如何评价试验结果

这个试验结果正常吗这是临床医学上最简单的常识，但其答案却往往令人误解，因为“正常”或“正常值”这个概念本身并不适合于恰当地说明试验结果。试验结果阳性为异常，表示有病，阴性为正常，表示无病，对被观察对象而言也有２种可能，有病或无病。这样一项诊断结果的解释就有４种可能，其中２种情况是正确的：受试者有病，试验结果阳性真阳性，受试者无病，试验结果阴性真阴性。另外２种情况是错误的：受试者有病，试验结果正常假阴性，受试者无病，试验结果异常假阳性。因此，即使某项试验结果有实用价值，也不应简单表示为“正常”或“…     

县级工作人员健康体检实验室检测结果分析

目的了解本县健康人群的主要实验室检查指标的异常率，为提高国民身体素质提供依据。方法收集2007年至2008年在华容县人民医院体检中心体检人员的资料10825例，按年龄分组对肝功能．血脂，血糖，乙型肝炎表面原，甲胎蛋白，癌胚抗原，EB病毒，血常规的实验室结果进行分析。结果血脂，血糖，血常规检测结果异常率随着年龄的增大而不断升高，各年龄组之间检测结果相比差异有显著性（P〈0．01），谷丙转氨酶，甘油三脂，胆固醇，血糖检测结果的异常率分别为11．0％，18．％，9．2％，6．4％，乙肝病毒，甲胎蛋白，癌胚抗原，EB病毒检测结果的阳性率分别为9．71％，0．08％。0．02％，1．1％，白细胞，血红蛋白，血小板的异常率分别为7．07％，7．26％，10．1％。结论血脂，血糖检测结果的异常率高于全国平均水平．阳性率与全国平均水平接近，乙肝病毒，甲胎蛋白，癌胚抗原，EB病毒检测结果的阳性率还处于较低水平。     

基础医学论文的写作要求与特点（二）

“讨论”是把实验结果提高到理论认识的部分，即所要报道的中心内容。如果说结果部分是“摆事实”的话，那么讨论部分就是“讲道理”，是通过对结果的分析，以事实为根据，从中找出内在联系，得出正确的结论，透过现象，探求本质，了解各种现象发生的真正原因，并推理探讨其机理。讨论中的主要内容有：①对该研究结果（阳性或阴性）作出合理的解释或补充说明；②将该研究结果与当前国内外有关研究结果加以比较，有何新、优、异之处，在观点和结果上有何异同点；③对该研究结果进行分析、讨论并对可能的原因、机理提出自己的看法与见解，以指…     

全自动生化分析仪检测结果异常原因探讨

目的：对引起全自动生化分析仪检测结果异常的原因作一总结。方法：终点法，速率法试验的结果分类加以讨论。结果：样品，试剂，仪器，标准与质控，审核等多方面因素均可引起结果异常。结论：抒好各个环节，才能使检测结果真实可靠。     

大肠菌群检验不同步骤的临床结果研究

目的比较大肠菌群检验初发酵、鉴别平板分离、复发酵三步骤中，一步、二步分别与三步结果的符合率，以便能通过二步法尽快报出结果，做到省时省力。方法结果比较步骤不同检验发酵饮用水阳性平板步法生活饮用水及卤菜均采用国标检验方法。结果一步与三步符合率为饮用水61％，卤菜81％，二步结果与三步符合率饮用水93％，卤菜为95％，经统计学处理，二步结果与三步结果差异无显著性（P〉0.05）。结论笔者认为大批量采集样本时初发酵产酸产气，平板分离菌落典型，革兰染色阴性，便不经复发酵，直接报出结果，可节省时间和人力物力，使公共卫生现场监督人员很快得到科学依据。     

尿试纸带的保存不当对检验结果的影响

笔者在临床工作中发现，开启使用后剩余的尿试纸带保存方法不当，会影响检验结果的质量。笔者把每天使用剩余试纸带放置在两种不同温度条件下密封保存，连续观察其结果变化，对两种结果进行了对比分折，发现两种保存方法所测结果有明显差异，结果如下。     

缓冲剂在凝血仪内的摆放位置对纤维蛋白原测定结果的影响

目的评价Owren’S缓冲剂分别摆放于冷藏区和非冷藏区两种情况下，对血浆纤维蛋白原（Fbg）的检测结果所产生的影响。方法将120例临床血浆标本分为两大组，分别将缓冲剂放置于凝血仪内试剂盘的非冷藏区和冷藏区，对Fbg进行连续测定分析。对两种情况下测定所得数椐分别进行F方差分析。结果（1）缓冲剂放置于非冷藏区（室温24～26％）情况下，3h内，4次测定结果之间比较无统计学显著性差异（P〉0．05）；而0h结果与4h结果，1h结果与5h结果，2h结果与5h结果，3h结果与6h结果，两两比较均具有统计学显著性差异（P〈0．05）。（2）缓冲剂放置于仪器内冷藏区情况下（实测温度9～12％），6h内7次测定结果之间组问比较均无统计学显著性差异（P〉0．05）。结论当凝血仪内缓冲剂放置于冷藏区内，6h内（可能更长时间）对测定结果无显著性影响；而当缓冲剂贮放于非冷藏区内，随着时间延长对Fbg测定结果影响逐渐增大，前5h内无影响；但3h后，测定值降低。因此认为，Clauss法测定Fbg时，Owren’s缓冲剂摆放位置应在凝血仪内冷藏区，此可保障测定结果的准确性。     

正文主体部分之“结果”

结果的叙述应实事求是，简洁明了，数据准确，层次清楚，逻辑严谨，不应与讨论内容相混淆。应着重总结重要的研究结果。以数据反映结果时，不能只描述导数（例如百分数），     

正文主体部分之“结果”

结果的叙述应实事求是，简洁明了，数据准确，层次清楚，逻辑严谨，不应与讨论内容相混淆。应着重总结重要的研究结果。以数据反映结果时,     

论文＂结果＂部分的基本内容与撰写要求简介

“结果”是论文的核心及重要组成部分，是结论的依据、基础和支柱，“结果”应体现研究过程中获得的所有信息。由于研究工作涉及的学科、选题、研究方法、工作进程等不尽相同，在结果的表达方面有很大差异，因此对“结果”的内容不能作统一规定。不过，对论文“结果”还是可归纳出一些共性的基本内容和要求：①在结果中应重点介绍新发现、新发明、新创造及／或新观点；②既介绍正面的、阳性的结果，也交待反面的、阴性的结果；③数据准确，真实可靠。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.