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世界核心医学期刊文摘（胃肠病学分册） 2006年第2期2卷 33-34页

作者： Bernstein C.N. Wajda A. Blanchard J.F. 陈云茹 University of Manitoba 804F-715 McDermot Avenue Winnipeg Man. R3E- 3P4 Canada Dr.

Background & Aims: We aimed to discern the relative risk for several chronic inflammatory conditions in patients with ulcerative colitis (UC) and Crohn s disease. Methods: We used the population- based University of Manitoba IBD- Database that includes longitudinal files on all patients from all health system contacts identified by International Classification of Diseases, 9th revision, Clinical Modification codes for visit diagnosis. From the provincial database we extracted a control cohort matching the IBD patients 10 ∶ 1 by age, sex, and geography. We considered a potential comorbid disease to be present if the patient had 5 or more health system contacts for that diagnosis. The comorbid disease period prevalence was analyzed separately for patients with UC and Crohn s disease and a prevalence ratio was calculated comparing the IBD populations with the matched cohort. Results: There were 8072 cases of IBD from 1984 to 2003, including UC (n = 3879) and Crohn s disease (n = 4193). There was a mean of approximately 16 person- years of coverage for both patients and control patients. Both UC and Crohn s disease patients had a significantly greater likelihood of having arthritis, asthma, bronchitis, psoriasis, and pericarditis than population controls. An increased risk for chronic renal disease and multiple sclerosis was noted in UC but not Crohn s disease patients. The most common nonintestinal comorbidities identified were arthritis and asthma. Conclusions: The finding of asthma as the most common comorbidity increased in Crohn s disease patients compared with the general population is novel. These may be diseases with common causes or complications of one disease that lead to the presentation with another. Studies such as this should encourage further research into the common triggers in the organ systems that lead to autoimmune diseases.

关键词：炎症性肠病慢性炎症性疾病克罗恩病样本人群集聚性溃疡性结肠炎国际疾病分类法潜在并发症卫

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非酒精性脂肪肝疾病自然史:一项基于大样本人群队列研究

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世界核心医学期刊文摘（胃肠病学分册） 2005年第12期1卷 28-29页

作者： Adams L.A. Lymp J.F. St. Sauver J. P. Angulo 王志宇 Division of Gastroenterology and Hepatology Mayo Clinic 200 First St. SW Rochester MN 55905 United States Dr.

Background & Aims: The natural history of nonalcoholic fatty liver disease (NAFLD) in the community remains unknown. We sought to determine survival and liver- related morbidity among community- based NAFLD patients. Methods: Four hundred twenty patients diagnosed with NAFLD in Olmsted County, Minnesota, between 1980 and 2000 were identified using the resources of the Rochester Epidemiology Project. Medical records were reviewed to confirm diagnosis and determine outcomes up to 2003. Overall survival was compared with the general Minnesota population of the same age and sex. Results: Mean (SD) age at diagnosis was 49 (15) years; 231 (49% ) were male. Mean follow- up was 7.6 (4.0) years (range, 0.1- 23.5) culminating in 3192 person- years follow- up. Overall, 53 of 420 (12.6% ) patients died. Survival was lower than the expected survival for the general population (standardized mortality ratio, 1.34; 95% CI, 1.003- 1.76; P = .03). Higher mortality was associated with age (hazard ratio per decade, 2.2; 95% CI, 1.7- 2.7), impaired fasting glucose (hazard ratio, 2.6; 95% CI, 1.3- 5.2), and cirrhosis (hazard ratio, 3.1, 95% CI, 1.2- 7.8). Liver disease was the third leading cause of death (as compared with the thirteenth leading cause of death in the general Minnesota population), occurring in 7 (1.7% ) subjects. Twenty- one (5% ) patients were diagnosed with cirrhosis, and 13 (3.1% ) developed liver- related complications, including 1 requiring transplantation and 2 developing hepatocellular carcinoma. Conclusions: Mortality among community- diagnosed NA- FLD patients is higher than the general population and is associated with older age, impaired fasting glucose, and cirrhosis. Liver- related death is a leading cause of mortality, although the absolute risk is low.

