城乡儿童适应行为特点比较

目的 探讨我区城乡儿童的适应行为特点。方法 用用湖南医科大学编制的“儿童适应行为评定量表”进行调查。结果 城市儿童在生活自理、语言发展、个人取向及劳动技术上较农村儿童有优势,农村儿童在社会责任、时空定向、经济活动上较城市獐有优势,提示我区城乡儿童适应行为的全面发展不平衡。     

AFP和CEA在两种化学发光免疫分析系统的比对研究

目的探讨不同化学发光检测系统测定甲胎蛋白(AFP)和癌胚抗原(CEA)结果的可比性,为本实验室不同检测系统检验结果的一致性提供依据。方法分别在西门子ADVIA Centaur XP和国产北京滨松BHP9504两种化学发光免疫分析系统测定AFP和CEA,依据美国临床实验室标准化协会(CLSI)EP9-A2文件的规定,以西门子ADVIA Centaur XP为比较方法,以国产北京滨松BHP9504为实验方法,进行方法学比对试验。结果两种系统各项结果间均呈良好的线性关系,其相关系数r均大于0.99,预期偏倚和相对偏倚均小于可接受限。结论两种化学发光免疫分析系统比对结果可以被临床接受。     

Comparison between subjective and actigraphic measurement of sleep and sleep rhythms

Sleep is often assessed in circadian rhythm studies and long-term monitoring is required to detect any changes in sleep over time. The present study aims to investigate the ability of the two most commonly employed methods, actigraphy and sleep logs, to identify circadian sleep/wake disorders and measure changes in sleep patterns over time. In addition, the study assesses whether sleep measured by both methods shows the same relationship with an established circadian phase marker, urinary 6-sulphatoxymelatonin. A total of 49 registered blind subjects with different types of circadian rhythms were studied daily for at least four weeks. Grouped analysis of all study days for all subjects was performed for all sleep parameters (1062-1150 days data per sleep parameter). Good correlations were observed when comparing the measurement of sleep timing and duration (sleep onset, sleep offset, night sleep duration, day-time nap duration). However, the methods were poorly correlated in their assessment of transitions between sleep and wake states (sleep latency, number and duration of night awakenings, number of day-time naps). There were also large and inconsistent differences in the measurement of the absolute sleep parameters. Overall, actigraphs recorded a shorter sleep latency, advanced onset time, increased number and duration of night awakenings, delayed offset, increased night sleep duration and increased number and duration of naps compared with the subjective sleep logs. Despite this, there was good agreement between the methods for measuring changes in sleep patterns over time. In particular, the methods agreed when assessing changes in sleep in relation to a circadian phase marker (the 6-sulphatoxymelatonin (aMT6s) rhythm) in both entrained (n = 30) and free-running (n = 4) subjects.     

两种不同方法学检测PSA、CA125、CA15-3、CA19-9的比对研究

为探讨不同检测方法测定PSA、CA125、CA15-3、CA19-9结果的可比性,参考EP9-A2文件的规定,使用RIA和微粒子酶免疫方法(MEIA)测定PSA、CA125、CA15-3及CA19-9并进行方法学比对试验,两种方法各项结果间均呈良好的线性关系,其相关系数R2均大于0.95;PSA和CA15-3系统误差均...     

不同类别军医大学生学习认识和期望的比较

目的调查不同类别军医大学生对于学习的认识和期望。方法应用自制问卷,比较不同类别军医大学生对于学习的认识和期望情况。结果无军籍学员对待学习的认识和期望较高;其次是联合培养学员、战士学员(χ2=33.933,97.079;P均0.001)。结论针对不同类别军医大学生对待学习的认识和期望情况,采取有针对性的教育措施保持和提高其水平。     

军校大学生与地方大学生心理健康、社会支持与应对方式比较

目的分析比较军校大学生与地方大学生心理健康、社会支持和应对方式的差异。方法采用症状自评量表(SCL-90)、领悟社会支持量表(PSSS)与应对方式问卷(CSQ)对某军校258名本科生与3所地方大学514名本科生进行测试研究。结果 1t检验得到,两组大学生SCL-90的强迫症状、人际关系敏感、抑郁等7项因子得分上均有显著差异(P0.05);2t检验得到,PSSS量表中两组的家庭支持、朋友支持得分存在显著差异(P0.05);CSQ问卷中两组在求助、合理化和解决问题3因子上存在显著差异(P0.05);3相关分析得到,两组大学生的心理症状普遍与社会支持、成熟型应对方式呈负相关(P0.01),普遍与不成熟应对呈正相关(P0.01)。结论针对两组不同群体,应针对性地给予社会支持,引导其采用成熟的应对方式,以提高心理健康水平。     

