独立法加比较法在老年心力衰竭教学中的应用

老年心衰是指发生在老年人群的心力衰竭(heart failure, HF)。如何在成年HF的基础上讲解好老年HF是个值得探讨的课题。我们采用独立加比较的教学方法来讲解老年HF,对于老年HF的流行病学及发病的生理基础,主要采用独立法,呈现老年HF独立性的一面。对于老年HF的病因诱因及临床表现,主要采用比较法,在与成年HF的比较中突出老年HF的特点。同学们在课堂上就能基本掌握老年HF的发病特点,形成对老年HF的独特的整体印象,反映课堂授课效果好,值得在老年教学中推广应用。     

MEIA法与ELISA法检测丙型肝炎病毒抗体结果比较

目的比较MEIA法与ELISA法检NHCV抗体的结果,以及2种方法在实际应用中的区别。方法收集152例ELISA法检NHCV抗体阳性的血清标本,并采用MEIA法检测,对2种检测方法的结果进行比较。结果152例ELISA法检NHCV抗体阳性的血清标本采用MEIA法检测后,144例为阳性,8例为阴性。结论ELISA法操作简单、灵敏度高,但在实际操作中,ELISA检测HCV抗体结果影响因素较多,易出现假阳性问题;MEIA法检测HCV抗体较ELISA法准确、灵敏、快速。     

Comparison of the Rau method and the Larsen method in the evaluation of radiographic progression in early rheumatoid arthritis

OBJECTIVE: To investigate the usefulness of the radiographic scoring method proposed by Rau, et al for evaluation of joint damage in patients with early rheumatoid arthritis (RA). METHODS: Radiographs of hands and feet of 30 prospectively observed patients with early RA were assessed by the Rau method, the Larsen method, and count of erosive joints. The standardized response mean (SRM) was used to estimate the sensitivity to change of each method of assessment. RESULTS: Although the Rau method evaluates only the amount of bony erosion, nearly equivalent radiographic progression was observed with the Rau and the Larsen methods. Radiographic changes in the first year were sensitively identified by all 3 methods (SRM for Rau method 0.83, Larsen method 0.88, and count of erosive joints 0.84). However, in the period from 2 to 6 years after entry into the study, sensitivity to change was maintained with use of the Rau (SRM 1.38) and Larsen (SRM 0.95) methods, but not by count of erosive joints (SRM 0.49). While an apparent ceiling effect was observed after 2 years in count of erosive joints, no ceiling effects were noted for the Rau and Larsen methods. CONCLUSION: Our study showed that the usefulness of the Rau method is equivalent to the Larsen method in clinical assessment of radiographic progression in early RA.     

Laboratory issues in the implementation of the marker method

Two important biomarkers for the identification of growth hormone or IGF-I administration are IGF-I and P-III-P. These substances are determined in plasma or preferably in serum. There are a number of assays on the market for IGF-I but only two for P-III-P. The principles behind these assays and the choice of assays for doping control purposes are discussed. The future possibility of quantification by mass spectrometry is also briefly discussed.     

传统方法和PCR法在结核分枝杆菌复合群菌种鉴定中的对比研究

目的 对结核分枝杆菌复合群菌种鉴定的传统方法与PCR法进行对比研究,为临床应用提供科学依据。 方法 分别采用传统结核分枝杆菌菌种鉴定方法（对硝基苯甲酸和噻吩-2-羧酸肼）和PCR法,对2010年4月至2011年5月新疆喀什胸科医院住院、临床确诊肺结核患者的313份（例）晨痰标本临床分离株进行菌种鉴定。立意抽样法抽出100份结核分枝杆菌、牛分枝杆菌及非洲分枝杆菌Ⅰ型菌株,用Spoligotyping法检测前两种方法结果的可靠性。 结果 传统方法检测出结核分枝杆菌253株,牛分枝杆菌60株;而PCR法检测出结核分枝杆菌306株,牛分枝杆菌1株,非洲分枝杆菌Ⅰ型6株,两者间差异无统计学意义(χ²=5.05, P=0.08),两者检测的一致率为79.87%（250/313）。传统方法和PCR法鉴定结果差异虽无统计学意义,但传统方法检测出牛分枝杆菌60株,而PCR法仅检测出牛分枝杆菌1株,差异有统计学意义(χ²=4.16, P=0.04),故用立意抽检100份菌株,用Spoligotyping检测出牛分枝杆菌2株,结核分枝杆菌90株、非洲分枝杆菌Ⅰ型6株,2株未能检出菌型;其和传统方法与PCR法的一致率分别为38.78%［（2+36）/98］、98.98%［（1+90+6）/98］。 结论 经过Spoligotyping法检测可知,在结核分枝杆菌复合群菌种鉴定中传统方法较PCR法耗时、繁琐,且不能较准确地鉴定出菌种,而PCR法可准确、快速的将其鉴定到亚种。     

Contraception and the effectiveness of the ovulation method in India

The Billings Ovulation Method was studied in India -- a method whereby a woman observes, records, and interprets her physiological sensations and symptoms during her menstrual cycle and thus is aware of the periods of her fertility or otherwise. The basis of the study was the evaluation of 3530 acceptors over the January 1975 through December 1977 period. The Centers participating in the study were located in several states of India, giving a varied picture of all cultures and socioeconomic classes. Evaluation of the program was carried out through aggregate and average woman months of use, net cumulative continuation rates and Pearl's pregnancy rates/life table pregnancy rates. 499 of the 3530 women discontinued the method at various points. The aggregate woman months of use was found to be 39,967 yielding an average of 11.3 months per woman. At the end of the 6th month, the continuation rate was 88.5, and at the cut-off point 80% of the women were continuing in the program. There were 176 pregnancies among the acceptors of this method during the study period. The Pearl's pregnancy rate was found to be 5.3 for all pregnancies. The life table pregnancy rate was found to be 5.7 at the end of 1 year.     

Statistical issues in implementing the marker method

The detection of growth hormone (GH) abuse by athletes raises statistical problems as well as biochemical ones. We outline the statistical approaches to the various issues which have arisen during the work of the GH-2000 and GH-2004 teams; in particular, it considers the need to develop a test which detects GH abuse in any elite athlete ‘beyond reasonable doubt’. The test needs to be robust enough to withstand legal challenge, while minimising the risk of false accusation. The paper identifies various issues which arise in the development of such a test, and describes how these were resolved.Since GH is a naturally occurring hormone whose concentration varies substantially, its abuse cannot be detected by direct measurement. The methodology considered here made use of markers whose levels are more stable but are influenced by GH. The statistical methods employed aimed to make the best use of these markers, taking account of all factors contributing to errors in measurement.There were two key steps in the statistical investigation undertaken to develop the GH detection algorithm. The first was the requirement to identify GH-dependent biomarkers which would identify GH doping reliably and robustly for a significant length of time. The second was to calibrate the GH detection method in the elite athlete population, so that the method would be applicable to all athletes, regardless of age, sex and ethnicity, and regardless of whether they had recently sustained an injury.In practice, further work was needed to ensure that the methodology met the WADA testing protocol rules, but also that the proposed method can be used by any WADA accredited lab without placing any athlete at an unfair disadvantage and ensuring a high level of confidence in any result produced.