tbuckley/cabot-search huggingface dataset:
Deep-learning analysis of H&amp;E images to define three immune phenotypes to reveal loss-of-target in excluded immune cells as a novel resistance mechanism of immune checkpoint inhibitor in non-small cell lung cancer.
Authors: Sehhoon Park, Chan-Young Ock, Minje Jang, Jiwon Shin, Sarah Lee, Kyunghyun Paeng, Jonghanne Park, Young Kwang Chae, Yoon La Choi, Tony S. K. Mok, Se-Hoon Lee
Journal: Journal of Clinical Oncology (2020)

3120 Background: Discovery of predictive biomarker to enrich the responder of immune checkpoint inhibitor (ICI) in PD-L1-low ( &lt; 50%) non-small cell lung cancer (NSCLC) is still challenging. Recent study showed that loss of heterozygosity (LOH) of HLA led to immune evasion. In the current study, we hypothesized that 3 immune phenotype (3IP): inflamed, excluded and desert would be reliably classified by deep-learning algorithm of H&amp;E image, called Lunit-SCOPE, which would dictate the responder in PD-L1-low NSCLC patients and discover a unique resistance pathway in excluded phenotype. Methods: Lunit-SCOPE was trained with 1,824 H&amp;E Whole-Slide Image (WSI) of NSCLC from Samsung Medical Center (SMC). WSI was divided into patches (~10 high-power fields) which was classified for 3IP, based on both quantity and localization of immune cells. The 3IP was trained and optimized by considering clinical outcome of 119 NSCLC patients with PD-(L)1 inhibitor (training cohort, patches = 25,897), and validated in 62 patients enrolled in LC-biomarker study (NCT03578185, validation cohort, patches = 8,929). Tumor Proportion Score (TPS) of PD-L1 22C3 immunohistochemistry was assessed by pathologists. Tumor Mutational Burden (TMB) was calculated as number of nonsynonymous alterations throughout whole-exome and HLA LOH was called by LOHHLA algorithm. Results: Interactive analysis to classify 3IP in training cohort showed that 8,726 (33.7%), 10,965 (42.3%), and 6,206 (24.0%) patches were classified as inflamed, excluded, and desert, respectively. In validation cohort, median progression-free survival (mPFS) of inflamed phenotype was 10.1 m, significantly prolonged compared to either excluded phenotype (3.0 m, P= 0.0053) or desert phenotype (1.4 m, P= 0.0011). Inflamed phenotype independently dictated favorable ICI outcome in PD-L1-low (TPS &lt; 50%, mPFS of inflamed: 14.3 m vs excluded/desert: 1.4 m, P= 0.0233) as well as in PD-L1-high (TPS≥50%, 10.1 m vs 4.2 m, P= 0.0361), respectively. Excluded phenotype had higher TMB compared to inflamed phenotype had (median 177 vs 107), and HLA LOH was also enriched in excluded phenotype (31.0%) compared to inflamed (17.6%) and desert (16.7%) phenotypes. Conclusions: Lunit-SCOPE based 3IP classification can predict ICI outcome especially in PD-L1-low ( &lt; 50%) patients. Excluded phenotype showed poor ICI outcome even with high TMB, partially explained by HLA LOH resulting in loss-of-target, as a novel resistance mechanism of ICI.
Prognostic factors for bloodstream infection in adults
Authors: 丁续红, 胡苏萍, 吴小军
Journal: BMJ (2006)

目的 了解所在医院成人血流感染后影响预后的相关因素.方法 收集所在医院2002年1月至2003年12月检验科记录的血培养阳性病例131例,查阅其中91例成人患者的相关临床资料,从而了解本院血流感染病原菌种类,分析影响预后的相关因素.结果 91例中革兰阴性菌53例(58.2%),主要为大肠埃希菌、沙门菌属细菌和肺炎克雷白杆菌;革兰阳性菌28例(30.8%),主要为金黄色葡萄球菌和凝固酶阴性葡萄球菌;真菌8例(8.8%),多重病原菌2例(2.2%).本组脓毒血症患者在院病死率30.8%,铜绿假单胞菌、金黄色葡萄球菌、嗜麦芽窄食单胞菌以及大肠埃希菌产超广谱β内酰胺酶菌株感染者死亡率高达50%以上.在院病死率与病情严重程度(OR=1.15)、初始抗生素经验性治疗不合适(OR=6.77)有关.结论 本研究所在医院成人血流感染病原茵以革兰阴性菌为主,病情严重以及初始抗生素经验性治疗不合适使血流感染病死率增加。
挤压综合征的急救与处理
Authors: 何新华, 李春盛
Journal: BMJ (2008)

