PP分布、PB分布及其应用──疾病的统计分布(三)

本文介绍并讨论了两种复合分布及其性质，即Ｐｏｉｓｓｏｎ－Ｐｏａｉｓｓｏｎ分布（ＰＰＤ）和Ｐｏｉｓｓｏｎ－二项分布（ＰＢＤ）。这两个分布的关系类似于Ｐｏｉｓｓｏｎ分布与二项分布的关系，所不同的是，二项分布属有限二项概型，而ＰＰＤ与ＰＢＤ均属无限二项概型。两者的应用条件同负二项分布，但不能相互替代．     

PP分布,PB分布及其应用

本文介绍并讨论了两种复合分布及其性质，即Ｐｏｉｓｓｏｎ－Ｐｏａｉｓｓｏｎ分布（ＰＰＤ）和Ｐｏｉｓｓｏｎ－二项分布（ＰＢＤ）。这两个分布的关系，所不同的是，二项分布属有限二项概型，而ＰＰＤ与ＰＢＤ均属无限二项概型。两者的应用条件同负二项分布，但不能相互替代。     

Poisson分布设计时样本含量的估算

Ｐｏｉｓｓｏｎ分布是一种离散分布，它在临床、预防、基础医学，及计划生育研究中有广泛应用。文中对提出的几种Ｐｏｉｓｓｏｎ分布设计时样本含量估算方法，以妇幼卫生、计划生育研究的实例介绍，并讨论了有关问题。     

585例痰涂片阳性肺结核病例空间聚集性分布探讨

本文应用Ｐｏｉｓｓｏｎ分布和负二项分布拟合法，对蓬溪县利用世界银行贷款结核病控制项目，１９９２年登记的５８５例谈涂片阳性结核病例进行拟合分析，并作拟合优度Ｘ２检验。结果不符从Ｐｏｉｓｓｏｎ分布（Ｐ＜０．００１），而与负二项分布非常满意的配合（Ｐ＜０．９０）。表明结核病这种慢性传染病在疫点内仍具有传染性疾病聚集性分布的特征。其防治工作的重点应放在痰涂片阳性的村、家庭中。     

应用Poisson分布研究流脑病例分布特征

应用Ｐｏｉｓｓｏｎ分布研究流脑病例分布特征唐河县卫生局秦成润，张志卿唐河县防疫站张晓波，郑柏林１９８６～１９９１年唐河县累计发生流脑９０例，１９８６年发病率为３．８４／１０万，１９９１年发病率为０．４３／１０万，呈下降趋势．但各年发病尚未间断。为反映...     

带协变量的统计分布及其应用：疾病的统计分布（四）

疾病的发生受诸多因素的影响，故疾病发生数的统计分布料随影响因素及其水平的变化而发生改变，即单位时间或空间的病例数的统计分布不是一成不变的。本文提出带协变量的统计分布之概念，并以时依Ｐｏｉｓｓｏｎ分布为例，说明了这类问题的求解有其应用。     

出生缺陷监测中O／E法的误差探讨

Ｏ／Ｅ法是出生缺陷监测中最常用的统计方法。长期以来，人们忽略了出生缺陷分布的多样性。本文讨论了Ｏ／Ｅ法的误差，结果表明：二项分布和Ｐｏｉｓｏｎ分布的误差可以忽略，但负二项分布和Ｐｉｓｏｎ分布的误差值得重视。     

Poisson回归在职业队列研究中的应用

本文介绍Ｐｏｉｓｓｏｎ回归模型及其计算方法，运用这一方法对某职业人群队列研究死亡资料作了Ｐｏｉｓｓｏｎ回归分析。研究结果提示该厂可能有某些职业危害因素存在，影响了职工寿命。     

