宁波市江北区2013—2017年度居民癌症高风险评估及临床筛查结果分析

目的评估浙江省宁波市江北区2013-2017年度居民癌症高风险并分析临床筛查结果,为癌症患者的早诊早治和管理提供参考依据。方法采用整群随机抽样方法于2013年12月-2017年7月在宁波市江北区抽取5个街道22 700名40~74周岁常住居民,采用国家癌症中心开发的防癌高风险评估问卷和软件系统评估肺癌、上消化道癌、肝癌、结直肠癌和乳腺癌的高风险人群并进行临床筛查,分析此5种癌症的高风险率、筛查率和检出率。结果宁波市江北区2013-2017年度完成癌症高风险评估的22 700名40~74周岁居民中,进行临床筛查者6 550人次,共检出660例癌症或疑似癌症和癌前病变;肺癌、上消化道癌、肝癌、结直肠癌和乳腺癌的高风险率分别为19.82%、39.01%、13.29%、12.21%和4.69%,筛查率分别为45.73%、16.33%、61.25%、18.11%和65.35%;肺癌或疑似肺癌、上消化道癌、肝癌或疑似肝癌、大肠癌和乳腺影像报告和数据系统(BI-RADS)4~5级检出率分别为1.55%、0.69%、0.11%、0.40%和2.87%。结论宁波市江北区2013-2017年度居民肺癌、上消化道癌、肝癌和结直肠癌患病风险较高,开展癌症早诊早治工作有利于早期发现癌症,提高患者的早期诊治率、生存率和生存质量。

门诊高风险患者评估体系的构建及在基层医院中的应用效果分析

目的:探讨与分析门诊高风险患者评估体系的构建及在基层医院中的应用效果。方法:2018年3月至2020年3月于本院门诊就诊的423例患者资料作为对照组,选择2021年11月至2022年2月于本院门诊就诊的422例患者作为观察组。对照组给予门诊常规工作管理,观察组给予门诊高风险患者评估管理。结果:观察组患者的就医不安全事件、护理不良事件、护理投诉纠纷事件发生率分别为0.47%、0.71%、0.23%,明显低于对照组患者的5.44%、6.15%、3.31%(P<0.05)。观察组患者的满意度为100.00%,与对照组的95.02%相比明显提高(P<0.05)。结论:门诊高风险患者评估体系的构建及在基层医院中的应用能降低患者的就医不安全事件、护理不良事件、护理投诉纠纷事件发生率,还可提高患者的满意度。

老年患者误吸与窒息的风险评估

目的采用误吸/窒息高风险评估表对老年患者误吸与窒息风险进行评估。方法选取我院2013年5月—2015年4月收治的神经外科的老年患者182例患者作为对照组,给予洼田饮水试验筛选高危患者;选取我院2015年5月—2016年4月收治的神经外科的老年患者164例患者作为观察组,给予误吸与窒息高风险评估表筛选高危患者,比较两组高危患者筛选比例。结果观察组高危患者筛选比例为47.6%(78/164),高于对照组的36.8%(67/182),组间比较,差异具有统计学意义(P<0.05)。结论实施误吸与窒息高风险评估表后,可以让临床医务人员迅速而准确的评估老年住院患者的误吸风险,进而减少并防范了住院患者误吸的发生。

内蒙古城市癌症早诊早治项目高风险人群特征及其影响因素分析

[目的]分析内蒙古城市癌症早诊早治项目风险评估资料,探讨5种常见癌症(肺癌、结直肠癌、胃癌、食管癌和肝癌)高风险人群特征及其影响因素。[方法]使用国家癌症中心的风险评估系统评估5种常见癌症高风险人群。组间高风险率比较采用卡方检验,趋势分析采用线性趋势性检验。使用多因素多元Logistic回归模型分析单癌种和多癌种高风险人群的影响因素。[结果]2017—2018年共对69740名城市居民进行了危险因素调查和风险评估,其中25179人被评估为5种常见癌症高风险人群,高风险率为36.10%,男性和女性高风险率分别为33.97%和37.93%。肺癌高风险率最高(22.77%),其次是结直肠癌(19.74%),肝癌高风险率最低(16.00%)。单癌种和多癌种高风险影响因素分析发现,危险因素聚焦于性别、年龄、民族、不良生活方式、非正常体质指数和癌症家族史,保护因素聚焦于良好的婚姻状态、较高学历、脑力劳动为主的职业、合理的膳食结构和健康生活方式。[结论]通过癌症风险评估,锁定高风险人群,明确影响因素,为制定防控策略提供数据依据,可有效降低内蒙古癌症高风险人群发病风险。

