Profile of clinical research subjects in an independent outpatient center

This paper assesses the quality of assistance in a clinical trial outpatient center as well as the patients understanding of the informed consent (IC); determine the reasons why they participate and detail socio-economic levels. A cross-sectional study was adopted in a clinical trial outpatient center using a self-explanatory questionnaire. All 100 respondents considered the assistance at the center excellent (86%) or good (9%). Almost all of them were well informed about the content of the IC. Their knowledge about the right to "confidentiality", present in all ICs, was 6 times higher than their knowledge about their right to "access the results", generally not included in the IC. The main reasons for participating were "to know more about ones health" (59%) and to "to benefit other people in the future" (47%). The participants income varied from 3 to 5 minimum wages (48%) and most (66%) concluded at least the 4th grade of basic education in Brazil. The subjects showed the economical characteristics of the average population of Rio de Janeiro. Their level of education allowed them to sign and to understand what they were signing. They were aware of the existence of the IC and its content. The main reason for participating was for one s own benefit and for the benefit of others.     

制定国家营养改善与慢性病控制政策需要循证

由我国卫生部、科技部和国家统计局共同领导的“2002年中国居民营养与健康状况调查”的初步结果,于2004年在国务院新闻发布会上公布后引起了国内外的广泛关注.在过去的一年中,课题组按计划对所获得的数据从多方面进行了深入分析,从膳食和营养素摄入、生活方式、体格检查、血液生化检测,到糖尿病、高血压、肥胖、血脂异常,以及这些指标之间的相关性,出版了一系列专著和学术论文,对进一步了解我国居民膳食、营养与疾病的关系提供了大量有意义的信息.     

羟乙基淀粉130/0.4对慢性阻塞性肺病患者进行液体复苏的临床研究

目的观察羟乙基淀粉130/0.4(万汶)对慢性阻塞性肺病(COPD)患者进行液体复苏的有效性和安全性。方法40例COPD患者,气管插管或机械通气后出现血压下降,随机分配到万汶组和林格液组,各20例。监测复苏时间、复苏液体量、血液流变学、凝血功能和肾功能以及不良反应。结果万汶组和林格液组输液量分别为(1535±380)ml和(2150±427)ml,复苏时间分别为(5.21±1.94)h和(6.48±2.36)h,P<0.05。万汶组血液流变学参数改善差异有统计学意义(P<0.01),而林格液组变化差异无统计学意义(P>0.05);两组的凝血功能和肾功能在复苏前后差异无统计学意义(P>0.05);林格液组出现3例下肢水肿加重。结论万汶能快速有效地稳定血流动力学,改善血液流变学,可能更有利于器官灌注和组织氧合,故可首先考虑用于COPD患者的液体复苏。     

慢性肾脏病发病风险预测模型研究进展

慢性肾脏病(CKD)是全球重要的公共卫生问题, 严重危害人群健康。利用预测模型对人群未来一段时间的CKD发病风险进行分层, 针对高危人群采取干预措施是实现CKD一级预防的重要途径。世界范围内已经开发出了二十多个CKD发病风险预测模型, 我国学者也开发出了4个适用于中国人群的预测模型, 但目前的临床指南中尚未推荐使用任何专门的CKD风险预测模型。现有模型在结局定义、预测因子、缺失数据处理和建模方法选择方面仍有局限。在未来, 新兴生物标志物和多基因风险评分的应用以及机器学习方法的发展将为继续改进模型提供更多可能。     

慢性肺心病并低钾血症临床分析

目的探讨慢性肺心病急性发作期并发低钾血症时与疾病预后的关系。方法对243例慢性肺心病患者临床资料进行了回顾性分析。结果肺心病患者并发低钾血症增加了患者病死率以及心律失常的发生。结论低钾血症是肺心病病情危重的重要指标之一,能否得到及时合理的治疗是影响患者预后的一个重要因素,应引起临床医师的重视。     

心内科住院患者医院感染的临床分析

目的对心内科住院患者医院感染的临床情况进行研究与分析。方法采用统计分析的方法,对本院心内科住院患者在医院的感染情况进行分析。结果本次共调查356例在我院住院的心内科患者,发生9例医院内感染,感染率为2.53%,感染的患者原发病都是心脏病。患者的感染部位以呼吸道为主,占66.67%,其次是泌尿道感染,占22.2%。导致住院患者感染的危险因素主要是患者年龄以及合并有基础病等等。结论心内科住院患者医院感染应通过加强基础护理以及治疗等方式来降低感染的发生率,医院应严格进行无菌操作。     

空间全生命周期流行病学在慢性病研究中的应用

近年来, 慢性病致病因素的研究从专注行为生活方式等非空间因素逐渐向地理环境等空间因素延伸。空间全生命周期流行病学是健康地理学的分支方向。作为全生命周期流行病学和空间流行病学的融合, 空间全生命周期流行病学结合先进的地理信息、测绘遥感、移动定位、人工智能等技术, 对个体的全生命周期暴露史(暴露组)进行精准回溯、测量及模拟, 采用累积风险模型和关键期/敏感期风险模型等全生命周期模型研究暴露史在个体全生命周期不同阶段对健康的影响。本文对空间全生命周期流行病学在慢性病研究中的理论基础、分析策略及重点研究内容进行综述, 旨在促进其在慢性病领域的致病因素研究中的应用, 为后续研究提供参考和建议, 推动健康地理学的发展, 最终实现全生命周期精准健康管理。     

The case for disease management in chronic kidney disease.

Chronic kidney disease (CKD) is a growing epidemic in the United States and worldwide, with nearly two thirds of CKD patients also having diabetes, hypertension, or both. Morbidity and mortality among patients with CKD are high, as are the costs associated with care, which is highly fragmented. Disease management (DM) programs are designed to coordinate the delivery of care to patients, improve clinical outcomes, and reduce costs along the continuum of care. The goals of DM programs in CKD patients are to fill the gaps in current care by focusing on four key areas: (1) slowing the progression of CKD, (2) identifying and managing the complications of CKD, (3) identifying and managing associated comorbid conditions, and (4) smoothing the transition to renal replacement therapy (RRT). To be successful, this approach requires multidisciplinary collaboration among physicians (eg, primary care physicians, endocrinologists, cardiologists, nephrologists, surgeons) and participating caregivers including nurses, dieticians, social workers, and pharmacists. Patient identification, limited reimbursement, late patient referral, and lack of primary care physician and nephrologist knowledge about the importance and details of CKD management are all barriers that must be overcome for such programs to be successfully implemented. Considering the magnitude of the opportunity, DM applied to CKD is a promising approach to the care of this vulnerable population.     

FGF-23与慢性肾脏病血管钙化关系的研究进展

成纤维细胞生长因子-23(FGF-23)主要由成骨细胞和骨细胞分泌,是新近发现的重要的钙磷代谢调节因子,在慢性肾脏病(CKD),尤其是终末期肾病(ESRD)患者血管钙化中的作用越来越受到人们的重视,文章就FGF-23与ESRD性血管钙化的研究进展进行综述。