1990～ 1999年梧州市传染病疫情动态分析

为了解梧州市９０年代传染病发生的特征和流行动态，特对此期间各类传染病疫情动态进行分析。１资料来源１９９０～１９９９年梧州市卫生防疫站法定传染病年报表。２结果２．１流行概况１９９０～１９９９年共发生乙类传染病１６种计１８０３１例，年均总发病率５８４．７３／１０万，波动在５２３．７９／１０万～６４９．０５／１０万，高于本省同期年均总发病率（１８４．００／１０万）；其中肠道传染病占４９．１４％，呼吸道、　血源及性传播类分别占２５．６５％、２５．０７％，见表１。２．２流行特征１０年来，病例分布无明显地区…     

1989～1998年广州市狂犬病流行病学情况分析

１９８９～１９９８年,广州市共发生狂犬病３０例,其中１９８９年就发生了２３例。经过多年艰苦防治,各职能部门共同配合,进入９０年代,狂犬病的发病率大幅下降,达到了历史最低水平。为探讨我市近１０年狂犬病的流行规律,我们对这３０例病例进行流行病学分析１资料...     

建湖县1989～1993年病毒性肝炎流行病学分析

建湖县１９８９～１９９３年病毒性肝炎流行病学分析建湖县卫生防疫站李德国本文分析建湖县１９８９～１９９３年发生的２３０７５例病毒世肝炎的流行病学特征。１流行特点１．１流行强度根据本县历年肝炎疫情资料分析表明，发病率不仅有周期性波动，而且流行强度有不断增...     

330例剖宫产分析

３３０例剖宫产分析李久如青海省妇幼保健院８１０００７为探讨合理降低剖宫产率的方法，笔者对３３０例剖宫产进行临床分析。１临床资料１．１一般资料１９８９～１９９４年住院分娩总数２５５７例，剖宫产３３０例，剖宫产率为１２．９％。其中１９８９年为１１．３％，...     

15例狂犬病流行病学分析

为探讨我市狂犬病流行特点及防制对策，现将我市１９８９～１９９６年１５例狂犬病流行病学调查情况分析如下：１流行特征（１）发病率１９８９～１９９６年全市狂犬病年平均发病率为０．１８／１０万，以１９９０年最高为０．６６／１０万，其次为１９９１年为０．２８／...     

姜堰镇1989～1999年甲型肝炎人群分布特征

我镇是姜堰市市政府所在地,１９９４年起接种甲肝疫苗,资料来源于我镇近年甲型肝炎情况调查,发现该病在年龄分布上出现新的特征,现报告如下。ｌ 材料与方法１．１ 材料 资料来源于我镇１９８９～１９９９年甲型肝炎病人的流行病学个案调查资料。１．２ 方法 将病人分为两个组,１９８９～１９９３年发病者为Ａ组,１９９４～１９９９年发病者为Ｂ组,同时统计分析其人群分布特征。２ 结果 １９８９～１９９９年我镇共报告甲型肝炎患者３９８例,其中男性２４３例,女性１５５例,男女比例为１．６：１;年龄０～７４岁。 从表１、２可见…     

90例狂犬病的调查与分析

９０例狂犬病的调查与分析吕洪，白燕，马晓红，刘静芹狂犬病在我国绝大多数省份时有发生。河北省发病率已上升至全国第１３位，我市由１９８７年的１例猛增到１９８９～１９９０年的２６例，且全部死亡。为引起重视，现将我们近三年来诊治的９０例报告如下。流行病学调查...     

淮阴市1989～1995年脊髓灰质炎疫情分析

淮阴市１９８９～１９９５年脊髓灰质炎疫情分析淮阴市卫生防疫站王仪吴良文１９８９年淮阴市发生了脊髓灰质炎（以下简称脊灰）暴发流行，为探讨流行因素，摸清流行规律制定防制对策，对本市１９８９～１９９５年脊灰疫情分析如下：１材料与方法１．１ＡＦＰ流调表、随访...     

某医院高级职称人员11年血脂变化趋势

为动态观察本院高级职称人员（高知）中血脂水平的变化趋势，对１９８９～１９９９年体检结果中的血脂水平变化进行分析，现报告如下。 对象与方法 １．对象：１９８９～１９９９年本院高级职称人员共７０８人次，其中男２９６人次，女４１２人次；年龄３３～８４岁。 ２．方法     

广州市1989～1991年钩端螺旋体病流行病学调查分析

广州市１９８９～１９９１年钩端螺旋体病流行病学调查分析张泽森，杜福娴，刘守芝钩端螺旋体病（下称钩体病）是人畜共患病，为掌握其流行现律，预测疫情，我们对广州市１９８９～１９９１年构体病例进行流行病学调查．现分析如下：１．１材料与方法１．１资料来源根据医...     