关键词：酒精性脂肪肝疾病自然史队列研究样本人群标化死亡率肝脏疾病肝纤维化空腹血糖受损自然病史血糖过高

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胃食管反流病的发病率、危险因素与影响:一项中国南方基于大样本人群的调查研究

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世界核心医学期刊文摘（胃肠病学分册） 2005年第12期1卷 50-51页

作者：郝筱倩

Objective. There are few data on the epidemiology of gastroesophageal reflux disease (GERD) in South China. The aim of this study was to assess the prevalence of GERD symptoms in South China and to evaluate the impact on health- related quality of life. Material andmethods. A face- to- face interview was carried out in South China using a validated Chinese version of the Reflux Disease Questionnaire to assess the prevalence of GERD symptoms. A randomly clustered sampling of permanent inhabitants aged 18 to 90 years was carried out under stratification of urban and suburban areas. The impact of GERD symptoms on health- related quality of life was evaluated using the Chinese version of SF- 36. Results. A total of 3338 residents (1468 M, 1870 F) were investigated. Mean age of the responders was 42.6 ± 16.4 years; response rate was 95% . The prevalence of heartburn and/or acid eructation occurring at least weekly was 6.2% . The age- and gender- adjusted point prevalence of GERD symptoms in South China is 2.3% (95% CI, 1.8% , 2.8% ) according to the definition in this study. There was no difference in prevalence between male (2.6% ) and female (2.4% ) subjects and there was no significant association between age and prevalence of GERD symptoms. Divorced/ widowed/ separated subjects (OR 4.61; 95% CI, 2.15% , 9.89% ) and subjects with a heavy burden of work (OR 3.43, 95% CI, 1.72% , 6.84% ) were significantly more likely to report GERD symptoms. As compared with the general population, subjects with GERD symptoms experienced considerable impairment in quality of life. Conclusions. The prevalence of GERD symptoms in South China was much lower than that reported in Western countries. GERD had a negative impact on quality of life.

关键词：胃食管反流样本人群胃灼热生活质量工作压力回复率西方国家

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糖尿病后发生胰腺癌的可能性:一项基于大样本人群研究

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世界核心医学期刊文摘（胃肠病学分册） 2005年第11期1卷 39-40页

作者： Chari S.T. Leibson C.L. Rabe K.G. 陈瑜 Mayo Clinic College of Medicine Division of Gastroenterology and Hepatology 200 First St SW Rochester MN 55905 United StatesDr.

Background & Aims: Although diabetes occurs frequently in pancreatic cancer, the value of new-onset diabetes as a marker of underlying pancreatic cancer is unknown. Methods: We assembled a population-based cohort of 2122 Rochester, Minnesota, residents age ≥ 50 years who first met standardized criteria for diabetes between January 1, 1950, and December 31, 1994, and identified those who developed pancreatic cancer within 3 years of meeting criteria for diabetes. We compared observed rates of pancreatic cancer with expected rates based on the Iowa Surveillance Epidemiology and End Results registry. In a nested case control study, we compared body mass index (BMI) and smoking status in diabetes subjects with and without pancreatic cancer. Results: Of 2122 diabetic subjects, 18 (0.85% ) were diagnosed with pancreatic cancer within 3 years of meeting criteria for diabetes; 10 of 18 (56% ) were diagnosed < 6 months after first meeting criteria for diabetes, and 3 were resected. The observed-to-expected ratio of pancreatic cancer in the cohort was 7.94 (95% CI, 4.70- 12.55). Compared with subjects without pancreatic cancer, diabetic subjects with pancreatic cancer were more likely to have met diabetes criteria after age 69 (OR = 4.52, 95% CI, 1.61- 12.74) years but did not differ significantly with respect to BMI values (29.2 ± 6.8 vs 26.5 ± 5.0, respectively). A larger proportion of those who developed pancreatic cancer were ever smokers (92% vs 69% , respectively), but this did not reach statistical significance. Conclusions: Approximately 1% of diabetes subjects aged < 50 yearswill be diagnosed with pancreatic cancer within 3 years of first meeting criteria for diabetes. The usefulness of new-onset diabetes as marker of early pancreatic cancer needs further evaluation.

关键词：样本人群研究人群吸烟状况病例对照研究罗切斯特明尼苏达爱荷华州日至

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初次内镜检查与抗酸药物的使用:一项大样本人群队列研究

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世界核心医学期刊文摘（胃肠病学分册） 2005年第11期1卷 59-60页

作者： Lassen A. Hallas J. De Muckadell O.B.S. 尹勇 Department of Medical Gastroenterology Odense University Hospital DK- 5000 OdenseC Denmark

