贲门癌危险因素病例对照研究

目的：探讨贲门癌发生的危险因素，为深入进行病因学研究提供线索。方法：对福州市6所医院2000年和2001年4月至7月的住院病人603例进行多组病例对照研究。贲门癌组为病理、手术和胃镜确诊的贲门癌191例，非贲门部胃癌190例，健康对照组为与肿瘤病例同期住院的骨科、泌尿外科的非肿瘤病人222例。采用统一调查表进行床边询问，对资料进行单因素及多因素Logistic分析。结果：贲门癌的主要危险因素有一一级亲属患肿瘤（OR＝4．286 95％CI：2．431－7．554）、进食速度快（OR＝2．028 95％ CI：1．142－2．912）、三餐不按时吃（OR＝1．909 95％ CI：1．396－2．610）、饮用井水（OR＝1．741 95％CI：1．042－2．910）每日吸烟量多（OR＝1．347 95％CI：0．989－1．835）。主要保护 因素有：常吃新鲜水果（OR＝0．645 95％CI：0．439－0．945）、使用冰箱年数长（OR＝0．731 95％CI：0．536－0．997）、化程度高（OR＝0．468 95％CI：0．276－0．74）。结论： 贲门癌与非贲门部胃癌可能有不同的危险因素，值得进一步研究。     

尿石症危险因素人群病例对照研究

目的 探索尿石症发病的危险因素，为人群预防提供依据。方法 选取深圳市尿石症现况调查发现的334例患者为病例组，721名健康者为对照组，进行尿石症危险因素人群病例对照研究；采用非条件logistic回归对34个变量进行分析，采用Falconer回归法估算遗传变。结果 尿石症病例组和对照组配比条件均衡可比，单因素logistic回归分析共有17个变量有统计学意义，但最终进入模型的因素有10个，其中4个变量为尿石症发病危险因素，OR值大小依次为既往泌尿系慢性炎症史（OR＝4.09,95%CI:1.38-12.14)，一级亲属尿石症史（OR＝2.61,95%CI:1.70-4.01)和多食动物蛋白质（OR＝2．14，95％CI：1．71－2．69），暴露日照时间长（OR＝1．39，95％CI：1．16－1．66）；而较高文化程度（OR＝0．46，95％CI：0．29－0．73），日引水量多（OR＝0．59，95％CI：0．48－0．72），饮果汁（OR＝0．41，95％CI：0．18－0．94），多食奶及奶制品（OR＝0．82，95％CI：0．68－0．99），多食蔬菜（OR＝0．70，95％CI：0．55－0．91）和多食水果（OR＝0．78，95％CI：0．64－0．94）6个变量为尿石症发病的保护因素。一级亲属尿石症患病率病例组高于对照组，尿石症分离比为0．0109，95％CI：0．0050－0．0168，一级亲属尿石症的遗传度为28．48％，男，女分别为32．06％和24．60％。结论 尿石症主要受饮食习惯影响，尿石症家族史和社会经济状况也与发病有关。     

男性不育症危险因素的病例对照研究

目的：探讨男性不育症的危险因素，方法：对94对病例和对照1：1配比进行病例对照研究。结果：长期大量吸烟（OR＝3．45，95％ CI：1．95－6．10）、婚外性生活史（OR＝7．29，95％CI：2．54－20．89）、高温大棚蔬菜种植（OR＝6．73，95％CI：1．91－23．69）、苯类化学品接触（OR＝20．53，95％CI：4．67－90．25），解脲支原体感染（OR＝5．55，95％CI：2．8－13．533）与男性不育症有关联，为其危险因素，结论：男性不育症是由多种因素长期反复作用的结果，其预防应从整治环境污染，加强职业防护，提高自我防护能力，改变不良工作生活习惯等方面做起。     

