对数线性模型在骨折资料分析中的应用

目的应用对数线性模型对骨折资料进行分析.方法收集了天津医院1993～2002年的骨折病历资料,采用对数线性模型对上述资料进行分析.结果骨折患者的年龄,性别和骨折原因间存在着交互作用.结论对数线性模型可以更好的分析多个变量间的交互作用,适用于探索性的研究.     

社区自理老年人运动锻炼情况与精神压力的相关性研究

[目的]探讨社区自理老年人的运动锻炼情况与精神压力的关系.[方法]随机抽取天津市某社区60岁以上老年人161人,采用焦虑自评量表(SAS)、生活方式自评量表测量老年人精神压力与运动锻炼情况.根据生活方式自评量表中锻炼和体能分数将老年人分为3组(即规律锻炼组、有时锻炼组、不锻炼组).[结果]3组老年人SAS标准分比较差异有统计学意义(F=3.680,P＜0.05),规律锻炼组和不锻炼组SAS得分比较差异有统计学意义(P＜0.05).[结论]规律运动锻炼可以缓解自理老年人的精神压力.     

应用型本科护理人才培养模式的改革与实践

通过系列“质量工程”和“本科教学工程”项目建设，建设办学特色鲜明、专业结构适应国家卫生事业发展需求的特色护理专业；加强教师队伍建设与人才队伍培养，着力大学生实践能力和创新创业能力培养，构建了厚基础、强能力、高素质、重发展的应用型本科护理人才培养模式。该模式结合中国健康事业发展对护理人才的需求，坚持知识、能力与素质培养为一体的“全人教育”理念，创建了高素质应用型护理人才“1234”培养模式，即一条主线、两个能力、三个体系、四个体现。即以医学人文素质教育贯穿于人才培养全过程为主线，强化理论与实践相结合的能力和职业发展能力的培养；构建本科护理学通科教育与专科化培养相结合的课程体系、实践体系和以复合型师资队伍建设为重要途径的教学质量保障体系；在教育教学中体现以素质为本，知识、能力、素质协调发展；体现强化基础，拓宽视野；体现培养独立学习能力、理论与实践结合的能力和创新精神；体现为职业持续发展奠定获取和再生知识能力的基础。     

S100P as a marker for poor survival and advanced stage in gallbladder carcinoma

AimsGallbladder carcinomas usually present in advanced stages and has a dismal prognosis despite modern imaging techniques and aggressive surgical intervention. Identification of biologic markers for early diagnosis and improved therapeutic strategies is thus of paramount importance. S100P has been identified in a variety of malignant neoplasms of the gastrointestinal and pancreaticobiliary systems, but it is not yet known if S100P expression is associated with clinically-relevant characteristics of gall bladder carcinoma. The aims of the present study were: 1) to investigate the relationship between S100P expression and histological type, grade, tumor-node-metastasis stage, presence of vascular invasion, perineural invasion and necrosis; and 2) to evaluate for any S100P-defined difference in the risk for tumor recurrence or death.MethodImmunostains for S100P were performed on 4 tissue microarray blocks containing 91 cases of gall bladder carcinoma.ResultThe intensity of S100P staining was significantly associated with pathological T stage 4 (p = 0. 0238). Staining intensity ≥3 in ≥25% tumor cells was associated with pathological T stage 4 (p = 0.0005). A higher S100P immunoreactivity score (IRS) was significantly associated with higher TNM stage (p = 0.0341). Age (p = 0.0485), presence of vascular invasion (p = 0.0359), pathological T stage (p = 0.0291) and TNM stage (p = 0.0153) were significantly associated with tumor recurrence. Intense S100P reactivity was associated with decreased overall survival [hazard ratio = 9.614; 95% confidence interval (CI), 1.873–49.338; p = 0.0067].ConclusionOur findings indicate that S100P over-expression is a potential prognostic marker for gall bladder carcinoma and is significantly associated with advanced tumor stage and poorer survival.     

肺癌患者同步放化疗期间症状群的调查研究

目的调查分析肺癌患者同步放化疗期间症状群的发生及分布特征。方法采用M.D安德森症状评估量表中文版(MDASI-C)对141例同步放化疗的肺癌患者进行调查。Spearman相关分析用于症状间相关性的分析;主成分分析用于提取患者的症状群。结果同步放化疗的肺癌患者疲乏症状强度得分最高,为(6.1±2.0)分,疲乏症状发生频率亦最高,为95.7%;MDASI-C各症状间均存在正相关(P<0.01),相关系数为0.13～0.74;主成分分析显示存在3个症状群:消化道症状群、情感症状群和病感症状群,3个症状群的内部信度Cronbach’sα系数分别为0.84、0.80和0.82。结论肺癌患者同步放化疗期间存在不同的症状群,认识该症状群有助于医护人员准确预见并为建立干预措施提供参考,以减轻肺癌患者的症状负担,提高其生活质量。     