Objective. Endoscopy is the gold standard for diagnostic evaluation of upper gastrointestinal symptoms. The relation between endoscopy and use of antisecretory medication on a population level is unknown. The aim of this study was to describe development in the number of patients undergoing first- time endoscopies and their use of antisecretory medication. Material and methods. Data on the use of endoscopies and antisecretory medication (H2 blockers and proton- pump inhibitors) were extracted from five population- based databases and included all citizens in Funen County (population 470,000) who had first time endoscopies between 1993 and 2002. Results. A total of 7,829 first- time endoscopy patients were identified. In 2002 the number of first- time endoscopies as 5.6/1000 persons. The proportion that had redeemed prescription(s) on antisecretory medication the last year before endoscopy increased from 33% (1095/3286) in 1993 to 41% (1012/2445) in 2002 (p = 0.000). Following endoscopy, average use of antisecretory medication increased by 90 defined daily doses (DDD)/patient/year (95% CI 84- 96) in patients with oesophagitis (N = 4850), by 59 DDD/patient/year (95% CI 54- 64) in peptic ulcer patients (N = 4373) and by 18 DDD/patient/year (95% CI 16- 20) in patients with normal endoscopies (N = 16,400). Conclusions. An increasing proportion of patients are treated with antisecretory medication before endoscopy. Following endoscopy, use of antisecretory medication increases irrespective of the diagnostic findings.

关键词：抗酸药物内镜检查样本人群队列研究消化性溃疡上消化道症状受体阻滞剂诊断评估食管炎金标准

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证实了结肠癌中的一项CpG岛甲基化表型:一项基于大样本人群评估

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世界核心医学期刊文摘（胃肠病学分册） 2006年第2期2卷 34-34页

作者： Samowitz W.S. Albertsen H. Herrick J. 陈云茹 Department of Pathology University of Utah Health Sciences Center Salt Lake City UT 84132 United States Dr.

Background & Aims: The concept of a CpG island methylator phenotype (CIMP), especially inmicrosatellite stable colon cancer, is not accepted universally. We therefore evaluated a large population-based sample of individuals with colon cancer and used univariate and multivariate analyses of CIMP with clinicopathologic variables and tumor mutations to determine the biologic relevance of this phenotype. Methods: A total of 864 tumors from individuals with colon cancer from Utah and Northern California were evaluated by methylation-specific polymerase chain reaction of CpG islands in hMLH1, methylated in tumors (MINT) 1, MINT 2, MINT 31, and CDKN2A (p16). CIMP high was defined as methylation at 2 or more of these loci. The BRAF V600E mutation was determined by sequencing. Microsatellite instability had been determined previously. Results: In a multivariate analysis of microsatellite stable tumors, CIMP high was related significantly to the V600E BRAF mutation (odds ratio, 39.52; 95% confidence interval, 11.44- 136.56), KRAS2 mutations (odds ratio, 2.22; 95% confidence interval, 1.48- 3.34), older age (P trend = .03), and increased stage (P trend = .03), and these tumors were less likely to be located in the distal colon (odds ratio, .42; 95% confidence interval, .27- .65). CIMP-high unstable tumors also were more likely to have the V600E BRAF mutation, be located proximally, and occur in older individuals (in univariate analyses). However, CIMP-high unstable tumors were significantly more likely than their stable counterparts to be KRAS2 wild type, TP53 wild type, poorly differentiated, proximally located, occur at lower stages, and have the BRAF V600E mutation (64.1% vs 17.6% ). Conclusions: The evaluation of a large, population-based sample strongly supports the biologic relevance of CIMP in colon cancer. However, the presence or absence of microsatellite instability has a major effect on the expression of this phenotype.

关键词： CpG岛甲基化结肠癌样本人群微卫星不稳定性近端结肠临床病理学北加利福尼亚单变量分析多

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老年结肠直肠癌患者相对存活率和最初治疗方式选择改变的趋势:一项基于丹麦大样本人群的研究

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世界核心医学期刊文摘（胃肠病学分册） 2006年第1期2卷 19-19页

作者： Iversen L.H. Pedersen L. Riis A. 尹勇 Department of Surgery Aarhus University Hospital Tage Hansens Gade DK- 8000 AarhusDenmark Dr.

PURPOSE: Elderly patients with colorectal cancer undergo surgery with curative intent less frequently than younger patients, and survival declines with increasing age. We compared relative survival of colorectal cancer among patients older than 75 years with that of younger patients in Denmark during the period 1977 to 1999. We also examined trends in choice of initial treatment. METHODS: From the files of the nationwide population- based Danish Cancer Registry, we identified all cases of colorectal cancer diagnosed between 1977 and 1999. We then linked this data to information on survival obtained from the Danish Register of Causes of Death and from the Central Population Register. RESULTS: During the entire study period, short- term and long- term relative survival improved for patients of all ages, but the improvement was more pronounced among elderly patients ( > 75 years). Radical resection was increasingly chosen as the initial treatment for elderly patients; during the 1995 to 1999 period it was performed on approximately 50 percent of such patients, almost as frequently as among younger patients. CONCLUSIONS: Relative survival of elderly colorectal cancer patients ( > 75 years) improved in Denmark between 1977 and 1999. In the most recent period studied, 1995 to 1997, only minor differences in five- year relative survival were observed among younger, middle- aged, and elderly patients. A simultaneous increase in the rate of radical resection among elderly patients, reflecting more effective treatment, may underlie this finding.

