辽河油田居民全血硒含量水平的评价

采用新极谱法对辽河油田居民的全血样品进行硒含量的测定。其中健康人 2 0 7例 ,血硒含量为 12 9 0± 4 8 1μg/L ,男性 10 5例 ,血硒含量为 12 5 3± 4 8 3μg/L ,女性 10 2例 ,血硒含量为 132 7± 4 7 6 μg/L ,处于营养状态。不同血型血硒含量没有明显差异 (P >0 10 )。患者 2 18例 ,血硒含量为 89 9± 2 6 5 μg/L ,男性12 4例 ,血硒含量为 90 9± 2 5 9μg/L ,女性 94例 ,血硒含量为 87 9± 2 7 0 μg/L。各种疾病患者血硒含量没有显著性差异 (P >0 10 ) ,但均显著低于健康人血硒含量 (P <0 0 0 1)。     

农村居民对饮水降氟技术的认知行调查

[目的]通过调查农村居民对饮水氟危害、饮水降氟站的作用的认知情况以及低氟水饮用的情况,了解农村饮水降氟站的实际运行效能。[方法]选择天津已经建成并运行3年以上的饮水降氟站所在的15个村庄,每个村庄随机抽访10户以上,进行问卷调查,每户调查1位成年人。问卷除包括一般人口学项目外,主要有饮水高氟危害的知晓情况,对饮水降氟站作用的认同情况和饮用低氟水的情况。[结果]回收有效问卷168份。居民对氟危害知晓率为60.7%,对饮水降氟站可以使高氟水降为低氟水的认同率为83.3%,差异有统计学意义（χ^2=20.354,P﹤0.001）。饮水高氟危害的知晓率与居民文化程度和性别有关。居民每户每月桶装低氟水消费量变幅较大,调查的168户中,有4.2%的家庭每月仅消费3桶,而4.8%的家庭每月消费8桶,70.2%的家庭每月消费5～6桶。以月消费3～8桶,5口之家计算,人均日饮用低氟水约0.4～1.0L。居民对不同降氟技术产生的降氟水的口感以电渗析水最可口,而对活性氧化铝口感较差。[结论]农村居民对饮水降氟知晓率较高,而实际饮用低氟水的量却偏少。     

Training in mitral valve surgery need not affect early outcomes and midterm survival: a multicentre analysis

Objective: Mitral valve surgery may be regarded as less favourable for training, due to greater mortality risk, technical complexity, and difficulty for the supervisor to observe. We examined this perception by reviewing a multicentre experience. Methods: We analysed a multicentre database over a 7-year period containing 2216 isolated and combined mitral procedures. Of these, 2048 were performed by consultants and 168 by trainees (92% vs 8%) of varying seniority. Preoperative characteristics, early postoperative outcomes and 6-year survival were compared between groups. Propensity-score matching was performed to correct for group differences. Results: Trainees were less likely to operate on patients, who had previously undergone coronary surgery (consultant 4.3% vs trainee 1.2%, p = 0.043) and those with moderate to severe mitral regurgitation (86% vs 81%, p = 0.012). There were no other statistically significant differences in preoperative variables, such as urgency, endocarditis and left-ventricular dysfunction. There were similar rates of mitral valve repair (48% vs 51%, p = 0.48). Trainees were more likely to operate on rheumatic valve pathology (20% vs 28%, p = 0.012). Intra-operatively, trainees had longer aortic cross-clamp times (119 ± 52 vs 136 ± 50 min, p = 0.0001). At 30 days, mortality was comparable (4.5% vs 3.6%, p = 0.56) with a trend towards higher any mortality/morbidity in consultant procedures (33% vs 26%, p = 0.059). At 6 years, survival was similar (79 ± 1.4% vs 78 ± 4.0%, p = 0.73). After derivation of 142 propensity-score-matched patient pairs, trainees cases still experienced longer cross-clamp times (121 ± 58 vs 137 ± 52 min, p = 0.023), but there was similar 30-day mortality (4.2% vs 3.5%, p > 0.99) and any mortality/morbidity (28% vs 24%, p = 0.52). Six-year survival between matched pairs was also similar (74 ± 7.2% vs 80 ± 4.4%, p = 0.64). Trainee status did not predict early or late adverse events after multivariate Cox regression with and without propensity-score adjustment. Conclusions: Trainee outcomes are not inferior even when corrected for risk. This suggests that excellent operative training and supervision can be achieved in mitral valve surgery.     

