Acute appendicitis in young children in the Belfast urban area: 1985-1992.

Eighty-one cases of acute appendicitis in children aged less than six years were identified in the Belfast urban area between 1985 and 1992. Appendiceal perforation, found in 43%, was related to symptom duration but not to age at presentation. Prolongation of symptoms was related to parental delay in seeking medical advice (52% > 36 hours), delayed or inappropriate general practitioner referral to hospital (19%) and diagnostic delay following surgical consultation (12% > 12 hours). Diagnostic delay in hospital was usually the result of nonspecificity of symptoms and signs and was therefore largely unavoidable. Delayed referral from general practice did not contribute unnecessarily to appendiceal perforation, and given that an individual general practitioner will see a case of preschool appendicitis once in 30 years, diagnostic accuracy was remarkably high.     

吉林地区低保人群脑卒中患病状况及相关因素分析

目的 探讨吉林地区低保人群脑卒中的患病状况及相关因素的分析.方法 对吉林地区低保人群脑卒中采取分层随机抽样的方法,按照中国慢病相关危险因素监测方案,采用集中调查.另外选取相应的普通脑卒中患者为对照组,分析性别、年龄及危险因素在两组中的特点.结果 低保人群脑卒中120例,男女性别比较有统计学意义;对照组80例,性别比较无统计学意义.低保人群脑卒中高发年龄40～59岁;对照组50岁以上.低保人群脑出血与脑梗死发生与对照组比较,无统计学意义.低保人群脑卒中合并偏瘫22例、语言障碍13例;对照组合并偏瘫5例、语言障碍4例.低保人群高血压64例;对照组44例.两组相关因素(文化程度、吸烟、饮酒、嗜成食、体重、糖尿病及家族史等)分析明显不同.结论 增强低保人群保健意识,倡导健康的生活方式,针对脑卒中高峰年龄、高发人群进行适当体检,降低该病的发生.     

河南食管癌高发区食管癌高癌家族调查

目的:了解食管癌家族聚集性的流行状况.方法:采用统一问卷调查表,逐户调查.对河南省食管癌高发区448户1 107人进行家系调查.结果:共收回264份问卷.264户中,有家族性食管癌共153户(58%).直系三代中发生10例以上食管癌患者的家庭有5户(2%),7例患者的家庭有8户(3%),而三代中发生6例、5例、4例和3例食管癌的家庭分别为13户(5%)、21户(8%)、28户(11%)和46户(17%).结论:河南食管癌高发区食管癌家族聚集性发生十分常见,提示遗传因素在食管癌变中可能起重要作用.     

Identifying people at high risk of cutaneous malignant melanoma: results from a case-control study in Western Australia

To assess whether screening people at high risk of malignant melanoma would be effective in reducing the mortality from the disease data from 400 case-control pairs in a study of cutaneous malignant melanoma conducted in Western Australia during 1980-1 were used to predict the risk of melanoma in the remaining 111 pairs. All variables previously shown to be associated with a decrease or increase in the incidence of melanoma were considered for inclusion in a single conditional logistic regression model of the incidence of melanoma in the randomly chosen subset of 400 case-control pairs. Five of these variables--number of raised naevi on the arms, arrival in Australia before 10 years of age, history of non-melanocytic skin cancer, time spent outdoors in summer from the age of 10 to 24, and family history of melanoma--provided good discrimination between patients and controls in this sample and the 111 other case-control pairs. Among the 222 subjects in these other case-control pairs a group defined as being at high risk of melanoma by a risk score derived from these five variables contained 60 (54%) of the patients with melanoma but only 18 (16%) of the controls. These data suggest that in Western Australia more than half of all new patients with melanoma arise in an identifiable subpopulation constituting less than one fifth of the whole population. Identifying this subpopulation and screening it regularly for cutaneous malignant melanoma could be cost effective in reducing mortality from this disease.     