累计和法的原理及其在出生缺陷监测中的应用

本文从序贯概率比检验的理论出发，介绍了累计和法的原理，并将其推广于非Ｐｏｉｓｓｏｎ分布资料，并通过实例说明了在出生缺陷监测中的具体应用。     

论负二项分布的应用条件

本文从复合分布的角度导出负二项分布的演绎过程，说明负二项分布即是Ｐｏｉｓｓｏｎ分布中参数λ服从Γ分布所得的复合分布，从而阐明了其生物学意义及其应用条件，更正了对负二项分布的一些误解和误用，指出复合分布有着广阔的应用前景。     

Work conditions and mental health among doctors from Salvador, Bahia, Brazil

This cross-sectional study investigated the association between work conditions and minor psychological disorders (MPD) in a random sample of 350 doctors from Salvador City, State of Bahia, Brazil. Data were gathered using an individual, self-report questionnaire that incorporated the demand-control model (Job Content Questionnaire) to evaluate psychosocial aspects of the doctors' work and the Self-report Questionnaire (SRQ-20) to evaluate their mental health. The study found increased work overload, overtime and extended work shifts, multiple jobs, low income per hour worked, and unstable work arrangements with payment per procedure. The prevalence of MPD was 26.0% and was more strongly associated with aspects of the psychological demands of work than with the doctors' control over it. Doctors with high strain (high demand and low control) jobs showed MPD prevalence of 3.07 (95%IC: 1.38-6.85) times higher than those in low strain (low demand and high control) jobs.     

高血压与糖尿病慢性并发症

分析了５７７例ＮＩＤＤＭ患者中高血压的检出率及其对糖尿病并发症影响。５７７例中正常血压（＜１８．７／１２．０ｋＰａ）２９１例，轻度高血压（１８．７～２１．３／１２．０～１３．２ｋＰａ）１２２例，中度高血压（２１．３～２４．０／１３．３～１４．７ｋＰａ）８１例，重度高血压组（＞２４．０／１４．７ｋＰａ）４１例。４２例正在服降压药的血压正常者单独分组。高血压组的糖尿病患者视网膜和肾脏并发症的发生率明显高于血压正常组，且神经、视网膜和肾脏并发症的程度更严重。重度高血压组的患者中，这三种并发症的发生率分别达到５９％、６０％和３２％。正常眼底的糖尿病患者血压明显低于有视网膜病变组。无神经病变患者的血压值明显低于有神经病变组。高血压组的平均心率、尿白蛋白明显高于无高血压组，而前者心率变异值明显低于后者。逐步回归分析显示，收缩压是微血管病变的独立的危险因素。结论：必须加强糖尿病合并高血压检测和治疗。     

贵州省初中生手机依赖症与学业负担的关系

目的 运用多水平模型探讨“双减”政策下贵州省初中生手机依赖症(MPD)与学业负担的关系,为预防初中生MPD的发生提供依据。方法 于2021年12月—2022年1月,用多阶段分层随机抽样法抽取贵州省3个市(州)7 868名初一至初三年级学生,采用自编调查问卷、青少年手机使用依赖自评问卷(SQAPMPU)进行现场调查,采用MLwiN 2.30软件拟合贵州省初中生MPD与学业负担关系的多水平模型。结果 贵州省初中生MPD检出率为20.9%。多水平模型显示,贵州省初中生MPD在学校、班级水平上存在聚集性(χ²=1 565.32,P<0.01);感知学业压力大对初中生MPD具有正向预测作用(β=1.96),周末完成书面作业时长≥90 min/d对初中生MPD具有负向预测作用(β=-0.55),学习日参加校外培训对初中生MPD具有正向预测作用(β=1.66)(P值均<0.05)。结论 贵州省初中生MPD发生水平较高;感知学业压力、周末完成书面作业时长、学习日参加校外培训等学业负担与初中生MPD均有关联,应引起学校、家庭及社会有关部门的重视。     

