南昌市社区中老年居民高血压患病影响因素分析

目的掌握影响城镇居民高血压病的危险因素,为预防和控制高血压提供依据。方法按性别和年龄分层抽取南昌市2个社区40岁及以上居民9 998人,进行个人基本信息、健康状况以及影响健康的相关行为危险因素的问卷调查及体格检查。结果9 998人收缩压、舒张压为（127.2±18.6）mmHg、（72.6±10.2）mmHg;检出高血压2 486人（24.86%）,男性高于女性（P〈0.01）;影响高血压的危险因素为年龄、慢性肾炎、腰臀比、文化程度、腰围、颈围、食用动物内脏、性别、饮酒、体重指数。结论南昌市2个社区居民高血压患病率略低于全国平均水平;年龄是影响高血压的主要危险因素。     

郑州市城区成年人慢性肾脏病流行病学调查

目的 了解郑州市城区成年人慢性肾脏病(CKD)的流行现状.方法 采取多阶段分层整群随机抽样的的方法,抽取郑州市4个社区内20岁及20岁以上常住居民共1855人,进行问卷调查、体格检查、肾脏损伤及相关危险因素检测.结果 在资料完整的1752名居民中,经人口年龄和性别构成比校正后,白蛋白尿、血尿、估算肾小球滤过率(eGFR)下降的患病率分别为5.78%、8.19%和1.58%.男性蛋白尿和血尿的患病率低于女性(4.37%比7.29%,X2=6.252,P=0.012;5.08%比11.51%,X2=24.499,P＜0.01);eGFR下降患病率高于女性(2.26%比0.86%,X2=5.830,P=0.016).按年龄将研究对象分为7个亚组,蛋白尿和eGFR下降患病率随年龄的增加而升高(X2=13.428,P=0.037;X2=17.080,P=0.009).该人群CKD的粗患病率为14.50%,经年龄、性别标化后的患病率为13.57%,女性高于男性(17.83%比9.59%,X2=23.132,P＜0.01). CKD最多见的表现形式是血尿(50.40%)和蛋白尿(31.89%).多因素Logistic回归结果显示,性别、年龄、吸烟、肥胖、高血压、糖尿病和高尿酸血症是CKD的危险因素.该人群CKD的知晓率为8.27%,治疗率为7.09%.结论 郑州市成年人群CKD的患病率为13.57%;知晓率为8.27%.CKD的相关危险因素包括性别、年龄、吸烟、肥胖、高血压及糖尿病等.     

基于临床和CT血管造影特征分析儿童多发性大动脉炎并发心功能不全危险因素

目的 基于临床和CT血管造影(CTA)特征分析儿童多发性大动脉炎(TA)并发心功能不全(CD)的危险因素。方法 回顾性分析39例TA患儿,男9例、女30例,年龄1个月～15岁、中位年龄8岁。39例中,7例伴CD(CD组),均为女性,年龄2～15岁、中位年龄13岁;32例无CD(无CD组),男9例、女23例,年龄1个月～14岁、中位年龄7岁;对比分析2组患儿性别、年龄及主动脉受累部位等。结果 2组患儿年龄分布范围差异有统计学意义(P<0.05)。高血压、升主动脉受累是TA患儿伴发CD的独立危险因素(P均<0.05),高血压及升主动脉受累TA患儿发生CD的概率分别为非高血压及无升主动脉受累者的14.493和13.889倍。结论 高血压及升主动脉受累均为TA患儿伴发CD的独立危险因素,应积极予以干预。     

新型冠状病毒肺炎流行期武汉某社区居民心理状况及影响因素研究

目的了解新型冠状病毒肺炎流行期社区居民的心理状况及其影响因素,为实施针对性心理干预提供参考。方法采用便利抽样法抽取武汉市某社区居民333人,应用患者健康问卷和广泛性焦虑量表进行调查。结果社区居民抑郁评分为(6.89±2.12)分,焦虑评分(7.10±2.14)分。社区居民中201人(60.36%)同时存在抑郁、焦虑情绪。多因素分析显示,性别、文化程度、有亲人为医护人员是影响社区居民抑郁、焦虑情绪的因素(P0.05,P0.01)。结论新型冠状病毒肺炎流行期,社区居民存在不同程度的抑郁、焦虑情绪,应针对影响因素对社区居民加强心理疏导,提高其心理健康水平。     

