优化流程 降低肿瘤患者再次化疗延期率

通过对肿瘤再次化疗患者流程管理实行优化,形成规范、合理的化疗流程,使肿瘤化疗延期率从69.1％降至21.1％,治疗效果提高,治疗风险减少,病人满意度上升,平均住院日缩短.     

基础FSH水平对不同年龄患者行供精人工授精结局的影响

目的:探讨年龄、血基础卵泡刺激素(bFSH)水平对不孕妇女行供精人工授精(AID)结局的影响。方法:回顾性分析郑州大学第一附属医院生殖中心2008年1月~2013年12月成功接受供精人工授精治疗的不孕妇女的年龄、bFSH水平与临床妊娠率、流产率的关系。结果:13 247个AID周期中,<35岁组和≥35岁组诱导排卵的妊娠率分别为28.76%,16.04%;自然周期的妊娠率分别为28.88%,16.93%,不同年龄诱导排卵妊娠率及自然周期妊娠率比较,差异有统计学意义(P<0.05)。2<35岁患者中,bFSH≤10 IU/L组诱导排卵和自然周期的妊娠率均高于bFSH>10 IU/L组(P<0.05),流产率对比均无统计学差异(P>0.05)。3≥35岁患者中,bFSH≤10 IU/L组与bFSH>10 IU/L组诱导排卵或自然周期的妊娠率、流产率均无统计学差异(P>0.05)。结论:年龄是影响AID助孕结局的重要因素之一;基础FSH水平对年龄<35岁患者妊娠结局有一定预测作用;诱导排卵并未明显增加AID妊娠率;AID助孕技术并未增加流产风险。     

年龄调整率的区间估计及其在宫颈癌患病率估计中的应用

目的 评价三种年龄调整率可信区间估计方法,探索适合江苏省宫颈癌筛查研究中年龄调整患病率可信区间估计的方法.方法 以二项分布正态近似法、Gamma分布法及"确切概率法"进行年龄调整率的区间估计,运用统计模拟考察多种率及阳性数情况下三种方法的区间覆盖率及宽度.结果 当样本量较小(阳性数较少)时,确切概率法的覆盖率离理论可信度的偏差及区间宽度均优于Gamma分布法,两者的覆盖率均明显优于正态近似法;随着阳性数增多,三法各自的覆盖率偏差及区间宽度均逐渐变小,方法间的差异亦逐渐缩小;当阳性数增至30以上时,确切概率法及正态近似法的覆盖率的偏差皆在±1%以内,此时两者的区间宽度接近;而Gamma分布法的覆盖率偏差若要达到1%以内,则要求总阳性数在100以上.无论样本构成是轻度偏离还是明显偏离总体构成,上述规律皆成立.结论 综合考虑区间覆盖率、区间宽度及计算便捷性,建议当总阳性数小于30时,采用确切概率法计算调整率的可信区间;当总阳性数大于等于30时,采用正态近似法.     

结肠镜检查中大肠肿瘤的漏诊率分析

目的 研究和探讨结肠镜检查中大肠肿瘤的漏诊率.方法 回顾分析了2008年9月至2011年9月来我院接受结肠镜检查并行内镜下息肉切除患者的临床资料,记录患者初次结肠镜检查出肿瘤后的结果,在患者接受肿瘤切除手术后的120天内进行结肠镜复查并再次记录结果,将两次结肠镜检查观察到的肿瘤特征进行分析,主要是将记录的肿瘤大小、所处的部位、形态、数量等相关记录结果进行对比,谈论不同类型的肿瘤在利用结肠镜检查时大概的漏诊率.结果 选取的809例肿瘤结肠镜检查案例中,有271例出现了漏诊,肿瘤平均患者漏诊率达到了33.5％(271/809);两次结肠镜检查总共观察到2134个肿瘤,其中有425个肿瘤漏诊,肿瘤总漏诊率是19.9％(425/2134).结论利用结肠镜检查大肠肿瘤的漏诊率较高,腺瘤漏诊现象尤为突出,恶性肿瘤的漏诊率相对较低.在利用结肠镜给患者进行肿瘤检查时,要针对漏诊问题执行相应的预防措施.     

