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Myco.is Fungo.des in Relatio. to.Enviro.mental and o.cupatio.al Expo.ures: A Case-Co.tro. Study in the Tunisian Center

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Internatio.al Jo.rnal o. Clinical Medicine 2018年第6期9卷 528-539页

作者： I. Kacem M. Hafsia L. Bo.so.fara N. Ghariani Feto.i o. el maalel W. Bo.ghattas N. Ghariani M. Denguezli A. Brahem S. el Guedri H. Kalbo.ssi S. Chatti N. Mrizak o.cupatio.al Medicine Department Teaching Hospital Farhat Hached Sousse Tunisia Dermato.o.y Department Teaching Hospital Farhat Hached Sousse Tunisia

Intro.uctio.: The myco.is fungo.des (MF) is the mo.t co.mo. cutaneo.s T-cell lympho.as representing abo.t 50% o. all cutaneo.s lympho.as. Its patho.enesis remains po.rly understo.d. Thus, its rising incidence rates call fo. an explanatio.. Several enviro.mental and o.cupatio.al facto.s have been implicated in the patho.enesis o. this disease. o.jective: To.determine the po.ential o.cupatio.al facto.s co.related in the o.currence o. MF. Metho.s: Case-co.tro. study was carried o.t at the teaching Ho.pital Farhat Hached o. So.sse (Tunisia) to.investigate asso.iatio.s o. MF and o.cupatio.al risk facto.s. A questio.naire o. lifetime jo. histo.y was administered to.24 cases and co.tro.s. Cases were patients with MF and who.e diagno.is was suspected by a dermato.o.ist and co.firmed by patho.o.ical examinatio.. Co.tro.s were patients co.sulting in the o.cupatio.al medicine department and matched to.cases by age and gender. Bivariate analysis was used to.calculate o.ds ratio. (o.) and 95% co.fidence intervals (CI). Results: The average age o. o.set o. the disease was 55.41 ± 17.4 years with a sex ratio.o. 2.42. We fo.nd an increased risk o. MF asso.iated with to.acco.co.sumptio. higher than 40 Pack-year (o. = 6.6;95% CI = 1.22 to.35.4), exercise in the textile secto. (o. = 9.4;CI = 1.06 to.84.3) and expo.ure to.diesel exhaust (o. = 9.47;95% CI = 1.06 to.84.3). Co.clusio.: o.cupatio.al facto.s co.ld play a ro.e in the patho.enesis o. MF. Regarding o.r study, smo.ing, wo.king in the textile industry and expo.ure to.diesel exhaust appear to.be invo.ved in the patho.enesis o. MF. Further investigatio. is needed to.co.firm these findings.

关键词： Myco.is Fungo.des o.cupatio.al Facto.s To.acco Textile Secto. Diesel Exhaust

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Parental o.cupatio.al Expo.ure and Risk o. Acute Leukemia in Children: A Tunisian Po.ulatio.-Based Case-Co.tro. Study

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Internatio.al Jo.rnal o. Clinical Medicine 2016年第3期7卷 193-203页

作者： H. Kalbo.ssi Y. Ben Yo.ssef I. Bo.gmiza F. Alo.i A. Alo.i W. Bo.ghattas M. Mao.a A. Brahem S. Chatti o. el maalel F. Debbabi A. Khlif N. Mrizak o.cupatio.al Medicine and o.cupatio.al Patho.o.ies Department Farhat Hached Teaching Hospital Sousse Tunisia Hemato.o.y Department Farhat Hached Teaching Hospital Sousse Tunisia Co.munity Medicine Department Faculty of Medicine of Sousse University of Sousse Sousse Tunisia

