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Who should be screened for colorectal cancer and how can it be prevented more effectively?
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作者 You-Xiang Wang Kai-Juan Wang 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第9期3741-3746,共6页
In this editorial,we comment on the article published by Agatsuma et al in a recent issue of the World J Gastroenterol(2024;30:1368-1376).We firmly concur with Agatsuma et al regarding the vital significance of colore... In this editorial,we comment on the article published by Agatsuma et al in a recent issue of the World J Gastroenterol(2024;30:1368-1376).We firmly concur with Agatsuma et al regarding the vital significance of colorectal cancer(CRC)screening as a public health strategy to diminish disease burden.Individuals exposed to risk factors for CRC,those with comorbid conditions,and those with limited health literacy should undergo screening.However,we believe that more regular screenings should be accompanied by a greater focus on primary prevention(PP)of CRC.CRC remains a significant global health challenge,and its incidence is strongly linked to age,lifestyle,and socioeconomic factors.It is particularly noteworthy that the majority of CRC patients are diagnosed outside of established screening pathways and frequently at an advanced stage of the disease,and the majority of patients possess inadequate or even nonexistent knowledge regarding CRC,which significantly impacts the prognosis and imposes a substantial economic burden.This study revealed that CRC identified during hospital visits for comorbid conditions was typically diagnosed at an earlier stage than detected via symptomatic pathways.Remarkably,early incidental detection of CRC aligns closely with the timing of discovery through routine cancer screenings.This suggests that by adopting more inclusive screening protocols that combine opportunistic testing with traditional screening methods,health care systems can create a more comprehensive safety net for individuals at risk of CRC.However,before maximizing the health benefits of screening programs,it is essential to make additional efforts prior to screening,such as raising awareness via public education,risk assessment,and personalized recommendations,enhancing the knowledge and skills of health care professionals,optimizing the accessibility and convenience of screening processes,ensuring the quality and safety of screening services,strengthening follow-up and support systems,and providing policy support and financial investment.The establishment of a comprehensive screening system often requires substantial investment in human,material,and financial resources,which can be challenging to achieve in regions with limited health care resources.Strengthening PP strategies can reduce the disease burden by targeting the cause,representing a more cost-effective and impactful approach.Establishing a comprehensive cancer PP service platform that integrates authoritative public education on malignant tumor PP,individualized malignant tumor risk assessment,and self-health management assistance accessible to the entire population will significantly enhance the overall effectiveness of CRC PP strategies. 展开更多
关键词 Colorectal cancer primary prevention screening program Disease burden Health literacy Economic benefits
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Colorectal cancer,screening and primary care: A mini literature review 被引量:13
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作者 Athanasios Hadjipetrou Dimitrios Anyfantakis +2 位作者 Christos G Galanakis Miltiades Kastanakis Serafim Kastanakis 《World Journal of Gastroenterology》 SCIE CAS 2017年第33期6049-6058,共10页
