社区老年人群脑卒中相关危险因素的分析及干预效果

目的探讨社区老年人群脑卒中相关危险因素及其干预措施效果。方法抽取我院辖区内年龄≥60岁的人群,发放调查问卷,问卷内容包括血压、心房颤动或瓣膜性心脏病、吸烟、血脂异常、糖尿病、体育锻炼较少、明显超重、脑卒中家族史等8项,并针对脑卒中危险因素实施干预措施,对调查结果进行统计学分析。结果本次研究共发放调查问卷5243份,回收有效问卷5112份,有效回收率为97.50%,有脑卒中病史者287例,脑卒中患病率为5.61%;其中男性186例,患病率为3.64%,女性101例,患病率为1.97%,差异具有统计学意义(P<0.05),有高血压病史、心房颤动或瓣膜性心脏病、吸烟、血脂异常、糖尿病、体育锻炼、明显超重、脑卒中家族史等人群脑卒中患病率明显高于无危险因素人群(P<0.05)。结论高血压病史、心房颤动或瓣膜性心脏病、吸烟、血脂异常、糖尿病、体育锻炼、明显超重、脑卒中家族史等是社区老年人群脑卒中的危险因素,对其实施有效干预措施,可有效降低脑卒中发病率,是预防脑卒中发病的有效手段。     

荆门市某社区居民脑卒中高危人群筛查及危险因素分析

目的:分析了解荆门市某社区脑卒中危险因素分布情况,为社区脑卒中高危人群的干预提供依据。方法:对荆门市某社区538例居民进行脑卒中高危人群筛查,高危人群判定标准为高血压、糖尿病、血脂升高(甘油三酯≥2.26 mmol/L)、房颤、肥胖、缺乏锻炼、吸烟、脑卒中家族史8项中满足3项及以上;或脑血管功能检测评分在75分以下。分析该地区脑卒中发病危险因素的分布情况。结果:538例中,共筛查出244例脑卒中高危者,其中脑血管功能检测评分75分198例(36.8%)。所占比例较高的危险因素依次为高血压(170例,69.67%)、超重或肥胖(113例,46.31%)、血脂升高(53例,21.72%)、吸烟(51例,20.90%)、家族史(44例,18.03%)、糖尿病(42例,17.21%)。结论:荆门市某社区脑卒中发病危险因素主要为高血压、肥胖、吸烟、血脂升高和糖尿病。     

黑龙江省佳木斯市某镇中青年脑卒中高危风险危险因素现况分析

目的:通过对黑龙江省佳木斯市某镇中青年人群(40～60岁)进行脑卒中危险因素现况调查及高危风险危险因素分析,为佳木斯市地区脑卒中预防及减轻脑卒中负担提供区域性的参考依据。方法:对2018年3月长期居住佳木斯市某镇中青年人群(40～60岁)173人,采用面对面调查法进行脑卒中危险因素现况调查,统计分析脑卒中高危风险人群各个危险因素的暴露水平、单因素及多因素Logistic逐步回归分析性别与脑卒中危险因素的相关性。结果:脑卒中高危风险人群中8项危险因素暴露水平依次为:高血压病(82. 18%)、血脂异常(70. 14%)、明显超重或肥胖(58. 59%)、运动缺乏(55.22%)、脑卒中家族史(46. 55%)、吸烟(42. 05%)、糖尿病(18.46%)、房颤或瓣膜疾病(2. 57%); Logistic单因素回归分析显示脑卒中高危风险因素中的糖尿病、吸烟史及运动缺乏的危险因素与性别之间存在相关性(P<0. 05),其中脑卒中高危风险人群中女性糖尿病和运动缺乏危险因素的暴露水平明显高于男性,差异有统计学意义(x~2=6.789, P<0. 01; x~2=4.107, P<0. 05);而脑卒中高危风险人群中男性吸烟史危险因素暴露水平显著高于女性,差异有统计学意义(x~2=138. 696, P<0. 01);多因素Logistic逐步回归分析显示脑卒中高危风险人群危险因素中糖尿病、吸烟史及运动缺乏与性别显著相关,其对应OR值及其95%CI分别为0.467 (0.293～0.774)、10.222 (6. 934～15.070)和0.668 (0.461～0.969)。结论:佳木斯市某镇中青年脑卒中高危风险人群在重视主要的危险因素的同时,女性需注重糖尿病及运动缺乏,而男性则更需注重吸烟的危险因素,为佳木斯市预防脑卒中日益年轻化的趋势而采取针对性干预措施提供一定的参考依据。     

