医疗保险风险因素的相对风险度分析

目的 :探讨医疗保险风险因素的相对风险度及其分析方法。方法 :借鉴流行病学研究方法 ,用 logistic回归模型产生比值比 (OR)来刻画风险因素与医疗保险赔付 (损失 )之间的定量关系。结果 :实例拟合单因素及多元 logistic回归模型 ,得到各风险因素的 OR值并能合理地解释。结论 :相对风险度分析为医疗保险风险控制提供了新的分析思路和定量依据     

阴道分娩产后出血相关因素分析

目的:探讨阴道分娩产后出血的相关因素,以加强防治。方法:对经阴道分娩的产妇793例,使用容积法、称量 法及面积法估计产后出血量,发生产后出血的有45例,占5.68％。结果:产后出血的主要原因是宫缩乏力,影响产后出血的因素 较多,包括使用产钳助产、新生儿体重偏大、使用人工剥离方式娩出胎盘等。结论:产后出血是受多种因素影响的,因此必须采 取相应的措施预防产后出血。     

使用反距离权重内插法绘制中国1990年代肿瘤分布地图

目的 绘制中国1990年代死因回顾1／10人口抽样调查肿瘤分布地图，展示中国1990年代肿瘤的地理分布和区域性集中趋势。方法 利用1990年代的全国死因抽样调查数据，根据中国1964年人口年龄分布计算标准化死亡率，以中国1990年代数字地图为背景，在Arcview软件支持下，利用反距离权重内插法（IDW）预测非采样地区的死亡率数值，绘制肿瘤死亡分布地图。结果 现已完成全国1990年代肿瘤分布地图绘制，与填充法相比，IDW所绘地图死亡率分布边续且过渡平滑，显示出肿瘤地区分布特点。结论 利用IDW根据抽样区域数据预测其他区域数据，可以实现用抽样数据绘制全国肿瘤分布地图，结果仍可以较为准确地反映出肿瘤分布规律。     

五莲县部分35岁以上人群代谢综合征及其相关疾病患病调查

[目的]了解五莲县居民糖尿病、高血压、血脂紊乱和代谢综合征（MS）的流行状况及其伴发胰岛素抵抗（IR）的情况,为进一步制定防治措施提供依据.[方法]2002年,在五莲县的叩官、许孟和县直社区,对1 410名（男性654人、女性756人）35～64岁居民进行问卷调查、体格检查及生化检验.[结果]MS患病率为9.15%,超重、肥胖、糖尿病、高血压、血脂异常和IR的罹患率分别为40.85%、6.67%、3.69@.85%、34.11%和25.18%;糖尿病、高血压、血脂异常和MS患病率随着年龄增加而增高;各年龄组均有胰岛素抵抗患者.[结论]五莲县部分社区35～64岁人群MS及相关疾病的罹患率较高.     

两种氟康唑胶囊的人体生物等效性研究

目的研究两种氟康唑胶囊的人体相对生物利用度和生物等效性。方法健康志愿者20例，随机交叉单剂量口服试验制剂氟康唑胶囊和参比制剂氟康唑胶囊，剂量均为300 mg，剂间间隔2周。分别于服药后120 h内多点抽取静脉血;用高效液相色谱法测定血浆中氟康唑的浓度。计算相对生物利用度并评价两种制剂的生物等效性。结果单剂量口服试验和参比制剂后血浆中氟康唑的Cmax分别为(6.271±0.874)和(6.374±0.806) mg·L^-1;tmax分别为(1.825±0.591)和(1.875±0.998) h;AUC(0-120)分别为(239.408±47.330)和(243.061±29.497) mg·h·L^-1;AUC(0-inf)分别为(255.835±51.738)和(261.675±35.995) mg·h·L^-1。Cmax、AUC(0-120)和AUC(0-inf)的90%可信区间分别为92.8%～104.0%，90.3%～104.9%和89.5%～104.3%。试验制剂与参比制剂的人体相对生物利用度为(99.0±18.7)%。结论试验制剂与参比制剂具有生物等效性。     

基才网络环境的远程数字人体中医脉诊智能诊断系统

本文主要阐述了中医学脉诊原理,分析了脉诊数字化的可行性,描述了数字脉诊诊断系统的设计方案及进行家庭远程诊断的设想,并对该系统的应用前景作了展望。     

生化止血饮对药流后出血动物模型粘附蛋白的影响

目的：探讨生化止血饮改善药物流产后阴道出血的作用机制。方法：建立正常组，药物流产模型组，流产后缩宫素组，益母草组，生化止血饮高剂量组，生化止血饮低剂量组，采用免疫组化法检测大鼠子宫内膜（包括蜕膜）中纤维粘连蛋白（FN），层粘连蛋白（LN），孕激素受体（PR）的变化。结果：生化止血饮可显著降低PR，LN，FN的表达水平（P〈0．05），而益母草组和缩宫素组与药流模型组没有显著性差异（P〉0．05），生化止血饮的疗效优于益母草组及缩宫素组。结论：生化止血饮能通过降低子宫内膜中PR，FN，LN的水平促进蜕膜剥脱，缩短药流后阴道出血的时间，达到减少阴道出血量的目的。     