Colorectal cancer(CRC) is a common health problem,representing the third most commonly diagnosed cancer worldwide and causing a significant burden in terms of morbidity and mortality,with annual deaths estimated at 70... Colorectal cancer(CRC) is a common health problem,representing the third most commonly diagnosed cancer worldwide and causing a significant burden in terms of morbidity and mortality,with annual deaths estimated at 700000. The western way of life,that is being rapidly adopted in many regions of the world,is a well discussed risk factor for CRC and could be targeted in terms of primary prevention. Furthermore,the relatively slow development of this cancer permits drastic reduction of incidence and mortality through secondary prevention. These facts underlie primary care physicians(PCPs) being assigned a key role in health strategies that enhance prevention and prompt diagnosis. Herein,we review the main topics of CRC in the current literature,in order to better understand its pathogenesis,risk and protective factors,as well as screening techniques. Furthermore,we discuss preventive and screening policies to combat CRC and the crucial role served by PCPs in their successful implementation. Relevant articles were identified through electronic searches of MEDLINE and through manual searches of reference lists. 展开更多
关键词 Colorectal cancer PREVENTION DIAGNOSIS screenING primary care
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What is the most cost-effective strategy to screen for second primary colorectal cancers in male cancer survivors in Korea? 被引量:2
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作者 Sang Min Park Sun-Young Kim +2 位作者 Craig C Earle Seung-Yong Jeong Young Ho Yun 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第25期3153-3160,共8页
AIM: To identify a cost-effective strategy of second primary colorectal cancer (CRC) screening for cancer survivors in Korea using a decision-analytic model. METHODS: A Markov model estimated the clinical and econ... AIM: To identify a cost-effective strategy of second primary colorectal cancer (CRC) screening for cancer survivors in Korea using a decision-analytic model. METHODS: A Markov model estimated the clinical and economic consequences of a simulated 50-year- old male cancer survivors' cohort, and we compared the results of eight screening strategies: no screening, fecal occult blood test (FOBT) annually, FOBT every 2 years, sigmoidoscopy every 5 years, double contrast barium enema every 5 years, and colonoscopy every 10 years (COL10), every 5 years (COL5), and every 3 years (COL3). We included only direct medical costs, and our main outcome measures were discounted lifetime costs, life expectancy, and incremental cost- effectiveness ratio (ICER). RESULTS: In the base-case analysis, the non-dominat- ed strategies in cancer survivors were COL5, and COL3. The ICER for COL3 in cancer survivors was $5593/life- year saved (LYS), and did not exceed $10000/LYS in one-way sensitivity analyses. If the risk of CRC in can- cer survivors is at least two times higher than that in the general population, COL5 had an ICER of less than $10500/LYS among both good and poor prognosis of index cancer. If the age of cancer survivors starting CRC screening was decreased to 40 years, the ICER of COL5 was tess than $7400/LYS regardless of screening compliance. CONCLUSION: Our study suggests that more strict and frequent recommendations for colonoscopy such as COL5 and COL3 could be considered as economically reasonable second primary CRC screening strategies for Korean male cancer survivors. 展开更多
关键词 COST-EFFECTIVENESS Second primary colorectal cancer screening Cancer survivor
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Knowledge and Skills Gap of Midwives to Conduct Obstetric Ultrasonography Screening in Primary Health Care Facilities in Kajiado and Kisii Counties, Kenya
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作者 Micah Matiang’i Priscilla Ngunju +1 位作者 Josephat Nyagero Jarim Omogi 《Open Journal of Clinical Diagnostics》 2020年第2期65-79,共15页
