上尿路结石微创术后尿源性脓毒血症的危险因素研究进展

【摘要】 尿脓毒血症又称尿源性脓毒血症, 其病情凶险、起病隐匿、进展快、病死率高。近年来随着腔内泌尿微创技术在上尿路结石手术治疗中的广泛应用, 尿源性脓毒血症的发病数逐渐增多, 死亡率上升。从手术患者中筛选出具有发生尿源性脓毒血症高危因素的患者并给予重点关注和追踪, 对术后尿源性脓毒血症的早期诊断和治疗有着重要意义。现结合文献复习, 对上尿路结石微创术后并发尿源性脓毒血症的常见危险因素研究进展做一综述。     

延长油田职工糖代谢异常患病情况调查

目的了解延长油田职工糖代谢异常情况,为制定防治措施提供理论依据。方法采用整群抽样的方法,对甘谷驿采油厂的全体职工进行问卷调查、人体学测量及相关生化指标检测,分析糖代谢异常的流行病学特征及危险因素。结果延长油田职工中糖尿病及糖尿病前期的患病率分别为9.8%和22.8%,均高于延安市居民平均水平。男性患病率高于女性,且患病率随年龄增长而增加(P<0.05)。糖代谢异常在超重、肥胖、高血压病、高尿酸血症及血脂异常人群中患病率较正常人群组偏高(P<0.05)。结论延长油田职工糖尿病及糖尿病前期患病率高于当地平均水平,应加强对职工的健康宣教,预防包括超重、肥胖及糖代谢异常在内的多重危险因素,减少心脑血管疾病的发生。     

早发ST段抬高型急性心梗患者临床特点分析

目的分析早发ST段抬高型急性心梗（STEMI）患者的传统危险因素分布以及血生化指标及冠状动脉造影结果特点。方法收集自2009年1月-2010年3月STEMI临床资料,比较早发STEMI患者（男性〈55岁,女性〈65岁）和非早发的STEMI患者（男性〉55岁,女性〉65岁）的传统危险因素、血生化代谢指标及冠脉造影结果的差异,并进行统计学分析。结果早发STEMI组与非早发组比较具有以下临床特点：吸烟（56.8%∶38.0%,P〈0.05）和代谢综合征（55.6%∶33.0%,P〈0.05）的比率较高。早发STEMI组的体重指数（BMI）显著高于非早发组[（25.94±3.15）∶（24.75±3.66）P〈0.05]。早发组以冠脉单支病变为主（58.0%∶31.0%,P〈0.05）,以前降支受累为主,而非早发组以三支病变为主（21.0%∶44.0%,P〈0.05）。针对早发STEMI危险因素的Logistic多元回归分析发现代谢综合征和吸烟是早发STEMI的独立危险因素,代谢综合征和吸烟的OR值分别是2.54和2.82。结论吸烟和代谢综合征在早发STEMI的发生、发展过程中起重要作用,对于存在代谢异常的青中年患者进行减肥和戒烟具有尤其重要的预防心血管事件的意义。     

Arsenic exposure and tobacco consumption: Biomarkers and risk assessment

Arsenic is measurable in tobacco and cigarette mainstream smoke (MSS). Whether arsenic has an independent role in diseases associated with tobacco consumption is not known. Epidemiology and biomonitoring data and probabilistic risk assessment (PRA) methods were used to investigate this potential association. Analysis of data from the National Health and Nutrition Examination Survey (NHANES) showed that urine arsenic concentrations in tobacco consumers were not different or were lower than levels in non-consumers of tobacco. Additionally, urine arsenic levels from NHANES tobacco consumers were five-times or more lower than levels reported in epidemiology studies to be associated with adverse health effects. Results of PRA indicated that mean non-cancer hazard estimates and mean incremental lifetime cancer risk estimates were within accepted ranges. Taken together, these results suggest that arsenic may not be independently associated with tobacco consumption or diseases related to tobacco consumption.     

主观认知障碍的相关危险因素分析及预防

目的 探讨主观认知障碍(SCI)的危险因素及预防措施.方法 选取2016年3~9月在上海长征医院痴呆门诊就诊患者54例,进行简易智力状况检查量表和SCI调查问卷调查.然后采用单因素和多因素条件Logistic回归分析对数据进行处理以筛查影响因素.结果 经单因素和多因素条件Logistic回归分析,筛选出3个有意义的独立因素:年龄(OR=1.243,95%CI=1.072~1.442)、脑血管疾病史(OR=130.466,95%CI=1.688~3630.660)是SCI发生的独立危险因素;文化程度是独立保护因素(OR=0.016,95%CI=0.007~0.607).结论 年龄与脑血管疾病史是SCI发病的危险因素,在该病防治上需主要加强危险因素的防治.文化程度是发病保护因素,因此应该倡导和鼓励老年人多思考、勤用脑.     

Diagnostic endoscopic ultrasonography: Assessment of safety and prevention of complications

Endoscopic ultrasonography (EUS) has gained wide acceptance as an important, minimally invasive diagnostic tool in gastroenterology, pulmonology, visceral surgery and oncology. This review focuses on data regarding risks and complications of non-interventional diagnostic EUS and EUS-guided fine-needle biopsy (EUS-FNB). Measures to improve the safety of EUS und EUS-FNB will be discussed. Due to the specific mechanical properties of echoendoscopes in EUS, there is a low but noteworthy risk of perforation. To minimize this risk, endoscopists should be familiar with the specific features of their equipment and their patients’ specific anatomical situations (e.g., tumor stenosis, diverticula). Most diagnostic EUS complications occur during EUS-FNB. Pain, acute pancreatitis, infection and bleeding are the primary adverse effects, occurring in 1% to 2% of patients. Only a few cases of needle tract seeding and peritoneal dissemination have been reported. The mortality associated with EUS and EUS-FNB is 0.02%. The risks associated with EUS-FNB are affected by endoscopist experience and target lesion. EUS-FNB of cystic lesions is associated with an increased risk of infection and hemorrhage. Peri-interventional antibiotics are recommended to prevent cyst infection. Adequate education and training, as well consideration of contraindications, are essential to minimize the risks of EUS and EUS-FNB. Restricting EUS-FNB only to patients in whom the cytopathological results may be expected to change the course of management is the best way of reducing the number of complications.     

孕产期心理保健干预研究

目的探讨孕产期心理保健重要性及对高危因素干预的必要性。方法把200名孕妇随机分为进孕妇学校组和未进孕妇学校组,并对其进行分析。结果两组比较差异有统计学意义(χ2≥3.84,P<0.01)。结论产褥期母体的精神变化相当复杂,据研究42%～76%的产妇表现为兴奋-抑郁过程。及时的发现,对产妇的生理、心理应激因素进行指导,有助于产妇产褥期的身心健康。