消化性溃疡患者生命质量测定量表研制及评价

目的 研制和评价慢性病患者生命质量测定量表体系之消化性溃疡量表(QLICD-PU).方法 用QLICD-PU对120名消化性溃疡患者住院治疗前后的生命质量进行测评,对量表信度、效度和反应度进行评价.结果 量表各条目与所属亚领域或领域的相关均大于该条目与其他亚领域或领域的相关,相关系数(r)>0.6;量表可以测出患者治疗前后各领域的生命质量变化,其中特异模块领域的标准化反应均数(SRM)=1.21,总量表SRM=1.10.结论 消化性溃疡患者生命质量测定量表(QLICD-PU)具有较好的信度、效度、反应度和临床可行性.     

慢性病生命质量量表中慢性胃炎量表研制

目的 研制慢性病患者生命质量测定量表体系之慢性胃炎量表(QLICD-CG),并对其信度进行考评.方法 采用共性模块和特异模块相结合的方式,经过文献回颐、核心小组讨论、重要性评分、统计筛选等过程研制量表;通过124名慢性胃炎患者的测定计算内部一致性系数α、重测相关系数r来反映量表的信度.结果 慢性病患者生命质量测定量表之慢性胃炎量表[QLICD-CG(V1.0)].其共性模块(QLICD-GM)含30个条目,慢性胃炎特异模块包含5个亚领域14个条目,总量表及各领域的内部一致性系数α、分半信度和重测相关系数分别为:总量表0.892,0.733,0.98;躯体功能0.784,0.851,0.958;心理功能0.878,0.891,0.99;社会功能0.686,0.678,0.955;慢性胃炎特异模块0.728,0.799,0.97.结论 QLICD-CG(V1.0)具有较好的信度和可行性.     

高血压患者生命质量量表研制及评价

目的 研制慢性病患者生命质量测定量表体系中的高血压量表(QLICD-HY),并对其进行测评.方法 采用程序化决策方式,结合我国语言和文化背景进行量表开发和研制,并通过157例高血压患者的测定对量表进行效度、信度、反应度等考核评价.采用统计描述、相关分析、因子分析、配对t检验等方法进行分析.结果 高血压患者生命质量测定量表(QLICD-HY),包括慢性病共性模块30个条目和高血压特异模块17个条目.量表各领域及亚领域(facet)的内部一致性信度α值基本在0.6以上、重测相关系数(r值)大多在0.8以上;各条目与所属亚领域及其领域的相关均大于与其他亚领域及领域的相关,相关系数(r值)在0.7以上者占56.52%;量表能够反映出高血压患者治疗前后生命质量的变化.结论 高血压患者生命质量测定量表(QLICD-HY)具有较好的信度、效度、反应度和临床可行性,可以作为我国高血压患者生命质量的测评工具.     

基于中医理论胃癌生活质量评价量表研制

目的 研制基于中医理论的恶性肿瘤生活质量评价体系之胃癌量表QLASTCM-Ga并对其测量学特性进行评价.方法 采用程序化决策方式(议题小组和核心小组)和量表开发理论分别研制共性模块与特异模块,二者结合形成量表,并通过240例胃癌患者生命质量测定对量表的测量学特性(信度、效度、反应度)进行评价,采用相关分析、因子分析及配对t检验等进行统计分析.结果 该量表及各领域的重测信度在为0.90～0.94,各领域内部一致性α值为0.86 ～0.93;相关分析与因子分析显示较好的结构效度;与QLQ-STO 52为效标的效标关联效度较好;已知组比较显示较好的临床效度;治疗后各领域及总量表得分均有统计学意义,且标准化反应均数SRM与QLQ-STO 52接近.结论 QLASTCM-Ga具有较好的信度、效度及一定的反应度,可用于胃癌患者的生命质量测定.     

肠易激综合征患者生命质量测定量表研制及评价

目的 研制与评价慢性病患者生命质量测定量表体系之肠易激综合征量表(QLICD-IBS).方法 采用程序化决策方式,结合中国人群背景,进行量表开发和研制;对99例肠易激综合征患者住院治疗前后的生命质量进行测评,评价量表效度、信度、反应度.结果 肠易激综合征患者生命质量测定量表(QLICD-IBS)包括慢性病共性模块30个条目和肠易激综合征特异模块15个条目,量表各领域及维度的内部一致性信度(α)基本>0.6以上、重测信度(r)>0.9;各条目与所属维度及其领域的相关均大于与其他维度及领域的相关,相关系数(r)值大多>0.6;量表能够反映出患者治疗前后生命质量的变化.结论 量表(QLICD-IBS)具有较好的信度、效度、反应度和临床可行性,可作为适合中国人群的生命质量测评工具.     

