背景高血压是心血管疾病主要的危险因素,降压用药不仅要考虑患者血压特征,也要考虑患者合并症情况。现阶段,基于家庭医生签约服务对高血压患者的服药状况及影响因素研究比较缺乏。目的调查安徽省界首市家庭医生签约服务的高血压患者服...背景高血压是心血管疾病主要的危险因素,降压用药不仅要考虑患者血压特征,也要考虑患者合并症情况。现阶段,基于家庭医生签约服务对高血压患者的服药状况及影响因素研究比较缺乏。目的调查安徽省界首市家庭医生签约服务的高血压患者服药现状,描述患者服药行为与患者特征之间的关联,探索患者用药调整的影响因素,并分析基层高血压患者用药的合理性。方法采用整群抽样的方法,于2021年7—8月从安徽省界首市随机抽取48个行政村,通过面对面调查法采用自制问卷收集患者特征和服药数据,参照《国家基层高血压防治管理指南2020版》将问卷中患者提到的降压药分为如下5类:A类为血管紧张素转换酶抑制剂(ACEI)和血管紧张素受体阻滞剂(ARB),B类为β受体阻滞剂,C类为钙通道阻滞剂(CCB),D类为利尿剂,E类为单片复方制剂。通过科大讯飞智能语音血压计的后台获取患者上传的近1年血压数据,分析不同特征患者的服药行为。采用多因素Logistic回归分析探讨高血压患者用药调整的影响因素。本研究中联合用药是指服用复方制剂或2种以上降压药,用药调整是指患者过去服用其他降压药。结果本研究共纳入高血压患者3005例,其中男1291例(43.0%)、女1714例(57.0%),平均年龄为(65.5±9.8)岁,高血压服药率为79.1%,联合用药率为40.2%。2376例服用降压药的患者中,不同类型降压药服用率从高到低依次为(部分患者存在联合用药):E类(39.6%)、C类(35.1%)、D类(20.3%)、A类(20.1%)、B类(3.7%);服用最多的降压药为复方利血平(33.7%)。对于年均血压≥160/100mm Hg的患者,仍有12.2%和4.9%未服用降压药。患者联合用药以E类降压药为主。年均“舒张压≥100 mm Hg”且“患合并症”的患者,调整后A类和C类降压药的服用率增加相对较多,年均“收缩压≥160 mm Hg”且“未患合并症”的患者,调整后E类降压药的服用率增加相对较多。多因素Logistic回归结果显示,服药年数长(OR=1.042,95%CI=1.031~1.053,P<0.001)、初中以上文化程度(OR=1.488,95%CI=1.195~1.853,P<0.001)、合并高脂血症(OR=1.267,95%CI=1.052~1.525,P=0.013)、合并心血管疾病(OR=1.394,95%CI=1.166~1.667,P<0.001)、合并脑血管疾病(OR=1.258,95%CI=1.040~1.522,P=0.018)是患者用药调整的促进因素,高龄(OR=0.980,95%CI=0.971~0.990,P<0.001)是用药调整的抑制因素。结论界首市农村地区高血压患者的服药率较高,主要服用E类和C类降压药。服药年数长、初中以上文化程度、合并高脂血症、合并心脑血管疾病是患者用药调整的促进因素,高龄是用药调整的抑制因素。展开更多
Based on current rural tourism development of China and its typical modes,this paper on the basis of studying significance and impact of characteristic culture on rural tourism proposes the concept of"integrating...Based on current rural tourism development of China and its typical modes,this paper on the basis of studying significance and impact of characteristic culture on rural tourism proposes the concept of"integrating characteristic culture and rural tourism,elaborates significance of attractive force of folk cultures,expressive power of vernacular cultures,appeal of characteristic cultures for the optimization of rural tourism industry.展开更多
At the beginning of the 1980s, the Central Place Theory(CPT) was introduced into China from the West. The authors of this article are the initiators of applying this model to China's urban and regional planning as...At the beginning of the 1980s, the Central Place Theory(CPT) was introduced into China from the West. The authors of this article are the initiators of applying this model to China's urban and regional planning as well as to the allocation of commercial activities. Since the commodity economy has been developing in China for thousands of years,most of the areas in eastern plains and inland basins of the country show the spatial structure of typical central places scene. During some six years, the authors participatd in a lot of rural, urban and regional planning projects in which the spatial phenomena and relevant internal mechanism proved this medel and its deformation. This paper gives only a few examples of the application of CPT in China. 1. The distribution of rural markets: the empirical study is based mainly on the situation in Shengfang Town and its vicinal area, 2. The spatial combination of urban Systems; problems about city allocation in North China are emphasized, 3. Commercial centres in city and the networks: a crucial study on commercial distribution of the metropolis Beijing is done by using the central place model.展开更多
