目的 分析1990年与2019年中国10～24岁青少年人群HIV/AIDS疾病负担在性别中的变化,为制定针对该年龄层人群的有效干预措施提供信息.方法 使用全球疾病负担(Global Burden of Disease,GBD)2019数据库资料,按性别和年龄提取1990-2019年中国10～24岁青少年人群因HIV/AIDS的死亡数和死亡率、伤残调整寿命年(DALY)、DALY率、过早死亡损失寿命年(YLL)、YLL率、伤残损失寿命年(YLD)、YLD率等指标来分析该群体HIV/AIDS疾病负担在性别中的变化幅度.结果 2019年,中国10～24岁青少年人群因HIV/AIDS的死亡数和死亡率、DALY、DALY率、YLL、YLL率、YLD 与 YLD 率分别为 847 人、0.37/10 万、62 621 人年、27.51/10 万、58 036 人年、25.49/10 万、4 584 人年与 2.01/10 万,相比 1990 年增幅分别为 401.18％,691.49％,370.48％,648.26％,409.53％,710.33％,138.87％与 279.25％.2019 年中国 10～14,15～19岁与20～24岁男性因HIV/AIDS的死亡数和死亡率、DALY与DALY率均高于女性,与1990年相比,增幅均高于女性;10～14岁人群疾病负担增幅高于20～24岁.1990-2019年,随着年龄和年份的增加,青少年死亡率和DALY率的性别差距增大.结论 与1990年相比,2019年中国10～24岁青少年人群HIV/AIDS感染风险持续增加,低龄HIV感染者增幅明显,性别差异日益明显.

课程思政是当前高校思想政治工作的新理念新模式,强调"立德树人",注重知识传授与社会主义核心价值观的融合,是当前教学改革中高度关注的理论和实践问题.文章从"大思政"理念下的"课程思政"改革的新要求、课程定位、课程思政的必要性、课程思政的原则、课程思政的途径等方面探索医学统计学课程思政教学改革,为新时期医学统计学教学改革提供了新思路.

目的 比较中国居民1990年与2019年抑郁症疾病负担,为抑郁症的预防控制提供参考依据.方法 收集全球疾病负担(GBD)2019中中国居民1990年和2019年的抑郁症发病数和伤残调整寿命年(DALYs),比较1990年与2019年中国居民抑郁症的变化情况.结果 中国居民2019年抑郁症的发病数和DALY分别为41 005 280例和7 561 985人年,较1990年的31 303 436例和5 486 751人年增加了 31.0％和37.8％;抑郁症的标化发病率和标化DALYs率由1990年的2 647.72/10万和470.65/10万下降至2019年的2 301.41/10万和416.95/10万.与1990年相比,男性居民2019年抑郁症的发病数和DALYs增加了 37.0％和41.9％,均高于女性居民的27.8％和35.5％;标化发病率和标化DALYs率降低了 7.8％和7.6％,均低于女性的16.5％和14.2％.2019年10～49岁男性、女性和总人群抑郁症DALYs率均低于1990年,≥50岁男性、女性和总人群抑郁症DALYs率均高于1990年.1990年和2019年重度抑郁症DALYs分别为4 006 829人年和5 087 997人年,分别占抑郁症总疾病负担的73.0％和67.3％,是中国居民抑郁症疾病负担最为严重的病种;2019年中国居民重度抑郁症和心境恶劣DALYs率分别较1990年增加了 5.7％和39.1％,心境恶劣疾病负担增加明显.结论 中国女性居民仍占抑郁症疾病负担的主导地位,但男性和中老年居民抑郁症疾病负担有所增加,心境恶劣的疾病负担亦增加明显,应予以重视.

目的 探讨项目分层教学法在医学统计学教学中的应用,为高质量完成医学统计学教学提供参考依据.方法 随机抽取我校2017级针灸推拿专升本专业两个班的学生作为研究对象,开展教学试验对比研究,试验组采用项目分层教学法,对照组采用传统教学法.结果 试验组的平均作业成绩、期末测试成绩和总成绩均高于对照组;学生对项目分层教学法的满意度高于传统教学组.结论 项目分层教学法可用于我校医学统计学的教学.