Backgro.nd: In recent decades, the incidence o. children’s hemato.o.ical malignancies has been increasing wo.ldwide including Tunisia. Their severity is reflected in the impo.tance o. the medical, so.ial and eco.o.ic impact. This increase remains fully unexplained, and the invo.vement o. genetic, enviro.mental and o.cupatio.al facto.s is stro.gly suspected. Materials and metho.s: o.r study was a cro.s-sectio.al survey o. the type case-co.tro. co.ducted in the University Ho.pital o. Farhat Hached o. So.sse during the perio. ranging between 1 July 2011 and 30 June 2012, and which included children with acute leukemia co.pared to.children unharmed by neo.lastic disease. Cases and co.tro.s were matched by age and gender. o.r o.jective was to.describe the so.io.o.cupatio.al characteristics o. the parents o. children with acute leukemia and to.identify po.ential o.cupatio.al facto.s implicated in the genesis o. acute leukemia. Results: The number o. acute leukemia cases in the Hemato.o.y Service and day ho.pital o. the University Ho.pital o. Farhat Hached during the study perio. was 66 cases divided into.in 40 bo.s and 26 girls with a sex ratio.o. 1.53. o.r cases and co.tro.s were matched by age and gender. The risk o. incidence o. leukemia in children fro. smo.ing fathers was higher (p = 0.02, o. = 2.24, IC = [1.11 - 4.52]). The risk o. incidence o. leukemia in children fro. alco.o.ic fathers was higher with p = 0.009, o. = 3.9;CI = [1.33 - 11.39]. After adjusting different variables, the difference persisted significantly with pa = 0.03 and o.a = 3.5, ICa = [1.09 - 11.6]. 25.7% o. cases had a family histo.y o. blo.d disease and neo.lasia, whereas no.co.tro. presented that. The difference was statistically significant (p = 0.006, o. = 1.46, IC = [1.38 - 1.56]). The parental o.cupatio.al expo.ures asso.iated to.the o.currence o. acute leukemia in children were pesticides with a statistically significant difference (p = 0.03, o. = 2.94, IC = [1.06 - 8.13]). This difference

关键词： o.cupatio.al Medicine Hemato.o.y Leukemia Children Case Co.tro. Survey

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NUMERICAL STUDY o. FLo. ARo.ND AN o.CILLATING DIAMo.D PRISM AND CIRCULAR CYLINDER AT Lo. KEULEGAN-CARPENTER NUMBER

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Jo.rnal o. Hydro.ynamics 2012年第5期24卷 767-775页

作者： GHo.LANI Belgacem HAFSIA Zo.haier maalel Khlifa Eco.e Natio.ale d'Ingénieurs de Tunis Laboratoire de Modélisation en'Hydraulique et EnvironnementB.P.37.Le Belvédère1002 TunisTunisia

In o.der to.identify the influence o. shape co.ers o. the instantaneo.s fo.ces in the case o. o.cillating bo.ies, the simula- ted flo. field is co.pared fo. two.kinds o. cro.s sectio.s： diamo.d prism and circular cylinder. Fo. these two.flo. co.figuratio.s, the same Reyno.ds number and a Keulegan-Carpenter are co.sidered. To.co.pute the dynamic flo. field surro.nding the bo.y, the Navier-Sto.es transpo.t equatio.s in a no.-inertial reference frame attached to.the bo.y are co.sidered. Hence, a so.rce term is added lo.ally to.the mo.entum equatio. to.take into.acco.nt the bo.y acceleratio.. The pro.o.ed mo.el is so.ved using the PHo.NICS co.e. Fo. the o.cillating circular cylinder, the simulated results are in go.d agreement with the experimental data availa- ble in the litterature. After validatio. o. this pro.o.ed mo.el, flo. field fo. diamo.d prism is determined. Fo. bo.h bo.ies, the pro. cess o. the vo.tex fo.matio. is similar, with the fo.matio. o. a recirculatio. zo.e in the near-wake co.taining a symmetric pair o. vo.tices o. equal strength and o.po.ite ro.atio.. The length o. recirculatio. zo.e varies appro.imately linearly with time. Ho.ever, the in-line fo.ce co.fficient o. the o.cillating diamo.d prism is fo.nd to.be greatest, since the recirculatio. zo.e is lo.ger co.pared with that o. the o.cillating circular cylinder.

关键词： o.cillating cylinder diamo.d prism bo.y shape no.-inertial frame numerical simulatio. in-line and transverse fo.ceco.fficient

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Buerger’s Disease and Fitness fo. Wo.k in a Flight Perso.nel: A Case Repo.t

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o.cupatio.al Diseases and Enviro.mental Medicine 2022年第2期10卷 71-77页

作者： Imen Jammeli Asma Alo.i Malek Ben Abdelkader Zeineb Athimni Marwa Bo.ho.la Cho.chene Asma Imen Kacem Maher Mao.a Aicha Brahem Ho.da Kalbo.ssi o.fa el maalel So.haiel Chatti Nejib Mrizak University Ho.pital Farhat Hached Sousse Tunisia Department o. o.cupatio.al Medicine University Hospital Ibnou El Jazzar Faculty of Medicine of Sousse University of Sousse Sousse Tunisia

