我国居家老人对社区三类健康服务需求的影响因素分析

目的 综合分析我国居家老人对社区保健知识、精神蔚籍和上门看病送药三类健康服务需求的影响因素。方法 利用CLHLS2017—2018调查数据,运用SPSS 23.0软件进行统计分析,采用二元logistic回归分析方法,探寻我国居家老人对社区三类健康服务需求的影响因素。结果 我国居家老人社区三类健康服务（保健知识:χ2 = 935.263,P＜0.001;精神蔚籍:χ2 = 406.578,P＜0.001;上门看病送药:χ2 = 325.448,P＜0.001）的需求与供给差异显著;除居住地、退休前职业、地区和抑郁程度是影响居家老人对三类健康服务需求的共同因素之外,两周患病（否:OR = 1.282,95%CI:1.072～1.534,P = 0.007）、每年体检（是:OR = 1.19,95%CI:1.021～1.387,P = 0.026）以及高血压诊断（否:OR = 1.224,95%CI:1.045～1.433,P = 0.012）等也影响居家老人对保健知识的需求,居住方式（独居:OR = 1.321,95%CI:1.094～1.594,P = 0.004）也影响居家老人对精神蔚籍的需求,年龄（70～79岁:OR = 0.792,95%CI:0.649～0.966,P = 0.022）和每年体检（是:OR = 0.821,95%CI:0.716～0.941,P = 0.005）也影响居家老人对上门看病送药的需求。结论 建议社区卫生机构全方位开展对健康居家老人的保健知识宣传;重视对独居和抑郁居家老人的心理健康服务;权衡自身资源和居家老人的实际情况,逐步推进上门看病送药服务。     

照料失能配偶对老年女性抑郁程度的影响--基于CHARLS数据的实证分析

目的:研究照料失能配偶对老年女性抑郁程度的影响。方法:利用“中国健康与养老追踪调查”2015年全国数据,通过工具变量回归进行分析。结果:相比于没有照料配偶的女性,参与配偶照料的女性抑郁得分更高(P<0.01)。结论:提供长期照料会增加老年女性的抑郁程度。制定老年长期照料政策时应关注女性照料者的心理健康。     

中国女性青年人体惯性参数的CT—图像分析法测定及其回归方程的研究

采用CT成像和图像分析技术，在尸体研究的基础上，对50例女性样本（18～23岁）进行全身CT横断层扫描、图像分析和测算以及建立数学模型等方面的研究。获得了人体的质量分布、质心位置和转动惯量等惯性参数。据此，建立了直接计算中国女性青年人体各环节惯性参数的二元回归方程。为中国人体运动学和动力学研究提供了基础数据；也为运动员的选材提供了有力的手段。     

Effect of Age and Sex on Stroke Mortality of Young and Middle-aged Adults in China, 2002–2019, and Predictions to 2030

Objective This study aimed to examine the trends in stroke mortality among young and middle-aged adults in China.Methods Data were obtained from the China national vital registration system. Significant changes in mortality were assessed by Joinpoint regression. Age-period-cohort analysis was used to explain the reasons for the changes. Future mortality and counts were predicted by the Bayesian age-period-cohort model.Results Between 2002 and 2019, a total of 6,253,951 stroke mortality in young ...     

Multiple drug use by older people: exploring the health development and political economy perspectives

The use of multiple medications by a large number of older people provides grounds for concern in terms of quality of life as well as cost. We argue that problems faced by older people are being over-medicalized in a manner that palliates and obscures social causes such as loss of income, the falling away of social support and a discounted role in society. Primary health care is a policy model for the development of health services which offers a credible strategy for addressing clinical problems associated with growing old in ways that also contribute to recognizing and addressing social and structural problems that may be expressed in people's private troubles.     

中国中老年人失能状况公平性与影响因素

目的 分析中国50岁及以上中老年人失能状况和失能状况公平性,并探究中老年人失能状况不公平的主要影响因素。方法 利用全球老龄化与成人健康研究(Study on Global Ageing and Adult Health,SAGE)中国2007—2010年第一轮调查数据,计算集中指数和集中曲线,并对集中指数进行分解。结果 中国中老年人失能评估量表平均分为7.32,中老年男性平均分为6.37,女性平均分为8.21。中老年人失能状况集中指数为-0.190 9,中老年男性为-0.184 4,中老年女性为-0.196 1。对集中指数进行分解后,社会经济地位对中老年人失能状况不公平的贡献较高,包括经济水平、受教育程度和工作类型,贡献率分别为66.41%、16.45%和13.10%。与社会结构因素相比,中老年人吸烟、饮酒和身体活动情况等个人生活方式因素的贡献率较低。结论 中国存在中老年人失能状况不公平,较好的健康状况集中在经济水平较好的中老年人群中。中老年男性失能状况较女性更轻,且失能状况不公平程度更小。经济水平、受教育程度和工作类型是对中国中老年人失能状况不公平贡献率较高的主要因素,提示仅通过促进中老年人健康生活方式不能够有效减少失能状况在经济水平较好和较差的中老年人群中的差异。政府需要在重视促进中老年人健康的基础上,进一步加强和完善适宜的社会和医疗保障措施,将减少中老年人健康不公平作为政策重点,尤其应该向发展相对滞后、中老年人相对聚集的地区重点分配医疗卫生和其他相关社会资源,同时应该加大对中老年人健康和健康公平相关研究的支持,为积极应对人口老龄化和制定政策收集证据。     

