基于农村社区人群的心血管危险因素相对效应和性别差异的分层研究

目的:调查北京市房山区农村人群心血管疾病及其相关危险因素的分布,并探讨该人群中主要危险因素与心血管疾病的关联强度.方法:采用普查的方法,对青龙湖镇32个行政村40岁以上人群进行横断面研究;通过问卷调查、体格检查和生化检测收集心血管疾病患病及其相关危险因素的资料,采用分层分析和多因素logistic回归模型进行统计学分析.结果:共计7 577名研究对象中冠心病、脑卒中、糖尿病、高血压、血脂紊乱、超重和肥胖的患病率分别为6.5%、4.1%、10.7%、39.5%、56.7%、44.0%和13.6%.采用多因素logistic回归模型调整变量后比较危险因素对脑卒中/冠心病的现患比值比(prevalence odds ratio,POR),发现高血压与脑卒中的关联更强(POR=2.780,95%CI:2.146～3.602),而糖尿病与冠心病的关联更强(POR=2.671,95%CI:2.121～3.363);按性别分层后各危险因素及数量性状指标与脑卒中的关联存在明显差异,在女性中主要是超重/肥胖(POR=1.652,95%CI:1.122～2.433)、体重指数(POR=1.048,95%CI:1.002～1.096)、收缩压(POR=1.017,95%CI:1.005～1.030)和血糖水平(POR=1.093,95%CI:1.048～1.140),而在男性中主要是血脂紊乱(POR=1.615,95%CI:1.124～2.319)、总胆固醇(POR=3.932,95%CI:1.533～10.086)和HDL-C水平(POR=0.072,95%CI:0.022～0.236).结论:本研究人群中心血管危险因素的聚集影响脑卒中和冠心病的高患病率,不同危险因素对脑卒中和冠心病的影响程度以及在不同性别人群中的影响存在差异.     

流水线作业照明调查分析及最适照度范围研究

目的:调查分析我国流水线作业的照明现状,提出流水线作业照度标准推荐值.方法:选取北京市、广东省的纺织、制鞋、电子3个行业7家工厂和752名流水线作业工人进行现场问卷调查以及对照度值进行实地测量,采用SPSS 13.0统计软件对调查资料进行相应的分析.结果:照明均匀度、工作面清晰度、整体满意度、视疲劳程度之间显著相关;5类不同视觉特性流水线作业照明最适范围推荐值分别为500～1 000～1 500 lx、300～500～1 000lx、200～300～750 lx、100～300～500 lx、50～100～200 lx.结论:流水线作业照明状况不理想,照度均匀度偏低,以及没有针对工人的整体满意度以及视疲劳程度提出相应的照度值等是重要影响因素,提示需进一步完善相关工作,改善流水线作业照明环境.     

中老年癌症患者抑郁情绪相关危险因素的调查分析

目的 了解中老年癌症患者抑郁情绪发生率及相关危险因素,为早期实施针对性心理干预提供临床依据.方法 183例中老年癌症患者进行老年抑郁量表简本(the geriatric depression scale-short form,GDS-SF)与社会人口学特征等定式问卷调查后,采用χ<'2>检验、Logistic回归分析对抑郁情绪相关危险因素进行统计学分析.结果 癌症患者抑郁发生率为26.2%,GDS-SF平均评分是(3.23～2.82).抑郁情绪发生的独立相关危险因素包括年龄(χ<'2>=14.5,p<0.001)、经济收入(χ<'2>=9.16,p=0.01)、家庭对患者的支持情况(χ<'2>5.02,p=0.02)、疾病本身或治疗引起的诸多不良症状(χ<'2>=26.46,p<0.001).结论 中老年癌症患者抑郁发生率高,应当根据抑郁症发生的社会人口学因素,早期实施有针对性的心理干预措施,有效地缓解患者的负性情绪,减少抑郁症的发生,提高患者生活质量.     

