2015年上海市杨浦区长白街道居民死因监测分析

目的:分析2015年杨浦区长白街道居民死因现状及其规律,为完善疾病预防干预措施、评价其效果提供依据.方法:收集2015年长白街道户籍居民的死亡及人口监测资料,按国际疾病分类法ICD-10标准进行分类,使用死亡率、构成比等对居民死因监测资料进行描述性统计分析.结果:居民总死亡率为982.94/10万,男性为977.45/10万,女性为988.71/10万,女性死亡率略高于男性;前5位死因顺位依次为循环系统疾病,恶性肿瘤,呼吸系统疾病,内分泌代谢疾病和消化系统疾病,占全死因的92.51％.结论:慢性非传染性疾病是长白街道居民死亡的主要死因,应有针对性地开展健康教育和健康促进工作,提高长白街道居民的健康寿命和生活质量.     

2008年湖北省人群死亡率及死亡特征分析

目的:通过对2008年湖北省死亡监测资料的分析,了解湖北省居民的死因状况。方法:分层整群抽取湖北省2008年监测地区的全部死亡病例,对湖北省居民死因状况做描述性分析,共抽取11个具有代表性的地区。结果:湖北省2008年监测总人数为6,059,001人,总体死亡率为580.74/10万人,其中男性为3,144,625人,死亡率为651.97/10万;女性2,914,376人,死亡率为503.88/10万,差异有统计学意义(P0.001)。2008年湖北省城市死亡率为666.85/10万,农村死亡率为558.58/10万人,差异有统计学意义(P0.001)。2008年湖北省前10位死因分别为脑血管病、肿瘤、心血管病、伤害、呼吸系统疾病、消化系统疾病、泌尿生殖系统疾病、内分泌营养和代谢疾病、传染病和寄生虫病和起源于围生期的某些情况,占全死因构成的87.83%。结论:心脑血管疾病和肿瘤等慢性病是造成湖北省居民死亡的主要原因,肿瘤和心脑血管病、损伤和中毒等是慢性病预防控制工作的重点。     

2008-2012年新郑市居民主要死因统计与分析

目的通过了解居民死亡原因用描述流行病学方法对死因、构成比以及死因的顺位变化进行统计,为医疗保健政策和卫生部门进行卫生规划和卫生资源的合理配置,降低本地区的居民死亡率提供理论依据。方法对新郑市2008--2012年的居民死亡原因谱,按照国际疾病分类（ICD-10）进行死因编码,采用Excel2003、进行统计分析。结果新郑市2008--2012年共报告死亡病例7306人,男4286人,女3019人,死亡率为239．36／10万。前6位的死因顺位依次为循环系统疾病、恶性肿瘤、呼吸系统疾病、消化系统疾病、损伤和中毒伤害、内分泌疾病。以上主要死因死亡率随年龄增加呈上升趋势。结论影响新郑市的居民健康和寿命的主要疾病是恶性肿瘤、循环系统疾病和呼吸系统疾病。廊加强对这三种疾病的综合防治。     

呼和浩特市赛罕区2012年居民死因调查研究

目的了解呼和浩特市赛罕区威胁人群健康的主要疾病,为卫生政策的制定提供基本数据。方法收集2012年赛罕区人口资料及死亡资料,采用Excel 2007方法进行统计分析。结果赛罕区2012年有人口418 443人,死亡2 272人,年均粗死亡率为542.97/10万,其中男性居民粗死亡率为667.32/10万,女性居民粗死亡率为413.92/10万;居民标化死亡率为512.5/10万,男性标化死亡率563.07/10万,女性标化死亡率446.28/10万。婴儿死亡率为8.9‰,孕产妇死亡率0。慢性非传染性疾病已占到全人群死因的87.68%,具体到各类疾病死因顺位,前五位分别是心脑血管疾病、恶性肿瘤、慢性呼吸道疾病、伤害、消化道疾病。结论心脑血管疾病是危胁赛罕区居民的首要疾病,应针对心脑血管的危险因素进行综合干预,使其发病率下降。     

河北省张北县2012年居民死因监测分析

目的分析2012年河北省张北县居民死亡率和主要死亡原因,为政府制定有效的疾病预防控制策略提供科学依据。方法资料来源于张北县2012年死因监测系统,按照国际疾病分类法ICD-10标准进行分类,以率、构成比为主要指标,进行统计分析。结果张北县居民2012年死亡率为564．91／10万,男性死亡率为687．39／10万,女性死亡率为435．63／10万,两者差异有统计学意义（X^2=56．5,P=0．000）。张北县居民前十位死因依次为心血管疾病、恶性肿瘤、脑血管疾病、慢性阻塞性肺病、肺源性心脏病、消化系统疾病、损伤和中毒、内分泌营养代谢系统疾病、其他呼吸系统疾病、泌尿系统疾病,其中前五位疾病导致的死亡占报告死亡人数的84．25％;从死亡的单病种看,居于前3位的是心肌梗死、肺癌、脑梗死;死因顺位在不同年龄中有差异。结论心、脑血管系统疾病和恶性肿瘤是张北县居民的主要死因,死因顺位随年龄的差异而呈现出不同的特点,应制定有针对性的疾病防治策略。     