肺源性心脏病患者生命质量量表研制及评价

目的 评价慢性病患者生命质量测定量表体系的肺源性心脏病量表(QLICD-CPHD).方法 采用程序化决策方式进行量表的开发和研制,通过120例肺心病患者的测定结果 ,采用因子分析、直线相关分析、结构方程模型、配对t检验等方法 对量表的效度、信度、反应度进行考评.结果 QLICD-CPHD包括慢性病共性模块30个条目和慢性肺源性心脏病特异模块21个条目.量表大多数条目与其领域的r>0.5,大于与其他领域的相关系数;探索性因子分析和结构方程模型分析显示量表具有较好的结构效度;以SF-36为校标,其与量表相关领域的r在0.56～0.67之间,量表的效标效度一般;各领域及总量表内部一致性系数≥0.75,重侧信度系数≥0.927,分半信度系数≥0.712,显示量表具有较好的信度;治疗前后各领域及绝大多数小方面得分的配对t检验差异均有统计学意义(P<0.05),标准化反应均数在0.10～0.54之间,显示量表有较好的反应度;绝大多数患者能在15 min内完成测定.结论 QUCD-CPHD具有较好的信度、效度、反应度和临床可行性,可以作为慢性肺源性心脏病患者生命质量的测评工具.     

糖尿病患者生命质量量表研制及评价

目的对慢性病患者生命质量量表系列-糖尿病量表(QLICD-DM)测试版进行评价。方法收集2型糖尿病住院患者159例,采用自主研制的QLICD-DM测试版,于患者入院时、入院第2天和出院时进行量表测评,对量表的信度、效度、反应度进行评价。结果量表各维度的内部一致性α系数和分半系数均在0.7以上,重测信度相关系数均高于0.9;量表各条目与所属维度或维度的相关均大于该条目与其他维度或维度的相关;探索性因子分析结果显示,第1主成分主要涵盖心理状况各条目,方差贡献率达到33.919%;其次为第2主成分的糖尿病并发症条目,方差贡献率为12.006%;治疗前后患者的躯体功能、心理功能、社会功能、特异模块评分及量表总评分差异均有统计学意义(P<0.01),标准反应均数(SRM)分别为0.691、0.638、0.428、1.148、1.223。结论所研制的慢性病患者糖尿病生命质量量表具有较好信度、效度和反应度,可作为国内糖尿病患者生命质量测评工具。     

基于中医理论的恶性肿瘤生活质量评价体系之肺癌量表的研制

[目的]研制基于中医理论的恶性肿瘤生活质量评价体系之肺癌量表QLASTCM-Lu,并对其测量学特性进行评价。[方法]采用程序化决策方式(议题小组和核心小组)和量表开发理论分别研制共性模块与特异模块,二者结合形成量表,并通过240例肺癌患者进行的生命质量测定对量表的测量学特性(信度、效度、反应度)进行评价。所用到的统计学方法有相关分析、因子分析及配对t检验等。[结果]该量表及各领域的重测信度在0.93～0.96间,各领域内部一致性α值在0.85～0.93间;相关分析与因子分析显示较好的结构效度;与QLQ-LC43为效标的效标关联效度较好;已知组比较显示较好的临床效度;治疗后各领域及总量表得分均有统计学意义,且标准化反应均数SRM较QLQ-LC43为大。[结论]QLASTCM-Lu具有较好的信度、效度及一定的反应度,可用于肺癌患者的生命质量测定。     

基于经典测量理论与项目反应理论的慢性胃炎生命质量测定量表QLICD-CG(V2.0)条目分析

目的 应用经典测量理论与项目反应理论对慢性胃炎患者生命质量量表QLICD-CG(V2.0)的条目进行分析。方法 采用QLICD-CG(V2.0)量表,对163名慢性胃炎患者进行生命质量评估。利用Multilog 7.03软件进行项目反应理论分析得出每个条目的难度、区分度系数和信息量,同时结合经典测量理论分析的4种统计方法来评价条目质量的优劣。结果 CTT结果显示,除了3个条目（GPH3、GPS3、CG11）外,剩余条目都符合4种统计学方法至少满足3种的标准;IRT结果显示,所有条目的难度系数都在-6.42～4.36,而且随着难度等级（B1→B4）增加呈现出单调递增的趋势,所有条目的区分度都在1.37～1.69,所有条目的平均信息量都在0.356～0.780。39个条目中,37个条目的性能良好,2个条目（GPH3、GPS3）需要优化。结论 QLICD-CG(V2.0)量表的大部分条目的性能较好,但少数条目仍需进一步改进。     

