简易精神状态检查适用人群及影响因素

目的：根据简易精神状态检查（MMSE）在大样本人群中的测试结果分析，探讨MMSE的适应人群及影响因素。方法：通过随机整群分层抽样，对4921名55岁或以上的西安市城市居民进行MMSE测查。分析MMSE得分在不同年龄，不同文化程度以及总体人群中的第10百分数、中位数、偏度、峰度以及对痴呆的阳性预测值。并用多元逐步回归法分析MMSE得分的影响因素。结果：MMSE得分在不同年龄、不同文化程度、总体人群中都呈现负偏态，尖峭峰型分布。在年龄较轻（70岁以下）、文化程度偏高（初中或以上）的人群中偏性分布最明显，痴呆的检出率较低；而在年龄偏大（70岁以上），文化程度偏低（小学及以下）的人群中接近正态分布，痴呆的检出率较高。文化程度、年龄、性别、受教育年限、听力下降、日常生活能力对MMSE得分有显著影响（P＜0．001）。结论：MMSE量表最适用于年龄偏大（70岁以上），文化程度偏低（小学或以下）的人群，对痴呆的筛选能力大；而对于年龄偏小，文化程度偏高的人群，MMSE的鉴别筛选力较低。实践中应根据具体研究目的选用适宜量表，并灵活掌握分界值，以达到最大效益。     

富拉尔基区阿尔茨海默病患病率及影响因素初步研究

目的探讨富拉尔基区（属黑龙江省齐齐哈尔市）老年性痴呆又称阿尔茨海默病（Alzheimer＇s disease,AD）的流行病学特点及分布规律。方法采用分层多级整群的抽样方法确定调查对象,调查采用筛查和临床诊断两阶段法,筛查阶段采用简易智能精神状态量表（MMSE）和日常生活能力量表（ADL）进行测验。临床诊断阶段根据病史、临床体格检查、神经心理测验作出评定,诊断采用DSM-和NINCDS-ADRDA的标准。结果 1调查的3698名≥60岁老年人中,查出老年性痴呆（AD）患者87人,老年性痴呆（AD）的患病率为2.4%,其中轻型占59.77%;中型占24.14%;重型占16.09%。;2AD患病率女为2.92%,男为1.83%,女性患病率高于男性,且男女比较差异有显著意义（χ2=4.79,P〈0.05）;3AD的患病率随着年龄的增加而升高,不同年龄段AD患病率趋势性检验（Z=7.90,P〈0.01）;4文化程度越低老年性痴呆的患病率越高,不同文化程度AD患病率趋势性检验（Z=-3.18,P〈0.01）;5农村AD患病率高于城市,但两者比较差异无统计学意义（χ2=0.77,P〉0.05）。结论富拉尔基区老年性痴呆（AD）患病率与国内外有关老年性痴呆患病率的报道接近,其中轻型所占比率较大,其次为中型,最后为重型;女性的患病率高于男性;患病率随着年龄的升高增加;文化程度越低患病率越高,随着文化程度的增高,患病率明显下降。女性,增龄和低文化程度是老年性痴呆患病的危险因素。患病率城乡之间无显著差异。     

从55岁以上城乡居民MMSE得分特征上探讨其适用范围

目的 :探讨MMSE的适用人群及影响因素。方法 :通过随机整群分层抽样 ,对 4 92 1名 5 5岁或以上的西安市城乡居民进行MMSE测查。分析MMSE在不同人群中的得分特征对痴呆的阳性预测值和分析影响MMSE得分的因素。结果 :MMSE得分在不同年龄、不同文化程度、总体人群中都呈现负偏态 ,尖峭峰型分布。在年龄较轻 (70岁以下 )、文化程度偏高 (初中或以上 )的人群中偏态分布最明显 ,痴呆的检出率较低 ;而在年龄偏大 (70岁以上 ) ,文化程度偏低 (小学及以下 )的人群中接近正态分布 ,痴呆的检出率较高。年龄、性别、受教育年限、听力下降、日常生活能力对MMSE得分有显著影响。结论 :MMSE量表最适用于年龄偏大 (70岁以上 ) ,文化程度偏低 (小学或以下 )的人群 ,对痴呆的筛选能力大 ;而对于年龄偏小 ,文化程度偏高的人群 ,MMSE的鉴别筛选力较低。     