不同年级军医大学生学习认识和期望的比较

目的调查不同年级军医大学生对于学习的认识和期望。方法应用自制调查表,比较不同年级军医大学生对于学习的认识和期望情况。结果年级越低的学员,对学习认识和期望的水平越高:学习认识越积极、认为学习成绩重要的比例越高,越能正确看待学员上课迟到早退现象,对于学习成绩的期望值是优秀的比例及打算考研的比例越高(χ2=28.220,65.429,4.335,37.397,34.491;P均0.05)。结论针对不同年级军医大学生对待学习的认识和期望情况,采取各种教育措施保持和提高其认识和期望水平。     

五年制和七年制临床医学专业病理生理学教学工作的比较研究

目的： 比较我校五年制和七年制学生对病理生理学教学需求的不同，分析在实施了不同内容和形式的教学计划后两种学制学生病理生理学考试成绩的差异，评价专业理论考试的质量，为五年制、七年制临床医学生的教育改革提供参考依据。方法: 采用问卷调查形式，分析本校2002级临床医学七年制和2003级临床医学五年制学生对教学要求的不同；运用标准化试题库编制试卷,对试卷质量和考试结果分析。结果: 问卷调查显示七年制学生更加赞成PBL和双语教学方式。试卷设计质量很高（各题P≥0.50,D≥0.15）。五、七年制学生考试试卷平均区分度分别为0.27±0.03和0.24±0.06，试卷的分半信度为0.75±0.05。七年制学生平均成绩为（69.1±10.2）分，χ2=0.990，P>0.05。五年制学生平均成绩为（74.4±11.3）分，χ2=0.111，P＜0.01。结论: 针对不同层次学生，我们的教学内容安排及试卷设计都是合理的。     

Asthma classification by score calculated from clinical findings and examinations. Comparison between clinical diagnosis and score diagnosis]

Asthma classification by clinical symptoms and signs (clinical diagnosis) was compared with the classification by score calculated from clinical findings and examinations (score diagnosis) in 25 patients with bronchial asthma. 1. Ten subjects classified as Ia (simple bronchoconstriction type) by clinical diagnosis were divided into 6 cases with expectoration of less than 49 ml a day and 4 cases with expectoration of between 50 and 99 ml. The level of serum IgE and number of eosinophils in BALF were significantly higher in the latter cases than in the former cases. The cases whose expectoration was from 50 to 99 ml a day were classified as Ib (bronchoconstriction with hypersecretion type) by score diagnosis. 2. The six subjects who were classified as type Ib by clinical diagnosis were also evaluated as type Ib by score diagnosis. 3. Nine of the 10 subjects classified as type II by clinical diagnosis were evaluated as type II by score diagnosis. One case, whose score was under 12 points, was evaluated as questionable type II by score diagnosis.     

基于人群监测和医院监测的高发地区出生缺陷流行病学特征比较

目的比较中国出生缺陷高发地区人群监测和医院监测出生缺陷流行病学特征的差异。方法在中国出生缺陷高发的山西省选择2个高发县作为研究地区,对该地区2002年1月1日至2004年12月31日孕满20周及以上胎儿及婴幼儿出生缺陷的发生水平进行分析。人群监测采用社区调查和医院登记相结合的方法,医院监测来自当地医院妇产科及B超检查的登记册,比较两种监测方法出生缺陷发生率及顺位,孕20周至生后7d或至3岁时的差异。结果 2002至2004年医院监测累积出生4855人,出生缺陷113例,出生缺陷发生率为232.7/万出生;人群监测累积出生6420人,出生缺陷223例,出生缺陷发生率为347.4/万出生,差异有显著统计学意义（P〈0.001）。在孕20周至生后7d的常规监测年龄段,医院和人群监测资料出生缺陷均以神经系统畸形为主,神经系统、耳部畸形、泌尿生殖系统以及皮肤缺陷发生率均为人群监测高于医院监测。人群与医院监测的前5位出生缺陷顺位一致,依次为无脑儿、脊柱裂、先天性脑积水、脑膨出、唇和（或）腭裂。当人群监测年龄延长至3岁时,出生缺陷发生率高达844.2/万出生,是孕20周至生后7d人群监测数据的2.43倍,是医院监测数据的3.63倍。人群监测孕20周至3岁时出生缺陷顺位变化较大,前5位依次为腹股沟疝、无脑畸形、先天性智力低下、先天性心脏病和脊柱裂。结论出生缺陷的水平和顺位与监测方法和时段密切相关,在常规人群出生缺陷监测基础上,可将部分出生缺陷监测时间延长至3岁,可发现更多常规监测以外的出生缺陷种类,为出生缺陷预防提供可靠依据。     

