松江区公共场所成人被动吸烟监测分析

目的了解松江区居民的被动吸烟状况及对吸烟的态度和认识。方法采用分层随机抽样的方法,在医院、商场、车站候车室、政府对外办公大楼等四类公共场所,随机抽取200名松江居民进行问卷调查。结果200名调查对象中不吸烟或已戒烟者共117人,占有58.5%;不吸烟者中被动吸烟率为48.7%,男女间被动吸烟情况没有显著性差异。55.6%的被动吸烟者认为绝大部分吸烟者当面吸烟前从不征求他们意见,只有10.3%的被动吸烟者每次都会表达反对意见。93%的调查对象都能认识到吸烟对吸烟者的危害,但有15%左右的调查对象不清楚吸烟对周围被动吸烟人群的危害。80%左右的调查对象赞成在医院和学校全部禁烟,而有40%左右的调查对象赞成在办公室、餐厅和酒吧实行部分禁烟。结论松江区居民的被动吸烟情况比较严重,居民对被动吸烟的危害认识不足,需要加强被动吸烟的干预工作。     

How do residents manage personal finances?

BACKGROUND: We examined three research questions: How do residents' debts and savings compare to the general public? How do surgical residents' financial choices compare to other residents? How may institutions help residents' personal financial decisions? METHODS: The Survey of Consumer Finances was modified and piloted tested to elicit financial information. The instrument was completed by 612 residents at 8 programs. RESULTS: Only 60% of residents budgeted expenses, and 25% and 10% maintained cash balances <611 dollars and unpaid credit card balances >10,000 dollars, respectively. Compared with controls, residents held greater median ratios of debt to household income (2.46 vs. 1.06, P <0.0001), fewer assets to income (0.64 vs. 2.28, P <0.0001), less net wealth to income -1.43 vs. 0.90, P <0.0001), and lower retirement savings balance to household income (0.01 vs. 0.12, P <0.0001). Surgery residents were the least financially conservative group. Mean annual resident contributions to retirement accounts were $1532 higher at institutions with versus without retirement plans (P <0.01). CONCLUSIONS: Resident debts are higher and savings lower than the general public. This behavior is most common among surgery residents. Residents save more for retirement when they are eligible for tax-deferred retirement plans. Graduate medical programs should instruct residents on financial management.     

Risk factors associated with anal sphincter tear difference among midwife,private obstetrician,and resident deliveries

To identify risk factors that account for the difference in anal sphincter tear (AST) among midwife, private obstetrician, and resident deliveries. We performed a retrospective review of our obstetrical database and used logistic regression analysis to identify risk factors for AST. The relationship between delivery technique and AST was evaluated by comparing AST increase between vaginal deliveries without and with an episiotomy among the three categories of providers. After adjusting for risk factors, private obstetricians (OR: 1.81, 95% CI: 1.27-2.56) and residents (OR: 1.60, 95% CI: 1.20-2.15) had a higher rate of AST during vaginal delivery than midwives. Episiotomy increased the odds of AST by four-fold for midwives, two-fold for private obstetricians, and eight-fold for residents. Although midwife and resident's delivery methods were associated with more AST, neither experienced this complication more frequently than private obstetricians. This suggests that midwives and residents probably misdiagnosed some AST.     

上海市松江区居民吸烟状况分析

[目的]了解上海市松江区居民的吸烟情况。[方法]在松江地区4个镇1个街道共16万人口中随机选择4772名居民采用统一标准的调查问卷进行入户调查。[结果] 被调查人群中现在吸烟率为23.62％,曾经吸烟率为2.83％,居民现在吸烟率与年龄、性别和文化程度有关P值均<0.01)。开始吸烟的平均年龄为22.59±5.43岁,最主要的原因是好奇、社交需要和解乏。77.3％的现在吸烟者还没有考虑在未来6个月内戒烟。被动吸烟率为65.13％,被动吸烟的场所主要是家中和公共场所。[结论] 松江地区居民的吸烟率低于全国1996年调查的15岁以上人群吸烟率(35.3％)。但松江地区大多数吸烟者尚未考虑戒烟,需要开展有针对性的控烟干预。大多数非吸烟者都受到被动吸烟的危害,有必要采取措施减少在家中和公共场所等地方被动吸烟的机会。     

Sonography of suspected acute appendicitis in children: Evaluation of the progress in performance of senior residents

Purpose

The objective of this study was to evaluate the progress in performance of senior residents in diagnosing acute appendicitis.

