心肌梗死患者重返工作后生活质量的现状调查

目的 对心肌梗死患者重返工作后的生活质量进行调查,分析影响生活质量的因素,为制订针对性的二级预防和干预措施提供借鉴。方法 采取便利抽样方法,采用一般资料调查表、医学结局研究简短量表-8、健康促进生活方式评定量表Ⅱ、医学应对方式量表和社会支持评定量表对郑州市3所医院326例已重返工作的心肌梗死患者进行问卷调查。结果 心肌梗死患者重返工作后生活质量总分为(28.03±2.55),在社会功能(2.48±1.09)、情感角色(2.22±0.87)和精神健康(2.38±0.88)方面得分较低,影响生活质量的因素为面对应对维度得分、屈服应对维度得分、年龄、重返工作时间、支架植入个数、家庭月收入、合并症、是否参与及完成心脏康复等(P<0.05)。结论 心肌梗死患者重返工作后的生活质量水平有待提高,应根据影响生活质量的因素开展针对性的干预,提高心肌梗死患者重返工作后的生活质量,从而帮助患者更好地回归社会。     

Inequalities in life expectancy by educational level and its decomposition in Barcelona, 2004-2018

ObjectiveTo analyse the gap in life expectancy by educational level in the city of Barcelona from 2004 to 2018 and to decompose this gap by age and causes of death.MethodWe computed abridged life tables at the age of 25 years by sex from 2004 to 2018 using standard methods. Educational level was categorised in two groups (lower secondary or less vs. upper secondary or higher education). The life expectancy gap was further decomposed by age and by causes of death based in Arriaga's method in 5-year age blocks up to the age of ≥ 90 years and broad causes of death using ICD-10 codes.ResultsThe life expectancy gap at 25 years by educational level oscillated without trend at around 3.08 years for men and 1.93 years for women. Decomposition by age showed a favourable significant shift in the contribution to this gap from young to older ages for men, with few changes for women. Decomposition by causes of death showed that the diseases concentrating the largest share of the contribution were neoplasms and respiratory and circulatory disease. There was a significant downward trend in external causes for men and in infectious diseases for both men and women but a significant upward trend for respiratory disease for both sexes.ConclusionsThe stability of the life expectancy gap by educational level during the period analysed resulted from a combination of divergent trends by age and causes of death among high and low educational levels.     

Supervivencia de los pacientes ancianos con implante percutáneo de válvula aórtica comparados con la población general

Introduction and objectivesSevere symptomatic aortic stenosis carries a very poor prognosis. Transcatheter aortic valve replacement has been demonstrated to change the natural history of the disease. However, it is not known whether the probability of survival in older patients receiving this treatment returns to a similar value to that in the general population. Our objective was to determine survival in these patients vs that in the general population.MethodsWe retrospectively analyzed the survival curves of patients older than 75 years who underwent transcatheter aortic valve implantation (TAVI) at our hospital and compared them with those in the general population of the same age, sex, and geographic region by using data from the Spanish National Institute of Statistics.ResultsWe analyzed 526 patients. Among postoperative survivors, survival curves were similar between the 2 groups during most of the follow-up. In TAVI patients, the probability of survival at 1, 3, 5, and 8 years of follow-up was 90.58% (confidence interval [CI] 95%, 87.54-92.91), 72.51% (95%CI, 67.38-76.97), 53.23% (95%CI, 46.52-59.48), and 35.73% (95%CI, 27.72-43.80). In the reference population, these percentages were 91.93%, 75.63%, 59.6%, and 37.47%.ConclusionsLong-term survival in elderly patients undergoing TAVI is influenced by postoperative mortality. In patients surviving the postoperative period, the probability of survival returns to a similar value to that in the general population of the same age, sex, and geographical area.     

浅析命门穴之“门户”作用

通过命门穴沟通他经他脏进行相关经络脏腑的疾病治疗,在多经受邪时能起到分利气血,通络祛邪之功。命门穴位于"阳经之海"的督脉上,本身即具有振奋督脉阳气的作用,若配合其相通经脉穴位或介质进行辨证施治,其治简而效验。     

A Systematic Review of Interventions to Improve Mental Health and Substance Use Outcomes for Individuals with Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder

Individuals with fetal alcohol spectrum disorder (FASD) experience remarkably high rates of mental health and substance use challenges, beginning early in life and extending throughout adulthood. Proactive intervention can help to mitigate some of these negative experiences. Although the literature on FASD intervention is growing, there is currently a lack of consolidated evidence on interventions that may improve mental health and substance use outcomes in this population. Informed by a life course perspective, we undertook a systematic review of the literature to identify interventions that improve mental wellness through all developmental stages for people with prenatal alcohol exposure (PAE) and FASD. A total of 33 articles were identified, most of which were focused on building skills or strategies that underlie the well-being of children with PAE and FASD and their families. Other interventions were geared toward supporting child and family wellness and responding to risk or reducing harm. There was a notable lack of interventions that directly targeted mental health and substance use challenges, and a major gap was also noted in terms of interventions for adolescents and adults. Combined, these studies provide preliminary and emerging evidence for a range of intervention approaches that may support positive outcomes for individuals with FASD across the life course.