地震中的伤害会有3%～20%为挤压伤,其中相当一部分将发展为挤压综合征.Bulut等[1]研究表明,地震后挤压综合征死亡率高达21%.因此,在救援过程中对挤压伤病员应该给予高度的关注,防止挤压综合征的发生。
Content analysis of pancreatic cancer conversations on Twitter: What matters most to users?
Authors: Udhayvir Singh Grewal, Jamie Doggett, Emil Lou, Allyson J. Ocean, Niraj Jaysukh Gusani, Arjun Gupta, Anirban Maitra, Muhammad Shaalan Beg
Journal: Journal of Clinical Oncology (2020)

11040 Background: Social media has an important role in addressing medical misinformation by connecting the global community of health care professional (HCP), cancer patients and advocates. We evaluated the content and dynamics of discussions around pancreatic cancer (PC) on Twitter to identify subtopics of greatest interest to these users. Methods: We used online analytical tool (CREATION Pinpoint) to quantify Twitter mentions (tweets and re-tweets) related to PC between 1/2018 to 12/2019. Keywords, hashtags, word combinations and phrases were used to query for PC mentions. HCP profiles were identified using machine learning and then human verified and remaining user profiles were classified as general public (GP). Data from conversations were analysed and stratified qualitatively (using e.g keywords/combinations/phrases) into 5 categories; 1) prevention (P), 2) survivorship (S), 3) treatment (T), 4) research (R), and 5) policy (Po). We analysed the impact of PC awareness month (PCAM) and celebrity PC diagnosis on the overall level of conversations. Results: Out of 1,258,028 mentions on PC, 313,668 unique mentions were classified into the 5 categories. We found that HCP discuss PC research more than the GP, while GP are more interested in treatment. PCAM did not increase mentions by HCP in any of 5 categories while GP mentions over 2 years, increased temporarily in all categories except prevention. HCP mentions did not increase with celebrity PC diagnosis. Alex Trebek’s diagnosis increased GP mentions on survivorship, while Ruth Ginsburg’s diagnosis increased conversations on treatment (Table). Conclusions: Twitter mentions between HCP and GP around PC are not aligned. The HCP conversation was mainly limited to research while GP were more interested in treatment. PCAM temporarily increased GP conversations around treatment, research, survivorship and policy but not prevention. Future studies should address which factors determine how celebrity diagnoses drive conversations. [Table: see text]
Real-world evidence of treatment patterns and pharmacy costs among patients with metastatic castration-resistant prostate cancer (mCRPC) in a managed care population in the United States.
Authors: Kelvin A. Moses, Katrine Wallace, Adrienne Landsteiner, Scott Bunner, Nicole Engel-Nitz, Lincy S. Lal, Anthony A. Golsorkhi
Journal: Journal of Clinical Oncology (2020)

e19319 Background: Prostate cancer (PC) is the most common cancer among men in the United States. Once the disease progresses to mCRPC, initial castration modalities may not be sufficient. This real-world data study describes the treatment patterns and pharmacy costs of US-insured patients with mCRPC. Methods: Adult males in an administrative claims database who had ≥1 claim for PC (ICD-9: 185 or 233.4; ICD-10: C61 or D075), had undergone pharmacologic or surgical castration, and had a code for metastatic disease during the identification period were included in the analysis. A minimum of 6 months of continuous enrollment (CE) pre- and post-index date (first metastatic claim) was required. Patients with metastatic claims at baseline were excluded. Patients were followed until the earliest of death (unless prior to 6-month CE), end of study period, or disenrollment. Claims-based algorithms were used to identify locally advanced and distant mCRPC patients and lines of therapy (LOT). The entire study period (baseline period through follow-up) was January 2008-March 2018. Results: 3690 patients with mCRPC were identified, of which 3150 received at least one LOT; 85.4% had ≥1 LOT, 69.4% had ≥2 LOTs, and 50.7% had ≥3 LOTs following metastatic diagnosis (Table). The average duration of treatment was similar across groups: 83.8, 86.5, 71.7, and 70.2 days for LOTs 1–4, respectively. The five most common LOTs were leuprolide (36.6%), bicalutamide-leuprolide (6.6%), abiraterone (5.9%), bicalutamide (5.0%), and enzalutamide (4.7%). Mean monthly per-patient pharmacy costs increased with each LOT ($2683, $2654, $2911, $2924, $3611, for LOTs 1–5, respectively). Conclusions: This is the first study to examine treatment patterns and drug costs of patients with mCRPC. Given the large number of LOTs this population moves through and the increasing costs associated with each, the development of more efficacious novel therapies for use earlier in the metastatic treatment regimen to prolong life is warranted. [Table: see text]
Decision aids for localized prostate cancer: Initial outcomes from NCI Community Oncology Research Program Alliance Research Base Cancer Care Delivery Research (CCDR) Protocol - A191402CD - A Cluster-Randomized Trial.
Authors: Jon Charles Tilburt, Joel E Pacyna, Daniel G. Petereit, Judith Salmon Kaur, Bruce D. Rapkin, Robert Grubb, George J. Chang, Michael J. Morris, Evan Kovac, Jeff A. Sloan, Ethan M. Basch, Elizabeth M. Storrrick, David Zahrieh, Amylou C. Dueck, Electra D. Paskett, Jan C. Buckner, Victor Montori, Domnick L Frosch, Robert Joseph Volk, Simon P. Kim
Journal: Journal of Clinical Oncology (2020)