社区低收入高血压患者生活质量及其影响因素分析

目的了解社区低收入高血压患者的生活质量现状,并探讨其影响因素,为健康扶贫工作开展提供依据。方法方便抽样选取武汉市6个社区中326例低收入高血压患者,采用一般资料调查问卷、家庭关怀度指数测评量表和健康调查简表进行问卷调查。结果低收入高血压患者生活质量的生理健康总分为(53.26±24.38)分,心理健康总分为(70.78±18.22)分;家庭关怀度为6(3,8)分。多元线性回归分析显示,社区低收入高血压患者生理健康总分的影响因素为年龄、性别、月收入、工作状况;心理健康总分的影响因素为家庭关怀度、年龄、月收入、工作状况和居住方式(P<0.05,P<0.01)。结论城市社区低收入高血压患者生活质量尚可,年龄大、收入低、女性、无业、无稳定居所等是患者生活质量的不利因素。家庭关怀度是社区低收入高血压患者心理健康的保护因素,但其家庭关怀度水平总体较差。在健康扶贫工作中,除经济帮扶外,还应注重改善低收入高血压患者居住环境,提高家庭支持水平,以改善患者的生活质量。     

孝感市社区居民脑卒中防治知信行现况调查分析

目的了解孝感市社区居民脑卒中防治知信行现状及相关影响因素,明确需要干预人群特点及干预重点,为开展社区脑卒中健康教育与健康促进干预提供依据。方法采取整群随机抽样方法,对孝感市6个乡镇社区居民1 420人进行脑卒中防治知信行现状调查。结果社区居民脑卒中防治相关知识总均分为28.43±6.79,总知晓率为39.47%,得分率由高到低依次为基础知识(42.26%)、诱发因素(39.36%)、危险因素识别(37.08%)、发病后急救处置知识(25.50%);脑卒中防治信念总均分为39.49±6.34,总得分率为62.68%,其中得分较低的为对脑卒中发病相关危险因素预防重要性的认识;防治行为总均分为37.46±6.47,总得分率为48.03%,其中相关疾病预防监测与治疗行为得分率不足50%。社区居民脑卒中防治知识、态度、行为互为影响(均P0.01)。结论社区居民脑卒中防治知识普遍缺乏,防治态度总体趋向积极,防治健康行为依从性较低。应针对居民知信行特点加大社区脑卒中健康教育和健康促进工作力度。     

上海浦东地区高尿酸血症的流行现状及影响因素分析

目的:探讨上海浦东地区常住人群中高尿酸血症的患病率及与慢性肾脏病危险因素的关系。方法:对上海浦东地区一个社区中1 024例常住居民进行问卷调查、尿酸、肌酐及慢性肾脏病相关危险因素的检测。采用多因素Logistic回归分析高尿酸血症发生的影响因素。本研究中以尿酸420μmol/L(男性)、360μmol/L(女性)定义为高尿酸血症。结果:在1 024例资料完整的居民中,年龄(56±14)岁,男女比例为404∶620,CKD患者为116例,高尿酸血症患者为182例(17.77%),其中非CKD患者为34例(18.58%),CKD患者为148例(81.42%),且CKD患者中女性高于男性;对高尿酸血症患者和非高尿酸血症患者CKD相关危险因素比较发现高尿酸血症患者年龄[(60±15)岁vs(55±13)岁,P0.01]、SBP[(135±13)mm Hg vs(128±15)mm Hg,P0.01]、DBP[(85.55±8.31)mm Hg vs(82.99±8.55)mm Hg,P0.01]、BMI(26.26±3.47)kg/m2vs(23.91±3.64)kg/m2,P0.01]、腰/臀围比[(0.88±0.05)vs(0.86±0.06),P0.01]、血BUN[(5.41±1.50)mmol/L vs(4.87±1.27)mmol/L,P0.01]、血清肌酐[(127.83±36.56)μmol/L vs(143.17±38.46)μmol/L,P0.01]高于非高尿酸血症组,e GFR[(127.83±36.56)ml·min-1·1.73 m-2vs(143.17±38.46)ml·min-1·1.73 m-2,P0.01]低于非高尿酸血症组,且高血压病(P0.01)、心血管病(P=0.04)和高脂血症(P0.01)比例高于非高尿酸血症患者。单因素回归分析显示年龄、SBP、DBP、BMI、腰/臀围比、BUN、血肌酐、Hb和e GFR与尿酸水平具有相关性;多因素Logistic回归显示性别、SBP、BMI和血肌酐以及高脂血症与高尿酸血症发生独立相关。结论:在上海社区人群中,高尿酸血症的患病率为17.77%,随着CKD的进展,高尿酸血症的发病率增加;相关危险因素包括性别、SBP、BMI、腰/臀围比、血肌酐。     

