老干部住院患者死因回顾分析

目的分析60岁以上老干部住院患者的死因。方法回顾我科15年来337例60岁以上老干部住院死亡患者病例,分析致死疾病的顺位排列。结果老干部住院患者死因前5位构成顺位依次是恶性肿瘤、呼吸系统疾病、脑血管疾病、循环系统疾病、消化系统疾病。结论增强干部保健意识,改善生活方式, 定期全面体检,做到对疾病早防早诊早治,是降低死亡的关键。     

650例60岁以上老年住院患者死因分析

目的分析老年住院患者死亡的主要病种，为提高老年人群生存质量，延长生命提供科学防治依据。方法对650例60岁以上老年住院病例的年龄、性别及死因进行统计分析。结果威胁老年人群寿命的主要疾病为循环系统疾病、恶性肿瘤和呼吸系统疾病，且男性大于女性。结论改善男性人群的生活质量，减少男性人群的生存压力，从而延长老年男性人群的生存寿命。     

418例60岁以上老年住院患者死亡原因分析

目的通过对我院1995-2004年60岁以上418例住院死亡患者死因病种分析,了解城区老年主要的致死疾病原因。方法运用湖北中医学院病案管理软件对病案首页进行计算机管理,筛选60岁以上的住院死亡病案按国际疾病ICD-10进行分类统计。结果 60岁以上的老年住院人数只占同期住院人数的15．8％,其死亡人数占同期住院死亡人数的42．09％,男性占主要。死因顺位一、二位是循环系统疾病和恶性肿瘤,占死亡人数的67．22％。死因主要病种顺位是脑出血、肺癌、损伤,男性以肺癌居首位,占男性恶性肿瘤死亡人数的36．5％;女性致死疾病病种以脑出血居首位。结论通过对老年人致死疾病原因分析,早期重点针对性的做好老年主要致死疾病的防治工作,从而改善老年人生存和生活质量,降低老年患者病死率。     

综合性医院老年住院患者疾病谱及死亡谱分析

目的分析老年专科病区住院老年患者疾病谱和死亡疾病谱的分布特征及变化趋势。方法采用回顾的方法以我院2004年1月至2008年12月间收治的大于60岁老年人住院患者2562例为对象,计算疾病患病率及构成比,并进行排序;按《国际疾病分类MCD-9标准》进行死因分类。结果患病率在前十位的依次是:原发性高血压、肺部感染、冠心病、慢性阻塞性肺病、胆囊炎胆囊结石、2型糖尿病、脑血管意外、前列腺增生、恶性肿瘤、痴呆;死亡病例前五位疾病排序依次:呼吸系统、恶性肿瘤、消化系统、脑血管意外、循环系统。结论循环系统、呼吸系统、神经系统和恶性肿瘤是老年人的多发病,前列腺增生是老年男性的多发病;心、脑血管疾病、肿瘤一直排在老年人住院疾病前列,是当前老年慢性病的防治重点,是医疗防治工作和卫生资源配置的重点。呼吸系统疾病、恶性肿瘤、消化系统疾病是老年人的主要杀手,应高度重视老年慢性病的康复和肿瘤病的早期诊治。     

2006年我院老年住院患者疾病构成分析

目的了解我院老年住院患者疾病构成情况,为老年疾病的防治提供临床资料。方法分析我院2006年60岁以上住院患者的疾病构成和病种分布。结果老年住院患者疾病构成以循环系统、消化系统、肿瘤、神经系统和呼吸系统疾病为主要疾病。结论加强慢性病的防治工作,普及健康教育,减轻老年患者的住院费用负担,提高老年人群的生存质量。     

17例老年干部保健对象糖尿病控制情况分析

目的观察中老年干部保健对象糖尿病患者各项指标控制情况,从一个方面评价干部医疗保健工作的成效。方法选取2003~2005年在宁夏回族自治区人民医院干部病房住院并已确诊患有糖尿病的老年患者17例,按照糖尿病三级预防的有关要求,加强临床治疗、疾病干预、宣教指导和日常患者的自我管理等措施,对其三年住院的血糖进行相关检查分析。结果患者的糖尿病控制较理想。结论加强糖尿病的三级预防,对已经发现的危险因素进行积极干预,制定强有力的保健措施,使得我们所服务的特殊群体患者糖尿病控制达标情况高于一般糖尿患者群2~3倍,充分证实,加强干部医疗保健工作对控制保健对象糖尿病方面有重要意义。     

