徐州市沛县学生近视追踪队列建立基线调查结果分析

  目的  了解徐州市沛县一至三年级学生的近视率及相关眼部生物学参数, 建立队列观察人群, 为降低近视率提供基线参考依据。  方法  2020年6月, 采用分层整群抽样方法, 抽取沛县的2所九年制学校, 共1 952名学生。由统一培训的监测人员使用统一配备的仪器开展监测, 监测项目包括裸眼视力, 散瞳前后屈光度, 眼压值, 眼轴长度等指标, 开展近视研究队列的基线调查。  结果  徐州市沛县2学校一至三年级学生的总体近视率为21.77%, 女生(23.81%)高于男生(20.16%), 随着年龄和年级增长, 近视率不断升高, 差异均有统计学意义(χ2值分别为134.10, 144.30, P值均 < 0.05), 6岁组已出现近视, 为8.87%。近视组学生左右眼的眼轴长度均高于非近视组学生, 差异均有统计学意义(t值分别为411.95, 366.85, P值均 < 0.01);近视组学生左眼的眼压值和平均角膜曲率均高于非近视组, 差异均有统计学意义(t值分别为5.91, 10.22, P值均 < 0.05)。  结论  徐州市沛县一至三年级近视率较低, 但6岁组已出现近视, 随着年龄和年级增长, 近视率不断攀升。探寻有效可行的近视防控措施刻不容缓。     

澳门2005年小学生近视现况及影响因素分析

目的 了解澳门小学生近视现况以及影响其近视的主要危险因素,为制订预防近视的相关措施提供参考依据.方法 应用分层整群抽样方法,抽取澳门14所小学学生2 492名,对所抽取的小学生进行视力检查和危险因素的问卷调查.结果 澳门小学生近视患病率为60.4%,轻度近视的构成比为75.9%.女生近视率(63.3%)高于男生(58.0%),高年级学生近视率(69.2%)高于低年级学生(49.0%),中国籍学生近视率(61.9%)高于非中国籍学生(43.6%);"阅读1 h没有休息10 min"和"每年不进行视力检查"是近视的危险因素.结论 澳门小学生近视率较高,以轻度近视为主,影响近视主要原因为外在因素.     

北京市中小学生近视状况及其影响因素分析

目的 了解北京市中小学生近视的患病率及其影响因素.为有效防治近视提供依据.方法 采用分层整群抽样方法,对北京市15 316名中小学生进行问卷调查和验光检测.结果 北京市中小学生近视率为53.8%,城区与郊区学生差异无统计学意义(P=0.28),重点与非重点学校、男生与女生之间差异均有统计学意义(P值均<0.01).近视与年龄、视近距离、视近持续时间、父亲学历以及家族史密切相关.看书、看电视距离适当是视力保护因素.结论 中小学生近视是严重的公共卫生问题,应把有近视家族史的学生作为防近工作的重点.良好用眼习惯是视力的保护因素.     

父母有无近视中小学生近视情况及影响因素比较

目的了解和比较父母近视者与父母不近视者子女近视发生的影响因素,为针对性地开展学生近视防控工作提供科学依据。方法采用整群随机抽样法对南京、南通、镇江市2 311名中小学生近视情况进行问卷调查,比较父母是否近视学生近视发生情况及其主要影响因素。结果父母双方均近视者学生近视率显著高于父母双方均不近视者;学生每天学习用眼时间长、睡眠时间短、睡眠后精神状态差、做作业姿势差、喜欢躺着看书是近视发生的危险因素,体育锻炼时间长是近视的唯一保护因素,但这些影响因素不是与所有学生近视发生有关。父母均不近视学生和父母一方或双方近视学生近视发生的影响因素不完全一致,做作业姿势差,睡眠时间短、睡眠后精神状态差是父母均不近视学生的主要危险因素;每天学习用眼时间长、晚上自习光线强、喜欢走路或坐车看书是父母一方或双方近视组学生近视发生的危险因素,每天锻炼1 h以上是父母一方或双方近视组学生发生近视的保护因素。结论父母近视或不近视学生近视发生的影响因素侧重有所不同。近视的预防控制应根据这些异同采取针对性的干预策略和措施才可取得事半功倍的效果。     