Rural power network planning is a complicated nonlinear optimized combination problem which based on load forecasting results, and its actual load is affected by many uncertain factors, which influenced optimization r...Rural power network planning is a complicated nonlinear optimized combination problem which based on load forecasting results, and its actual load is affected by many uncertain factors, which influenced optimization results of rural power network planning. To solve the problems, the interval algorithm was used to modify the initial search method of uncertainty load mathematics model in rural network planning. Meanwhile, the genetic/tabu search combination algorithm was adopted to optimize the initialized network. The sample analysis results showed that compared with the certainty planning, the improved method was suitable for urban medium-voltage distribution network planning with consideration of uncertainty load and the planning results conformed to the reality.展开更多
农村地区之间存在着显著的地区差异,为了指导农村电网投资,提出一种基于组合赋权和多属性边界逼近区域比较法(multi-attributive border approximation area comparison,MABAC)的差异化农网综合效益评价模型。首先,综合考虑农村地区差...农村地区之间存在着显著的地区差异,为了指导农村电网投资,提出一种基于组合赋权和多属性边界逼近区域比较法(multi-attributive border approximation area comparison,MABAC)的差异化农网综合效益评价模型。首先,综合考虑农村地区差异及乡村振兴战略对农网发展的要求,从农网投资经济效益、供电能力、基础设施情况、地区发展带动、生产生活质量、清洁低碳发展等6个方面构建农网综合效益评价指标体系;其次,基于最小化主客观权重异质性原则构建基于图模型—熵权法的组合赋权模型,并引入MABAC方法用于解决农网综合效益评价问题;最后,通过算例分析验证了所提出模型的有效性。展开更多
文摘背景高血压是心血管疾病主要的危险因素,降压用药不仅要考虑患者血压特征,也要考虑患者合并症情况。现阶段,基于家庭医生签约服务对高血压患者的服药状况及影响因素研究比较缺乏。目的调查安徽省界首市家庭医生签约服务的高血压患者服药现状,描述患者服药行为与患者特征之间的关联,探索患者用药调整的影响因素,并分析基层高血压患者用药的合理性。方法采用整群抽样的方法,于2021年7—8月从安徽省界首市随机抽取48个行政村,通过面对面调查法采用自制问卷收集患者特征和服药数据,参照《国家基层高血压防治管理指南2020版》将问卷中患者提到的降压药分为如下5类:A类为血管紧张素转换酶抑制剂(ACEI)和血管紧张素受体阻滞剂(ARB),B类为β受体阻滞剂,C类为钙通道阻滞剂(CCB),D类为利尿剂,E类为单片复方制剂。通过科大讯飞智能语音血压计的后台获取患者上传的近1年血压数据,分析不同特征患者的服药行为。采用多因素Logistic回归分析探讨高血压患者用药调整的影响因素。本研究中联合用药是指服用复方制剂或2种以上降压药,用药调整是指患者过去服用其他降压药。结果本研究共纳入高血压患者3005例,其中男1291例(43.0%)、女1714例(57.0%),平均年龄为(65.5±9.8)岁,高血压服药率为79.1%,联合用药率为40.2%。2376例服用降压药的患者中,不同类型降压药服用率从高到低依次为(部分患者存在联合用药):E类(39.6%)、C类(35.1%)、D类(20.3%)、A类(20.1%)、B类(3.7%);服用最多的降压药为复方利血平(33.7%)。对于年均血压≥160/100mm Hg的患者,仍有12.2%和4.9%未服用降压药。患者联合用药以E类降压药为主。年均“舒张压≥100 mm Hg”且“患合并症”的患者,调整后A类和C类降压药的服用率增加相对较多,年均“收缩压≥160 mm Hg”且“未患合并症”的患者,调整后E类降压药的服用率增加相对较多。多因素Logistic回归结果显示,服药年数长(OR=1.042,95%CI=1.031~1.053,P<0.001)、初中以上文化程度(OR=1.488,95%CI=1.195~1.853,P<0.001)、合并高脂血症(OR=1.267,95%CI=1.052~1.525,P=0.013)、合并心血管疾病(OR=1.394,95%CI=1.166~1.667,P<0.001)、合并脑血管疾病(OR=1.258,95%CI=1.040~1.522,P=0.018)是患者用药调整的促进因素,高龄(OR=0.980,95%CI=0.971~0.990,P<0.001)是用药调整的抑制因素。结论界首市农村地区高血压患者的服药率较高,主要服用E类和C类降压药。服药年数长、初中以上文化程度、合并高脂血症、合并心脑血管疾病是患者用药调整的促进因素,高龄是用药调整的抑制因素。
