综合医院内科与中医科门诊抑郁障碍患病率比较

目的调查沈阳市不同级别综合医院内科和中医科门诊病人抑郁障碍的患病率。方法采用分层随机整群抽样方法抽取沈阳市23家综合医院进行调查,共调查7448例年龄?15岁的内科和中医科门诊病人。调查员在门诊于病人就诊前使用扩展的一般健康问卷(GHQ-12)为筛查工具,将病人分为精神疾病高、中、低危险组,然后由精神科医生使用DSM-Ⅳ定式临床检查(SCID-I/P)对高、中、低危险组100%、40%、10%的调查对象进行SCID诊断。结果沈阳市综合医院内科门诊任何抑郁障碍的总现患率为11.01%(95%CI10.05%-12.06%),中医科抑郁障碍患病率为16.22%(95%CI13.23%-19.87%),高于内科门诊抑郁障碍患病率,RR值为0.68。结论沈阳市综合医院中医科门诊抑郁障碍患病率高于内科门诊,应该更加关注中医科就诊患者的抑郁障碍问题。     

Contrasting patterns of hepatitis C virus infection in two regions from Tunisia

This report is a population-based study describing the pattern of hepatitis C virus (HCV) infection in two distinct regions in Tunisia. The study included a total of 11,507 individuals sampled in 1996 from both genders, all age groups, urban and rural settings belonging to 2,973 families. HCV infection was assessed by commercial enzyme immunoassay (EIA) and immunoblot assays and detection of HCV RNA by PCR. HCV genotypes and subtypes were determined by sequencing in the 5'-untranslated region (UTR) viral genomic region and the INNO-LiPA HCVII genotyping kit. Genetic relatedness between HCV strains was assessed by sequencing of a portion of the NS5B region. HCV prevalence was significantly higher in the North-Western region than in the Southern one: 1.7% versus 0.2% (P < 10(-3), chi(2) = 8,506). There was no difference in positivity according to gender or living in rural or urban settings; the only significant risk factor was advanced age. HCV prevalence among household contacts of HCV positives was not significantly higher than the prevalence in the whole study population. These results indicate a heterogeneity in the geographical distribution of HCV in Tunisia. An increased HCV transmission occurs in the North-Western region with large predominance of genotype 1b (88%) and low contribution of intrafamilial transmission.     

Hepatitis C infection and viremia in Dutch Hemophilia patients

Serum samples from 316 patients visiting the Dutch National Hemophilia Center were collected from 1979 to 1993 and stored at ?30°C. Patients were placed into three different groups: (1) patients ever treated with large pool non-hepatitis C virus (HCV)-safe concentrate (n=179); (2) patients treated with cryoprecipitate (n = 125); and (3) patients treated exclusively with HCV-save concentrate (n=12). In order to examine the prevalence of HCV infection in the different treatment groups serum samples were tested retrospectively for anti-HCV antibody using second generation enzyme-linked immunosorbent assay (ELISA) and recombinant immunoblot assay (RIBA-2). Significant differences in the prevalence of HCV infection were found between these 3 groups (group 1: 99%, group 2: 66%, group 3: 0%). The safety of currently administered clotting products is demonstrated in 57 patients who remained without HCV markers between 1989 and 1993. To examine the natural course of HCV infection fresh-frozen plasma samples were obtained recently from a subgroup of 277 hemophilia patients for HCV-RNA detection by a well-validated cDNA-PCR assay. In contrast to other reports, no evidence was found for seronegative HCV carriers. None of 52 patients without anti-HCV had detectable HCV-RNA. Of 225 patients with anti-HCV, 182 (81%) were HCV-RNA positive. None of 39 anti-HCV positive patients with a negative HCV-RNA reaction had serum alanine aminotransferase (ALT) levels above 50 U/l, whereas 44% of HCV-RNA positive patients had persistently elevated ALT levels above 50 U/l. These results indicate that 20% of hemophilia patients who have been infected with HCV in the past eliminated the virus or have viral replication below the detection limit of polymerase chain reaction (PCR) without biochemical evidence of liver damage. © 1995 Wiley-Liss, inc.     

