简易精神状态检查表在成都市不同区域55周岁以及上人群中 …

研究中文版简易精神状态检查在成都市不同区域５５周岁以及上人群中的应用及差异。方法：采用随机整抽样方法从成都市五城区中抽取两个区,然后再从城中心和城郊城镇中各抽取２－３个居委会,并从两区所辖的农村抽取一个村进行调查。调查分为筛查和复查诊断两阶段,筛查用ＣＭＭＳＥ作筛查工作,复查诊断则用Ｐｆｅｆｆｅｒａ功能活动量表和一组神经心理测验,结果１２０１人完成了ＣＭＭＳＥ评定。发现男性ＣＭＭＳＥ评分显著高于女     

简易精神状态检查表在不同人群中的试测研究

为提供适合于我国痴呆研究工作的简单标准化认知功能检查方法,我们将美国的简易精神状态检查表(MMSE)引入到中国,在137例50岁及以上的各种精神障碍患者和正常人中进行试测。结果表明:检查者间一致性和量表的可重复性均达理想程度;但发现检查结果易受被检查者文化程度和年龄的影响。以临床诊断为标准,选定 MMSE 评定痴呆的界线值为≤17分,其敏感性为1.00,特异性为0.89。未发现除痴呆以外的各种精神障碍患者与正常人 MMSE得分有差异。试测结果表明 MMSE 确具有简单、易行、易接受等特点。     

简易精神状态量表在不同性别及文化程度老年人群中的测量等值性

目的：检验简易精神状态量表（the Mini-mental State Examination, MMSE）在不同性别和不同受教育程度的社区老年人之间的测量等值性。方法：使用MMSE对长沙市999名社区老人进行测量,对不同性别及不同受教育程度被试的MMSE得分进行差异性分析以及多组验证性因素分析。结果：老年男性与同龄女性在MMSE得分上差异不显著（P>0.05）。不论在总分还是五个因子上,高文化程度组得分均显著高于低文化程度组（P<0.05）。多组验证性因素分析结果显示MMSE在男女组以及不同文化程度组间的形态等值、弱等值、强等值均成立。结论：MMSE在不同性别和不同受教育程度的老年人之间具有测量等值性。     

哈萨克文版简易智能精神状态检查量表的应用

<正>简易智能精神状态检查量表(Mini-Mental State Examination,MMSE)是国际上最具影响力的认知缺损筛查工具,现已被广泛应用痴呆临床及流行病学研究[1-3]。但由于地域差别、人文及社会背景不同,MMSE被采用的筛查痴呆界定值标准尚不统一,文化及语言差异也对评估效度有所影响[4-7],从而造成临床痴呆筛查诊断存在很大差异。     

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。     

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.     

中国版简易精神状态检查表在中国农村地区的适用性

目的：分析中国版简易精神状态检查表（CMMSE）和日常生活能力量表（ADL）在河南农村地区的应用特点。方法：对50岁以上共16488名农村人群进行阿尔茨海默病（AD）筛查，采用CMMSE和ADL评定量表为工具。结果：16095名完成了CMMSE，847名为CMMSE阳性，其中283名符合DSM－IV关于AD的诊断；CMMSE的敏感度为95．9％，特异度96．4％。16192人完成ADL，442名阳性，107人符合DSM－IV关于AD的诊断,敏感度为35．5％，特异度为97．9％。结论：CMMSE在中国农村地区用于AD筛查有较好的适用性，ADL为AD筛查的辅助工具。     

河南林县55岁及以上人群MMSE调查结果分析

目的 :了解河南林县 5 5岁及以上人群的神经心理学检查 ,研究痴呆情况及其危险因素。方法 :研究分两期进行 ,即筛查期和诊断期。在 1999年 11月和 2 0 0 0年的 4月的筛查期 ,来自林县 4个村的1396 2名老年被试接受了检查。使用中文版简明精神状况检查 (CMMSE)为筛查工具 ,根据被试的文化程度不同设定三个临界分。结果 :林县被试者的MMSE总分偏低 ,尤其是计算分较低 ,年龄较大、文化程度较低者、女性、经济水平较低地区者MMSE总分较低。MMSE总分越低日常生活能力 (ADL)总分越高。结论 :女性、增龄、低文化程度、低经济水平是林县被试出现痴呆 (智力受损 )的危险因素     

自制简易洗头器在长期卧床患者中的应用

目的 探讨自制简易洗头器在长期卧床患者中的应用效果.方法 将100例骨科卧床患者随机分为试验组50例和对照组50例,对照组采用传统的马蹄式洗头法洗头,试验组使用自制简易洗头器洗头,对两组患者进行患者舒适度、满意度以及护理人员满意度进行比较.结果 试验组患者床上洗头后的舒适度、满意度以及护理人员满意度与对照组患者床上洗头后相比,差异有统计学意义(P＜0.01).结论 使用简易洗头车为卧床患者进行床上洗头,不仅能为医院节省开支,同时患者感觉更舒适,缩短了洗头时间,减轻了护士的劳动强度,达到了省时、省力、省电的目的,提高了护理人员的工作效率,值得临床推广使用.     