青年人胃癌临床病理34例分析

目的　探讨青年人胃癌的临床病理特点。方法　回顾性分析 34例青年胃癌病人的临床表现、病理特点、治疗及预后 ,并与 4 0例中老年胃癌病人进行对比。结果　青年人胃癌与中老年人胃癌的临床表现相似 (P >0 .1) ,诊断常被延误 (P <0 .0 5)。其病理类型以未分化癌及低分化腺癌多见 ( 79.4 % ) ,手术切除率低( 4 1.2 % ) ,预后差 ( 5年生存率 8.8% ) ,与中老年组比较P均 <0 .0 1。结论　青年人胃癌病情进展快 ,转移早 ,改善预后的关键是早诊断 ,早治疗。     

降纤酶治疗青年人短暂性脑缺血发作的临床研究

目的 探讨降纤酶对青年人短暂性脑缺血（ＴＩＡ）发作的治疗效果。方法 将７２例患者随机分为两组。治疗组３７例,给予降纤酶静滴至ＴＩＡ发作终止或治疗达１周;对照组３５例,给予阿司匹林、尼莫地平、低分子右旋糖酐、脉络宁治疗２周。两组于治疗前、后分别采静脉血检测血浆纤维蛋白原、红细胞压积、全血粘度和血浆粘度的变化。结果 总有效率治疗组为９１．６６％,对照组为７７．１４％,２组间有显著性差异（Ｐ〈０．０１）     

青年与老年急性心肌梗塞临床差异性探讨

目的 :探讨青年与老年急性心肌梗塞 (AMI)的临床特点。方法 :对 1 5例青年组 (年龄≤ 40岁 )与 1 4 3例老年组 (年龄≥ 6 5岁 ) AMI的临床资料进行了对比分析。结果 :青年组 AMI吸烟者占 73.3% ,明显高于老年组 (P<0 .0 1 )。老年组 AMI发病率 38.9% ,无心绞痛者占 37.8% ,合并心力衰竭、心源性休克及病死率分别为 2 9.4%、2 2 .4%及 2 7.3% ,均明显高于青年组 (P<0 .0 5 )。结论 :青年组 AMI吸烟者明显高于老年组 ,老年组 AMI发病率、无心绞痛者、合并心力衰竭、心源性休克及死亡率均明显高于青年组     

Improved survival in young women with breast cancer

Background: Young age has been hypothesized to be an adverse prognostic factor for women with breast cancer. This association, based on historical data, may not reflect recent advances in breast cancer management. Methods: A retrospective study was conducted of all women age 30 or younger who underwent definitive operation at our institution for primary operable breast carcinoma during one of two consecutive 20-year periods (1950–1969 or 1970–1989). All cancers were restaged according to current staging criteria. Actuarial survival and recurrence-free survival rates from the two patient eras were compared with each other and with published statistics for older breast cancer patients. Results: Eligibility criteria were met by 81 women from the 1950–1969 era and 146 women from the 1970–1989 era. Histologic diagnoses, tumor sizes, incidence of axillary nodal metastases, number of positive nodes, and American Joint Committee on Cancer stage at presentation were similarly distributed in the two eras. Despite these similarities, improved survival (p=0.009) was observed in the later era. Local recurrences were also more common (p<0.05) in the later era in association with less extensive resections. These local recurrences had an adverse impact on recurrence-free survival in the later era, but no concomitant decrease in overall survival was observed. Node-positive patients who received chemotherapy demonstrated a trend toward improved survival (p=0.06) compared with node-positive patients who did not. Survival for patients in the later era was similar to that for older women as reported in other published series. Conclusions: The stage of presentation of breast cancer in women 30 years or younger appears unchanged from prior decades, but survival has improved in association with the use of less extensive surgical resections and the introduction of cytotoxic chemotherapy. With current treatment, primary operable breast cancer in young women appears to have a similar prognosis to breast cancer in older women.Results of this study were presented at the 47th Annual Cancer Symposium of The Society of Surgical Oncology, Houston, Texas, March 17–20, 1994, and was judged Best Clinical Paper in the Resident/Fellow Essay Contest.