Trends in colorectal cancer care in southern England, 1989-1993: using HES data to inform cancer services reviews

BACKGROUND: This paper describes trends in hospital activity, hospital admissions, and treatments for colorectal cancer on residents of the South Thames regions (population 8 million) between 1989-1993 against the background of the Calman Report on the future of cancer services in England and Wales. METHODS: The analyses are derived from UK hospital data, which are collected as finished consultant episodes (FCEs). These are defined as episodes "where a patient has completed a period of care under a consultant and is either transferred to another consultant or is discharged." Probability matching was used to derive patient-based records, matching FCEs to admissions. A total of 18,542 South Thames residents aged 40-99 were admitted for colorectal cancer between 1 January 1989 and 31 December 1993. Time trends were analysed for procedures, FCEs, admissions, and patient numbers by admission type (ordinary admissions and day case admissions). RESULTS: Between 1989 and 1993 inclusive colorectal cancer admissions doubled (98% increase p (trend) < 0.0001). These admissions were a result of a 6.4-fold increase in day case admissions and a 41% increase in ordinary admissions. The proportion of patients having a day case admission rose from 9% in 1989 to 18% in 1993 (p < 0.0001). Overall, 2894 (16%) patients had a day case admission; 1894 of these (65%) were also admitted as ordinary admissions. The number of FCEs and admissions per patient rose from 1.37 and 1.28 respectively in 1989 to 2.09 and 1.99 respectively in 1993. FCEs were between 5% and 8% higher than admissions over the five years. The number of ordinary (that is, overnight) inpatient admissions per patient rose from 1.23 to 1.41 over the five year period and day case inpatient admissions from 1.25 to 3.45. Chemotherapy accounted for 50% of the rise in day case admissions; colonoscopy and sigmoidoscopy were associated with a further 18%. Fourteen per cent of the increase in ordinary admissions was also because of chemotherapy. CONCLUSION: The monitoring of site specific trends in admission, treatments, and procedures on a population basis should be a core requirement of health authorities to inform needs assessment, resource allocation, and service planning. The rise in admissions and chemotherapy treatments have implications for drug costs, laboratory and inpatient services, monitoring, and clinical audit.

 

     

连云港市第一医院1988～1996年流行性乙型脑炎住院患者临床流行病学分析

为研究近９年来连云港市第一人民医院流行性乙型脑炎（简称乙脑）住院患儿的发病率及死亡率，对在１９８８￣１９９６年之间儿科住院的１０７例乙脑患者进行临床流行病学分析。结果：１０７全占９年中总住院数０．６５％，其中农村９８例，城市９例，农村与城市之比为１０．８：１。大多数在４岁以下发病，计８７例，占８１．３１％．９年中的发病时间均集中于７月下旬及８月上中旬。其中１９９０年及１９９２年两年的住院病例最多，     

Relative frequency of esophageal squamous carcinoma and adenocarcinoma in a series of endoscopic biopsies performed in Rosario, Argentina]

OBJECTIVES: To determine the relative frequency of adenocarcinoma and squamous carcinoma in a series of endoscopic biopsies of the esophagus registered in consecutive order in a pathology laboratory in the city of Rosario, Argentina, during two time periods: 1992-1999 and 2000-2006. To determine if the relative frequency of esophageal adenocarcinoma has increased over that of squamous carcinoma, in keeping with the trends noted in other Western countries. METHODS: We studied the endoscopic esophageal biopsies diagnosed with infiltrating adenocarcinoma and squamous carcinoma and Barrett's esophagus (BE) between 1992 and 2006. The relative frequency of these cancers were compared for the periods 1992-1999 and 2000-2006 using the z-test. A distribution analysis for age and sex was performed by the chi-square test using a confidence level (alpha) of 0.05. RESULTS: In all, 125 infiltrating squamous carcinomas and adenocarcinomas were found. The relative frequency of adenocarcinoma/squamous carcinoma for the entire series was 0.33/0.67; for the period from 1992-1990, 0.28/0.72; and from 2000-2006, 0.38/0.62. The differences were not statistically significant. Males constituted 75.6% of the cases of adenocarcinoma and 57.1% of the cases of squamous carcinomas; this difference was statistically significant (P < 0.05). The mean age of the patients at the time of diagnosis was 66.0 years of age for adenocarcinoma and 67.9 years for squamous carcinoma. The frequency of infiltrating carcinoma was greater among the men than among the women of the age group under 65 years (P < 0.025). BE was diagnosed at a rate of 6:1 relative to adenocarcinoma. CONCLUSIONS: Adenocarcinoma and squamous carcinoma were predominant among men, though adenocarcinoma was the major part of these. The relative frequency of adenocarcinoma rose 10% in the last 7 years of the series compared with the first 7 years. This difference was not significant, but it may signal a general trend similar to that described in other countries.     

