酒精性脂肪肝临床流行病学调查及病因量化标准探讨

目的探讨饮酒与脂肪肝的关系 ,以及酒精性脂肪肝病因的量化标准。方法将连续性体检人群分成非饮酒组、白酒组 (按日均饮酒量下分 <5 0g、5 0～ 1 0 0g及 >1 0 0g白酒组 )和啤酒组 (按日均饮酒量下分 <2 5 0mL、2 5 0～ 5 0 0mL及 >5 0 0mL啤酒组 ) ,对各组脂肪肝检出率及脂肪肝患者饮酒至发病时间进行流行病学调查。结果 5 0～ 1 0 0g及 >1 0 0g白酒组 ,2 5 0～ 5 0 0mL及>5 0 0mL啤酒组脂肪肝检出率分别为 4 3.6 % ,5 0 .0 % ,6 4.5 % ,6 6 .7% ,较非饮酒组的 2 5 .0 %明显增高 (P <0 .0 1 )。各组中脂肪肝患者饮酒时间显著高于同酒量非脂肪肝者 (P <0 .0 1 )。以日均饮白酒 80g、时间 9.0年 ,或日均饮啤酒 4 0 0mL、时间 5 .0年作为各自酒精性脂肪肝病因量化标准 ,分别具有 82 .6 %、88.6 %敏感性 ,72 .2 %、78.3%特异性。结论饮酒与脂肪肝的发生具有量效和时效关系 ,日均饮白酒 80g、时间 9.0年 ,以及日均饮啤酒 4 0 0mL、时间 5 .0年为其各自酒精性脂肪肝较好的病因量化诊断标准。     

新生儿血清Alb与脓毒血症病情和预后的相关性

目的分析新生儿血清白蛋白(Alb)水平与早期脓毒血症病情诊断和预后的相关性分析。方法对浙江省余姚市人民医院2016年11月至2017年12月的122例新生儿的临床资料进行回顾性分析,分为脓毒血症组41例,非脓毒血症组54例,对照组27例。比较三组新生儿临床基本资料(性别、胎龄、日龄及出生体质量)、低蛋白血症和死亡的发生情况。依据新生儿Alb水平,分为A组(Alb低于25g/L)61例,B组(Alb为25~30g/L)29例,C组(Alb高于30g/L)32例。比较三组新生儿脓毒血症、多脏器功能障碍、住院时间及死亡的情况。结果脓毒血症组低蛋白血症(85.37%)和死亡率(14.63%)较非脓毒血症组(48.15%、1.85%)、对照组(22.22%、0)均显著升高(χ~2=28.01,P<0.05;χ~2=9.15,P<0.05)。A组脓毒血症(49.18%)、多脏器功能障碍(57.38%)及死亡率(1.48%)较B组(20.69%、13.79%、0)、C组(15.63%、9.38%、0)显著升高,且住院时间(12.87±1.46)d较B组(10.02±2.32)d、C组(8.96±2.11)d明显延长(χ~2=13.44,P<0.05;χ~2=28.60,P<0.05;χ~2=7.43,P<0.05;F=14.97,P<0.01)。结论新生儿血清Alb浓度越低,发生脓毒血症、多脏器功能障碍及死亡的风险性越高,住院时间明显延长,预后状况较差,提示血清Alb浓度可用于评估新生儿早期脓毒血症病情及预后状况。     

饮酒与脂肪肝的关系研究

目的探讨不同酒精摄入量对脂肪肝发生率及其危险因素高血糖、高血脂等代谢紊乱的影响。方法选取2013年10—12月期间温州市中心医院体检中心394名体检人员进行问卷调查,并进行人体学和实验室指标测量作分析。结果经LSD-t检验,甘油三酯随着饮酒量增加而升高(P0.05);高甘油三酯、高尿酸、高胆固醇在不同饮酒量组间的检出率差异有统计学意义(P均0.05),经卡方线性趋势检验显示,高甘油三酯及高尿酸患病率随着酒精摄入量增加而升高(P均0.05)。饮酒量在脂肪肝和非脂肪肝的分布差异无统计学意义(P0.05)。二项分类变量Logistic回归分析显示,腰臀比超标、高血压、超重肥胖、高甘油三酯血症为脂肪肝的独立危险因素,但未见"日均饮酒量"是脂肪肝的独立危险因素。结论腰臀比超标、高血压、超重肥胖、高甘油三酯血症是脂肪肝的危险因素,饮酒虽可导致高甘油三酯、高尿酸患病率升高,但未发现饮酒对脂肪肝患病率的直接影响。     

