目的了解2009年基诺族精神分裂症的患病率和发病率,并了解其近30年的患病率变化趋势。方法 2009年对基诺族44个自然村总计10610人进行单纯整群随机抽样,对实际抽样的1984人进行精神分裂症的患病率调查。采用一般健康问卷12项(12-item ge...目的了解2009年基诺族精神分裂症的患病率和发病率,并了解其近30年的患病率变化趋势。方法 2009年对基诺族44个自然村总计10610人进行单纯整群随机抽样,对实际抽样的1984人进行精神分裂症的患病率调查。采用一般健康问卷12项(12-item general health questionnaire,GHQ-12)进行筛查,依据GHQ-12得分按比例抽取危险人群,采用SCID-I/P工具进行面检并作出诊断。同时,对有精神分裂症患病线索资料的个体进行入户访谈,其中包括既往流行病学调查中已诊断的33例精神分裂症病例。比较两种调查方法得到的精神分裂症患病率,对近30年来的精神分裂症患病率进行掊2趋势检验。结果线索调查中精神分裂症的终生和时点患病率、年发病率均高于抽样调查,但差异均无统计学意义(P>0.05)。线索调查结果显示,基诺族精神分裂症终生患病率0.37%(39/10610),时点患病率0.27%(29/10610),男性均高于女性(掊2=10.27,P<0.01;掊2=8.02,P<0.01)。近10年新发病例12例,其中近一年新发病1例,年发病率9.43/10万(1/10610)。与1979年、1989年、1999年比较,基诺族30年来的精神分裂症的终生患病率和时点患病率并无明显变化(掊2=0.18,P>0.05;掊2=0.18,P>0.05)。结论基诺族精神分裂症终生患病率及时点患病率近30年来无明显变化趋势。展开更多
AIM:To investigate the prevalence of gallstone dis-ease(GSD) and to evaluate the risk of symptomatic GSD among diabetic patients.METHODS:The study was conducted by analyzing the National Health Research Institutes(NHR...AIM:To investigate the prevalence of gallstone dis-ease(GSD) and to evaluate the risk of symptomatic GSD among diabetic patients.METHODS:The study was conducted by analyzing the National Health Research Institutes(NHRI) dataset of ambulatory care patients,inpatient claims,and the updated registry of beneficiaries from 2000 to 2008.A total of 615 532 diabetic patients without a prior history of hospital treatment or ambulatory care visits for symptomatic GSD were identified in the year 2000.Age-and gender-matched control individuals free from both GSD and diabetes from 1997 to 1999 were randomly selected from the NHIR database(n = 614 871).The incidence densities of symptomatic GSD were estimated according to the subjects' diabetic status.The distributions of age,gender,occupation,income,and residential area urbanization were compared between diabetic patients and control subjects using Cox proportion hazards models.Differences between the rates of selected comorbidities were also assessed in the two groups.RESULTS:Overall,60 734 diabetic patients and 48 116 control patients developed symptomatic GSD and underwent operations,resulting in cumulative operation rates of 9.87% and 7.83%,respectively.The age and gender distributions of both groups were similar,with a mean age of 60 years and a predominance of females.The diabetic group had a significantly higher prevalence of all comorbidities of interest.A higher incidence of symptomatic GSD was observed in females than in males in both groups.In the control group,females under the age of 64 had a significantly higher incidence of GSD than the corresponding males,but this difference was reduced with increasing age.The cumulative incidences of operations for symptomatic GSD in the diabetic and control groups were 13.06 and 9.52 cases per 1000 person-years,respectively.Diabetic men exhibited a higher incidence of operations for symptomatic GSD than did their counterparts in the control group(12.35 vs 8.75 cases per 1000 person-years).CONCLUSION:The association of diabetes with increased symptomatic GSD may provide insight to the treatment or management of diabetes in clinical settings.展开更多
目的:以往研究都表明,2型糖尿病患者易发生体位性低血压,但该人群的体位性高血压的临床重要性及患病率情况如何并不清楚。方法:选择连续入院277例2型糖尿病患者,包括90例高血压患者及128例年龄匹配的非糖尿病个体。体位性高血压定义为...目的:以往研究都表明,2型糖尿病患者易发生体位性低血压,但该人群的体位性高血压的临床重要性及患病率情况如何并不清楚。方法:选择连续入院277例2型糖尿病患者,包括90例高血压患者及128例年龄匹配的非糖尿病个体。体位性高血压定义为体位便从卧位变为立位时,收缩压和(或)舒张压从140mmHg/90mmHg以下上升并超过140/90mmHg。所有受试者均采集临床资料及生化指标。结果:体位性高血压的在糖尿病患者中患病率都显著高于对照组(12.8 vs 1.8%,P<0.01)。糖尿病合并体位性高血压患者由体位变化引起的血压水平增加程度显著高于糖尿病不合并体位性高血压的患者。(收缩压平均变化值:6.8±11.4 vs 1.6±9.0 mmHg,P<0.05;舒张压平均变化值:9.1±5.2 vs 3.8±6.6 mmHg,P<0.005)。糖尿病合并体位性高血压的患者血压水平及血清甘油三酯水平均高于其他组(P<0.05)。结论:2型糖尿病患者合并早期神经病变更易出现体位性高血压,并且可能是糖尿病患者发展为原发性高血压的危险因素。展开更多