上海市松江区大肠癌发病状况及趋势分析

[目的]了解松江区1988—2002年大肠癌发病的状况及变化趋势。[方法]通过肿瘤登记系统收集1988—2002年松江区居民大肠癌发病资料,统计分析大肠癌发病的时间趋势、人群分布和地区分布。[结果]1988—2002年松江区大肠癌年平均发病率为18.54/10万,占全部恶性肿瘤的9.24%,居第3位;男女性大肠癌发病率随年龄增长而升高,高发年龄在45岁以上年龄组。男性大肠癌发病率高于女性。在地区分布上城区最高,城乡结合部其次,农村最低。[结论]大肠癌发病率呈上升趋势,必须针对大肠癌的危险因素积极采取措施。     

Impact of alcohol related disease and inpatient workload of gastroenterologists in Scotland

BACKGROUND: Concern among Scots gastroenterologists about alcohol related illness prompted this inpatient prevalence study during the winter of 2000-01. AIMS: To study gastrenterology inpatient workload due to alcohol-related illness, to determine how much was specialty specific, and if there were regional variations. METHODS: 40 Consultant gastrenterologists throughout Scotland collected data on the prevalence of alcohol related conditions among inpatients under their care on each of three specified days during the winter of 2000/2001. All inpatients under the care of participating consultants on the designated study days were included in the study. Overall return rate was 65%. Patients were categorised as follows; (a) general medical inpatients admitted for reasons other than alcohol related illness (b) general medical inpatients with no gastrointestinal or liver disease, but whose admission to hospital was primarily related to alcohol misuse, (c) gastrointestinal (including liver) inpatients admitted for reasons unrelated to alcohol intake, and with no alcohol related disease, and (d) gastrointestinal inpatients whose admission to hospital resulted from alcohol related disease. Additionally the numbers of patients with (e) decompensated liver disease of all causes, (f) decompensated alcoholic liver disease, and (g) the numbers "blocking" acute beds after initial hospitalisation with an alcohol related illness were collected. RESULTS: Overall, 829 general medical and 538 gastroenterology inpatients were entered in the study; total 1367 (705 male, 662 female). Of these, 25% (337/1367) were admitted because of alcohol related illness: 15% (201/1367) had decompensated alcoholic liver disease. Of 538 gastroenterology inpatients, 238 (44%) had problems related to alcohol and 201 of these (37% of all gastoenterology inpatients) had decompensated alcoholic liver disease. Of 246 inpatients with decompensated liver disease, 82% (201) had alcoholic liver disease. Alcohol related illness was significantly more prevalent among male inpatients in the West of Scotland. 10% of specialist gastroentelogy beds were occupied by patients whose discharge was delayed because of alcohol related problems. CONCLUSION: Most Scottish gastroenterlogists contribute to general medical receiving but their specialist inpatient workload is dominated by treatment of patients with alcohol related disease. (44% in gastroenterology v 12% in general medicine). Inpatients with decompensated alcoholic liver disease form 37% of gastroenterology workload. Alcohol related disease contributes to delayed discharge in acute medical units, especially in gastroenterology wards. There are regional differences in prevalence of alcohol related disease, which is greatest in male inpatients in the West of Scotland. Here, alcoholic liver disease accounts for nearly a decompensated liver disease. The findings point to a need to review the current patterns of acute service provision for alcohol related illnesses, so as to assess and improve both the linical effectiveness and cost effectiveness of care, and to ensure that alternatives to acute hospital admission are available when appropriate. This need should not be neglected while efforts are simultaneously being made to improve the early detection of alcohol abuse and prevent irreversible alcohol related disease.     

