目的 了解2017年兰州市七里河区居民的死亡水平及主要死亡原因,为制定疾病预防控制策略提供参考依据.方法 采用2017年兰州市七里河区疾病预防控制中心收集的居民全死因监测数据,户籍人口信息源自兰州市七里河区公安局;计算该地区粗死亡率、标化死亡率、期望寿命、去死因期望寿命及早死概率等指标.结果 2017年兰州市七里河区居民粗死亡率为637.83/10万,标化死亡率为732.81/10万,男性居民死亡率高于女性(x2=82.187,P＜0.05);三大类疾病中主要死因为慢性非传染性疾病(90.76％);当地居民期望寿命为76.82岁,男性74.68岁,女性79.01岁,四种主要慢性病(心脑血管疾病、恶性肿瘤、慢性呼吸系统疾病、糖尿病)所致的寿命损失分别为5.51、2.43、1.58和0.60岁,去除影响后寿命分别增加7.17％、3.16％、2.06％和0.78％;四种主要慢性病总的早死概率为15.30％,心脑血管疾病、恶性肿瘤、慢性呼吸系统疾病、糖尿病分别为6.23％、7.61％、1.24％和1.01％,男性居民的早死概率是女性的2.21倍.结论 影响2017年兰州市七里河区居民健康的疾病类型主要是慢性病,已成为严重的公共卫生问题,应给予重点关注并采取有效的干预措施.

目的 了解甘肃省兰州市七里河区居民恶性肿瘤死亡情况,为恶性肿瘤预防策略的制定提供依据.方法 利用2016-2018年兰州市七里河区疾病预防控制中心收集的居民全死因监测数据,以及七里河区公安局提供的常住人口信息,计算恶性肿瘤死亡率和潜在减寿年数等指标.结果 2016--2018年兰州市七里河区恶性肿瘤死亡率分别为162.78/10万,157.54/10万和152.51/10万,无明显变化趋势(趋势x2=1.574,P＞0.05),年平均标化死亡率168.26/10万;男性恶性肿瘤标化死亡率(216.40/10万)高于女性(124.79/10万),差异有统计学意义(x2=173.049,P＜0.001);前十位恶性肿瘤死因依次为肺癌、胃癌、肝癌、结直肠癌、胰腺癌、肺继发性恶性肿瘤、食道癌、肝继发性恶性肿瘤、白血病、淋巴癌与多发性骨髓瘤;0～34岁及35岁以上居民首位死因分别为白血病和肺癌;恶性肿瘤潜在减寿年数为26 137人年,平均减寿年数15.08年/人,减寿率18.93‰.结论 兰州市七里河区恶性肿瘤居死因第二位,优势癌种为肺癌;应加强肺癌的防护,积极开展癌症早诊、早治,推动癌症防控工作的开展.

Objective:To understand the distribution characteristics of pulse oxygen saturation (SpO 2) in the high altitude areas. Methods:From September 2016 to December 2017, all healthy and full-term live births in the First Hospital of Lanzhou University and Dunhuang, Jiuquan, Jingning and Lintao branches were selected as the research objects.Critical congenital heart disease or pulmonary diseases were excluded in advance.SpO 2 in different parts of newborns within 12 hours of birth was measured.Statistical comparisons of SpO 2 in different parts of male and female neonates in the same area and SpO 2 in different parts of different regions were made.The number of SpO 2 and the distribution of percentile difference between the lower limbs and the right upper limb of newborns at different altitude areas were obtained. Results:There were no significant difference between male and female infants in SpO 2 value at any lo-wer extremity and right upper extremity and the difference value in the same area (all P>0.05). There were significant differences in the median ( M) values of SpO 2 and the M value of the difference between the two values of any lower limb and right upper limb at different altitudes (all P<0.05). The results showed that the M value of SpO 2 of the right upper limb ( M=96%) in Lanzhou (1 520 m above sea level) was lower than that in Dunhuang (1 138 m above sea level, M=97%) and Jiuquan (1 481 m above sea level, M=97%), and the M value of the difference between the two values ( M=2%) was higher than that in Dunhuang and Jiuquan ( M=1%) ( P<0.05). The M of SpO 2 of any lower limb ( M=96%) and right upper limb ( M=96%) in Jingning areas (1 668 m above sea level) were lower than that in Dunhuang and Jiuquan area (all P<0.05). The median value of SpO 2 of any lower limb ( M=96%) and right upper limb ( M=96%) in Lintao area (1 883 m above sea level) was lower than that in Dunhuang and Jiuquan areas, and the M value of the difference between the two values ( M=2%) was higher than that in Dunhuang and Jiuquan (all P< 0.05). When the altitude was lower than 1 500 m, the M value of SpO 2 was 97%, P3- P97 was 93%-100%; the M value of the difference between any lower limb and right upper limb was 1, and P3- P97 was 0-4.When the altitude was higher than 1 500 m, the M value of SpO 2 was 95%-96%, P3- P97 was 89%-100%; the M value of SpO 2 of an lower limb and right upper limb was 1%-2%, and P3- P97 was 0-9%. Conclusions:The SpO 2 number and percentage distribution of the difference between any lower limb and right upper limb of newborns at different altitudes are different.

