上海市闵行区精神卫生专科医疗机构人力资源的现状

目的了解上海市闵行区精神卫生专科医疗机构人力资源现状。方法对闽行区全部精神卫生专科医疗机构进行问卷调查。结果 8家精神卫生专科医疗机构共计职工1 254人,其中卫生技术人员792人,康复治疗人员5人;职工学历大专以上占69.7%;卫生专业技术职称中级占28.5%,高级占3.6%。结论闵行区精神卫生专科医疗机构卫生技术人员数量严重不足,结构不平衡,需进一步加大投入和发展。     

石家庄市农村垃圾与污水处理现状

目的了解石家庄市农村垃圾与污水现状,为制定农村垃圾污水治理策略提供依据。方法依照分层随机抽样方法,选取6个县(市)为调查对象,每个县随机选取20个村进行调查。结果生活垃圾定点堆放的村占75.83%,统一收集的村仅占3.33%;生活污水随意排放的村占46.67%,没有村将污水排入处理厂;大部分村工业和养殖业污水未经处理直接排放。结论该市应加强农村垃圾与污水管理和环境卫生基础设施建设,提高农民卫生意识,建立一种环境卫生长效工作机制。     

广西南丹县吸毒人员HIV、HCV、梅毒感染现状调查分析

目的:为了解南丹县吸毒人员感染现状,重点开展艾滋病、HCV、梅毒监测分析,为制定吸毒人群的艾滋病干预及综合防治提供科学依据。方法:针对吸毒人群的特殊性,采取面对面的访谈交流,采用统一的吸毒者登记表对吸毒人员进行问卷调查,采集静脉血进行检测。结果:共调查162名吸毒人员,其中HIV抗体阳性率为2.47%;HCV抗体阳性率为75.31%;梅毒抗体阳性率为23.46%。结论:吸毒人群是艾滋病、HCV、梅毒传播的主要人群;因此加强对吸毒人员的性病防治知识及技巧培训刻不容缓,教育吸毒人员增强防范意识,降低行为风险,即时治疗性病、改变吸毒方式、有效地降低艾滋病、HCV、梅毒感染率。     

浙江嵊州剡溪相关区域的水质现状分析

目的:了解嵊州剡溪相关区域的水质现状及影响,为政府部门水污染治理效果评价提供科学依据,以确保当地居民合理、安全地利用水资源。方法:对嵊州剡溪相关区域的嵊新交接段布三个断面进行监测,采用单因子指数评价法对嵊州剡溪水质综合评价。结果:嵊州剡溪相关区域的水质良好,另外其铁和锰分别超标0.68倍和0.4倍。结论:经过多年治理,目前剡溪相关区域的水质为良好,但尚不适于用作直接的生活饮用水源。     

从糖尿病的现患率知晓率分析血糖控制率

目的:调查并掌握2010年苏州市居民血糖现状,考察慢病工作的防治效果,及时调整下一个5年计划。方法:社区医生入户调查,和调查对象面对面询问,填写问卷并进行血糖测量,结果汇总到经整理后采用χ2检验分析数据。结果:35岁～70岁的居民糖尿病的现患率随年龄的增加逐渐上升(χ2=283.937,P<0.005);男女之间没有显著差异(χ2=0.1050,P>0.05);50岁以下的城乡居民比较,糖尿病患病率差别无统计学意义(χ2=1.210,P>0.05);而50岁以上城市居民的糖尿病患病率却明显高于农村居民(χ2=91.454,P<0.01)。结论:虽然苏州市对糖尿病人群的管理工作已有一定成效,但形势仍不容乐观,加大力度宣传糖尿病的预防,从而降低血糖的超标率,提高糖尿病人血糖的控制率。     

Left ventricular function in mitral valve prolapse: Assessment with radionuclide cineangiography

Abnormalities of left ventricular contraction in patients with mitral valve prolapse have suggested a myocardial factor in this disease. To determine systolic left ventricular function in mitral valve prolapse, technetium-99m gated equilibrium radionuclide cineangiography was performed in 47 patients with this diagnosis. In 39 patients without mitral regurgitation the average ejection fraction was normal at rest (average [± standard error of the mean] 57 ± 3 percent, normal 57 ± 1 percent, difference not significant) and exceeded the lower limits of normal in all but 1 patient, whose ejection fraction was 41 percent. However, ejection fraction during maximal exercise was lower for the group of patients with mitral prolapse without mitral regurgitation than for normal subjects (average 64 ± 2 percent, normal 71 ± 2 percent, p < 0.005). In eight patients with mitral prolapse and mitral regurgitation, the average ejection fraction was normal at rest but was diminished with exercise in comparison with both normal subjects and patients with mitral valve prolapse without mitral regurgitation. Chest pain, arrhythmia and the pattern or extent of mitral valve prolapse on echocardlography were not independently associated with impaired left ventricular functional reserve. We conclude that, although many patients with mitral valve prolapse have normal left ventricular function, there is a subgroup without mitral regurgitation in whom diminished left ventricular functional reserve is suggestive of a cardiomyopathic process.     