血液病相关颅内出血的临床和影像学特点分析

目的 分析血液病相关颅内出血(ICH)的临床和影像学特点,提高临床医师的认识.方法 1998年1月至2010年5月发生的与原发血液病相关的ICH病例31例,回顾性分析其基础疾病、临床和影像学表现以及导致死亡的危险因素.结果 发生ICH的血液病以急性髓细胞白血病(AML)、特发性血小板减少性紫癜(ITP)多见,分别为13例和6例,多表现为头痛、烦躁、恶性呕吐和意识障碍,缺乏定位体征,影像学表现以渗血为主,CT与MRI诊断的符合率为60%(3/5),头颅MRI的ICH检出率高于CT.总病死率为71%(22/31),发热、白细胞＞5×109/L、血小板＜50×109/L、免疫球蛋白增高、凝血功能异常、全身多部位出血等是ICH的危险因素,具备≥2个危险因素者病死率为86.4%(19/22),显著高于有≤1个危险因素的患者病死率[33.3%(3/9)](x2=8.718,P=0.003).结论 血液病相关ICH是威胁患者生命的严重并发症,头颅MRI有助于提高血液病相关ICH诊断率,发热、白细胞＞5×109/L、血小板＜50×109/L、免疫球蛋白增高、凝血功能异常等多种危险因素并存可导致血液病ICH患者死亡率增加.     

中国东北地区成人非传染性慢性疾病的流行病学调查及影响因素分析

目的:了解中国东北吉林省德惠市城乡居民高血压、糖尿病(DM)、血脂紊乱、酒精性肝病(ALD)、非酒精性脂肪性肝病(NAFLD)、代谢综合征(MS)及肥胖(Obesity)等9种非传染性慢性疾病的流行病学现状,并对这些慢性病危险因素进行分析.方法:采用分层抽样方法,对德惠市11个居委会和9个村共6 043人进行问卷调查和体格检查.采用多因素Logistic回归分析对各疾病的相关危险因素进行分析.结果:东北地区德惠城乡居民的高血压、DM、血脂紊乱、ALD、NAFLD、MS、超重和中心型肥胖的患病率分别为28.67%、4.82%、51.00%、3.74%、15.5%、21.54%、58.22%和36.67%;不同疾病患病率性别间比较有差异,高血压患病率男性多于女性(P<0.001),中心性肥胖、血脂紊乱、MS和NAFLD患病率女性大于男性(P<0.05).高龄(OR=1.04,95%CI为1.03～1.05)、脂肪肝(OR=19.42,95%CI为11.62～32.4)、高血糖(OR=1.15,95%CI为1.06～1.26)、高胆固醇血症(OR=1.38,95%CI为1.19～1.59)、高甘油三酯血症(OR=1.32,95%CI为1.1～1.49)和高体重指数(OR=1.42,95%CI为1.3～1.47)是非传染性慢性病的主要危险因素.结论:中国东北部地区德惠市部分非传染性慢性病的发病率较高,且随着年龄的增长患病率逐渐增高;慢性病的发病和进展与本地区的生活、饮食习惯、经济水平、教育程度、地区差异有明显相关性.     

冠状动脉旁路移植手术后早期谵妄与认知功能障碍的关系

目的:观察中国人冠状动脉旁路移植手术后谵妄与认知功能障碍的关系.方法:接受择期冠状动脉旁路移植手术的107例患者,记录术前基础指标、围术期相关指标及术后并发症发生情况.术后第1～7天采用CAM-ICU法(Confusion Assessment Method-Intensive Care Unit)每天2次评估是否发生谵妄;分别在术前1天和术后第7天进行9项认知功能测验,术后认知功能障碍的诊断采用与ISPOCD1研究同样的标准.结果:术后谵妄的发生率为47.7%(51/107),术后认知功能障碍的发生率为55.3%(57/103).多因素Logistic回归分析显示术后谵妄的独立危险因素有年龄增加(OR 1.174,95%CI1.085～1.269,P＜0.001)、术前糖尿病史(OR 4.224,95%CI1.543～11.563,P=0.005)、术后发生并发症(OR 3.667,95% CI 1.152～11.670,P=0.028)和术后监护室停留时间长(OR1.024,95%CI1.005～1.044,P=0.016);术后认知功能障碍的独立危险因素有年龄增加(OR 1.065,95%CI1.001～1.134,P=0.047)和术后谵妄持续时间长(OR 1.744,95%CI1.173～2.593,P=0.006).结论:谵妄和认知功能障碍是中国人冠状动脉旁路移植手术后早期常见的并发症,术后谵妄持续时间长是术后认知功能障碍的独立危险因素.     