新型冠状病毒肺炎疫情防控期间,各高校无法开展实体课堂教学,线上教学成为主体授课模式.文章以本科生流行病学课程为例,围绕教学目标,发挥互联网信息技术的优势,利用网络平台学习资源,积极开展基于“微信、慕课和超星学习通”的线上教学模式,既培养了学生自主学习的能力,也探索了新的教学模式,以促进开展线上教学及线上线下混合式教学的发展.

卫生统计学是将统计原理、方法和医学专业知识相结合的一门应用学科,是医学专业学生必须掌握的专业基础课程,也是培养学生科研能力和综合素质的一门重要公共基础课程.如何在“互联网+教育”背景下,以各种线上辅助教学平台为工具,弥补传统教学的不足,为卫生统计学提升教学效果与质量,是新时代下进行教学模式改革亟待解决的问题.本研究对微助教与蓝墨云班课两款不同的网络教学辅助平台在卫生统计学教学应用中的效果进行了初步探讨,以期为教学改革的实施提供理论依据.

《卫生统计学》在各个领域的应用日趋广泛,医学领域各级课题的申报以及各种新药研发和报批的过程,必须严格遵守统计学准则,统计学的思维模式以及方法已经渗透到了医学研究的各个领域中.然而,目前中医类院校对于这类课程普遍存在着不够重视,学生积极性不高的现状.因此,如何改变传统教学模式,由教师满堂灌改为以学生为主体,积极参与到教学过程中来,成为《卫生统计学》课程教学改革时需要思考的方向.文章对于如何能够提高中医类学生对于《卫生统计学》课程的主观能动性进行了探讨.

目的 探讨BP神经网络(back propagation neural network,BPNN)模型和穷举卡方自动交互诊断器(Exhaustive CHI-squared Automatic Interaction Detector,Exhaustive CHAID)算法模型在重症手足口病(hand-foot-mouth disease,HFMD)临床早期预警指标分析中的应用价值.方法 收集2017年4-7月河南郑州某医院收治的469例HFMD患儿流行病学资料,采用SPSS Modeler 18.0软件进行单因素logistic回归分析筛选出有统计学意义的变量,构建BPNN模型、Exhaustive CHAID算法模型与logistic回归模型,比较三种方法的差异.结果 在训练样本和测试样本中,BPNN模型预测正确率(95.28％,93.33％)、灵敏度(0.971,0.905)、约登指数(0.907,0.863)与受试者工作特征曲线下面积(receiver operating characteristic,ROC)(0.992、0.967)均高于Exhaustive CHAID算法模型和logistic回归模型.重症HFMD临床早期预警指标重要性依次为:易惊(0.18)、手足抖动(0.13)、呕吐(0.12)、精神差(0.07)、心率≥140次/min (0.05)、呼吸≥30次/min(0.05)、中性粒细胞比率升高(0.05)、血糖升高(0.05)、四肢发凉(0.04)、热峰≥39℃(0.04).结论 BPNN模型预测能力优于Exhaustive CHAID算法模型和logistic回归模型.

目的 探讨郑州市中学生亚健康现状及其影响因素,为河南省制定中学生亚健康预防干预策略提供科学依据.方法 采用分层整群随机抽样方法、在郑州市随机抽取初中2所、高中2所,初一、初二、高一和高二4个年级共1 461名中学生进行青少年亚健康多维评定问卷和自编中学生亚健康影响因素问卷调查. 结果 郑州市中学生身心亚健康症状检出率为67.15％,身心亚健康状态检出率为25.26％,男生躯体亚健康症状检出率高于女生,高中生躯体亚健康症状、心理亚健康症状和身心亚健康症状检出率均高于初中生(均P＜0.05).非单亲家庭、三餐饮食规律、采纳食物多样、荤素搭配饮食、少熬夜、增加课外锻炼时间、减少上网时间、学习成绩中下等以上、学业负担小、有3位以上知心朋友均可降低中学生身心亚健康状态(均P＜0.05). 结论 郑州市中学生亚健康状况较严重,可能与不健康生活方式和学业负担较大等危险因素有关,建议采取健康教育知识讲座、心理指导、体育社团活动等有效的干预措施.