e24176 Background: Decision aids for prostate cancer treatment can improve knowledge, but the relative effect of pre-consultation and within-consultation DAs is not known. Methods: We conducted a parallel design, 2-by-2 factorial, 4-arm, cluster-RCT in urology practices affiliated with the NCI’s Alliance research base. We compared patient knowledge immediately after consultation (%12-item% correct) intervention arms compared to usual care. We used mixed effects regression modeling to assess effect of interventions on knowledge adjusting for site-clustering, race/ethnicity (non-Hispanic White; Other), age (years), clinical stage (T1-3), PSA, and Gleason score. Results: 15 of 21 randomized centers accrued 158 pts from Nov 2017 to June 2019. The arm delivering both DAs (n = 3 sites) recruited 25 pts. The pre-consultation DA arm (n = 4 sites) recruited 39 pts. The within-consultation DA arm (n = 4 sites) recruited 44 pts. The no DA arm (n = 4 sites) accrued 50 pts. Overall, mean age was 64; 54% were AA; 73% had T1 stage; median Gleason = 7; and median PSA = 7. The combined DAs group, followed by pre-consultation reported higher median knowledge (75% and 67%, respectively). The within-consultation and no DA arms both reported median knowledge scores (58%). Within arm, inter-site standard deviations in mean knowledge scores ranged from 0.164 in in the pre-consultation arm to 0.232 in the usual care arm. Neither pre-consultation nor within-consultation DAs had statistically significant effects (p = .15 and p = .99, respectively). Pre-specified adjusted difference [97.5% CIs], comparing the pre-consultation DA and the within-consultation DA with the control was 9.4% [-7.3%, 26.2%] and -0.4% [-16.9%, 16.1%], respectively. Intra-cluster correlation (ICC) coefficient was high (.24). No interaction effects were identified (p = .98). A post-hoc analysis comparing any DA vs usual care found a mean adjusted difference [95% CI] of 5.6% [-8.5%, 19.8%] (p = 0.40), 63.9% for any DA and 58.3% for usual care. Conclusions: Possible knowledge gains associated with some DAs for early prostate cancer were obscured by larger-than-expected intra-cluster correlation effects associated with the primary outcome. How interventions were used was not measured. Support:UG1CA189823; https://acknowledgments.alliancefound.org ; R01 MD008934-06. Clinical trial information: NCT03103321 .
Meta-analysis of cyclin-dependent kinase (CDK) 4/6 inhibitors with endocrine therapy versus endocrine therapy alone on progression-free survival (PFS) and overall survival (OS) for metastatic breast cancer (MBC).
Authors: Ranju Kunwor, Ramkaji Baniya, Maysa M. Abu-Khalaf
Journal: Journal of Clinical Oncology (2020)

