The management of the cause of death is a part of the disease prevention and control.The data accuracy impacts the effectiveness of disease prevention and control in our country,which has great significance in improving the life expectancy and preventing disease.The cause of death coding is an important part of the management of the cause of death,and coding quality is particularly critical.This paper reviews the management of the cause of the death both at home and abroad,clears the management research status of the cause of the death at home and abroad,and finds out the gap between each other.It is to find reliable basis for improving the quality of the national death coding and provide the basis and suggestion for enhancing the management level of the cause of death.

目的了解ICD-9-CM-3中具有未特指情况的手术与操作编码误用问题,分析错误原因,探讨对策。方法总结2011版ICD-9-CM-3中所有具有未特指情况的手术与操作编码,与北京协和医院现有手术和操作编码字典库进行比对,并在北京协和医院病案首页管理信息系统下对2012年住院首页信息中手术与操作的上述编码逐一进行检索,统计误用编码检索量,计算误用率。结果参照最新版ICD-9-CM-3,共筛选出162个具有未特指情况的手术与操作编码,其中58个编码存在于我院字典库,逐一进行检索后发现的60.3%（35/58）的编码有病例支持,存在误用现象。总体上具有未特指情况编码误用率为15.5%,"NOS"编码误用率和"unspecified"编码误用率分别为17.0%和5.6%。结论病案编目人员应谨慎使用具有未特指情况的手术与操作编码,建议添加编码信息质控程序提高编码准确性。

宫颈癌是最常见的妇科恶性肿瘤,全球有80％宫颈癌病例发生在发展中国家[1].近20年来,在中西部一些农村地区,其发病率和死亡率仍居高不下,且趋于年轻化[2],建立适合经济欠发达地区的宫颈癌早诊早治筛查方案是当今亟待解决的问题.世界卫生组织推荐在资源欠发达的地区应用醋酸肉眼观察进行宫颈癌的筛查[3].本研究旨在应用醋酸肉眼观察法(visual inspection with acetic acid,VIA)和碘染色肉眼观察法(visual inspection with Lugol's iodine,VILI)对筛查宫颈癌的作用进行综合评价,探讨VIA/VILI作为经济欠发达地区宫颈癌筛查方法的实用价值.

目的 调查北京市初中生家长及大学生对人乳头瘤病毒(HPV)及其预防性疫苗的认知情况和接种态度.方法 采用便利抽样的方法,选择北京两所普通大学及两所普通初中,用多阶段抽样方法,得到大学生和初中生家长的样本,对自填式问卷调查进行分析.结果 被调查者中大多数人67.80%(537/792)听说过子宫颈癌;仅有15.91%(126/792)的人听说过HPV,其中40.48%(51/126)的人认为HPV感染后可能会导致子宫颈癌.有11.36%(90/792)的人听说过HPV疫苗;初中生家长和大学生在知道HPV疫苗可有效预防宫颈癌知晓率方面比较差异有统计学意义(χ2=7.541,P<0.01).被调查的409名大学生中,有234人愿意接种HPV疫苗,占总人数的57.21%;被调查的383名初中生家长中,271人(70.76%)愿意接种疫苗,164人(42.82%)愿意让其孩子接种疫苗.家长性别对是否愿意让孩子接种疫苗有明显的影响(χ2=10.742,P=0.001).结论 北京市初中生家长及大学生对HPV及HPV预防性疫苗认知率较低,但对HPV疫苗的接种总体上持积极支持的态度.

Objective To explore the influence of screening programme on awareness of cervical cancer prevention among 30 to 59 years old women who live in rural areas of Beijing.Methods A face-to-face cross-sectional survey on women's knowledge on cervical cancer prevention was conducted in 2008 and 2009 among subjects recurited by three-stage stratified random sampling.Results Univariate analysis showed that since the initiation of cervical cancer screening in Daxing District of Beijing,the overall awareness of cervical cancer was significantly increased among women residents,and the percentage of women with 5 or more correct answers was increased from 37.3％ to 51.0％ ( x2=62.06,P＜0.001).After adjusting confounding factors,multivariate analysis showed that cervical cancer screening programme contributed to improved awareness of cervical cancer-related knowledge ( OR =1.853,95％ CI1.590 -2.159).In addition,current place of residence,education level,household income per-capita and screening history within 5 years were major factors affecting women's awareness of cervical cancer ( OR vales were 1.766,2.580,1.350 and1.676,respectively),and higher education level and personal income were correlated with increased awareness rate.Conclusion Cervical cancer screening could improve general knowledge of cervical cancer,especially for those who have never participated in the screening programme.