南通市儿童青少年近视现状调查

目的 调查南通市儿童青少年视力及屈光状态,摸清儿童青少年近视患病总体情况,为近视防控提供依据.方法 采用分层整群抽样方法,兼顾农村和城市、普通高中和职业高中,随机抽取4967名在校学生进行裸眼视力、矫正视力检查、屈光检查.结果 调查南通市4 967名青少年儿童中,检出近视患病人数3 177人,总体近视患病率67.89％...     

漯河市中小学生近视患病情况调查

了解漯河市中小学生近视患病情况和影响因素,为采取相应干预措施提供依据.方法 采用分层整群抽样方法,从漯河市所有中小学中随机抽取9所学校的7 059名学生作为调查对象,分期分批进行眼科检查,同时发放调查问卷以了解学生用眼卫生知识掌握情况和用眼行为等.结果 漯河市中小学生总体近视率为59.1%,其中小学生为31.0%,初中生为59.4%,高中生为82.5%;小学生以轻、中度近视为主,初中生和高中生以中、高度近视为主;男生近视率为54.2%,女生为65.2%;各个年级女生近视率均高于同年级男生.结论 课业负担重、休息时间少、睡眠不足、女性、用眼卫生知识的欠缺、不良的用眼行为等是当前中小学生近视的主要危险因素.学生近视的防治工作应从小抓起,并贯穿于整个求学阶段.     

Poisson和Cox回归模型在队列随访资料分析中的应用和对比

Ｐｏｉｓｓｏｎ与Ｃｏｘ回归模型是流行病学队列随访资料分析中常用的两类多变量分析方法。本文对有关这两类多变量回归模型的统计方法等问题进行了系统的回顾（相乘模型），并用一个实例的结果来说明两者的应用。从本文的结果和讨论来看，Ｐｏｉｓｓｏｎ和Ｃｏｘ回归模型均适合于队列随访资料的分析，但两者各有一些优势和不足。最后，笔者就目前两者的应用情况和相互比较提出了一些看法。此外，还讨论了其它形式的回归模型（相加模型）及在回归模型中如何引入外部对照率等。     

江苏省海门市原发性肝癌队列随访结果分析

目的 分析海门原发性肝癌队列（海门队列）中死亡情况及其危险因素。方法 海门队列自1992年建立,共纳入25~69岁健康人群89 789人。对入组研究对象进行基线调查并采集外周静脉血10 ml,检测HBsAg,并对生存状况及肝癌死亡情况每年进行1次随访。计算肝癌死亡率,采用Cox比例风险模型进行多因素分析。结果 截至2014年12月31日,海门队列共随访1 299 611人年,其中2 583（男性2 149,女性434）例死于肝癌。肝癌死亡病例中HBsAg阳性者占73.87%。男女性肝癌死亡率分别为247.80/10万人年和100.38/10万人年。多因素分析显示,HBsAg阳性是海门队列男女性原发性肝癌最为主要的危险因素（男性：HR=15.97,95% CI：14.29~17.85;女性：HR=21.63,95% CI：16.16~28.96）。年龄、吸烟史、既往肝炎史以及肝癌家族史均与原发性肝癌发病风险有关。结论 海门地区成年人原发性肝癌死亡率处于较高水平,HBV感染仍为该地区最主要的危险因素。     

上海市原南汇地区小学生近视状况及其影响因素分析

了解上海市原南汇地区小学生视力状况及其影响因素,为小学生视力保健工作的开展提供科学依据.方法 采用整群抽样调查方法,对3 385名上海市原南汇地区一~五年级小学生进行视力检查,并发放问卷进行相关因素调查.结果 学生近视率为60.3%,其中中度近视为42.7%.女生近视率(63.1%)高于男生(57.6%).小学生近视率随着年级的升高而呈现增高趋势(x2=370.5,P<0.01).Logistic回归分析结果显示,学龄前健康状况、学习压力、读写姿势、母亲视力以及照明光源是小学生近视发展的影响因素(P值均<0.05).结论 小学生近视率随着年级与学习压力的增加而上升.学校需重点关注高年级学生,且需将视力预防保健工作前移,动员家长积极主动配合并参与儿童正确读写姿势的培养,构筑家庭、学校、社会三位一体的视力预防保健体系.     