中国头颈癌生命质量测定量表QLICP-HN的研制与考评

[目的]研制中国版头颈癌生命质量测定量表QLICP-HN,并对其进行评价。[方法]通过提出量表条目形成条目池、确定条目的形式与回答选项、条目分析与筛选、预调查与量表考评、修改完善制定出中国版的头颈癌患者生命质量测量量表QLICP-HN,并通过133例头颈癌患者进行的生命质量测定对量表进行评价。[结果]5个领域的重测信度均在0.90以上;各领域内部一致性信度的α值均在0.7以上;各条目与其领域的相关系数r值均在0.6以上。该量表在入院治疗后4周就基本上可以反映生命质量的变化。[结论]QLICP-HN中文版具有较好的信度、效度和反应度,可用于中国头颈癌患者的生命质量测定。     

有机磷中毒后对神经电图的慢性影响

对21例有机磷作业工人周围神经损害的临床表现与神经电图进行分析，发现长期接触有机磷致神经轴索损害为主，运动神经与感觉神经传导速度观察组与对照组比较，差异有显著性（P＜0．01）。神经传导速度检测，不仅可以提高有机磷中毒神经电生理检测异常率，还可以对神经损害程度、范围，提供可靠的诊断依据。     

Age-associated chronic diseases require age-old medicine: Role of chronic inflammation

Most chronic diseases—such as cancer, cardiovascular disease (CVD), Alzheimer disease, Parkinson disease, arthritis, diabetes and obesity—are becoming leading causes of disability and death all over the world. Some of the most common causes of these age-associated chronic diseases are lack of physical activity, poor nutrition, tobacco use, and excessive alcohol consumption. All the risk factors linked to these chronic diseases have been shown to up-regulate inflammation. Therefore, downregulation of inflammation-associated risk factors could prevent or delay these age-associated diseases. Although modern science has developed several drugs for treating chronic diseases, most of these drugs are enormously expensive and are associated with serious side effects and morbidity. In this review, we present evidence on how chronic inflammation leads to age-associated chronic disease. Furthermore, we discuss diet and lifestyle as solutions for age-associated chronic disease.     

Symptomatology of chronic brucellosis

McDevitt, D. G. (1973).British Journal of Industrial Medicine,30, 385-389. Symptomatology of chronic brucellosis. A survey of the occurrence of symptoms commonly attributed to chronic brucellosis was carried out by questionnaire in four different occupational groups in Northern Ireland—veterinary surgeons working in private practice, veterinary surgeons employed by the Ministry of Agriculture, general medical practitioners, and a group of forestry workers. The veterinary surgeons generally had a higher incidence of symptoms than the other two groups. This could not be accounted for by age, heavy physical exertion or professional familiarity with disease but could be related to contact with cattle and hence to possible brucella infection. Of the symptoms investigated, sweating, weakness, malaise, irritability, depression, rheumatism, arthritis, and backache occurred significantly more often in the veterinary surgeons than in the others, with selective differences between the types of veterinary practice: the alimentary system symptoms, headache, and insomnia were more evenly distributed between all groups and their inclusion as part of the chronic brucellosis symptom complex must be seriously questioned. The lack of specificity of the symptoms, their occurrence in normal persons, and the finding of high serological brucella antibody titres in asymptomatic persons who are exposed to brucella infection emphasize the need for caution against overdiagnosis. This need is illustrated by the fact that a higher proportion of Ministry veterinary surgeons unexpectedly complain of symptoms now than five years ago. The incidence of symptoms in this group is now approximately equal to that of the veterinary surgeons in private practice, although the latter continue to have much greater exposure to brucella infection. Alternative explanations for this increase are discussed.     

Comorbidity of chronic diseases

Although much research has been done on the impact of chronic illness on quality of life, still relatively little is known about the role of comorbidity. Given the growing number of (older) people with multiple chronic conditions, more information is needed on the effects of specific disease combinations for preventive purposes. In a nationwide representative sample of 1673 non-institutionalized chronic disease patients (recruited in 56 general practices) in The Netherlands, we assessed the separate and joint effects of cardiovascular disease, cancer, arthritis, chronic respiratory disease, diabetes mellitus, and thyroid dysfunction on physical and mental functioning. Data on medical diagnoses were provided by the general practitioners; data on physical and mental functioning were collected by a patient survey (SF-36). Compared to reference data of the general population, physical functioning appeared to be worse in all six diagnostic groups, whereas mental functioning was more or less comparable. Patients with arthritis or those suffering from comorbidity reported the lowest levels of physical functioning. Synergistic effects of combinations of diabetes, cardiovascular disease and/or chronic respiratory disease were found, indicating that patients suffering from these disease combinations run a higher risk of physical disability than could be expected from their separate effects.