创伤性浮膝伴血管损伤的早期诊治

目的 探讨创伤性浮膝同时伴同侧血管损伤患者的早期诊断及救治.方法 总结1996年6月～2002年12月收治28例30个浮膝的手术固定方法、血管修复情况及术后治疗和恢复情况.结果 术后伤口一期愈合5例,17例伤口二期行植皮修复,4例胫前骨折部外露二期行皮瓣转移术,截肢2例,保肢成功率92.9%.术后26例经18个月～8年随访,骨折均愈合,下肢功能恢复优良率64.3%.结论 对浮膝损伤患者应高度重视伴有血管损伤可能,早期作出诊断,积极合理治疗,对患者预后至关重要.     

治疗时机对创伤性漂浮膝预后的影响

目的:探讨不同的手术时机对于创伤性漂浮膝术后功能恢复的影响。方法:回顾性分析42例接受手术治疗并获得随访的漂浮膝患者术后膝关节功能恢复情况,将患者按接受手术的时间分为72h内（23例）和72h后（19例）手术组,根据Karlstrom标准对两组患者术后膝关节功能恢复情况进行评定,将评定结果使用SPSS10·0软件进行统计学分析。结果:随访11个月⁶年,平均26个月,72h内接受手术者膝关节功能恢复情况优10例,良7例,中5例,差1例;72h后接受手术者优2例,良5例,中4例,差8例,两组结果差异有显著性统计学意义（P<0·01）。结论:早期手术坚强内固定、早期进行功能锻炼对于漂浮膝损伤远期功能的恢复具有重要的意义。     

一种适合正颌外科的成人个体化头影测量颅颌关系的方法

目的本研究选择在判断矢状向和垂直向颅颌关系中最常用的5项X线头影测量项目并以此为基础,运用多元回归的方法探讨并建立我国成都地区成人个体化颅颌关系浮动正常值,并探讨其应用方法.方法搜集符合纳入标准的未接受过正畸治疗的成都地区18岁至45岁正常(牙合)97例,其中男性48例,女性49例.测量各样本上颌突度(SNA),下颌突度(SNB),上颌相对颅底倾角(NL-NSL),下颌相对颅底倾角(ML-NSL),颅底角(NSBa).对测量项目进行多元统计分析并建立成都地区成人个体化头影测量颅颌关系浮动正常值.结果(1)5个测量项目之间均存在显著相关关系,其中SNB与其余4个测量项目的相关强度最大;(2)以SNB为自变量建立成都地区成人个体化头影测量颅颌关系浮动正常值.结论本研究为成人正畸患者,特别是拟进行正颌外科治疗的成人患者提供了一种辅助性的头影测量诊断方法.     

Fisher information matrix for nonlinear mixed effects multiple response models: Evaluation of the appropriateness of the first order linearization using a pharmacokinetic/pharmacodynamic model

We focus on the Fisher information matrix used for design evaluation and optimization in nonlinear mixed effects multiple response models. We evaluate the appropriateness of its expression computed by linearization as proposed for a single response model. Using a pharmacokinetic–pharmacodynamic (PKPD) example, we first compare the computation of the Fisher information matrix with approximation to one derived from the observed matrix on a large simulation using the stochastic approximation expectation–maximization algorithm (SAEM). The expression of the Fisher information matrix for multiple responses is also evaluated by comparison with the empirical information obtained through a replicated simulation study using the first‐order linearization estimation methods implemented in the NONMEM software (first‐order (FO), first‐order conditional estimate (FOCE)) and the SAEM algorithm in the MONOLIX software. The predicted errors given by the approximated information matrix are close to those given by the information matrix obtained without linearization using SAEM and to the empirical ones obtained with FOCE and SAEM. The simulation study also illustrates the accuracy of both FOCE and SAEM estimation algorithms when jointly modelling multiple responses and the major limitations of the FO method. This study highlights the appropriateness of the approximated Fisher information matrix for multiple responses, which is implemented in PFIM 3.0, an extension of the R function PFIM dedicated to design evaluation and optimization. It also emphasizes the use of this computing tool for designing population multiple response studies, as for instance in PKPD studies or in PK studies including the modelling of the PK of a drug and its active metabolite. Copyright © 2009 John Wiley & Sons, Ltd.     

水分胁迫条件下不同栽培居群菘蓝中4种有机酸的变化

目的:检测北京、内蒙古、河北和陕西等4个栽培居群菘蓝叶片中草酸、苹果酸、柠檬酸和抗坏血酸等4种有机酸成分含量的差异及在淹水胁迫下的变化.方法:采用高效液相色谱法测定正常及水分胁迫下不同栽培居群的菘蓝叶片中4种有机酸的含量.结果:不同栽培居群叶片中有机酸含量不同,而在水分胁迫条件下,各栽培居群有机酸含量变化趋势相同,草酸、苹果酸和柠檬酸含量升高,抗坏血酸含量下降.结论:不同栽培居群的菘蓝所含各有机酸存在一定差异,在水淹等逆境条件下,其叶片中有机酸含量发生不同程度地变化,并与其逆境生理密切相关.     