Antibodies to HTLV-I in populations of the southwestern Pacific

Sera collected from 1,102 individuals in 14 populations of the southwestern Pacific between 1956 and 1979 were tested by ELISA for antibodies to human T-cell leukemia virus type I (HTLV-I). Selected sera were also tested by particle agglutination and immunoblotting. Six of the populations had prevalences of antibodies greater than 4%, two populations had prevalences greater than 15%. Six populations had antibody prevalences of 2% or less. Three populations from the coast and northern islands of New Guinea had high prevalences of antibodies, while three New Guinea highland groups had virtually none. One population from the Solomon Islands had a high prevalence, while two others had very low prevalences. Two populations from small remote islands in Vanuatu both had high prevalences. Pacific sera did not neutralize a standard strain of virus readily neutralized by Japanese, European, and American sera. We conclude that infections with HTLV-I, some acquired more than 20 years ago, are widespread throughout the southwestern Pacific, even in several very isolated populations, although others have been spared. Some strains of HTLV-I in populations of the Pacific may have substantially different envelope proteins from prototype strains of America, Europe, and Japan.     

The risk for congenital heart defects in offspring of individuals with congenital heart defects

BACKGROUND: Congenital heart defects (CHDs) occur in approximately 1% of all live births. Although most CHDs are of unknown etiology, a family history of CHDs is a known risk factor, and offspring of individuals with CHDs are at a higher risk of having CHDs. The aim of this study was to investigate the relative risk for CHDs to offspring of individuals with CHDs. METHODS: The prevalence rates of CHDs in offspring of 203 individuals with CHDs and 282 individuals without CHDs were investigated. The study participants completed a questionnaire that included information on medical and reproductive history, lifestyle indicators, and family history of CHDs and other congenital malformations. The prevalence rates of CHDs in offspring were calculated. RESULTS: The prevalence of CHDs was 3.1% (18/575) in offspring of individuals with CHDs and 1.3% (8/589) in offspring of individuals without CHDs. The adjusted odds ratio for CHDs to offspring of parents with CHDs was 1.73 (95% confidence interval [95% CI] 0.89-2.44, p=0.02). The estimated relative risk for offspring to females with CHD was higher than for males [2.3 (95% CI 1.1-4.7, p=0.03) versus 1.31 (95% CI 0.48-4.30, p=0.66), respectively]. There was no suggestion of association between CHDs and maternal smoking, alcohol consumption, and use of medication during pregnancy. CONCLUSIONS: Offspring of parents with CHDs are at a higher risk for CHDs compared with the general population. Couples where one member is affected with CHD should receive pre-conceptional or pre-natal genetic counseling and should be informed about the magnitude of the potential risk of CHDs to the offspring.     

内蒙古中学生神经衰弱患病情况调查

目的 :调查研究内蒙古不同民族中学生神经衰弱患病情况。方法 :采用随机整群抽样法 ,对内蒙古八所中学六个民族的中学生进行调查 ,以CCMD -2 -R中神经衰弱标准作最后医学诊断 ,所得数据进行卡方检验。结果 :总患病率为 2 3 5 % ,城市学生患病率高于乡村学生 ,高中生患病率高于初中生 ,均有显著差异 (P <0 0 5 ) ;男女生之间患病率无显著性差异。回族学生患病率最低 ,鄂伦春族学生患病率最高 ,汉族与回族学生之间患病率无显著差异 ,而与蒙古族、鄂温克族、鄂伦春族、达斡尔族之间患病率有显著差异(P <0 0 5 )。结论 :内蒙古中学生神经衰弱患病率较高 ,对来自于城市生、高中生应作为重点防治对象 ,关注少数民族学生的心理健康状况     

湖南省两地区成瘾物质使用状况调查报告：使用率及相关因素

本文采用整群抽样的方法，对湖南两地区城乡共２３７７人（１５岁以上）的成瘾物质使用状况进行调查，其中男１１７９（４９．６％）人，女１１９９（５０．４％人），平均年龄男女分别为４１．２（ＳＤ＝１７．５）和４３．４（ＳＤ＝１８．６）。结果表明，饮酒率男性为５７．５％，女性为１７．３％，吸烟率男女分别为６８．２％和１１．７％；饮酒者多集中在每月饮１次左右的人群中（男５７．９％，女７７．９％），但吸烟者多集中在每日吸２０支及以上（男５２．４％，女４２．９％）的人群中。除解热镇痛剂外，男性各种精神活性物质的使用频率及剂量皆男高于女性，开始使用的年龄及成瘾的年龄男性低于女性；性别、使用频度、最早使用的年龄、婚姻与饮酒、吸烟量关系最为密切。有１４人使用过鸦片类物质，４人使用过兴奋剂。作者讨论了我国成瘾物质使用的特点，指出经济水平、社会文化背景等因素与我国社会性成瘾物质的使用有密切关系。     