影响准分子激光角膜原位磨镶术后屈光度欠矫的多因素分析

目的：探讨各种因素与准分子激光角膜原位磨镶术（LASIK）后屈光度欠矫的关系。方法：对行LASIK的近视患者696例中屈光度欠矫病例，按年龄、性别、职业、住址、近视时间、家族史以及手术前后全部检查资料分左右眼两组进行单因素χ^2检验和多因素logistic回归分析。结果：多因素条件logistic回归分析显示，左、右眼两组均与4种因素有关：近视时间（左眼组OR＝1．076，95％CI：1．030－1．124；右眼组OR＝1．093，95％CI：1．046－1．142）、近视屈光度（左眼组OR＝7．799，95％CI：1．755－34．654；右眼组OR－28．823，95％CI：5．750－144．467）、术前矫正视力（左眼组OR＝0．000，95％CI：0．000－0．262；右眼组OR＝0．000，95％CI：0．000－0．144）和角膜厚度（左眼组OR＝0．976，95％CI：0．965－0．987；右眼组OR＝0．975，95％CI：0．965－0．986）。结论：近视时间长，近视屈光度大是LASIK术后屈光度欠矫的危险因素；术前矫正视力好，角膜厚度厚是LASIK术后屈光度欠矫的保护因素。     

隐睾发生的危险因素研究

目的：研究隐睾发生的危险因素。方法：采用以医院为基础的1：2配比的病例对照研究方法，按统一的调查方法对99例隐睾及198例对照组面对面问卷调查。应用SAS6。12软件对所调查因素进行单因素及多因素logistic回归分析，结果：胎儿隐睾与母亲孕早期感冒伴发热（OR＝9．37，95％CI：2．25－39．09），孕期发生先兆流产（OR＝4．66，95％CI，2．02＝10．74），孕期发生先兆子痫（OR＝16．33，95％CI：1．40－191．20），父亲职业性接触农药（OR＝12．79％CI；2．90－56．43），低出生体重（OR＝5．77，95％CI：1．39－23．98），母亲怀孕年龄＜24（OR＝2．89，95％CI：1．29－4．06）呈正相关。结论：母亲孕早期感冒伴发热，孕期发生先兆流产及先兆子痫，父亲职业性接触农药，低出体重，母亲怀孕年龄＜24岁是隐睾发病的主要危险因素。     

福建省贲门癌病例对照研究

目的：探讨贲门癌发生的危险因素,为病因学研究提供线索。方法：对福州市6所大医院2000年4－7月的住院病人进行多组病例对照研究,其中男性287例（82．5％）,女性61例（17．5％）,病例组为经病理,手术或胃镜确诊的贲门癌病例93例,非贲门部胃癌病例85例及非消化道肿瘤病例73例,对照组为与肿瘤病例同期住院的骨,泌尿外科的非肿瘤病例97例,采用统一调查表进行床边询问,内容包括一般人口学特征,身高,体重体,吸烟,饮酒,饮食状况,既往疾病史,家族肿瘤史等,对资料进行单因素及多因素Logistic分析。结果：贲门癌的危险因素有每日吸烟量（OR＝1．76,95％CI：1．19－2．58）,10年前食用猪油（OR＝4．24,95％CI：2．01－8．92）,父母患胃癌（OR＝3．78,95％）,CI：1．06－13.41）,胃部疾病史（OR＝3。19,95％CI：1．46－6．96）,常吃新鲜蔬菜（OR＝0．21,95％CI：0．07－0．62）,豆及豆制品（OR＝0．29,95％CI：0．09－0．92）为保护因素。结论：贲门癌与非贲门部胃癌可能有不同的危险因素,值得进一步研究。     

沈阳农村60岁以上人群良性前列腺增生危险因素的病例对照研究

目的：探讨各种危险因素与良性前列腺增生（BPH）的关系。方法：采用以人群为基础的病例对照研究，病例组为沈阳市某郊区农村60周岁以上BPH患者，对照组为无前列腺增生（排除前列腺癌、前我腺炎等疾病）的老年男性，病例与对照各100例，单因素分析采用χ^2检验，多因素分析利用非条件logistic回归分析。结果：多因素非条件logistic回归分析显示BPH发病与下列5种因素有关：患前列腺炎（OR＝5．577，95％CI：2．147－14．482）；20世纪80年代初每月肉类摄入量（OR＝4．930，95％CI：2．404－10．111）；舒张压（OR＝1．050，95％CI：0．480－0．881）。结论：患前列腺炎、80年代初每月过多摄入肉类、舒张压高可能是BPH的危险因素；吸烟量大、饮酒量大可能是BPH保护因素。     