临床类毕业生焦虑抑郁及相关心理易感因素的调查

采用医院焦虑抑郁量表(HAD)、艾森克人格问卷(EPQ)、简易应对方式量表和领悟社会支持童表(PSSS)对181医学毕业生和127名参照对象进行问卷调查,以探索医学院校临床类毕业生焦虑、抑郁状况及相关心理易感因素关系.结果发现,医学院校临床类毕业生的焦虑、抑郁检出率分别为21.5%和17.1%,焦虑、抑郁情绪与人格特质、应对方式、领悟社会支持具有显著相关性.应对医学毕业生采取有针对性的心理健康教育措施,以防止或降低焦虑、抑郁情绪的发生,从而提高毕业生心理素质.     

南阳市老年人高血脂相关危险因素的Logistics回归分析

目的:探讨老年人群高血脂发生的相关影响因素.方法:以2009年3月至2010年3月期间在我院进行体检的本市老年干部769例作为研究对象,回顾性收集与高血脂发生相关的可能影响因素;用SPSS13.0统计软件进行多因素Logistics回归分析.结果:可引起血脂增高的影响因素有:年龄(OR=1.4731)、肥胖(OR=2.1882)、高血压(OR=1.5471)、吸烟史(OR=1.8973)及糖尿病史(OR=1.6296).结论:年龄、肥胖、高血压、吸烟及糖尿病等因素为老年人群高血脂发生的危险因素,故在老年人高血脂防治工作中,应着重注意加强对具有此因素的高危人群进行重点防控,通过健康教育来减少相关危险因素的发生.     

心血管疾病一级预防的生活方式干预

心血管疾病中主要是动脉粥样硬化性疾病,动脉粥样硬化的发生是多种危险因素共同作用的结果,控制危险因素可有效预防其发生。生活方式干预是一级预防措施的基石,主要包括平衡膳食、戒烟、规律运动、控制体重、心理平衡等5个方面内容。     

利用茶渣提取水不溶性膳食纤维

在分析茶渣主要成分含量基础上,研究以酸、碱处理和脱脂制备茶叶水不溶性膳食纤维.结果表明,酸的种类对水不溶性膳食纤维含量的影响不显著,pH的影响显著.在考察HC1溶液的pH、温度及时间对水不溶性膳食纤维含量的单因素影响规律基础上,采用L9(34)正交试验优化酸提取工艺,优化的结果为:pH为1、温度90℃、时间1.5 h,获得水不溶性膳食纤维含量为31.27%的初品,初品得率为58.30%.采用NaOH溶液对初品进一步处理,在研究pH、温度及时间对水不溶性膳食纤维含量的单因素影响规律基础上,采用L9(34)正交试验优化碱提取工艺,优化的结果为:pH13.5、温度90℃、时间3h,获得水不溶性膳食纤维含量为85.25%的中间品,中间品得率为21.47%.中间品经乙醚脱脂后制备的茶叶水不溶性膳食纤维产品中的水不溶性膳食纤维含量为91.32%,产品得率为20.11%.     

转炉炉壳热应力分析

根据实际转炉建立实体模型。以有限元为手段,考虑了炉衬和炉壳材料的物性参数随温度变化的特点和炉衬与炉壳之间膨胀间隙,计算了转炉炉壳在温度载荷和炉衬膨胀压力同时作用下的热应力。所得结果可为转炉炉壳设计提供依据。     

焦炭热性能指标意义浅析

通过对焦炭在高炉内的历程及其变化规律的剖析,阐述焦炭热性能指标的意义,形象地把焦炭在高炉内的损耗分为三部分(M1,M2,M3)。指出M2对焦比及焦炭价格有一定的指导作用。     

