肝炎合剂1号的药效学研究

目的肝炎合剂1号对α-萘异硫氰酸酯（ANIT）所致小鼠急性黄疸模型的退黄降酶作用。方法将小鼠随机分为正常组、模型组、阳性药物对照组（茵栀黄注射液）和提取液大、中、小给药组。各治疗组连续灌胃给药7d后,ANIT诱发黄疸模型,48h后摘眼球取血,分离血清,以血清肝功能指标以及肝脏组织病理学的改变为观察指标。结果与模型组比较,茵栀黄组、合剂小剂量给药组的ALT、AST、ALP、TBIL、IBIL,均显著下降（P〈0105）;与茵栀黄组比较,合剂小剂量给药组ALT、AST、ALP、TBIL、IBIL,均无差异（P〉0.05）肝脏病理组织学检查表明,合剂能明显减轻肝细胞变性、坏死和肝小胆管增生。结论合剂具有降低黄疸小鼠血清胆红素、转氨酶和改善肝脏组织损伤的作用。     

A computer graphical user interface for survival mixture modelling of recurrent infections

Recurrent infections data are commonly encountered in medical research, where the recurrent events are characterised by an acute phase followed by a stable phase after the index episode. Two-component survival mixture models, in both proportional hazards and accelerated failure time settings, are presented as a flexible method of analysing such data. To account for the inherent dependency of the recurrent observations, random effects are incorporated within the conditional hazard function, in the manner of generalised linear mixed models. Assuming a Weibull or log-logistic baseline hazard in both mixture components of the survival mixture model, an EM algorithm is developed for the residual maximum quasi-likelihood estimation of fixed effect and variance component parameters. The methodology is implemented as a graphical user interface coded using Microsoft visual C++. Application to model recurrent urinary tract infections for elderly women is illustrated, where significant individual variations are evident at both acute and stable phases. The survival mixture methodology developed enable practitioners to identify pertinent risk factors affecting the recurrent times and to draw valid conclusions inferred from these correlated and heterogeneous survival data.     

降脂通脉胶囊联合阿托伐他汀钙治疗混合型高脂血症疗效观察

目的：探讨中药降脂通脉胶囊与阿托伐他汀钙联合应用对混合型高脂血症的临床疗效。方法：将2009年10月～2010年10月我院60例混合型高脂血症患者随机分为A、B两组,A组单服阿托伐他汀钙片,B组联合服用降脂通脉胶囊及阿托伐他汀钙片。服药前和服药后30 d检测空腹血清总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）以及相关的谷丙转氨酶（ALT）及肌酸激酶（CK）。结果：A、B两组均能明显降低血清TC、LDL-C,组间比较差异无统计学意义（P〉0.05）,而TG疗效B组明显优于A组（P〈0.001）。结论：降脂通脉胶囊联合阿托伐他汀钙片能更安全、更有效地纠正混合型脂质代谢紊乱。     

桑生除痹合剂对膝骨性关节炎兔组织形态学和血液流变学的影响

目的：观察桑生除痹合剂对膝骨性关节炎家兔组织形态学和血液流变学的影响。方法：选取健康6月龄新西兰大白兔36只,将其随机分为正常组、造模组、对照组、桑生除痹合剂高（治疗Ⅰ组）、中（治疗Ⅱ组）、低（治疗Ⅲ组）剂量组,每组6只。按照Hulth造模方法造模,治疗Ⅰ组、治疗Ⅱ组、治疗Ⅲ组分别灌服高、中、低剂量桑生除痹合剂,对照组灌服壮骨关节丸。12周后,处死动物,取软骨及滑膜标本行光镜观察,并测定血液流变学指标。结果：关节软骨及滑膜标本光镜下呈显著退变表现;对照组和治疗组的用药可显著改善骨性关节炎家兔全血黏度、全血还原黏度、血浆黏度及红细胞聚集指数（P〈0.05或P〈0.01）。结论：从关节软骨及滑膜的光镜观察可以判断,兔膝骨性关节炎模型建立成功;桑生除痹合剂能明显改善血液流变学状态,改善局部血液循环,延缓软骨退化。     

