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目的探讨围孕期妇女服用叶酸与产儿先天性心脏病的关系,为采取有针对性的干预措施提供科学依据。方法应用分层随机整群抽样方法,抽取陕西省30个区县。对2010年1月至2013年11月间曾经怀孕、符合纳入标准、已知生育结局并知情同意的育龄妇女及其生育子女进行入户调查。采用Logistic回归模型控制相关影响因素分析妇女叶酸服用与产儿先天性心脏病发生的风险关系。结果本研究共纳入28 354名育龄妇女,其活产儿先天性心脏病患病率为7.3‰,育龄妇女围孕期叶酸服用率为64.4%,但其中按照规范服用叶酸的妇女仅占17.2%。围孕期妇女规范服用叶酸可能是产儿先天性心脏病的保护因素,单因素分析结果显示OR为0.502（95%CI：0.279-0.902）;在控制了家庭背景因素,母亲因素以及孕期接触危险因素后多因素分析发现,叶酸规范服用仍然是先天性心脏病的保护性因素（调整OR=0.512,P=0.046）。然而,尚未发现不规范服用叶酸对产儿先天性心脏病发生的保护作用。结论按照规范时间和剂量服用叶酸（孕前3个月至孕早期3个月,每天服用0.4mg,且累计服用时间超过90d）,可能预防先天性心脏病的发生。

目的 探讨股骨颈骨折复位内固定术后股骨头坏死的相关危险因素。方法 回顾性分析2014年1月至2015年6月在我院行股骨颈骨折复位内固定手术治疗的145例患者的临床资料,对其中29例术后股骨头坏死的患者资料与同期其他患者的临床资料进行对比,应用Logistic回归分析比较两组患者年龄、性别、手术方式、骨折类型（Garden分型）、复位质量、伤后手术时间、术前牵引、负重时间、内固定是否取出等因素,分析可能导致术后股骨头坏死的危险因素。结果 单因素非条件Logistic回归分析显示,骨折类型（Garden分型）、复位质量、术前牵引与术后股骨头坏死有显著相关性（P〈0.05）。多因素非条件Logistic回归分析显示,骨折类型（Garden分型）、复位质量、术前牵引显著相关（P〈0.05）。结论 骨折类型（Garden分型）、复位质量、术前牵引是股骨颈骨折内固定术后股骨头坏死的危险因素,而年龄、性别、手术方式、伤后手术时间和内固定是否取出等与术后股骨头坏死关系不密切。

目的探讨陕西省出生缺陷发生的影响因素,为采取有针对性的干预措施提供依据。方法应用分层随机整群抽样方法,抽取陕西省9市12个区县共124个乡镇。对终止妊娠日期发生在2007年10月至2009年7月间且孕满28周的13 273名妇女进行入户调查。要求妇女均为调查点的常住人口。收集完成围孕期状况调查的完整问卷有7 531份。采用SPSS 13.0软件对所有调查因素进行非条件Logistic回归分析。结果多因素Logistic回归模型中,按其贡献大小,危险因素由高到低依次为：父系家族出生缺陷史（OR=14.283）、孕期精神状态差（OR=10.835）、有不良孕产史（OR=8.264）、母亲居住农村（OR=5.067）、母亲孕期饮酒史（OR=4.598）、母亲年龄〉35岁（OR=3.696）、母亲孕期农药接触史（OR=3.507）、母亲孕期饮浓茶（OR=1.993）。孕期服用叶酸（OR=0.549）和家庭人均收入高（OR=0.422）为出生缺陷的保护因素。结论加强优生宣教,提高育龄妇女自我保健意识,改善居住环境,改变不良生活方式,对于降低出生缺陷发生风险尤为重要。

背景与目的抗血管生成药物是治疗恶性肿瘤的有效手段之一,美国FDA批准的药物的各期临床试验结果提示其疗效是令人惊喜的、但也必需重视不良反应、特别是心血管系统相关不良反应。本研究观察、分析恩度联合化疗之心血管系统相关不良反应的影响因素。方法观察我院2007.4-2009.2治疗的61例非小细胞肺癌（NSCLC）,每日监测血压、定时观察心电图、D-二聚体及心悸、胸闷等症状。结果各心血管系统相关不良反应从高到低的发生率依次为：心电图异常、D-二聚体异常、血小板异常、临床症状和血压异常波动。每例治疗前、后的各不良反应发生率差异均无意义,而每周期治疗前、后比较：心电图改变、临床症状和血压波动均有统计学意义（P〈0.05）;单因素logistic回归分析提示：按周期数观察,年龄对血压波动和ST-T段改变及治疗周期对血压波动均有影响（P〈0.05）;多因素logistic回归分析、排除混杂干扰因素后提示：按周期数观察,年龄对ST-T改变和血压波动有影响（P〈0.05）。结论不良反应中心电图异常最常见,高龄患者和年轻患者相比,发生心电图异常改变和血压波动的可能性大;另外,治疗周期是血压发生波动的危险因素。但治疗结束后,上述不良反应均可恢复。