Comparison of chromosomal aberrations between primary tumors and their synchronous lymph-node metastases in intestinal-type gastric carcinoma

Lymph-node metastasis is a main factor causing poor prognosis of patients with gastric cancer (GC). In order to determine the genes involved in lymph-node metastasis, we compared primary tumors with their synchronous lymph-node metastases for DNA sequence copy number aberrations (DSCNAs) in 20 patients diagnosed as having intestinal-type GC using comparative genomic hybridization (CGH). The results showed that some DSCNAs (gains at 8q, 13q, 5p, 7 and X, and losses at 1p, 17p, 19, 21q and 22q) were frequently found in both primary tumors and their metastases. However, metastases often contained DSCNAs that were not found in corresponding primary tumors, and gain at 20q12–13 and losses at 21qcen-21, 4q and 14q22-ter were significantly more frequently observed in metastatic lesions than in their primary tumors (10:2, 9:0, 6:0, and 7:0 between metastases and corresponding primary tumors, respectively). Our data indicate that gain at 20q12–13 and losses at 21qcen-21, 4q, and 14q22-ter are involved in lymph-node metastases, and that these chromosomal regions may contain the genes related to lymph-node metastases in intestinal-type GC.     

Pentacam、IOLMaster和A型超声测量近视患者前房深度的比较

目的 对Pentacam、IOLMaster和A型超声测量仪测量前房深度(ACD)的准确性进行比较.方法 对69例(138眼)近视患者分别使用Pentacam、IOLMaster和A型超声测量仪进行ACD测量,对所得数据进行统计学处理与分析.结果 Pentacam、IOLMaster和A型超声的ACD测量值分别为(3.77±0.24)、(3.73±0.23)、(3.69±0.22) mm,3种方法测量结果差异有统计学意义(F=4.49,P=0.01).Pentacam测得的ACD值比A型超声大约(0.08±0.07) mm(t=13.25,P＜0.001).3种仪器ACD测量值相互正相关(r=0.987、0.951、0.946,P＜0.001),且变异系数很小(0.012±0.07).Bland-Altman分析结果显示,3种方法的ACD测量平均值一致性较好(Pentacam vs IOLMaster:CoA 0.04 mm,LoA 0.13～-0.05 mm;A型超声vs IOLMaster:CoA 0.04 mm,LoA 0.08～-0.17 mm;Pentacam vs A型超声:CoA 0.08 mm,LoA 0.22～-0.06 mm).结论 Pentacam、IOLMaster和A型超声测量ACD的可重复性均很好、变异小、高度相关.Pentacam测得的ACD值稍大于A型超声,但由于3组数据可重复性好,变异系数小,其差异没有重要的临床意义,临床上可相互代替使用.     

新鲜附睾精子与冷冻复苏后的附睾精子临床结局比较

目的探讨经皮附睾穿刺取精术（PESA）获得精子经冷冻复苏后行卵胞浆内单精子注射术（ICSI）的临床效果。方法将采用新鲜附睾精子的94例患者作为新鲜组对照,冷冻复苏后附睾精子的92例患者作为冻精组,比较二组的受精率,可利用胚胎率及妊娠率。结果新鲜组与冻精组相比受精率,可利用胚胎率及妊娠率无显著性差异（75.04%vs78.4%,78.3%vs81.3%,47.87%vs44.44%P〉0.05）。结论PESA精子经冷冻后有很好的复苏率（97.94%）,结合ICSI可得到与使用新鲜PESA精子同样的临床结局,可作为梗阻性无精症的治疗方法。     