<b><span style="font-family:Verdana;">Background: </span></b></span><span><span><span style="font-family:""><span style="font-family:Ver... <b><span style="font-family:Verdana;">Background: </span></b></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Ultrasound remains a tool of much importance in maternity care with midwives regarded as key health professionals when it comes to care of pregnant mothers. There is however limited study on the knowledge and skills gaps of midwives in conducting obstetric ultrasonography screening. The purpose of this study was to assess the specific obstetric ultrasonography knowledge and skills gaps among midwives based in primary health care facilities. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">A cross-sectional study employing both qualitative and quantitative method was conducted between July and August 2019 with 274 midwives. A structured questionnaire was used to collect data while Focus group discussion and Key Informants Interview were used to collect qualitative data. Descriptive statistics were used to summarize the data test associations between variables while the qualitative data were used to compliment the questionnaire data in eliciting more information on the gaps. </span><b><span style="font-family:Verdana;">Findings: </span></b><span style="font-family:Verdana;">Almost all (94.5%) the midwives had never been trained on any basic obstetric ultrasound while six of those that had been trained in early stages by the project</span><b> </b><span style="font-family:Verdana;">lacked equipment to practice the acquired skills. More than three quarters of the respondents opined that they wished to provide personalized care services to mothers/clients seeking Antenatal Care Services (ANC) in </span><span style="font-family:Verdana;">their community at a fee while only 13.9% had knowledge that obstetric</span><span style="font-family:Verdana;"> screening should be done before 24 weeks gestation. Four out of ten</span><b> </b><span style="font-family:Verdana;">of the respondents scored themselves a one (1) on the level of confidence they have using an ultrasound machines or technology. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">There still remains </span><span style="font-family:Verdana;">a huge gap as far as training of midwives on basic ultrasound screening is</span><span style="font-family:Verdana;"> concerned. The lack of basic obstetric ultrasound screening skills is a barrier </span><span style="font-family:Verdana;">to rolling out Point of Care Ultrasound (POCUS) screening services. Howev</span><span style="font-family:Verdana;">er, midwives are motivated and willing to learn basic ultrasonography skills to further the objectives of Universal Health Coverage (UHC). Concerted efforts should be made to train midwives on basic obstetric ultrasonography skills in addition to availing mobile/hand held ultrasound technology in Primary Health facilities for them to apply the transferred skills. A sustainable business model to enable mothers continuously afford the services is critical as well. 展开更多
关键词 Antenatal Care Basic Ultrasound screening MIDWIVES primary Health Care
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Adapting the PPRNet TRIP QI Model to Increase Colorectal Cancer Screening in Primary Care
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作者 Katherine Atassi Lynne Nemeth +2 位作者 Barbara Edlund Martina Mueller Irene Tessaro 《Journal of Cancer Therapy》 2012年第6期866-873,共8页