羟基磷灰石诱导脂肪间充质干细胞成骨分化的实验研究

目的 探究羟基磷灰石（HA）对脂肪来源的间充质干细胞（ADSCs）向成骨分化的影响。方法 分离、纯化 并鉴定C57BL/6小鼠的ADSCs，将HA与ADSCs共培养，CCK-8法检测不同浓度（0、5、10、20、50、100、500 mg/L）的HA 对ADSCs增殖的影响；碱性磷酸酶（ALP）染色检测不同浓度HA对ADSCs成骨分化的影响；实时荧光定量逆转录-聚 合酶链反应（qRT-PCR）检测ADSCs成骨相关基因骨钙素（BGLAP）、碱性磷酸酶（ALP）、Ⅰ型胶原（COL1A1）、骨桥蛋 白（OPN）、Runt相关转录因子2（Runx2）的mRNA表达情况。结果 低浓度HA（≤20 mg/L）对ADSCs增殖的影响较 小，随着HA浓度增加，细胞的增殖活性下降。HA与ADSCs共培养可显著增加其ALP活性，并促进成骨相关基因的 表达（P＜0.01），且HA为20 mg/L时诱导效果较好。结论 HA具有诱导ADSCs向成骨细胞分化的能力，为两者混合 制作成新的骨支架修复材料提供了理论基础。     

Characterization of 114 insertion/deletion (INDEL) polymorphisms,and selection for a global INDEL panel for human identification

Bi-Allelic Insertions and Deletions (INDELs) are a powerful set of genetic markers for Human Identification (HID). They have certain desirable features, such as low mutation rates, no stutter, and potentially small amplicon sizes that could prove effective in some circumstances. In this study, we analyzed the distribution of 114 INDELs in four North American populations (Caucasian, African American, Southwest Hispanic, and Asian) to estimate their distribution in major global populations. Of the 114 INDELs a primary panel of 38 candidate markers was selected that met the criteria of (1) a minimum allele frequency of greater than 0.20 across the populations studied; (2) general concordance with Hardy–Weinberg equilibrium (HWE) expectations; (3) relatively low F_ST based on the major populations; (4) physical distance between markers greater than 40 Mbp; and (5) a lack of linkage disequilibria between syntenic markers. Additionally, another 11 supplemental markers were selected for an expanded panel of 49 markers which met the above criteria, with the exception that they are separated at least by 20 Mbp. The resulting panels had Random Match Probabilities that were at least 10⁻¹⁶ and 10⁻¹⁹, respectively, and combined F_ST values of approximately 0.02. Given these findings, these INDELs should be useful for HID.     

颞下经小脑幕入路治疗基底动脉顶分叉部动脉瘤:附三例报告

探讨基底动脉顶分叉部动脉瘤的手术适应证及手术操作技巧。回顾分析3例经颞下入路手术治疗基底动脉顶分叉部动脉瘤患者临床表现、影像学资料及手术过程。其中2例动脉瘤完全夹闭,1例因保护穿支动脉而残留部分瘤颈。术后随访6个月至2年,均恢复良好,改良Rankin量表评分分别为2分、0分、1分;日常生活活动能力量表(Barthel指数)评分为65分、100分和95分。     

机械加载对慢性脑缺血大鼠学习记忆障碍的改善作用

摘要：目的 探讨脉冲式机械加载对慢性脑缺血大鼠学习记忆能力的改善作用。方法 27只健康雄性SD大鼠 按随机数字表法分为假手术组（Sham组）、血管性痴呆模型组（VD组）和脊柱加载治疗组（VD+L组），每组9只。Sham 组仅分离双侧颈总动脉但不结扎；VD组分离双侧颈总动脉后永久性结扎建立VD模型；VD＋L组建立模型后每天接 受脊柱机械加载治疗，共5周。Morris水迷宫测试大鼠学习记忆能力；HE染色及尼氏染色观察大鼠大脑皮质及海马 组织的病理改变；免疫组织化学技术检测神经胶质纤维酸性蛋白（GFAP）的表达。结果 与VD组相比，VD+L组大 鼠逃避潜伏期明显缩短，穿越平台次数和停留平台象限时间显著增加，加载后明显改善神经元形态结构和存活状 态，海马锥体细胞明显增多，并抑制了海马及皮质中GFAP的表达。结论 机械加载可以明显改善慢性脑缺血后大 鼠的学习记忆障碍、保护缺血后神经元，该治疗作用可能与机械加载减轻海马和皮质神经元病理损伤、抑制胶质细 胞的活化有关。     

如何正确运用t检验——两几何均值比较一般差异性t检验及SAS实现

本文目的是介绍几何均数以及两组近似对数正态分布数据几何均数的一般差异性t检验及SAS实现。首先对几何均数的概念、适用条件和计算公式进行介绍;并且将几何均数与统计学中常用的算术均数的特点进行比较;其次,呈现两组药物浓度数据,该数据近似服从对数正态分布,符合几何均数的适用条件,使用SAS的TTEST过程对两组几何均数的一般差异性进行t检验,并对相关结果进行解释和比较;最后,讨论几何均数使用时的注意事项。