Patient comprehension and recall of laparoscopic surgery and outcomes in a non-English speaking population.

BACKGROUND AND OBJECTIVES: The purpose of this study was to determine patient recall and comprehension after laparoscopic appendectomy in an underserved population. Laparoscopic surgery can lead to diagnostic uncertainty secondary to poor recall and variable port placement. METHODS: After institutional review board approval, we identified a cohort of patients who underwent laparoscopic appendectomy from 2000 to 2004 at a single institution. We then attempted to contact the patients to conduct a 10-question telephone survey, which determined whether the patient spoke English or Spanish as a primary language, ethnicity, educational level, and questions about recall of perioperative events and diagnoses. If we could not reach the patient, we tried to call back on 2 different occasions. RESULTS: Between 2000 and 2004, 186 patients underwent laparoscopic appendectomy. Of these, 65% were Hispanic. We found that only 17% of these patients returned for a postoperative visit. Only 19.3% could be contacted by phone. Forty-seven percent of the patients contacted by phone spoke Spanish exclusively. Overall 92% of patients contacted knew what operation they had, and gave their correct diagnosis. CONCLUSIONS: The low percentage of patients available to follow-up makes this study statistically insignificant. However, we believe that fact in itself is important. In Southwestern states, we see a large migrant population. This highlights the need to communicate effectively with the patients at the time of surgery, which we speculate we did based on the percentage of patients that knew their diagnosis.     

上海市流动人口血吸虫病、疟疾、丝虫病监测结果分析

目的：评价外来流动人口对上海市人群传播血吸虫病、疟疾、丝虫病(简称“三病”)的潜在危害，从而预防和控制外源性“三病”在本市传播。方法：对外省市来沪居留3个月以上人员，进行“三病”血清免疫学检测，达到规定的阳性滴度时进行病原学追踪及治疗。结果：2001—2003年共监测外来流动人口909960人次，血吸虫病、疟疾、丝虫病抗体阳性率分别为0．55％、0.28％和0．02％；质量抽检符合率分别为98、42％、94．21％和99．84％。结论:必须加强外来流动人口“三病”监测和防治管理，以有效预防和控制外源性“三病”在本市传播。     

医保对象对职工医疗保险制度反应性的分析

该文对享受上海市城镇职工基本医疗保险的市民进行随机抽样调查,就其对医保政策的评价和就医行为反应性改变,分析医保改革的有效性和震荡度.提出加强医保法制建设,强化费用分担意识,完善医保政策,进一步体现福利性、公益性、公平性.     

产后小鼠子宫内膜边缘群干/祖细胞的分离纯化

目的分离和纯化小鼠子宫内膜边缘群(side population,SP)干/祖细胞,为进一步探讨产后子宫修复的细胞机制奠定基础。方法分别采用酶消化和机械分离结合法与机械研磨分离的方法,原代分离小鼠子宫内膜上皮细胞与基质细胞,通过Hoechst33342-SP法(对照加入维拉帕米),使用流式细胞仪检测子宫内膜SP细胞。结果未孕小鼠子宫内膜上皮与基质中均无明确SP干/祖细胞,产后哺乳期后的小鼠子宫内膜基质中含有SP干/祖细胞达(3.44±1.59)%。结论本研究初步检测到小鼠产后子宫内膜中含有SP干/祖细胞。产后更多SP细胞的出现可能与修复损伤的子宫内膜有关。这群SP细胞是子宫原位干细胞还是有其他来源,如何参与子宫内膜的修复,其分子机制如何,尚待进一步研究。     

南山区与某社区常住人口6年恶性肿瘤发病调查

目的：了解某社区常住人口恶性肿瘤平均年发病率是否高于周边人群，重点是白血病平均年发病率。方法：采用回顾性调查法及个案调查表收集该社区1998年6月～2004年9月常住人口中的确诊恶性肿瘤病人22例，将该社区恶性肿瘤平均年发病率与南山区在该时段恶性肿瘤平均的发病率进行比较。结果：1998年6月～2004年9月南山区常住人口恶性肿瘤平均年发病66．1／10万，某社区常住人口恶性肿瘤平均年发病率29．9／10万，两地差异有统计学意义（F=0．0001，P〈0．05）；南山区常住人口白血病平均年发病率2．79／10万，某社区常住人口白血病平均年发病率4．07／10万，两者无统计学意义差异（F=0．467，P〉0．05）。结论：该社区常住人口恶性肿瘤及白血病平均年发病水平低于南山区全区水平。