目的 分析引起根面龋的危险因素。方法 采用分层随机抽样方法，对唐山市600名40岁以上中老年人进行日腔健康检查，数据应用SAS8．0软件进行Logistic多因素回归分析。结果 Logistic多因素回归分析表明年龄、口腔牙石指数、义齿修复和牙龈退缩4个因素是中老年人根面龋的相关危险因素，竖式刷牙、使用含氟牙膏是根龋的保护性因素。结论 年龄、口腔牙石指数、义齿修复和牙龈退缩是根面龋的相关危险因素。

目的探讨酒精依赖与明尼苏达多相人格测验（MMPI）临床基本量表各因子的相关性。方法研究组系2008年6月-2010年6月在临沂市精神卫生中心就诊的酒精依赖患者。采用MMPI计算机测试软件,对酒精依赖组（n=162）和正常对照组（n=99）进行测试,对两组MMPI的疑病、抑郁、癔症、人格偏离、男子气、偏执、精神衰弱、精神分裂、躁狂、社会内向10个因子标准分进行统计分析,并进行logistic回归分析。结果除男子气因子外,酒精依赖组MMPI临床基本量表各因子标准分均高于对照组（P〈0.01）;多因素logistic回归分析发现酒精依赖与抑郁、癔症呈正相关,与精神分裂呈负相关（P均〈0.05）。结论酒精依赖患者可能存在心理及躯体症状,尤其与抑郁、癔症关系密切。

Background： Nontraumatic osteonecrosis of the femoral head （NONFH） is a debilitating disease that represents a significant financial burden for both individuals and healthcare systems. Despite its significance, however, its prevalence in the Chinese general population remains unknown. This study aimed to investigate the prevalence of NONFH and its associated risk factors in the Chinese population. Methods： A nationally representative survey of 30,030 respondents was undertaken from June 2012 to August 2013. All participants underwent a questionnaire investigation, physical examination of hip, and bilateral hip joint X-ray and/or magnetic resonance imaging exalnination. Blood samples were taken after overnight fasting to test serum total cholesterol, triglyceride, and high-density lipoprotein （HDL） and low-density lipoprotein （LDL） levels. We then used multivariate logistic regression analysis to investigate the associations between various metabolic, demographic, and lifestyle-related variables and NONFH. Results： NONFH was diagnosed in 218 subjects （0.725%） and the estimated NONFH cases were 8.12 million among Chinesepeople aged 15 years and over. The prevalence of NONFH was significantly higher in males than in females （1.02% vs. 0.51%, x^2 = 24.997, P 〈 0.001 ）. Among NONFH patients, North residents were subjected to higher prevalence of NONFH than that of South residents （0.85% vs. 0.61%,x^2= 5.847, P = 0.016）. Our multivariate regression analysis showed that high blood levels oftriglycerides, total cholesterol, LDL-cholesterol, and non-H DL-cholesterol, male, urban residence, family history of osteonecrosis of the femoral head. heavy smoking, alcohol abuse and glucocorticoid intake, overweight, and obesity were all significantly associated with an increased risk of NONFH. Conclusions： Our findings highlight that NONFH is a significantpublic health challenge in China and underscore the need for policy measures on the national level. Furthermore, NONFH shares a number of risk factors with atherosclerosis.