兖州市2010年居民死因监测现况分析

目的了解2010年兖州市居民死亡报告基本情况,为制定兖州市健康防治策略提供基础资料。方法利用死因登记信息报告系统,建立Excel数据库,采用SPSS软件分析兖州市2010年居民死亡现况。结果 2010年1月1日零时～2010年12月31日24时兖州市共报告已审核死亡病例717例,总死亡率为113.33/10万,75～79岁年龄段报告死亡率最高,死亡率为17.23/10万;农、林、牧、渔、水利业生产人员伤病死亡率最高,占总死亡率的61.23%;前5位死因依次为循环系统疾病、肿瘤、损伤和中毒外部原因疾病、呼吸系统疾病、诊断不明疾病,且男女之间死因顺位差异无统计学意义(x2=0.241,P>0.05)。结论兖州市2010年老年人口死亡率占较高比例,慢性非传染性疾病是引起兖州市居民死亡的主要原因,应加强对慢性非传染性疾病的控制工作。     

2020—2022年上海宝山区高境镇户籍居民死因监测结果分析

目的 ：分析2020—2022年上海宝山区高境镇户籍居民主要死亡原因,为今后在社区中开展疾病防控策略提供依据。方法 ：收集上海宝山区高境镇2020—2022年的死因监测数据及人口学资料,按国际疾病分类（ICD-10）进行死因编码分类,分析高境镇辖区户籍居民的死亡率、死因构成和死因顺位。结果 ：2020—2022年上海市宝山区高境镇户籍居民年均死亡率为1049.26/10万。死因顺位前六位分别为循环系统疾病、肿瘤、内分泌营养和代谢疾病、呼吸系统疾病、损伤和中毒、消化系统疾病。随着年龄的增长,死亡率呈上升趋势,15～44岁和45～59年龄组首位死因都为肿瘤,而60岁及以上年龄组首位死因为循环系统疾病。结论 ：上海高境镇户籍居民的主要死亡原因为慢性非传染性疾病。社区防病工作中应以慢病非传染性疾病为主,加强对社区居民慢性非传染性疾病防治的健康教育,提倡早发现、早诊断、早治疗,减少慢性非传染性疾病的发病和死亡,提高居民的生活质量。     

某市2009年居民主要死因及潜在寿命损失分析

目的了解周口市居民死亡水平和主要死亡原因,为综合防治提供依据。方法按ICD-10国际疾病分类对死因进行分类及编码,统计分析人群的粗病死率、标化病死率及死因构成。结果周口市2009年居民年均病死率为643.80/10万,标化病死率为590.83/10万。主要死因顺位为脑血管病、恶性肿瘤、心脏病、呼吸系统疾病、损伤和中毒,这5类死因死亡人数占总死亡数的89.48%。结论慢性非传染性疾病、损伤和中毒已成为周口市居民的主要死亡原因和疾病负担,是周口市重要的公共卫生问题。     

上海市某社区2007-2009年死因分析

目的:分析3年内上海市杨浦区延吉街道居民的死亡率及前十位死因顺位,为制定社区慢性病管理计划提供依据.方法:根据2007~2009年延吉街道居民的死因监测资料,分析不同年龄组的死亡率以及前十位死因顺位.结果:该社区居民不同年度的死亡率呈逐年上升趋势,男性死亡率高于女性,60岁以上老年人的死亡率为86.94%;死因顺位前5位依次为循环系统疾病、肿瘤、呼吸系统疾病、内分泌系统疾病、损伤和中毒,占死亡人数的比例依次为38.88%、32.30%、9.67%、5.32%、5.13%,合计占死亡人数的91.30%.结论:该社区死因主要为循环系统、肿瘤、呼吸系统、内分泌系统疾病和损伤中毒,应有针对性地加强老年人的健康教育和健康促进工作     

上海市奉贤区2011年居民死因分析

目的了解上海市奉贤区2011年居民死亡水平及主要死因构成,为制定疾病防控措施提供依据。方法采用死亡率、死亡构成比、死因顺位等指标,对奉贤区居民2011年死亡资料进行分析。结果死亡率729.1/10万;前5位死因依次为恶性肿瘤、循环系统疾病、呼吸系统疾病、损伤与中毒、内分泌系统疾病,占死亡总数的83.4%;恶性肿瘤死因中前5位依次为肺癌、肝癌、胃癌、大肠癌和食管癌,占恶性肿瘤死亡总数的65.6%。结论恶性肿瘤、心脑血管疾病等慢性非传染性疾病是奉贤区居民的主要死因,应加强相关卫生服务项目的投入及健康教育力度。     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

基层医院护士在临床合理用药中的作用

目的充分利用护士在医师和患者间的特殊地位和作用,促进基层临床合理用药。方法从护士的工作性质出发,论述护士参与促进合理用药的方便和优势。结果通过实践,护士在促进合理用药中的作用得到有效发挥,基层合理用药环境得到极大改善。结论充分利用护士与医师和患者间的特殊桥梁作用,在基层医院促进合理用药,规范医师用药行为,防止药物滥用,引导患者安全用药,降低药源性疾病。