武汉市及其周围地区恶性淋巴瘤危险因素的病例对照研究

目的 探索恶性淋巴瘤发病的危险因素。方法 采用1：1配对的病例对照研究方法，对武汉市及其周围地区115对恶性淋巴瘤病人及对照进行问卷调查。研究因素采用条件Logistic回归单因素和多因素逐步回归分析。结果 吸烟（OR＝1．76，95％CL：1．06－2．92）、家族肿瘤史（OR＝2．05，95％。CL：1．05－4．00），人均月收入（OR＝0．53，95％，CL：0．35－0．80），手术史（除扁桃体除、阑尾炎切除）（OR＝0．41，95％CL：0．19－0．89）。结论 吸烟、家族肿瘤史是恶性淋巴瘤的危险因素；家庭经济状况好，既往手术史是其保护因素。     

胃腺癌危险因素的病例对照研究

目的 探讨与胃癌有关的危险因素。方法 对天津市区1998－1999年的189例新发胃癌病人进行1：1配对病例对照研究,采用条件Logistic回归分析。结果 烟熏食品OR＝2．34,OR95％CI＝1．60－4．98;吸烟量OR＝6．07,OR95％CI＝1．26－7．16;喜食重盐饮食OR＝1．95,OR95％CI＝1．27－3．23;过量摄入动物肉类OR＝1．46,OR95％CI＝1．05－2．02。结论 经常食用烟熏食品、吸烟量大、重盐饮食、过量摄入动物肉类等可能是胃癌的危险因素。     

非胰岛素依赖型糖尿病视网膜病变危险因素的探讨

目的：采用1：1配比的病例对照研究对DR患病的危险因素进行了初步探讨。方法：采用条件Logistic回归分析程序对105名DR病例和对照进行分析。结果：单因素分析显示：糖尿病病程,糖尿病诊断年龄,高血压,SBP,尿蛋白,使用胰岛素治疗与糖尿病视网膜病变有关。经多因素分析进入主效应模型的因素为病程,其OR＝2．32（95％CI：1．32－4．5）;SBP,其OR＝4．78（95％CI：1．83－12．52）;尿蛋白,其OR＝1．9％（95％:1．21－2．99）;胰岛素使用量,其OR＝1．98（95CI：1．05－3．74）。吸烟,饮酒,饮茶,运动锻炼,社会经济状况,看书时间,社会心理因素以及BMI与DR无关。结论：在糖尿病人群中,DR发生的危险因素为病程长,使用胰岛素治疗,尿蛋白增高和SBP增高。     

某高校大学生自杀风险的影响因素及教育策略研究

目的 了解徐州市大学生自杀风险并探究其影响因素,为青少年自杀问题的教育策略提供参考依据。方法 基于中文版死亡态度量表(修订版)(DAP-R),采用整群分层随机抽样的方法,通过电子问卷调查902名大学生以了解其自杀风险,并通过Logistic回归分析自杀风险的影响因素。结果 独生子女(OR=0.698,95%CI:0.505～0.966)、有亲人离世经历 (OR=0.562,95%CI:0.404～0.782)、内在心理控制源 (与低分组比,高分组OR=0.283,95%CI:0.169～0.476)是大学生自杀风险的保护因素,差异均有统计学意义(P＜0.05);有宗教信仰 (OR=1.713,95%CI:1.118～2.623)、身体状况不佳 (OR=1.925,95%CI:1.199～3.090)、外在心理控制源(与低分组比,高分组OR=2.028,95%CI:1.228～3.348) 和死亡恐惧(与低分组比,高分组OR=3.356,95%CI:1.815～6.204)是大学生自杀风险的危险因素,差异有统计学意义(P＜0.05)。结论 大学生自杀防控工作需要重点针对有宗教信仰、身体不佳等高危人群,引导大学生充分感受生活意义,同时需要关注死亡恐惧可能是某些青少年自杀的驱动力而非保护因素。     

Perinatal conditions and parental age at birth as risk markers for subsequent suicide attempt and suicide: a population based case–control study