老年患者肺功能检测的操作体会

肺功能测定是一项十分重要的呼吸系统疾病诊治技术，能客观地检测呼吸功能，用于疾病的诊断和鉴别诊断。由于部分老年患者听力减退、接受能力迟缓和疾病等因素影响，因此肺功能检测过程中的配合就显得尤为重要。我科在2000年至2008年对2250例住院老年患者进行肺功能检测，现体会如下。     

干部病房老年住院患者医院感染危险因素分析及对策

目的分析干部病房老年住院患者医院内感染现状、感染部位及细菌分布,探讨医院内感染发生的危险因素,为防控老年患者医院感染提供科学依据。方法回顾性分析2012～2014年340例干部病房老年住院患者的临床资料,对于合并院内感染的患者,分离培养病原菌,并探讨老年患者发生医院感染的危险因素。结果 340例老年患者并发医院感染40例,感染率为11. 76%,感染部位以呼吸道为主,占56. 5%,其次为消化道和泌尿系统,分别占17. 5%和7. 5%;共分离出病原菌45株,其中革兰氏阴性菌41株,占91. 11%,革兰氏阳性菌3株,占6. 67%,真菌1株,占2. 22%,前三位病原菌依次为肺炎克雷伯菌、大肠埃希菌、流感嗜血杆菌,分别占40. 00%,26. 67%,11. 11%;医院感染危险因素分析结果显示,高龄(≥80岁)、男性、住院时间长(≥14天)、合并肿瘤、营养状态差(NRS 2002评分≥3分)及侵入性操作是老年住院患者医院感染的危险因素(P 0. 05)。结论根据干部病房老年患者医院感染特点,针对高危因素重点监控,制定相应的预防和控制措施,可有效降低医院感染率。     

1427例住院老年人患恶性肿瘤的统计分析

目的了解我院老年患者患恶性肿瘤疾病的性别、年龄、部位及构成,为医疗管理层制定合理的、科学的老年肿瘤防治措施提供依据。方法整理分析我院2004年至2008年60岁以上老年住院患者资料。结果食管癌、肺癌、胃癌、肝癌、直肠癌为我院老年性患者的主要恶性肿瘤。结论老年人恶性肿瘤的发病存在着年龄、性别、部位的分布特征,老年人是患肿瘤的高危人群,应做好预防工作,降低发病率,提高生存率。     

精细化管理提高呼吸系统疾病住院老年患者的护理安全性研究

目的探讨基于精细化管理理念的安全护理对呼吸系统疾病老年住院患者的影响。方法选2019年7月至2020年12月入住本院中医肺病一部的1017例老年患者为研究对象,实施基于精细化管理理念的安全护理,比较实施前后安全事件发生率、医患人员的满意度。结果实施后患者的安全事件发生率由0.83%降至0.20%,患者满意程度(为非常满意)由23.09%提高至28.02%,不满意的患者比例由4.50%下降到2.26%,医护人员的满意度评分由(3.50±0.51)分提高至(4.38±0.50)分,P0.05,差异有统计学意义。结论基于精细化管理理念的呼吸系统疾病老年住院患者的安全护理可以降低患者安全事件发生率,提升患者及医护人员满意度,效果显著,可以推广。     

