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1.
目的 探索内镜介入治疗疼痛性慢性胰腺炎(CP)无效的风险因素。方法分析随访1997年至2006年仅经内镜治疗且存活的疼痛性慢性胰腺炎资料,根据患者临床特征及相关研究资料选择与治疗无效可能相关的风险因素,利用Cox比例风险模型进行逐步回归分析。结果患者中男114例、女58例,平均39.4岁,148例(86.0%)内镜治疗有效。多因素Cox比例风险模型逐步回归显示,首发年龄(〉36岁)、治疗前轻中度腹痛、内镜治疗后酒精摄入量无明显减少和饮食不节为内镜治疗无效的预后因素,风险比分别为3.5、2.4、1.9和2.8。结论疼痛性慢性胰腺炎内镜介入治疗后应戒酒和低脂规律饮食,首发年龄大、腹痛程度相对较轻的患者尤其应当注意。  相似文献   
2.
目的 系统评价可吸入颗粒物(PM10)对心血管系统急性有害效应的影响.方法 检索PubMed、CBM、CNKI 等数据库,同时手工检索相关杂志和参考文献,选择符合标准的文献,进行meta分析. 结果截至2008年8月,共纳入21 篇文献,其中11 篇文献是时间序列研究,10 篇文献是病例交叉研究.meta 分析提示可吸入颗粒物(PM10)与心血管疾病发作有关(OR=1.008,95%CI=1.006~1.011,P=0.000),同时会增加心血管疾病的死亡风险(OR=1.006,95%CI=1.004~1.009,P=0.000).结论 PM10 短期暴露与人群心血管疾病发作、死亡风险存在关联.  相似文献   
3.
Objective To investigate the incidence of diabetes mellitus and risk factors for the disease in chronic pancreatitis (CP) patients.Methods A historical cohort study on subjects with painful CP who were admitted to hospital from Jan.1997 to July 2007 were conducted.A life-table method was used to estimate the cumulative probability of the development of diabetes mellitus once clinical onset of abdominal pain.Cox proportional-hazards model was used for multivariate analysis of the variables including age,sex,drinking and smoking habits,etiological factor,presence of pancreatic masses,pancreatic calcifications,measure of intervention,diarrhea,weight loss and degree of pain.Results Data were obtained from 354 patients (239 males,mean age at onset of pain (38.1±17.6) years;alcoholic origin 18.1%) with painful CP.The mean follow-up period was (45.2±32.9)months.The rate of diabetes mellitus in CP patients was 16.1%.There was a high incidence (29.8%)of diabetes mellitus 1 year before the episodes of abdominal pain.The cumulative risk of diabetes mellitus in subjects 5 and 10 years after the episodes of pain was 9.3% and 20.7%,respectively.Cox proportional-hazards model selected smoking (>10 pack years) (hazard rate (HR)= 3.3),mild abdominal pain (HR=5.2),weight loss (HR = 2.6) and pancreatic calcifications (HR = 2.2) as variables identifying subjects with diabetes mellitus in patients with painful CP before they were performed therapeutic endoscopy or surgical intervention.Smoking (>10 pack years) (HR = 3.0),weight loss (HR= 2.8) and distal pancreatectomy (HR =7.3) were identified with an increased risk of diabetes mellitus in these cases after they received therapeutic endoscopy or surgical intervention.Conclusion The risk factors of diabetes mellitus for CP appears to be independent of smoking (>10 pack years),mild abdominal pain,weight loss,pancreatic calcifications and distal pancreatectomy.  相似文献   
4.
目的探讨Bayesian两变量层次模型的构建及其在诊断试验系统评价中的应用。方法将Bayesian两变量层次模型应用于传统Pap细胞学涂片诊断子宫颈癌准确性评价的历史Meta分析资料,估计相关的效应指标敏感度和特异度及筛查研究比随访研究的相对可信度。结果与经典综合受试者工作特征曲线方法相比,Bayesian两变量层次模型估计得到三个层次的效应指标,其中综合敏感度和特异度均数及95%可信区间分别为0.64(0.56,0.72)和0.74(0.67,0.80),预测敏感度和特异度均数及95%可信区间分别为0.61(0.12,0.96)和0.69(0.21,0.97),筛查研究比随访研究的相对可信度估计为1.3(0.59,2.48)。结论采用Bayesian两变量层次模型进行诊断试验Meta分析,更加灵活、有效,易于实现和解释,值得推广应用。  相似文献   
5.