Restricted fetal growth and young maternal age have been associated with increased risk of suicidal behaviour later in life. Research investigating the independent and interacting effects of these risk factors with parental mental health and socio-economic status is scarce. A case–control study was effected through record linkage between Swedish registers. Individuals born 1973–1983 who were hospitalized due to a suicide attempt (n?=?17,159) or committed suicide (n?=?1,407) were matched to ≤10 controls by sex, month and county of birth. Controlling for parental conditions, significantly increased odds ratios (OR) for suicide attempt were found for low birth weight (OR?=?1.12, 95?% CI 1.01–1.25), short birth length (OR?=?1.15, 95?% CI 1.08–1.22), short and light for gestational age (OR?=?1.23, 95?% CI: 1.10-1.38), short but not light for gestational age (OR?=?1.18, 95?% CI: 1.09, 1.29), teenage motherhood (OR?=?1.66, 95?% CI 1.53–1.80), young fatherhood (OR?=?1.33, 95?% CI 1.27–1.39) and multiparity (OR?=?1.40, 95?% CI 1.31–1.50). For completed suicide, increased odds ratios were found for low birth weight (OR?=?1.65, 95?% CI 1.16–2.35), teenage motherhood (OR?=?1.44, 95?% CI 1.09–1.90) and young fatherhood (OR?=?1.20, 95?% CI 1.02–1.41). There was a synergy effect between teenage motherhood and parental psychiatric inpatient care with regard to suicide attempt in offspring [synergy index?=?1.53 (95?% CI 1.27–1.84)]. Low birth weight and length, and short and light for gestational age may increase the risk of subsequent suicidal behaviour, and more research is needed to investigate underlying mechanisms. Public health implications from this study include measures to improve pre- and perinatal parental mental health, particularly in teenage pregnancies.     

中国八城市大中学生自杀未遂心理社会因素研究

目的 了解中国城市大中学生自杀未遂发生的报告率及其与心理社会因素的关系.方法 选取全国8城市17 622名大学、高中、初中的一年级和二年级学生,进行问卷调查,收集自杀未遂及其相关心理社会因素等资料.结果 8城市大中学生中自杀未遂报告率为2.2%,多因素logistic回归分析显示,焦虑程度高(OR=2.61,95%CI:1.64～4.16)、抑郁程度高(OR=2.05,95%CI:1.35～3.10)、有自杀意念(OR=14.21,95%CI:9.88～20.43)、有自杀计划(OR=3.50,95%CI:2.59～4.73)是自杀未遂发生的危险因素.少年阶段母亲陪伴长大是自杀未遂发生的保护因素(OR=0.38,95%CI:0.20～O.74).结论 情绪症状和既往自杀心理与大中学生自杀未遂相关联.     

Parenteral nutrition as a risk factor for central venous catheter-related infection

BACKGROUND: The role of parenteral nutrition (PN) therapy as an independent risk factor for central venous catheter (CVC)-related infection in nonselected adult patients is not well established. The aim of this study was to evaluate PN as a risk factor for central venous catheter-related infection in nonselected adult patients in a general university hospital. METHODS: Patients using central venous catheters, exposed or nonexposed to PN, were prospectively followed for development of central venous catheter-related infection. RESULTS: One hundred fifty-three patients were studied; 28 developed central venous catheter-related infection. Patients with central venous catheter-related infection presented higher frequency of PN use than patients without infection (60.7 vs 34.4%; p = .010). Multivariate Cox analysis showed that PN (relative risk (RR) = 3.30; 95% confidence interval [CI], 1.30-8.34; p = .012) was the only risk factor for central venous catheter-related infection. Malnutrition (RR = 0.45; 95% CI, 0.15-1.34; p = .152), days of hospitalization before central venous catheter insertion (RR = 1.00; 95% CI, 0.98-1.02; p = .801), and sustained hyperglycemia (RR = 0.49; 95% CI, 0.98-1.21; p = .091) were not significant in the model. Multiple logistic regression revealed that mal-nutrition (odds ratio [OR] = 8.05; 95% CI, 1.85-35.03; p = .005), central venous catheter indication for surgical-related pathology (OR = 7.26; 95% CI, 2.51-21.04; p < .001), sustained hyperglycemia (OR = 4.34; 95% CI, 1.79-10.52; p = .001), and days of hospitalization before central venous catheter insertion (OR = 1.04; 95% CI, 1.01-1.07; p = .004) were associated with PN use after adjustment for Assessment Score Intervention System score (OR = 0.33; 95% CI, 0.14-0.80; p = .014). CONCLUSIONS: PN therapy is an independent risk factor for central venous catheter-related infection in nonselected hospitalized adult patients.     