Buerger’s disease, also.called thro.bo.ngiitis o.literans (TAo., is an inflammato.y disease affecting small and medium size blo.d vessels o. the limbs. Several risk facto.s are stro.gly asso.iated with this disease. In fact, heavy smo.ers represent 99% o. patients diagno.ed with Buerger’s disease and smo.ing cessatio. can slo. do.n the pro.ressio. o. the patho.o.y. Ulcers and gangrene are very co.mo. co.plicatio.s and TAo.may also.cause a vasculitis as well as ischemic damage to.the distal part o. the limbs that can eventually lead to.limb amputatio.. Here, we repo.t the case o. a 43 years o.d patient, a flight perso.nel wo.king in a Tunisian airline co.pany who.co.sults fo. a lesio. o. the left to. that appeared 2 weeks ago. He is a chro.ic inveterate smo.er with 36 pack-years. The diagno.is o. TAo.was made based o. the clinical presentatio. and the results o. the Do.pler Ultraso.nd o. the left to.. This disease has a majo. impact o. the quality o. life due to.the risk o. necro.ic ulcers and amputatio.. Navigatio. is a pro.essio. that requires a high level o. physical and mental fitness. Acco.ding to.the internatio.al and Tunisian standards, the applicant o. the ho.der o. medical certificate must no. have a cardio.ascular co.ditio. that may affect the safety o. the exercise.

关键词： Buerger’s Disease Flight Perso.nel Medical Fitness

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Healing Humo.: The Use o. Humo. in the Nurse-Patient Relatio.ship

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o.cupatio.al Diseases and Enviro.mental Medicine 2022年第3期10卷 217-231页

作者： Farah Chelly Imène Kacem Amen Mo.ssa Amal Ghenim Imen Krifa Feriel Methamem Asma Cho.achane Asma Alo.i Aicha Brahem Ho.da Kalbo.ssi o.fa el maalel So.hail Chatti Maher Mao.a Sameh Bannano. Nejib Mrizak Université de So.sse Faculty of Medicine of Sousse Sousse Tunisia Department o. o.cupatio.al Medicine Farhat Hached Academic Hospital Sousse Tunisia University o. Sciences Arts and Techniques of Sousse Sousse Tunisia

o.jective: To.identify the impo.tance o. using humo. in patient/nurse relatio.ship, its facto.s, its co.ditio.s and the barriers that might limit its use. Metho.s: We systematically searched PubMed, Science Direct and Go.gle Scho.ar, fo. relevant articles published in English between 2010 and 2019. We included the studies that investigated humo. between nurses and their patient’s relatio.ship. Results: Fro. the initial 287 articles fo.nd, 15 were included fo. final revisio.. Data allo.ed retrieving info.matio. o. humo. definitio.;its applicability as a nursing interventio.;humo. as a to.l to.impro.e nurse-patient co.municatio. and relatio.ship;influencing facto.s;humo. benefits in health care co.text and the limits that co.e against its use. Co.clusio.: Humo. is co.sidered a po.erful co.municatio. to.l, it pro.o.es well-being, relieves anxiety and stress, helps deal with stressful situatio.s but it sho.ld be used cautio.sly in o.der to.prevent undesired co.sequences.

关键词： Humo. Patient/Nurse Relatio.ship Co.municatio.

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Lo. Back Pain amo.g Nurses: Prevalence, and o.cupatio.al Risk Facto.s

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o.cupatio.al Diseases and Enviro.mental Medicine 2017年第1期5卷 26-37页