胃宁合剂抗炎镇痛的药效学及急性毒性实验研究

目的 :探讨胃宁合剂抗炎镇痛的作用机制。方法 :检测胃宁合剂对冰乙酸致痛扭体小鼠的影响 ;对热板致痛小鼠的影响 ;对小鼠毛细血管通透性增高的影响 ;测小鼠一日最大耐受量。结果 :胃宁合剂对冰乙酸致痛扭体小鼠及热板致痛小鼠均有镇痛作用 ;能抑制小鼠腹腔注射冰乙酸所致的毛细血管通透性增高 ,有抗急性炎症作用 ;一日最大耐受量相当于临床用量的 12 0倍 ,提示临床用量在安全范围。结论 :胃宁合剂有抗炎、镇痛作用 ,与该方临床功效相符 ;临床用量在安全范围     

10-year risk for atherosclerotic cardiovascular disease and coronary heart disease among Korean adults: Findings from the Korean National Health and Nutrition Examination Survey 2009–2010

Background

This study examined the distribution of the 10-year risk for development of atherosclerotic cardiovascular disease (ASCVD) and coronary heart disease (CHD), and the proportion of participants eligible for lipid management, in the Korean population.

Methods

The risk was estimated using the Pooled Cohort Equations for non-Hispanic Whites and the Adult Treatment Panel (ATP) III equations. Eligibility for lipid-lowering treatment was assessed using the American College of Cardiology/American Heart Association Blood Cholesterol Guideline and the ATP III recommendation. Complex sampling design and area under the receiver operator characteristic curve (AUC) were used.

Results

Among 7594 ASCVD-free Korean adults, aged 40–79 years, 31.3% (men, 44.1%; women, 19%) had a 10-year risk for an ASCVD event of ≥ 7.5%, and 27.1% (men, 39.4%; women, 15.2%) had a 10-year risk for a CHD event of ≥ 10%. These proportions differed according to age groups, ranging from 6.1 to 91.9% and 8.7 to 58.7% for patients in their 40s–70s, using the ASCVD and CHD risk estimations, respectively. Overall, 78.7% of individuals remain in the same risk stratum. Those eligible for lipid management included 32.8% of the participants using the ACC/AHA Guideline and 11.9% of those using the ATP III recommendation. In discriminating ASCVD, AUCs for the ASCVD risk assessment method and the CHD risk assessment method were 0.70 and 0.64, respectively (P < 0.001).

Conclusions

The distribution of 10-year ASCVD and CHD risk was different according to the risk assessment methods.     

不同剂量阿托伐他汀在症状性颅内动脉粥样硬化性狭窄中的影像学评估

目的 观察不同剂量阿托伐他汀在症状性颅内动脉粥样硬化性狭窄（intracranial arterial stenosis,ICAS）中的疗效。方法 选择120例症状性ICAS患者,采用随机表法,分为低剂量组（10 mg/d）、标准剂量组（20 mg/d）和强化组（40 mg/d）,每组患者各40例。临床随访52周,观察治疗前后脑血流灌注值及血管狭窄程度的变化,评价强化降脂疗效。结果 三组在治疗后26周和52周,相对脑血流量（rCBF）、相对脑血容量（rCBV）较治疗前均明显升高;低剂量组和标准剂量组相对达峰时间（rTTP）与治疗前比较,均有不同程度的延长,但差异无统计学意义,强化组rTTP与治疗前比较明显缩短,差异有统计学意义;强化组平均狭窄率与治疗前相比明显降低,与治疗后低剂量组和标准剂量组相比差异也有统计学意义。结论 长期他汀强化降脂治疗（40 mg/d）可以降低颅内动脉狭窄程度及提高脑血管的血流灌注。     

自拟降脂方治疗高血脂症96例

高血脂症是以血浆脂质浓度增高为主要表现的一类病症。分为原发性和继发性两大类,本文治疗的均为原发性,是临床常见病、多发病之一。     

Predicting Binary Outcomes Using Trajectory Classes

In longitudinal data, the interest often lies in the repeatedly measured variable itself. However, in some situations, the changing pattern of the variable over time may contain information about a separate outcome variable. In such a situation, longitudinal data provide the opportunity to develop predictive models of subsequent observations of the separate outcome variable given current data for an individual. In particular, longitudinally changing patterns of repeated measurements of a variable, or trajectories, measured up to time t can be used to predict an outcome measure or event that occurs after time t. We propose a predictive model based on latent classes of trajectories, which is fitted using the expectation-maximization (EM) algorithm, and show how to get model estimates with other covariates in the model. Applications of our methodology are demonstrated through an example of a smoking cessation trial.