武汉西马街社区成人健康相关危险因素调查

目的 探讨当地成人健康相关危险因素构成，尝试低费用下开展此类监测的方法。方法 依托教育系统对武汉市江岸区西马街地区成人进行随机抽样入户问卷调查。结果 人群吸烟率32．4％，男性吸烟率60．6％，中年人高于老年人，女性吸烟率5．9％；92．5％的人不愿意自己的孩子在将来成为烟民；人群饮洒率为26．5％，其中男性饮洒率51％，23．5％的饮酒者存在违意饮酒情节；33．3％的成人有体育锻炼习惯，其比例随文化程度的升高而升高；19％的人每周户外活动时间达不到1天1小时；35．6％的人存在体重过重问题，分解19．2％为超重，14．7％为肥胖，1．7％为Ⅱ度肥胖。人群自述（非现场测量）高血压患病率为11．1％，自述糖尿病患病率为2．8％，但自觉有糖尿病典型症状而从未检测血糖的比例达16％。结论 落实社区人群基础医学检查任务迫切，依托教育系统进行的成人健康相关危险因素监测方法足当前经济适用的监测方法。     

高血压病患者心肌灌注断层显像的相关因素研究

目的探讨高血压病患者心肌灌注断层显像的结果和多种临床因素的关系.方法将97例高血压病患者的心肌灌注断层显像结果同患者的年龄、性别、体重指数、患高血压病的时间、有无抗高血压治疗,有无高血压家族史,患者的血清葡萄糖、肌酐、尿素氮、甘油三酯、胆固醇、脉搏、收缩压、舒张压、脉压差、平均动脉压、患者是否吸烟、饮酒进行非条件Logistic回归分析.结果患高血压病的时间(βi=0.4914,P=0.0017)、吸烟(βi=3.5022,P=0.0176)、高胆固醇血症(βi=1.6147,P=0.0194)是高血压病患者并发心肌缺血的危险因素.结论高血压痛患者戒烟、治疗高胆固醇血症,可降低其并发心肌缺血的风险.     

Dotlike Hemosiderin Spots Are Associated With Past Hemorrhagic Strokes in Patients With Lacunar Infarcts

BACKGROUND AND PURPOSE: Dotlike hemosiderin spots ongradient-echo T2(*)-weighted magnetic resonance imaging of the brain have been histologically diagnosed as old microbleeds associated with small vessel disease (SVD). The authors hypothesize that the presence of many dotHSs may be correlated with the fragility of small vessels and the recurrence of SVD, including lacunar infarction and deep intracerebral hemorrhage (ICH). METHODS: To investigate how dotHSs are related to past history of SVD, the number of subcortical or deep dotHSs was investigated in 146 patients with lacunar infarctions (95 men, 51 women, age 38 to 90 [66.6+/-9.4] years). They were divided into 2 subgroups according to history of deep ICHs or lacunar infarctions. The odds ratio (OR) for past history was estimated from logistic regression analyses with the number of subcortical or deep dotHSs as well as other factors. RESULTS: Of 146 patients with lacunar infarctions, 11 had past symptomatic ICHs and 19 had past symptomatic lacunar infarctions. An elevated rate of history of ICH was found for lacunar infarction patients with many deep dotHSs (>or=3; OR, 9.1; 95% confidence interval, 1.6-51, P=.015). However, history of lacunar infarction was not significantly associated with the number of subcortical or deep dotHSs. CONCLUSIONS: Our findings suggest that many deep dotHSs on T2(*)-weighted magnetic resonance imaging may be correlated with deep ICH-lacunar infarction type of SVD recurrence but not lacunar infarction-lacunar infarction type.     