患者术前压疮高风险预警评估的重要性及护理对策

收集、归纳、整理实践应用压疮风险评估表的经验,及时筛选存在术前压疮高危风险患者,提供最优解的医疗护理服务,减少压疮病例发生。方法 选取2019年1月至2020年1月新疆自治区中医院麻醉科提供医护服务的420例有压疮发生风险病人,随机分为两组,包括筛查组和对照组,各210人。对照组行常规压疮风险监控护理服务,筛查组在常规服务基础上参照我院编制的手术室压疮风险评估表,根据表中各项评分指标行压疮发生风险评估,量化打分,积分越高,发生风险越大,暨评分结果筛查出高风险患者,对其中高危患者实施针对性的个性化预防护理,最后对两组患者发现压疮的概率做评估。结果 筛查组压疮发生3例,发生机率0.95%,对照组手术室牙疮发生8例,发生率为3.8%,对照组的压疮发生率高于筛查组,统计学差异明显(P<0.05)。结论 手术室压疮风险评估表的应用,把发生压疮高危人群风险的判定从以前根据抽象的发病因素择取,跨越到形象的数字量化筛选,把预防手术室高风险患者发生压疮的预警功能提升到了一个全新的高度。既大大降低医护人员工作量,又实现了对发生压疮发生的精确预控和管护,优化了护理流程,节省了护理人力资源,大幅减少了术中压疮发生,提高了救护质量。

住院患儿误吸高风险因素评估表的设计及应用

目的 探讨小儿误吸高风险因素,为临床提供客观依据.方法 江苏省徐州市儿童医院根据患儿误吸高风险因素并结合患儿的特点设计儿内科住院患儿误吸高风险因素评估表,该评估表从年龄、呕吐次数、误吸史、气促呛咳、体位、声带受损、置鼻胃肠管、意识状态8项内容进行评估.得分范围8-30分,评估分值〈13分列为低危度,评估分值≥13分列为高危度.并且制定了各危度前瞻性干预措施,提前进行护理干预.对照组选择2014年6—12月全院内科出院患儿20265例,观察组选择2015年6—12月全院内科出院患儿19826例.观察两组患儿误吸的预防效果.结果 临床应用儿内科住院患儿误吸高风险因素评估表的前后进行比较,两组误吸/窒息发生率比较有统计学意义（P〈0.01）.结论 儿内科住院患儿误吸高风险因素评估表应用于临床,提高了护士对误吸风险的识别及判断能力.降低高危患儿误吸/窒息的发生率.

Technology Research on Lightning Strike Risk Evaluation of a Cable Car

According to structure function and lightning damage of a cable car, a feasible method of lightning strike risk evaluation for a cable car was put forward based on the evaluation model and evaluation method in the standard IEC62305-2. According to the difference between common buildings and cable cars, problems of height non-uniformity of equivalent section caused by inclination of the cable car and diversity of lightning activity regularity caused by the large area were resolved, and expected annual average frequency of lightning strike was calculated using three dimensional graphic approach and regional lightning characteristic analysis. Based on different types of damage process and loss consequences, according to interception effect against lightning invasion of the lightning protection measures and the method of probability selection proposed in the standard, the probability of casu- alty caused by direct lightning strike in a cable car and a waiting area as well as probabilities of casualty caused by failure of electronic information systems were cal- culated.

