的了解。城乡居民个人卫生行为形成率较高（城市居民〉90．7％,农村居民〉76．0％）,但其他健康行为特别是体检行为（城市居民37．9％,农村居民26．6％）和体育锻炼行为（城市居民52．2％,农村居民17．0％）形成率则较差。城乡居民都具有较高的信念性健康素养（城市居民〉78．8％,农村居民〉61．6％）。在功能性健康素养方面,城乡居民在就医时沟通和清楚介绍病情能力最好（城市居民〉73．8％,农村居民〉66．2％）,对健康词汇的认知能力最低。结论城乡居民健康素养水平存在着较大差别,应该根据城乡居民的不同特点开展针对健康素养的健康教育和健康促进工作。     

产妇血、乳汁与婴儿血微量元素水平及相关性分析

目的 分析产妇血、乳汁及婴儿血微量元素水平及相关性.方法 收集250例自然分娩产妇产后42 d血、乳汁及其婴儿血为标本,采用原子吸收光谱法测定其中所含的钙(Ca)、铁(Fe)、锌(Zn)、镁(Mg)与铜(Cu)的含量,并分析产妇血、乳汁与婴儿血微量元素相关性.结果 除产妇血钙与婴儿血钙水平差异无统计学意义(P＞0.05)外,产妇血、乳汁及婴儿血中Ca、Fe、Zn、Mg、Cu水平两两比较差异均有统计学意义(P＜0.05);产妇血与婴儿血中Ca、Fe水平均呈正相关[Ca(r=0.221,P=0.047)、Fe(r =0.107,P=0.043)];产妇乳汁与婴儿血中Fe水平呈正相关(r=0.139,P=0.035);产妇血与其乳汁中Ca、Fe、Zn、Cu微量元素均呈正相关[Ca(r=0.016,P=0.007)、Fe(r =0.143,P=0.022)、Zn(r =0.162,P=0.019)、Cu(r =0.274,P=0.013)].结论 产后42 d妇女血微量元素与乳汁微量元素水平形成梯度,使乳汁维持微量元素一定比例,有助于婴儿的微量元素的吸收,与其生长发育密切相关,故定期测定孕期、产后妇女及婴儿微量元素水平,指导产妇平衡膳食,提倡母乳喂养,及时科学补充微量元素量,可早期预防婴儿早期钙、铁、锌等微量元素的缺乏.     

金华市源东乡农村居民健康状况调查与分析

目的:了解和分析金华市源东乡农村居民的主要健康问题及其影响因素和社区卫生服务需求,为进行社区诊断提供依据.方法:采用入户调查的方法对随机抽取的91户家庭171名村民进行问卷调查和定性访谈法收集资料.结果:高血压(8.6％)是源东乡村民患病率最高的疾病,其次是糖尿病(0.97％);存在喜咸食(62.9％)、喜甜食(56.9％)、运动不足(51.5％)、吸烟(31.1％)等不良生活方式;多数村民主要通过看电视获取保健知识,他们对于健康咨询、饮食指导和体格检查等社区卫生服务有强烈的需求.结论:要在农村社区加强预防服务工作,重点培养农村社区医生的临床预防服务能力和社区预防服务能力,创建具有健康人群、健康环境的健康社区.     

安徽省县区居民艾滋病知识和行为调查

目的 了解安徽省城区居民(包括流动人口)对艾滋病的认知水平和行为状况,评估项目前期工作效果和为制定后期计划提供依据。方法 采用整群抽样方法,在安徽省8个艾滋病综合防治示范区/全球基金项目县的城区抽取1654名居民作为调查对象,采用自行设计的调查问卷面对面进行匿名问卷调查。结果 在1614份有效问卷中,艾滋病知识平均知晓率为84.3%;3种传播途径的知晓率为93.5%,6条非传播途径的知晓率为82.6%,二者差异有统计学意义(χ²=325.94,P<0.001)。自愿咨询检测(VCT)服务知晓率为76.5%,使用率为17.5%。无偿献血知识知晓率为55.7%。流动人口中婚外性行为的比例为3.7%,坚持安全套使用率为36.7%。结论 安徽省项目地区城区居民艾滋病知识知晓率较高,但艾滋病知识认知不全,无偿献血知识知晓率不高,VCT服务知晓率和利用率低。今后应加强艾滋病健康教育和行为干预工作,全面提高各类城区居民的艾滋病(包括无偿献血和VCT)知识知晓率,提高安全性行为的形成率和VCT服务利用率。     

城镇居民医疗保险制度的风险及规避

介绍了部分城市的城镇居民医疗保险制度，分析了由保障对象的高风险与自愿参加的形式所带来的逆向选择问题，认为规避风险的方法是与城镇职工基本医疗保险制度逐步融合起来，以便采用强制性措施来分散风险。提出以下对策建议：第一，出台全国统一的实施指导意见，提高统筹层次；第二，政府加强对公共卫生和社区卫生服务的投入。     

Lead concentrations in maternal blood and breast milk and pediatric blood of Andean villagers: 2006 follow-up investigation