Objective To investigate the incidence of diabetes mellitus and risk factors for the disease in chronic pancreatitis (CP) patients.Methods A historical cohort study on subjects with painful CP who were admitted to hospital from Jan.1997 to July 2007 were conducted.A life-table method was used to estimate the cumulative probability of the development of diabetes mellitus once clinical onset of abdominal pain.Cox proportional-hazards model was used for multivariate analysis of the variables including age,sex,drinking and smoking habits,etiological factor,presence of pancreatic masses,pancreatic calcifications,measure of intervention,diarrhea,weight loss and degree of pain.Results Data were obtained from 354 patients (239 males,mean age at onset of pain (38.1±17.6) years;alcoholic origin 18.1%) with painful CP.The mean follow-up period was (45.2±32.9)months.The rate of diabetes mellitus in CP patients was 16.1%.There was a high incidence (29.8%)of diabetes mellitus 1 year before the episodes of abdominal pain.The cumulative risk of diabetes mellitus in subjects 5 and 10 years after the episodes of pain was 9.3% and 20.7%,respectively.Cox proportional-hazards model selected smoking (>10 pack years) (hazard rate (HR)= 3.3),mild abdominal pain (HR=5.2),weight loss (HR = 2.6) and pancreatic calcifications (HR = 2.2) as variables identifying subjects with diabetes mellitus in patients with painful CP before they were performed therapeutic endoscopy or surgical intervention.Smoking (>10 pack years) (HR = 3.0),weight loss (HR= 2.8) and distal pancreatectomy (HR =7.3) were identified with an increased risk of diabetes mellitus in these cases after they received therapeutic endoscopy or surgical intervention.Conclusion The risk factors of diabetes mellitus for CP appears to be independent of smoking (>10 pack years),mild abdominal pain,weight loss,pancreatic calcifications and distal pancreatectomy.  相似文献   
6.
Objective To investigate the incidence of diabetes mellitus and risk factors for the disease in chronic pancreatitis (CP) patients.Methods A historical cohort study on subjects with painful CP who were admitted to hospital from Jan.1997 to July 2007 were conducted.A life-table method was used to estimate the cumulative probability of the development of diabetes mellitus once clinical onset of abdominal pain.Cox proportional-hazards model was used for multivariate analysis of the variables including age,sex,drinking and smoking habits,etiological factor,presence of pancreatic masses,pancreatic calcifications,measure of intervention,diarrhea,weight loss and degree of pain.Results Data were obtained from 354 patients (239 males,mean age at onset of pain (38.1±17.6) years;alcoholic origin 18.1%) with painful CP.The mean follow-up period was (45.2±32.9)months.The rate of diabetes mellitus in CP patients was 16.1%.There was a high incidence (29.8%)of diabetes mellitus 1 year before the episodes of abdominal pain.The cumulative risk of diabetes mellitus in subjects 5 and 10 years after the episodes of pain was 9.3% and 20.7%,respectively.Cox proportional-hazards model selected smoking (>10 pack years) (hazard rate (HR)= 3.3),mild abdominal pain (HR=5.2),weight loss (HR = 2.6) and pancreatic calcifications (HR = 2.2) as variables identifying subjects with diabetes mellitus in patients with painful CP before they were performed therapeutic endoscopy or surgical intervention.Smoking (>10 pack years) (HR = 3.0),weight loss (HR= 2.8) and distal pancreatectomy (HR =7.3) were identified with an increased risk of diabetes mellitus in these cases after they received therapeutic endoscopy or surgical intervention.Conclusion The risk factors of diabetes mellitus for CP appears to be independent of smoking (>10 pack years),mild abdominal pain,weight loss,pancreatic calcifications and distal pancreatectomy.  相似文献   
7.
Objective To investigate the incidence of diabetes mellitus and risk factors for the disease in chronic pancreatitis (CP) patients.Methods A historical cohort study on subjects with painful CP who were admitted to hospital from Jan.1997 to July 2007 were conducted.A life-table method was used to estimate the cumulative probability of the development of diabetes mellitus once clinical onset of abdominal pain.Cox proportional-hazards model was used for multivariate analysis of the variables including age,sex,drinking and smoking habits,etiological factor,presence of pancreatic masses,pancreatic calcifications,measure of intervention,diarrhea,weight loss and degree of pain.Results Data were obtained from 354 patients (239 males,mean age at onset of pain (38.1±17.6) years;alcoholic origin 18.1%) with painful CP.The mean follow-up period was (45.2±32.9)months.The rate of diabetes mellitus in CP patients was 16.1%.There was a high incidence (29.8%)of diabetes mellitus 1 year before the episodes of abdominal pain.The cumulative risk of diabetes mellitus in subjects 5 and 10 years after the episodes of pain was 9.3% and 20.7%,respectively.Cox proportional-hazards model selected smoking (>10 pack years) (hazard rate (HR)= 3.3),mild abdominal pain (HR=5.2),weight loss (HR = 2.6) and pancreatic calcifications (HR = 2.2) as variables identifying subjects with diabetes mellitus in patients with painful CP before they were performed therapeutic endoscopy or surgical intervention.Smoking (>10 pack years) (HR = 3.0),weight loss (HR= 2.8) and distal pancreatectomy (HR =7.3) were identified with an increased risk of diabetes mellitus in these cases after they received therapeutic endoscopy or surgical intervention.Conclusion The risk factors of diabetes mellitus for CP appears to be independent of smoking (>10 pack years),mild abdominal pain,weight loss,pancreatic calcifications and distal pancreatectomy.  相似文献   
8.
目的 回顾分析依达拉奉治疗急性脑梗死等国内文献资料中依达拉奉的不良反应.了解依达拉奉不良反应的发生率及其临床应用的安全性.方法 计算机检索Pubmed、中国生物医学文献数据库及所获文献的参考文献,对8645例患者进行不良反应分析,并对依达拉奉治疗急性脑梗死随机对照试验研究应用Meta分析来全面分析依达拉奉的安全性.结果 依达拉奉不良反应最多见的是轻度氨基转移酶升高、肾功能异常及皮疹,不良反应(283例)占总例数(8645例)比例为3.27 % ;共纳入10项依达拉奉治疗急性脑梗死的随机对照试验研究,Meta分析显示:依达拉奉+常规治疗组与常规治疗组的不良事件发生率差异(OR=1.18,95 % CI 0.70-2.00,P=0.536)、氨基转移酶升高发生率差异(OR=1.23,95 % CI 0.57-2.68,P=0.595)以及肾功能异常(蛋白尿、肌酐升高、尿素氮升高)发生率差异(OR=1.65,95 % CI 0.57-4.79,P=0.353)均无统计学意义.结论 依达拉奉的不良反应发生率很低,临床应用较为安全.  相似文献   
9.
全基因组关联研究中的统计分析方法   总被引:1,自引:1,他引:0       下载免费PDF全文
随着人类基因组计划的完成,疾病的全基因组关联研究成为可能.该类研究的数据特点是:高维、小样本.面对浩瀚的数据,传统分析方法 受到严重挑战.文中介绍全基因组关联研究中的数据分析策略和步骤,包括质量控制、分析、结果 表示等,并对全基因组关联研究的局限性和目前统计分析方法 的不足进行讨论.
Abstract:
In lieu of large samples of cases and/or controls with hundreds of markers spreading throughout the human genome, researchers started to notice the dramatic increase of genome-wide association study (GWAS) for complex disorders, in the last 5 years. This paper highlights the statistical challenges in such huge-scale genetic studies, and introduces the analytical strategies and steps for handling GWAS data. Such issues as quality control of data, population stratification, methods available to data analysis and results presentation, replication, as well as the limitations of GWAS studies and the challenges presenting for statistics, are addressed.  相似文献   
10.
于浩  陈晓媛  柏建岭  赵杨  陈峰  夏结来 《肿瘤》2008,28(1):68-73
在肿瘤新药Ⅱ期临床试验中,往往要对多个瘤种、多种剂量或用法进行探讨,目的是淘汰无效剂量、筛选敏感瘤种,以便进一步深入研究。当某试验组疗效未达到预期效果时,研究者希望尽可能早地终止该试验组的研究,避免更多的受试者接受无效的治疗。本文介绍多阶段设计,包括单阶段设计、二阶段设计和三阶段设计的统计学原理和设计思路,并提供各阶段设计所需样本含量和早期终止的价值,并以实例说明。  相似文献   
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