农村订单定向医学生就业与规培:两年跟踪分析

目的:跟踪分析两届订单定向医学生毕业后两年的就业与规培情况,探讨首届定向生规培结束后能否"回乡"履约,并提出政策建议。方法:选取中西部四所医学院校,分别对2015届305名和2016届435名订单定向生在毕业当年建立队列,随后连续两年开展随访调查和深入访谈。结果:当前订单定向毕业生履约率高于99%,工作落实率高于98%,2015届和2016届定向生编制落实的比例分别为86.7%和93. 8%,参加规培的比例分别为97. 4%和68. 3%,规培期间月总收入分别为3 879元和3 783元。结论:与首届定向生相比,2016届毕业生的工作及编制待遇落实更为顺畅,但是出现与家乡所在地签约率下降、定向工作地点限制过严、部分定向生参加规培未得到有效落实等问题。相关部门应尽早明确规培与"回乡"的转接办法,充分调动地方政府的积极性,促进定向生履约。     

Two-year experience with telemedicine in the follow-up of patients in home peritoneal dialysis

We evaluated the use of telemedicine in the long-term control of stable patients undergoing peritoneal dialysis at home. From September 2003 to August 2005, patients were randomly selected from current cases and invited to join study group A, in which they had telemedicine support. Patients not selected for this group, or who refused the invitation, were placed in study group B, and used for comparison. There were 25 patients in group A and 32 patients in group B. Videoconferencing equipment was installed in each patient's home, connected to a videoconferencing unit at the hospital by three ISDN lines. Patients in group A were followed for a mean of 8 months (range 3-24) with alternate months of teleconsultations and hospital visits. A total of 172 teleconsultations were conducted. A mean of 22 min (SD 9) were spent on each teleconsultation, significantly less than in hospital consultations, which took a mean of 33 min (SD 8) (P<0.01). In 148 teleconsultations (89%) medical treatment was modified. In 4 cases (2%) patients needed a hospital visit. In all instances (100%) the condition of the catheter exit site and the presence of oedema could be evaluated. In group A, the estimated cost of telemedicine was euro198 and that of a hospital visit was euro177. The mean hospitalization rate was 2.2 days/patient/year in group A and 5.7 days/patient/year in group B (P<0.05). Home telemedicine appears to be clinically useful in the long-term follow-up of stable patients undergoing peritoneal dialysis, and the costs and savings also seem to be encouraging.     

Two-year follow-up of changes in clinical chemistry in Singaporean Norplant acceptors: metabolic changes

In this longitudinal study involving 100 Singaporean acceptors, the effects of Norplant on metabolic function was evaluated. With respect to liver function, the results at the end of two years still indicate the presence of possible hepatocellular dysfunction. Despite a 4.5% decrease in serum bilirubin during the second year, the mean serum bilirubin still remained significantly raised (p less than 0.001). Furthermore there was a significant fall in total proteins and globulin during the period under review (p less than 0.001). However mean levels of all three parameters remained within the normal clinical range. As regards lipid metabolism, the total triglycerides and total cholesterol still remained significantly decreased at the end of two years (p less than 0.001). The LDL-cholesterol, which was significantly decreased at the end of one year, increased by 2.2% during the second year. However, this rise in LDL-cholesterol was not significant and was still below the preinsertion level. The HDL-cholesterol levels returned to their preinsertion levels after a significant increase in the first year. The HDL-cholesterol/Total cholesterol - HDL-cholesterol ratio returned to its preinsertion value at the end of two years while the LDL-cholesterol/HDL-cholesterol ratio was still significantly lower than the preinsertion ratio (p less than 0.05). As we have not incorporated a simultaneous non-steroid treated control group, the observed changes in lipoprotein lipids could be attributed to extraneous factors such as diet, exercise or other environmental changes.(ABSTRACT TRUNCATED AT 250 WORDS)     

