广西阳朔县15年农药中毒流行病学分析

笔者对阳朔县１９７９～１９９３年农药中毒进行流行病学分析。１５年间发生农药中毒共３６６８例，其中生产性中毒１２３５例，占３３．６７％，死亡２例；非生产性中毒２４３３例，占６６．３３％，死亡７９９例。中毒农药达２０余种，其中以甲胺磷为主。结果提示：忽视个人防护、违反安全施药规定是引起生产性农药中毒主因；家庭纠纷、婚姻恋爱处理不当而导致服毒自杀居非生产性农药中毒首位。农药毒性、用量与当地农药中毒发生率、病死率密切相关。     

A global view of suicidal behaviour

Suicidal behaviour is a major public health problem. There is no one explanatory theory of suicidal behaviour, and various combinations of sociological and biological/medical interventions are required to reduce associated mortality and morbidity. The importance of primary prevention varies from community to community, and may have an impact at the population level. However, individual suicidal persons always require optimum assessment and management and that is usually provided by primary care and emergency physicians. This paper provides an overview of issues to be addressed in the assessment and management of suicidal patients. See Commentary, page 8.     

慢性前列腺炎相关危险因素的调查报告

目的:探索不良生活习惯、精神、心理等相关因素与慢性前列腺炎发病的关系. 方法:对600例慢性前列腺炎患者进行流行病学调查,采用单因素及多因素条件Logistic回归法进行统计分析,判断危险因素.结果:多因素Logistic回归分析发现引起慢性前列腺炎的可能因素为尿道炎、无节制的性生活、频繁的手淫、固定体位(尤其长时间骑跨、坐位)、酗酒、生活方式改变、长时间憋尿、紧张焦虑心理等.结论:本研究结果对慢性前列腺炎的预防、治疗及防止复发具有参考价值.     

Comparison of the diagnostic criteria for diabetes mellitus, WHO-1985, ADA-1997 and WHO-1999 in the adult population of Asturias (Spain).

AIMS: To estimate the prevalence of diabetes mellitus with three diagnostic criteria (WHO-1985 and 1999 and ADA-1997), evaluate their concordance and analyse the sensitivity and specificity of the different screening strategies for diabetes. METHODS: A cross-sectional population study with two-step sampling. One thousand and 34 people were selected randomly. A 75-g oral glucose tolerance test (OGTT) was performed and venous blood samples were obtained fasting and at 2 h. RESULTS: The prevalence of known Type 2 diabetes mellitus (DM-2) is 4%[95% confidence interval (CI) 2.8, 5.1]. By WHO-1985 criteria the prevalence of unknown DM-2 is 5.9% (4.5, 7.4); by ADA-1997 criteria 3.5% (2.5, 4.6) and by WHO-1999 criteria 7.3% (5.8, 8.8). Diagnostic overlap and statistical concordance (coefficient K) are WHO-1985/ADA-1997 29.3%, K=0.42; WHO-1985/WHO-1999 80%, K=0.88; ADA-1997/WHO-1999 48%, K=0.63. If only fasting glucose was used (following ADA-1997), 36.3% of those with diabetes (2-h glucose > or =11.1 mmol/l) would be diagnosed. If OGTT was performed (i) in those with a fasting glucose between 6.1 mmol/l and 6.9 mmol/l (9.8% of the population) we would diagnose 66.6%, and (ii) in all those between 5.7 mmol/l and 6.9 mmol/l (18.9% of the population) 81.8% would be diagnosed. CONCLUSIONS: The ADA criteria decrease the prevalence of DM in the adult population of Asturias by 2.4% and concordance with the classical criteria (WHO-1985) was only 29.3%. Using fasting glucose only (ADA-1997) diagnoses 36.3% of those with diabetes. The recent recommendations of the WHO-1999 increases this to 66.6%. To improve the diagnostic strategy for diabetes and detect up to 81.8% of patients, we propose the use of OGTT for all those with a fasting glucose between 5.7 mmol/l and 6.9 mmol/l.     

烧伤病区多重耐药铜绿假单胞菌DNA的脉冲场凝胶电泳分析

目的:了解烧伤病区铜绿假单胞菌(Pseudomonas aeruginosa,PA)感染的分子流行病学特征。方法:采用脉冲场凝胶电泳(PFGE)分型的方法,对15株分离自烧伤临床病人的多重耐药PA染色体组DNA进行分析。结果:15株检测菌株中有9株菌分别属于两种不同的PFGE图谱类型,具有同源性的菌株占测试菌株的60%。结论:导致我院烧伤患者感染多重耐药的PA中有同源性的比例较高,提示在烧伤救治中采取有针对性的措施,防止烧伤病房内的交叉感染对于降低烧伤感染率、提高烧伤救治水平具有重要意义。     

Predictors of mortality in an aging community-based cohort in Korea

Background: Multiple factors related to specific dimensions of health – general, physical and mental – contribute to mortality in the elderly, but their relative contributions to mortality risk is not well‐known. The objectives of this prospective population‐based cohort study were to measure mortality rates and to identify predictors of mortality in community‐dwelling men and women aged 65 years or older in Korea by examining self assessments of general health, objective medical burden, and measurement of cognition, mood and function. Methods: A total of 1245 elderly (529 men; 716 women) were followed up longitudinally for 3.5 years. Fixed predictor variables observed at baseline examined in Cox proportional hazards models were age, sex, education, chronic medical illnesses, self‐rated health, basic activities of daily living, depression measured by the Geriatric Depression Scale, and cognition measured by the Mini‐Mental State Examination. Results: Mortality rates were similar to those of the 2001 Korean population. Older age, male sex, poor self‐rated health and presence of cerebrovascular disease were significant predictors of mortality. Presence of ischemic heart disease and cerebrovascular disease at baseline predicted mortality in men, but not in women. Depression predicted mortality only when chronic medical illnesses were excluded from the model. Conclusions: Subjective self‐rated health and objective medical burden are strong independent predictors of mortality in this elderly community population, in addition to age and sex.