铅致心肌细胞巯基改变与锌对其改变影响的研究

采用体外心肌细胞培养技术，研究了铅致心肌细胞总巯基、非蛋白巯基、蛋白巯基的改变与锌对其改变的影响。结果表明：与对照相比，铅可使非蛋白巯基、蛋白巯基降低，且呈剂量反应关系。非蛋白巯基先降低，蛋白巯基后降低。在高剂量组蛋白巯基反而比对照为高，可能系蛋白结构改变使内部巯基暴露所致。锌可进一步降低铅致总巯基、非蛋白巯基、蛋白巯基的量。从而提示：巯基参与了铅的心脏毒性作用，预防性给锌在一定程度上可拮抗铅的心脏毒性。     

Poor mental health associated with job dissatisfaction among school teachers in Japan

School teaching is regarded as a stressful occupation. The present study aimed to compare the likelihood of having minor psychiatric disorders (MPD) among school teachers with that among civil servants, and to investigate what factors were specifically associated with MPD in teachers. We conducted a questionnaire-based survey of 403 teachers employed at state schools and 611 civil servants as a comparison group in a medium-sized city in Japan. The response rate was 59.6% for teachers and 62.0% for civil servants. Mental health was assessed using the 28-item General Health Questionnaire (GHQ-28), according to which those with a score of six or higher were considered to have MPD. Logistic regression analysis was used to identify the factors associated with MPD. Although the proportion of subjects with MPD among teachers was greater than that among civil servants, the difference in the proportion was not statistically significant in the multiple logistic regression analysis adjusted for potential confounders. In a separate analysis of the teachers, reduced job satisfaction and shorter time spent of leisure were significantly associated with an increased likelihood of having MPD. In the group of civil servants, longer working hours, reduced life satisfaction, a history of sick leave, and physical illness were associated with an increased likelihood of having MPD. When this analysis was conducted separately for male and female teachers, job dissatisfaction alone was associated with MPD only in female teachers. Poor mental health of Japanese school teachers, female teachers in particular, was found to be associated with job dissatisfaction.     

Evaluation of three molecular typing techniques for nonfermentative Gram-negative bacilli.

OBJECTIVE: To evaluate three different DNA techniques for typing nonfermentative gram-negative bacilli isolated from Latin American hospitals. DESIGN: One hundred twenty-six nonfermentative gram-negative bacilli were typed. PARTICIPANTS: Pseudomonas aeruginosa (n = 64) and Acinetobacter baumannii (n = 42) samples were obtained from blood cultures of patients admitted to 10 medical centers in Latin America during 1998 and Stenotrophomonas maltophilia (n = 20) samples were obtained from patients admitted to the Hospital S?o Paulo between 1999 and 2001. METHODS: All samples were typed using automated ribotyping, PFGE, and ERIC-PCR. The discriminatory power for each technique was calculated using Hunter's generalized formula. RESULTS: All strains could be typed by automated ribotyping and ERIC-PCR, but two strains (1.6%) were not typeable by PFGE. All three techniques showed 100% reproducibility. The time to obtain the results was shorter for automated ribotyping and ERIC-PCR compared with PFGE. Likewise, the costs for ERIC-PCR and PFGE were lower than those for automated ribotyping. The interpretation of results was more complicated and more difficult with ERIC-PCR than with both PFGE and automated ribotyping. All techniques presented excellent discriminatory power for P. aeruginosa (0.98). PFGE presented the highest discriminatory power (0.94) for A. baumannii, and both PFGE and ERIC-PCR showed higher discriminatory power (0.90 for both) than automated ribotyping (0.82) for S. maltophilia. CONCLUSIONS: PFGE showed the highest discriminatory power for typing these nonfermentative gram-negative bacilli. However, automated ribotyping and ERIC-PCR can provide results in a shorter time period with similar discriminatory power.     

