强化干预代谢综合征改变心脑血管事件发生风险的纵向随访研究：社区人群心脑血管事件前瞻性研究系列之四

目的了解药物综合干预代谢综合征（MS）是否可以改变发生心脑血管事件的风险。方法采用随机整群抽样南宁市两个社区的1215人符合纳入标准为本次综合干预治疗的研究对象,随机分为强化干预组和对照组。强化干预组人群按照是否患有MS及其相关疾病、疾病前状态（包括高血压、血压前期、肥胖、超重、糖尿病、糖耐量减退、血脂异常）等分别采取不同的强化治疗方案进行干预;对照组人员维持志愿就诊和志愿服药的正常医疗状态,每年随访1次,按WHO—MONICA方案心血管病事件（CVD）的诊断标准登记本年度发生的CVD和死亡事件。结果前瞻性随访研究43．5个月后：①经比较对照组中MS亚组与非MS亚组,MS患者发生心脑血管事件比非MS显著增高（P=-0．02）;②经比较干预组中MS亚组与非MS亚组,干预后MS心脑血管事件下降明显,MS患者发生心脑血管事件与非MS相比无差异（P〉0．05）;③经比较干预和对照两组MS亚组之间心脑血管事件的发生率,干预组为2．7％,对照组为10．1％,差异显著（P=0．03,OR值=4．01,95％CL：1．07—15．10）;两组非MS亚组之间心脑血管事件的发生率分别为2.3％和4．2％,无显著性差异（P=0．12）。结论药物综合干预代谢综合征（MS）可以改变发生心脑血管事件的风险,与对照相比干预后风险降低了约4倍。     

高敏C反应蛋白与冠心病相关性的研究

目的评价血清高敏C反应蛋白（hs—CLIP）在不同类型冠心病（CHD）患者中的血清水平,总结临床经验。方法随机选取60例冠心病患者,包括稳定型心绞痛（SAP）20例,不稳定型心绞痛（UAP）20例,急性心肌梗死（AMI）20例,并以30例健康人作为对照组。采用透射免疫比浊法,分别测定各组血清中hs—CRP的浓度,并分析治疗前后hs—CRP水平的差异。结果不同临床类型冠心病hs—CRP浓度与正常对照组比较有显著性差异（P〈0．01）。不同临床类型冠心病hs—CRP浓度也有显著性差异（P〈0．05）。冠心病各组的hs—CRP水平在治疗前后比较有统计学意义（P〈0．01）。结论hs—CRP不仅参与冠心病的发生与发展,且其血清浓度越高,临床情况越重,预后越差,心脏事件发生率越高。检测hs—CRP对冠心痛的辅助诊断、疗效观察及预后判断具有重要价值。     

氧雾化吸入博利康尼、布地奈德治疗慢性阻塞性肺病急性加重期临床分析

目的观察博利康尼、布地奈德氧雾化治疗慢性阻塞性肺疾病急性加重期（AECOPD）的临床疗效。方法30例AECOPD住院患者随机分为三组,分别给予布地奈德,博利康尼＋布地奈德氧雾化吸入治疗和空白对照组治疗。观察三组疗效、临床表现、肺功能,动脉血气变化及副作用发生情况。结果博利康尼＋布地奈德组临床表现FEV1和动脉血气的改善显著优于空白对照组,略优于布地奈德组,布地奈德组显著优于空白对照组。结论氧雾化吸入博利康尼、布地奈德治疗AE—COPD有效、安全、易行,可作为AECOPD常规治疗措施     

Mental disease postpartum and parent‐infant interaction—evaluation of videotaped sessions

In order to investigate the influence of maternal mental illness postpartum on mother‐infant and father‐infant interaction, infants of 14 mentally ill women admitted to hospital within 6 months after delivery were compared to infants of 22 women who had been somatically ill. Videotaped sessions when the infant was 10 months old revealed that mothers in the psychiatric sample showed less sensitivity in comparison to mothers in the somatic sample. When the infant was 2 years old, mothers in the psychiatric sample showed less positive affect and less link‐infant follow (stimulation dimension) as compared to the somatic mothers. However, there were no differences between fathers in the psychiatric sample and fathers in the somatic sample in any of the interaction variables. In the psychiatric sample, fathers showed more warmth as compared to mothers. In the somatic sample, fathers scored higher than mothers on autonomy but lower than mothers on link‐infant follow (stimulation dimension). A possible interpretation of our data was that the mental illness of the mothers may lead to a more active parenting role of the father in order to buffer the deficit in the mother‐infant relation. Copyright © 2001 John Wiley & Sons, Ltd.     