Two hundred and sixty-two patients with carpal tunnel syndrome (CTS) were analyzed retrospectively. Results showed that middle-and older-age women were more apt to have CTS than men, and that the dominant hand was mor...Two hundred and sixty-two patients with carpal tunnel syndrome (CTS) were analyzed retrospectively. Results showed that middle-and older-age women were more apt to have CTS than men, and that the dominant hand was more frequently affected. Hormonal changes , repetitive and forceful movements, awkward positions of hand and wrist, and other factors may be associated with CTS. Typical clinical manifestations include pain and paresthesia in the median nerve territory, worsening at night or in the early morning , and being relieved by shaking the hand. Although the patients may localize the discomfort beyond the territory, sensory changes are variable and not entirely reliable. Conduction abnormalities often appeared selectively in the median nerve distal to the wrist in CTS. If the patient who is clinically suggestive of CTS shows normal conduction with conventional methods, palmar stimulation and inching technique is recommended. The diagnosis of CTS requires confirmation of illness history, symptoms and signs with objective electrodiagnostic tests.展开更多
This paper pays a tribute to Dr.Frank I Tovey on his 90th birthday which happens on September 1,2011,and briefly describes the major findings in his research career and contributions as follows.The geographical preval...This paper pays a tribute to Dr.Frank I Tovey on his 90th birthday which happens on September 1,2011,and briefly describes the major findings in his research career and contributions as follows.The geographical prevalence of duodenal ulceration is related to staple diets.Unrefined wheat and maize,soya,certain pulses and millets are associated with a low prevalence while refined wheat,maize and rice,yams,cassava and green banana with a high prevalence.Predominant foodstuffs from low prevalence areas are ulceroprotective in rat peptic ulcer models.The protective activity lies in the lipid fraction present in these foodstuffs.The lipid fraction also promotes ulcer healing,is active both orally and intramuscularly and is ulceroprotective against nonsteroidal anti-inflammatory drugs(NSAIDs).The phospholipids and phytosterols present in the lipid have been identified to be responsible for this protective activity.The combination of phospholipids and phytosterols may be of value in the prevention and treatment of duodenal ulceration and protection against the ulcerogenic effect of NSAIDs.展开更多
Background:Autoimmune hepatitis may flare up after treatment withdrawal,especially in those who had not achieved histological remission but had normal liver enzymes.The European Association for the Study of the Liver(...Background:Autoimmune hepatitis may flare up after treatment withdrawal,especially in those who had not achieved histological remission but had normal liver enzymes.The European Association for the Study of the Liver(EASL)and the American Association for the Study of Liver Disease(AASLD)Guidelines recommend performing liver biopsy before treatment withdrawal.The aim of the study is to define the outcome of treatment withdrawal in adults with wellcontrolled disease for 2 years with and without liver-biopsy guidance.Methods:A retrospective observational study was conducted on biopsy-proven autoimmune hepatitis patients who were treated for 2 years and with persistently normal aspartate aminotransferase(AST)and alanine aminotransferase(ALT)or nearly so for 6 months prior to treatment withdrawal.Exclusions were:juvenile onset autoimmune