多器官功能障碍综合征病人低白蛋白血症的临床分析

目的 :研究多器官功能障碍综合征 (MODS)病人低白蛋白血症的临床特点。　方法 :选择 80例APACHE Ⅱ评分为 17～ 18分的MODS病人 ,分为腹腔感染组和非腹腔感染组 ,动态监测其血清白蛋白浓度 ,对结果进行统计学处理。　结果 :80例MODS病人低白蛋白血症的发生率为 73 8% ,其中腹腔感染组发生率为 97 0 % ,最低值发生于第 2天 ,为 (2 4± 3.5 ) g/L ,非腹腔感染组的发生率为 5 7.4 % ,最低值发生于第 7天 ,为 (35± 2 .9)g/L ,二者无论在低白蛋白血症的发生率 ,还是最低值发生时间及水平上的差异均非常显著 (P <0 .0 1) ;发生低白蛋白血症病人的病死率为 4 9 1% ,明显高于未发生低白蛋白血症者 (2 3.8% ,P <0 .0 5 )。发生低白蛋白血症的MODS病人中 ,腹腔感染组病死率为 5 9.4 % ,明显高于非腹腔感染组 (37.0 % ,P <0 .0 5 )。　结论 :危重病人低白蛋白血症的发生率较高 ,合并腹腔感染的病人较无腹腔感染者无论在低白蛋白血症的发生率、发生时间、降低程度都更明显 ,且降低的程度与预后呈明显相关。     

贵州省成人居民饮酒现状调查

目的了解贵州省成年民居民饮酒现状,为制定相应的干预措施提供科学依据。方法采用多阶段随机整群抽样方法,对贵州省12个县(区)≥18岁共9 280名居民进行一般情况及饮酒相关情况的问卷调查。结果调查对象饮酒率为32.1%。其中,男、女性饮酒率分别为52.8%,13.2%;在不同年龄组中,45~59岁组饮酒率最高;城市、农村饮酒率分别为30.8%,32.6%;日均饮酒量为25.2 g。其中,男性为29.9 g、女性为7.9 g;在不同年龄组中,以45~59岁组最高,为30.4 g;男性中每周饮酒5 d以上者32.4%,女性12.7%;饮酒种类中以高度白酒饮用率最高(43.5%),其后依次为啤酒(42.6%)、米酒(36.7%)、低度白酒(28.2%)、葡萄酒、黄酒及青稞酒。高度白酒饮用者以中年男性居多,低度白酒者以老年男性为主。啤酒饮酒者以青年人群为主,女性居民米酒和葡萄酒饮用率高于男性。其中米酒饮用者以老年女性为主。饮酒者中具有危险饮酒行为者9.4%。其中,男性10.5%,女性5.2%,男女差异有统计学意义(χ2=16.730,P0.001)。有害饮酒者11.1%。其中,男性13.0%,女性3.6%,男女差异有统计学意义(χ2=45.296,P0.001)。结论贵州省饮酒现象较为普遍,应加强饮酒危害健康的相关知识宣传,降低饮酒相关疾病患病率。     

铁路职工脂肪肝与饮酒的相关性研究

[目的]研究铁路职工饮酒习惯与脂肪肝患病率的关系。[方法]采用病例对照研究方法,对共调查304例经B超诊断的脂肪肝患者及540人对照组,用SAS（6.12）软件对资料进行χ^2检验。[结果]饮啤酒和白酒者患脂肪肝的相对危险度较很少饮酒者分别增加1.092倍和2.098倍,饮酒34次/周和每天饮酒者患脂肪肝的相对危险度较很少饮酒者分别增加1.329倍和3.329倍,饮酒等级（g/日×年）〉600者患脂肪肝的相对危险度较〈600者增加了57.4%。[结论]饮酒习惯与脂肪肝的发生率有显著相关性。     

脂肪肝与代谢相关性疾病的关系

[目的]研究脂肪肝与高血压、肥胖、血糖、血脂及血尿酸等代谢相关性疾病的关系,为临床治疗提供参考。[方法]对安岳县1450例体检者均行乙肝两对半、肝功、肾功、血脂、血糖、血尿酸、血常规、尿常规检查及肝、胆、胰、脾、双肾等脏器的超声检查,比较脂肪肝患者与非脂肪肝患者患高血压病、肥胖、糖尿病、高脂血症及高尿酸血症的差异;脂肪肝检出率在年龄及性别上的差异。[结果]脂肪肝组并存肥胖、高血压、糖尿病等疾病者明显高于非脂肪肝组。脂肪肝组中,男性脂肪肝检出率明显高于女性,差异有统计学意义(χ2=51.901,P﹤0.001)。40～49岁及50～59岁男性脂肪肝检出率均高于女性,差异有统计学意义(卡方值分别为χ2=42.866和χ2=14.181)。[结论]脂肪肝是代谢相关性疾病在消化器官的局部表现。     