Background: Established CRCS guidelines for providers and the public exist, but due to several versions of CRCS guidelines and the variety of test options, confusion often arises among patients and providers, adversel... Background: Established CRCS guidelines for providers and the public exist, but due to several versions of CRCS guidelines and the variety of test options, confusion often arises among patients and providers, adversely affecting CRCS rates. Improving providers’ opportunities to recommend CRCS through provider-directed office-system interventions is critical to increase CRCS rates. Objective: The purpose of this study was to demonstrate the feasibility of adapting provider-directed office-system interventions developed by the Practice Partner Research Network (PPRNet) Translation of Research into Practice (TRIP) Quality Improvement (QI) Model for implementation in an independent, rural West Virginia primary care practice, and to obtain estimates of variability for relevant outcome measures of the interventions to increase CRCS recommendation and rates. Methods: Retrospective and prospective patient data from medical records and electronic medical records were extracted to compare pre-with post-intervention CRCS rates and analyze any significant demographic data. Also, office staff participated in a focus group interview. Results: The pre-intervention CRCS status/completion rate was 4.3% and increased to 36.2%. CRCS recommendation rate rose from 4.3% to 42.1%. Patients in the post group were almost 7 times more likely to get CRCS recommendation compared to patients in the pre group, adjusting for demographic information. Similar to findings for CRCS recommendations, patients in the post group were more than 12 times more likely to have CRCS completion compared to their counterparts in the pre-group (OR 12.61, p < 0.000, CI: 8.30, 19.15). Conclusion: This study demonstrated the feasibility as well as statistically significant preliminary indications that CRCS rates will increase after implementation of this model. 展开更多
关键词 COLORECTAL Cancer screening primary CARE Practice-Based Research Quality Improvement
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Case-finding for mental distress in primary health care: An evaluation of the performance of a five-item screening instrument
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作者 Peter J. Chipimo Knut Fylkesnes 《Health》 2013年第3期627-636,共10页
Background: There is an increased interest in developing better and more accurate methods to recognize and manage mental health problems in primary care settings. Abbreviated screening instruments for mental distress ... Background: There is an increased interest in developing better and more accurate methods to recognize and manage mental health problems in primary care settings. Abbreviated screening instruments for mental distress are useful tools for research and clinical practice. The present study seeks to investigate whether only a few questionnaire items from the Self-Reporting- Questionnaire-10 (SRQ-10) can be a robust method in the screening for Mental Distress in Primary Health care. Methods: We compared the screening accuracy of a short, five-item (SRQ-5) version of the SRQ-10 with that of the SRQ-20, General Health Questionnaire 12 (GHQ-12) using the DSM-IV axis as a gold standard and analyzed its performance in different diagnostic entities. We also assessed the correlation, sensitivity and specificity between the 4 instruments. All the instruments were administered to 400 primary health care attendees. Results: The estimated prevalence of mental distress was 13.6% in the study sample (Depression 11%, anxiety disorders 1.8%). The SRQ-5 was highly correlated to SRQ-10 (0.923, p < 0.001), SRQ-20 (0.764, p < 0.001) and only moderately correlated to GHQ-12 (0.417, p < 0.001). The SRQ-5 had high properties for identifying mental distress. The AUC for overall mental distress was 0.925 while that for depression and anxiety were 0.915 and 0.849 respectively. Conclusion: This validation showed that in moving from SRQ with 10 or 20 items to one with merely 5 items, we do not seem to lose the screening prowess of the instrument. The SRQ-5 represents a simplified and less time-consuming screening instrument with strong performance characteristics. We therefore recommend it for inclusion into existing patient assessment protocols, thus enhancing case finding at primary health care level. 展开更多