hepatitis and prior treatment or use of agents other than corticosteroids and azathioprine.The primary endpoint was to define freedomfrom flare-ups for 1 year after treatment withdrawal.Results:Thirty-four consecutive subjectsmeeting study criteria were identified.Treatment withdrawal was accomplished in 24 subjects without liver-biopsy guidance and 10 had pre-treatment withdrawal liver biopsy.Demographics,immunosuppressive usage,pre-treatment cirrhosis and pre-treatment liver enzymes were similar between the two groups,and 25%had an enzyme flare-up within 12months after treatment withdrawal,which was similar in the two groups(20.8 vs 30.0%,P=0.57).Conclusions:Adults with autoimmune hepatitis and excellent response to therapy for 2 years are candidates for treatment withdrawal without the need for liver biopsy.展开更多
文摘目的了解2009年基诺族精神分裂症的患病率和发病率,并了解其近30年的患病率变化趋势。方法 2009年对基诺族44个自然村总计10610人进行单纯整群随机抽样,对实际抽样的1984人进行精神分裂症的患病率调查。采用一般健康问卷12项(12-item general health questionnaire,GHQ-12)进行筛查,依据GHQ-12得分按比例抽取危险人群,采用SCID-I/P工具进行面检并作出诊断。同时,对有精神分裂症患病线索资料的个体进行入户访谈,其中包括既往流行病学调查中已诊断的33例精神分裂症病例。比较两种调查方法得到的精神分裂症患病率,对近30年来的精神分裂症患病率进行掊2趋势检验。结果线索调查中精神分裂症的终生和时点患病率、年发病率均高于抽样调查,但差异均无统计学意义(P>0.05)。线索调查结果显示,基诺族精神分裂症终生患病率0.37%(39/10610),时点患病率0.27%(29/10610),男性均高于女性(掊2=10.27,P<0.01;掊2=8.02,P<0.01)。近10年新发病例12例,其中近一年新发病1例,年发病率9.43/10万(1/10610)。与1979年、1989年、1999年比较,基诺族30年来的精神分裂症的终生患病率和时点患病率并无明显变化(掊2=0.18,P>0.05;掊2=0.18,P>0.05)。结论基诺族精神分裂症终生患病率及时点患病率近30年来无明显变化趋势。
基金Supported by The Cheng-Hsin General Hospital and National Yang-Ming University
文摘AIM:To investigate the prevalence of gallstone dis-ease(GSD) and to evaluate the risk of symptomatic GSD among diabetic patients.METHODS:The study was conducted by analyzing the National Health Research Institutes(NHRI) dataset of ambulatory care patients,inpatient claims,and the updated registry of beneficiaries from 2000 to 2008.A total of 615 532 diabetic patients without a prior history of hospital treatment or ambulatory care visits for symptomatic GSD were identified in the year 2000.Age-and gender-matched control individuals free from both GSD and diabetes from 1997 to 1999 were randomly selected from the NHIR database(n = 614 871).The incidence densities of symptomatic GSD were estimated according to the subjects' diabetic status.The distributions of age,gender,occupation,income,and residential area urbanization were compared between diabetic patients and control subjects using Cox proportion hazards models.Differences between the rates of selected comorbidities were also assessed in the two groups.RESULTS:Overall,60 734 diabetic patients and 48 116 control patients developed symptomatic GSD and underwent operations,resulting in cumulative operation rates of 9.87% and 7.83%,respectively.The age and gender distributions of both groups were similar,with a mean age of 60 years and a predominance of females.The diabetic group had a significantly higher prevalence of all comorbidities of interest.A higher incidence of symptomatic GSD was observed in females than in males in both groups.In the control group,females under the age of 64 had a significantly higher incidence of GSD than the corresponding males,but this difference was reduced with increasing age.The cumulative incidences of operations for symptomatic GSD in the diabetic and control groups were 13.06 and 9.52 cases per 1000 person-years,respectively.Diabetic men exhibited a higher incidence of operations for symptomatic GSD than did their counterparts in the control group(12.35 vs 8.75 cases per 1000 person-years).CONCLUSION:The association of diabetes with increased symptomatic GSD may provide insight to the treatment or management of diabetes in clinical settings.