OBJECTIVE: To determine the current lead (Pb) concentration in blood (PbB) and breast milk (PbM) of mothers and the PbB of children living in Andean Ecuadorian villages with high Pb contamination. METHODS: Samples of whole blood from 93 participants (74 children and 19 adult women) were analyzed for Pb concentration by graphite furnace atomic absorption spectroscopy with Zeeman background correction, and milk samples from nursing mothers were analyzed by inductively coupled plasma-mass spectrometry (ICP-MS). RESULTS: Mean PbB concentration in children in 2006 was 26.7 microg/dL (SD: 23.0), and significantly lower than the mean PbB level in 1996 to 2000, but similar to the PbB level found in 2003. The mean PbB level of 22.0 microg/dL (SD: 20.6) for the 19 women in the 2006 study group did not differ significantly from the women in the 1996 to 2000 or 2003 study group. The PbM levels (range: 1-49 microg/L) of nursing mothers in the 2006 group were similar to the PbM values observed in the breast milk of nursing mothers in the same study area in 2003, and matched high PbB levels in some mother-infant pairs. CONCLUSION: This study found elevated, but stable, PbB and PbM levels in mothers and elevated, but stable, PbB levels in children in 2006 that were consistent with the levels observed in 2003 in the same Andean villages.     

Occurrence and transport of synthetic musks in paired maternal blood,umbilical cord blood,and breast milk

Although early exposure to environmental pollutants may have important toxicological consequences, the mechanisms of transplacental transfer of synthetic musks are still not well understood. The objective of the present study was to learn the musk contaminations in three matrices, including maternal blood, umbilical cord blood, and breast milk; and investigate their placental transfer mechanisms.The concentrations of eight commonly used synthetic musks were measured in 42 paired samples (126 individual samples in total) of maternal serum, umbilical cord serum, and breast milk from Chinese women living in Shanghai.Musks were ubiquitously detected, especially galaxolide (HHCB) and musk xylene (MX). The total lipid-based concentrations were higher in umbilical cord sera (87.3 ng/g), but lower in breast milk (35.2 ng/g), compared with maternal serum concentrations (71.2 ng/g). There were significant correlations between maternal serum concentrations of HHCBs (HHCB and HHCB-lactone) and umbilical cord serum concentrations, and between maternal serum concentrations and breast milk concentrations (Spearman's rho = 0.338–0.597, p < 0.05), when outliers are excluded. The average transfer ratios of HHCB and HHCB-lactone between maternal sera and umbilical cord sera were >1. And the HHCB-lactone/HHCB ratio in maternal sera was higher compared with umbilical cord sera.Contamination levels were low compared with other regions and HHCBs were found to be the predominant constituents. No regional differences or age-related accumulations were observed. Our study suggests that prenatal exposure to HHCBs occurs and that transplacental transfer is the main route of exposure. Preferential accumulation in umbilical cord blood was observed. The results showed that transplacental transfer of HHCB did not correspond to passive diffusion since the transfer ratios were significantly different from 1. The transfer ratio for HHCB was also larger than that of HHCB-lactone, although HHCB has higher lipid solubility. Low fetal metabolism of HHCB was suggested by the HHCB-lactone/HHCB ratio in maternal and umbilical cord blood.     

富阳市某镇农民健康状况及卫生服务需求调查

目的：了解富阳市某镇农民健康状况及卫生需求。方法：采用整群随机抽样方法,抽取富阳市里山镇3个行政村6个自然村2047名农民进行健康检查,对1181名农民上门调查;召开30名代表（镇干部、社区卫生服务中心代表、村干部和村民代表）参加的座谈会。结果：农民慢性患病率高;社区卫生服务内容仍需不断拓展,补偿机制不合理,专业人员素质不高;健康教育工作未能满足广大农民需求。结论：应增加投入全面实施农民健康工程;推进包括调整和制定相应政策、加快人才队伍建设、研究和制定相应评价体系在内的农村社区卫生服务工作;建立农村健康教育体系,提高健康教育效率。     

Nucleic acid levels in milk and blood of healthy cows and those with mastitis]

Investigations were carried out in 30 ncb breed cows divided into two groups. First group was consisted with cows in good health. In second group there were cows ill with mastitis. Number of somatic cells in milk was evaluated by California Mastitis Test and nucleic acids content in milk and blood by spectrophotometric method. Nucleic acids content in group of healthy cows amounted 273 micrograms/100 ml in milk and 0.114 g/100 ml in blood. In this group correlation factor concerning nucleic acids content in milk and blood amounted r = +0.57. In group ill cows nucleic acids content in milk and blood amounted respectively 500 micrograms/100 ml and 0.140 g/100 ml, and value of correlation factor r = -0.09 was noted. Differences in nucleic acids content in milk and blood between both groups healthy and ill cows correspond to values 227 micrograms/100 ml and 0.026 g/100 ml and were statistically significant by p less than 0.01. Above results allow to formulate the following conclusions: 1. Statistically high correlation between quality of somatic cells and nucleic acids content in milk exists--it is confirmation well known fact. 2. The rise of nucleic acids content in blood of cows can be an index of udder inflammation in cows.