Aim:To explore the application value of ARIMA and Holt-Winters seasonal model for predicting the monthly incidence of syphilis.Methods:SPSS 22.0 and Eviews 8.0 were used to establish the seasonal model of ARIMA and Holt-Winters based on the data of the monthly incidence of syphilis in China from January 2005 to December 2015.Then the actual data from January to June in 2016 were used to confirm the predicted results.The prediction evaluation index was error and MAE.The data from July to December in 2016 were forcasted by the model with higher precision in the similar manner.Results:In the comparison of MAE,the prediction accuracy of the seasonal ARIMA model was higher than the Holt-Winters seasonal model.The optimal model for the monthly incidence was ARIMA (1,1,1) × (0,1,1) 12,the model equation was (1-B)(1-B12)(1 +0.374B)x1 =(1 +0.740B)(1 +0.775B12)ε1.The predicted results of the monthly incidence of syphilis(1/100 000) from July to December in 2016 were 3.107,2.989,2.879,2.658,2.631,2.644.Conclusion:The seasonal ARIMA model features higher predictive accuracy,and could agree well with the trend of the monthly incidence of syphilis.

随着信息化教育时代的到来,传统教学方法已无法达到较为满意的教学效果.本研究尝试将网络教学平台与CBL结合的方法授课,选取2015级针灸推拿学本科一班和三班的学生为研究对象,随机分为观察组和对照组,以期末考试成绩和调查问卷结果作为评价指标.结果显示,观察组期末考试成绩高于对照组,提示传统教学方法辅以网络教学平台结合CBL的混合教学法获得学生普遍认可.

目的 探讨C5.0模型结合Logistic回归分析(以下简称C5.0组合模型)在手足口病(hand,foot and mouth disease,HFMD)合并脑膜脑炎重症化影响因素分析中的应用价值.方法 整群抽取2015年4月～ 2017年7月河南郑州某医院收治的324例HFMD患儿,应用SPSS 21.0进行Logistic回归分析,应用SPSS Modeler 18.0建立C5.0模型,利用单因素Logistic回归分析结果建立C5.0组合模型,比较三种方法的差异.结果 重症化危险因素结果分别为:C5.0组合模型显示心率≥140次/min、血糖升高、手足抖动与烦躁不安是其危险因素;C5.0模型显示心率≥140次/min、血糖升高、意识障碍、手足抖动和呕吐是其危险因素;Logistic回归模型显示心率≥140次/min、手足抖动、血糖升高、呕吐、烦躁不安、中性细胞比率升高是其危险因素.三种模型的灵敏度、特异度、约登指数与受试者工作特征曲线(receiver operating characteristic,ROC)曲线下面积分别如下:C5.0组合模型依次为95.7％,94.2％,0.90,0.946;C5.0模型依次为80.7％,88.3％,0.69,0.845;Logistic回归模型依次为98.0％,70.0％,0.68,0.840.结论 C5.0模型结合单因素Logistic回归在预测HFMD合并脑膜脑炎重症化危险因素方面价值优于C5.0模型和Logistic回归模型.

Objective To explore the value of the autoregressive integrated moving average model (ARIMA) applied to predict monthly incidence of syphilis so as to provide basis for prevention and control of syphilis . Methods Eviews 8 .0 was used to establish the ARIMA model based on the data of monthly incidence of syphilis in China from January 2009 to December 2015 .Then the data of the first half of 2016 were used to verify the predicted results .The predictions were evaluated by RMSE ,MAE ,MAPE and MRE models .Then the monthly incidence of syphilis in the second half of 2016 was predicted .Results The optimal model for the monthly incidence of syphilis from January 2009 to June 2016 was the model of ARIMA (2 ,1 ,1) × (0 ,1 ,1)12 ,its equation was (1 - B)(1 - B12 ) (1+0 .820 B)(1+0 .566 B2 ) x2t = (1+0 .365 B) (1+0 .897 B12 )εt ,its parameters are as follows :R2 =0 .832 ,RMSE=0 .181 ,MAE=0 .118 ,MAPE=5 .088 .The predicted monthly incidence values (10-5 ) of the second half of 2016 were 3 .124 ,3 .008 ,2 .906 ,2 .691 ,2 .714 ,and 2 .717 .Conclusion ARIMA model has a relatively good prediction precision .Therefore , it can make short-term prediction based on the evolution trend of monthly incidence of syphilis in China .