Two-year follow-up of changes in clinical chemistry in Singaporean Norplant acceptors: haemostatic changes

A longitudinal study of coagulation parameters was carried out on 100 Singaporean acceptors using Norplant for contraceptive purposes. At the end of 2 years of use, results from this ongoing study indicate that these acceptors continue to have an increased predisposition to thrombosis as evidenced by significant increases in platelet count and aggregability. The shortened but stable prothrombin time and activated partial thromboplastin time and increase in certain coagulation factors indicate that Norplant acceptors still have a possible potential for hypercoagulation at the end of two years of use.     

中学生流感疫苗接种2年后免疫效果评价

了解流感疫苗接种2a后对中学生的保护作用,为探讨流感疫苗对青少年的长期保护作用提供参考.方法 采用回顾性队列研究方法,整群分层抽取上海市长宁区4所中学1 048名学生进行问卷调查,根据流感疫苗的接种情况,将观察对象分为接种组和对照组.结果 不同年级、不同性别群体接种组和对照组中学生流感样病例发病密度差异均无统计学意义(P值均>0.05),对照组女生发病密度高于男生(x2=6.43,P=0.01);初高中学生中,均表现为低年级组(六、七年级和高一、高二)发病密度高于高年级组(八、九年级和高三)(x2=13.62,P<0.01);疫苗保护率在接种后0.5 a最高(58.30%),随后逐渐下降,在接种后第二个流感流行周期中疫苗不再有保护作用.结论 流感疫苗在接种后第一个流感流行周期内保护效果好,但免疫力不持久,需每年定期接种.     

HBV,HDV and HIV infections in 242 drug addicts: Two-year follow-up

Of 242 north Italian heroin addicts, 24 (9.9%) were HBsAg positive. HBeAg was positive in two of them (8.3%), anti-HBe in 16 (66.6%) and anti-HDV in 21 (87.5%). Of the 218 HBsAg negative, 182 (83.5%) had anti-HBc, 72 (33.0%) anti-HBe and 97 (44.5%) anti-HBs. One-hundred-eighty-five drug addicts were anti-HIV positive (76.4%); 77 of these (41.6%) were asymptomatic, 93 (50.3%) had PGL and 15 (8.1%) ARC. T4+ cell count was significantly lower in subjects with ARC as was T4+/T8+ ratio in subjects with PGL and ARC. During a median follow-up of 9.5 months (range 4–25), we observed three new cases of hepatitis (two caused by NANBV and one by HBV with HDV coinfection) and one new HIV infection. Ten anti-HIV positive subjects developed PGL and one AIDS.     

苏中地区农村普通人群尿镉水平及参考值研究

目的分析苏中地区农村普通人群尿镉(Cd)含量,探讨其参考值范围,为我国制定尿镉参考值范围提供依据。方法在江苏中部地区某市,按东西南北中5个方位抽取5个乡镇,共调查1 000人;在每个乡镇采集3份农田土壤和当年产大米6份,共45份环境样品,进行镉含量测定。结果土壤、大米中镉的平均含量分别为0.16、0.05mg/kg,均低于国家标准限值(0.20mg/kg)。总人群尿镉(肌酐校正值)的中位数为0.19μg/g,参考值上限为0.98μg/g。尿镉含量在性别组间差异无统计学意义。吸烟组尿镉含量明显高于非吸烟组(P0.01)。尿镉含量随着年龄和烟龄的增加而呈不同程度的增高趋势。尿镉与NAG、RBP有弱相关性,与β2-MG无相关性。结论苏中地区农村普通人群尿镉含量处于正常浓度水平,尿镉含量可能受吸烟因素的影响。