Coronary heart disease: incidence, risk factors and interventions in Jiaozhou of Shandong province

Background Coronary heart disease （CHD） is the most common type of heart disease and cause of heart attacks.This study investigated the epidemiological characteristics of CHD and its risk factors in Jiaozhou,Shandong province,to ultimately find a way of reducing the prevalence of cardiovascular disease,and to provide a theoretical basis for establishing a cardiovascular disease management path under the regional medical collaborative mechanism.Methods A questionnaire survey was performed including 1 952 people aged 35 years or older who were questioned by means of stratified,cluster,proportional sampling to investigate the prevalence of CHD and its risk factors.The data were inputted into SPSS11.0 statistical software for processing and analysis.We advised the local medical institutions to establish health files for the residents with CHD and risk factors.They were followed up regularly.Their risk factors and life-style were monitored,and advice was given as to proper medications.Green channels were established,and the patients were transmitted in a timely manner to superior hospitals for better treatment if the necessary treatments were not available in the local hospitals.The control of risk factors was observed after the follow-up for half a year.Results In Jiaozhou,the rates of coronary artery disease,hypertension,diabetes,hyperlipidemia and overweight were 8.15％,28.54％,11.43％,35.46％,and 18.70％ respectively.The rates of hypertension,diabetes,hyperlipidemia and overweight were higher than the data published in ＂The report of Chinese cardiovascular disease 2012＂; which are 24％,9.7％,18.6％,and 9.7％,respectively.The control of risk factors improved significantly after the guidance of the residents lifestyle and medication for six months.Conclusions The high prevalence of coronary artery disease in Jiaozhou is closely related to age,gender,diet structure,family history of cardiovascular disease,hypertension,diabetes,hyperlipidemia,overweight,and unhealthy lifestyle.Under the regional medic     

Improved unhealthy lifestyle habits in patients with high cardiovascular risk: results from a structured lifestyle programme in primary care

Abstract

Background. Physical activity, healthful dietary habits, and not smoking are associated with reduced cardiovascular morbidity and mortality. However, few studies have examined how counselling to improve poor lifestyle habits might be carried out in clinical practice. In Swedish primary care, structured lifestyle counselling is still not integrated into everyday clinical practice. The aim of the present study was two-fold: (1) to describe a novel lifestyle intervention programme in primary care; and (2) to evaluate change in unhealthy lifestyle habits over 1 year in men and women with high cardiovascular risk who participated in the lifestyle intervention programme.

Method. A single-group study with a 1-year follow-up was carried out. A total of 417 people was enrolled, median age 62 years (54% women), with either hypertension (69%), type 2 diabetes mellitus, or impaired glucose tolerance. The 1-year intervention included five counselling sessions that focused on lifestyle habits, delivered by a district nurse with postgraduate credits in diabetes care and the metabolic syndrome. All patients were offered in-depth counselling for one or more lifestyle habits when needed. Lifestyle habits were assessed by a questionnaire at baseline and 1-year follow-up. Total change was assessed using a nine-factor unhealthy lifestyle habit index.

Results. Favourable, significant changes were observed for physical activity, dietary habits, smoking, and stress over 1 year. Similar improvements were seen for both sexes and type of diagnosis.

Conclusions. The results support the utility of a multifactorial, structured approach to change unhealthy lifestyle habits for cardiovascular risk prevention in a primary care setting.     

500例患儿麻醉后躁动的多因素分析

目的：分析该院2年500例患儿麻醉手术后躁动发生的影响因素。方法该院A S A分级为Ⅰ～Ⅱ级的500例患儿,根据麻醉手术后苏醒的躁动情况分为躁动组和非躁动组。对患儿年龄、性别、体质量、术前焦虑分级、所患疾病种类、ASA分级、麻醉用药种类及剂量、插管、麻醉时间、停药后患儿苏醒时间、患儿苏醒后躁动情况做Logistic回归分析。结果500例患儿,术后躁动153例,占总数的30．6％;Logistic回归分析得出患儿年龄较大、性别、应用氯胺酮等项目回归系数为负,患儿体质量、术前焦虑分级、七氟醚麻醉、插管等项目回归系数为正;ROC曲线下面积为0．850。结论患儿体质量、术前焦虑分级、气管插管、七氟醚麻醉可以增加患儿麻醉手术后躁动发生率,而患儿年龄较大、女性患儿、应用氯胺酮可以减少麻醉手术后躁动发生率。     

宜宾地区COPD患病情况及危险因素分析

目的 了解宜宾地区慢性阻塞性肺疾病的患病情况并分析其可能的危险因素.方法 采用整群抽样抽取宜宾地区40岁以上居民974人进行COPD患病率调查并用自设计问卷进行危险因素分析.结果 宜宾地区40岁以上居民COPD平均患病率14.5%,高于全国水平;患病率存在男女和城乡差异;吸烟、家族史、污染、饮酒等是COPD的重要危险因素.结论 宜宾地区COPD发病率偏高,应加强健康教育,建议老年人定期体检.     

