There are necessities to the legislation of new rural area cooperative medical system as it impelled nationwide.For it is the system that guarantees peasants' basic medical rights and turns out to be part of China's social security.The key of the system construction is its legislation aspect.The first thing to consider is the necessity and feasibility of its legislation.Then comes to its legislative principles from the standpoint of legislative ethics,which is determined by its particularity that it faces to a majority of peasants concerning their public interest and so on.

Humans ; Musculoskeletal Diseases ; epidemiology ; prevention & control ; Occupational Diseases ; epidemiology ; prevention & control

Objective To evaluate the security and effect of combination of adjuvant hormonal thera- py and brachytherapy for localized prostate cancer.Methods 22 patients with T1-T2c prostate cancer were treated with transperineal ultrasound-guide 125I seeds prostate implantation and adjuvant hormonal therapy for 4～7 months.The hormonal therapy include 2-4 months before brachytherapy and 1～4 months after brachytherapy.Results The median operation time was ninety minutes,the median number of ~(125)I seeds used was 56.The follow up time was 12～48 months,the cases of PSA

OBJECTIVETo explore the relationship between occupational stress and serum glycosylated hemoglobin A1c (HbA1c) level.

METHODSA cross-sectional epidemiological study was conducted in 115 dispatchers. The occupational stressors, personality, occupational strain and coping with stress were measured using Occupational Stress Instrument. Serum HbA1c levels were measured by stratigraphic analysis of cation exchange resin.

RESULTSSerum HbA1c level (6.63% ± 1.93%) in the shiftwork group was significantly higher than that (5.73% ± 1.57%) in the daily relay work group (P < 0.05). Spearman correlation analyses showed the positive correlation between type A behavior and serum HbA1c level (r = 0.221), the negative correlation between organizational commitment and serum HbA1c level (r = -0.218). Variance analyses revealed that serum HbA1c levels among high, middle and low job requirement groups and job control groups were significantly different (P < 0.05). There were significant differences of serum HbA1c levels among different type A behavior, internal control, susceptibility of stress and organizational commitment groups (P < 0.05). Stepwise regression analyses indicated that shiftwork affects obviously serum HbAlc level, internal control and job future were the predictors of serum HbA1c level (R2 = 0.082).

CONCLUSIONSerum HbA1c may be a potential biomarker in field investigation of the effects of occupational stress.

Adult ; Cross-Sectional Studies ; Glycated Hemoglobin A ; metabolism ; Humans ; Male ; Middle Aged ; Occupational Diseases ; blood ; Serum ; chemistry ; Stress, Psychological ; blood ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo explore gender difference of relationship between occupational stress and depressive symptoms.

METHODSThe cross-sectional study was used to investigate 5338 workers in 13 factories and companies, the depressive symptoms were assessed with Epidemiologic Studies Depression Scale (CES-D) and the perceived occupational stress was evaluated by the Chinese version of the Job Content Questionnaire (JCQ) and Effort-Reward Imbalance (ERI) Model Questionnaire. Logistic regression analyses were conducted to estimate the associations between occupational stress and prevalence of depressive symptoms.

RESULTSPrevalence of depressive symptoms was 31.8% for all subjects, 33.8% for males and 27.7% for females, gender difference of prevalence was significant (P < 0.01). Psychological demands, physical demands, job control, effort, overcommitment and negative affectivity scores for males were significantly higher than those for females(P < 0.01 or 0.05), social support, reward and job satisfaction scores for males were significantly lower than those for females (P < 0.01). Psychological demands, physical demands, job control, effort, overcommitment and negative affectivity scores for workers with depressive symptoms were significantly higher than those for workers without depressive symptoms (P < 0.01) but job control, social support, reward, job satisfaction and positive affectivity scores for workers with depressive symptoms were significantly lower than those for without depressive symptoms (P < 0.01). Psychological demands, physical demands, job control, effort, overcommitment and negative affectivity scores for male workers with depressive symptoms were significantly higher than those for female counterparts (P < 0.01), but social support, reward, job satisfaction scores for male workers with depressive symptoms were significantly lower than hose for female workers with depressive symptoms (P < 0.01). Ratio of male workers and male workers with depressive symptoms with job strain and ERI > 1, high demands and low control, and high effort and low reward were higher than female counterparts (P < 0.01). The risk of depressive symptoms for female with high demands and low control was about two times as high as that for female workers with low demands and high control for psychological demands and physical demands (OR = 2.0), risk for females was slightly higher than that for males (OR = 2.04 and 2.17, respectively). The risk of depressive symptoms for workers with high efforts and low rewards was about two times as high as that for workers with low efforts and high rewards (OR = 1.70). No interactive effect between gender and job strain and ERI on depressive symptoms were found.