A poor performance in comprehensive geriatric assessment is associated with increased fall risk in elders with hypertension： a cross-sectional study

Background Fall and serious fall injuries have become a major health concern for elders. Many factors including blood pressure and anti-hypertensive medication application were reported as hazards of fall. The purpose of this study was to determine if age related systemic functional decline related with increased fall risks in elderly patients with hypertension. Methods A total of 342 elderly hypertension patients （age 79.5 ＋ 6.7 years, male 63.8%） were recruited to the study. Comprehensive geriatric assessment （CGA）, including measurements about activity of daily living （ADL）, nutrition, cognition, depression, numbers of prescription medication and number of clinical diagnosis, was conducted to evaluate the physical and mental status of each participants. Fall risk was evaluated by Morse fall scale, Tinetti perform- ance oriented mobility assessment （POMA） and history of fall in the recent years. Participants were grouped into tertiles according to CGA score. Correlation between CGA and fall risk was analyzed through SPSS 18.0. Results Participants with higher CGA score were likely to be older, had a lower body mass index （BMI）, and a higher prevalence of cardiovascular disease, chronic obstructive pulmonary disease （COPD）, cerebrovascular disease and osteoarthropathia. Participants in higher tertile of CGA score got increased prevalence of fall risk than those in lower tertile （P 〈 0.01 T3 vs. T1, P 〈 0.01 T3 vs. T2）. Correlation analysis and regression analysis showed significant association between CGA and Morse fall scale （P 〈 0.001）, as well as CGA and POMA （P 〈 0.001）. Meanwhile, CGA components also showed co-relationships with increase fall risks. After adjusting age, BMI, benzodiazepine use, cardiovascular disease, cerebrovascular disease, COPD and osteoarthropathia, both history of fall in the recent year and rising Morse fall scale were significantly associated with ADL im- pairment （OR： 2.748, 95%CI： 1.598-4.725）, （OR： 3.310, 95%CI： 1.893-5.788）. Decreased Tinetti POMA score was associated with Mini-Mental State Examination （MMSE） （OR： 4.035, 95%CI： 2.100-7.751）, ADL （OR： 2.380, 95%CI： 1.357-4.175） and shortened MNA form （MNA-SF） impairment （OR： 2.692, 95%CI： 1.147-6.319）. Conclusions In elderly adults with hypertension, impaired physical and mental function is associated with increased fall risk. Further study is required to investigate possible mediators for the association and effec- tive interventions.

Effects of High-temperature Damage on Rice Growth and Its Countermeasures

This study introduced the effects of high-temperature damage on rice and reviewed the damage mechanism, heat damage index and risk assessment, forewarning and monitoring. On the basis of extensive studies, this paper put forward the viewpoints of ascertaining the fundamental mechanism of high temperature damage to rice at the molecular level, establishing a comprehensive heat damage index taking variety, growth stage and other meteorological factors into consideration, selecting appropriate sowing time, choosing heat-resistant varieties and improving the prevention system. All of these are aimed at providing a solid foundation for coping avoiding the harms from heat damage and improving the coping method.

Regional landslide hazard assessment based on Distance Evaluation Model

There are many factors influencing landslide occurrence.The key for landslide control is to confirm the regional landslide hazard factors.The Cameron Highlands of Malaysia was selected as the study area.By bivariate statistical analysis method with GIS software the authors analyzed the relationships among landslides and environmental factors such as lithology,geomorphy,elevation,road and land use.Distance Evaluation Model was developed with Landslide Density(LD).And the assessment of landslide hazard of Cameron Highlands was performed.The result shows that the model has higher prediction precision.

The distribution of 10-year cardiovascular risk in Chinese adults： analysis of the China Health Examination Database （CHED） 2008

Objective Global cardiovascular risk assessment has been incorporated into current Chinese guidelines for the management of hypertension and hypercholesterolemia. The aim of our study is to determine the distribution of 10-year risk for ischemic cardiovascular disease （ICVD） among middle-aged Chinese adults, and to evaluate the usefulness of global risk assessment tools in the primary prevention of ICVD in Chinese population.Methods Simplified prediction tools derived from the USA-PRC Collaborative Study of Cardiovascular Epidemiology cohort were applied to the Chinese Health Examination Database （CHED） 2008. 10-year risk for ICVD was estimated in 461 157 ICVD-free subjects （264 432 male and 196 725 female） aged 35 to 59 years. Results Among the male subjects, 82.4% had a 10-year risk for ICVD of 〈5%, 14.4% of 5% to 12.1% and 3.4 of≥ 12.2%, and in female subjects, 86.7% had a 10-year risk for ICVD of 〈5%, 12.1% of 5% to 12.0% and 1.2% of ≥ 12.1%. All subjects with predicted high level ICVD risk （≥ 12.2% in male or ≥ 12.1% in female） had either remarkably elevated （≥ 160 mmHg） blood pressure, significantly increased （≥ 6.22 mml/L） total serum cholesterol or diabetes.Conclusion Using the currently recommended prediction tools, only very small proportions of middle-aged Chinese men and women who were free of ICVD would be classified into high level risk group. These prediction tools are unlikely to help for the medical intervention decision making in Chinese adult patients with hypertension and/or hypercholesterolemia

