不良生活方式与高血压病的流行病学调查分析

目的:调查不良生活方式对高血压发病的影响。方法:以国际通用血压测量方法对全区15 384人进行整群随机抽样调查,着重对有、无不良生活方式的两组人群进行高血压患病率调查,及相对危险度(RR)、归因危险度(AR)、人群归因危险度(ARp)、U检验等的检测,以及相关及多元回归分析。结果:食盐量≥12 g/d高血压患病率31.6％,<12 g/d的为 4.4％(P<0.001,RR 7.3,AR 27.3,ARp 57.2％,r=0.8517);BMI>24高血压患病率 23.2％,<24者 6.4％(P<0.001,RR 3.7,AR 16.9,ARp 37.2％,r=0.3215);肥胖患病率 34.7％,无肥胖8.1％(P<0.001,RR 4.3,AR 26.6％,ARp 19.7％,r=0.3529);油腻饮食高血压患病率14.8％,非油腻饮食8.7％(P<0.001,RR1.7,AR 6.1,ARp 13.9％,r=0.3853);吸烟高血压患病率 12.5％,非吸烟 9.2％(P<0.001,RR1.4,AR 3.3,ARp 8.3％,r=0.8403);饮酒患病率 12.7％,非饮酒 9.4％(P<0.001,RR1.35,AR 3.3,ARp6.7％,r=0.4650)。为进一步了解各危险因子与高血压患病率之间的数量关系和对高血压影响作用的大小,对所有对象用年龄(15～80岁)进行了分组,龄差1岁,共66组,多元回归结果为:偏相关系数0.3775～0.0809,建立的统计模型达到极显著水平(P<0.001),复相关系数0.9525。6个回归因子中按对高血压患病率影响(偏相关系数)大小排序:     

Prediction of Remission of Acute Posttraumatic Stress Disorder in Motor Vehicle Accident Victims

One hundred forty five individuals who sought medical attention as a result of a motor vehicle accident (MVA), and who were initially assessed 1 to 4 months post-MVA, were followed up prospectively for 6 months to determine how many of the 55 with posttraumatic stress disorder (PTSD) and the 43 with sub-syndromal PTSD would remit and what variables would predict remission. Thirty (55%) of those with initial PTSD had remitted at least in part by 6 months while 67% of those with sub-syndromal PTSD had remitted (and 5% had worsened). Four variables, including severity of initial symptoms, degree of initial physical injury, relative degree of physical recovery by 4 months and whether a close family member suffered a trauma during the follow-up interval, combined to classify 6-month clinical status of 84% of those with initial PTSD secondary to MVAs.     

Population kinetics of gentamicin in neonates

A population kinetic analysis was carried out on sparse plasma gentamicin (GE) concentration data from 469 neonates obtained as part of a routine therapeutic drug monitoring (TDM) programme in the hospital neonatology unit.The best predictors of the kinetic parameters of the monoexponential model, volume of distribution (Vd) and clearance (CL), were the weight (WT) and gestational age (GA). Vd of the neonates was only related to WT, whereas the half-life was only related to the GA.     

阳江高本底地区居民健康流行病学调查数据库与统计分析方法

目的 研究应用计算机数据库技术及先进统计分析方法,对阳江高本底地区10多万人20余年的健康随访研究资料和剂量学调查资料进行储存、管理和分析。方法 通过调研和比较分析,确定采用Foxbase系列数据库管理系统按专题建立数据库,借助于ID号实现记录连接；一般统计分析由SAS完成；交叉分组人年列表由Epicure中的Datab完成；癌症相对危险分析用AMFIT程序。结果 建立了40MB的各专题研究库,主要包括：10余万人的人口学数据库(1979～1995)、1.2万人的死因数据库(1979～1995)和526个村庄6783户、5273人的剂量数据库。提出了动态群组研究资料(1979～1986)与固定群组研究资料(1987～1995)的合并方法：首选方法是建立假想的基于记录连接的以1979年为起点的(固定)群组。另一方法是将不同阶段群组研究的人年表分层直接相加。计算了每个成员基于卧室内、起居室内、室外村平均剂量率与性别-年龄别居留因子的累积剂量。完成了以性别、atainedage、随访年代及剂量交叉分组的人年列表,对癌症死亡资料(1979～1990)进行了危险分析。结论 应用计算机数据库管理系统与统计分析技术使阳江高本底地区研     

Eighteen-month Coronal Caries Incidence in North Carolina Older Adults

In this longitudinal study of a random sample of North Carolinians over the age of 65 and living in their homes, 325 blacks and 280 whites were examined and interviewed 18 months after baseline examinations. Coronal caries incidence was greater among whites than blacks. The increment due to teeth becoming root fragments were similar for both races; however, there were more newly crowned teeth among whites. Newly crowned surfaces were not used as part of the caries increment in logistic regression models to investigate potential risk predictors. For blacks, caries development over the 18-month period was associated with a higher lactobacillus score and more coronal caries at baseline, more previously filled coronal surfaces, and lack of active membership in clubs or other groups. For whites, having no self-reported tooth sensitivity, having a lower socioeconomic index score, taking antihistamine medications at baseline, and having the perception of more problems after the age of 40 than before were all associated with the development of coronal caries.     

