研究的开始:研究方案

为了研究活动的有效性和准确性，研究需要一张“路线图”，称为“研究方案”，研究方案须符合标准格式。它包括摘要、研究概述、伦理问题、研究意义、研究预算和研究者简介。其中，研究概述要清楚地阐明所要研究的问题、研究的理论基础，包括课题的既往研究情况、研究目标、研究假设和目的、设计和方法、项目管理、研究实力和局限性以及参考文献。目标、假设和目的是通过描述研究主题、根据研究主题提出研究假设、将研究假设转化为无效假设、再提出拒绝或接受无效假设的研究步骤等过程来实现。研究设计和研究方法部分则描述研究的种类，研究选取的人群包括样本含量和统计效能、研究对象的选择，数据收集方法以及数据管理和统计分析纲要等内容。研究方案的细节有助于保证研究的成功完成，这对所有卫生领域的研究都是必要的。     

我国老年人工作记忆研究的文献计量分析

目的 揭示近年来我国老年人工作记忆研究的大致轮廓和存在的问题.方法 对我国老年人工作记忆研究的31篇研究报告进行文献计量分析.结果 ①研究论文总体数量较少.②研究的关注群体主要集中在60岁以上的老年人.③研究内容包括工作记忆在认知老化中的作用、工作记忆老化机制的研究以及老年人工作记忆的干预研究.结论 我国老年人工作记忆研究取得了一定的成果,跨学科交叉研究以及老年人工作记忆训练研究将会成为日后该领域在我国的研究趋势.     

《中华传染病杂志》对稿件的基本撰写要求

论著(包括短篇论著)可按前言、对象(材料)与方法、结果、讨论四部分的结构进行撰写。前言应简要阐明研究设计的背景、采用的研究方法,以及拟达到的目的,可引用文献,以200~300字为宜。研究方法中应明确提出研究类型,研究类型的关键信息也需在摘要和文题中体现。具体内容包括:①临床研究或实验研究;②前瞻性研究或回顾性研究;③病例系列研究、病例对照研究、队列研究、非随机对照研究,或随机对照研究。结果需与方法一一对应,避免出现评论性语句。讨论中出现的结果必须在前文结果部分有所表述。     

TDR研究能力加强基金情况介绍

TDR有两大类基金,即研究和发展基金以及研究能力加强基金。本文介绍第二类基金。研究能力加强基金共有9种,分为三类,即机构研究能力加强,科学家个人培训和研究,研究机构为科学家提供培训和研究。研究能力加强基金的申请报告由TDR研究加强组进行评审。每年开两次会,一次     

中国临床医学真实世界研究施行规范

真实世界临床研究是指在真实临床、社区或家庭环境下获取多种数据,从而评价某种治疗措施对患者健康真实影响的研究。真实世界研究包括观察性真实世界研究和试验性真实世界研究,真实世界研究的纳入人群均为临床实际的患者群体,样本量通常较大。真实世界研究证据是随机对照研究证据的重要补充。真实世界研究的概念于1993年正式提出,近10余年来真实世界研究逐渐兴起,但我国真实世界研究的质量参差不齐,有待规范。为指导我国真实世界研究,我们撰写了本规范,以供临床研究相关人员参考。     

第二代生物可降解聚合物涂层西罗莫司洗脱支架治疗原发原位冠状动脉病变的5年临床疗效分析

目的:评价第二代生物可降解涂层钴铬合金西罗莫司洗脱支架EXCROSSAL治疗原发原位冠状动脉病变的长期安全性和有效性。方法:本研究纳入CREDIT Ⅱ研究和CREDIT Ⅲ研究中置入EXCROSSAL支架的冠心病患者,CREDIT Ⅱ研究是一项随机对照研究,CREDIT Ⅲ研究是一项单臂研究。本研究从2013年11月至...     

方法学连续讲座 队列研究(二)

(上接本刊2006年第17期1374页)6研究内容与资料收集6·1研究内容6·1·1筛检研究对象与收集基线资料基线资料也称本底资料,即研究对象与暴露因素在研究开始时的有关资料。在队列研究开始时,应对选择的暴露组与非暴露组的所有研究对象进行筛检,记录相关资料,并根据基线调查结果将其中不合格的研究对象剔除;同时还应对暴露因素的情况进行调查。6·1·2确定研究结局或终点队列研究在设计时,就应该规定好研究结局。所谓结局,即被研究事件的发生。不同的研究目的,其研究结局不同。如在研究疾病病因时,结局往往是被研究疾病的发生或所致的死亡,有…     

MOOCs平台大数据的教育实证

随着大数据技术和大规模在线开放课程(MOOCs)的不断发展,基于MOOCs平台数据的教育研究也日益涌现.然而,相关研究在研究问题、理论基础和研究方法等方面还有待进一步探索.MOOCs平台大数据将为教育问题的研究提供不同类型的数据,有助于打破以往的一些限制.目前来看,基于MOOCs平台大数据的教育实证研究可能会出现聚焦MOOCs本身的研究、大规模在线开放式研究和应用于经典教育研究框架内的研究3种类型.     

中国老年心理学研究文献计量学

目的总结现有老年心理学研究的特点和发展趋势。方法统计中国知网(CNKI)和ISI Web of Knowledge中1981²010年老年心理学中文和英文文献。结果①研究数量逐年增长,近10年的数量超过前20年;在英文期刊发布的文章数量在近5年出现快速增长;②研究主题投入不均衡,主要集中在心理健康方面;③研究的核心力量尚未形成,且力量分布地区差异较大;④研究方法以实证研究为主,但相关研究多于实验研究。结论未来应在关注老年心理健康的同时多进行其他方面的研究,深化加强专业性,加强合作研究的同时继续在多种研究机构中开展,平衡各地区的研究,早日形成核心研究力量,继续保持文献数量增长趋势,打开研究的国际视野。     

临床研究方案设计要点之构建研究问题

临床研究开展的根本目的是解决临床实际问题。研究问题是研究者希望通过研究解决的问题。好的临床研究问题的提出,才能更好的达到设计研究的初衷,才能让研究的设计和执行变得有价值,是研究设计、研究执行的基石。本文简要探讨了临床研究设计中构建研究问题的要求和如何自检构建的研究问题。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.