A retrospective analysis of hospital treatment expenditures among young and middle age patients with cancer, 2013–2017 under health reform

Under 60 year olds represent a rapidly growing segment of the cancer population. They often face longer hospital stays, higher treatment intensity, and hospitalization costs. In this background, we aim to assess the impact of the 2009 reforms on the hospital expenses of younger cancer inpatients. Our study sample included 11 791 young and middle age stomach, lung, colorectal, esophageal, and breast cancer inpatients hospitalized during 2013 to 2017. Hospitalization treatment costs of under 60 cancer inpatients increased, but it fell in 2017 under the impact of the health reforms. However, out-of-pocket expenditures rose, which partly reflected the failure of the health insurance scheme to adequately cover cancer inpatient cost, potentially imposing financial hardships on cancer inpatients and their families. To continue to reduce the economic burden of cancer patients, early screening and diagnosis among younger populations and enhanced hospice care integrated with the ongoing primary health care reform are important.     

济南市农村居民住院服务利用率及费用影响因素

目的了解济南市农村居民的住院服务利用率、住院费用及其影响因素,为合理利用住院服务、有效控制住院费用上涨提供依据。方法采用分层随机抽样方法对在济南市抽取的章丘市、长清区、平阴县3个市(县、区)共3 458名居民进行问卷调查。结果济南市农村居民2006和2008年的住院服务利用率分别为4.89%和3.90%,次均住院费用分别为6 385.74和7 127.08元,日均住院费分别为459.34和534.17元,新农合补偿费用分别为701.49和914.82元,新农合补偿比例分别为10.99%和12.84%,自付费用比例分别为89.01%和87.16%;不同特征农村居民比较,不同性别、年龄、职业、文化程度、自评健康状况、吸烟、饮酒情况的农村居民的住院服务利用率间差异均有统计学意义(P<0.05),不同地区、经济收入居民的住院服务利用率间差异均无统计学意义(P>0.05);多因素回归分析结果表明,自评健康状况较差是济南市农村居民住院概率的危险因素,年龄15～24岁是农村居民住院概率的保护因素;住院天数、新农合补偿费用、住院机构、住院疾病和地区是农村居民住院费用的主要影响因素。结论济南市农村居民住院服务利用率较低,住院费用较高,新农合补偿较少;完善各级医疗机构分流制度、缩短住院时间、加大新农合补偿力度是控制住院费用、减轻农民经济负担的有效手段。     

1989年-2008年海门市女性乳腺癌死亡趋势分析

目的：掌握海门市女性乳腺癌死亡水平及其变化趋势。方法：采用描述性分析研究海门市1989年-2008年间居民全死因登记报告资料,分析统计女性乳腺癌死亡率。结果：1989年～2008年海门市女性乳腺癌粗死亡率为6．75／10万,调整死亡率为4．15／10万。该市女性乳腺癌粗死亡率20年间上升了62．62％,呈逐年上升趋势,乳腺癌死亡居女性各类癌症死亡率的第6位。该资料显示女姓乳腺癌的死亡有两个年龄段高峰,即55岁组和80岁组。结论：海门市乳腺癌死亡率略高于全国平均水平,并呈逐年上升趋势,应引起关注。     

Haem and non-haem iron intake through 17 years of adult life of a British Birth Cohort

An investigation was carried out to determine whether there were significant changes in the intake of haem and non-haem Fe of adult men and women in the UK from 1982 (aged 36 years) to 1999 (aged 53 years). The 1253 subjects studied were members of the Medical Research Council National Survey of Health and Development; a longitudinal study of a nationally representative cohort of births in 1946. Food intake was recorded in a 5-d diary at age 36 years in 1982, 43 years in 1989 and 53 years in 1999. Outcome measures were mean intakes of total Fe, haem and non-haem Fe, by year, gender and food source. There were significant changes in total Fe, haem Fe and non-haem Fe intake over the three time points. Total Fe intake was significantly higher in 1989 than in 1982 or 1999 for both men and women but haem Fe was significantly lower in 1999 mainly due to a 40% fall in haem Fe from beef during this period. Haem Fe from processed meats fell by more than 50% between 1989 and 1999 but that from poultry rose by more than 50%. Cereal foods remained the most important source of non-haem Fe and the contribution from breakfast cereals rose relative to that of bread over the 17 years. Several factors could be responsible for these changes, particularly the importance of the epidemic of BSE from 1990. The possible advantages of a lower haem Fe intake in older subjects are discussed.