河北省2012年国家疾病监测点居民死因及分类构成分析

目的：了解河北省国家疾病监测点居民的死亡水平,主要死亡原因,为制定相关卫生政策、评价医疗卫生工作质量和效果提供科学依据。方法收集2012年河北省死因监测点死因监测资料,分析监测居民主要死亡原因及其死亡水平。结果死因监测点居民平均期望寿命78\．59岁,男性76．06岁,女性81．50岁。粗死亡率495．39／10万、标化死亡率610．47／10万,男性死亡率590．32／10万、男性标化死亡率699．96／10万,女性死亡率396．73／10万、女性标化死亡率518．94／10万。前五位死亡原因依次是循环系统疾病、肿瘤、损伤和中毒、呼吸系统疾病、消化系统疾病。结论慢性非传染性疾病是当前危害全省疾病监测点居民健康的主要疾病,应加强疾病的宣传教育,防治结合,提高居民的健康水平。     

2016年上海市嘉定区徐行镇户籍居民死亡原因分析

目的:通过分析2016年徐行镇沪籍居民死亡原因和死因顺位,了解影响徐行镇居民死亡的疾病及因素,从而为制定预防保健措施提供科学依据.方法:从死因监测系统收集2016年徐行镇沪籍居民死亡信息,然后按ICD-10进行编码统计,分析徐行镇沪籍居民死亡原因和死因顺位.结果:2016年徐行镇342人死亡,其中男性居民死亡169人,死亡率为1123.60/10万,女性居民死亡173人,死亡率为1093.81/10万,男女死亡率之比为1.03:1.死因前5位分别是循环系统疾病、肿瘤、呼吸系统疾病、其他疾病(褥床感染和老衰)和损伤与中毒,占总死亡率的84.86%.结论:慢性非传染性疾病成为威胁徐行镇居民的主要因素.一方面应针对不同人群开展慢性病危害因素的健康教育,另一方面也应对不合理的生活方式进行干预.     

2008年湖北省人群死亡率及死亡特征分析

目的:通过对2008年湖北省死亡监测资料的分析,了解湖北省居民的死因状况。方法:分层整群抽取湖北省2008年监测地区的全部死亡病例,对湖北省居民死因状况做描述性分析,共抽取11个具有代表性的地区。结果:湖北省2008年监测总人数为6,059,001人,总体死亡率为580.74/10万人,其中男性为3,144,625人,死亡率为651.97/10万;女性2,914,376人,死亡率为503.88/10万,差异有统计学意义(P0.001)。2008年湖北省城市死亡率为666.85/10万,农村死亡率为558.58/10万人,差异有统计学意义(P0.001)。2008年湖北省前10位死因分别为脑血管病、肿瘤、心血管病、伤害、呼吸系统疾病、消化系统疾病、泌尿生殖系统疾病、内分泌营养和代谢疾病、传染病和寄生虫病和起源于围生期的某些情况,占全死因构成的87.83%。结论:心脑血管疾病和肿瘤等慢性病是造成湖北省居民死亡的主要原因,肿瘤和心脑血管病、损伤和中毒等是慢性病预防控制工作的重点。     

呼和浩特市赛罕区2012年居民死因调查研究

目的了解呼和浩特市赛罕区威胁人群健康的主要疾病,为卫生政策的制定提供基本数据。方法收集2012年赛罕区人口资料及死亡资料,采用Excel 2007方法进行统计分析。结果赛罕区2012年有人口418 443人,死亡2 272人,年均粗死亡率为542.97/10万,其中男性居民粗死亡率为667.32/10万,女性居民粗死亡率为413.92/10万;居民标化死亡率为512.5/10万,男性标化死亡率563.07/10万,女性标化死亡率446.28/10万。婴儿死亡率为8.9‰,孕产妇死亡率0。慢性非传染性疾病已占到全人群死因的87.68%,具体到各类疾病死因顺位,前五位分别是心脑血管疾病、恶性肿瘤、慢性呼吸道疾病、伤害、消化道疾病。结论心脑血管疾病是危胁赛罕区居民的首要疾病,应针对心脑血管的危险因素进行综合干预,使其发病率下降。     

2010-2014年郑州市中原区居民伤害死因分析

目的 了解2010—2014年郑州市中原区居民伤害死亡原因及分布特点,为伤害预防策略的制定提供依据。方法 利用中原区死因监测死亡报告数据,用Excel软件进行伤害死亡原因及分布特点的分析。结果2010—2014年中原区因伤害引起死亡893例,平均死亡率为30.97/10万,标化死亡率为26.30/10万;男性年平均死亡率为44.68/10万,女性年平均死亡率为17.41/10万。前五位主要死亡原因为运输事故、意外跌落、自杀、其它意外事故和有害效应、意外中毒,占伤害总死亡86.45%,男性和女性均以运输事故为第一位死因。5~14岁组伤害死亡率最低,为7.25/10万,淹死为第一位死因;65岁以上人群伤害死亡率最高,为95.32/10万,意外跌落为首位死因。结论 伤害严重威胁中原区居民的生命健康,应根据本地的伤害死亡谱制定有效的预防策略。     

2012年郑州市居民死因监测结果分析

目的了解2012年郑州市居民死亡原因及数据为制定疾病预防控制策略提供科学依据。方法对郑州市2012年死因监测资料,利用国家死因数据清洗分析工具进行统计分析。结果2012年郑州市居民死亡率509．63／10万,标化死亡率378．22／10万,男性高于女性,前五位死因依次为心脏病、脑血管疾病、恶性肿瘤、呼吸系统疾病、伤害。慢性病占死因构成的86。49％。平均期望寿命为79．62岁,其中男性76．84岁,女性82．64岁。结论心脑血管疾病、恶性肿瘤等慢性病已成为危害郑州市居民的主要疾病,慢性病的防治工作应摆在疾病控制的主要位置。     