安徽省成人慢性肾脏病流行病学调查

目的 探讨安徽省成人慢性肾脏病(CKD)患病率及相关危险因素.方法 采用分层多级抽样的方法随机抽取安徽省18岁以上常住居民3800人,进行CKD及相关危险因素的检测和问卷调查.结果 在资料完整的3374名居民中,经人口年龄、性别构成比校正后,白蛋白尿患病率为9.8％(95％CI 8.8％～10.9％);肾功能下降患病率为2.1％(95％CI 1.7％～2.7％).该人群CKD患病率为10.4％(95％CI 9.4％～11.5％);知晓率为6.5％.女性、年龄增加、糖尿病、高血压和高尿酸血症是CKD的独立危险因素,而肥胖、高脂血症、吸烟和饮酒与CKD发病率增高无关.结论 安徽省成人CKD患病率为10.4％,知晓率为6.5％.女性、年龄增加、高血压、糖尿病及高尿酸血症是CKD的独立危险因素.     

荆门市城区居民对亚健康及中医保健的认知调查

目的了解荆门市城区居民亚健康及中医保健状况并探讨其影响因素。方法采用自行设计的问卷,对551名社区居民进行亚健康及中医保键知识、亚健康症状、中医保健行为3个方面的调查。结果社区居民亚健康及中医保健认知总分为12～54(32.88±7.64)分,均分占满分的54.80%,其中亚健康及中医保键知识、亚健康症状、中医保健行为得分分别占各维度满分的68.60%、62.85%、32.75%。不同性别、年龄、文化程度和家庭月收入居民其亚健康及中医保键知识、行为比较,差异有统计学意义(P0.05,P0.01)。结论社区居民对亚健康知识认知较缺乏,采用中医保健行为较少,应加大宣传,利用中医保健提高社区居民生命质量。     

结肠憩室出血相关危险因子

Yamada A, Sugimoto T, Kondo S等人通过对9 499例患者实施结肠镜检查并进行结肠憩室出血危险因子的相关研究,证实高血压、非甾体类抗炎及抗凝药(包括阿司匹林)是结肠憩室出血的独立危险因素,而年龄、性别和动脉粥样硬化与结肠憩室出血并无显著相关性[Dis Colon Rectum, 2008; 51(1) : 116-120].     

2015年乳腺癌辅助化疗进展

【摘要】〓乳腺癌是危害我国女性健康的头号杀手,尽管近年来辅助化疗的研究进展突飞猛进,但临床中仍有不少问题未能明确,如辅助化疗的合适人群、化疗的开始时间、蒽环及紫杉类的地位和用法、强化维持治疗的作用、疗效及预后的生物标志物等。本文结合乳腺癌辅助化疗在临床上的常见问题和2015年各大乳腺癌会议阐述乳腺癌辅助化疗的最新进展。     

Alterations in T-Cell Subset Frequency in Peripheral Blood in Obesity

Background: Obesity affects the regulation of immune and inflammatory responses. This study characterizes differences in peripheral blood lymphocyte phenotype in obese humans. Methods: Frequencies of lymphocyte subsets among peripheral blood mononuclear cells were compared between 10 obese (BMI ≥35) and 10 lean subjects, as determined by antibodies directed against cluster differentiation (CD) markers. Results: Obese patients demonstrated an increased frequency of CD3+CD4+ T-cells (mean difference 12%, P=0.004), a decreased frequency of CD3+CD8+ T-cells (mean difference 9.4%, P=0.016) and an increased frequency of CD3+CD8+CD95+ T-cells (mean difference 13.3%, P=0.032). No other differences among T-cell or monocyte subsets were noted. Conclusions: Obesity is associated with alterations in frequencies of peripheral CD4+ and CD8+ T-cells and aberrations in the expression of CD95 among CD8+ T-cells. These data suggest both CD4+ and CD8+ T-cell compartments, as well as the regulation of CD95 expression on CD8+ T-cells, as targets for further study into obesity's effects on the immune system.     

西宁地区烧伤病人动脉血气分析观察

对高海拔地区的27例烧伤病人动脉血气变化进行了分析和观察。结果证明:无论是存活病人还是死亡病人伤后均存在有低氧血症问题。并且在死亡病人和烧伤合并吸入性损伤病人其低氧血症的发生早于单纯烧伤病人。提示:吸入性损伤病人应立即行气管切开术以保障氧气供给,单纯烧伤病人可常规吸氧以维持正常血 PaO_2,ARDS 均发生在合并吸入性损伤的病人,高频喷射通气技术对纠正低氧血症有一定效果。     

Controversies in Fistula in Ano

Managing a complex fistula in ano can be a daunting task for most surgeons; largely due to the two major dreaded complications—recurrence & fecal incontinence. It is important to understand the anatomy of the anal sphincters & the aetiopathological process of the disease to provide better patient care. There are quite a few controversies associated with fistula in ano & its management, which compound the difficulty in treating fistula in ano. This article attempts to clear some of those major controversies.     