全额保障老年患者在基层公平享有合理使用基本药物政策研究

目的:为实施全额保障老年患者在基层公平享有、合理使用基本药物费用政策提供可行的管理策略。方法:以南京市江宁区参加职工医保的65岁以上老年患者就诊的数据为来源,分析其基本药物使用的状况和主要疾病病种的构成。结果:老年患者主要以抗微生物药、调节水、电解质及酸碱平衡药、内科用药(中成药)和心血管系统用药为主;主要是心脑血管疾病、呼吸系统疾病、消化系统疾病以及损伤骨折等;用药经济负担较重。结论:应加强老年人常用基本药物的配备,提高可获得性;实施分类管控,最大程度地减轻使用基本药物的经济负担;规范医师用药行为,提高基层医疗机构合理用药的水平;加强用药知识宣教,发挥社区药学服务的作用。     

Recent Life Expectancy Divergence in Baltic Countries

Until the end of the 1990s, mortality patterns and trends in Estonia, Latvia and Lithuania were remarkably similar. However, from the year 2000 onwards, life expectancy trends in the three countries started to diverge. In particular, sustainable progress in Estonia over the period 2000–2007 contrasts with stagnation in Latvia, and even worsening trends in Lithuania. These contradictory changes seem to be mainly explained by contrasting dynamics in mortality from cardiovascular diseases, external causes of death and digestive system diseases. Whereas cardiovascular and external-cause mortality declined in Estonia and Latvia, worsening or stagnation of mortality from these causes of death was observed in Lithuania. The negative mortality changes in Lithuania were also reinforced by a striking increase in mortality from alcohol-related digestive system diseases. The findings suggest that the divergence in health trends between the three countries may be attributable to their varying degrees of success in implementing structural health care reforms and specific health policy measures. By contrast, the very recent improvement (since 2008) is parallel in the three countries and is largely because of the introduction of rather similar anti-alcohol measures.     

Health Convergence Between East and West Germany as Reflected in Long-Term Cause-Specific Mortality Trends: To What Extent was it Due to Reunification?

The sizeable mortality gap between the German Democratic Republic (East Germany) and the pre-unified Federal Republic of Germany (West Germany) narrowed rapidly after the two states were unified. Despite extensive research, the mechanisms underlying the convergence process are still not fully understood. Significant changes to coding practices and the system of data collection introduced in East Germany shortly after reunification have further complicated the ability of researchers to interpret mortality trends. Our aim is to assess the role of German reunification in the convergence process in light of the evolution of long-term mortality trends by causes of death. Compared to previous studies, we rely on much more detailed mortality data, which we first adjust for notable distortions. We propose an upward correction of cancer mortality, as well as corrections that account for obvious changes in the items selected within the ICD chapter of circulatory diseases. We identify three distinct processes that took place in East Germany around the time of reunification: (1) a sustained reduction in mortality that started before reunification; (2) a temporary increase in mortality in 1990–1991 that was related to the abrupt social transition, as reflected by socially sensitive causes such as accidents, alcohol-related diseases, and acute myocardial infarction; and (3) a reunification-driven process of convergence that was mostly caused by the accelerated decline in mortality from cerebrovascular and chronic heart diseases. Mortality improvements observed in the GDR starting in the 1980s might be interpreted as the first signs of a cardiovascular revolution. Shifts in individual behaviour likely started before reunification, whereas the real progress in medical care occurred later with the implementation of the Western system of health care. We therefore conclude that German reunification per se did not initiate the convergence process, but rather reinforced and accelerated trends that were already apparent.     

Life table analysis for areas using vital register data

This study considers the utility of parameterised life tables derived by survival analysis for comparing mortality between areas, using death registration records and accompanying information on the social characteristics for each individual deceased. Such methods enable a comparison of summary measures of mortality experience such as life expectancy and median age at death before and after adjustment for socio-economic variables. In the absence of comparable information on the survivor population an approximate life table method is investigated as a means of comparing mortality profiles and the effects of social factors. Such factors may pertain both to the individuals (e.g. their birthplace) or to their small area of residence (e.g. measures of area deprivation). These methods also permit a comparison of the impact of socio-economic factors on different causes of death. The application is to mortality in London over the period 1990–92 and to its constituent boroughs and electoral wards.     

Recent Mortality Trend Reversal in Russia: Are Regions Following the Same Tempo?