HOW TO ASSESS THE RELATIVE RANGE OF TWO CONSECUTIVE LABORATORY MEASUREMENTS TO MONITOR PATIENTS

An integral part of routine health checkups involves laboratory measurements on various analytes in the blood. It is then common to compare the value of two consecutive measurements sampled at different times from the same patient. A “significant” change requires an action (additional sample and/or clinical action). The current rule is to check whether the relative range of measurement is larger than a certain critical threshold. This rule should guarantee a specified confidence level (e.g., 95%), but its derivation was based on an approximation. We derive the exact distribution and show that it is related to the doubly noncentral F distribution. The currently used threshold values are compared with the exact ones, and some limited power calculations are presented to detect changes in the patient condition.     

An unusual origin of the celiac trunk and the superior mesenteric artery in the thorax

The authors report a case of a 44‐year‐old male found to have unusual origins of the celiac trunk (CT) and superior mesernteric artrery (SMA) as revealed by routine multidetector computed tomograph (MDCT) angiography. The CT and SMA originate from the thoracic aorta (TA) 21 mm and 9 mm above the aortic hiatus, respectively. The median arcuate ligament (MAL) is located at the level of the L1–L2 intervertebral disc. The course of the CT descends in the thoracic cavity making a 14° acute downward angle in front of the TA; below the level of the MAL, the CT descends, making an angle of 47°. The course of the SMA descends at both the thoracic and abdominal level making an angle of 17°, and having an aortomesenteric distance of 9 mm at the level of the third part of the duodenum. In the present case, the supradiaphragmatic origin of the CT and the SMA was determined by their incomplete caudal descent, associated with a pronounced apparent descent of the diaphragm. A thoracic origin of the CT and SMA and the acute downward aortomesenteric angle (17°) associated with a reduced aortomesenteric distance at the level of the third part of the duodenum (9 mm), although no clinical signs are present, may predispose the patient to develop simultaneously a triple syndrome: the compression of CT by MAL (celiac axis compression syndrome), the compression of SMA by MAL (superior mesenteric artery compression syndrome), and the compression of the duodenum by the SMA (superior mesenteric artery syndrome). Clin. Anat. 26:975–979, 2013. © 2013 Wiley Periodicals, Inc.     

Quantification of coronary arterial stenoses in CTA using fuzzy distance transform

Quantification of coronary arterial stenoses is useful for the diagnosis of several coronary heart diseases. Being noninvasive, economical and informative, computed tomographic angiography (CTA) has become a common modality for monitoring disease status and treatment effects. Here, we present a new method for detecting and quantifying coronary arterial stenosis in CTA using fuzzy distance transform (FDT) approach and a new coherence analysis of observed data for computing expected local diameter. FDT allows computing local depth at each image point in the presence of partial voluming and thus, eliminates the need for binarization, commonly, associated with inclusion of additional errors. In the current method, coronary arterial stenoses are detected and their severities are quantified by analyzing FDT values along the medial axis of an arterial tree obtained by its skeletonization. A new skeletal pruning algorithm has been developed toward improving the quality of medial axes and thereby, enhancing the accuracy of stenosis detection and quantification. Further, we have developed a new method to estimate “expected diameter” along a given arterial branch using a new coherence analysis of observed diameter values along the branch. The overall method is completed in the following steps - (1) fuzzy segmentation of coronary artery in CTA, (2) FDT computation of coronary arteries, (3) medial axis computation, (4) estimation of observed and expected diameters along arteries and (5) detection of stenoses and quantification of arterial blockage. The performance of this method has been quantitatively evaluated on a realistic coronary artery phantom dataset with randomly simulated stenoses and the results have been compared with a binary distance transform based and a conventional binary algorithm. The method has also been applied on a clinical CTA dataset from thirteen heart patients and the results have been compared with an expert's quantitative assessment of stenoses. Results of the phantom experiment indicate that the new method (error: 0.53%) is significantly more accurate as compared to both binary distance transform based (error 2.11%) and conventional binary (error 3.71%) methods. Also, the results of the clinical study indicate that the new FDT-based method (kappa coefficient = 87.9%) is highly in agreement with the expert's assessments and, in this respect, outperforms the other two methods (kappa coefficients = 75.2% and 69.5%).