体重指数、高脂血症、脂肪肝3者的关系探讨

目的　探讨体重指数 (BMI)、高脂血症、肪肪肝 3者的关系。方法　从 1999-2 0 0 1年在华西医大附属第三医院门诊健康体检人群中整群抽取完整资料 2 110例 ,对不同水平的BMI组别的高脂血症、脂肪肝的检出率进行比较 ;对不同血脂水平组别进行脂肪肝检出率比较。结果　随BMI的增加 ,高脂血症、脂肪肝的检出率增加 ,其组间差异有统计学意义 (P <0 0 1) ;高脂血症组别脂肪肝的检出率高于无高脂血症组别 ,其差异有统计学意义 (P <0 0 1)。脂肪肝的检出率与血脂成份有关 ,甘油三脂水平越高的组别脂肪肝的检出率越高 ,其组间差异具有统计学意义 (P <0 0 1) ,而不同水平胆固醇组别脂肪肝检出率差异无显著性 (P >0 0 5 )。结论　体重指数与高脂血症、脂肪肝的发生呈正相关 ,脂肪肝的形成与甘油三脂关系密切。     

饮酒对人血清γ—GT活性影响的初步报告

本文结果表明饮酒及饮酒量与人血清γ谷氨糖肽酶活性等于或大于50单位阳性率呈正比关系.经统计学处理,不饮组、少量组、中量组、大量组间差异极显著(P<0.01).白酒组、黄酒组的γ-GT等于或大于50单位阳性率亦显著高于啤酒组(P<0.001,P<0.01).故饮酒者要控制饮酒量,尤其是烈性酒的量.     

体重指数与高脂血症、脂肪肝和高血压病的相关性观察

目的 :观察体重指数与高脂血症、脂肪肝和高血压病的相关性。方法 :将不同体重指数人群分组 ,观察不同体重指数人群间血清胆固醇及甘油三脂水平、脂肪肝和高血压病检出率的差异。结果 :随着体重指数的增高 ,血清胆固醇和甘油三脂水平明显升高 (P<0 .0 0 1) ,脂肪肝及高血压病的检出率明显上升 (P<0 .0 0 5 )。结论 :体重指数与高脂血症、脂肪肝和高血压病的相关性非常显著。     

企业职工高尿酸血症与血压、血脂、血糖的相关性研究

目的探讨企业职工高尿酸血症（HUA）与血压、血脂、血糖的相关性,为企业进行健康管理提供依据。方法以中国石油长庆油田公司各下属企业为抽样单位,整群随机抽取2个单位,每个单位中所有的HUA者作为HUA组,共720人;同时在尿酸水平正常者中随机选取620人为正常组。通过Logistic回归分析HUA与年龄、性别、血压、血脂、血糖的关系。结果HUA合并高血压、高血脂、空腹m糖受损任意一项、两项、三项的比例均远高于正常组（OR值分别为：4．036,2．562,4．174）。多因素Logistic回归发现：男性、收缩压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇是HUA的危险因素（OR值分别为7．736,2．309,1．721,2．761,1．411）;高密度脂蛋白胆固醇为HUA的保护因素（OR值为0．211）。结论HUA存在性别差异,且与血压、血脂密切相关。企业对职工的健康管理应充分考虑多危险因素的综合作用,全面的进行健康教育及干预。     

癌缺氧病因及预防和治疗

目的 探讨癌及安阳林州市食管癌高发原因及癌病因预防和治疗措施.方法 对林州市食管癌等疾病现场进行调查,在进行10余年统计分析基础上,综合分析了全国156篇文献成果.结果 提出癌缺氧病因学说,使用制氧机、按摩器、饮用纯净水治疗恶性肿瘤,取得良好效果,改水能够大幅降低林州市居民食管癌发病率、死亡率.结论 癌可能是由于机体长...     

Recruitment and retention challenges and successes

Objective: Addressing health disparities requires well designed, culturally adapted research. However, recruiting/retaining minority participants has often been challenging. We present strategies used to successfully recruit and retain rural Hispanic women during a breastfeeding education intervention.

Design: This study involved a two-group repeated measures quasi-experimental design with assessments at seven intervals between enrollment and 6 months postpartum. Participants (Hispanic women?≥?15 years old) were recruited through a regional hospital.

Results: We successfully met our recruitment goals, most women contacted were enrolled (46 of 58), and 100% completed the study.

Discussion: Research staff with ties within the community helped establish trust. Using bilingual study materials, simple language, and an interpreter addressed language/literacy concerns. Phone assessments facilitated participation as transportation was an issue. Accommodating requests to deliver or mail study materials and providing incentives were important. Extra effort was needed to maintain contact when phone service was disrupted or participants moved. Keys to success were persistence, flexibility, and alleviating barriers to participation.     