香港地区1022例中医体质流行病学调查

目的研究香港地区一般人群的中医体质类型分布状况,分析香港地区不同社会人口学人群体质类型的特征。结论针对香港地区一般人群,填写＂中医体质调查表＂收集数据,应用判别分析法判定个体体质类型,利用χ2检验分析其中医体质类型与性别、年龄、文化程度、职业等因素的相关性。结果香港地区一般人群中平和质占46.77%、8种偏颇体质占55.24%;8种偏颇体制中居于前3位的体质类型是阳虚质（9.88%）、气虚质（9.59%）及湿热质（8.22%）;不同的体质类型构成比不同,差异具有统计学意义（P〈0.01）。结论香港地区一般人群中约1/2人群为平和体质,约1/2为偏颇体质,偏颇体质中阳虚质、气虚质及湿热质较多见。不同性别、年龄、文化程度、职业等人群的体质特点不同。     

舟山海岛地区不育症患者的精液质量与年龄等因素的关系

目的探讨海岛不育男性精液质量与年龄、文化程度和不育时间的关系。方法采用统一调查表,对2004年3月~2005年9月在舟山市生殖研究中心门诊的228例不育症男性患者进行流行病学问卷调查及精液常规分析（SFA）。资料应用SPSS13.0统计软件进行处理。结果（1）研究对象的平均年龄为31.00岁,不育时间是3.00年;文化程度以初中为主,占24.12%,其次是高中,占20.18%;（2）b级、d级、正常形态和体部、尾部畸形精子比例在不同文化程度和年龄组之间的差异有统计学意义（P〈0.05）;（3）在不同的不育时间组之间极慢或不动（d级）精子比例有统计学意义（P〈0.05）。结论（1）生殖损害在年龄分布中有提前的趋势。（2）研究对象的年龄、文化程度和不育时间等因素可能与精液质量有关。     

北京市55周岁及以上人群精神障碍防治知识知晓率

目的 调查北京市老年人群对老年期常见精神障碍症状和预防知识的知晓情况.方法 采用分层随机抽样方法选取北京市1200名55周岁及以上的老年人,其中1031名接受调查并进行简易智能精神状态检查量表的筛查,应答率85.9％.1002名排除认知功能障碍之后进行老年期常见精神障碍症状和预防知识问卷调查.结果 该人群对老年期常见精神障碍症状和预防知识的平均知晓率为68.8％,城镇与农村、不同区县、年龄组、受教育程度、个人收入的人群,知晓率的组间差异有统计学意义（P均＜0.05）,受教育程度高,居住于市区的老年人知晓率相对较高（R2 =0.091,P＜0.001）.结论 北京市55周岁及以上人群精神卫生健康知识普及程度总体较好,但对于老年痴呆和抑郁症的临床表现、就诊途径、早期治疗及护理等知识的教育普及仍需加强.     

桂西地区育龄人群地中海贫血知识、信念、行为调查研究

目的 调查桂西地区育龄人群地中海贫血知识、信念、行为现状,并分析其影响因素,为制定地贫防控干预措施提供参考依据。方法 采用自行设计的地中海贫血知识、信念、行为调查问卷表,对桂西地区的1051名育龄人群进行调查。结果 桂西地区育龄人群地中海贫血知识平均得分为（58.12±11.59）分,信念平均得分为（28.91±4.57）分,行为平均得分为（13.78±3.65）分。线性逐步回归分析显示,影响知识、信念、行为的主要因素有：文化程度、职业、婚育状况、亲属朋友中是否有医务工作者、是否接触过地贫患者。结论 桂西地区育龄人群地中海贫血知识掌握处于中上水平,信念较积极,但预防行为仍有待加强;知识、信念、行为得分受文化程度、职业、婚育状况、亲属朋友中是否有医务工作者、是否接触过地贫患者因素的影响;需针对不同职业、文化程度、婚育状况者进行灵活有效的健康教育,提高其对地中海贫血知识掌握水平,树立积极的信念,采取健康行为。     

未婚女青年流产及生殖健康状况分析

目的了解芜湖市未婚女青年流产状况,分析其相关因素,发现未婚女青年流产中存在的问题及其生殖健康状况。方法采用横断面调查的方法对2009年1月～12月在我院门诊要求流产的309名未婚女青年进行问卷调查,描述性分析其流产及生殖健康状况。结果研究对象平均年龄21.90岁,以社会人员为多（51.13%）,高中学历占57.93%,避孕率达90.61%,且与文化程度有关,避孕失败率78.93%;药物流产加清宫术91例,人工流产218例（70.55%）,药流组与人流组无痛率差异无统计学意义;能正确认识人流的危害性者仅占13.27%;有流产史者生殖系统疾病患病率明显高于无流产史（P〈0.01）;不同文化程度人群中生殖系统患病差别无统计学意义（P〉O.05）。结论未婚女青年流产中社会人口学特征不容忽视,人工流产比例高,流产危害被不同程度忽略,生殖健康存在隐患,应采取科学有效的措施来降低流产率及生殖系统疾病的发生率。     