After several decades of negative trends and short-term fluctuations, life expectancy has been increasing in Russia since 2004. Between 2003 and 2014, the length of life rose by 6.6 years among males and by 4.6 years among females. While positive trends in life expectancy are observed in all regions of Russia, these trends are unfolding differently in different regions. First, regions entered the phase of life expectancy growth at different points in time. Second, the age- and cause-specific components of the gains in life expectancy and the number of years added vary noticeably. In this paper, we apply decomposition techniques—specifically, the stepwise replacement algorithm—to examine the age- and cause-specific components of the changes in inter-regional disparities during the current period of health improvement. The absolute inter-regional disparities in length of life, measured by the population-weighted standard deviation, decreased slightly between 2003 and 2014, from 3.3 to 3.2 years for males, and from 2.0 to 1.8 years for females. The decomposition of these small changes by ages and causes of death shows that these shifts were the result of diverse effects of mortality convergence at young and middle ages, and of mortality divergence at older ages. With respect to causes of death, the convergence is mainly attributable to external causes, while the inter-regional divergence of trends is largely determined by cardiovascular diseases. The two major cities, Moscow and Saint Petersburg, are currently pioneering mortality improvements in Russia and are making the largest contributions to the inter-regional divergence.     

3197例干部体检颈动脉彩色多普勒超声检查结果分析

目的探讨干部人群颈动脉彩色多普勒超声检查结果及其相关因素,实施健康干预,以降低心、脑血管疾病的发生。方法对3197例干部健康体检人员颈动脉彩色多普勒超声检查结果,进行不同年龄和性别颈动脉斑块发生率和内膜中层厚度分析,研究颈动脉斑块的发生与年龄、性别、体重指数、血压和生化指标的关系,找出危险因素。结果 3197例颈动脉超声检查,颈动脉内膜中层增厚和斑块发生率分别为34.34%和20.80%,斑块的发生率随年龄的增加而升高,男性发生率（36.86%）高于女性（16.74%）,差异有统计学意义（χ^2=55.288,P〈0.01）;单纯高血压、单纯高血糖、单纯高血肌酐、单纯高尿素氮的颈动脉斑块发生率分别为76.82%,54.38%,62.22%和96.22%。Pearson方法分析显示颈动脉斑块的发生与单纯高血压、单纯高血糖、单纯高血肌酐、单纯高尿素氮有明显关联性。结论干部人群中存在着较高的颈动脉斑块发生率,其发生率随年龄的增加而升高,男性高于女性,颈动脉斑块的发生与肾功异常、高血压和高血糖相关。     

学习型社会的建立与教育观念的转变

现代社会是一个终身学习的社会 ,教育必须对学生的终身发展负责 ,为此 ,需要转变陈旧、落后的教育观念 ,确立科学的人才观 ,树立正确的师生观和教学观 ,致力于学习方式的变革     

实现高校后勤社会化党委应高度重视后勤干部队伍建设

论述了高校后勤干部队伍在学校的地位和作用 ,提出了党委重视是搞好高校后勤队伍建设的关键的观点 ,阐述了高校后勤队伍培养教育的三项重要内容。     

Reclassifying causes of death to study the epidemiological transition in The Netherlands, 1875–1992

This article describes a method for reclassifying causes of death in the Netherlands for the period 1875–1992. Two criteria should be met to obtain a useful classification to study the epidemiological transition. First, the categories should be nosologically continuous over the period under study and second, there should be enough detail in causes which are important in the context of the epidemiological transition viz. communicable diseases, non-communicable diseases and external causes of death. A method developed by Vallin and Meslé (1988), which involves ‘dual correspondence tables’ and ‘fundamental associations’, was used to create nosologically continuous categories. These categories were tested for statistical continuity during the transition years of one ICD-revision to the next, using ordinary least squares regression analysis. The reclassification procedure resulted in a nested classification consisting of three levels of refinement of causes of death: 27 causes, 1875–1992; 65 causes, 1901–1992; and 92 causes, 1931–1992. On the basis of this classification, 43% of all deaths in 1875–79 and 98% of all deaths in 1992 could be allocated to either communicable diseases, non-communicable diseases or external causes.