青年初发急性心肌梗死患者的临床特征及危险因素分析

摘要 目的：探讨青年初发急性心肌梗死（Acute myocardial infarction, AMI）的临床特点及其发生心功能下降的相关危险因素。方法：收集年龄＜45岁的初发AMI且行冠脉造影检查的患者86例及同期60-75岁的患者96例,对两组患者的临床资料进行对比分析,并对青年组心功能下降的危险因素进行Logistic回归分析。结果：青年组年龄中位数为40岁,男性患者及吸烟人群比例显著高于老年组（P＜0.01）,高血压及糖尿病患者的比例显著低于老年组（P＜0.001）;血尿酸水平、甘油三酯、低密度脂蛋白胆固醇均显著高于老年组,而高密度脂蛋白胆固醇及脂蛋白（a）显著低于老年组（P＜0.01）;冠脉多支病变的比例和Gensini评分低于老年组（P＜0.001）,左室射血分数＜40%的比例显著低于老年组（P＜0.01）。两组罪犯血管为前降支、回旋支及右冠脉的比例比较无明显差异（P＞0.05）。Logistic回归分析显示高尿酸和高冠脉Gensini评分是青年初发AMI患者心功能下降的危险因素（P＜0.05）。结论：青年初发AMI以男性为主,吸烟、高尿酸、血脂异常更为多见,冠脉病变严重程度相对较轻,高尿酸和冠脉Gensini评分是青年初发AMI后心功能下降的危险因素。     

青年人群抗生素知识掌握和使用行为及其影响因素的研究

目的:研究黑龙江省青年人群抗生素知识掌握和使用行为及其影响因素。方法:随机抽取黑龙江省16~44岁之间的青年人,采用问卷调查法进行定量性的横断面研究。结果:2630名受访者中,38.62%知道抗生素可治疗细菌感染但不可治疗病毒感染,30.59%是根据医生处方选择抗生素的,有52.09%的受访者不能按疗程使用抗生素。其中,女性、自觉健康状况较差的受访者抗生素知识掌握与使用行为相对较好。结论:青年人群正确的抗生素知识和规范的抗生素使用行为的比例较低,需要加强青年人群抗生素相关知识及规范应用的教育。     

青年卒中后抑郁/焦虑危险因素logistic回归分析

目的:探讨青年卒中患者抑郁/焦虑发生的危险因素,为制定科学的管理策略提供依据。方法:选择2012年7月至2013年7月我院收治的69例青年卒中患者,采用《Hamilton抑郁量表(HAMD)》和《Hamilton焦虑量表(HAMA)》筛选出抑郁/焦虑病例作为病例组,其他病例作为对照组,通过多因素非条件Logistic回归模型分析青年卒中后抑郁/焦虑产生的危险因素。结果:69例青年卒中病人中,抑郁、焦虑的发生率分别约26.0%和36.2%。多因素Logistic回归分析显示NIHSS评分(OR值5.002,95%CI为4.015~6.023)、幕下病变(OR值0.466,95%CI为0.145~1.505)、伴随基础疾病(OR值0.093,95%CI为0.008~1.129)是青年卒中后抑郁/焦虑出现的危险因素。结论:对青年卒中患者要积极控制基础疾病,重视幕下病变和严重残疾,有助于预防及早期识别卒中后抑郁/焦虑的产生。     

Intra-population variation in anemia status and its relationship to economic status and self-perceived health in the Mexican Family Life Survey: Implications for bioarchaeology

Recently scholars have advocated for the use of a critical biocultural approach in bioarchaeology, where osteological and dental markers of stress are used to understand the broader biosocial context of past populations. However, the ability to accomplish this task rests on the assumption that ultimate-level environmental stressors and well-being in the past can be reconstructed from the prevalence of pathologies in skeletal collections. Here we test this assumption using anemia prevalence in the Mexican Family Life Survey. Specifically we test three hypotheses: (1) that individuals sharing the same household are more likely to share anemia status; (2) anemia status is a predictor of economic status (a common proxy for broader environmental context); and (3) anemia status is related to self-rated health. Results demonstrate that: anemia status was not commonly shared between household members; there was a significant overlap in economic status between anemic and nonanemic individuals (i.e., anemia poorly predicted economic status) and; while anemia status was associated with self-perceived health, the majority of those who reported poor health were nonanemic while a significant number of those who reported very good health were anemic. We argue that these findings are likely related to variation in individual frailty, which is shaped by biological and cultural risk factors. Therefore, we advocate for greater incorporation of individual frailty into bioarchaeological investigations, and, in effort to overcome some of the difficulties associated with this task, increased use of data from living populations and greater collaboration between bioarchaeologists and human biologists. Am J Phys Anthropol 155:210–220, 2014. © 2014 Wiley Periodicals, Inc.     