对脑死亡立法问题的思考

随着医学科学和技术的发展,脑死亡作为新的死亡判定标准被许多国家和地区的人们所接受。但在中国,受医学知识、传统文化、风俗习惯和社会伦理等各方面的影响,人们对脑死亡仍然存在许多不解和误解。脑死亡立法更是步履维艰、任重道远。其实,脑死亡立法是医学科学发展的结果,也是社会文明发展的需要,具有广泛的社会价值。本文将从医学基础、伦理原则和社会意义三方面来探讨这一问题。     

不同年级军医大学生学习认识和期望的比较

目的调查不同年级军医大学生对于学习的认识和期望。方法应用自制调查表,比较不同年级军医大学生对于学习的认识和期望情况。结果年级越低的学员,对学习认识和期望的水平越高:学习认识越积极、认为学习成绩重要的比例越高,越能正确看待学员上课迟到早退现象,对于学习成绩的期望值是优秀的比例及打算考研的比例越高(χ2=28.220,65.429,4.335,37.397,34.491;P均0.05)。结论针对不同年级军医大学生对待学习的认识和期望情况,采取各种教育措施保持和提高其认识和期望水平。     

北京城郊青少年抑郁现状及其影响因素

目的:调查北京城郊青少年抑郁现状,探究影响城郊青少年心理健康的人口统计学因素。方法:采用分层随机整群抽样的方法,在城郊调查了700名青少年,在城市调查了475名青少年,使用流调用抑郁自评量表(CES-D)作为调查问卷。结果:①城郊青少年抑郁得分(15.4±9.3)显著高于城市青少年(10.4±9.1);城郊青少年抑郁的现患率为32.1%,而城市青少年抑郁现患率为14.7%。②城郊女生抑郁水平显著高于男生;随着年龄的增长抑郁得分逐渐递增,并且不同年龄组间抑郁差异显著;家庭收入对孩子的抑郁得分有显著影响,收入越低的家庭,孩子抑郁水平越高。③Logistic回归分析结果表明,年龄、性别、母亲受教育程度是城郊青少年抑郁的预测性因素。结论:城郊青少年的抑郁程度显著高于城市青少年,特别是城郊年龄较大、母亲受教育程度低的女生,尤其需要重视。     

Characteristics Associated with High Resilience among Aged People Exposed to the Jeju 4·3 Incident

The purpose of this study was to identify characteristics related to high resilience among older people exposed to the Jeju 4·3 incident. A total of 1,121 aged adults were assigned to low, medium, and high resilience groups, and factors associated with low and high resilience were investigated. High resilience was significantly associated with a low prevalence of depression and high levels of life satisfaction and psychosocial support, as well as with younger age, being a man, higher education level, and current employment. The results deepen our understanding of resilience in the aged people who experienced the early life trauma.     

Public Awareness of Stroke and Its Predicting Factors in Korea: a National Public Telephone Survey, 2012 and 2014

The aim of this study was to investigate time trends in the public awareness of stroke and its predicting factors. The target population was 9,600 community-dwelling adults, aged 19–79 years, in 16 metropolitan cities and provinces in Korea. The survey samples in 2012 and 2014 were selected separately (entirely different sets of subjects) using a proportionate quota sampling method. Information concerning knowledge of stroke and demographics was collected by trained telephone interviewers using random digit dialing. After excluding subjects with a non-response or refusal to answer any question, the analyses included 8,191 subjects in 2012 and 8,127 subjects in 2014. Respondents’ awareness of stroke warning signs (numbness or weakness, difficulty speaking or understanding speech, dizziness, visual impairment, and severe headache) was highest for difficulty speaking or understanding speech (80.9% in 2012 and 86.4% in 2014). There were significant increases in the proportion of respondents understanding the appropriate action (i.e., calling an ambulance) at the time of stroke occurrence (59.6% to 67.1%), and in the proportion aware of the general need for prompt treatment (86.7% to 89.8%). In multivariable logistic regression analysis, older age, higher education level, higher household income, current non-smoking, exposure to stroke-related public relations materials, and experience of stroke education were significantly associated with both high knowledge of stroke warning signs and awareness of the need for prompt treatment. Between 2012 and 2014, the public’s awareness of stroke increased significantly. More specialized interventions, including public relations materials and education, should focus on subgroups who have lower stroke knowledge.     