CONCLUSIONThe gender difference of relationship between depressive symptom prevalence and job strain may due to the difference of psychosocial factors between females and males. There may be no interactive effect between psychosocial factors and gender on depressive symptoms.

Adolescent ; Adult ; Cross-Sectional Studies ; Depression ; epidemiology ; Female ; Humans ; Job Satisfaction ; Male ; Middle Aged ; Sex Factors ; Stress, Psychological ; epidemiology ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo analyze the distribution of the musculoskeletal disorders, work load and working postures in different factories, gender, education levels, age and working years among manufacturing workers.

METHODSIn a cross-sectional study of 5134 manufacturing workers in 12 factories, the morbidities for musculoskeletal disorders in one year period were measured with questionnaires.

RESULTSThe morbidities for musculoskeletal disorders in body sites: waist, neck, shoulder, wrist, ankle/feet, knee, hip/buttocks and elbows were 59.7%, 47.9%, 38.1%, 33.7%, 26.9%, 25.4%, 15.2%, and 14.9%, respectively in one year period. There were significant differences of morbidities for musculoskeletal symptoms in body sites of workers among different factories (P < 0.05 or P < 0.01). The morbidities of musculoskeletal symptoms in elbows, waist, wrists and ankle/feet of the workers in refractory material and chemical fiber factories were higher than those in other factories, the morbidities for musculoskeletal symptoms of workers in garments and diamond factories were lower than those in other factories. The morbidities for musculoskeletal symptoms in neck, shoulders and wrists of female workers were significantly higher than those of male workers (P < 0.01). There were significant differences of the morbidities for musculoskeletal symptoms in body sites among workers with different educational levels (P < 0.05 or P < 0.01). There were significant differences of the morbidities for musculoskeletal symptoms in neck, shoulders, wrists, hip/buttocks and knee among groups with different age or different working years (P < 0.01), and the morbidities for musculoskeletal symptoms increased with age and working years. The proportions of unhealthy working postures and high working load among workers in refractory material and chemical fiber factories were higher; but those in garments and diamond factories were lower.

CONCLUSIONThe morbidities for musculoskeletal symptoms in waist, neck, shoulder and wrists of workers in manufacturing workers were higher; the gender, education level, age and working years could influenced the morbidities for musculoskeletal disorders.

Adult ; Female ; Humans ; Industry ; Male ; Musculoskeletal Diseases ; epidemiology ; Occupational Diseases ; epidemiology ; Posture ; Surveys and Questionnaires

OBJECTIVETo explore the risk factors of low back pain among the Chinese occupational population in several major industries.

METHODSA total of 7200 subjects (3600 cases and 3600 controls) were randomly sampled from a cross-sectional study, and they were investigated for individual and occupational factors of low back pain. The potential risk factors were first selected by using chi-square tests. Secondly, collinearity diagnosis proceeded by using the Kendall's rank correlation. Finally, binary logistic regression model was used for multi-factor analysis.

RESULTSCollinearity diagnosis showed that there was a severe collinearity problem among the potential risk factors of low back pain. Logistic regression model included 20 variables with statistical significance. Bending neck forward or holding neck in a forward posture for long periods (OR=1.408) was the most important risk factor inducing low back pain in this study, followed by bending heavily with the trunk (OR=1.402), carrying out identical work almost for the whole day (OR=1.340). Additionally, sufficient normal break was a protective factor of low back pain.

CONCLUSIONLow back pain among the Chinese occupational population was associated with body height, occupation, work organization, physical work, working posture, and others. All these risk factors could be regarded as the indicators of low back pain, and some relevant preventive measures should be taken to reduce low back pain risk.

Adolescent ; Adult ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Low Back Pain ; epidemiology ; Male ; Occupations ; Posture ; Risk Factors ; Young Adult

OBJECTIVETo develop a draft questionnaire (China Musculoskeletal Questionnaire, CMQ) for evaluating of musculoskeletal workload and associated potential hazardous working conditions as well as musculoskeletal symptoms of workers in Sitting Posture.