1060 Background: CDK 4/6 inhibitors with Endocrine therapy (ET) are the preferred first line treatment for Hormone Receptor positive and Human Epidermal Growth factor receptor 2 negative (HR+/HER2-) MBC. Over the last few years multiple trials have shown benefit in PFS. Only two studies evaluating Ribociclib and Abemaciclib showed an OS benefit while no statistically significant OS benefit has been reported in any of the studies evaluating Palbociclib raising the possibility that this benefit may be drug specific rather than applicable to all CDK 4/6 Inhibitors. This updated meta-analysis of randomized controlled trials (RCTs) aims to assess the PFS and OS of all three CDK 4/6 inhibitors in HR+/HER2- MBC. Methods: We performed a systematic search for RCTs using Cochrane Library, PubMed, Embase, and Web of Science. Only the phase II and III RCTs comparing CKD 4/6 inhibitors plus ET with ET alone were eligible for this meta-analysis. The pooled analysis of Hazard Ratio (HR) was performed with Review Manager 5.3 using random effect model. Results: A total of 8 RCTs including 4338 patients with HR+/HER2- MBC were included in this meta-analysis (table). The pooled HR for PFS was 0.55 (95% confidence interval (CI), 0.50-0.59; P &lt; .00001) and the pooled HR for OS was 0.75 (95% CI, 0.68-0.84; P &lt; .00001). Conclusions: The result of our meta-analysis confirms the previously reported PFS benefit from CDK 4/6 inhibitors plus ET and shows an OS benefit when including RCTs of all 3 CDK 4/6 inhibitors for the treatment of HR+/HER2- MBC. [Table: see text]
高血压患者的饮食管理
Authors: 王增武, 郭瑞
Journal: BMJ (2012)

饮食习惯与高血压的发生发展密切相关,高血压患者通过合理饮食,控制不良膳食习惯,如减少钠盐摄入、戒烟、戒酒等,可使血压水平下降,或减少降压药物的用量,并减少其他疾病和并发症的发生风险。
Single-institution experience of allogeneic stem cell transplantation for diffuse large B-cell lymphoma.
Authors: Benjamin Puliafito, Solmaz F. Afshar, Zachary Galitzeck, Amir S. Steinberg
Journal: Journal of Clinical Oncology (2020)

e19524 Background: Given the promising results of novel therapies such as CAR-T, there is heightened scrutiny on the long-term outcomes of allogeneic stem cell transplant (alloHCT) in diffuse large B cell lymphoma (DLBCL). We present the characteristics and long-term follow-up of DLBCL patients (pts) who underwent alloHCT at our institution over the past 10 years. Methods: Adult pts who underwent an initial alloHCT for DLBCL at our institution from 2008 to 2018 (n = 18) were included. Pt, disease, transplant (tx), and GVHD history were retrospectively collected from reports to CIBMTR and chart review. Outcomes of progression-free survival (PFS) and overall survival (OS) were analyzed in February 2020. Results: Eighteen pts underwent an alloHCT for DLBCL at a median of 19.5 months post-diagnosis (range, 6 – 83 mo). The median age at the time of tx was 53 years old (range, 30 – 67 yrs). The median Karnofsky score was 70 (range, 30 – 100). The majority of the pts (78%) had stage IV disease. The median number of prior chemotherapy regimens was 3 (range, 1 – 6). Disease was chemosensitive in 11 pts (61%), chemoresistant in 4 pts (22%), and undetermined in 3 pts (16%). Eleven pts (61%) had a previous autoHCT with a median time between txs of 8 months (range, 4 – 28 mo). The disease status at time of tx included CR1 (n = 2), CR3+ (n = 2), PR (n = 4), PIF-resistant (n = 3), PIF-sensitive (n = 1), REL1-resistant (n = 1), and REL3+-sensitive (n = 3). Fifteen patients received PBSC and 3 patients received cord blood. Donors were HLA-identical siblings (n = 5), monozygotic twins (n = 1), and unrelated (n = 12). Conditioning regimens were Flu/Mel (n = 10), Flu/Mel/ATG (n = 2), Flu/TBI (n = 2), Flu/Cy/TBI (n = 1), Cy/TBI (n = 2), and BEAM (n = 1). Acute GVHD developed in 16 pts (89%) with max grades of III or IV in 10 pts despite 94% of pts receiving GVHD prophylaxis. Chronic GVHD developed in 5 pts (28%; 3 pts with limited disease and 2 pts with extensive disease). PFS rates were 56% at 6 months, 33% at 1 year, and 24% at 3 years. OS rates were 72% at 6 months, 39% at 1 year, and 24% at 3 years. The median time to death was 7.5 months (range, 1 – 74; mean 12.9 mo) with primary disease as the most common cause of death (5/18 pts; 28%). At the time of analysis, 4 pts (22%) were alive with a maximum survival of 58 months (range, 28 – 58 mo). Conclusions: A significant portion of DLBCL patients had durable responses after alloHCT with 24% of patients alive at 3 years, despite high rates of GVHD and a broad range of disease status. As novel therapies continue to emerge, alloHCT should still be considered in specific populations of relapsed and refractory DLBCL.
由皮肤病的症状和皮疹辨认皮肤病
Authors: 蔡林
Journal: BMJ (2007)