Age-related structural changes in the stimuli-conducting system of the human heart

The cardionectors of 32 patients who had died at different ages without clinical or morphological indications of heart disease were examined. The autopsy was performed 8 to 24 h after death. Histochemical and histomorphometric tests were used to detect age-related changes in the conduction system (sino-auricular and AV nodes). The proportion of connective tissue increases in the cardionector and diminishes in the muscle tissue with increasing age, the changes being more pronounced in the sino-auricular than in the AV node. In the age group over 60, for instance, the proportion of connective tissue by volume is over 120% higher, in the sino -auricular node and 90% higher in the AV node than in the age group under 10. The correlation coefficient between age and proportion of connective tissue is also higher in the sino-auricular node (0.65) than in the AV node (0.53).     

不同年龄女性人群血液中的Dkk-1水平与骨密度相关性的分析研究

目的:探讨不同年龄女性人群血液中的Dickkopf-1(Dkk-1)水平与骨密度之间的相关性。方法:选取2013年3月~2014年6月在我院行体检的100例年龄处于20~80岁之间的女性志愿者,按照不同年龄分为青年组(20~39岁)、中年组(40~59岁)和老年组(60~80岁),从中年女性组中抽取45~55岁25人,分为绝经期女性组和未绝经女性组。采用酶联免疫吸附法测3组志愿者血清Dkk-1的表达水平,采用双能X线骨密度测量仪测定3组志愿者全身矿含量,分析不同年龄女性以及绝经与否女性血清Dkk-1水平的差异及Dkk-1水平与骨密度的关系。结果:随着年龄的增长,人群血清Dkk-1水平相应增高(P0.05),骨密度相应降低(P0.05);3组志愿者中,血清Dkk-1水平与骨密度均呈负相关(P0.05)。45~55岁年龄范围内,绝经组女性血清Dkk-1与未绝经妇女相比,Dkk-1水平与骨密度降低的相关性更为密切(P0.05)。结论:人体随着年龄的增加,血清Dkk-1水平会上升,并出现骨密度下降,有发生骨质疏松症的风险。相同年龄范围妇女中,绝经后妇女Dkk-1水平表达较高,骨密度降低更明显,有更大的发生骨质疏松症危险。Dkk-1表达的增加同时可抑制骨形成和促进骨吸收,有望成为预防和治疗骨质疏松症治疗的一个新靶点。     

The kids are all right. Interview by Benjamin Shepard

Several gay, bisexual, and transgendered youth were interviewed on how they feel their lives are different from those of earlier generations. Some of the youth noted that gay people are more visible and accepted, especially gay celebrities, however, they resisted being grouped as people who should all feel the same way on an issue. Also discussed are pride in one's sexuality, the decision to come out, and the need for older gay, bisexual, or transgendered men and women to serve as positive role models for gay, bisexual, or transgendered youth.     

862例血吸虫病知识态度行为知晓率的调查分析

目的了解疫区不同人群最易接受的健康教育方式和方法。方法采用问卷调查、村民小组座谈会和班级提问等方式，对湖北省阳新县富池镇岗下村等862人的血防知识、态度以及生产、生活行为进行定性调查。结果862人血吸虫病的知晓率达85％。血防知识获得的主要途径为在校教育和血防人员的宣传教育。结论疫区人群个体及社会生活中以文字、语音、声像等方式进行血防知识的传播。是有效改善人群健康行为的主要方式之一。     

Survey of cadaveric donors to a body donation program: 1978–1993

Body donation files from the Department of Anatomy at Northeastern Ohio Universities College of Medicine were reviewed from the 569 donors used in our program from 1978–1993. The data were entered into a computerized database to evaluate the characteristics of people who have contributed to the body donation program for cadaveric dissection. The purpose of this review was to reveal a profile of the people who have contributed to our program and enable us to identify any deficiencies or disproportionate representation of donors which can be used when targeting future applicants. Donors to our program were predominantly male (58%), although there was a clear trend for increasing numbers of females over the latter period of the program. Donors were almost exclusively white (98%) with an average age at death of 73 years (range 18–98 years). The combination cardiovascular (46%), cancer (27%), and pulmonary dysfunction (16%) accounted for nearly all deaths of our donors. Approximately half of the donors (49%) were married and they completed an average of 12.5 years of education. The typical donor bequested at, or near, the time of death. From these data we conclude that certain characteristics of our donors can be primarily attributable to the population base of our sample. Other characteristics, for example, gender, age at death of females, and educational level, show marked departures from population values and suggest some unique attributes of our donors. Bequests to our body donation program do not appear to represent a long-term plan, but rather a decision made just prior to death. © 1996 Wiley-Liss, Inc.