关键词 MENTAL DISTRESS screening Instruments Validity primary Health CARE SRQ-5 SRQ-10 SRQ-20 GHQ12 DSM-IV Zambia
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New Screening Approach for Ocular Diseases
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作者 Rogil José De Almeida Torres Andréa Luchini +2 位作者 Rogério João De Almeida Torres Mebaliah Luchini De Almeida Torres Lucas Antônio De Almeida Torres 《Health》 2023年第10期1059-1069,共11页
Objective: Present a new screening approach for ocular diseases. Method: Transversal, retrospective, single center study that analyzed medical records of patients from a social project on the prevention of blindness a... Objective: Present a new screening approach for ocular diseases. Method: Transversal, retrospective, single center study that analyzed medical records of patients from a social project on the prevention of blindness and amblyopia, which aimed at: 1) Detect the main ocular disorders such as amblyopia, primary angle-closure suspect (PACS);glaucoma suspect (GS);predisposing retinal detachment lesions (PRDL);age-related macular degeneration (AMD), and diabetic retinopathy (DR);2) Perform cataract diagnosis;3) Provide guidance and treatment for allergic conjunctivitis. 4) Prescribe glasses for children until 14 years of age. Participants were examined by a single specialist, holder of a post-doctoral degree in ophthalmology, with 36 years of experience and a sub-specialization in retina and vitreous. All data were analyzed in 2022. Results: The examiner diagnosed 42 cases of PACS, 21 of GS, 8 of PRDL, 14 of AMD, 3 of DR, 40 of cataract and 31 cases of allergic conjunctivitis. Thirty-three participants younger than 14 were prescribed glasses. Other pathologies included retinal detachment, papilledema, corneal ulcer, suspected conjunctival squamous cell carcinoma, retinal vasculitis, strabismus, uveitis, bilateral papilla paleness and lacrimal duct obstruction. Out of the 297 cases examined, 168 participants presented some type of alteration that could compromise their vision. Conclusion: The examiner’s experience and knowledge were decisive factors for the quick diagnosis, advice, screening and/or treatment of several ocular diseases. The social project results reveal that the primary care and/or the screening performed by a specialist are likely to reduce blindness cases. 展开更多
关键词 screenING Ocular Diseases primary Prevention Secondary Prevention Health Care Quality ACCESS EVALUATION AMAUROSIS
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宁波市江北区中小学生脊柱侧弯情况调查及影响因素
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作者 周娓 蔡一飙 陆毓剑 《健康研究》 CAS 2024年第2期143-147,共5页
目的 了解宁波市江北区中小学生脊柱侧弯初筛阳性情况并分析其影响因素,为青少年脊柱侧弯防治提供科学依据。方法 采用两阶段整群抽样的方法,抽取宁波市江北区2所小学、2所初中、2所普通高中的1 648名学生为调查对象,通过问卷收集基本... 目的 了解宁波市江北区中小学生脊柱侧弯初筛阳性情况并分析其影响因素,为青少年脊柱侧弯防治提供科学依据。方法 采用两阶段整群抽样的方法,抽取宁波市江北区2所小学、2所初中、2所普通高中的1 648名学生为调查对象,通过问卷收集基本信息、饮食运动、读写习惯、背包行为和行走姿态等资料;采用一般检查、前屈试验和脊柱侧弯测量仪初筛脊柱侧弯情况;采用Logistic回归分析脊柱侧弯的影响因素。结果 回收有效问卷1 639份,中小学生脊柱侧弯初筛阳性113例,检出率为6.89%;女生脊柱侧弯检出率(10.15%)高于男生(4.16%),差异有统计学意义(χ~2=22.730,P<0.05)。多因素Logistic回归分析结果显示,女性(OR=2.559,95%CI:1.698~3.855)、消瘦(OR=1.660,95%CI:1.123~2.455)是中小学生脊柱侧弯阳性的危险因素,父母偶尔或经常提醒读写姿势不正确(偶尔OR=0.557,95%CI:0.296~1.051,经常OR=0.430,95%CI:0.246~0.754)是中小学生脊柱侧弯阳性的保护因素(P<0.05)。结论 江北区中小学生脊柱侧弯问题较严重,应重视女生的健康教育,加强学生营养,父母应注重提醒学生及时纠正读写姿势。 展开更多
关键词 中小学生 脊柱侧弯 筛查
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多学科个性化动态营养干预对促进老年原发性肝癌患者术后恢复效果的影响 被引量:1
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作者 孟杨 侯婧悦 +2 位作者 梁东如 李洁 纪虹 《肿瘤综合治疗电子杂志》 2024年第1期128-133,共6页