我市某区脑卒中患者患病情况及危险因素分析

目的 分析我市某区脑卒中患者发病及其主要危险因素,为脑卒中患者的预防控制提供参考依据。方法 采用随机整群抽样法,以街道办事处(乡镇)、社区村委会(社区居委会)所辖社区常住人口底册为依据,以居民家庭为单位,以40岁以上常住居民为调查对象进行问卷调查,采用多因素非条件logistic回归分析探讨其脑卒中发病的危险因素。结果 在我市某区29 505名40岁以上常住居民中,脑卒中患者915例,脑卒中患病率为3.10%。不同性别、年龄、吸烟情况、运动情况、脑卒中家族史、高血压史、血脂异常、体质量指数患病率不同,差异均有统计学意义(P<0.01)。男性、年龄≥50岁、吸烟、有脑卒中家族史、高血压史、血脂异常、体质量指数≥18.5 kg/m²的常住居民脑卒中患病率较高,女性和经常运动的脑卒中患病率较低。结论 40岁以上脑卒中患病率较高,性别、年龄、吸烟情况、运动情况、脑卒中家族史、高血压史、血脂异常、体质量指数是该地区常住居民脑卒中患病的主要危险因素。     

江阴市社区诊断报告

目的 为掌握江阴市社区慢性非传染性疾病现状及原因,确定目标干预人群,为慢性病防治干预措施提供依据.方法 采用分层随机整群抽样法抽取35岁以上常住人群4500人进行入户调查.结果 缺少体育锻炼率81.8%、肥胖率52.7%、吸烟率26.3%(男性60.1%)、过量饮酒率22.7%、口味偏咸率15.8%.高血压、高脂血症、冠心病、脑卒中、糖尿病现患率为35.4%、2.6%、2.4%、1.4%、1.3%.结论 江阴市居民35岁以上人群中有46.6%的人患有各种慢性病,主要病种为高血压、心脑血管疾病、糖尿病、胃及十二指肠疾病、慢性呼吸道疾病、恶性肿瘤等.60岁以上老年人患有高血压、冠心病、脑卒中、糖尿病或恶性肿瘤的总比率达72.5%.与慢性病相关的主要行为危险因素为吸烟、过量饮酒、肥胖、超重、缺少体育锻炼、口味偏咸等.积极倡导健康科学的生活方式,切实加强慢性病干预工作,是降低江阴市慢性病发病率的当务之急.     

佳木斯市某镇脑卒中高风险人群危险因素现况分析

目的:通过对黑龙江佳木斯市郊区某镇脑卒中高风险分级的人群进行危险因素现况分析,为脑卒中预防及针对危险因素干预提供区域性的临床依据。方法:通过面对面调查法对长居某镇40～89岁的人群进行脑卒中危险因素现况调查,统计分析高风险人群各个危险因素的暴露水平、不同性别间年龄、体重、血脂异常的差异及年龄组间各数值[体质指数(BMI)、收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]均数及标准差。结果:本研究8项危险因素根据暴露水平从高至低依次为高血压病(86.1%)、血脂异常(69.65%)、明显超重或肥胖(56.46%)、运动缺乏(54.87%)、吸烟(40.53%)、脑卒中家族史(39.47%)、糖尿病(22.04%)、房颤或瓣膜性疾病(2.83%);性别间年龄、体重、血脂异常结果显示,年龄、BMI、TG、HDL-C的差异无统计学意义(P>0.05),TC、LDL-C的结果差异具有统计学意义(P<0.05)。结论:高血压病仍是脑卒中最危险的因素,可改变的吸烟危险因素暴露比高于不可改变的脑卒中家族史的暴露比,而糖尿病和房颤或瓣膜性疾病所占比例相对较低。     