Meta-analysis of effects of obstructive sleep apnea on the renin-angiotensinaldosterone system

Background Obstructive sleep apnea （OSA） is the most common cause of resistant hypertension, which has been proposed to result from activation of the renin-angiotensin-aldosterone system （RAAS）. We meta-analyzed the effects of OSA on plasma levels of RAAS components. Methods Full-text studies published on MEDL1NE and EMBASE analyzing fasting plasma levels of at least one RAAS component in adults with OSA with or without hypertension. OSA was diagnosed as an apnea-hypopnea index or respiratory disturbance index 〉 5. Study quality was evaluated using the Newcastle-Ottawa Scale, and heterogeneity was assessed using the 12 statistic. Results from individual studies were synthesized using inverse variance and pooled using a random-effects model. Subgroup analysis, sensitivity analysis, and meta-regression were performed, and risk of publication bias was assessed. Results The meta-analysis included 13 studies, of which 10 reported results on renin （n = 470 cases and controls）, 7 on angiotensin II （AnglI, n = 384）, and 9 on aldosterone （n = 439）. AnglI levels were significantly higher in OSA than in controls [mean differences = 3.39 ng/L, 95% CI： 2.00-4.79, P 〈 0.00001], while aldosterone levels were significantly higher in OSA with hypertension than OSA but not with hypertension （mean differences = 1.32 ng/dL, 95% CI： 0.58-2.07, P = 0.0005）. Meta-analysis of all studies suggested no significant differences in aldosterone between OSA and controls, but a significant pooled mean difference of 1.35 ng/mL （95% CI： 0.88-1.82, P 〈 0.00001） emerged after excluding one small-sample study. No significant risk of publication bias was detected among all included studies. Conelusions OSA is associated with higher AnglI and aldosterone levels, espe- cially in hypertensive patients. OSA may cause hypertension, at least in part, by stimulating RAAS activity.

Evaluation of Disaster Risks, Vulnerabilities and Response Strategies of High Rise Buildings in Lagos Municipality

Although disasters can occur anywhere, certain types of disasters are more likely to have more effects on some buildings than others, especially on those in urban areas. Buildings in Lagos have had nasty experiences from both natural and artificial disasters, claiming lives and properties in the past. This study aims at evaluating the disaster risks, vulnerabilities and response strategies in the high rise buildings in Lagos municipality. Structured questionnaire was administered to building owners, estate managers and disaster managers who manage the high rise buildings. The information obtained was supplemented by personal interviews conducted with tenants and rescue organizations. The study identified collapse of building, fire out break, and communication and power failure as the most likely potential disasters, power failure and collapse had the highest severity of impact, and the degree of preparedness achieved to confront the disasters was below satisfaction. However, the specific status of the response strategies was as expected, but there was room for improvements. The potential disasters were natural, human and environmental and the most vulnerable sectors were other properties rather than the high rise buildings themselves. The magnitude of risk levels could be contained with the level of response strategies already achieved if coordinated.

The Risk Evaluation of Enterprise Technological Innovation Network Based on Extenics

Growing competition has prompted enterprises to choose construct Technological Innovation Network to promote innovation, however the innovation network is a risky innovation system, how to carry out a comprehensive risk assessment of the innovation network is particularly important. This paper focused on the technological innovation network risk analysis, used extenics to define which risk levels should these various risk factors in technological innovation network belongs to. And used Shanghai Caohejing hi tech park to do the empirical research, comfirmed risk factors which have the larger influence on technological innovation network.Enterprises can face them as the main objects of enterprise risk management, in order to improve the success rate of the innovation of the enterprise technological innovation network.