心血管内科住院医师规范化培训的探索

住院医师规范化培训是提高住院医师素质、培养高素质人才必不可少的阶段。从培养方案的合理制定、注重实用型人才的培养、加强人文素质的培养及培养终生学习能力等4个方面探讨心血管内科住院医师规范化培训,探索建立符合心血管内科特点的住院医师培训模式。     

Seroepidemiological Investigation of Lyme Disease and Human Granulocytic Anaplasmosis among People Living in Forest Areas of Eight Provinces in China

Objective Lyme disease and Human granulocytic anaplasmosis are tick‐borne diseases caused by Borrelia burgdorferi and Anaplasma phagocytophilum respectively. We have investigated infection and co-infection of the two diseases in the population of forest areas of eight provinces in China by measuring seroprevalence of antibodies against B. burgdorferi and A. phagocytophilum. Methods Forest areas in 8 provinces were chosen for investigation using whole sampling and questionnaire survey methods. 3 669 serum samples from people in the forest areas were tested for the presence of antibodies by indirect immunofluorescent assay (IFA). Results Seroprevalence against B. burgdorferi was 3% to 15% and against A. phagocytophilum was 2% to 18% in the study sites in the 8 provinces in China. We also found co-infection of B. burgdorferi and A. phagocytophilum in 7 of the 8 provinces (the exception being the Miyun area in Beijing). The seroprevalence for both B. burgdorferi and A. phagocytophilum was significantly higher among people exposed to ticks than among people who were not exposed to ticks. Conclusion We conclude that both pathogens are endemic in the forest areas in the eight provinces, but the prevalence of B. burgdorferi and A. phagocytophilum differs between the provinces.     

2011-2012年江阴市农村居民死因监测分析

目的了解江阴市农村居民死因分布,为制定防治措施提供依据。方法利用死因登记信息报告系统进行资料分析。结果 2011-2012年我市农村居民死亡率为747.57/10万,其中男性为768.22/10万,女性726.47/10万,性别间差异无统计学意义(χ2=0.48,P>0.05);平均寿命为74.0岁,其中男性70.1岁,女性78.2岁,性别间差异有统计学意义(t=10.25,P<0.005)。前5位死因依次是循环系统疾病、恶性肿瘤、呼吸系统疾病、意外死亡、内分泌系统。死因以慢性非传染性疾病为主,占总死因的83.77%。结论慢性非传染性病病已成为我市居民的主要致死疾病,应积极开展针对性健康教育为主要手段的综合防治策略,提高居民整体健康水平。     

社区居民骨质疏松及相关骨折认知程度的调查分析

目的调查社区居民骨质疏松及相关骨折的认知程度。方法选择社区居民进行抽样调查,采用骨质疏松知识评价问卷对社区居民骨质疏松及其骨折认知程度进行调查。结果社区居民对骨质疏松及骨折认知的相关知识得分情况中,预防跌倒的答对率最高,其次为骨骼与运动和日常饮食,对诊断和治疗知识的答对率最低。女性、年龄小、文化程度较高、专业技术人员的总分、危险因素、诊断与治疗的得分较高。结论社区居民对骨质疏松及其骨折的认知程度较低,其中对预防跌倒的认知较好,而对诊断和治疗方面的知识了解较差。     

2015年和2018年深圳市公众参与控烟监督意愿变化对比分析

目的评估深圳市公众参与控烟意愿变化,为进一步加强控烟工作及控烟社会监督提供依据和建议。方法于2015年8月和2018年8月采用多阶段随机抽样方法对15岁以上居民进行问卷调查;问卷内容包括人口学特征、吸烟、二手烟暴露及控烟条例知晓情况、对社会公众参与控烟监督的看法、参与控烟监督的意愿。资料使用SPSS 21.0进行χ^2检验、多因素Logistic回归分析。结果调查对象2015年和2018年愿意参与控烟监督的比例分别为65.90%和54.98%,愿意通过随手拍参与控烟监督的比例分别为63.20%和58.70%,控烟条例知晓率分别是66.29%和48.91%;调查对象是否吸烟、是否知晓控烟条例以及其所在行政区,在两个时间段的调查中均与其控烟监督参与具有显著性的相关性,年龄在2018年的调查中对公众吸烟监督意愿的影响差异具有统计学意义。结论深圳市公众控烟条例知晓率及参与控烟监督的意愿及行为均有所降低;加强控烟条例的宣传及政府主导的监督方式可能有利于提高公众参与控烟监督;非吸烟人群和45~64岁人群可能是提高公众参与控烟监督的关键人物。     

基于智能健康监测系统的社区居民健康状况及影响因素分析

目的 旨在调查社区居民健康状况,分析影响健康的相关因素。 方法 2019年4月—5月,采用描述性横断面研究,便利获取来自全国不同地区4 311例居民为研究对象,通过智能健康监测系统获取研究对象的健康数据,包括一般特征、健康行为及健康状况、广泛性焦虑障碍量表和抑郁症筛查量表测评结果。 结果 研究对象年龄为（29.25±11.88）岁,慢性病患病率为13.8%。存在焦虑者有1 480例（34.3%）,存在抑郁症状者有1 620例（37.6%）。吸烟率、饮酒率分别为12.2%、32.3%。年龄、文化程度、已婚、饮食规律性、上午加餐情况、以肉食为主、饮食偏咸、其他特殊饮食、饮酒频率、是否剧烈运动、焦虑程度、抑郁程度是慢性病患病情况的影响因素。结论 社区居民健康状况良好,普遍存在焦虑、抑郁,需重视心理健康。老年、已婚、进餐不规律、以肉食为主、饮食偏咸、其他特殊饮食、经常饮酒、无剧烈运动、抑郁和焦虑的社区居民易患慢性病,建议参考慢性病影响因素制订社区居民健康促进措施。