文摘目的:以往研究都表明,2型糖尿病患者易发生体位性低血压,但该人群的体位性高血压的临床重要性及患病率情况如何并不清楚。方法:选择连续入院277例2型糖尿病患者,包括90例高血压患者及128例年龄匹配的非糖尿病个体。体位性高血压定义为体位便从卧位变为立位时,收缩压和(或)舒张压从140mmHg/90mmHg以下上升并超过140/90mmHg。所有受试者均采集临床资料及生化指标。结果:体位性高血压的在糖尿病患者中患病率都显著高于对照组(12.8 vs 1.8%,P<0.01)。糖尿病合并体位性高血压患者由体位变化引起的血压水平增加程度显著高于糖尿病不合并体位性高血压的患者。(收缩压平均变化值:6.8±11.4 vs 1.6±9.0 mmHg,P<0.05;舒张压平均变化值:9.1±5.2 vs 3.8±6.6 mmHg,P<0.005)。糖尿病合并体位性高血压的患者血压水平及血清甘油三酯水平均高于其他组(P<0.05)。结论:2型糖尿病患者合并早期神经病变更易出现体位性高血压,并且可能是糖尿病患者发展为原发性高血压的危险因素。
文摘Two hundred and sixty-two patients with carpal tunnel syndrome (CTS) were analyzed retrospectively. Results showed that middle-and older-age women were more apt to have CTS than men, and that the dominant hand was more frequently affected. Hormonal changes , repetitive and forceful movements, awkward positions of hand and wrist, and other factors may be associated with CTS. Typical clinical manifestations include pain and paresthesia in the median nerve territory, worsening at night or in the early morning , and being relieved by shaking the hand. Although the patients may localize the discomfort beyond the territory, sensory changes are variable and not entirely reliable. Conduction abnormalities often appeared selectively in the median nerve distal to the wrist in CTS. If the patient who is clinically suggestive of CTS shows normal conduction with conventional methods, palmar stimulation and inching technique is recommended. The diagnosis of CTS requires confirmation of illness history, symptoms and signs with objective electrodiagnostic tests.
文摘This paper pays a tribute to Dr.Frank I Tovey on his 90th birthday which happens on September 1,2011,and briefly describes the major findings in his research career and contributions as follows.The geographical prevalence of duodenal ulceration is related to staple diets.Unrefined wheat and maize,soya,certain pulses and millets are associated with a low prevalence while refined wheat,maize and rice,yams,cassava and green banana with a high prevalence.Predominant foodstuffs from low prevalence areas are ulceroprotective in rat peptic ulcer models.The protective activity lies in the lipid fraction present in these foodstuffs.The lipid fraction also promotes ulcer healing,is active both orally and intramuscularly and is ulceroprotective against nonsteroidal anti-inflammatory drugs(NSAIDs).The phospholipids and phytosterols present in the lipid have been identified to be responsible for this protective activity.The combination of phospholipids and phytosterols may be of value in the prevention and treatment of duodenal ulceration and protection against the ulcerogenic effect of NSAIDs.
文摘Background:Autoimmune hepatitis may flare up after treatment withdrawal,especially in those who had not achieved histological remission but had normal liver enzymes.The European Association for the Study of the Liver(EASL)and the American Association for the Study of Liver Disease(AASLD)Guidelines recommend performing liver biopsy before treatment withdrawal.The aim of the study is to define the outcome of treatment withdrawal in adults with wellcontrolled disease for 2 years with and without liver-biopsy guidance.Methods:A retrospective observational study was conducted on biopsy-proven autoimmune hepatitis patients who were treated for 2 years and with persistently normal aspartate aminotransferase(AST)and alanine aminotransferase(ALT)or nearly so for 6 months prior to treatment withdrawal.Exclusions were:juvenile onset autoimmune hepatitis and prior treatment or use of agents other than corticosteroids and azathioprine.The primary endpoint was to define freedomfrom flare-ups for 1 year after treatment withdrawal.Results:Thirty-four consecutive subjectsmeeting study criteria were identified.Treatment withdrawal was accomplished in 24 subjects without liver-biopsy guidance and 10 had pre-treatment withdrawal liver biopsy.Demographics,immunosuppressive usage,pre-treatment cirrhosis and pre-treatment liver enzymes were similar between the two groups,and 25%had an enzyme flare-up within 12months after treatment withdrawal,which was similar in the two groups(20.8 vs 30.0%,P=0.57).Conclusions:Adults with autoimmune hepatitis and excellent response to therapy for 2 years are candidates for treatment withdrawal without the need for liver biopsy.