目的 分析多学科个性化动态营养干预对促进老年原发性肝癌患者术后恢复效果的影响。方法 选取开滦总医院2022年1―12月收治的接受营养风险筛查2002(nutritional risk screening 2002,NRS 2002)风险评估且存在营养不良风险的老年原发性... 目的 分析多学科个性化动态营养干预对促进老年原发性肝癌患者术后恢复效果的影响。方法 选取开滦总医院2022年1―12月收治的接受营养风险筛查2002(nutritional risk screening 2002,NRS 2002)风险评估且存在营养不良风险的老年原发性肝癌患者80例作为研究对象,按随机数字表法分为对照组(n=40)和干预组(n=40)。对照组给予常规术后护理,干预组给予多学科个体化动态营养干预。比较两组患者术后恢复评分、术后恢复速度指标及护理前后患者的衰弱程度、绝望量表评分和营养指标。结果 干预组患者术后早期进食时间、肛门排气时间、达到目标70%进食量时间均显著早于对照组(均P <0.05),干预组患者住院天数显著短于对照组(P <0.05),干预组患者住院费用显著少于对照组(P <0.05)。干预组患者术后7 d恢复评分显著高于对照组(P <0.05)。两组患者护理后健康状况、社会支持、自制力、情绪指标评分均有所下降(均P <0.05),且干预组下降幅度均显著大于对照组(均P <0.05)。两组患者护理后对未来感觉评分和对未来期望评分均有所下降(均P <0.05),且干预组患者评分下降幅度均显著大于对照组(均P <0.05)。干预组患者术后并发症发生率明显显著低于对照组(P <0.05)。结论 多学科个性化动态营养干预促进老年原发性肝癌患者术后恢复的临床效果较好。 展开更多
关键词 原发性肝癌 老年 多学科个性化动态营养干预 营养风险筛查量表 术后恢复
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子宫颈癌十年研究回顾
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作者 李晓 吕卫国 《实用肿瘤杂志》 CAS 2024年第4期298-304,共7页
子宫颈癌是一种病因明确且可防可控的恶性肿瘤。尽管人乳头瘤病毒(human papillomavirus,HPV)疫苗研发和子宫颈癌筛查已广泛开展,但其发病率仍逐年上升,并呈现低龄化的趋势,提示子宫颈癌防控仍有待优化。因此世界卫生组织提出加速消除... 子宫颈癌是一种病因明确且可防可控的恶性肿瘤。尽管人乳头瘤病毒(human papillomavirus,HPV)疫苗研发和子宫颈癌筛查已广泛开展,但其发病率仍逐年上升,并呈现低龄化的趋势,提示子宫颈癌防控仍有待优化。因此世界卫生组织提出加速消除子宫颈癌全球战略。随着对HPV致癌机制的深入研究,子宫颈癌筛查技术不断革新,出现HPV拓展分型、p16INK4a(p16)/Ki-67双重染色(双染)、基因甲基化和HPV整合检测等具有临床前景的新技术。另外,为改善子宫颈癌患者的预后,基于新辅助化疗、同步放化疗、免疫治疗和靶向治疗等不同治疗方式的联合方案成为临床研究热点。本文就子宫颈癌10年研究现状进行述评。 展开更多
关键词 子宫颈癌 人乳头瘤病毒疫苗 人乳头瘤病毒初筛 靶向治疗 免疫治疗
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三基色LED显示屏的设计与实现
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作者 唐美玲 王小兵 林必忠 《现代信息科技》 2024年第21期16-19,共4页
LED显示屏因其低成本、高亮度、易维护等优势,逐渐成为主流的大型显示设备。文章描述了运用单片机H8/3048和FPGA芯片EPF10K10TC144-4作为主控制器件的LED显示屏设计方案,该方案运用单片机进行算法控制产生显示的数据信号和同步的控制信... LED显示屏因其低成本、高亮度、易维护等优势,逐渐成为主流的大型显示设备。文章描述了运用单片机H8/3048和FPGA芯片EPF10K10TC144-4作为主控制器件的LED显示屏设计方案,该方案运用单片机进行算法控制产生显示的数据信号和同步的控制信号。同时,运用FPGA搭建逻辑功能模块,用于接收信号,存储信号,将信号从串行输入变换成并行输出,再将信号传递给三极管功率驱动器件和LED显示屏,从而生成可静止、可上下左右移动显示的性能稳定的绿色、红色和橙色的三基色LED显示屏。 展开更多
关键词 单片机 FPGA 三基色 LED显示屏
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专科护士参与的住院患者脑卒中风险筛查及随访管理 被引量:2
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作者 孙莉 陆敏智 +2 位作者 浦菊芬 包秋芳 杨靖华 《护理学杂志》 CSCD 北大核心 2024年第3期1-5,共5页
目的探讨专科护士参与的住院患者脑卒中风险筛查及随访管理效果,为全面落实脑卒中一级预防提供借鉴。方法构建住院患者脑卒中风险筛查模式,对内外科≥40岁的住院患者进行脑卒中风险筛查。由病区责任护士对患者进行初筛、专科护士对高危... 目的探讨专科护士参与的住院患者脑卒中风险筛查及随访管理效果,为全面落实脑卒中一级预防提供借鉴。方法构建住院患者脑卒中风险筛查模式,对内外科≥40岁的住院患者进行脑卒中风险筛查。由病区责任护士对患者进行初筛、专科护士对高危风险患者进行卒中一级预防管理,进行1年的随访。结果2021年9月从内外科36个病区中筛查出脑卒中风险患者3416例,其中高危513例(15.02%),中危1926例(56.38%),低危977例(28.60%);对3类患者实施分级管理,其中高危患者由神经内科进一步诊疗;完成1年随访的197例高危患者,随访后血压、血脂、运动等达标率显著高于随访前(均P<0.05),健康自我管理能力得分显著提高(均P<0.05)。结论专科护士参与的住院患者脑卒中风险筛查模式有利于早期发现脑卒中风险患者,落实一级预防,从而降低脑卒中发生率。 展开更多
关键词 住院患者 脑卒中 风险筛查 专科护士 脑卒中门诊 随访 一级预防 神经内科护理
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基层糖尿病微血管疾病筛查与防治专家共识(2024) 被引量:1
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作者 中国微循环学会糖尿病与微循环专业委员会 中华医学会内分泌学分会基层内分泌代谢病学组 +14 位作者 孙子林 管庆波 郭海健 李红 李凯利 李甦雁 刘芳 任利群 王清 吴静 邢昌赢 薛耀明 严孙杰 杨兵全 余江毅 《中国全科医学》 CAS 北大核心 2024年第32期3969-3986,共18页
糖尿病微血管疾病(DMiVD)是糖尿病常见的慢性并发症,早期识别及有效干预可以显著提高患者生活质量,改善预后。中国微循环学会糖尿病与微循环专业委员会和中华医学会内分泌学分会基层内分泌代谢病学组组织领域内专家,以2021年版为基础,... 糖尿病微血管疾病(DMiVD)是糖尿病常见的慢性并发症,早期识别及有效干预可以显著提高患者生活质量,改善预后。中国微循环学会糖尿病与微循环专业委员会和中华医学会内分泌学分会基层内分泌代谢病学组组织领域内专家,以2021年版为基础,结合最新研究进展,特别针对基层临床实际需求,修订《基层糖尿病微血管疾病筛查与防治专家共识(2024)》。该共识详尽阐述了DMiVD(糖尿病视网膜病变、糖尿病肾脏病、远端对称性多发性神经病变和糖尿病心肌病)的筛查方法、综合管理及防治策略,明确分级诊疗及转诊流程,强化防治DMiVD重要性,为广大医师特别是基层医生及全科医生提供指导和建议,降低DMiVD的发生率、恶化率以及致残致死率。 展开更多
关键词 糖尿病微血管疾病 基层 危险因素 筛查 疾病综合管理 分级诊疗 转诊 专家共识
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中老年居民动脉硬化自我筛查与基层医疗机构初筛工具构建
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作者 蒙玥 郑利 +6 位作者 周静 王大珊 胡瑾 汪蝶 李游 汪俊华 王子云 《实用医学杂志》 CAS 北大核心 2024年第14期1947-1951,共5页
