高血压病患者颈动脉粥样硬化与心血管危险因素的相关性研究

目的探讨高血压病患者颈动脉粥样硬化程度、斑块形成与高血压等心血管危险因素之间的相关性。方法检测490例高血压病患者的颈动脉内膜中层厚度、斑块,并与高血压分级、病程、脉压、年龄、性别、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血尿酸、C-反应蛋白、空腹血糖等心血管病危险因素进行相关性分析;另选253例同期住院的无高血压患者为对照组,行相关指标检测及统计学分析;并对412例高血压合并颈动脉粥样硬化者采用个体化降压治疗、强化调脂治疗。随访一年,观察治疗前后动脉粥样硬化程度变化情况及心血管事件发生情况。结果颈动脉粥样硬化、斑块形成与高血压分级程度、收缩压、脉压高血压病程呈正相关,与TC、LDL—C、UA、CRP、FBG等心血管危险因素均有关,高血压及颈动脉粥样硬化与冠心病的发病呈正相关,有统计学意义：强化降压调脂及综合性干预治疗后动脉粥样硬化程度明显减轻,临床冠心病发病率、心血管事件发生率、死亡率及再次入院率均明显降低,与治疗前比较差异显著。结论颈动脉粥样硬化及斑块的发生、发展与高血压等心血管危险因素有密切关系,早期强化降压调脂治疗及相关危险因素的综合性干预治疗可延缓动脉粥样硬化的发生发展。     

甘肃民族地区新型农村合作医疗运行研究

农村医疗保障制度是社会保障体系的重要组成部分,对保障广大农民身体健康、促进农村经济和社会发展起重要作用。民族地区农民＂因病致贫、因病返贫＂现象严重,甘肃民族地区新型农村合作医疗存在政府财政投入不足,筹集资金困难,基金使用率低;基金补偿率低,农民参合意愿较差;定点医疗机构偏少,医疗设备缺乏,卫生人员水平低;报销程序繁琐,报销比例低。甘肃民族地区完善新型农村合作医疗制度应进一步加大宣传,提高农民对新型农村合作医疗的认识;大力支持民族地区的经济发展,提高农民参合积极性;改善医疗条件,加大农村医疗队伍的培养和再培训力度;制定便捷的报销政策,鼓励使用中医药和民族医药;结合民族地区实际,采取各种方式拓宽筹资渠道。     

我国农村地方病型贫困的思考——以贵州省地方病氟中毒为例

农村地方病型贫困是农村居民致贫的一大根源,分析农村地方病型贫困的成因、危害,可提出相应的扶贫对策,以缓解贫困压力.     

80例中老年女性平板运动试验假阳性原因分析

目的探讨中老年女性患者平板运动试验假阳性的鉴别。方法回顾性总结我院2001年11月～2006年12月80例中老年女性患者出现平板运动试验假阳性的原因。结果临床最后诊断:心脏植物神经功能紊乱32例,高血压病14例,单纯高脂血症8例,糖尿病6例,X综合征6例,高血压合并糖尿病6例,冠状动脉心肌桥5例,心尖部肥厚型心肌病3例。结论平板运动试验假阳性与心脏植物神经功能紊乱、X综合征、冠状动脉肌桥、高血压病、糖尿病等因素有关,心脏植物神经功能紊乱为最常见病因,正确分析平板运动试验的假阳性原因,对提高冠心病无创性检查的确诊率有一定的意义。     

The Promise of Molecular Epidemiology for Quantitative Risk Assessment

In the long run, molecular epidemiological techniques can provide important insights for understanding a wide variety of important issues in current risk assessment and are applicable across a broad spectrum of adverse effects in addition to carcinogenesis. Unfortunately, current risk assessment practices make very little use of the kind of detailed mechanistic information that molecular epidemiology can provide. Eventually, there is reason to hope that the availability of mechanistic insights provided in part by molecular epidemiology can produce some of the "essential tension" required to reform paradigms for the formulation of quantitative risk assessment models in general.     