Comparison of endometrial and subendometrial blood flow measured by three-dimensional power Doppler ultrasound between stimulated and natural cycles in the same patients

BACKGROUND: Low implantation rates in stimulated IVF cycles may be related to suboptimal endometrial perfusion. Endometrial and subendometrial blood flow was compared between stimulated and natural cycles in the same patients undergoing IVF. METHODS: Three-dimensional (3D) ultrasound examination with power Doppler was performed in stimulated and natural cycles of 67 consecutive patients to measure endometrial thickness, uterine artery pulsatility index/resistance index, endometrial volume, vascularization index (VI)/flow index (FI)/vascularization flow index (VFI) of endometrial and subendometrial regions. RESULTS: Endometrial and subendometrial blood flow was absent in four (6.0%) patients in the stimulated cycle and two (3.0%) patients in the natural cycle. Endometrial and subendometrial VI/FI/VFI were significantly lower in stimulated cycles than those in natural cycles. The median (95% CI) decreases in endometrial VI/FI/VFI were 35.8% (-2.5, 216.8), 5.0% (0.1, 12.3) and 48.4% (2.5, 315.3) respectively whereas the corresponding decreases in the subendometrial region were 66.6% (-0.2, 220.5), 4.3% (0.8, 16.2) and 76.3% (41.0, 303.4) respectively. CONCLUSION: Endometrial and subendometrial blood flow was significantly lower in the stimulated cycle than that in the natural cycle.     

京万红软膏和纳米银凝胶治疗糖尿病足溃疡的临床疗效比较研究

目的通过随机、对照方法对糖尿病足溃疡患者分别使用京万红软膏和纳米银凝胶进行治疗,比较两药的疗效。 方法选取2015年7月至2018年5月在广东省人民医院(广东省医学科学院)接受治疗,满足入组标准的96例糖尿病足溃疡患者,按照随机对照表法进行分组,分为京万红软膏组和纳米银离子组,每组各48例。2组分别用京万红软膏或纳米银凝胶涂于创面治疗,药物厚达3 mm,隔日换药,治疗满16周或16周内任意时间点创面愈合,即试验完成。比较2组在治疗后第4、8、12、16 周患者的视觉模拟评分法(VAS)评分、愈合例数、创面愈合时间,患者脉搏、心率、血压等生命体征。对数据行χ²检验和t检验。 结果京万红软膏组VAS评分[(3.09±1.08) 分]明显较纳米银离子组[(5.83±1.15) 分]要低,差异有统计学意义(t＝28.25,P<0.05);京万红软膏组与纳米银离子组患者在治疗后第8、12、16 周愈合例数比较,差异均无统计学意义(χ²＝0.26、0.71、0.26,P＝0.77、0.45、0.77);京万红软膏组平均愈合时间[(72.6±16.2)d]与纳米银离子组平均愈合时间[(69.8±21.3)d]比较,差异无统计学意义(t＝0.37,P＝0.71);两组患者呼吸频率、心率和血压变化无异常。 结论京万红软膏与纳米银凝胶均有促进糖尿病足慢性创面愈合的作用,京万红软膏作用疼痛更小,治疗更舒适。     

Comparison between measured and calculated length of side branch ostium in coronary bifurcation lesions with intravascular ultrasound

Purpose

Accurate evaluation of side branch (SB) ostium could be critical to the treatment of bifurcation lesions. We compared measured and calculated values of side branch ostial length (SBOL) in coronary bifurcation lesions with intravascular ultrasound (IVUS).

Materials and Methods

Pre-intervention and post-intervention IVUS was performed in 113 patients who underwent stent implantation of bifurcation lesions. For the IVUS longitudinal reconstruction of the bifurcation lesions, SBOL, SB diameter, and the angle between the distal portion of the main vessel (MV) and SB were directly measured. In addition, SBOL was calculated as: SB diameter/sin (angle between distal MV and SB). The relationship between measured and calculated SBOL was then evaluated.

Results

The angled between the distal MV and SB were 57.3±12.4° at pre-intervention and 59.4±12.6° at post-intervention. The mean measured and calculated SBOL values were 2.91±0.86 mm and 3.06±0.77 mm at pre-intervention and 2.79±0.82 mm and 2.92±0.69 mm at post-intervention, respectively. Differences between measured and calculated SBOL were 0.15±0.44 mm at pre-intervention and 0.13±0.41 mm at post-intervention. We found that calculated SBOL was correlated with measured SBOL (pre-intervention r=0.863, p<0.001; post-intervention r=0.868, p<0.001).