Coronary artery disease in young patients: clinical review and risk factor analysis

Fifty consecutive younger patients (< or = 40 years) with coronary artery disease, who underwent coronary angiography in National Institute of Cardiovascular Diseases were evaluated clinically and coronary risk factors were analyzed and compared with those of fifty older patients with coronary artery disease. Mean age of younger and older patients were 37.31 and 54.58 years respectively and myocardial infarction was the most common presenting complain in both the groups. Smoking and family history of premature coronary artery disease were more common in younger patients but the older patients were more diabetic and hypertensive. Central obesity and dyslipidemia did not vary between the two groups. Fifty percent of younger patients had one or two modifiable risk factors where sixty four percent of older patients had three or more modifiable risk factors. Forty four percent younger patients had hypercholesterolemia but a majority of patients had either isolated hypertriglyciredemia or decrease high density lipoprotein cholesterol or both with normal total cholesterol level but the total cholesterol and high density lipoprotein cholesterol index were more than 4.5. Younger patients had more number of normal coronary or single vessel diseases but older group had more number of triple vessel diseases. So the higher incidence of non-insulin dependent diabetes mellitus with central obesity suggesting insulin resistance along with unique profile of dyslipidemia, higher incidence of smoking and familial predisposition of premature coronary artery disease may be responsible for higher incidence of coronary artery disease at a premature younger age in this population.     

Correlation between birth defects and dietary nutrition status in a high incidence area of China

Objective To investigate the association between birth defects and dietary nutrient intake in a high risk area of China. Methods A dietary survey was performed and serum folic acid was measured in women whose pregnancy was affected by neural tube defects （NTDs） or unaffected by any birth defects （BDs） in Zhongyang and Jiaokou Counties in Shanxi Province of China. ResuIts The local average consumption of foods including dark green vegetables, fruits, fat and meat, and nutrient intake （e.g. energy, protein, retinol, riboflavin, vitamin E, and selenium） were lower than the national average level. In women of childbearing age, these regions, the intake of nutrients was much lower than the recommended nutrient intake （9%-77%）. The case-control dietary nutrition study of women whose pregnancy was affected by BDs （including NTDs and congenital heart defects） demonstrated that, in early pregnancy, adequate nutrition （i.e. eating meat, fresh vegetables, fruit more than once a week） was a protective factor, while eating germinated potatoes was a risk factor. The geometrical mean （pS- p95） of serum folic acid in women with NTD birth defects was 9.6 nmol/L （3.6, 23.03）, which was significantly lower than that in normal women （14.03 nmol/L）. Conclusion Women of childbearing age in the two counties of Shanxi Province, China, have a marked insufficient intake of some nutrients, especially folic acid, zinc, vitamins A and B12. This nutrient deficiency may be an important risk factor for the high prevalence of birth defects in these regions. Therefore, adequate dietary nutrition in early pregnancy can prevent BDs.     

河南贲门癌高发区贲门癌组织ATP7B的表达

目的:了解贲门癌组织中ATP7B的表达情况.方法:采用免疫组化ABC法检测49例河南贲门癌高发区贲门癌及其相应癌旁正常组织中ATP7B的表达.结果:ATP7B在贲门癌组织中阳性表达率为51%(25/49),高于癌旁正常组织中的29%(14/49),差异有统计学意义(x2=5.15,P＜0.05).贲门癌组织ATP7B表达与肿瘤体积、淋巴结转移和远处转移无关,而与肿瘤分化程度有关.结论:ATP7B在贲门癌对铂类抗肿瘤药的先天耐药形成过程中发挥了重要作用,ATP7B可作为贲门癌的预后判断指标.