1705例河南农村地区拟孕妇女生殖道感染及社会学因素效应

目的：探讨包括咨询和治疗在内的社会学因素等对河南省农村地区拟孕妇女生殖道感染（RTI）的影响。方法：采用多阶段随机整群抽样方法抽取1705例研究对象,并进行临床诊断和问卷调查。应用多变量Logistic回归模型,分析健康咨询、门诊诊治、年龄、地区职业等因素对RTI的影响。结果：农村拟孕妇女生RTI现患率为37.95%（95%CL：35.6416~40.2529）;多因素分析表明：26~30年龄组RTI患病风险增高（OR=1.053）,26岁以下年龄组最低（OR=0.748）;有生殖道感染患病史者,发病风险明显增加（OR=2.342）;随年收入增加发病风险有增高趋势;1年门诊治疗和咨询未能发现有效降低发病风险。结论：RTI是社会性的问题,对认识RTI的社会学效应整体上提高认识,可对降低RTI起到推动作用。     

儿童饮水摄入率的研究进展

当前水污染形势严峻,要评价水中某种化合物对儿童造成的健康风险,需要对饮用水中化合物的暴露量进行计算,饮水摄入率是饮用水暴露健康风险评价中最主要的暴露参数。该文在总结国内外儿童饮水摄入率研究的基础上,提出了我国今后在儿童饮水摄入率发展方向的建议。     

年龄标化率在长期趋势研究中的适用性

率的标准化(standardization)是为了在比较两个不同人群的患病率、发病率、死亡率等资料时，消除其内部构成不同的影响。在流行病学研究中对年龄进行标化处理是非常多见的，因为年龄的差异与多种疾病的危险因素有关。1844年，Neison在比较两个社区人群的死亡率时首次使用了年龄标化法，     

常宁市小学生龋病的流行病学调查

目的 了解常宁市城乡儿童龋病的发病情况及分布规律。方法 按龋病调查标准和诊断标准进行。结果 所调查的小学生患龋率为40.24%,其中城市、农村小学生龋均、患龋率均有显著性差异。农村男、女学生患率差异无显著性,不同年龄患龋率城市、农村均以7岁组为最高,7岁以后的患龄率有随年龄增加减少趋势,以12－岁组患龋率最低。人工喂养与母乳喂养的儿童患龋率有显著性差异。结论 儿童患龋率与饮食习惯、食物构成、儿童喂养方式、年龄等有关,且存在城乡、性别间的差异。     

1990—2019年我国酒精性肝病的疾病负担分析

目的 分析我国1990—2019年酒精性肝病的疾病负担数据,为我国酒精性肝病的防控工作提供参考依据。方法 从GBD 2019数据库收集1990—2019年我国酒精性肝病患者的发病率、死亡率、DALY率来描述疾病负担,使用Joinpoint回归模型分析发病率、死亡率、DALY率的变化趋势,使用APC模型分析年龄效应、时期效应及队列效应对发病率和死亡率的影响。结果 1990—2019年我国酒精性肝病的标化发病率总体呈上升趋势(AAPC=0.12%),标化死亡率、DALY率呈下降趋势(AAPC分别为-2.43%、-2.65%),男性的发病率、死亡率、DALY率高于女性。年龄效应结果显示男性的酒精性肝病发病风险在45～49岁最高,其RR值为8.01,女性的发病风险在50～54岁阶段最高,其RR值为12.07,死亡风险随年龄的增长而增加。时期效应结果显示酒精性肝病发病风险和死亡风险逐渐降低,出生队列效应结果显示酒精性肝病的发病风险总体上随出生队列而增加,死亡风险总体上随出生队列而降低。结论 中国酒精性肝病的发病率总的呈上升趋势,死亡率、DALY率呈下降趋势,发病和死亡风险存在性别和年龄的差异。     