【Objective】 To evaluate the effect of integrated health-care interventions for children under 5 years old in target rural counties of Shaanxi Province and to provide experiences and lessons for following projects.【Methods】 From 2007 to 2010,a project focusing on maternal and child health care was launched in targeted rural areas of Shaanxi Province,with integrated interventions.Together with using multistage,stratified,randomly,non-probability sampling,two cross-sectional surveys were conducted in 2006 and 2010,and a before/after intervention design was used to assess the effectiveness of the integrated interventions by changes in children's growth and development,health outcome,guardians' health-related knowledge and behavior.【Results】 The decrease in the stunting rate was more than 50% after intervention(6.9% to 3.4%,P0.01).The rate of anemia was still high and also little effect had been shown in reduction of both two-week prevalence of suspected pneumonia and two-week prevalence of diarrhea(P0.05).However,there was significant improvement in health awareness and behavior among caregivers,especially the rate of professional care-seeking when either of the disease occurred increased dramatically to more than 85%.【Conclusions】 This project,to some extent,has promoted the health of children under 5 and the level of health care,but little effect showed in the reduction of anemia,suspected pneumonia and diarrhea.So it is still urgent to seek more specific and targeted interventions fighting against such problems and to improve intensity of interventions as well.

Objective To explore influence factors on compliance to colposcopy in cervical cancer screening and propose corresponding strategies.Methods The multistage,stratified,randomly,non-probability sampling was used to choose one street and four towns from Daxing District of Beijing and a cervical cancer screening cohort was established for two years.Women with positive result at first screening stage were given a face to face interview and then were required to have further colposcopy tests with reservation within 6 months.Results Of 458 women with positive result in the first screening procedure,301(65.7%)women had taken colposcopy screening test in given period under instruction,while 157(34.3%) failed.The multiple logistic regression showed that,compared to younger women aged 30~,women aged 40~ had 1.958(1.207-3.176) times the odds,of taking colposcopy examination.Besides,compared to women living in the most remote rural areas with poor transportation,women living in areas close to testing site for colposcopy had 2.014(1.097-3.695) times the odds,of taking follow-up colposcopy examination.Women with good awareness of four aspects of knowledge including "More than 1 of 3 of all lives lost to cancer could be saved by early detection followed by early diagnosis and treatment","early stages of cervical cancer","HPV is a necessary cause of cervical cancer","treatment of early stage cervical cancer",were more likely to take colposcopy test in given period than women with little awareness,with 1.817(1.078-3.060),2.061(1.220-3.482),2.539(1.254-5.143),1.820(1.123-2.949) times the odds,respectively.Women not fear of pain during screening tests had higher compliance rate,with 2.159(1.266-3.681) times the odds of taking colposcopy test than those who were.Conclusion In women,extensive health education projects focusing on cervical cancer prevention and cure knowledge and the great significance of screening should be vigorously implemented.

Objective To investigate the awareness status of knowledge on cervical cancer prevention and cure as well as relevant influencing factors to provide basis for developing corresponding intervention measures.Methods An epidemiological questionnaires survey was conducted among 2000 women recruited by the stratified cluster sampling after distributing propaganda materials in Daxing District,Beijing.Results The awareness rate about cervical cancer among women was rather low ranged from 15.8%(HPV infection was the main cause of developing cervix cancer) to 75.5%(keeping sexual hygiene was good for cervix cancer prevention).Multifactorial analysis indicated educational level,district,uptake of cervical cancer screening test or gynecologic examination in the past 5 years and annually average income of family members were major factors influencing awareness of women.The higher level of education the women were,the higher knowledge awareness rate the women had and so were the women with higher annually average income of family members.Among the 2000 women,the screening rate in past five year was 36% and no significant difference were found between urban and rural groups.Lack of knowledge or wrong perception towards cervical cancer screening and the subsequent physical and mental fear were the main factor influencing the screening rate among women in Daxing District.Conclusion Intelligible health education pattern should be applied to improve women's awareness of cervical cancer related knowledge especially among women with low education and low income in rural areas,which will help raise screening rate and contribute to the success of any cervical cancer prevention program.

在当今竞争日趋激烈的社会环境中,现代职业女性要面临工作、生活、家庭等来自各个方面的压力,很容易罹患各种妇科疾病.因此,进行常规妇科疾病筛查,对妇科疾病,尤其是妇科肿瘤的早期发现、治疗尤为重要.