METHODSMulti-methods, which include the reviewing references, the summarizing results of preliminary studies, the reviewing ergonomic tools, the consulting experts and occupational health workers and the interviewing or discussing with individual workers in sitting posture, were used in developing item pool. The experts and epidemiologists of occupational health scored the importance of every single item in the item pool, and then the survey and sampling were carried out in 325 workers of sitting posture who completed the questionnaire. On the basis of these data, the methods including experts scoring, item analysis, Cronbach's α analysis and factor analysis were synthetically used to select the reliable items which consisted of the formal questionnaire.

RESULTSThe standard of the CMQ, which consists of 34 items on musculoskeletal workload and associated potentially hazardous working conditions, can be divided into nine indices (dynamic loads, static loads, repetitive loads, forces-exertion, prolong time, climatic factors, vibration, position and ergonomic environmental factors).

CONCLUSIONThe CMQ possesses good content validity, and the items of CMQ are divergent, reliable and typical. However, the reliability and validity of CMQ should be validated.

China ; Ergonomics ; Humans ; Musculoskeletal System ; Occupational Health ; Posture ; Surveys and Questionnaires ; Workload

OBJECTIVETo explore the relationship between occupational stress and musculoskeletal disorders in lower extremity.

METHODSThe cross-sectional study was used to investigate 5338 workers in 13 factories and companies for prevalence of musculoskeletal disorders in lower extremity, working postures and occupational stress were investigated with questionnaires for past year. Perceived occupational stress was evaluated by the Chinese version of the Job Content Questionnaire (JCQ) and Effort-Reward Imbalance (ERI) Model Questionnaire. Logistic regression analyses were conducted to estimate the associations between occupational stress and prevalence of musculoskeletal disorders in lower extremity.

RESULTSIn the main dimensions of job strain and ERI model, physical demands and effort were risk factors of hip disorders, but job control was a protective factor of hip disorders. When job strain and ERI model scales were analyzed simultaneously, only physical demands were risk factor of hip disorders. When job strain and the effort-reward imbalance were computed by creating four independent categories, job strain was a risk factor of hip disorders, ERI was a risk factor of hip and knee disorders. The risk of imbalance between job strain and effort-reward the protective effect of job control increased with the disorder regions. According to continuous variable analysis, job strain by calculated with physical demands was risk factor of hip disorders, continuous ERI variable was risk factor of hip and knee disorders.

CONCLUSIONOccupational stress is associated significantly with musculoskeletal disorders in lower extremity. The control of occupational stress and increase of job control should be considered for preventing the musculoskeletal disorders in lower extremity.

Adult ; Cross-Sectional Studies ; Female ; Humans ; Job Satisfaction ; Lower Extremity ; physiopathology ; Male ; Musculoskeletal Diseases ; epidemiology ; Occupational Diseases ; epidemiology ; Risk Factors ; Stress, Psychological ; epidemiology ; Surveys and Questionnaires

The present study was aimed to explore the changes of phosphorylated AMP-activated protein kinase (pAMPK) level in skeletal muscle after exposure to acute hypobaric hypoxia and exhaustive exercise. Thirty-two male Sprague-Dawley (SD) rats were randomly divided into sea level and high altitude groups. The rats in high altitude group were submitted to simulated 5 000 m of high altitude in a hypobaric chamber for 24 h, and sea level group was maintained at normal conditions. All the rats were subjected to exhaustive swimming exercise. The exhaustion time was recorded. Before and after the exercise, blood lactate and glycogen content in skeletal muscle were determined; AMPK and pAMPK levels in skeletal muscle were detected by Western blot. The results showed that the exhaustion time was significantly decreased after exposure to high altitude. At the moment of exhaustion, high altitude group had lower blood lactate concentration and higher surplus glycogen content in gastrocnemius compared with sea level group. Exhaustive exercise significantly increased the pAMPK/AMPK ratio in rat skeletal muscles from both sea level and high altitude groups. However, high altitude group showed lower pAMPK/AMPK ratio after exhaustion compared to sea level group. These results suggest that, after exposure to acute hypobaric hypoxia, the decrement in exercise capacity may not be due to running out of glycogen, accumulation of lactate or disturbance in energy status in skeletal muscle.
AMP-Activated Protein Kinases ; metabolism ; Altitude ; Animals ; Computer Simulation ; Glycogen ; metabolism ; Hypoxia ; physiopathology ; Lactic Acid ; blood ; Male ; Motor Activity ; physiology ; Muscle, Skeletal ; enzymology ; metabolism ; Phosphorylation ; Physical Exertion ; physiology ; Rats ; Rats, Sprague-Dawley