常用医学统计方法及其应用第四讲t检验

常用医学统计方法及其应用第四讲ｔ检验中山医科大学卫生统计学教研室游志颖，骆福添上一讲介绍了适用于大样本资料的ｕ检验，本讲介绍适用于小样本的ｔ检验。ｔ检验用于比较两个均数，因可用于不同设计类型资料而有样本均数与总体均数比较的ｔ检验、配对设计资料的ｔ检验...     

含有区间删失数据时的生存函数估计及其SAS实现

目的 介绍生存分析中区间删失数据的特点及含区间删失数据生存函数估计的非参数方法,并介绍其在SAS9.2中的程序实现.方法 采用非参数极大似然估计法对Beadle等研究2种疗法对早期乳腺癌患者形体美容效果研究的区间删失数据进行生存函数估计,并利用SAS中的宏程序%EMICM实现其计算.结果 非参数极大似然估计法有效的计算出了2组疗法患者每个个体的生存概率、死亡概率、累积生存概率以及生存率的标准误,绘制出了2组疗法患者的生存曲线.结论 区间删失数据是临床实践中较常见的一类数据,区间删失数据生存函数估计的非参数方法 是常用的一种方法,但其计算相对右删失数据过程复杂,缺乏相应的软件实现,本文提供的SAS宏程序可以有效的实现计算,为实际工作提供帮助.     

卵巢癌细胞减瘤术后腹腔热灌注化疗临床疗效及安全性的荟萃分析

目的 评估卵巢癌细胞减瘤术后腹腔热灌注化疗的临床疗效和安全性.方法 按制定的标准选取公开发表的文献,分别记录手术的种类和方法、腹腔热灌注化疗的方式、并发症、病死率、住院时间和生存时间等,并对化疗药物剂量、热灌注的方法、化疗持续时间等进行描述.结果 本荟萃分析最终有14篇符合标准的文献入选,7项研究表明进行了肿瘤根治术后腹腔热灌注化疗的患者预后较好.原发性卵巢癌和复发性卵巢癌患者治疗后的中位生存期为22个月到54个月;中位无病生存期为10个月到26个月.卵巢癌细胞减瘤术后腹腔热灌注化疗的严重并发症发生率为5％ ～ 36％;中位病死率3％(0％～10％),并发症发生率和病死率均较低.结论 卵巢癌患者细胞减瘤术后腹腔热灌注化疗是可以选择的一种良好的治疗方式,临床应用安全可行.     

公立及私立学校初中生艾滋病知识认知状况调查

目前深圳学校主要分为公立学校和私立学校两类,本次调查拟了解公立学校与平民私立学校的学生对于艾滋病的认知及影响他们认知差异的主要原因,为采取相应干预措施提供科学依据,以预防艾滋病的发生.     

我国大中城市院前心脏性猝死流行病学调查分析

目的调查我国大中城市院前心脏性猝死患者流行病学情况,探讨院前心脏性猝死病例特点。方法从我国8个大中城市急救中心系统数据库中导出2008年度全部死亡数据,就其有完整记录的资料进行统计分析。结果①院前心脏性猝死的调度时间、到达时间、现场时间、返回时间、总时间、急救半径分别为（2．12±1．02）min、（14．10±7．05）min、（24．79±12．08）min、（13．79±6．61）min、（54．80±25．36）min、7．90±3．92（km）;②院前心脏性猝死的病例数以第一季度为最多,且最多时间段是8：00～10：00,最少时间段是2：00～4：00;③男性院前心脏性猝死明显多于女性,但年龄明显小于女性;④院前心脏性猝死目击者CPR为4．48％,医护人员现场CPR成功率2．26％。结论①心脏性猝死已成为我国大中城市最常见的院前死亡原因;②加强心血管病防治,提高中老年患者的常见急危重症早期识别与院前急救水平以及普及公众CPR对降低死亡有重要意义。     