The population structure of drug-resistant Mycobacterium tuberculosis clinical isolates from Sichuan in China

China ranks second next to India among 22 high-burden countries despite decades' effort on tuberculosis (TB) control. The Sichuan province today contains the second-largest number of TB cases among Chinese provinces, where the prevalence of drug-resistant TB, especially MDR-TB, is much higher than the average level in eastern China. In this study, the population structure and the transmission characteristics of drug-resistant TB in Sichuan province were studied by spoligotyping and 24-locus Mycobacterial interspersed repetitive units-variable number tandem DNA repeats (MIRU-VNTR), applied to a total of 306 clinical isolates. Spoligotyping-based analysis showed that Beijing family represented 69.28% of all isolates and constituted the largest group (66.24%) of MDR-TB in Sichuan. The remaining isolates, accounting for 33.76% of MDR isolates, belonged to the ill-defined T family, Manu2, H3, LAM9, and other minor unassigned clades. The discriminatory power evaluated for spoligotyping was poor (HGI=0.595), but high for 24-locus MIRU-VNTRs (HGI=0.999). The number of the most discriminatory loci (h>0.6) was 12, including locus 424, 802, 960, 1644, 1955, 2163b, 2996, 3007, 3192, 3690, 4348 and 4052. It was concluded that 24-locus MIRU-VNTRs could be a more discriminatory tool for differentiating clinical isolates from Sichuan region. The small clustering size obtained from the current population structure analysis suggested that the high prevalence of drug-resistant TB in this region might be attributed partially to the acquired resistance due to inappropriate drug use rather than active transmission of drug-resistant TB (primary resistance).     

肥胖及相关因素与非胰岛素依赖型糖尿病患病关系的病例对照研究

采用１∶１配比病例对照研究方法，对１１０名非胰岛素依赖型糖尿病（ＮＩＤＤＭ）病例的患病危险因素进行研究。条件Ｌｏｇｉｓｔｉｃ回归分析结果表明，开始发胖年龄越早、发胖程度越大患病的危险性越大；既往最大体重指数（ＢＭＩ）大于２８ｋｇ／ｍ２者患病危险性是小于２５ｋｇ／ｍ２者的１１．５２倍。目前的腰围、腰股比（ＷＴＲ）、收缩压（ＳＢＰ）亦与ＮＩＤＤＭ患病有关，而与目前的ＢＭＩ未见有统计学联系。血脂各项显示，总胆固醇（ＴＣ）、甘油三酯（ＴＧ）、载脂蛋白ＡⅠ、Ｂ病例组均高于对照组。多因素调整后，既住最大ＢＭＩ、ＳＢＰ、ＴＧ仍有明显作用     

Multiple personality in eating disorder patients

Although the overlap between childhood sexual and physical abuse and eating disorders is well known, little work has been done on the sequelae of childhood trauma in eating disorder patients. Dissociative phenomena are common in adult survivors of childhood abuse, with multiple personality disorder (MPD) being the most extreme form of dissociative disorder. We describe two women who presented for inpatient treatment of eating disorders who were subsequently found to have MPD. Because the eating pathology in these patients contained atypical features related to the MPD process, uncovering MPD was critical in the treatment of their eating behavior. MPD should be considered in any atypical or treatment-resistant eating disorder patient. © 1993 by lohn Wiley & Sons, Inc.     

Work and psychological distress among public school teachers in Vitória da Conquista, Bahia State, Brazil

A cross-sectional study with all the teachers in the municipal school system in Vitória da Conquista, Bahia State, Brazil, investigated the association between work content (psychological demand and control over work) and the occurrence of minor psychiatric disorders (MPD) among teachers. The Karasek demand-control model was used to evaluate control over work. The Self-Report Questionnaire-20 was used to evaluate minor psychiatric disorders. MPD prevalence was 55.9% among the 808 teachers studied. Crude prevalence of MPD showed a positive and significant association with psychological demand and a negative and significant association with control over work. MPD prevalence was higher in teachers with highly demanding work, characterized by heavy demand and low control (PR = 1.74; 95%CI: 1.44-2.10), and in those with active work, with heavy demand and low control (PR = 1.35; 95%CI: 1.13-1.61), as compared to teachers with low-demand work (light demand and high control), after adjusting for confounders in a multiple logistic regression model. As a conclusion, teachers' mental health is strongly associated with their work content.