Background： Female sexual dysfunction （FSD） is a highly prevalent and often underestimated problem. However, large-scale, population-based epidemiological surveys of FSD are scarce in China. The present study was conducted to evaluate the prevalence and the potential risk factors of FSD across a selection of social groups in Beijing, China, based on the Female Sexual Function Index （FSFI）. Methods： A cross-sectional study based on the multiple-stage cluster sampling was performed with adult women throughout the Dongcbeng and Shunyi districts of Beijing. The Chinese version of FSFI was used, as well as questions on demographic characteristics, the disease-related context, and social relationships. Results： A total of 6000 consecutive women entered this study, with an actual response from 5024 women, corresponding to a response rate of 83.7%. A total of 4697 （78.3%） questionnaires were effective. The prevalence of adult FSD in Beijing was 2973 （63.3%） using a score of 26.55 as the boundary value, whereas the total mean FSFI score was 23.92 ~ 6.37. However, 1423 （30.3%） women did not seek help. By multivariate logistic regression analysis, the possible potential risk factors included age （odds ratio [OR] = 1.051 ）, dissatisfaction with the spouse＇s sexual ability （OR = 3.520）, poor marital affection （OR = 2.087）, spouse sexual difficulties （OR = 1.720）, dissatisfaction with married life （OR = 1.476）, living in a rural area （OR = 1.292）, chronic pelvic pain （OR = 1.261）, chronic disease （OR = 1.534）, previous pelvic surgery （OR = 1.605）, vaginal delivery （OR = 2.285）, lower education （OR = 3.449） and postmenopausal （OR = 3.183）. Conclusions： As suggested by the FSFI scores, female sexual problems are highly prevalent in Beijing. Dissatisfaction with the spouse＇s sexual ability, poor marital affection, sexual difficulties of the spouse, dissatisfaction with the marriage, rural life, CPP, and postmenopausal were conceivable risk factors for FSD in Beijing women.

Background： Patient trust in physicians, which can be considered a collective good, is necessary tot an effective health care system. However, there is a widespread concern that patient trust in physicians is declining under various threats to the physician patient relationship worldwide. This article aimed to assess patient trust in physicians through a quantitative study in Shanghai, China, and to provide appropriate suggestions for improving the trust in China. Methods： The data from a survey conducted in Zhongshan Hospital and Shanghai Tenth People＇s Hospital which are two tertiary public hospitals in Shanghai, were used in this study. Patient trust in physicians was the dependent variable. Furthermore, a 10-item scale was used to precisely describe the dependent variable. The demographic characteristics were independent variables of trust in physicians. Binomial logistic regression was employed to analyze the fhctors associated with the dependent variable, which was divided into two categories on the basis of the responses （1： Strongly agree or agree and 0： Strongly disagree, disagree, or neutral）. Results： This study tbund that 67% of patients trusted or strongly trusted physicians. The mean score of patient trust in physicians was 35.4 from a total score of 50. Furthermore, patient trust in physicians was significantly correlated with the age, education level, annual income, and health insurance coverage of the patients. Conclusions： Patient trust in physicians in Shanghai, China is higher than previously reported. Furthermore, the most crucial reason for patient distrust in physicians is the information asymmetry between patients and physicians, which is a natural property of the physician patient relationship, rather than the so-called for-profit characteristic of physicians or patients＇ excessive expectations.

OBJECTIVE： To investigate the factors associated with sensory and motor recovery after the repair of upper limb peripheral nerve injuries. DATA SOURCES： The online PubMed database was searched for English articles describing outcomes after the repair of median, ulnar, radial, and digital nerve injuries in humans with a publication date between 1 January 1990 and 16 February 2011. STUDY SELECTION： The following types of article were selected： （1） clinical trials describ- ing the repair of median, ulnar, radial, and digital nerve injuries published in English; and （2） studies that reported sufficient patient information, including age, mechanism of injury, nerve injured, injury location, defect length, repair time, repair method, and repair materials. SPSS 13.0 software was used to perform univariate and multivariate logistic regression analyses and to in- vestigate the patient and intervention factors associated with outcomes. MAIN OUTCOME MEASURES： Sensory function was assessed using the Mackinnon-Dellon scale and motor function was assessed using the manual muscle test. Satisfactory motor recovery was defined as grade M4 or M5, and satisfactory sensory recovery was defined as grade S3＋ or S4. RESULTS： Seventy-one articles were included in this study. Univariate and multivariate logistic regression analyses showed that repair time, repair materials, and nerve injured were inde- pendent predictors of outcome after the repair of nerve injuries （P 〈 0.05）, and that the nerve injured was the main factor affecting the rate of good to excellent recovery. CONCLUSION： Predictors of outcome after the repair of peripheral nerve injuries include age, gender, repair time, repair materials, nerve injured, defect length, and duration of follow-up.