作者： Wided Bo.ghattas o.fa el maalel Maher Mao.a Iheb Bo.gmiza Ho.da Kalbo.ssi Aicha Brahem So.haiel Chatti Fethi Mahjo.b Néjib Mrizak Department o. o.cupatio.al Medicine Faculty of Medicine Ibn El Jazzar Sousse Tunisia Department o. Co.munity Health Faculty of Medicine Ibn El Jazzar Sousse Tunisia

o.jectives: Lo. back pain is a majo. o.cupatio.al pro.lem especially amo.g nursing staff. The o.jectives o. o.r study are to.evaluate the prevalence o. lo. back pain amo.g nurses and to.lo.k fo. physical and psycho.o.ial risk facto.s. Metho.s: It is a cro.s-sectio.al study based o. a self-administered questio.naire destined fo. all nurses wo.king in Farhat Hached Teaching ho.pital o. So.sse (Tunisia). Results: o.r study included 203 nurses with an average age o. 39.8 years. The prevalence o. lo. back pain o.er the last twelve mo.ths was 58.1%. The facto.s that are significantly asso.iated to.lo. back pain were: high BMI, number o. pregnancies, arthritis, po.r physical co.ditio., daily frequency o. inappro.riate po.ture fo. the activity being perfo.med, and the layo.t o. materials in the wo.kplace. Co.clusio.: o.r study evidenced the high prevalence o. LBP amo.g nurses and allo.ed bringing to.light the ro.e o. individual and ergo.o.ic physical facto.s in the genesis o. LBP. Such identificatio. permits to.undertake targeted preventive actio.s. The asso.iatio. between psycho.o.ial facto.s and LBP was no. emphasized.

关键词： Lo. Back Pain Prevalence Nurses Physical Facto.s Psycho.o.ial Facto.s

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o.cupatio.al Allergic Co.tact Dermatitis in Tunisia: Epidemio.o.y and o.cupatio.al o.tco.e

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o.cupatio.al Diseases and Enviro.mental Medicine 2018年第3期6卷 107-117页

作者： Asma Alo.i Maher Mao.a Ho.da Kalbo.ssi Imène Kacem Sana el Guedri Aicha Brahem o.fa el maalel Faten Debbabi So.haiel Chatti Néjib Mrizak Department o. o.cupatio.al Medicine Faculty of Medicine of Sousse University of Sousse Farhat Hached Teaching Hospital Sousse Tunisia

Backgro.nd: o.cupatio.al allergic co.tact dermatitis (ACD) is o.e o. the mo.t frequent diseases o. the wo.kplace wo.ldwide. Its natio.al incidence and prevalence were no. previo.sly studied in Tunisia. o.jective: To.assess incidence o. o.cupatio.al allergic co.tact dermatitis and its o.cupatio.al o.tco.e in Tunisia. Metho.s: Descriptive epidemio.o.ical study o. all cases o. o.cupatio.al allergic co.tact dermatitis repo.ted fro. 2002 to.2012 in Tunisia and reco.nized by the medical co.missio.s o. the Natio.al Health Insurance Fund. Results: 315 cases o. o.cupatio.al ACD were co.lected representing an annual incidence o. 31.65 cases/100.000 wo.kers in the private secto. in Tunisia. The mean age o. o.r po.ulatio. was 42.70 ± 9.02 years with a male predo.inance (sex ratio.3.03). The mo.t affected secto.s were the clo.hing secto. (14.3% o. cases) and the cement industry (13.7% o. cases). Patch tests were po.itive in 188 patients (59.67%). The mo.t frequently po.itive allergen was po.assium dichro.ate in 27.3% o. the cases. o.erall, 25.4% o. patients had lo.t their jo.s. After multiple binary lo.istic regressio., jo. lo.s had a statistically significant relatio.ship with lo.alizatio. o. lesio.s o. the face and o. do.inant hand. Co.clusio.: o.cupatio.al ACD is frequent in Tunisia and is respo.sible fo. an impo.tant rate o. jo. lo.s. Preventive measures must be reinfo.ced, especially the wearing o. pro.ective glo.es.

关键词： Epidemio.o.y o.cupatio.al Disease Allergic Co.tact Dermatitis Jo. Lo.s Tunisia

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Ho.pital Night Shift and Its Effects o. the Quality o. Sleep, the Quality o. Life, and Vigilance Tro.bles amo.g Nurses

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Internatio.al Jo.rnal o. Clinical Medicine 2014年第10期5卷 572-583页

作者： Wided Bo.ghattas o.fa el maalel Ridha Ben Chikh Maher Mao.a Kalbo.ssi Ho.da Aicha Braham Ho.ssem Rhif So.heil Chatti Faten Debbabi Mo.amed Do.ui Nejib Mrizak Neuro.hysio.o.y Department Sahloul Teaching Hospital Sousse Tunisia o.cupatio.al Medicine and Pro.essio.al Patho.o.ies Department Medicine Faculty of Sousse Sousse Tunisia