Continuity and change in neighborhood disadvantage and adolescent depression and anxiety

We used data from the Fragile Families and Child Wellbeing Study which includes a sample of adolescents of age 15 at the most recent wave (between 2014 and 2017) from mainly low-income urban families in the United States, to examine the association between neighborhood poverty entries and exits and adolescent depression and anxiety. In addition, we examined whether these associations differed by gender. Adolescents who consistently lived in disadvantaged neighborhoods had the highest level of depression and anxiety. Those who entered poor neighborhoods were more depressed than those who never lived in poor neighborhoods. Those who exited poor neighborhoods showed no significant difference in depression and anxiety compared to those never lived in poor neighborhoods. Furthermore, these associations applied to adolescent girls only and were not statistically significant for boys. The results suggest that neighborhood poverty has cumulative negative impacts on adolescent mental health and disproportionally affects adolescent girls. Reducing neighborhood poverty would substantially improve the health of adolescents, especially girls, which would reduce health disparities.     

Enabling positive change: Progress and setbacks in HIV and sexual and reproductive health and rights

At a point in history when the future of sexual and reproductive health including HIV looks particularly uncertain, it is helpful to recognise that many of the challenges currently faced are neither new nor insurmountable. Reflecting on past achievements and lessons learned helps us to have confidence that positive change is feasible. This paper reflects on some of the changes observed in countries like India and Mozambique and identifies a range of factors which need to coalesce to enable these developments, along with specific contextual factors. It is the combination of these influences rather than any one of them alone that brought about the change in the three instances described – fostering a positive political response to HIV in its early years in India; bringing about policy reform on abortion in Mozambique; and increasing contraceptive prevalence and age at marriage in some districts in Bihar, India. Change is always fragile and susceptible to setbacks, but change-seekers can learn in the process and gain renewed hope that progress can and often does take place if they persevere.     

初产妇与经产妇焦虑抑郁状态分析及干预

目的：分析初产妇、经产妇心理状态特点,以便采取更有效的干预措施。方法筛选2014年6月至2015年1月在咸阳市旬邑县妇幼保健院产科门诊产前检查的健康初产和经产妇各60名,孕周为28~40周。入组时用焦虑自评量表( SAS)、抑郁自评量表(SDS)对两组孕妇进行心理评定,并给1次支持性心理干预(40~60分钟),1周后再次用SAS、SDS对两组孕妇进行评定分析。结果经产妇干预前SAS(50.73±3.45)、SDS(49.13±3.86)评分明显高于初产妇SAS(42.45±2.08)、SDS(41.77±2.21),差异均有统计学意义(t值分别为-15.921、-12.817,均P<0.01);干预后两组SAS、SDS评分均比干预前明显降低,差异均有统计学意义(t值分别为14.999、15.413;15.724、15.832,均P<0.01);干预后经产妇 SAS(38.61±5.02)、SDS(39.10±3.03)评分明显高于初产妇SAS(34.88±3.31)、SDS(32.01±4.27),差异均有统计学意义(t值分别为-4.805、-10.489,均P<0.01)。结论初产妇和经产妇均伴有焦虑、抑郁情绪,干预前后经产妇抑郁、焦虑情绪均较初产妇明显,支持性心理干预能有效改善孕妇的不良情绪。     

儿童青少年超重肥胖评价方法及SPSS和SAS实现

超重肥胖已成为世界各国儿童青少年面临的重大公共卫生问题之一。现行的儿童青少年超重肥胖筛查标准不统一,逐条评价或自行编写程序容易出错且效率较低。本研究以中国学龄儿童青少年超重与肥胖筛查标准为例,详细介绍了国际和中国共四种评价儿童青少年超重肥胖的方法和步骤,结合具体案例详细介绍其应用方法,同时编制SPSS和SAS程序包和解...     

Car ownership and the association between fruit and vegetable availability and diet

Objective

Nearly all research on the food environment and diet has not accounted for car ownership — a potential key modifying factor. This study examined the modifying effect of car ownership on the relationship between neighborhood fruit and vegetable availability and intake.

Methods

Data on respondents' (n = 760) fruit and vegetable intake, car ownership, and demographics came from the 2008 New Orleans Behavioral Risk Factor Surveillance System. Shelf space data on fresh, frozen, and canned fruits and vegetables were collected in 2008 from a random sample of New Orleans stores (n = 114). Availability measures were constructed by summing the amount of fruit and vegetable shelf space in all stores within defined distances from respondent households. Regression analyses controlled for demographics and were run separately for respondents with and without a car.

Results

Fruit and vegetable availability was positively associated with intake among non-car owners. An additional 100 m of shelf space within 2 km of a residence was predictive of a half-serving/day increase in fruit and vegetable intake. Availability was not associated with intake among car owners.

Conclusions

Future research and interventions to increase neighborhood healthy food options should consider car ownership rates in their target areas as an important modifying factor.     

医用电子仪器中干扰与噪声的防止与抑制(上)

介绍了医用电子仪器中的干扰与噪声的产生、危害、抑制及其应用，其中有的干扰与噪声是首次提出的。