Predicting the experience of dentinal caries or restorative dental treatment in adolescents using D1 and D3 visual caries assessments

Standardised epidemiological caries assessments used in oral health surveys have been shown to be poor at predicting whether a tooth surface will be treated restoratively when a patient visits a dentist. However, it has been argued that oral health surveys may be more relevant in determining needs at the level of an individual or groups of individuals. The objective of this study was to determine the discriminatory power of visual caries assessments at two thresholds (D₁ & D₃) in adolescents of average age 12.1 years to predict experience of dentinal caries 3 years later or the experience of restorative treatment (not re‐treatment) during the 3‐year period. The data was derived from a prospective 3‐year longitudinal study in which the dental care provided by 41 dentists for 403 adolescents was monitored. Dental caries experience was monitored by annual standardised assessments of caries undertaken by a single trained examiner. ROC analysis showed that caries assessed visually at the D₁ threshold in 12‐year‐olds was a better predictor (P < 0.001) of experiencing some dentinal caries after 3 years (Az = 0.781) than was caries assessed visually at D₃ threshold in 12‐year‐olds (Az = 0.670). Assessing caries visually at either the D₁ or the D₃ threshold had no discriminatory power for predicting whether an individual would experience some restorative treatment during the ensuing 3‐year period (Az for D₁ = 0.507; Az for D₃ = 0.518).     

Acute subdural hematoma: Outcome and outcome prediction

Patients with traumatic acute subdural hematoma were studied to determine the factors influencing outcome.Between January 1986 and August 1995, we collected 113 patients who underwent craniotomy for traumatic acute subdural hematoma. The relationship between initial clinical signs and the outcome 3 months after admission was studied retrospectively.Functional recovery was achieved in 38% of patients and the mortality was 60%. 91% of patients with a high Glasgow Coma Scale (GCS) score (9–15) and 23% of patients with a low GCS score (3–8) achieved functional recovery. All of 14 patients with a GCS score of 3 died. The mortality of patients with GCS scores of 4 and 5 was 95% to 75%, respectively. Patients over 61 years old had a mortality of 73% compared to 64% mortality for those aged 21–40 years. 97% of patients with bilateral unreactive pupil and 81% of patients with unilateral unreactive pupil died. The mortality rates of associated intracranial lesions were 91% in intracerebral hematoma, 87% in subarachnoid hemorrhage, 75% in contusion.Time from injury to surgical evacuation and type of surgical intervention did not affect mortality. Age and associated intracranial lesions were related to outcome. Severity of injury and pupillary response were the most important factors for predicting outcome.     

Associations of Early Premenopausal Fractures with Subsequent Fractures Vary by Sites and Mechanisms of Fractures

In a retrospective population-based study we assessed whether and how self-reported former fractures sustained at the ages of 20–34 are associated with subsequent fractures sustained at the ages of 35–57. The 12,162 women who responded to fracture questions of the baseline postal enquiry (in 1989) of the Kuopio Osteoporosis Study, Finland formed the study population. They reported 589 former and 2092 subsequent fractures. The hazard ratio (HR), with 95% confidence interval (CI), of a subsequent fracture was 1.9 (1.6–2.3) in women with the history of a former fracture compared with women without such a history. A former low-energy wrist fracture was related to subsequent low-energy wrist [HR = 3.7 (2.0–6.8)] and high-energy nonwrist [HR = 2.4 (1.3–4.4)] fractures, whereas former high-energy nonwrist fractures were related only to subsequent high-energy nonwrist [HR = 2.8 (1.9–4.1)] but not to low-energy wrist [HR = 0.7 (0.3–1.8)] fractures. The analysis of bone mineral density (BMD) data of a subsample of premenopausal women who underwent dual x-ray absorptiometry (DXA) during 1989–91 revealed that those with a wrist fracture due to a fall on the same level at the age of 20–34 recorded 6.5% lower spinal (P= 0.140) and 10.5% lower femoral (P= 0.026) BMD than nonfractured women, whereas the corresponding differences for women with a former nonwrist fracture due to high-energy trauma were −1.8% (P= 0.721) and −2.4% (P= 0.616), respectively. Our results suggest that an early premenopausal, low-energy wrist fracture is an indicator of low peak BMD which predisposes to subsequent fractures in general, whereas early high-energy fractures are mainly indicators of other and more specific extraskeletal factors which mainly predispose to same types of subsequent fractures only. Received: 21 February 1996 / Accepted: 24 September 1996     

Evidence for differential effects of 8-OH-DPAT on male and female rats in the Anxiety/Defense Test Battery

The Proxemics/Activity test and the Eat/Drink test, two components of the Anxiety/Defense Test Battery, were developed to measure defensive reactions to situations associated with a natural predator (cat). In the present studies the behavioral effects of 8-OH-DPAT treatment (0.01–1.0 mg/kg, SC) were entirely consistent with anxiety/fear reduction. These effects included an increase in time spent near the cat compartment, and a complimentary decrease in time spent farthest from this compartment, together with an increase in transits and locomote behavior. 8-OH-DPAT (1.0 mg/kg) also increased eat frequencies and durations (highly preferred food) both during and following cat presentation, without influencing drinking. This finding is discussed with reference to previous findings with 8-OH-DPAT in studies assessing both food intake and anxiolysis. Interestingly, 8-OH-DPAT was more potent in a majority of its effects in female subjects, a finding consistent with recent neurochemical data. These findings provide important behavioral evidence for a sexual differentiation in 5-HT function, and support the case for greater emphasis on female subjects in animal models of anxiety.Supported by NIH MH42803 and RCMI Grants RR03061 and RR01825