绵阳市水稻主要病虫区域分布及其测报

对绵阳市 1980～ 1999年水稻病虫害发生、为害情况进行了分析、研究 ,初步明确了我市水稻主要病虫及其区域分布 ,据此提出了疫情调查的关键时期、重点区域及调查线路     

A Model for Optimization of Biomarker Testing Frequency to Minimize Disease and Cost: Example of Beryllium Sensitization Testing

A common problem with medical surveillance programs using biomarkers is determining the optimal frequency of testing to minimize adverse health effects and cost. In the case of beryllium-exposed workers, frequency of testing for beryllium sensitization may be especially important. Recent studies indicate a lack of dose response for beryllium sensitization, but do support a dose response for the development of chronic beryllium disease (CBD). Though unproven, this implies that early identification of sensitization and immediate removal from exposure may reduce development of CBD. A model is proposed to project the optimal frequency of sensitization testing using the current beryllium lymphocyte proliferation test (BeLPT) to minimize disease-related costs, assuming that a positive BeLPT will precede CBD. Conversion rates for cumulative exposure to disease development were adapted from the literature and used with testing costs and cost of disease estimates in the model. The model was run assuming several test frequency regimes. Results support the use of periodic testing in line with the annual schedule proposed in the Final Chronic Beryllium Disease Prevention Program Rule (1999) following initial testing within three months of first beryllium exposure. The financial and health benefits of reducing the time from exposure to detection of early disease was also explored with the model and demonstrated as a highly desirable characteristic for an alternative test or improved BeLPT. Limitations of the approach are discussed as well as options for adapting this biomarker optimization methodology to consider biomarkers of other exposure-associated diseases.     

Probability of Exporting Infected Carcasses from Vaccinated Pigs Following a Foot‐and‐Mouth Disease Epidemic

Emergency vaccination is an effective control strategy for foot‐and‐mouth disease (FMD) epidemics in densely populated livestock areas, but results in a six‐month waiting period before exports can be resumed, incurring severe economic consequences for pig exporting countries. In the European Union, a one‐month waiting period has been discussed based on negative test results in a final screening. The objective of this study was to analyze the risk of exporting FMD‐infected pig carcasses from a vaccinated area: (1) directly after final screening and (2) after a six‐month waiting period. A risk model has been developed to estimate the probability that a processed carcass was derived from an FMD‐infected pig (P_carc). Key variables were herd prevalence (P_H), within‐herd prevalence (P_A), and the probability of detection at slaughter (P_SL). P_H and P_A were estimated using Bayesian inference under the assumption that, despite all negative test results, ≥1 infected pigs were present. Model calculations indicated that P_carc was on average 2.0 × 10^?5 directly after final screening, and 1.7 × 10^?5 after a six‐month waiting period. Therefore, the additional waiting time did not substantially reduce P_carc. The estimated values were worst‐case scenarios because only viraemic pigs pose a risk for disease transmission, while seropositive pigs do not. The risk of exporting FMD via pig carcasses from a vaccinated area can further be reduced by heat treatment of pork and/or by excluding high‐risk pork products from export.     

Estimating precision,repeatability, and reproducibility from Gaussian and non- Gaussian data: a mixed models approach

Quality control relies heavily on the use of formal assessment metrics. In this paper, for the context of veterinary epidemiology, we review the main proposals, precision, repeatability, reproducibility, and intermediate precision, in agreement with ISO (international Organization for Standardization) practice, generalize these by placing them within the linear mixed model framework, which we then extend to the generalized linear mixed model setting, so that both Gaussian as well as non-Gaussian data can be employed. Similarities and differences are discussed between the classical ANOVA (analysis of variance) approach and the proposed mixed model settings, on the one hand, and between the Gaussian and non-Gaussian cases, on the other hand. The new proposals are applied to five studies in three diseases: Aujeszky's disease, enzootic bovine leucosis (EBL) and bovine brucellosis. The mixed-models proposals are also discussed in the light of their computational requirements.