目的 了解1999-2015年我国孕产妇保健工作开展情况以及工作质量,为完善相关的政策提供参考依据.方法 以1999-2015年活产数、高危产妇比重、建卡率、系统管理率、产前检查率、产后访视率、住院分娩率、新法接生率、孕产妇死亡率等指标为基础,运用TOPSIS法、秩和比法以及两者模糊联合的方法对各年孕产妇保健情况进行综合评价.结果 我国的孕产妇保健情况逐年改善,尤其是2009-2015年,2003年情况最差.结论 运用TOPSIS法、秩和比法以及两者模糊联合的方法对我国孕产妇保健情况的评价结果基本一致,能够较准确、客观地反映孕产妇保健情况.

目的 分析兰州市城关区、全国及全省新生儿、婴儿和5岁以下儿童死亡率的变化趋势及关系,为儿童保健工作的开展提供参考.方法 基于城关区、全国及全省儿童死亡数据,分析儿童死亡率指标的增长速度及其之间的关系.结果 2001-2016年城关区儿童死亡率低于全国及全省水平,但下降幅度小,波动大.5岁以下儿童死亡中以婴儿死亡为主,婴儿死亡中又以新生儿死亡为主,所占比例均达50％以上.2001年以来儿童死亡率逐渐下降,平均下降速度城关区＜全国＜全省,儿童死亡率指标平均下降速度也不同,其中城关区婴儿＞5岁以下儿童＞新生儿,全国及全省新生儿＞婴儿＞5岁以下儿童死亡率.结论 兰州市城关区儿童死亡率已进入一个下降缓慢的“平台期”,应采积极取措施防止儿童死亡率的反弹增加,新生儿死亡率下降速度较慢,婴儿、新生儿死亡一直占5岁以下儿童死亡的主要部分.

目的 探讨先天性心脏病(congenital heart disease,CHD)患儿与母亲孕前3个月及孕期环境暴露因素的关系,为CHD病因防治提供线索.方法 选择2017年8月至2018年7月,兰州大学第一医院经超声心动图检查确诊为CHD的患儿为病例组,对照选择同期在兰州大学第一医院、兰州市妇幼保健院就诊的健康儿童,采用1∶2频数匹配的病例对照研究,对病例组和对照组儿童母亲孕期环境因素暴露情况等进行问卷调查.使用logistic回归分析母亲孕前3个月及孕期环境暴露因素对CHD的影响.结果 经多因素非条件logistic回归分析发现,母亲孕早期服用药物(OR=3.40,95％CI:1.58～7.33);孕期负性生活事件(OR=4.20,95％CI:2.16～8.17);孕前3个月及孕早期接触特殊物质(OR=3.68,95％CI:1.83～～7.43);孕期被动吸烟(OR=1.96,95％CI:1.15～3.33);孕早期情绪状况(OR=1.91,95％ CI:1.27～2.89)为儿童CHD可能的危险因素.母亲文化程度(OR=0.41,95％CI:0.31～0.53);孕12周前补充复合维生素(OR=0.32,95％CI:0.16～0.63);叶酸(OR=0.38,95％CI:0.20～0.72);孕期适当体育锻炼(OR=0.44,95％CI:0.22～0.91)为儿童CHD的保护因素.结论 孕期避免不良行为习惯,保持孕期心理健康,加强孕期保健,进行正规产前检查,有利于降低CHD发生的风险.

先天性心脏病(CHD),简称先心病,是新生儿最常见的先天性疾病,指胎婴儿心脏或大血管大体的结构异常,对心功能产生实际或潜在影响的一组出生缺陷,发病率较高,在出生婴儿中达0.4％～0.8％[1].尽管在儿科心脏诊断和医疗保健方面已取得进展,但CHD仍然是围产儿和婴儿死亡的首要原因[2].《中国心血管2012》显示,每年有16万左右的CHD患儿出生[3],总经济负担超过126亿元.CHD种类繁多,病因复杂,除个别小缺损在患儿5岁前有自愈机会外,绝大多数需进行手术治疗.其临床后果严重,通常导致流产、死产、死胎、新生儿死亡,及儿童、青少年和成人残疾,给社会、家庭带来沉重的负担.然而,有关CHD危险因素的信息很少,特别是可改变的环境和行为因素.目前,CHD被认为是胚胎期遗传与环境因素共同作用所导致[4].研究CHD的病因,了解与CHD发生相关的因素,对于降低CHD的发病率、提高人口素质具有重要意义.所以,本文就CHD各病因的研究进展作一综述.