Conclusion

There was a good correlation between measured and calculated SBOLs of the bifurcation lesions in IVUS longitudinal reconstruction. SBOL in the bifurcation lesions can therefore be estimated using the SB diameter and the angle between distal MV and SB.     

肥胖儿童血压及其与X线心脏大小的关系

目的：探讨不同判定标准下3～7岁单纯肥胖儿童高血压发生率,以及血压与心脏大小的相关性。方法：体质测量、血压测量、X线测量心脏大小,对有关数据的相关性进行统计学分析。结果：肥胖儿童血压及不同标准下高血压检出率显著地高于正常儿童。高血压肥胖儿童心脏大小10个指标均大于非高血压肥胖者。血压与心脏面积、心脏体积呈低～中度相关。结论：高血压肥胖儿童心脏向各个方向增大,与非高血压者有显著差异。血压与心脏体积指数关系不密切,血压升高,会引起心脏增大和受累。     

CT和MRI在鼻咽癌诊断和临床分期的比较

目的 通过分析鼻咽癌在纤维鼻咽镜下、CT和MRI的影像学表现,评价其诊断价值.方法 回顾性分析经病理证实的82例鼻咽癌的CT和MRI的影像学检查资料作分期比较.结果鼻咽癌各期(T1,T2,T3,T4)CT和MRI方法的阳性检测率分别是42.7％和19.5％,13.4％和17％,24.4％和39％,19.5％和24.4％...     

A nonrandomized comparison of the clinical outcome of ocular involvement in patients with mucous membrane (cicatricial) pemphigoid between conventional immunosuppressive and intravenous immunoglobulin therapies

The purpose of this study was to compare the clinical outcomes of intravenous immunoglobulin (IVIg) therapy to conventional immunosuppressive therapy in patients with mucous membrane pemphigoid (MMP), also known as cicatricial pemphigoid (CP), whose disease progressed to involve the eye. Before ocular involvement, all the patients in this study were diagnosed and treated with immunosuppressive agents, for biopsy-proven MMP, affecting the skin and/or mucous membranes, other than the conjunctiva. Eight patients in group A were treated with IVIg after the diagnosis of ocular cicatricial pemphigoid (OCP) was established. The efficacy and safety of IVIg therapy were compared to a clinically similar group of eight patients treated with conventional immunosuppressive therapy (group B). The inclusion criteria for both groups were: (1). presence of MMP at extraocular sites confirmed by biopsy before entry into the study; (2). entry into the study occurred when ocular involvement was noted and confirmed by biopsy; (3). presence of conventional immunosuppressive therapy at the time of ocular involvement; (4). a minimum of 18 months of follow-up after diagnosis of ocular involvement. The mean length of the therapy, after the onset of ocular involvement, was 24 months (range 16-30) in group A and 45 months (range 21-90) in group B. The median time between initiation of therapy and clinical remission in group A and group B was 4 and 8.5 months, respectively. This difference was statistically significant (P < 0.01). No recurrence of ocular inflammation was recorded in any of the patients in group A. On the contrary, at least one recurrence (median 1) was recorded in five patients in group B (range 0-4). This difference was statistically significant (P < 0.05). All eight patients in group A and group B presented to the ophthalmologist in stage 2 of OCP at the time of the initial visit. At the last follow-up visit, no progression to advanced stages of OCP was recorded in all eight patients in group A. On the contrary, only four patients in group B remained in stage 2 of OCP at the last follow-up exam. The conjunctival scaring progressed from stage 2 to stage 3 in the remaining four patients of group B. At the last follow-up visit, both eyes of each patient in group A were free of inflammation. Some level of conjunctival inflammation at the last follow-up visit was noted in five patients in group B (range 0-1.5, P < 0.05). Both groups of patients were studied during the same time period. The results of this study suggest that ocular involvement in patients with MMP may be considered an indication for initiating IVIg therapy, since it was more effective in arresting progression of OCP, when compared to conventional immunosuppressive therapy. These data indicate that IVIg produced a faster control of the acute inflammation and that no recurrences were observed during the follow-up. This clinical difference could be because of the reduced production of pathogenic antibody, and/or restoration of the immunoregulation, which may have been disturbed.