合肥市某社区中老年人群超重肥胖流行现状及其与相关慢性病关系的研究

目的了解合肥市某社区中老年人群超重、肥胖的流行现状,探讨超重、肥胖与高血压及糖尿病的相关性。方法采用普查方法,对社区内40岁及以上常住居民进行超重与肥胖流行病学调查并进行体格检查和实验室检查。结果此次共调查2 860人,超重者1 181人,超重率41.3%,肥胖者343人,肥胖率12.0%;40～49岁、已婚、文盲与半文盲、与配偶子女一起居住的调查对象超重与肥胖患病率较高,不同性别的调查对象之间超重与肥胖差异无统计学意义(P>0.05)。共筛查出高血压患者1 056人,糖尿病患者400人,患病率分别为36.9%和14%;单因素Logistic回归分析提示体质指数(BMI)从过轻到肥胖,每增加一个等级,患高血压与糖尿病的可能性分别增加了1.723倍和1.409倍。结论调查对象超重与肥胖的发生率较高,超重与肥胖是高血压和糖尿病的重要危险因素。     

上海市高桥社区65岁及以上老年人健康体检结果分析

目的:了解高桥社区65岁及以上老年人的健康状况及疾病谱的分布,为进一步开展慢性病管理及健康教育工作提供依据.方法:2015年3月至6月为本辖区自愿参与的7 001名65岁及以上老年人进行免费健康体检,其中男性3 032名(43.3％);女性3 969名(56.7％).检测内容包括血压、空腹血糖、血脂、肝功能和肾功能等.结果:共检出至少一个指标异常的人数为6 756人,异常率为96.50％,有2种及以上疾病或指标异常的老年人占62.79％.检出的主要疾病或指标异常的前4位分别为肥胖或超重、高血压、糖尿病和血脂异常;女性的糖尿病、血脂异常检出率均高于男性(P＜0.05);超重或肥胖、高血压、糖尿病和血脂异常检出率均有随年龄增加而下降(P＜0.01).结论:肥胖或超重、高血压、糖尿病、血脂异常是老年人最常见的慢性疾病或危险因素,需进一步加强对老年人进行健康宣教,倡导健康生活方式,尤其是对年龄较轻的老年人群.     

林校路街道职业人群慢性病及其危险因素分布情况调查

目的了解林校街道辖区职业人群慢性病及其危险因素分布情况。方法由北京市卫生局直接抽取的两个功能单位203人为被调查对象,对其进行高血压、糖尿病、心脑血管病和恶性肿瘤4种慢性病及其危险因素情况进行问卷调查。结果 72.9%的调查人群具有一种或一种以上高危因素,调查人群中高血压、血脂异常、高血糖、超重及肥胖患病率分别为18.7%、56.2%、3.9%、38.9%、25.6%。高血压、血脂异常、高血糖及肥胖的患病率是男性高于女性,血脂异常在不同年龄分布不同,差异有统计学意义（P〈0.05）。35-49岁为高发年龄段。结论该地区职业人群慢性病及其危险因素处于高水平状态,危险因素的持续存在可能造成慢性病的患病率增高,应迅速开展对慢性病的干预活动,控制慢性病的流行。     

基于ROSIER评分量表筛查急诊脑卒中高危人群效果及其危险因素暴露情况

目的 探讨急诊脑卒中识别评分量表(ROSIER)与面、臂、言语、时间评分量表(FAST)筛查脑卒中(CI)的应用价值,并分析高危人群危险因素暴露情况。方法 选取2020年1月—2022年7月南阳市中心医院收治的疑似CI患者207例为研究对象,采用ROSIER、FAST分别对疑似CI患者进行评估。以综合诊断结果为金标准,对比分析两种量表筛查CI的价值。基于ROSIER筛查CI患者高危人群,并分析其危险因素暴露情况。结果 207例疑似CI患者中,确诊为CI 140例、非CI 67例;FAST诊断CI的敏感度、特异度、准确度分别为83.57%、73.13%、80.19%;ROSIER诊断CI的敏感度、特异度、准确度分别为92.86%、80.60%、88.89%;不同年龄、性别、文化程度、居住地、婚姻状况、事业、吸烟史、缺乏运动、脑卒中家族史、高血压、糖尿病、房颤、血脂异常、超重患者高危人群检出率比较差异有统计学意义(P<0.05);基于ROSIER检出的CI高危人群中超重、高血压、糖尿病、缺乏运动、血脂异常5个方面危险因素处于较高暴露水平;logistic回归分析显示与CI高危人群关联...     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Trichinellosis in immigrants in Switzerland

We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia.