中老年牙周炎患者口腔菌丛的非条件Logistic回归分析

本研究对４０－７９岁的牙周炎患者１４３例及２０例同龄健康人，取龈下百 着菌斑进行厌氧菌及需搓力分离培养，共检出２２个菌属１５６２个菌株，用ＰＥＭＳ统计软件包装１６３个宿主的２２个菌属加性别２，年龄共２４个变量进行成组的Ｌｏｇｉｓｔｉｃ回归模型春其结果显示：年龄是最危险的因素。依次是产黑色素类杆菌、葡萄球菌、梭杆菌、其他类杆菌同消化链球菌，而且常常彼此共生。     

放射治疗外照射百分深度剂量的数学拟合

目的百分深度剂量是放射治疗外照射剂量计算的主要参量，临床放射治疗时此参量通常通过查表内插求得，本研究拟利用数学拟合的方法求得放射治疗外照射百分深度剂量的表达公式。方法分别对射线能量为Ｃｏ６０γ至１８ＭＶＸ射线百分深度剂量数据利用数学统计软件包进行多元拟合，拟合结果与实验实际测量值对比。结果所得到的百分深度剂量表达式在射野４ｘ４到４０ｘ４０ｃｍ２，ｄｍａｘ到３０ｃｍ深度范围内与实测数据的均方差小于１％。结论提供的％ＤＤ拟合公式适于剂量建成区以外即ｄｍａｘ至３０ｃｍ组织深度处。     

高危人群慢性支气管炎与肺癌关系的研究

本文应用前瞻性队列研究方法，探讨了慢支史与肺癌发生的联系。结果显示：慢支史与肺癌的发生有联系，相对危险度２．０左右；慢支史暴露的病因分值约５０％，说明慢支致肺癌的病因作用不容忽视；分析没有发现慢支史与粉尘、砷、氡子体暴露及吸烟间有相乘的交互作用关系。     

US health services employment: A time series analysis

The growth of health services employment in the United States is modelled using ARIMA analysis, and related to the growth in total U.S. employment. It is argued that specific features of the medical care sector (licensed professional manpower, non-profit firms, third-party financing) create institutional rigidities which delay adjustment to macroeconomic conditions and other shocks. Tests of Granger causality and the pattern of coefficients in the cross-correlation function show that health services employment does lag other sectors of the economy by an average of 2 to 4 years. A Box-Jenkins transfer-noise function model between total and health employment is constructed and evaluated, and the impact dynamics of adjustment to Medicare and Medicaid are estimated.     

Clinical and histologic follow-up after antireflux surgery for Barrett’s esophagus

There are few prospective studies that document the histologic follow-up after antireflux surgery in patients with Barrett’s esophagus, as defined by the recently standardized criteria. We report the clinical, endoscopic, and histologic results of patients with Barrett’s esophagus followed postoperatively for at least 2 years. Diagnosis of Barrett’s esophagus required preoperative endoscopic evidence of columnarlined epithelium in the esophagus and a biopsy demonstrating specialized intestinal metaplasia, which stains positively with Alcian blue stain. Between April 1993 and November 1998, a total of 104 patients meeting these criteria underwent fundoplication (laparoscopic [n = 84] or open [n = 6] nissen, laparoscopic Toupet [n = 11], laparoscopic Collis-Nissen [n = 1], Collins-Toupet [n = 1] or open Dor [n = 1]). Short-segment Barrett’s esophagus (length of intestinal metaplasia <3 cm) was found preoperatively in 34% and low-grade dysplasia in 4% of patients. All patients were contacted yearly by mail, phone, or clinic visit. At a mean follow-up of 4.6 years (range 2 to 7.5 years), 81% of patients had stopped taking antisecretory medications and 97% were satisfied with the results of their operations. Eight patients have undergone reoperation for recurrence of symptoms. Two patients have died and two were excluded from endoscopic biopsy because of portal hypertension. Sixty-six patients complied with the surveillance protocol, and their histologic results were returned to our center. Symptomatic follow-up of the 34 patients who refused surveillance esophagogastro and duodenoscopy revealed two patients who were taking medication for reflux symptoms. None of the patients have developed high-grade dysplasia or esophageal carcinoma during surveillance endoscopy (337 total patient-years of follow-up). The incidence of regression of intestinal metaplasia to cardiac-fundic-type metaplasia after successful antireflux surgery is greater than previously reported. We suspect that this is a result of longer follow-up and the inclusion of patients with short-segment Barrett’s esophagus. A substantial number of patients with Barrett’s esophagus who are asymptomatic after antireflux surgery refuse surveillance endoscopy. Presented at the Forty-Second Annual Meeting of The Society for Surgery of the Alimentary Tract, Atlanta, Georgia, May 20–23, 2001 (oral presentation).     

影响新生儿出生状况的多因素Logistic回归分析

目的：研究多因素对新生儿出生状况的影响。方法：采用回顾性队列研究方法对1405例产妇进行调查。在单因素X^2分析基础上进行非条件Logistic回归分析。结果：对新生儿出生状况产生显影响的因素共8项，总判对力为88．7％，其中孕时年龄越大，巨大儿，新生儿窒息发生机会越多。孕期体重增长过速，巨大儿发生机会增大，相反则低出生体重儿（LBW）、新生儿死亡机会增多，巨大儿母亲孕早期体重指数（BMI）显高于其他组群。低体重儿有早产倾向。巨大儿的剖宫产率显高于正常足月儿，职业为另一重要影响因素。按OR值大小，可将对新生儿出生状况产生影响的各因素按程度从强至弱依次排列为：孕早期BMI、孕期体重增长，孕时年龄，分娩方式，妊娠结局，职业特点，孕周及胎盘重量。结论：（1）孕时年龄偏大，孕早期BMI偏低而孕期体重过缓，或孕早期BMI偏高而孕期体重增长过速及职业特点，孕周，胎盘重量是影响新和儿出生状况的危险因素。（2）不同新生儿状况决定分娩方式与妊娠结局。     

大肠癌雌孕激素受体的测定及其预后价值

目的 :探讨大肠癌的激素依赖性及大肠癌雌、孕激素受体的预后价值。方法 :用单克隆抗体免疫组化法结合微波处理抗原恢复方法检测福尔马林固定、石蜡包埋大肠癌组织切片中的雌、孕激素受体 ,结合临床及随访资料进行回顾性分析。结果 :(1)雌激素受体 (ER)和孕激素受体 (PR)的阳性率分别为 5 9.3%和 6 5 .5 %。ER与PR的表达呈正相关关系 (Rs=0 .5 40 3,P =0 .0 0 0 1)。 (2 )Cox回归多因素生存分析结果表明 :性别、病灶部位、Dukes’分期、ER表达状况等对大肠癌病人术后生存期的影响具有统计学意义。结论 :大肠癌细胞对雌激素调节具有反应性 ;ER的表达对大肠癌病人术后生存期具有独立的影响     

Using Data Mining to Address Heterogeneity in the Southampton Data

When analyzing complex traits such as asthma, heterogeneity needs to be assumed. With this in mind, to identify a more homogeneous group of asthmatic patients, we analyzed the Southampton data using the data mining technique known as the regression tree method and the two most inheritable quantitative phenotypes (LnIgE and RAST) as the target variables. Two‐point and multipoint nonparametric linkage analyses were carried out using one of the subgroups as affected. In addition, we performed quantitative trait loci nonparametric linkage analysis using each phenotype as the outcome. The results from the affected‐sib‐pairs method and quantitative linkage analysis were compared. © 2001 Wiley‐Liss, Inc.     

Effects on locomotor activity after local application of (+)-UH232 in discrete areas of the rat brain

Summary The preferential dopamine autoreceptor, and slightly D3 preferring, antagonist (+)-UH232 (cis-(+)-(1S,2R)-5-methoxy-1-methyl-2-(n-dipropylamino) tetralin) increases locomotor activity and synaptic dopamine release in the nucleus accumbens and striatum after systemic administration to the rat. As shown in this study, (+)-UH232, was unable to produce anincrease in locomotor activity measured for 60 minutes after local administration into the terminal or somato-dendritic regions of the mesolimbic dopamine pathways or into the lateral ventricle. Instead, a dose dependent decrease of spontaneous locomotor activity after local application (0.05–50.0 nmol/ side) of (+)-UH232 into the nucleus accumbens, was seen. A similar reduction in locomotor activity was produced by the classical dopamine antagonist raclopride. Analysis of the dose*time interactions on locomotor activity did, however, indicate that there is a significant dose*time interaction after local application of (+)-UH232 into the lateral ventricle and VTA. Raclopride, on the other hand, produced only a weak time dependent effect in the VTA. The potential problem of Leao's spreading depression in micro-injection experiments were considered, however, spreading depression does not seem to influence the effects of (+)-UH232 locally applied into the nucleus accumbens. In conclusion, both (+)-UH232 and raclopride produced a dose dependent decrease in spontaneous locomotor activity when examined as the total activity count over 60 minutes after local application into the N Acc.     

Predictors of Outcome of Epilepsy Surgery: Multivariate Analysis with Validation

Summary: Purpose: To identify predictors of outcome of epilepsy surgery, using the Duke experience, applying multivariate analysis and validation techniques. To compare the results of different modeling algorithms. Few previous studies have reported multivariate analysis, or validated their results. Methods: Records of 116 patients with focal resections for intractable epilepsy from January 1, 1980 through June 30, 1989 were analyzed. Primary outcome variable was patient's condition in second postoperative year: seizure free (except auras), or not. Three predictors of biologic interest were specified a priori for confirmatory analysis. Additional predictors were considered within exploratory analysis. Logistic regression techniques were applied to assess relations with pre-and postoperative predictors. Internal validity was assessed by repeated random selection of training and validation samples, used in conjunction with bootstrap techniques. Results: By using multivariate analysis, percentage of epileptic EEG activity arising from the site of resection and either imaging localization or lack of use of invasive monitoring were the only statistically significant preoperative predictors for good outcome at 2 years. Presence of seizures'within 2. months of surgery was a significant postoperative predictor for a poor outcome. Adding more variables did not result in significantly improved models. Use of validation techniques reduced the degree of optimism in the predictive value of the models. Conclusions: Pooling of data from multiple institutions is needed to attain the large sample sizes needed for multivariate analysis with validation.