广州地区某肿瘤医院2018—2022年医院感染现患率调查

目的 了解肿瘤患者医院感染特点及其变化趋势,为进一步完善肿瘤患者医院感染防控措施,降低院内感染发生风险提供科学依据。方法 依据全国医院感染监测网的调查方法,采取床旁调查和查阅病历相结合的方法分别对某肿瘤专科医院2018—2022年某一日0:00～24:00住院患者开展现患率调查。采用χ²检验、χ²线性趋势性检验、Kruskal-Wallis H检验进行统计分析。结果 2018—2022年医院感染现患率为1.80%～4.37%,呈下降趋势(P<0.01)。医院感染部位以呼吸系统、消化道腹部和手术部位较常见,分别是37.04%、26.34%和11.11%。抗菌药物使用率为21.22%～31.45%,呈下降趋势(P<0.05),病原学培养送检率上升趋势(P<0.01),以革兰阴性菌检出为主。结论 该肿瘤医院医院感染现患率呈下降趋势,需加强重点部位及革兰阴性菌感染防控。     

Turning points in time trends of cancer mortality in Japan: Premature mortality is more sensitive in the progress of cancer prevention

The aims of this study were to demonstrate the trend of overall mortality rate and premature mortality rate for select types of cancer in Japan and to assess the utility as a target indicator. The age-adjusted mortality rate for the total population (overall mortality rate) and that for persons under 65 years of age (under 65 mortality rate) for stomach cancer, liver cancer and lung cancer from 1950 to 1997 in Japan were calculated. Moreover, the turning point year of the mortality trend was estimated using a regression model of the rate of annual increase in each mortality rate. As the results show, a decline in the under 65 mortality rate preceding a decline in the overall mortality rate was observed in stomach cancer and male liver cancer. Also, the under 65 mortality rate due to lung cancer seemed to begin to decline in recent years for males, while the overall mortality rate has been increasing. This study suggests that the premature mortality rate is a more sensitive indicator of the effectiveness of cancer prevention. Hence, because of not only the larger burden of premature deaths, but also the sensitivity, premature mortality is considered to be suitable as a target indicator for cancer prevention strategies.     

2003-2017年中国女性宫颈癌死亡趋势分析--基于年龄-时期-队列模型

目的:探讨2003-2017年我国成年女性宫颈癌死亡趋势。方法:采用年龄-时期-队列模型和内生因子法估计宫颈癌死亡风险的年龄、时期和队列效应。结果:2003-2017年,我国女性宫颈癌死亡率整体呈上升趋势,APC模型分析显示,我国女性宫颈癌死亡风险的年龄效应随年龄增加而增大,城市和农村女性分别在70~74岁和50~54岁面临更高的死亡风险;出生队列效应整体呈下降趋势,且变化速度波动较大。结论:应积极开展宫颈癌防治相关知识宣传工作,加大宫颈癌筛查力度,提倡健康的生活方式。     

成都市温江区肺癌发病率和死亡率调查分析

目的 调查分析成都市温江区肺癌的发病率和死亡率,为制定肺癌的科学防治策略提供指导. 方法 整理成都市温江区疾病预防控制中心2008-2010年肺癌的发病资料和死亡资料,统计和分析肺癌发病和死亡病例数、粗发病率和死亡率、中国标化发病率和死亡率、世界标化发病率和死亡率等指标. 结果 成都市温江区2008-2010年肺癌粗发病率为32.65/10万,其中男性39.62/10万,女性25.56/10万.粗死亡率为19.05/10万,其中男性22.31/10万,女性15.43/10万.男性肺癌的发病率居恶性肿瘤发病率的第一位,女性居第二位.男性肺癌的死亡率居恶性肿瘤的第一位,女性居第四位. 结论 肺癌是严重危害温江居民的恶性肿瘤,但总体上温江区肺癌发病率和死亡率较低,男性和中老年是肺癌防治的重点对象.     