简易尿管冲洗器在临床中的运用及研究

目的 观察简易尿管冲洗器在冲洗堵塞尿管中的临床效果.方法 选择留置导尿患者60例,随机分为观察组(n=30)和对照组(n=30).观察组采用简易尿管冲洗器对堵塞尿管进行冲洗,对照组直接用注射器对堵塞尿管进行尿道冲洗,分别冲洗后第1、3、7天采集尿液进行细菌培养,并在冲洗时收集渗漏液体进行比较.结果 在冲洗后第7天观察组细菌培养阳性率较对照组低(P＜0.05),冲洗时外漏液量比较(P＜0.01)有统计学意义.结论 使用简易尿管冲洗器进行冲洗堵塞尿管,不仅能减少冲洗时液体外渗,还可减少医源性感染.     

成都地区55周岁及以上人群中抑郁症患病率调查

目的了解成都地区55周岁及以上人群中抑郁症患病率及其影响因素。方法本文采用分层随机整群抽样方法,从成都市所辖地区抽取10个区市县。按农业人口和非农业人口所占比例确定应查城乡55周岁及以上人口数。调查由两阶段组成,先用流调用抑郁自评量表(CES-D)筛查,然后用DSM-Ⅲ-R定式临床检查(SCID-P)进行诊断复查。应查5587人,实查5385人,其中5350人完成了CES-D检查,35人因耳聋(且不识字),失语无法完成CES-D,改用SCID-P询问家属或其他知情者。外出171人,拒查31人,漏查率3.6%。结果发现CES-D评分≥16分者168人,为被调查人口的3.14%。诊断复查发现各类抑郁症的患病率分别为适应性障碍0.85%。心境恶劣障碍0.76%,躯体疾病所致抑郁心境0.52%,重型抑郁症0.45%。各类抑郁症总患病率为2.62%,其中男性1.60%,女性3.54%,女性患病率显著高于男性。多元逐步回归分析表明日常生活能力受损、女性以及认知功能下降老人有抑郁症状者较多。结论本文结果表明我国抑郁症患病率较低。适应性障碍,心境恶劣障碍和躯体疾病引起的抑郁是主要的抑郁类型。     

Clinical history for diagnosis of dementia in men: Caerphilly Prospective Study

Background

Diagnosis of dementia often requires specialist referral and detailed, time-consuming assessments.

Aim

To investigate the utility of simple clinical items that non-specialist clinicians could use, in addition to routine practice, to diagnose all-cause dementia syndrome.

Design and setting

Cross-sectional diagnostic test accuracy study. Participants were identified from the electoral roll and general practice lists in Caerphilly and adjoining villages in South Wales, UK.

Method

Participants (1225 men aged 45–59 years) were screened for cognitive impairment using the Cambridge Cognitive Examination, CAMCOG, at phase 5 of the Caerphilly Prospective Study (CaPS). Index tests were a standardised clinical evaluation, neurological examination, and individual items on the Informant Questionnaire for Cognitive Disorders in the Elderly (IQCODE).

Results

Two-hundred and five men who screened positive (68%) and 45 (4.8%) who screened negative were seen, with 59 diagnosed with dementia. The model comprising problems with personal finance and planning had an area under the curve (AUC) of 0.92 (95% confidence interval [CI] = 0.86 to 0.97), positive likelihood ratio (LR+) of 23.7 (95% CI = 5.88 to 95.6), negative likelihood ratio (LR−) of 0.41 (95% CI = 0.27 to 0.62). The best single item for ruling out was no problems learning to use new gadgets (LR− of 0.22, 95% CI = 0.11 to 0.43).

Conclusion

This study found that three simple questions have high utility for diagnosing dementia in men who are cognitively screened. If confirmed, this could lead to less burdensome assessment where clinical assessment suggests possible dementia.     

Accuracy of one or two simple questions to identify alcohol-use disorder in primary care: a meta-analysis

Background

There is much interest in ultra-short alcohol screening in primary care that may support brief alcohol interventions. Brief screening consisting of one or two questions might be used alone or in combination with longer tests as recommended by the Primary Care Service Framework.

Aim

To investigate whether a simple one and two question screening might prove an accurate and acceptable screening method in primary care.