A latent process model for dementia and psychometric tests

We jointly model longitudinal values of a psychometric test and diagnosis of dementia. The model is based on a continuous-time latent process representing cognitive ability. The link between the latent process and the observations is modeled in two phases. Intermediate variables are noisy observations of the latent process; scores of the psychometric test and diagnosis of dementia are obtained by categorizing these intermediate variables. We propose maximum likelihood inference for this model and we propose algorithms for performing this task. We estimated the parameters of such a model using the data of the 5 year follow-up of the PAQUID study. In particular this analysis yielded interesting results about the effect of educational level on both latent cognitive ability and specific performance in the mini mental test examination. The predictive ability of the model is illustrated by predicting diagnosis of dementia at the 8 year follow-up of the PAQUID study based on the information from the first 5 years.     

论心理挫折、心理疾病产生的原因及对策

人遇挫折会造成身心痛苦 ,影响学习和工作效率。本文论述了受挫折后人的心理和行为变化 ,提出战胜挫折的方法 ,增强身心健康 ,提高效率。     

网络群体事件政府治理的演化博弈分析

利用演化博弈模型预测舆论的发展趋势,对政府应对网络群体事件采取的治理模式进行了研究.在一般化复制动态模型基础上建立网络群体事件舆论的传播方程,将地方政府部门与弱势群体的策略互动和行为演化融入到传染病传播模型中,用以模拟舆论的扩散和收敛过程.结果表明:在网络群体事件初期,如果弱势群体通过抗争获得政府补偿的概率不断增大,将造成事态的扩大.此时,地方政府应控制信息的交流程度与初始抗争人数,减缓舆论的扩散;在网络群体事件舆论大范围扩散阶段,上级政府介入并采取惩罚措施,及时披露信息,促使网络舆论的收敛平息,实现社会福利最大化.     

Measuring Self-Appraised Changes following Participation in an Intervention for Caregivers of Individuals with Dementia

This study examined the psychometric properties of the Self-Appraisal of Change Scale, a measure designed to capture domains that are subjectively relevant to caregivers, associated with overall well-being, and amenable to change upon engaging in an intervention. Data from 107 caregivers of veterans with dementia enrolled in a randomized controlled trial of a telephone-delivered caregiver psychoeducation and support group program (the Telehealth Education Program (TEP)) were analyzed. The TEP, which was delivered by master’s prepared social workers and a nurse dementia care manager, targeted caregivers’ dementia-related knowledge, attitudes, and self-management skills. Analyses were conducted to determine the factor structure, reliability, validity, and measurement invariance of the scale. Factor analyses yielded a single-factor solution for the scale’s nine items. The reliability and construct validity of the scale were also supported by the analyses. Multi-group analyses suggested that meaningful comparisons of scale items and total raw scores can be made across usual care (UC) and intervention groups. The findings offer preliminary support that the scale may represent a valid and reliable instrument that captures perceived changes in key domains (e.g. caregiving knowledge, attitudes, and skill) following participation in a psychoeducational and support intervention trial.     

重大传染病疫情演化情境下应急物资配置决策建模分析:以新冠肺炎疫情为例

基于对新冠肺炎疫情时空分布的分析,从时段、关键事件、传播动力学、空间分布、感染规模、信息特征、医疗资源等7个维度构建了重大传染病疫情演化的5种情境,提出了各种情境下需要解决的5个关键应急物资配置决策问题。综合考虑应急物资配置的空间、信息、物资、供应、需求和网络等特性,分析了每一个决策问题进行建模优化的关键因素。基于这些关键因素构建了一个多周期贝叶斯序贯决策模型,给出了求解步骤和解析解,并结合武汉疫情进行了算例分析,验证了模型的有效性。在重大传染病疫情演化情境下,综合考虑这些关键因素,应用贝叶斯决策分析进行应急物资配置决策建模有利于建立更加符合实际的决策模型,减少决策损失。     

我国古代政府的疫病控制措施

疫病是人类共同的敌人,在历史发展过程中,它无时无刻不在威胁着我们祖先的身体健康和生命安全。直到医学科学高度发达的今天,我们仍然不能摆脱疫病造成的恐惧和苦难。我国是世界文明发祥地之一,很早以前就有了同疫病做斗争的经验和教训,在长期艰苦不懈的探索中,我们的祖先不断发现治疗疾病和控制传染的办法,无论是医家还是政府,都为我们留下了宝贵的财富。了解历史,能够为当前有效预防和控制SARS的再次出现提供借鉴和帮助。