Apolipoprotein E phenotype,arterial disease,and mortality among older women: The study of osteoporotic fractures

This study is an investigation of the relationship between apolipoprotein E (apoE) phenotype, arterial disease, and mortality in a group of women (n = 1,751) aged 65 years and older enrolled in the Study of Osteoporotic Fractures. Crude mortality rates were highest among women with the 4-3 and 4-4 phenotypes but age-adjusted mortality showed no statistically significant variations across the phenotype groups. Using multivariate analysis, the mortality experience of women with 4-3 or 4-4 apoE phenotypes was compared to that of women with the 3-3 phenotype; no significant excess total mortality was found [relative risk (RR) = 1.2,95% confidence interval (CI) 0.8,1.8] among women with the ϵ4 allele. Similarly, neither cardiovascular (RR = 0.9,95% CI 0.5,1.8) nor cancer (RR = 1.5,95% CI 0.8,2.8) mortality rates were significantly different in this group of women. Inclusion of cholesterol levels in the regression models did not change the relative mortality risks. Among women 65–69 years of age, ϵ4 was associated with an approximate doubling of RR for death due to both cardiovascular disease and cancer. No association was found between apoE phenotype and the presence of lower extremity arterial disease (defined as an ankle/arm index of 0.9 or less). These results suggest that women with the ϵ4 who survive to age 70 years or beyond have a life expectancy that is similar to that for women homozygous for the 3 allele who comprise the majority of the population. Genet. Epidemiol. 14:147–156,1997. © 1997 Wiley-Liss, Inc.     

Geographical pattern of malignant neoplasm by cluster analysis using standardized mortality ratios (SMRs) in Ibaraki Prefecture,Japan

We investigated the geographical patterns of mortality from eight (males)/ten (females) sites of malignant neoplasm, using cluster analysis with Standardized Mortality Ratios (SMRs), and examined the relationship between the mortality structure and urbanization. To explore the geographical tendencies is important for the prevention of cancers; such as noticing risk factors associated with regional variance. The death rates, by site, gender and age from 1990 to 1994 in Japan, were obtained from Vital Statistics. The deaths and population in municipalities were obtained from "Population of Ibaraki Prefecture". These were represented as averaged values in five-year periods. As an indicator of urbanization and mortality structure, the population density of municipalities and the overall rank scores of SMRs were used, respectively. Cluster analysis formed some distinctive structures. For males, Cluster 1 included four municipalities and three of these were located in the mountainous area in northwest Ibaraki, characterized by high SMRs from bone marrow. Cluster 5 consisted of the mid-south areas, characterized by high SMRs from stomach cancer. For females, the clusters seemed to be characterized by SMRs from esophagus cancer. An association between mortality structure and urbanization was found for females, 0.364 (p<0.01), but not for males, 0.162 (p=0.14).     

安徽省1996~2005年恶性肿瘤死亡率分析

目的了解安徽省恶性肿瘤的死亡状况,为制订本地区肿瘤防治策略提供依据。方法以死亡率作为分析指标,比较全部恶性肿瘤和主要肿瘤的分地区和性别的年龄别死亡率;计算恶性肿瘤的死亡构成,比较不同部位肿瘤的构成比。结果1996~2005年安徽省恶性肿瘤平均粗死亡率为127.69/10万(标化率为113.35/10万)。城市地区死亡率前三位分别为肺癌、胃癌和肝癌,农村地区为胃癌、肝癌和食管癌。无论城市和农村,肺癌死亡率上升明显,且女性上升幅度超过男性。45岁以上人群恶性肿瘤死亡占全部肿瘤死亡的90.32%。结论肺癌、胃癌、肝癌是安徽省恶性肿瘤的主要死亡原因。肺癌应成为我省肿瘤防治工作的重点,女性肺癌快速上升原因有待进一步研究。保障中老年人健康是刻不容缓的工作。     

Mortality analysis on wastewater exposure in Shijiazhuang,Hebei, China,from 2007 to 2011