Design and setting

A systematic literature search, critical appraisal and meta-analysis were conducted.

Method

A comprehensive search identified 61 analyses of single questions to detect alcohol problems including 17 that took place in primary care, using a robust interview standard. Despite focusing alcohol-use disorder in primary care settings, heterogeneity remained high, therefore random effects and bivariate meta-analyses were used.

Results

After adjustments, diagnostic accuracy of a single-question approach was given by a sensitivity of 54.5% (95% CI = 43.0% to 65.5%) and a specificity of 87.3% (95% CI = 81.5% to 91.5%) using meta-analytic weighting. Two questions had a sensitivity of 87.2% (95% CI = 69.9% to 97.7%) and specificity of 79.8% (95% CI = 75.7% to 83.6%). Looking at each question individually, the most successful single question was a modification of the Single Alcohol Screening Question (SASQ) namely, ‘How often do you have six or more drinks on one occasion?’. The optimal approach appears to be two questions followed by the CAGE questionnaire, which achieved an overall accuracy of 90.9% and required only 3.3 questions per attendee.

Conclusion

Two brief questions can be used as an initial screen for alcohol problems but only when combined with a second-step screen. A brief alcohol intervention should be considered in those individuals who answer positively on both steps.     

连续顺序追踪超声法联合实时三维超声在胎儿手畸形诊断中的应用

目的探讨连续顺序追踪超声法联合实时三维超声在胎儿手畸形诊断中的应用价值。方法对5988例胎儿先后行胎儿产前常规超声和连续顺序追踪超声法超声检查,回顾性分析临床资料和结果。结果连续顺序追踪超声联合实时三维超声应用于胎儿手畸形诊断中的灵敏度、特异性、阳性预测值和阴性预测值分别为93.3%、99.9%、82.4%和100%,均显著优于常规超声46.7%、99.7%、26.0%和99.9%,差异显著,具有统计学意义(P0.05)。结论连续顺序追踪超声法联合实时三维超声在胎儿手畸形诊断中的应用,可有效降低漏诊和误诊的发生率,具有推广价值。     

2017~2018年成都市三区县外环境禽流感监测分析

目的 监测四川省成都市三区县外环境中禽类流行性感冒（禽流感）病毒的分布状况,为人禽流感防控提供参考依据。方法 我中心在2017年5月~2018年5月采用实时荧光定量PCR检测成都市三区县外环境中甲型流感通用病毒,再将阳性标本进行H5、H7、N9和H9分型,采用χ2检验比较定性资料。结果 在497份样本中,甲型流感病毒阳性标本87份,检出率为17.91%;分型实验中,H5、H7、N9和H9分别检出7份、6份、12份和41份,其阳性检出率依次为1.41%、1.21%、2.41%、8.25%,未分型成功23份,占总样本的4.63%。结论 成都市三区县外环境存在禽流感病毒污染,有人感染禽流感风险;需加强对外环境及高危人群禽流感监测,并规范对市场的管理机制,落实消毒和检疫准入等预防措施。     

Aminopeptidase N in Sera of Healthy Subjects Is a Different N-Terminal Processed Derivative from the One Obtained from Maternal Serum

A major aminopeptidase present in normal human serum was purified to homogeneity as a 150-kDa molecular species. Western blotting confirmed the binding of an anti-aminopeptidase N antibody to the protein. The N-terminal amino acid sequence of the enzyme was determined. The first 13 amino acids of the enzyme completely matched amino acids 59–71 of the sequence predicted from the human intestinal aminopeptidase N cDNA nucleotide sequence. As reported previously, aminopeptidase N from maternal serum had 68 fewer amino acid residues at the N-terminus than the enzyme obtained from detergent-solubilized membranes. The results indicate that aminopeptidase N in normal serum is a different N-terminal processed derivative from that obtained from maternal serum.     

Whole-cell voltage-clamp recordings in granule cells acutely isolated from hippocampal slices of adult or aged rats

Whole-cell voltage-clamp recordings were undertaken in granule cells acutely dissociated by a simple enzymatic procedure from the dentate gyri of hippocampal slices obtained from adult or aged rats. This dissociation procedure also allowed the concomitant isolation of other neuron types from diverse hippocampal subfields for the study of ionic currents through voltage- and neurotransmitter-gated channels. For example, in isolated granule cells of the dentate gyrus both transient and sustained Ca2+ currents could be observed in the presence of extracellular tetrodotoxin (TTX) and intracellular Cs+. In addition, ionic currents mediated by activation of excitatory amino acid receptors of the N-methyl-D-aspartate (NMDA) type were present. A technique for the rapid dissociation of neurons from brain slices of adult or aged rats is described in detail.