河北省张北县2012年居民死因监测分析

目的分析2012年河北省张北县居民死亡率和主要死亡原因,为政府制定有效的疾病预防控制策略提供科学依据。方法资料来源于张北县2012年死因监测系统,按照国际疾病分类法ICD-10标准进行分类,以率、构成比为主要指标,进行统计分析。结果张北县居民2012年死亡率为564．91／10万,男性死亡率为687．39／10万,女性死亡率为435．63／10万,两者差异有统计学意义（X^2=56．5,P=0．000）。张北县居民前十位死因依次为心血管疾病、恶性肿瘤、脑血管疾病、慢性阻塞性肺病、肺源性心脏病、消化系统疾病、损伤和中毒、内分泌营养代谢系统疾病、其他呼吸系统疾病、泌尿系统疾病,其中前五位疾病导致的死亡占报告死亡人数的84．25％;从死亡的单病种看,居于前3位的是心肌梗死、肺癌、脑梗死;死因顺位在不同年龄中有差异。结论心、脑血管系统疾病和恶性肿瘤是张北县居民的主要死因,死因顺位随年龄的差异而呈现出不同的特点,应制定有针对性的疾病防治策略。     

上海市某社区2007-2009年死因分析

目的:分析3年内上海市杨浦区延吉街道居民的死亡率及前十位死因顺位,为制定社区慢性病管理计划提供依据.方法:根据2007~2009年延吉街道居民的死因监测资料,分析不同年龄组的死亡率以及前十位死因顺位.结果:该社区居民不同年度的死亡率呈逐年上升趋势,男性死亡率高于女性,60岁以上老年人的死亡率为86.94%;死因顺位前5位依次为循环系统疾病、肿瘤、呼吸系统疾病、内分泌系统疾病、损伤和中毒,占死亡人数的比例依次为38.88%、32.30%、9.67%、5.32%、5.13%,合计占死亡人数的91.30%.结论:该社区死因主要为循环系统、肿瘤、呼吸系统、内分泌系统疾病和损伤中毒,应有针对性地加强老年人的健康教育和健康促进工作     

2010年郑州市城区居民伤害死亡分析

目的为了解郑州市城区居民伤害死亡水平及伤害死因分布,为针对性开展伤害预防工作提供科学依据。方法利用2010年郑州市城区居民死因监测点数据,按照ICD-10编码,利用SPSS14.0软件对城区居民伤害死亡进行统计分析。结果 2010年郑州市城区居民伤害死亡476人,占死亡总数的8.8%,居全死因第四位,粗死亡率43.62/10万,其中男性343人,粗死亡率62.68/10万,女性133人,粗死亡率24.44/10万,男性高于女性,差异有统计学意义(P<0.01)。伤害的减寿年数为14581.9人.年,减寿率为14.26‰。结论伤害是该市城区居民死亡重要原因,在寿命损失中位居第一位,对不同年龄段的伤害死亡原因,应开展伤害防制工作。     

2007-2013年宜川主要死因减寿分析

目的 :了解宜川居民主要死因特征、分布和对居民健康的危害程度,为恶性肿瘤、脑血管疾病和心脏病的防治提供科学依据。方法 :采用2007-2013年死亡证调查资料,以死亡率、构成比、去死因寿命表等统计指标分析恶性肿瘤、心脑血管疾病对患者生命的影响。结果 :死因顺位前三位分别是恶性肿瘤、脑血管病和心脏病,分别占全死因的30.03%、20.08%和死17.71%;粗亡率分别为269.86/10万(标化死亡率为108.51/10万)、186.97/10万(标化死亡率为64.66/10万)和159.19/10万(标化死亡率为54.27/10万)。三大死因占全死因的68.54%。2007-2013年居民平均寿命为80.91岁,男性平均寿命为78.82岁,女性平均寿命为82.68岁。患者因恶性肿瘤、脑血管疾病和心脏病死因减少寿命分别为3.57岁、2.29岁和1.94岁,对平均寿命造成的损失分别为4.41%、2.82%和2.39%。结论 :恶性肿瘤、脑血管疾病和心脏病是社区的主要死因,死亡率随着年龄的增长而增加,对居民预期寿命损失较大。     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

Comparison of in vitro cell models in predicting in vivo brain entry of drugs

Although several in vitro models have been reported to predict the ability of drug candidates to cross the blood-brain barrier, their real in vivo relevance has rarely been evaluated. The present study demonstrates the in vivo relevance of simple unidirectional permeability coefficient (P(app)) determined in three in vitro cell models (BBMEC, Caco-2 and MDCKII-MDR1) for nine model drugs (alprenolol, atenolol, metoprolol, pindolol, entacapone, tolcapone, baclofen, midazolam and ondansetron) by using dual probe microdialysis in the rat brain and blood as an in vivo measure. There was a clear correlation between the P(app) and the unbound brain/blood ratios determined by in vivo microdialysis (BBMEC r=0.99, Caco-2 r=0.91 and MDCKII-MDR1 r=0.85). Despite of the substantial differences in the absolute in vitro P(app) values and regardless of the method used (side-by-side vs. filter insert system), the capability of the in vitro models to rank order drugs was similar. By this approach, thus, the additional value offered by the true endothelial cell model (BBMEC) remains obscure. The present results also highlight the need of both in vitro as well as in vivo methods in characterization of blood-brain barrier passage of new drug candidates.