????(epidemiology)

1
????(epidemiology)

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• ????????????

2

??? ??(Introduction of Epidemiology)

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• ???????
• ??????????
• ?????????
• ???????
• ????????????????

3
??? ???????

• ??????????
• ??????(18??)
• ????(???) (18???20???)
• ?????(20??40?50??)
• (????????)

4
(?)??????

• ??18????
• ???????????,???????????????????????????????????
  ??????,?????????????
• ??
• ?????????????????
• ????????????
• Hippocrates Airs,waters
  and place
• ???? ???,?????
• ?,????

5

• ?1736??????????
• ???,???,???????,
• ?????,??????
• ???,???,???????,
• ???,???,????????
• ????????????
• ? 11????????,?????????????
• ? 15????,???????????????????40?,guarantine(??)

6
??????
Hippocrates (460-377 BC) ????????
????????? Epidemic ? Epidemic ? On Airs,
Waters and Places

• ????
• ??????
• ????????????????

7
??????
??????-?????

• 14???????????????40?
• quadraginta (???,???40) ? quarantine
• 1423?????????????

8
??????
John Graunt (1620-1674)

• ??????????????????
• ?????????,??????
• ?????????????????
• ??????????
• ????????????

9
(?)?????(???)

• ??18????20???
• ?????????????,?????????????,????????,???????????
  ?????
• ??
• 1796???Jenner??????????
• 1848??1854???John Snow??????
• 1850?????????????

10
?????
James Lind (1716-1794)
VitC?? ??? (1747)
11
?????
Edward Jenner (1749-1823)
(1796) ???? ????
12
?????
William Farr (1807-1883)

• ?????????????????
• ?????????????????????????????????????

13
?????
John Snow (1813-1858)

• ????-????
• ?????
• ???????
• ?????????
• ??????????

14
?????
London Epidemiological Society (1850)
???????????? ????????????
15
(?)?????

• ??20??40????(??????)
• ??????????????????????????????????????????????
• ??
• 20????????????
• 50??????????(Doll Hill
• ????????????)
• 51?Cornfield??RR?OR???
• 59?Mentel-Haenszel?????
• 60????????????

16
?????
?????????(??????) -??????

• ???? (194620??60????)
• ???? (20??60????80????)
• ???? (20??80??????)

17
?????

• ??
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• ???????????

18
Richard Doll Austin Bradford Hill
??-?????
19
Nathan Mantel William Haenszel
?????
Mantel N, Haenszel W. Statistical aspects of
the analysis of data from retrospective studies
of disease. J Natl Cancer Inst 1959 22 (4)
719-748.
20
???????????/??
MacMahon B and Pugh TF. Epidemiology Principles
and Methods. Boston Little, Brown and Company.
1970.
Lilienfeld AM and Lilienfeld DE. Foundations of
Epidemiology (2nd ed.). New York Oxford
University Press. 1980
Last JM. A dictionary of epidemiology. Oxford
University Press. 1983.
Rothman KJ. Modern Epidemiology. Boston Little,
Brown and Company. 1986
21
(No Transcript)
22
???????????

• ???(1877-1960)????????????? ???????????????,?????
  ????????? 1911??????????1937??????????????????
• ???(1906-1985)???????????????
• 1??????????
• 2?1972??????????
• 3??????????

23

• ??? (1911-1995)???????????????
• 1????????????????????
• 2????????????????
• 3???????????????????
• 4?70????????????????????
• 1949???????????????,????????????(64?)?????????????
  ?
• 1960?????(77???????)

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• 50?????????????????????
• 58???????????????
• 60??????????????
• 70???????????????
• 74??????????????
• 80?????????????????????
• 89?????????????
• 89????????????????
• 90????????????
• 00??????????????
• 03?????????????????

25
??? ??????

• ????????
• ????
• ???????
• ??????
• ???????
• Epidemiology
• Upon people science

26
(?)?????(1)

• Stallybrass(1931)
• ?????????????????????????
• ???????(1936)
• ????????????,???????????????????,?????????????
• Maxcy(1951)
• ????????????,????????????????????????????????????
  ?

27
?????(2)

• MacMahon(1970)
• ??????????????????????????????
• ????????(1971)
• ????????????????????????????
• Lilienfeld(1978)
• ?????????????????????????????????

28
?????(3)

• ?????????(1979)
• ????????????????????????,????????????????????????
  ?
• WHO????????????(1980)
• ????????????????????????,????????????,?????????,?
  ?????????????
• Last??????????(1983)
• ???????????????????????????,????????????????????

29
?????(??)

• ????????EPIDEMIOLOGY,???EPI(???)DEMO(??)OLOGY
  (??)??????????(??)????
• ????
• ????

???
??
?? ??
???? ??
30
????

• ????(Epidemiology)????????????????????
  ?,??????????????????????
• ?????????(1994)
• ?????????(19992004)

31
???????????
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32
??? ?????????

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• 5?????????
• 6??????????????
• 7???????????

33
?? ????

• ???????????
• ??????????(7984-85?)84??????TB?????????????23?11
  ?10/10?
• ??????????????(75-85?)??????????????????????????
  ?????
• ?12???????(82?)????12.67,??gt??
• ????????????(849196?)96?????????37(?69,?4 .
  2)
• ? 14???????????(94?)20-7-??II?????????3.2,?81???
  ?5?
• ? ???????????(79?92?)92?HBsAg 9.75 ?-HAVIgG
  80.9 ?-HCVIgG 3.2 ?-HEV 17.2

34

• ??????
• ?????????
• ??????????????
• ?40??Gregg????????????????????
• ?50??Doll Hill????????????
• ?????
• 58????????????????
• 59????????????
• 72??????????
• ??????????
• ???????????

35
??? ????????
??(census)
????

???? (Prevalence)
?????? Descriptive epi.
??(census)
???? (Longitudinal)
??? observation method
????? (ecological)
??????(case control)
?????? Analytical epi.
???? (cohort study)
????(clinical trial )
? ? ? ?
??? experiment method
????(field trial )
????(community trial )
???(quasi-experiment )
?????? theoretical epi.
???? ???
?????? Methodology study
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??? ???????

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37
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38
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