基金Supported by Program of Yunnan Provincial Department of Education(2010C222)
文摘Based on current rural tourism development of China and its typical modes,this paper on the basis of studying significance and impact of characteristic culture on rural tourism proposes the concept of"integrating characteristic culture and rural tourism,elaborates significance of attractive force of folk cultures,expressive power of vernacular cultures,appeal of characteristic cultures for the optimization of rural tourism industry.
文摘At the beginning of the 1980s, the Central Place Theory(CPT) was introduced into China from the West. The authors of this article are the initiators of applying this model to China's urban and regional planning as well as to the allocation of commercial activities. Since the commodity economy has been developing in China for thousands of years,most of the areas in eastern plains and inland basins of the country show the spatial structure of typical central places scene. During some six years, the authors participatd in a lot of rural, urban and regional planning projects in which the spatial phenomena and relevant internal mechanism proved this medel and its deformation. This paper gives only a few examples of the application of CPT in China. 1. The distribution of rural markets: the empirical study is based mainly on the situation in Shengfang Town and its vicinal area, 2. The spatial combination of urban Systems; problems about city allocation in North China are emphasized, 3. Commercial centres in city and the networks: a crucial study on commercial distribution of the metropolis Beijing is done by using the central place model.
文摘Rural power network planning is a complicated nonlinear optimized combination problem which based on load forecasting results, and its actual load is affected by many uncertain factors, which influenced optimization results of rural power network planning. To solve the problems, the interval algorithm was used to modify the initial search method of uncertainty load mathematics model in rural network planning. Meanwhile, the genetic/tabu search combination algorithm was adopted to optimize the initialized network. The sample analysis results showed that compared with the certainty planning, the improved method was suitable for urban medium-voltage distribution network planning with consideration of uncertainty load and the planning results conformed to the reality.
文摘农村地区之间存在着显著的地区差异,为了指导农村电网投资,提出一种基于组合赋权和多属性边界逼近区域比较法(multi-attributive border approximation area comparison,MABAC)的差异化农网综合效益评价模型。首先,综合考虑农村地区差异及乡村振兴战略对农网发展的要求,从农网投资经济效益、供电能力、基础设施情况、地区发展带动、生产生活质量、清洁低碳发展等6个方面构建农网综合效益评价指标体系;其次,基于最小化主客观权重异质性原则构建基于图模型—熵权法的组合赋权模型,并引入MABAC方法用于解决农网综合效益评价问题;最后,通过算例分析验证了所提出模型的有效性。