Intro.uctio.: The expo.ure to.shift wo.ks, and especially to.night shift, go.s against the circadian rythmicity o. the so.ial man, which brings abo.t a multitude o. disruptive effects o. health. In a ho.pital enviro.ment, such night shift is necessary so.as to.ensure the co.tinuity o. care. Sleep and vigilance diso.ders related to.this wo.k mo.e are frequent and o.ten po.e adaptatio. pro.lems. The o.jective o. this study is to.detect the harmful effects o. night shift o. sleep, vigilance and the quality o. life o. nurses in Farhat Hached Teaching Ho.pital in So.sse. Material and Metho.s: It is a cro.s-sectio.al study carried o.t amo.g two.gro.ps o. nurses: o.e gro.p perfo.ming a fixed night wo.k and the o.her o.e wo.king permanently during the day at Farhat Hached Teaching Ho.pital in So.sse. Data co.lectio. is mainly based o. validated questio.naires evaluating sleep quality (Pittsburg sleep quality index), daytime sleepiness (Epwo.th sleepiness scale), sleep typo.o.y (Ho.ne and o.tberg questio.naire), and the quality o. life (SF-12). An o.jective evaluatio. o. vigilance was realized by the study o. reactio. time and erro. rates to.different tasks o. “Super lab” so.tware. Results: 50 night and 50 day nurses have been co.ligated. Bo.h gro.ps were age- and gender-matched. Sleep quality mean index was significantly higher amo.g night nurses in co.pariso. with day nurses (10.2 ± 5.9 versus 6.76 ± 5.16). After multivariate analysis, sleep quality was significantly co.related to.age, department, schedule and the cho.ce o. schedule. Night shift was no. related to.daytime sleepiness. The o.jective analysis o. vigilance sho.ed that the reactio. time to.different tasks explo.ing the attentio.al mechanisms, as well as erro.s rate, were significantly mo.e impo.tant amo.g the night gro.p. The mental sco.e o. the quality o. life was significantly higher amo.g day nurses. Ho.ever, such difference was no. significant with regard to.physical sco.e. Co.clusio.: The findings o. o.r s

关键词： Night Shift Nurse Quality o. Life Sleep Vigilance

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Epidemio.o.y o. o.cupatio.al Asthma in Tunisia: Results o. a First Natio.al Study

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o.cupatio.al Diseases and Enviro.mental Medicine 2016年第2期4卷 27-36页

作者： Mao.a Maher el maalel o.fa Bo.ghattas Wided Chatti So.hail Gharbi Ezzeddine Kammo.n Ho.da Kalbo.ssi Ho.da Mlao.ah Jabrane Abbassi Ammar Brahem Aicha Lo.kil Mo.na Haj Salah Habib Ben Khdimallah Khaled Masmo.di Tasnim Benzarti Mo.amed Debbabi Faten Mrizak Néjib o.cupatio.al Medicine and Pro.essio.al Patho.o.ies Department Faculty of Medicine of Sousse Sousse Tunisia University o. So.sse Sousse Tunisia CNAM Regio.al Centers o. So.sse Tunis and Sfax Tunisia English Department Faculty of Medicine of Sousse Sousse Tunisia Fo.ensic Medicine Department Faculty of Medicine of Sousse Sousse Tunisia Department o. Pneumo.o.y and Allergo.o.y Farhat Hached Teaching Hospital Sousse Tunisia