Results of treatment of cancer of the cardia

Cancer of the cardia is traditionally discussed with cardiac cancer of the lower portion of the esophagus and upper gastric cancer invading the esophagus, and the specific characteristics of cancer of the cardia have never been clearly defined. We reviewed the outcome of 172 patients with adenocarcinoma of the cardia who had undergone radical surgery between 1949 and 1994 in the Division of Gastrointestinal Surgery of the Cancer Institute Hospital. The centers of the tumors were located within 2 cm above and below the boundary between the esophagus and the stomach, and their longitudinal diameter was less than 8 cm. We divided the patients into an early period (1949-1979; n = 79) and a late period (1980-1994; n = 93), and focused on the historical transition. There were no differences in patient gender or histology between the two periods. However, the late period was associated with fewer cases of esophageal invasion and shorter longitudinal diameter, as the age of the population advanced. The number of advanced cancers such as the localized and infiltrative type had decreased, and early cancer and early clinical stage had become more common, but despite the fact that the number of early cancers had increased, extended dissection, such as thoracic and paraaortic lymph node dissection, was performed more frequently. By clinical stage, the long-term outcome markedly improved in Stage I patient in the late period, and tended to improve in Stage II and III patients. This appears to have been attributable to the prevention of micrometastasis by extended dissection, although the number of early cancers is another major potential cause. There were no differences in the outcome of Stage IV patients between the two periods, and further advances in multimodality therapy must be awaited. The range of resection is basically proximal gastrectomy, and if there are adequate indications, the prognosis is favorable. In view of the status of lymphatic flow and lymph node metastasis, and long-term results, lateroaortic lymph node dissection is important. Since the number of early cancer patients has been increasing, if intraabdominal recurrence is prevented, intrathoracic lymph node dissection will contribute greatly to the outcome of such patients.     

The effect of amount of possession of the trait of hostility on accuracy of perception of hostility in others.

Some theories of personality hold that an individual's perception of others is influenced by his own personality characteristics; more specifically, that a trait of low social value will be projected more into others, and that insight into the possession of these characteristics reduces this distortion. These 2 hypotheses were tested by having a group of college students rate each other (including themselves) on degree of friendliness or hostility. Agreement with group rating about self yielded the insight score. In general, the hypotheses were supported; the "friendly" Ss were most accurate in their perception of others, and insight was positively associated with accurate perception. From Psyc Abstracts 36:04:4HL16M. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of rates of infection of two methods of emergency ventricular drainage

The rates of infection of two methods of external ventricular drainage in use at Atkinson Morley's Hospital--namely, (a) percutaneous drainage with Rickham reservoirs and (b) tunnelled ventriculostomies--were compared in this retrospective review. Percutaneous drainage of CSF with Rickham reservoirs was associated with a 27% rate of infection as identified by positive microbiological cultures; tunnelled ventriculostomy catheters had a 10% infection rate. The difference in the infection rate between the two methods was statistically significant (P < 0.015). Other variables examined, including the age and sex of the patients and the reasons for ventricular drainage, were not associated with an increased rate of infection. Most infections from either method were caused by a coagulase negative staphylococcus. The average duration of ventricular drainage before identification of positive cultures was 5.7 days for Rickham reservoirs and 6.0 days for ventriculostomies.     

浅析《野草》的版画特征

鲁迅先生一生热爱美术作品,对版画中木刻兴趣尤甚.<野草>作为其"写心之作",亦呈现出一些与木刻版画一致的审美特征:一是具有木刻版画的色彩特征,多对比、多冷色,有阴郁的美感;二是具有木刻版画的力度特征,环境描写、人物刻画处处刀锋毕现,遒劲有力,有一种"力之美".     

四辊破碎机车刀架的改造

针对四辊破碎机车刀架车削中存在的几个问题,详细介绍了电动车刀架的结构和工作原理,建立主要设计参数的数学表达式,并进行适当的分析。改造后,这种电动车刀架运行平稳、可靠、方便、省力,取得了预期的效果。     

Effect of antibiotics of chemotaxis of human leukocytes

The effect of 20 different antibiotics on chemotaxis by human neutrophils was studied. Human leukocytes incubated with chloramphenicol, rifampin, sodium fusidate, and tetracyclines in vitro showed markedly depressed migration. The mechanisms by which these antibiotics affect leukotaxis are discussed.