目的探索简便的动脉硬化初步筛查模型,为40~65岁居民早期识别动脉硬化风险,基层医疗机构改进动脉硬化筛查服务提供可行工具。方法数据来源于福泉市睡眠与慢性病研究的基线调查。按8:2的比例分为训练集与验证集,使用LASSO和logistic回归... 目的探索简便的动脉硬化初步筛查模型,为40~65岁居民早期识别动脉硬化风险,基层医疗机构改进动脉硬化筛查服务提供可行工具。方法数据来源于福泉市睡眠与慢性病研究的基线调查。按8:2的比例分为训练集与验证集,使用LASSO和logistic回归模型筛选变量、进行多因素回归分析,采用Bootstrap法进行内部验证。构建列线图模型,并根据ROC曲线确定风险评分阈值以划分高风险人群。结果居民初筛模型包括年龄、性别、午睡、睡眠效率、睡眠障碍及患高血压、糖尿病的情况,AUC为74.80%,模型风险评分阈值为84.20分。基层医疗机构初筛模型包括年龄、性别、午睡、睡眠效率、收缩压、空腹血糖、脉搏变量,AUC为82.80%,风险评分阈值为78.00分。决策曲线显示两个模型在健康管理实际获益方面表现良好。结论居民初筛模型、基层初筛模型两个模型准确性、区分度较好,可在居民自我健康管理和基层医疗机构初筛工作中推广应用。 展开更多
关键词 动脉硬化 筛检模型 中老年人 列线图 基层医疗机构
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基层医院营养风险筛查评分与营养不良等级的分析
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作者 赵霞 陶芝英 孙莉萍 《中国现代医生》 2024年第27期61-63,共3页
目的 分析区级基层医院对住院患者的营养风险筛查2002(nutritional risk screening 2002,NRS 2002)评分与全球领导人发起的营养不良诊断共识(global leadership initiative on malnutrition,GLIM)标准诊断的营养不良等级的相关性。方法... 目的 分析区级基层医院对住院患者的营养风险筛查2002(nutritional risk screening 2002,NRS 2002)评分与全球领导人发起的营养不良诊断共识(global leadership initiative on malnutrition,GLIM)标准诊断的营养不良等级的相关性。方法 回顾性选取2023年11月至2024年2月在绍兴第二医院医共体总院住院的361例营养风险筛查阳性(NRS2002评分≥3分)患者,按GLIM标准诊断患者是否存在营养不良,并对诊断为营养不良的患者进一步评定其营养不良等级(中度营养不良或重度营养不良),分析NRS2002评分与营养不良等级之间的相关性。结果 361例患者中最终诊断为无营养不良179例,中度营养不良140例,重度营养不良42例,Kendall’s tau-b系数值分析NRS2002评分和营养不良等级之间具有较强正相关性(Kendall’s tau-b>0.6,P<0.0001)。不同年龄段组别(<70岁与≥70岁)营养不良发生率差异有统计学意义(P<0.05)。不同性别组别营养不良发生率比较,差异无统计学意义(P>0.05)。结论 基层医院患者的NRS 2002评分越高,GLIM评定法诊断为营养不良的等级越高,两者具有较强的正相关关系。营养不良发生率与性别无关,但相较于年龄<70岁的人群,年龄≥70岁的人群营养不良发生率更高。 展开更多
关键词 营养风险筛查 GLIM标准 营养不良 基层医院
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HPV阳性女性中宫颈液基细胞学、DNA倍体分析及P16/Ki-67双染检测对宫颈癌前病变的分流效果研究
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作者 关春艳 董格红 +6 位作者 陈柯霖 李佳 冯力民 廖柯鑫 李少祥 李洪利 张国军 《标记免疫分析与临床》 CAS 2024年第6期1157-1161,共5页
目的探讨在HPV阳性女性中,液基细胞学、DNA倍体分析及P16/Ki-67双染检测对宫颈癌前病变的分流作用。方法回顾性分析2021年5月至2022年12月在我院妇科行阴道镜及宫颈活检的妇女590例。患者高危人乳头瘤病毒(human papilloma virus,HPV)... 目的探讨在HPV阳性女性中,液基细胞学、DNA倍体分析及P16/Ki-67双染检测对宫颈癌前病变的分流作用。方法回顾性分析2021年5月至2022年12月在我院妇科行阴道镜及宫颈活检的妇女590例。患者高危人乳头瘤病毒(human papilloma virus,HPV)检测阳性,且行液基细胞学(liquid-based cytology,LBC)、DNA倍体分析、P16/Ki-67双染3种检查,对上述3种方法的灵敏度、特异性、受试者工作特征(receiver operating characteristic,ROC)曲线进行统计分析。结果液基细胞学、DNA倍体分析和P16/Ki-67双染3种筛查方法对宫颈癌前病变的灵敏度分别为84.2%、77.5%、76.4%,特异性分别为40.7%、49.2%、70.1%,曲线下面积(area under the curve,AUC)分别是0.625、0.634、0.733,其中,P16/Ki-67双染检测显著优于液基细胞学检查及DNA倍体分析(P<0.0001)。结论本研究认为,在HPV阳性女性中,P16/Ki-67双染检测的分流效果最佳。 展开更多
关键词 宫颈癌前病变 初筛 DNA倍体分析 P16/Ki-67双染 人乳头瘤病毒 液基细胞学
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初筛谷丙转氨酶结果偏高献血者的补救方法
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作者 祝丽双 王浩 《河南医学研究》 CAS 2024年第3期404-407,共4页
目的 通过初筛无偿献血者谷丙转氨酶(ALT),对献血前ALT初筛结果偏高的献血者制定相应补救措施,一定程度上解决生理因素引起的献血前ALT异常造成的献血者流失问题。方法 采用干式生化法,对2022年1—6月至河南省某血站的所有无偿献血者进... 目的 通过初筛无偿献血者谷丙转氨酶(ALT),对献血前ALT初筛结果偏高的献血者制定相应补救措施,一定程度上解决生理因素引起的献血前ALT异常造成的献血者流失问题。方法 采用干式生化法,对2022年1—6月至河南省某血站的所有无偿献血者进行ALT初筛,对于ALT>45 U·L^(-1)且乙肝和血红蛋白初筛合格的献血者重复初筛检测3次,取3次结果的平均值,如仍>45 U·L^(-1)则进行相应干预措施,献血后采用速率法复检ALT,比较干预前后献血合格率及血液ALT报废率情况。结果 对乙肝和血红蛋白初筛合格的献血员,ALT水平在45~50 U·L^(-1)者,嘱其安静休息30 min复测ALT。结果显示,在安静休息30 min后,ALT轻度偏高的献血者,初筛ALT检测值越低,复测ALT合格率越高,实施补救措施的献血员献血后追踪复检ALT合格率为99.9%。对于安静休息30 min后复测ALT仍不合格者,嘱其清淡饮食、避免饮酒和熬夜,5~7 d后1 250名该类人员参与献血健康检查,其中430名初筛ALT合格,献血后追踪复检ALT合格率为99.7%。结论 对于初筛ALT不合格献血员,通过实施相应干预措施,可使部分ALT异常的献血者降至正常,提升献血合格率,在一定程度上缓解临床用血紧张。 展开更多
关键词 谷丙转氨酶 初筛 无偿献血者
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基于激光光幕的高速小目标信噪比研究
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作者 许鹏 李旭东 +3 位作者 刘俊良 陈明刚 樊家豪 赵辉 《光电子技术》 CAS 2024年第1期13-18,33,共7页
通过对目标过靶时光电探测器与运算放大器所产生信号和噪声的研究,推导出信噪比与激光出射功率、原向反射屏逆反射效率的理论关系;进行多组实验验证激光功率、反射效率对信号信噪比的影响。结果表明所设计的激光光幕系统,通过适当提高... 通过对目标过靶时光电探测器与运算放大器所产生信号和噪声的研究,推导出信噪比与激光出射功率、原向反射屏逆反射效率的理论关系;进行多组实验验证激光功率、反射效率对信号信噪比的影响。结果表明所设计的激光光幕系统,通过适当提高激光功率、采用逆反射效率高的反射屏,可以有效提升高速小目标过靶信号的信噪比。 展开更多
关键词 激光光幕系统 高速小目标 光电探测器 原向反射屏 信噪比
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‘Prediabetes’ as a practical distinctive window for workable fruitful wonders: Prevention and progression alert as advanced professionalism