皮肤病千差万别,要正确诊断皮肤病,必须了解皮肤病的症状和体征.皮肤病的症状分为自觉症状和他觉症状.自觉症状系指患者自己主观感觉到的症状,主要有瘙痒、疼痛、麻木、灼热等.自觉症状常因致病因素或诱发原因、病情、个体敏感性不同而有差异.他觉症状是指医生检查所见的各种皮肤损害,如风团、丘疹、渗出等,是诊断皮肤病的重要依据。
Retrospective analysis of clinical characteristics and prognostic factors of neuroendocrine carcinoma of the gynecologic tract: A preliminary report of ten years follow-up.
Authors: Y Zhang, J Yang, Qy Li, Zg Zhang, MJ Sun, Yg Shi
Journal: Journal of Clinical Oncology (2020)

e18001 Background: To investigate the clinical characteristics and prognostic factors of neuroendocrine carcinoma of the gynecologic tract (NECGT). Methods: Patients with NECGT diagnosed during 2010 to 2019 were enrolled in this retrospective study. Clinical parameters were calculated, including age, childbearing history, initial symptoms, blood indexs, International Federation of Gynaecology and Obstetrics (FIGO) stages, treatment modalities and survival data. The cut-off values of parameters were screened by receiver-operating characteristic (ROC) curves and their significance was assessed by multivariate logistic regression. Results: We indentified forty five NECGT patients available with the median follow-up time of 5.5 months (9.7±1.98 months). 42 cases (93.3%) originated from cervix uteri, 2 cases (4.4%) from vagina and 1 case (2.2%) from fallopian tube. Irregular vaginal bleeding was the most frequent symptom at the first visit accounting for 75.6%. FIGO stages I to IV distributions were 16 (35.6%), 15 (33.3%), 6 (13.3%), and 8 patients (17.8%). Squamous carcinoma (16.7%) and adenocarcinoma (11.9%) were the common mixed pathological types. 66.7% patients underwent radical surgery, almost all of which received 4-6 cycles adjuvant chemotherapy and half followed by radiation therapy. While data analysis showed that adjuvant radiotherapy could not bring additional survival benefits (p = 0.523). The median PFS of enrolled patients was 14 months (1-78months). Pelvic recurrence (66.7%) and lymphatic metastasis (52.6%) were the main failure patterns. In multivariate analysis, leukocyte count (HR = 0.068, 95%CI: 0.007-0.673, p = 0.021), neutrophil-to-leukocyte ratio (HR = 0.151, 95%CI: 0.024-0.95, p = 0.044), lactic dehydrogenase (LDH) (HR = 6.632, 95%CI: 1.31-33.569, p = 0.022) and carbohydrate antigen-ca 125 (CA-125) (HR = 7.173, 95%CI: 1.25-41.06, p = 0.027) were the independent prognostic factors of PFS. In addition, age at natural menopause (ANM) later than 51.5years (p = 0.009) and an optimal maximum diameter &gt; 62.1mm (p = 0.002) were closely related with poor survival. Conclusions: NECGT is a rare malignant tumor of female genital system. Surgery combined with chemotherapy is the essential treatment, addition of adjuvant radiotherapy did not improve survival. More high-quality clinical trials are needed to provide powerful evidence.
系统性红斑狼疮合并结核性脑膜炎一例
Authors: 华冰珠, 王红, 冯学兵, 丁从珠, 刘布骏, 孙凌云
Journal: BMJ (2007)