Intro.uctio.: Apart fro. its increasingly impo.tant frequency, o.cupatio.al asthma (o.) has beco.e the mo.t impo.tant cause o. o.cupatio.al respirato.y diso.ders in develo.ed co.ntries. The number o. etio.o.ical agents co.tinues to.gro. fo.lo.ing the co.stant intro.uctio. o. new harmful substances in industry. o.jectives: Determine the prevalence and incidence o. o. in o.r co.ntry, the so.io.o.cupatio.al characteristics o. asthmatics, and study the fo.ensic and so.ial impact o. such patho.o.y. Material and Metho.s: An exhaustive retro.pective epidemio.o.ical study was co.ducted in Tunisia abo.t charts o. o.cupatio.al asthma cases reco.nized by the co.petent co.missio.s o. the Natio.al Medical Care Fund (CNAM) during the perio. ranging fro. January 1st 2000 to.December 31st 2008. Results: 361 o.cupatio.al asthma cases, acco.nting fo. a prevalence o. 7.17% o. all o.cupatio.al diseases, were reco.nized during the perio. o. the study. o.cupatio.al asthma annual incidence was estimated to.be 24.42 cases per 1000000 wo.kers. o.r study po.ulatio. was mainly wo.en with a sex ratio.o. 0.86. Mo.e than a half (57.6%) o. reco.nized o. cases were wo.king in the textile industry secto.. Co.cerning the asthmatics’ pro.essio.al career, mo.t o. reco.nized o. cases (n = 225 i.e. 70.6% o. cases) kept their jo.s, whereas 58 patients did no.. The pro.essio.al career was linked to.gender with a jo. lo.s that is 1.79 time mo.e impo.tant in asthmatic wo.en. Co.clusio.: The incidence o. o.cupatio.al asthma in Tunisia is co.parable with that fo.nd in o.her Mediterranean co.ntries. A rigo.o.s and adequate preventio. is necessary and allo.s reducing the impo.tance o. this o.cupatio.al patho.o.y and its serio.s co.sequences.

关键词： Epidemio.o.y o.cupatio.al Asthma Pneumo.o.y Allergo.o.y Tunisia

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Extrapro.essio.al and o.cupatio.al Risk Facto.s fo. Co.o.ectal Cancer

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Jo.rnal o. Life Sciences 2012年第8期6卷 848-857页

作者： o.fa el maalel Wided Bo.ghattas Maher Mao.a Ho.da Kalbo.ssi Iheb Bo.gmiza Ho.ssem Rhif So.haiel Chatti Kader N'Daye Faten Debbabi Ali Mtirao.i No.jib Mrizak Department o. o.cupatio.al Medicine Teaching Hospital Farhat Hached of Sousse Avenue Ibn El Jazzar 4000 Tunisia Department o. Co.munal Medicine Medicine University Avenue Mohamed Karoui Sousse 4002 Tunisia

Co.o.ectal cancers (CRC) acco.nt fo. frequent and serio.s cancers which result fro. the interactio. between individual genetic facto.s and enviro.mental facto.s, and in particular widely studied nutritio.al o.es. The ro.e o. o.her o.cupatio.al facto.s remains a co.tro.ersial subject. The o.jective o. this study is to.evaluate the po.sible impact o. o.cupatio.al facto.s o. the risk o. develo.ing CRC. Materials and Metho.s: This is a retro.pective case-co.tro. study. The cases and the co.tro. gro.p were enlisted in the general surgical ward o. Farhat Hached Teaching Ho.pital o. So.sse (Tunisia) during the perio. extending fro. 2004 to.2008, and they were age and gender-matched. The data were analyzed using SPSS 11.0 so.tware with a significatio. thresho.d fixed at 5%. A univariate analysis was carried o.t as well as a multiple binary lo.istical regressio.. Results: During the perio. o. the study, 40 cases o. co.o.ectal cancers have been co.ligated including 28 men and 12 wo.en with a sex ratio.o. 0.43. The average age o. the cases was 61.55 ± 13.3 years and 60.40 ± 12.84 years fo. the co.tro. gro.p, with a no. significant difference (P = 0.69). The univariate analysis has o.jectivized significant asso.iatio.s between co.o.ectal cancer and the ho.sing co.ditio.s, the neo.lastic and digestive family histo.y, the o.cupatio.al activity secto., expo.ure to.pesticides, and lack o. perio.ic medical supervisio.. After lo.istical regressio., the o.currence risk o. CRC was significantly asso.iated with: alco.o. and smo.ing (o.a = 3.43; Pa = 0.05), meat co.sumptio. (o.a = 3.34; Pa = 0.03), expo.ure to.pesticides (o.a = 20.44; Pa = 0.012) and lack o. perio.ic medical supervisio. (o. = 7.45; P = 0.004). Co.clusio.: The o.cupatio.al risk facto.s might play a ro.e in the etio.atho.enesis o. co.o.ectal cancers. With regard to.o.r study, pesticides seem to.be mo.t implicated and necessitate suitable preventive measures. Nevertheless, it seems useful to.multiply the studies to.a much l

关键词：职业活动大肠癌危险因素单因素分析平均年龄疾病预防 CRC 结直肠癌

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