Risk factors for Salmonella typhimurium DT104 and non-DT104 infection: a Canadian multi-provincial case-control study

To identify risk factors for sporadic Salmonella Typhimurium definitive phage-type 104 (DT104) and non-DT104 diarrhoeal illness in Canada, we conducted a matched case-control study between 1999 and 2000. Cases were matched 1:1 on age and province of residence. Multivariate analysis suggested that recent antibiotic use [odds ratio (OR) 5.2, 95% confidence interval (CI) 1.8-15.3], living on a livestock farm (OR 4.9, 95% CI 1.9-18.9), and recent travel outside Canada (OR 4.1, 95% CI 1.2-13.8) are independent risk factors for DT104 illness. Similar analyses suggested that recent travel outside North America is a sizable risk factor for non-DT104 illness (OR 66.8, 95% CI 6.7-665.3). No food exposure was a risk factor in either analysis. Educating health-care providers and the public about appropriate antibiotic use and antimicrobial resistance is important. Appropriate administration of antibiotics to livestock, particularly cattle, and hygienic measures such as handwashing after contact with farm animals may reduce risk. Travel represents an important and probably underestimated risk factor for sporadic illness with S. Typhimurium. Improved national surveillance and detailed investigation of travel-related illness are required.     

215例抑郁症患者自杀未遂危险因素的配对病例对照研究

目的了解汉族人群抑郁症患者自杀未遂的环境危险因素、色氨酸羟化酶2(TPH2)基因rs7305115单核苷酸多态性与自杀未遂有无关联。方法采用配对病例对照研究,对215例自杀未遂者(男性92例、女性123例)与相应对照(与病例同性别、年龄相差3岁以内、同地区)进行TPH2 rs7305115基因型测定、自杀行为干预研究量表调查环境因素与抑郁症自杀未遂的关系研究。结果研究组与对照组在TPH2 rs7305115基因型、基因频率的差异有统计学意义(P<0.001);多因素条件logistic回归模型分析显示,绝望、负性生活事件、有自杀家族史,均为抑郁症自杀未遂危险因素,OR值分别为7.68(95%CI:5.79-13.74)、6.64(95%CI:2.48-11.04)、2.98(95%CI:1.17-5.04); TPH2 rs7305115 A/A为抑郁症自杀未遂的保护因素0.33(95%CI:0.22-0.99)。结论绝望、负性生活事件、自杀家族史是抑郁症自杀未遂的危险因素,TPH2 rs7305115 A/A可能是抑郁症自杀行为的保护因素。     

HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: implications for public health intervention

OBJECTIVES: This study described HIV prevalence, risk behaviors, health care use, and mental health status of male-to-female and female-to-male transgender persons and determined factors associated with HIV. METHODS: We recruited transgender persons through targeted sampling, respondent-driven sampling, and agency referrals; 392 male-to-female and 123 female-to-male transgender persons were interviewed and tested for HIV. RESULTS: HIV prevalence among male-to-female transgender persons was 35%. African American race (adjusted odds ratio [OR] = 5.81; 95% confidence interval [CI] = 2.82, 11.96), a history of injection drug use (OR = 2.69; 95% CI = 1.56, 4.62), multiple sex partners (adjusted OR = 2.64; 95% CI = 1.50, 4.62), and low education (adjusted OR = 2.08; 95% CI = 1.17, 3.68) were independently associated with HIV. Among female-to-male transgender persons, HIV prevalence (2%) and risk behaviors were much lower. Most male-to-female (78%) and female-to-male (83%) transgender persons had seen a medical provider in the past 6 months. Sixty-two percent of the male-to-female and 55% of the female-to-male transgender persons were depressed; 32% of each population had attempted suicide. CONCLUSIONS: High HIV prevalence suggests an urgent need for risk reduction interventions for male-to-female transgender persons. Recent contact with medical providers was observed, suggesting that medical providers could provide an important link to needed prevention, health, and social services.     