心理干预对脑卒中抑郁焦虑情绪的康复作用及对患者治疗依从性的影响研究

目的:探讨心理干预对脑卒中抑郁焦虑情绪的康复作用及对患者治疗依从性的影响。方法:我院老年科、神经内科、康复医学科治疗的脑卒中并出现抑郁焦虑情绪障碍的患者120例,随机分为观察组和对照组,各60例,两组患者均入院以后给予脑血管药物进行常规治疗和日常功能训练;观察组同时给予心理干预并根据病情应用抗抑郁抗焦虑药物等。于干预前、干预后3个月、6个月、1年分别对两组患者用SCL-90量表、总体幸福感指数量表、Barthel指数量表对患者进行评估,并评估患者治疗依从性。结果:干预后,观察组SCL-90各因子评分及总分均较干预前明显降低(P0.05),对照组SCL-90各因子评分及总分与干预前比较无统计学差异(P0.05)。干预前两组患者总体幸福感评分和Barthel评分比较无统计学差异(P0.05),干预后3个月、6个月和1年观察组总体幸福感评分和Barthel评分均明显高于对照组(P0.05)。观察组患者在治疗期间总体依从率明显高于对照组(P0.05)。结论:心理干预能够有效的改善脑卒中患者早期康复病人抑郁和焦虑的情绪,提高患者治疗的依从性。     

温度对圆尾肖蛸个体发育和繁殖力的影响

圆尾肖蛸(Tetragnotha vermiformis)在我国广泛分布于棉田、稻田、森林、果园。该蜘蛛具有捕食多种农作物害虫的能力,在湖堤、河岸、沟边更是蚊虫的有效天敌。本文仅就圆尾肖蛸的历期和繁殖力与温度的关系方面的试验结果进行了整理,并力图建立相应的数学模型,旨在为保护和利用工作提供科学依据。     

夏季南亚热带森林演替中后期优势种幼叶花色素苷的光保护作用

为探讨夏季南亚热带森林演替过程中优势树种幼叶的光保护机制,以演替中期优势树种木荷(Schima superba)、黧蒴(Castanopsis fissa)、锥栗(C.chinensis)和演替后期优势种华润楠(Machilus chinensis)、厚壳桂(Cryptocarya chinensis)、黄果厚壳桂(C.concinna)为材料,分析了2种生长光强(全光照和30%全光照)下6种优势种幼叶和成熟叶的叶片表型、光合色素含量、花色素苷含量、抗氧化能力、类黄酮含量、总酚含量和最大量子产量(Fv/Fm)恢复效率间的差异。结果表明,两个演替阶段幼叶的叶绿素含量(Chl a+b)、Chl a/b比成熟叶低,但光保护物质比成熟叶多;演替中期幼叶的花色素苷含量和总抗氧化能力比演替后期的高,而类黄酮和总酚含量比演替后期的低;全光照下幼叶的总酚、类黄酮、总抗氧化能力及Fv/Fm恢复效率都要比30%全光照的高,并且含有花色素苷的幼叶恢复得更快。因此,植物的光合能力与自身的光保护潜力成反比关系,演替中期优势种幼叶的光保护在很大程度上是因为花色素苷的积累而演替后期优势种是因为自身抗氧化物质(类黄酮、总酚)的共同作用。     

老年性白内障患者住院费用及相关因素的现况调查

目的 探讨老年性白内障住院患者住院费用的年龄、性别和不同医院的分布特点,为提供科学收费标准提供参考依据。方法 采用整群抽样的方法对2009年不同医院9 464例老年性白内障患者的住院费用及相关因素进行横断面调查并进行初步分析。结果 将老年白内障患者按<60岁、60~80岁、>80岁分为3组,床位费、西药费、检验费、放射费、特检费、治疗费、手术费和护理费均随年龄增加而增加且存在统计学差异。以上费用,男性患者均高于女性且存在统计学差异。海军医院患者最高（P<0.05）,其他由高至低依次为全军陆军医院、全军空军医院和全军二炮医院患者。结论 卫生决策部门应针对其不同特点制定适宜收费标准,有必要跟进研究不同病种费用区别的制度或管理层面的原因。

     

Physical Fitness and Other Individual Factors Relating to the Shiftwork Tolerance of Women

Maximal oxygen consumption (V˙O₂max), muscle strength (MS) and physical activity were compared to age, shiftwork experience, morningness, personality traits and social factors intervening in the shiftwork tolerance of 128 women. The subjects were nurses and nursing aids working irregular shifts in a hospital. Neuroticism was the most powerful negative factor connected to higher fatigue and various symptoms of the subjects. High V˙O₂max and good MS were, on the other hand, the most important positive factors connected to lower fatigue and musculoskeletal symptoms and better sleep quality of the subjects. In different shifts, fatigue, sleep length and quality were influenced most by morningness. It is concluded that physical fitness is an important individual factor explaining the variations of shiftwork tolerance in women.     

A Study on the Relationship Between the Net Photosynthetic Rate of Young European Beech and Main Climatic Factors Under Natural Conditions

Young European beech lives under the blank of European beech mature forest. Its photosynthetic rate was significantly affected by climatic factors. This paper deals with the effect of climatic factors on diurnal variations of the net photosynthetic rate,photosynthetic capacity,lightphocosynthesis curve and temperature effect of net photosynthetic rate under different radiations. The results are as follows:the climatic factors have greater influence on diurnal variations of the net photosynthetic rate. The influence coefficient of radiation,temperature and relative humidity on photosynthetic capacity are 0. 51, 0. 22. and 0. 17,respectively. The light-photosynthesis curve is Y= 1. 49273–1. 58993 × 0. 09328(0.01x). The optimum combination of environmental conditions of photosynthetic rate under natural conditions is:the radiation is more than 45 μE · m-2 · s-1 and meantime the temperature is between 10℃ and 20℃.