Objective To explore the value of the multiple seasonal autoregressive integrated moving average model(ARIMA) applied to predict the monthly incidence of hand-foot-mouth disease(HFMD),and to provide a reference for the prevention and control of HFMD.Methods Eviews 8.0 was used to construct the multiple seasonal ARIMA model based on the data of the monthly reported cases of HFMD in China from Jan.2009 to Dec.2015,then the data of the first half of 2016 were used to verify the predicted results.The predictions were evaluated by models of RMSE,MAE,Theil IC,BP,VP,CP and MRE.In the same way,the monthly incidence from July to December in 2016 was predicted.Results The optimal model for the monthly incidence from Jan.2009 to Jun.2016 was ARIMA (1,0,1) × (0,1,1) 12,and the equation of the model was (1-B12) (1-0.574B)xt =(1-0.441B) (1 +0.919B12)εt.The parameters were as follows:RMSE =4.15,MAE=2.59,Theil IC =0.143,BP =0.045,VP =0.225,CP =0.730.The predicted monthly incidence values (10-5) of the second half of 2016 were 24.70,14.96,15.00,14.12,13.05,and 11.22.Conclusion The multiple seasonal models of ARIMA(1,0,1) × (0,1,1) 12 can be used to fit the evolution trend of the national HFMD monthly incidence,and it can be used to predict the monthly incidence of HFMD in a short-time.

Objective:To assess the efficacy of the oxymatrine combined with antihistamines in the treatment of chronic urticaria.Methods:The articles about the oxymatrine combined with antihistamines for treating chronic urticaria were searched in CNKI, WANGFANG database, VIP database, Pubmed, EMbase and Cochrane library.The Meta-analysis was performed by Review Manager 4.2 software.Results:A total of 14 researches were included, with small bias and no heterogeneous (P=0.25).The results of meta-analyses showed that compared with the group of antihistamines alone, the effective rate in the group of oxymatrine combined with antihistamines was higher (P<0.00001,RR=1.40, 95% CI(1.30~1.51)) and the recurrence rate was lower (P<0.00001, RR=0.19,95% CI(0.10-0.37)).Conclusion:Oxymatrine combined with antihistamines was more effective than antihistamines alone in the treatment of chronic urticaria.

Objective To explore a model for forecasting acquired immunodeficiency syndrome (AIDS) in Henan Province, and accurately and quickly predicting the future trend of AIDS, so as to provide reference for AIDS prevention and control. Methods Data of AIDS incidence in Henan Province from 2000 to 2014 were collected. The incidence prediction model was established using support vector machine. The data from 2000 to 2013 were taken as training samples, and the data of 2014 were used as testing sample. Average relative error was used to evaluate the effect of prediction. Then the model was utilized to predict the incidence of AIDS in Henan Province from 2015 to 2019. Results The average relative error of the established support vector machine model was 0.5512%. It is predicted that the incidences of AIDS in Henan Province from 2015 to 2019 are 0.85/105, 1.84/105, 1.64/105, 1.30/105 and 2.01/105 respectively. Conclusions Support vector machine model has high prediction accuracy and small error, and is suitable for AIDS prediction in Henan Province.

目的 探讨BP神经网络(BPNN)模型在儿童手足口病(HFMD)重症化进程预测中的应用价值,为HFMD重症病例早期识别提供参考依据.方法 采用MATLAB 7.0软件对2013年4～6月河南郑州某医院收治的445例HFMD患儿临床资料构建BPNN模型,得出平均影响值(MIV)排序并归一化;从中挑选32例符合重症标准且自发病到重症的病例作为重症组,对照组纳入60例普通病例,以较大MIV值的因素为变量重新整理数据,统计分析得出单个因素水平和综合因素水平在重症化期间的变化趋势,阐述其与HFMD重症早期识别的关系.结果 在HFMD重症化进程中,精神差、颈强直、易惊的变化是先上升,重症当天及前一天平稳且至最高,随后下降;呼吸频率、心率、嗜睡、热程≥3d及血糖水平的变化是先升后降,重症当天最高;手足抖动的变化是先升后降,重症前一天最高;呕吐呈下降趋势;热峰大致呈下降趋势,重症当天略微回升,之后降至正常体温;白细胞计数变化基本不大,均高于正常值范围,在重症次日恢复至正常值水平;综合因素水平是先上升至重症当天并达到最高,之后下降.结论 BPNN模型可用于分析HFMD重症化进程中的相关因素变化,可为重症病例的早期识别提供参考依据.