我国八个大中城市院前急救流行病学调查分析

Objective To investigate the epidemiological information of patients in pre-hospital medical care for our large and medium-sized cities and probe the patients' characteristic. Method The data in 2008 were exported from the computer databases of 8 large and medium-sized cities' emergency medical centers in our country.The thorough records of data were conducted to statistical analysis. Results ( 1 ) The scheduling time, running time, rescue time, returning time, total time and service radius in the pre-hospital medical care group were 2.16± 1.10(min), 14.01 ±6.82(min), 12.12±5.96(min), 14.08± 6.85(min), 42.34± 20.21(min)and 8.50±4.18(km), and the above parameter in the non-death group were 2.19 ± 1.13(min), 14.15 ± 7.14(min),11.60±6.72(min), 14.92 ±6.89(min), 41.86± 19.53(minutes) and 8.63±4.31(Km), and the above parameter in the death group were 2.10± 1.08(min), 13.68 ± 7.14(min), 25.25 ± 12.34(min), 13.75±6.48(min), 54.74 ± 25.47(min) and 7.86± 3.91(Km), and the above parameter in the non-sudden cardiac death group were2.09± 1.03(min), 13.58±6.78(min), 25.53± 12.34(min), 13.60± 6.54(min), 53.79±23.77(min) and 7.67 ± 3.86(Km), and the above parameter in the sudden cardiac death group were 2.12 ±1.02(min), 14.10±7.05(min), 24.79± 12.08(min), 13.79±6.61(min), 54. 80 ± 25. 36( min) and 7.90±3.92(Km) respectively. The scheduling time, running time, returning time and service radius in the death group were less than those of the non-death group, but the rescue time and total time of the former were more than those of the latter respectively ( P ＜ 0.05 or P ＜ 0. 001 ). The scheduling time and returning time didn' t have significant difference between the sudden cardiac death group and the non-sudden cardiac death group respectively ( P ＞ 0.05), but the running time, total time and service radius of the sudden cardiac death group were more than those of the non-sudden cardiac death group, and the rescue time of the former was less than that of the latter respectively ( P ＜ 0.05 or P ＜ 0.001 ). (2)The patients' amount in pre-hospital medical care group, the non-death group, the death group, the non-sudden cardiac death group and the sudden cardiac death group were at most in first quarter, and the least time slice of patients' amount were 4:00～ 6:00, 4:00～6:00, 4:00～ 6:00, 22:00～ 24:00, 2:00～4:00 respectively, and the most time slice of patients' amount were 20:00～ 22:00, 20:00～22:00, 8:00～ 10:00, 2:00 ～ 4:00, 8:00 ～ 10:00 respectively. (3)In 241 876 cases of pre-hospital medical care group, the patients' amount of trauma was at most, whose age grades was by far among21 ～50, and the others in sequence were nervous system, circulatory system, other group, digestive system, respiratory system and poisoning group respectively, whose age grades in nervous system, circulatory system and respiratory system was by far above 51, especially above 70. The patients' age grades in other group and digestive system had two climax age groups, which the one was 21 ～ 30, and the other was above 70. The patients' age grades in poisoning group was by far among 21 ～ 50, which the patients' amount of acute alcoholism was at the most. (4) In 12 568 cases of death group, the death amount of circulatory system, other group, respiratory system, nervous system and digestive system ranked at the lst,2nd,4th,5th 8th respectively, whose age grades was by far above 51, especially above 70,and the patients' amount of sudden cardiac death was at the most in the death amount of circulatory system. The death amount of trauma and poisoning group ranked at the 3rd, 6th respectively, whose age grades was by far among 21 ～ 50. (5)The total amount, the death amount and the sudden cardiac death amount of male patients were more than those of female patients. (6)The percentage of the death group to the pre-hospital medical care group was 5.20%, and the percentage of the sudden cardiac death group to the pre-hospital medical care group was 1.29%,and the percentage of the sudden cardiac death group to the death group was 24.87 %, and the percentage of the sudden cardiac death group to the circulatory system group was 67.33 %. Conclusions ( 1 )The trauma and the sudden cardiac death are the overriding reason of disease and the overriding reason of death in our large and medium-sized cities respectively. (2) It is very important to cut the death rate of the middle-old age patients by strengthening prevention and cure of cardiovascular and cerebrovascular diseases, discerning the critical illness early and improving the level of pre-hospital medical care. (3)It is a strong method to decrease the total amount and the death amount of the trauma, especially in traffic accident, by strengthening safety in production, observing traffic regulation and enhancing the legal awareness.     

COX模型分析Ⅲ—危险度与生存率

一、危险度1.因素的相对危险度:设第 k 个因子变量值 Z_(jk)为0—1数据,且其参数β_k 有显著性,那么该因子的相对危险度为     

腹膜假性黏液瘤减瘤术后腹腔热灌注化疗疗效与安全性的文献复习

目的评估腹腔热灌注化疗（HIPC）对于预防与治疗腹膜假性黏液瘤（PMP）减瘤术后复发的疗效和安全性。方法在PubMed等数据库中检索2010年以前发表的相关文献．根据评估方案综合研究结果。结果通过文献的纳入、排除标准和质量评估。最终有11篇文献入选。入选文献中的患者中位随访时间22。60个月;中位生存期25．6～156．0个月;1、2、3、5和10年的生存率分别为72％～100％、55％～96％、59％～96％、52％～96％和55％～96％。减瘤术后HIPC化疗药物不良反应发生率为2％～15％,围手术期死亡率为0～7％。结论PMP患者减瘤术后予以HIPC治疗安全、有效．     

COX讲座模型分析Ⅰ—结构与原理

医学上常遇到“时间—反应”类型的资料,如生命现象的生存期,疾病的潜伏期,疗效转归的缓解期(复发时间)、恢复期(治愈     

小地域分析的研究进展

传统流行病学研究疾病的的空间分布．探讨疾病的危险因素，总是基于较大的范围收集数据和整理资料，并进行分析处理后得出结论。这些结论因为要求观测单位（地域或人口）相对过大，淹没了疾病分布中局部的、特征性的规律，所以不可能是疾病在地理上的真实反映，也就不适合于检测与空间定位有关的环境危险因素，尤其是对于罕见病如肿瘤的发病和死亡的研究就更显出其不足。但如果我们直接用小地域资料进行参数估计，也会因为样本含量小，