BACKGROUND: Linxian County of China is one of the areas with the highest incidence of esophageal cancer and gastric cardia cancer in the world, and nutrition-deficiency is widely existing in local people. In recent years, many researches around the world revealed that the cause of Parkinson disease (PD) is related to factors of gene, age, environment, diet, nutrition and smoking. More and more studies confirmed that primary hypertension may be in relation to vascular Parkinsonism (VP) and long-term hypertension was apt to VP.OBJECTIVE: To investigate the relationship between hypertension and clinical probable Parkinson disease (PPD) in nutrition-deficient population of Linxian County and provide a theoretical basis for early prevention and treatment of PD.DESIGN: Cross-sectional study.PARTICIPANTS: A total of 4 335 subjects aged over 55 years were selected. These subjects have taken part in the nutritional intervention study of Linxian County and first entered in the cohort study in 1985. They were enrolled in the nutritional intervention study in Linxian County in 1985.METHODS: A prospective cohort study was conducted. ①Case screening: PD questionnaire (used in American Gebai County) combined with general neurological examination were adopted. ②The diagnosis of PD: Clinical diagnostic criteria of UK Parkinson Disease Society Brain Bank were taken as the criteria for screening PD. Further evaluations were undertaken for clinical PPD and clinical possible PD on subjects who had PD symptoms.The diagnostic criteria of clinical PPD: Subjects were diagnosed as having clinical PPD if they presented any two of the following two cardinal features (resting tremor, hypermyotonia, bradykinesia and impairment of postural reflexes) or presented any one of the following features (resting tremor, hypermyotonia and bradykinesia). Diagnostic criteria of clinical possible PD: Subjects were diagnosed as having clinical possible PD when presented any one of the following four cardinal features (resting tremor, hypermyotonia, bradykinesia, and impairment of postural reflexes).③Definition of hypertension: Hypertension was defined as the systolic blood pressure (SBP) ≥ 140 mm Hg or the diastolic blood pressure (DBP) ≥ 90 mm Hg. Data were processed with linear trend test and nonconditional logistic regression.MAIN OUTCOME MEASURES: Status of final diagnoses on patients and relationship between hypertension and clinical PPD.RESULTS: A total of 4 335 subjects including 2 008 males (46.32%)and 2 327 females (53.68%) participated in the screening of PD.①Results of final diagnosis on patients: Among all the 4 459 survival participants,46 subjects were diagnosed as having PD, 118 as having clinical PPD and 78 as having clinical possible PD. After excluding patients with PD or clinical possible PD, only 118 patients were diagnosed as having clinical PPD. These patients and 4 217 normal controls were analyzed and a total of 2 035 patients had hypertension. ②There were statistical correlation between hypertension and clinical PPD, RR was 1.648 (1.147-2.638), which was 1.668 (1.145-2.432) after being adjusted by possible confounding factors including age, gender, smoking, drinking and so on, the association mentioned above still existed (χ2=7.463,P=0.006). Analysis of gender showed statistically significant differences between female patients with hypertension and clinical PPD(χ2=9.669 P=0.002), and RR before adjust ment was 2.347 (1.347-4.091), which was 2.346 (1.327-4.150) after being adjusted and correlation still existed. While there were no statistical corre lations between male patients with hypertension and clinical PPD (χ2 =0.697 ,P=0.404)but there was also an ascending trend in RR value. ③ With the blood pressure increasing, the RR value correspondingly in creased with the linear trend test (χ2=11.325 ,P=0.003). And there was sta tistical significance in raw and adjusted RR value of hypertension with the BP ≥ 140/90 mm Hg. Respective statistics of SBP and DBP showed a dose-response relationship between SBP and clinical PPD; When the SBP ≥ 140 mm Hg, there were statistical significances in values of raw RR or adjusted RR of hypertension (χ2=8.007 ,P=0.018). While there were no sta tistical significances in RR values before and after adjustment of DBP (χ2 =2.569,P=0.227). CONCLUSION: Hypertension is one of the risk factors of clinical PPD in female residents older than 55 and the incidence of getting clinical PPD is increased with the heightening of BP.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的　探讨林县营养缺乏人群高血压与临床很可能帕金森病 （ClinicallyProbableParkinson’sdisease,PPD）之间的关系 ,为早期防治帕金森病 （PD）提供理论依据。方法　采用前瞻性队列研究方法。人群血压资料来源于1985年林县营养干预试验开始时研究对象的基线调查。病例的诊断 ,通过两个步骤完成 ,即第一步采用调查问卷与体格检查相结合的办法 ,对队列人群进行PPD的筛查 ,第二步对可疑病例 ,由中美神经科专家联合诊断 ,并依据英国帕金森病协会脑库临床诊断标准进行PPD的临床诊断。资料处理采用线性趋势检验 ,及非条件Logistic回归。 结果　单因素分析显示 :高血压与PPD有统计学关联 ,其RR值为 1 6 4 8（ 1 14 7～ 2 36 8） ;用年龄、性别、吸烟、饮酒等可能的混杂因素进行调整后 ,上述关联依然存在。分性别后统计显示 ,男性高血压与PPD无统计学关联。女性高血压与PPD统计学上有显著性相关 ,其RR值调整前为 2 347（ 1 347～ 4 0 91） ,经混杂因素进行调整后关联依然存在。随着血压的增高 ,其对应的RR值也随之增加 ,经线性趋势检验 （ χ2 =11 32 5 ,P =0 0 0 3） ,表明血压与PPD存在剂量 -反应关系。结论　在林县营养缺乏地区 ,高血压是 5 5岁以后女性居民罹患PPD的危险因素之一 ,并且患PPD的危险性随血压的增</span>

目的:进一步探讨吸烟与食管癌发病的关系.方法:采用前瞻性队列的研究方法.随访对象为1986年-1991年中美合作林县营养干预试验中的普通人群组,所有受试对象符合试验条件并完成了基线调查的全部内容.该研究从1986年3月开始,随访截止到2001年12月31日,共15 a.采用相对危险度(RR)等指标对吸烟的作用大小进行评估.结果:吸烟增加了食管癌发病的危险性,相对危险度RR=1.289(95%CI=1.133～1.466),P=0.000.吸烟指数与食管癌的发病率存在剂量反应关系,χ 2=17.905,P=0.000.结论:在食管癌高发区林县,吸烟是食管癌发病的危险因素之一,并且随吸烟指数的增加食管癌发病的相对危险度呈增加的趋势.