<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的探讨北京市体检人群白细胞及其分类计数与2型糖尿病患病的关系,为2型糖尿病的早期诊断和预防提供理论依据。方法采用立意抽样方法抽取北京市体检中心2016年1—12月参加健康体检的16 855名体检人群作为研究对象,根据2型糖尿病诊断标准将其分为糖尿病和非糖尿病2组,采用多因素非条件logistic回归模型分析白细胞及其分类计数水平对2型糖尿病患病风险的影响。结果糖尿病组患者白细胞计数、中性粒细胞计数、淋巴细胞计数、单核细胞计数、嗜酸性粒细胞计数和嗜碱性粒细胞计数中位数分别为6.91×10⁹/L 4.13×10⁹/L、2.18×10⁹/L、0.37×10⁹/L、0.13×10⁹/L和0.03×10⁹/L,均高于非糖尿病人群的6.14×10⁹/L、3.50×10⁹/L、2.09×10⁹/L、0.33×10⁹/L、0.10×10⁹/L和0.02×10⁹/L,差异均有统计学意义（均P&lt;0.001）。在控制了年龄、腰围、总胆固醇水平、吸烟情况、饮酒情况和是否患高血压等混杂因素后,多因素非条件logistic回归分析结果显示,男性白细胞计数5.50×10⁹/L～6.39×10⁹/L、&gt;7.49×10⁹和中性粒细胞计数&gt;2.96×10⁹/L是2型糖尿病患病的危险因素;女性白细胞计数&gt;5.10×10⁹/L、中性粒细胞计数&gt;2.74×10⁹/L、淋巴细胞计数&gt;2.39×10⁹/L、单核细胞计数&gt;0.37×10⁹/L和嗜酸性粒细胞计数&gt;0.14×10⁹/L是2型糖尿病患病的危险因素。结论白细胞计数和中性粒细胞计数与2型糖尿病患病是2型糖尿病患病的危险因素,而淋巴细胞计数、单核细胞计数和嗜酸性粒细胞计数与2型糖尿病的关系具有性别特异性。</span>

目的 分析我国大陆地区肾综合征出血热发病的时间与空间特点及空间聚集性、聚集区域随着时间变化的规律.方法 采用空间自相关分析(即Moran's I和Getis G指数)描述我国大陆地区2006年至2010年肾综合征出血热发病的时间、空间特征,并对肾综合征出血热监测数据在市(区)级尺度上进行全局和局部空间聚集性分析.结果 肾综合征出血热的发病每年均有两个发病高峰(6月和11月),在全国市(区)级尺度上的全局自相关分析2006年至2010年的Moran’sI系数分别为0.0540、0.038 2、0.024 8、0.033 5和0.024 5(P值均＜0.05);局部自相关分析显示高聚集的区域主要分布于山东省南部、江苏省、海南省和陕西省;逐年发病热点区域主要分布有变化.结论 我国大陆地区肾综合征出血热的发病存在季节周期性,发病整体上呈现较弱的聚集性,聚集区域从海南省、山东省、江苏省、安徽省等地区逐渐转移到陕西省及周边省份地区.

Objective:To explore the etiological factors of obsessive compulsive disorder(OCD) by investigating characteristics of irrational beliefs, social support and their relationship with symptoms of OCD.Methods:80 OCD pa tients and 40 normal participants were assessed with Irrational Beliefs Scale(IBS) and Social Support Rating Scale(SSRS). Logistic regression analysis and multiple stepwise regression analysis were applied to examine the relationship between clinical symptoms and the irrational beliefs and social support.Results:①The scores of all the sub-scales in the irrational beliefs in the patient group were significantly higher(P0.05) than control group, the scores of objective support and subjective support in the patient group were also significantly lower than control group(P0.05). ②The de mandingness is the risk factor for OCD(OR=1.149, P0.05). The severity of obsessive compulsive symptoms was posi tively correlated with the level of low frustration tolerance(β=0.404, P0.01). The severity of depression and anxiety were positively correlated with the level of low frustration tolerance(β=0.558, P0.01) and utilization of support(β=-0.363, P0.01).Conclusion:OCD patients have more irrational beliefs and less social support, relative to the controls.The demandingness is the risk factor of OCD. The severity of obsessive compulsive symptoms can be predicted by low frustration tolerance, and the depression and anxiety symptoms were influenced by low frustration tolerance and utiliza tion of support in the OCD patients.

Objective:To evaluate the efficacy of pharmacotherapy combined with cognitive behavioral therapy( CBT) in the treatment of obsessive compulsive disorder( OCD) w ith meta-analysis of data came from randomized controlled trials( RCTs) and to help choose suitable treatment plan in clinic. Methods: The databases of Pubmed, Embase and Central w ere searched to collect efficacy data of pharmacotherapy combined w ith CBT versus either alone in RCTs,the mean difference w as used as effect size and the measured data of Yale-Brow n Obsessive Compulsive Scale( Y-BOCS) w ere extracted from each study to conduct a meta-analysis w ith RevM an5. Results: Seven studies w ere involved in the meta-analysis,including 468 patients w ith OCD. There w as no heterogeneity betw een 3 sets of data w hich compared the efficacy of combined therapy and pharmacotherapy alone after excluding 1 set of data w hich possibly caused the heterogeneity( Q = 0. 48,P > 0. 1) and combined therapy w as superior to pharmacotherapy alone in improving obsessive compulsive symptom( MD = 6. 46,Z = 5. 03,P≤0. 05). There w as no heterogeneity betw een 7 sets of data w hich compared the efficacy of combined therapy and CBT alone( Q = 9. 08,P > 0. 1) and combined therapy w as not superior to CBT alone in improving obsessive compulsive symptom( MD = 0. 87,Z = 1. 22,P > 0. 05). Conclusion: It suggests that pharmacotherapy combined w ith CBT may be superior to pharmacotherapy alone but be comparable to CBT alone in improving obsessive compulsive symptom and further study is necessary.

Objective To evaluate the suitability of cognitive behavioral therapy (CBT) techniques for obsessive-compulsive disorder (OCD),and analyze the domestic application status of CBT techniques for OCD and lay a foundation of standard CBT in China.Methods Delphi method was adopted to evaluate 30 CBT techniques on four dimensions,including operability,frequency,contribution of treatment and acceptability,and calculated the final scores of all techniques on different dimension and their comprehensive rank.Results After two rounds of experts consulting,Kendall coefficients of four dimensions were 0.249,0.269,0.234,0.250 (P＜0.01),coefficient of variation ranged from 0.05 to 0.31 of each technology on different dimension.The operability score of thought stopping,cost-benefit analysis and pie chart belonged to general suitability.The frequency and treatment contribution score of thought stopping and pie chart belonged to occasional use and small.The acceptation score of socratic question,thought stopping,in vivo exposure and behavior prevention belonged to partial acceptation.Weight coefficients of four dimensions were 0.26,0.18,0.27,0.29 and techniques ranking in the top three were information collection and evaluation,therapeutic alliance foundation and psychological education.Conclusion Most CBT techniques for OCD are suitable in China but some techniques still need to be improved.