Prognosis of asymptomatic or mildly symptomatic patients with coronary artery disease

One hundred forty-seven asymptomatic or mildly symptomatic patients with coronary artery disease, who did not have significant left main coronary occlusion and had an ejection fraction greater than 20 percent, were followed up prospectively for 6 to 67 months (average 25). Significant obstruction of one coronary artery was present in 28 percent of patients, of two coronary arteries in 31 percent and of three coronary arteries in 41 percent. Ejection fraction was 55 percent or greater in 69 percent of patients. During the follow-up period there were eight deaths (annual mortality rate 3 percent for the entire group, 1.5 percent for patients with single and double vessel disease but 6 percent for those with triple vessel disease). Better definition of high and low risk subgroups of patients with three vessel disease was accomplished with exercise testing. Despite a history of mild symptoms, 25 percent of the patients with triple vessel disease exhibited poor exercise capacity on exercise testing after administration of beta adrenoceptor blocking agents and nitrates was discontinued; of these, 40 percent either died (20 percent) or had progressive symptoms requiring operation (20 percent) (annual mortality rate 9 percent). Of the patients with good exercise capacity, only 22 percent either died (7 percent) or had progressive symptoms (15 percent) (annual mortality rate 4 percent).

Thus, prognosis is excellent in patients with no or mild symptoms who have one or two vessel coronary disease. Patients with three vessel disease who have good exercise capacity documented by objective testing have an annual mortality rate of 4 percent. However, because patients with three vessel disease and poor exercise capacity have an extremely grave prognosis, it would appear reasonable to recommend coronary bypass surgery for this subgroup, even in the absence of supporting data derived from a definitive randomized study.     

Radionuclide angiographic assessment of left ventricular function during exercise in patients with a severely reduced ejection fraction

To study the effect of exercise on left ventricular ejection fraction in patients with congestive cardiomyopathy and the relation of the response to the origin of the myocardial dysfunction, 30 patients with a severely reduced ejection fraction (30 percent or less) were evaluated with radionuclide angiography. Group I consisted of 16 patients with ischemic cardiomyopathy and a mean (± standard deviation) resting ejection fraction of 22.3 ± 6.1 percent. Group II was composed of 14 patients with primary cardiomyopathy and a mean resting ejection fraction of 19.3 ± 4.7 percent. The mean age, left ventricular end-diastolic pressure, cardiac index and resting left ventricular ejection fraction of Groups I and II were similar; however, the change in the ejection fraction during similar levels of exercise differed significantly. The mean exercise ejection fraction decreased to 16.7 ± 6.8 percent in Group I, but increased to 24.6 ± 6.4 percent in Group II (p < 0.001). Thus, exercise usually results in a directionally opposite change in left ventricular ejection fraction depending on the origin of the congestive cardiomyopathy.     

The pituitary--adrenal axis in the sea snake, Hydrophis cyanocinctus daudin.

The sea snake Hydrophis cyanocintus was subjected to conventional pharmacological tests of pituitary-adrenal function. Administration of synthetic ACTH resulted in adrenal hypertrophy, enhanced Δ⁵-3β-hydroxysteroid dehydrogenase (3β-OHSD) activity and raised peripheral titres of corticosterone and aldosterone to 300% those of controls. Metopirone treatment resulted in adrenal hyperplasia and enhanced 3β-OHSD activity, but aldosterone titres were unchanged despite a 90% reduction in corticosterone titre. Dexamethasone administration was followed by adrenal atrophy and diminished 3β-OHSD activity. Titres of both corticosteroids were much lowered. Despite such marked variations in adrenal function, no alteration in plasma ion concentrations or total osmolarity could be detected. These and earlier data suggest that separate regulatory mechanisms for corticosterone and aldosterone may exist in the sea snake, and such a differential regulation may be of physiological importance.     

社区居家养老服务现况调查与相关对策研究

目的了解社区居家养老服务现况,针对存在的问题提出相关对策与建议。方法以位于长三角核心区域的苏州市为例,走访相关社区居家养老服务站,抽样调查60岁以上老年人,了解社区居家养老服务提供情况。结果调查数据显示,苏州市社区居家养老服务业正处在发展初期,政府重视,政策扶持,受到老人及其子女的认可。但是,提供的服务面与服务内容不能满足社区老人的需求。结论提供贴心、有效、及时的社区居家养老服务,是老龄化社会必须面对和迫切需要解决的民生问题,需要政府、社区、家庭责任共担,通过多元发展促进其科学、可持续发展。