贵阳市农民工自杀意念及其社会心理影响因素研究

目的了解农民工自杀意念的发生率及其社会心理影响因素。方法采用分层随机整群抽样方法,应用社会支持评定量表(SSRS)、健康调查量表(SF-36)对贵阳市501名农民工进行现场调查。结果农民工自杀意念发生率为9.58%,Logistic回归分析揭示自杀意念形成的主要社会心理影响因素是性别(OR:2.279;95%CI:1.107～4.693)、生活满意度(OR:0.368;95%CI:0.188～0.722)、主观支持(OR:0.921;95%CI:0.857～0.990)和精神健康(OR:0.991;95%CI:0.986～0.997)。结论女性农民工应成为贵阳市农民工自杀行为预防的重点对象,改善和提高农民工心理健康状况对预防自杀意念发生尤为重要。     

深圳市某学校初中生自杀相关行为影响因素的研究

目的 了解中学生自杀相关行为发生率及影响因素,为中学生自杀相关行为的防治与干预提供参考。方法 采用自编的一般情况调查表及儿童青少年心理健康量表(MHS-CA)、DSM-5一级跨界症状量表(DSM5-L1CCSM)、青少年生活事件量表(ASLEC)、儿童期创伤问卷(CTQ)对深圳市某学校914名初中生进行相关评估,进一步分析结果。结果 该校18.9%的初中学生两周内存在自杀企图,20.9%曾有过自杀经历。二分类logistic回归分析显示,意志行为(OR=0.923,95%CI:0.868～0.981)、儿童期躯体虐待(OR=1.977,95%CI:1.076～3.630)、物质滥用(OR=4.148,95%CI:2.898～5.939)可能是初中生自杀企图的独立影响因素;同时,意志行为(OR=0.898,95%CI:0.844～0.955)、童年期躯体虐待(OR=2.409,95%CI:1.313～4.421)、物质滥用(OR=4.991,95%CI:3.475～7.170)也是初中生自杀经历的独立影响因素。结论 该校中学生自杀相关行为发生率较高,学生的心理健康状态、精神行为症状、童年创伤经历、生活事件等因素影响自杀相关行为的发生。     

Correlates of suicide ideation and attempt among youth living in the slums of Kampala

While suicidal behavior is recognized as a growing public health problem world-wide, little is known about the prevalence and risk factors for suicidal behaviors among street and slum youth in Africa, and in Uganda, specifically. The number of youth who live on the streets and in the slums of Kampala appears to be growing rapidly, but their mental health needs have not been documented, which has hampered resource allocation and service implementation. This study of youth, ages 14-24, was conducted in May and June of 2011, to assess the prevalence and correlates of suicidal behavior. Participants (N = 457) were recruited for a 30-minute interviewer-administered survey through eight drop-in centers operated by the Uganda Youth Development Link for youth in need of services. Bivariate and multivariate logistic regression analyses were computed to determine associations between psychosocial correlates and suicide ideation and suicide attempt. Reporting both parents deceased Adj.OR = 2.36; 95% CI: 1.23-4.52), parental neglect due to alcohol use (Adj.OR = 2.09; 95% CI: 1.16-3.77), trading sex for food, shelter or money (Adj.OR = 1.95; 95% CI: 1.09-3.51), sadnesss (Adj.OR = 2.42; 95% CI: 1.20-4.89), loneliness (Adj.OR = 2.67; 95% CI: 1.12-6.40) and expectations of dying prior to age 30 (Adj.OR = 2.54; 95% CI: 1.53-4.23) were significantly associated with suicide ideation in multivariate analyses. Parental neglect due to alcohol use (Adj.OR = 2.04; 95% CI: 1.11-3.76), sadness (Adj.OR = 2.42; 95% CI: 1.30-7.87), and expectations of dying prior to age 30 (Adj.OR = 2.18; 95% CI: 1.25-3.79) were significantly associated with suicide attempt in multivariate analyses. Given the dire circumstances of this vulnerable population, increased services and primary prevention efforts to address the risk factors for suicidal behavior are urgently needed.