Sleep bruxism based on self-report in a nationwide twin cohort

The relative roles of genetic and environmental factors in bruxism are not known. In 1990 a questionnaire sent to the Finnish Twin Cohort yielded responses from 1298 monozygotic and 2419 dizygotic twin pairs aged 33–60 years. We used structural equation modelling to estimate genetic and environmental components of variance in the liability to bruxism. There was a significant gender difference both in childhood (P =0.001) and adult (P =0.007) bruxism. Females compared to males reported childhood bruxism ‘often’ 5.2% vs 4.1% and ‘sometimes’ 17.4% vs 17.3%, and as adults ‘weekly’ 3.7% vs 3.8% and ‘monthly’ 3.9% vs 4.6%, respectively. Bruxism in childhood and adulthood is highly correlated (0.86 in males and 0.87 in females). The proportion of total phenotypic variance in liability to bruxism attributed to genetic influences in childhood bruxism was 49% (95% CI 37–60%) in males and 64% (55–71%) in females, and for adults 39% (27–50%) among males and 53% (44–62%) among females. The correlation between the genetic effects on childhood bruxism and the genetic effects on adult bruxism was estimated in a bivariate model to be 0.95 (95% CI 0.94–0.96) in males and 0.89 (0.88–0.90) in females. Bruxism appears to be quite a persistent trait. There are substantial genetic effects on bruxism both in childhood and as adults, which appear to be highly correlated.     

Familial prevalence of uterine fibroids is associated with distinct clinical and molecular features

BACKGROUND: Although uterine fibroids are very common, their pathogenesis and clinical behaviour are poorly understood. Since they may be prevalent in some families, we investigated whether such a prevalence was associated with distinctive clinical and molecular features. METHODS: A case-control questionnaire study of 300 multi-ethnic women with uterine fibroids at a London university hospital was undertaken, with review of case notes and immunohistochemical determination of vascular endothelial growth factor (VEGF-A) in fibroids. RESULTS: When compared with families with sporadic fibroids, familial prevalence of fibroids was associated with a higher incidence of abdominal swelling (59.1% versus 41.6%; P=0.037), menorrhagia (84.4% versus 51.9%; P=0.042), dysmenorrhoea (64.4% versus 46.3%; P=0.004), dyspareunia (43.2% versus 27.9%; P=0.012) and family history of cancers (52.3% versus 32.4%; P<0.01). The fibroids were also more multiple (mean +/- SEM: 7 +/- 0.86 versus 3 +/- 0.42; P<0.011) and strong VEGF-A expression in fibroids was more common in the familial group (64% versus 28%). Racial distribution was the same in both groups (blacks 49%, whites 33.4%, others 18.6%). CONCLUSIONS: Familial prevalence of uterine fibroids is associated with distinct clinical and molecular features that differ from those found when fibroids occur sporadically in families.     

武汉市4～16岁儿童注意缺陷多动障碍分型的调查分析

目的:了解武汉市4~16岁儿童注意缺陷多动障碍(ADHD)的流行病学情况。方法:对武汉市2188名4~16岁儿童进行注意及多动问题量表评分,该量表按照DSM-Ⅳ的ADHD诊断标准编写,并以DSM-Ⅳ标准对可疑患儿及其家长进行诊断性访谈,将ADHD患者分为注意缺陷为主型(ADHD-I)、多动-冲动为主型(ADHD-HI)和混合型(ADHD-C)。量表还包括Achenbach's儿童行为量表(父母用)和Conners教师量表。结果:(1)ADHD患病率13.58%,其中ADHD-C型2.63%,ADHD-I型8.27%,ADHD-HI型2.68%;男童患病率18.58%,女童患病率8.78%,男女患病率之比为2.12:1。(2)不同年龄段ADHD的患病率差异有显著性,4~5岁组15.88%,6~11岁组15.85%,12~16岁组9.98%。随着年龄的增加,ADHD的患病率呈下降趋势,尤其是ADHD-HI组患病率下降得更明显,但ADHD-I型却呈坡型上升,特别是6~11岁男性组发病比例高达12.19%:(3)ADHD儿童和正常儿童的社交能力有显著差异。(4)无论何种年龄段和性别,ADHD儿童的行为问题评分都高于正常儿童,而且随着年龄的增长,ADHD儿童的行为问题因子也增加。结论:在DSM-Ⅳ定义的三个表型中ADHD-I型患病率高,尤其是6~11岁男性组患病率最高,年龄和性别对表型分布有影响。