关键词：结肠直肠癌治疗方式选择样本人群根治性切除率根治性切除术死亡原因外科手术年龄组

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老年人群胰腺外分泌功能不全的发病和决定因素:一项大样本人群研究结果

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世界核心医学期刊文摘（胃肠病学分册） 2005年第11期1卷 59-59页

作者： Rothenbacher D. Lw M. Hardt P.D. 杨媛 Department of Epidemiology German Centre for Research on Ageing University of Heidelberg Bergheimer Str. 20 DE- 69115 Heidelberg Germany Dr.

Objective. The prevalence and main determinants of exocrine pancreatic insufficiency were investigated in a large population based sample of older adults by measuring pancreatic elastase- 1 in stool. Material and methods. The study comprised 914 participants aged 50 to 75 years recruited by their general practitioner during a general health examination. All participants and their physicians were asked to fill out a standardized questionnaire which contained information on socio- demographic and lifestyle factors as well as medical history. Native stool was examined for pancreatic elastase- 1 with a commercially available ELISA (ScheBo(r) Tech, Giessen, Germany). Results. Overall, 524 women and 390 men aged 50 to 75 years (mean age 61.9 years) were included in the analysis. In total, 105 (11.5% ) of the 914 subjects showed signs of exocrine pancreatic insufficiency (EPI) with ≤ 200μ g elastase- 1/g stool, and 47 (5.1% ) subjects showed signs of a severe exocrine pancreatic insufficiency (SEPI, < 100μ g elastase- 1/g stool). There was a clear increase in EPI with age. Patients taking angiotensin- converting enzyme (ACE) inhibitors had a lower prevalence than subjects without this medication; these associations persisted after adjustment for covariates. Conclusions. Prevalence of EPI increases with age and seems to be tentatively higher in men than in women. However, smoking seems to be an independent risk factor for EPI and SEPI whereas ACE- inhibitor intake might be a protective factor. The latter finding may even point to new options in the treatment of chronic pancreatitis.

关键词：胰腺外分泌功能胰弹性蛋白酶样本人群慢性胰腺炎主要决定因素人口统计学患者发病率保护措施

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斑点追踪超声心动图在脓毒症心肌病中的研究进展

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中华急诊医学杂志 2021年第3期30卷 375-379页

作者：江信睿卢庚刘恒均何飞王军南京医科大学鼓楼临床医学院急诊科 210008

脓毒症和脓毒症休克是急危重症医学面临的重要临床问题,全球每年脓毒症患病人数超过1900万,病死率超过25%[1-2]。虽然国内外指南[1-2]给出了脓毒症及脓毒症休克的最新定义及相关诊疗策略,但指南中并未提及有关脓毒症心肌病的最新定义及... 详细信息

脓毒症和脓毒症休克是急危重症医学面临的重要临床问题,全球每年脓毒症患病人数超过1900万,病死率超过25%[1-2]。虽然国内外指南[1-2]给出了脓毒症及脓毒症休克的最新定义及相关诊疗策略,但指南中并未提及有关脓毒症心肌病的最新定义及相关诊疗。目前脓毒症心肌病定义尚未完全统一,因不同定义导致统计出的发病率及病死率差异较大,目前也缺乏脓毒症心肌病在大样本人群中的流行病学资料。

关键词：脓毒症休克危重症医学斑点追踪诊疗策略脓毒症心肌病超声心动图样本人群流行病学资料

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年轻人的解压新方式

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检察风云 2024年第2期 62-63页

作者：项艺(文/图) 不详

2023年2月,《中国国民心理健康发展报告(2021—2022)》正式发布。数据显示,在参与调查的样本人群中,18—24岁年龄组的抑郁风险检出率最高,为24.1%;25-34岁年龄组的抑郁风险检出率次之,为12.3%。参与调查的其他年龄组数据均低于10%。18-3... 详细信息

2023年2月,《中国国民心理健康发展报告(2021—2022)》正式发布。数据显示,在参与调查的样本人群中,18—24岁年龄组的抑郁风险检出率最高,为24.1%;25-34岁年龄组的抑郁风险检出率次之,为12.3%。参与调查的其他年龄组数据均低于10%。18-34岁的年轻人成为了抑郁的高风险群体。

关键词：样本人群数据显示年龄组抑郁心理健康发展检出率年轻人

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