目的 通过对全国孕产妇保健资料进行系统分析和综合评价,了解全国31个省(区、市)2015年孕产妇保健工作的质量,为逐步缩小地域间孕产妇保健水平差距提供科学依据.方法 选取与孕产妇保健相关的9个指标,采用秩和比法对全国各省(区、市)孕产妇保健情况进行综合分析.结果 孕产妇保健工作质量综合排序,前3位分别是江苏、浙江、广西,最后2位是新疆、西藏.结论 西部地区孕产妇保健工作质量普遍低于东中部地区.政府的政策与投入适当向西部地区倾斜,控制好西部地区的孕产妇死亡率和东部部分地区的高危产妇比重.

To investigate the effects of iNOS/p38 MAPK signaling pathway induced via acrylonitrile (ACN) on brain injury, which are beneficial to provide the basis for neurological toxicity of ACN, we randomly distributed fifty healthy adult male SD rats into five groups of 10 rats each. After adaptive feeding for one week, rats in the exposed groups were respectively treated with doses of 12.5, 25.0 and 50.0 mg·kg-1 of ACN via gavage, and the control group was given corn oil. After being treated with 50.0 mg·kg-1 ACN 30 minutes, rats in the N-acetylcys-teine (NAC) group were treated with 300.0 mg·kg-1 NAC. All the rats were gavaged once a day, six days per week. The final body weights were recorded after 13 weeks, then all rats were sacrificed. The contents of nitric ox-ide (NO) and the activities of total nitric oxide synthase (tNOS) in rats brains were detected. The expression levels of inducible or immunological nitric oxide synthase (iNOS), phospho-p38 and p38 proteins were also measured by Western blot. Results showed that the relative organ weights of the rat brain tissues in the low, medium and high dose groups were significantly lower than that in the control group, but no significant difference between NAC group and the high dose group. Compared with the control group, marked increase of NO level and the activities of tNOS in the high group were observed. However, there was no significant difference in the level of NO and the ac-tivities of tNOS between NAC group and the high dose group. And the levels of iNOS, phospho-p38 proteins and the ratios of phospho-p38 protein to p38 protein in the high dose group were significantly higher than that in the control and NAC group. The activation of iNOS/p38 MAPK signaling pathway may be one of the mechanisms of brain injury induced by ACN in rats.

To investigate the effect of acrylonitrile (ACN) -induced oxidative stress on nuclear transcription factor-κB (NF-κB) signaling pathway in rats spleen, 60 specific pathogen free (SPF) grade healthy adult male rats were randomly divided into 5 groups: control group (corn oil), low-, medium-, and high-dose groups (11.5, 23, 46 mg·kg-1 ACN) and NAC groups (46 mg·kg-1 ACN + 300 mg·kg-1 NAC), and were treated once/day, 6 days/week, by intragastric gavage for 4 weeks. The spleen was isolated and weighed. The activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT), the contents of glutathione (GSH), malondialdehyde (MDA) and total antioxidant capacity (T-AOC) in spleen were detected by spectrophotometry. The interleukin 6 (IL-6), interleukin 1β (IL-1β), tumor necrosis factor-α (TNF-α) levels were determined by Elisa.The expressions of NF-κB, IκB and p-IκB were measured using western blotting and the expressions of NF-κB and IκB mRNA were determined by RT-qPCR. The results showed that the splenic wet weight of the rats were significantly decreased in the low-and middle-dose groups compared with the control group (P＜0.05). The splenic coefficient was also significantly decreased in the middle-dose group (P＜0.05). The contents of MDA in the spleen of rats were significantly increased in the medium-and high-dose groups (P ＜ 0. 05) and the activities of SOD and GSH-Px were significantly increased in the high-dose group (P＜0.05). The activity of CAT and the contents of TAOC and GSH were all decreased in the low-dose group, whereas, the CAT activity was increased in the high-dose group (P＜0.05).Meanwhile, the activities of SOD, CAT and GSH-Px and the contents of MDA, GSH and T-AOC were significantly decreased in the NAC group compared with the high-dose group (P＜0.05). Compared with the control group, the contents of IL-1β were decreased in the middle-and high-dose groups, and the levels of TNF-αwere increased significantly in all dose groups (P＜0.05). Compared with the high-dose group, the content of TNF-α was significantly decreased in the NAC group (P＜0.05). Western Blot results showed that the expressions of NF-κB, IκB, and p-IκB were significantly increased in the medium-and high-dose groups compared with the control group (P＜0.05). The expressions of IκB and p-IκB in NAC group was decreased in the high ACN group (P ＜0.05). RT-PCR results showed that the expression of NF-κB mRNA were increased in the low-, medium-and highdose ACN groups compared with the control group (P＜0.05). And the expressions of IκB mRNA were increased in the medium-and high-dose ACN groups compared with the control group (P＜0.05). The expression of NF-κB mRNA was decreased in the NAC group compared with the high-dose group (P＜0.05). Therefore, the present study suggests that subacute exposure to ACN could produce oxidative damage and immune system response in rats 'spleen, and NAC might reduce the degree of injury through antagonism.