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作者 Sunil Jain 《World Journal of Clinical Pediatrics》 2024年第1期1-6,共6页
Diabetes is a devastating public health problem.Prediabetes is an intermediate stage in the disease processes leading to diabetes,including types 1 and 2 diabetes.In the article“Prediabetes in children and adolescent... Diabetes is a devastating public health problem.Prediabetes is an intermediate stage in the disease processes leading to diabetes,including types 1 and 2 diabetes.In the article“Prediabetes in children and adolescents:An updated review,”the authors presented current evidence.We simplify and systematically clearly present the evidence and rationale for a conceptual framework we term the‘3ASs’:(1)Awareness Sensible;(2)Algorithm Simple;and(3)Appealing Strategies.Policy makers and the public need to be alerted.The prevalence of prediabetes should send alarm bells ringing for parents,individuals,clinicians,and policy makers.Prediabetes is defined by the following criteria:impaired fasting glucose(100-125 mg/dL);impaired glucose tolerance(2 h postprandial glucose 140-199 mg/dL);or hemoglobin A1c values of 5.7%–6.4%.Any of the above positive test alerts for intervention.Clinical guidelines do not recommend prioritizing one test over the others for evaluation.Decisions should be made on the strengths and shortfalls of each test.Patient preferences and test accessibility should be taken into consideration.An algorithm based on age,physiological stage,health status,and risk factors is provided.Primordial prevention targeting populations aims to eliminate risk factors through public education and encouraging practices through environmental modifications.Access to healthy foods is provided.Primary prevention is for individuals with a prediabetes diagnosis and involves a structured program to reduce body weight and increase physical activity along with a healthy diet.An overall methodical move to a healthy lifestyle for lifelong health is urgently needed.Early energetic prediabetes action is necessary. 展开更多
关键词 Obesity OVERWEIGHT Awareness Algorithm Lifestyle Physical exercise screening Primordial prevention primary prevention Adolescents
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Screening and Identification of Antagonistic Bacterium ZG-10 against Spot Blotch Disease in Pakchoi
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作者 赵光 《Plant Diseases and Pests》 CAS 2010年第3期11-14,共4页
[ Objective] The purpose was to screen bacterium with antagonistic effect against pathogen of spot blotch disease in pakchoi in vegetable field. [Method] More than 200 strains of bacteria which could produce spore wer... [ Objective] The purpose was to screen bacterium with antagonistic effect against pathogen of spot blotch disease in pakchoi in vegetable field. [Method] More than 200 strains of bacteria which could produce spore were isolated from soil in different places. Through screening and rescreening, the bacteria with higher antibacterial activity were conducted observation about thallus shapes and colony characters, a series of physiological and biochemical tests were performed. [Result] Rescreening results indicated that the strains including ZG-10, ZG-19, ZG-59, ZG-72 and ZG-31 had significant antibacterial activity, which had very high research value and good application prospect for biocontrol on spot blotch disease in pakchoi; the strain ZG-10 was identified to be Bacillus subtilis. [ Conclusion] The strain ZG-10 had biocontrol potential and good development prospect. This research laid certain basis for subsequent research and strated a new way for the application of antagonistic strain and proteinum polypeptide in agdculture. 展开更多
关键词 Spot blotch disease in pakchoi Antagonistic bacterium primary screening Rescreening IDENTIFICATION
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