β-半乳糖苷酶在体内外成骨细胞中的表达

目的 研究β—半乳糖苷酶(β—gal)在成骨细胞中的表达状况，为阐明MorquioB综合征的发病机制提供依据。方法 裸鼠各器官和骨组织标本行X-gal染色检测。抽取羊和人骨髓行骨髓基质细胞(BMSCs)培养，分为4组：I：Adv-hBMP-2转染组；Ⅱ：Adv—β—gal转染组；Ⅲ：未转染组；Ⅳ：地塞米松诱导组。分别行X-gal染色和RT-PCR检测β—gal的表达。结果 裸鼠骺板两侧、骨膜内面及松质骨的成骨细胞和破骨细胞可见多量β—gal的表达。未转染BMSCs组有少量β—gal的表达，其他3组细胞的β—gal表达增高。结论成骨细胞和破骨细胞可表达多量β—gal，该两种细胞的β—gal缺乏可能是MorquioB综合征骨骼异常的直接原因。     

Fluid-phase transcytosis in the primate epididymis in vitro and in vivo

Ligated tubules from the corpus epididymidis of men and monkeys were incubated in medium containing horseradish peroxidase (HRP) as a marker for fluid-phase endocytosis. HRP was localized by light and electron microscopy after 0, 15, 30 and 60 min of incubation. Movement between the cells was prevented by tight junctions, but bypass of this barrier was apparently achieved by an intracellular vesicular mechanism leading to a time-dependent appearance of HRP in the lumen. Uptake of HRP into basal cells and capture by the lysosomal apparatus of principal cells were also observed. HRP-filled vesicles also appeared in the basal, mid and apical cytoplasm of epithelial cells in the caput 1 h after injection of the tracer into the epididymal circulation of the monkey, suggesting that this pathway also operates in vivo.     

Surgical management of ductal carcinoma in situ in Australia in 1995

Background: In the present paper we describe the presentation and management of ductal carcinoma in situ (DCIS) of the breast in women in Australia in 1995. This representative, national data set provides a historical comparator for studies examining DCIS management that follow. Methods: Surgeons identified by population‐based cancer registries as having treated a new diagnosis of DCIS between 1 April and 30 September 1995 completed a questionnaire on the presentation and management of each case. Results: Two hundred and five surgeons supplied treatment details on 418 DCIS tumours in 415 women . Half of all tumours were detected at BreastScreen clinics and a further 25% were detected at other mammography centres. Twenty‐six percent of tumours were palpable at presentation, 33% were multifocal and 55% were high grade (including comedocarcinoma). Breast conserving therapy (BCT) rather than mastectomy was utilized in 260 (62%) of cases. Tumours that were of low grade, small in size and not multifocal were more likely to be treated by BCT. Surgeons seeing six or more DCIS cases in the 6‐month period were more likely to utilize BCT. Of the conservatively treated cases, 22% were referred for a radiation oncology consultation. The most common reasons for treating DCIS with mastectomy were that the tumour was too extensive or multifocal (63%), it extended to margins of the specimen (42%), or patient concerns about recurrence (34%). Conclusions: In 1995 the majority of DCIS was treated with breast conserving surgery alone. Surgeons treating more DCIS cases were more likely to perform conservative surgery than surgeons treating only one DCIS case in the study period.     

Smoking-Attributable mortality in Spain in 2016

IntroductionSmoking-attributable mortality (SAM) is a valuable indicator that can be used to characterize the course and health burden of the smoking epidemic. The aim of this paper was to estimate SAM in Spain in 2016 in the population aged 35 and over, using the best available evidence.MethodsA smoking prevalence-dependent analysis based on the estimation of population-attributable fractions was performed. Smoking prevalence (never, former, and current smokers) was calculated from a combination of the Spanish Health Survey (2016) and the European Health Survey (2014); the relative risk of death among current and former smokers was taken from the follow-up of various cohorts; and mortality rates were obtained from National Center for Statistics data. SAM estimates are presented globally, and by sex, age groups, and major disease categories: cancer, cardiometabolic diseases and respiratory diseases.ResultsIn 2016, 56,124 deaths were attributed to tobacco consumption, 84% in men (47,000), and 50% in the population aged over 74 (27,795). Overall, 50% of SAM was due to cancer (28,281), 65% of which was lung cancer. One in 4 attributable deaths (13,849) occurred before the age of 65.ConclusionsOne in 7 deaths in Spain in 2016 were attributable to smoking. This estimation of SAM clearly highlights the great impact of smoking on mortality in Spain, mainly due to lung cancer and chronic obstructive pulmonary disease.