Diabetic retinopathy: different risk factors for exudates and haemorrhages

The retinae of 137 patients were examined ophthalmologically and for visual acuity at diagnosis of noninsulin dependent diabetes and again in 1982 and 1983, approximately 7 and 8 years later, when colour photographs were also taken. In 1983, 46% were without detectable retinopathy, 32% had haemorrhages (including microaneurysms) only, 4% exudates alone and 18% both lesions. Those with haemorrhages were more hyperglycaemic than those without retinopathy and those with exudates only. Indeed, those with exudates alone had lower mean glucose levels than those without retinopathy (p<0.05). Patients with exudates (± haemorrhages) had a lower percentage of the fatty acids of plasma cholesterol esters as linoleate than those without (p<0.05) but this did not hold for those developing haemorrhages. Different risk factors appear to operate in different features of diabetic retinophathy. In some respects exudate formation may be more akin to macro than to micro angiopathy.     

Cholesterol-based personal risk assessment in coronary heart disease

Using data from the National Health and Nutrition Examination Survey (NHANES II) 1976-1980, we demonstrate how cross-sectional total serum cholesterol surveillance data can be used by an individual to assess current and future personal cholesterol risk status. We propose statistical models, based on a person's current measured cholesterol level and the relationship between cross-sectional age and cholesterol percentile estimates, that will allow prediction of future cholesterol levels or the age at which specified cholesterol risk levels will be reached if no cholesterol-altering intervention is taken. These models incorporate the observed variation in the NHANES II data and expected intraperson biological variation and intralaboratory analytical variation. We illustrate the adequacy of the models using data from the longitudinal Framingham Study.     

骨科住院患者下肢深静脉血栓形成的危险因素及相关性分析

目的探讨骨科住院患者下肢深静脉血栓形成(lower extremity deep vein thrombosis,LD-VT)的危险因素。方法2003年8月~2006年8月收治的350例骨科住院患者中,确诊为LDVT者38例,对其相关因素进行回顾性分析。结果27项单因素相关分析中有9项有显著性意义,经Logis-tic回归分析显示,危险因素为:血浆D-二聚体、纤维蛋白原、血管性血友病因子阳性,4周内有手术史以及有外伤史。结论对上述危险因素存在的骨科住院患者,应警惕LDVT发生,如有D-二聚体测定阳性等危险因素应予预防性治疗。     

Feeding practice of infants and their correlates in urban areas of Beijing, China

BACKGROUND: Optimal feeding practice in the first year of life is crucial for the survival and health of infants, and has long-term consequences in later life. However, non-optimal feeding practices exist widely. The present study aims to explore various constraints to optimal feeding practices in the first year of life of infants in urban areas of Beijing, China. METHODS: A cross-sectional study was conducted in urban areas of Beijing from 4 July to 20 August, 1998. Two hundred and fifty-one mothers of infants aged 6-12 months were chosen from six child health centers in three different urban districts in Beijing. A self-administered structured questionnaire was used to collect data regarding feeding practices and potentially related factors. RESULTS: Feeding practice for most of the infants was in accordance with the national and international recommendations. However, the rate of incidence of exclusive breast-feeding at 3 months of age was lower than that recommended by the World Health Organisation (WHO) (55.8%), and the introduction of solid/semisolid food before 4 months of age was found in approximately 19.3% of the infants. Cow's milk was given to 21.2% of infants from 6 months of age as the sole source of milk or as a supplement. Maternal education level (OR = 2.44, 95% CI: 1.42-4.19, P < 0.05), employment (OR = 2.05, 95% CI: 1.13-3.74, P < 0.05) and antenatal nonexclusive breast-feeding plans (OR = 4.10, 95% CI: 2.24-7.50, P < 0.001) were found to be correlated to inappropriate feeding practices. CONCLUSIONS: The feeding practices for most of the urban infants was found to be in accordance with the Chinese government and WHO recommendations; however, non-optimal feeding practices presenting as the early cessation of breast-feeding and the introduction of solid/semisolid foods existed. Information regarding optimal feeding practices should be disseminated to mothers and medical professionals in China, to ensure optimal infant health.