患者女,37岁.因反复高热40 d于2005年12月13日入院.患者10余年前无明显诱因出现面部红斑,查蛋白尿(+),抗核抗体(+),抗双链DNA(ds-DNA)抗体(+)、抗SM抗体(+),诊断为系统性红斑狼疮(SLE),给予糖皮质激素治疗(具体不详),病情缓解.本次发病前用泼尼松10 mg/d维持.40 d前因外出旅游劳累后出现全身疼痛,发热,体温最高40℃,无畏寒,伴口腔溃疡、咽痛、咳嗽、少量白黏痰.查血白细胞3.4×109/L,血小板53×109/L,红细胞沉降率(ESR)50 mm/1 h,C反应蛋白(CRP)17.0 mg/L(正常值0～8 mg/L).给予泼尼松45 mg/d,体温不降,后加消炎痛栓50 mg/d能降至正常,但药效过后仍发热.于2005年12月13日收住我科。
Contribution of family history of gynecologic cancers to associated risk-factors and screening: Analysis of an Internet-based risk assessment tool.
Authors: Ryan M. O'Keefe, Michael Joseph Lariviere, Carolyn Vachani, Margaret K. Hampshire, Christina Bach, Karen Arnold-Korzeniowski, Marisa Healy, James M. Metz, Christine E. Hill-Kayser
Journal: Journal of Clinical Oncology (2020)

e13605 Background: Well-established risk-factors exist for gynecologic cancers (GC): estrogen exposure increases risk of endometrial cancer (EC); HPV infection and smoking are associated with cervical cancer (CC); oral contraceptive (OCP) use may be associated with an increased risk of CC but a reduced risk of EC and ovarian cancer (OC). Women with a family history (FH) of cancer are more likely to receive regular CC screening, but the association between FH of GC and other risk factors has not been investigated. Methods: Reduce My Risk is an Internet tool created in 2009 to provide personalized information regarding cancer risk, available at OncoLink.org. Voluntary participants were asked about risk factors and risk-associated behaviors. Differences between female respondents with v. without FH of GC were analyzed using chi-square test. Results: Among 16,878 female respondents, 841 (5.0%) had FH of CC, 345 (2.0%) EC, 1,117 (6.6%) OC, and 92 (0.5%) vulvar/vaginal (VC) cancer. Those with FH of any GC showed no difference in alcohol consumption compared to those without FH. Those with FH of CC, EC, OC, and VC were more likely to be obese (34.1% v. 24.7%; 37.2% v. 24.9%; 31.4% v. 24.7%, 43.7% v. 25%, p &lt; 0.001 for all). Those with FH of CC were more likely to have first sexual intercourse before age 18 (69.2% v. 57.8%, p &lt; 0.001) and to have &gt; 10 sexual partners (24.0% v. 16.7%, p &lt; 0.001). This group was also more likely to be current smokers (19.3% v. 11.7%, p &lt; 0.001), and to smoke &gt; 1 pack/day (6.5% v. 2.8%, p &lt; 0.001). They were more likely to receive regular CC screening (91.2% v. 86.8%, p = 0.09), though the difference was not statistically significant. Women &lt; 35 y with a FH of CC showed no differences in HPV vaccination rate (37.0% v. 39.3%, p = 0.29). Those with FH of EC were more likely to have menarche before age 12 (39.3% v. 32.0%, p = 0.005), and to have taken post-menopausal HRT for ≥2 y (77.6% vs. 66.8%, p &lt; 0.001). Those with FH of EC, and OC were more likely to have taken OCPs (77.6% v. 66.8%; 71.9% v. 66.7%, p &lt; 0.001 for both). Conclusions: Many with a FH of GC have increased likelihood of both modifiable and non-modifiable risk factors that are associated with the development of cancer. FH of CC did not increase likelihood of regular screening or HPV vaccination, but was associated with smoking, early intercourse, and multiple sexual partners. Future work should explore targeted intervention for those with FH of GC as a teachable opportunity for the benefits of weight reduction, smoking cessation, pap screening, and HPV vaccination.
Current status in epidemiological studies on Alzheimer disease in China
Authors: 王华丽, 于欣
Journal: BMJ (2006)

我国平均预期寿命的延长预示着老年人口将不断增加,我国65岁及以上老人占总人口的比例从1990年的5.57%增至2000年的6.96%,现已达8 811万.随着人口老龄化的日趋明显,阿尔茨海默病(Alzheimer disease,AD)作为老年期痴呆最常见的一种类型,必将成为一个重要的医学和社会问题.AD是一种进行性中枢神经系统退行性疾病,以不断进展的记忆障碍、全面智能减退、个性改变以及精神行为异常为主要临床表现.1906年德国精神科医生Alzheimer描述此病,后以其名字为该病命名,迄今国内外对AD进行了许多深入研究,近年来我国流行病学研究结果提示,AD是中国最常见的一类痴呆,控制方法学因素后,中国AD的地理分布差异甚小[1],现就其流行病学特征作一综述。