The study investigated the age-adjusted mortality rate and disease odds among deceased residents living in areas exposed to wastewater and cleanwater from 2007 to 2011, in Shijiazhuang, China. Mortality data for eight villages exposed to wastewater and 16 villages not exposed to wastewater were collected and crosschecked from multiple sources. Overall mean age-adjusted mortality rate for wastewater areas was 798/105 (95?% Confidence Interval (CI)?=?±?68), insignificantly higher than the mean mortality rate for cleanwater area, 726/105 (95?% CI?=?±?46), p?>?0.05. Malignant neoplasms and respiratory mortality and disease odds were higher in wastewater areas than in cleanwater areas, OR?=?1.7 (95?% CI?=?1.3–2.2, p?p?p?p?相似文献   

2015—2019年苏州市相城区居民死因分析

目的:对苏州市相城区2015—2019年居民死因进行分析,为制定疾病预防控制策略提供科学依据。方法:收集整理2015—2019年相城区居民死因数据,对其进行死因分析。结果:2015—2019年,相城区居民粗死亡率在644.66/10万~716.52/10万之间波动;年龄别死亡率呈"J"形变化。从死因顺位来看,相城区前6位死亡主要原因是恶性肿瘤、脑血管疾病、呼吸系统疾病、心脏病、神经系统疾病及损伤和中毒,各年龄组的主要死因各不相同;相城区居民期望寿命从82.41岁上升至83.56岁。结论:相城区主要死因是慢性非传染性疾病,占80%以上,应针对人群死因特点,有针对性地采取相应防治措施,倡导居民健康生活方式,控制主要危险因素,逐步提高居民健康水平。     

Ready-to-Eat Cereal Consumption with Total and Cause-Specific Mortality: Prospective Analysis of 367,442 Individuals

Background: Intakes of ready-to-eat cereal (RTEC) have been inversely associated with risk factors of chronic diseases such as cardiovascular disease (CVD), type 2 diabetes, and certain cancers; however, their relations with total and cause-specific mortality remain unclear.

Objective: To prospectively assess the associations of RTEC intakes with all causes and disease-specific mortality risk.

Design: The study included 367,442 participants from the prospective National Institutes of Health (NIH)–AARP Diet and Health Study. Intakes of RTEC were assessed at baseline.

Results: Over an average of 14 years of follow-up, 46,067 deaths were documented. Consumption of RTEC was significantly associated with reduced risk of mortality from all-cause mortality and death from CVD, diabetes, all cancer, and digestive cancer (all p for trend < 0.05). In multivariate models, compared to nonconsumers of RTEC, those in the highest intake of RTEC had a 15% lower risk of all-cause mortality and 10%–30% lower risk of disease-specific mortality. Within RTEC consumers, total fiber intakes were associated with reduced risk of mortality from all-cause mortality and deaths from CVD, all cancer, digestive cancer, and respiratory disease (all p for trend < 0.005).

Conclusions: Consumption of RTEC was associated with reduced risk of all-cause mortality and mortality from specific diseases such as CVD, diabetes, and cancer. This association may be mediated via greater fiber intake.     

2010—2019年广州市肝癌死亡情况与趋势分析

目的 分析2010—2019年广州市肝癌死亡情况及趋势,为降低肝癌死亡率的科学防控提供数据支持。 方法 人口资料来源于市公安局。死亡数据来源于中国疾病预防控制信息系统“人口死亡信息登记管理系统”。计算死亡率、年龄别死亡率、世界人口标化死亡率(简称世标率)和年度变化百分比(annual percentage change, APC)。利用Joint Regression Program软件分析肝癌死亡的时间变化趋势。 结果 2010—2019年广州市肝癌年平均死亡率为24.40/10万,男性(38.37/10万)高于女性(10.25/10万),男性死亡中位年龄比女性早11岁。49.69%的男性肝癌死亡发生在45～64岁组,68.95%的女性集中在65岁以上组。近10年肝癌整体、男性和女性死亡均呈下降趋势且有统计学意义,APC分别为-2.06%、-1.82%和-2.49%。15～44岁、45～64岁和65岁以上组肝癌死亡均呈下降趋势,APC分别为-3.78%、-2.01%和-1.17%。 结论 广州市近10年肝癌死亡率呈下降趋势,男性和老年人为防控重点。应重视肝癌筛查,进一步提升居民健康素养,加强自我管理能力,降低死亡风险。