微创脊柱外科影像资料在脊柱外科教学中的应用分析

目的观察分析微创脊柱外科影像资料在脊柱外科教学中的应用疗效。方法随机选取2016年9月～2018年6月实施外科教育教学工作的4个班级200名学生为本次研究对象,2016年9月～2017年6月实施教育教学工作的2个班级100名学生为对照组,该组学生脊柱外科教学活动中均给予传统教学;2017年9月～2018年6月实施教育教学工作的2个班级100名学生为实验组,该组学生脊柱外科教学活动中均给予微创脊柱外科影像资料教学,比较两组学生外科教学期末考试成绩。结果实验组脊柱外科基本解剖结构、腰椎间盘突出症发病机制、外科无菌操作等外科考试指征得分均明显优于对照组(P 0.05)。实验组学生期末调查问卷显示学生对脊柱外科教育教学满意度(98.0%)明显高于对照组(P 0.05)。结论脊柱外科教学中给予微创脊柱外科影像资料有利于学生结合临床资料,更好的掌握脊柱外科相关基础知识。     

Quality of life and sociodemographic data in patients after spine surgery

Objectives  

To assess the quality of life and its correlation with sociodemographic data in patients after spine surgery and limb amputation relative to controls.     

Deriving knowledge through data mining high-throughput screening data

Deriving general knowledge from high-throughput screening data is made difficult by the significant amount of noise, arising primarily from false positives, in the data. The paradigm established for screening an encoded combinatorial library on polymeric support, an ECLiPS library, has a significant amount of built-in redundancy. Because of this redundancy, the resulting data can be interpreted through a rigorous statistical analysis procedure, thereby significantly reducing the number of false positives. Here, we develop the statistical models used to analyze data from high-throughput screens of ECLiPS libraries to derive unbiased true hit rates. These hit rates can also be calculated on subsets of the collection such as those compounds containing a carboxylic acid or those with molecular weight below 350 Da. The relative value of the hit rate on the subset of the collection can then be compared to the overall hit rate to determine the effect of the substructure or physical property on the likelihood of a molecule having biological activity. Here, we show the effects that various functional groups and the standard physical properties, molecular weight, hydrogen bond donors, hydrogen bond acceptors, log P, and rotatable bonds, have on the likelihood of a compound being biologically active. To our knowledge this is the first published account of the use of high-throughput screening data to elucidate the effects of physical properties and substructures on the likelihood of compounds showing biological activity over a broad range of pharmaceutically relevant targets.     

Generic data

In an earlier issue of Pharmacoepidemiology and Drug Safety, I described an IMBRF/ISPE meeting on proposed European and British regulations on confidential medical data. ISPE members commonly deal in confidential medical data when they evaluate adverse drug reactions, when they make and respond to regulatory requests for population data on drug safety, and when they compare the health and economic consequences of treatment strategies! Here I would like to open a discussion of the first of the research areas that were raised by that meeting. This is the question of when data must be regarded as ‘personally identified’.     

Evaluation and comparison of simple multiple model, richer data multiple model, and sequential interacting multiple model (IMM) Bayesian analyses of gentamicin and vancomycin data collected from patients undergoing cardiothoracic surgery

This study compared the abilities of three Bayesian algorithms-simple multiple model (SMM) using a single creatinine measurement; richer data multiple model (RMM) using all creatinine measurements; and the sequential interacting multiple model (IMM)-to describe gentamicin and vancomycin concentration-time data from patients within a cardiothoracic surgery unit who had variable renal function. All algorithms start with multiple sets of discrete parameter support points obtained from nonparametric population modeling. The SMM and RMM Bayesian algorithms then estimate their Bayesian posterior probabilities by conventionally assuming that the estimated parameter distributions are fixed and unchanging throughout the period of data analysis. In contrast, the IMM sequential Bayesian algorithm permits parameter estimates to jump from one population model support point to another, as new data are analyzed, if the probability of a different support point fitting the more recent data is more likely. Several initial IMM jump probability settings were examined-0.0001%, 0.1%, 3%, and 10%-and a probability range of 0.0001% to 50%. The data sets comprised 550 gentamicin concentration measurements from 135 patients and 555 vancomycin concentration measurements from 139 patients. The SMM algorithm performed poorly with both antibiotics. Improved precision was obtained with the RMM algorithm. However, the IMM algorithm fitted the data with the highest precision. A 3% jump probability gave the best estimates. In contrast, the IMM 0.0001% to 50% range setting performed poorly, especially for vancomycin. In summary, the IMM algorithm described and tracked drug concentration data well in these clinically unstable patients. Further investigation of this new approach in routine clinical care and optimal dosage design is warranted.     

损伤控制性手术在肝胆外科中的应用效果分析

目的 探讨在肝胆外科开展损伤控制性手术的临床效果.方法 选取2015年1月至2016年6月我院肝胆外科收治的76例肝胆创伤患者,随机分为对照组36例和观察组40例,对照组实施传统手术,观察组实施损伤控制性手术,比较两组的效果.结果 观察组治疗总有效率明显高于对照组,患者术后肺部感染、粘连性肠梗阻等并发症的发生率及病死率明显低于对照组,差异均有统计学意义(P＜0.05).结论 在肝胆创伤的手术治疗中实施损伤控制性手术,可有效改善患者的预后,提高外科手术治疗的安全性,值得在临床普及和推广.