某退役铀矿山周围居民淋巴细胞微核率分析

目的 调查某退役铀矿山周围居民外周血淋巴细胞微核情况,初步探讨环境因素对微核的影响,为综合治理退役铀矿周围环境提供科学依据。方法 采集100名退役铀矿山周围居民外周静脉血,用常规淋巴细胞微核培养法,检查淋巴细胞微核,进行统计分析。结果 在100名居民中,微核检出率为88.0%,细胞微核率（9.46±6.62）‰、微核细胞率为（8.77±5.92）‰;按性别和年龄分别分组分析得出,细胞微核率和微核细胞率整体随着年龄的增加而增加,但男性和女性增加的速度和幅度在各年龄段稍有不同,男性各组间无明显差异（P>0.05）,女性微核细胞率各组间无明显差异（P>0.05）,细胞微核率各组间差异具有统计学意义（P<0.05）。结论 该退役铀矿山周围居民外周血淋巴细胞微核检出率、淋巴细胞微核率和微核细胞率远超过国内外报道的本底范围,应对退役铀矿周围环境采取更具针对性的综合治理措施,以确保退役铀矿山周围居民的健康。     

城镇居民基本医疗保险与城镇贫困人群医疗救助制度衔接刍议

城镇居民基本医疗保险与城镇贫困人群医疗救助制度是社会保障体系的重要组成部分和社会保障领域改革的重要环节,两者衔接对缓解城镇贫困人员“看病难、看病贵”,提高卫生服务可及性、公平性有重要现实意义。结合两制度衔接现状,探讨两个制度衔接的必要性和可能性,以及当前两个制度衔接存在困难和问题,并提出相关的政策建议。     

徐州市居民糖尿病的脆弱性调查分析

目的掌握徐州市居民罹患糖尿病的脆弱性情况,为进一步的干预提供科学依据。方法采用多阶段分层随机抽样方法,抽取徐州市15～69岁居民共4980人,进行统一的问卷调查,分析应对糖尿病的脆弱性。结果被调查人群中不知道肥胖易患糖尿病者共2427例（48：73％）,不清楚糖尿病常见症状者2053例（41．22％）,不知道父母患糖尿病子女易患糖尿病者共2746例（55．14％）,不知道糖尿病会演变成其他疾病者2771例（55．64％）,从未测血糖者共3424例（68．76％）：1556例测过血糖中检出糖尿病116例,患病率为7．46％,其中未采取措施控制血糖者30例（25．86％）;文化程度、家庭每月人均收入低者应对糖尿病脆弱性较高。结论徐州市居民罹患糖尿病脆弱性偏高,不同居民罹患糖尿病脆弱性不同,针对不同年龄、文化程度、收入等不同层次的人群加大多样化的健康教育和干预措施,降低居民罹患糖尿病的脆弱性。     

Laparoscopic Appendectomy Performed by Residents and Experienced Surgeons

Background:

Laparoscopic appendectomy is widely performed by surgical residents, but its changing indications and outcomes have been poorly investigated. The aim of this study was to examine whether a difference exists in indications and outcomes between laparoscopic appendectomies performed by residents and those performed by experienced surgeons.

Methods:

Between 1999 and 2007, 218 laparoscopic appendectomies were performed and recorded. Data were analyzed to compare operations performed by residents with those by experienced surgeons in terms of indications for surgery and severity of disease. Moreover, laparoscopic appendectomies were thoroughly compared regarding outcomes and complications.

Results:

The residents had fewer conversions with laparoscopic appendectomy (8% vs 17%, P=0.04), and similar complication rates (12% vs 13%, P=0.16), compared with experienced surgeons. The median operating time was also comparable (67 minutes vs 60 minutes, P=0.23). However, patients operated on by residents had more emergencies (86% vs 70%, P=0.009), included more foreigners (27% vs 15%, P=0.03), and had intermediate to severe diseases, (81 vs 52%, P<0.001) than patients did operated on by experienced surgeons.

Conclusions:

Surgical residents performed more emergency laparoscopic appendectomies on foreign patients suffering from intermediate to severe diseases compared with experienced surgeons, with comparable surgical outcomes and lower conversion rates.