A comparison of three urobilinogen tests in trie urine, (the watson,Sparkman, and Wallace and diamond methods) in jaundice and diseases of the liver

The American Journal of Digestive Diseases -     

Short paroxysms of impure auricular flutter probably induced by normal sinus beats

Electrocardiograms of a patient with transient auricular fibrillation and flutter and complete A-V heart block are presented. Further tracings, taken immediately after the resumption of normal sinus activity, show short paroxysms of what is believed to be impure flutter induced by normal sinus beats. Some experimental evidence tending to support this view is mentioned.     

The interpretation of the galvanometric curves obtained when one electrode is distant from the heart and the other near or in contact with the ventricular surface: Part II. Observations on the mammalian heart

When the exploring electrode is placed in the left ventricular cavity of the dog's heart, the QRS group of the curve obtained is represented by a single deflection. The direction of this deflection is upward, indicating that the potential of this cavity is negative throughout the QRS interval. When this electrode is placed in the right ventricular cavity, the curve obtained is similar but may show a small preliminary dip preceding the main upstroke.When the exploring electrode is placed on the epicardial surface, its potential is conspicuously different from that of the nearest portion of the ventricular cavity only during the period when the excitation wave is spreading outward through the subjacent ventricular wall. Before the endocardial surface becomes active and after the epicardial surface has been fully activated, there is no electromotive force across the ventricular wall, and a lead from the epicardial surface is, in effect, a lead from the ventricular cavity.The occurrence in an epicardial lead of an upward deflection which precedes the main downstroke is therefore attributed to late activation of the endocardial surface. The main downstroke is due to electric forces produced by the progress of the excitatory process outward through that portion of the ventricular wall lying between the exploring electrode and the ventricular cavity. The intrinsic deflection marks the arrival of the excitation wave beneath the exploring electrode, and hence the extinction of the electromotive force across the subjacent ventricular wall. The sudden upstroke which constitutes this deflection occurs as this electrode assumes the potential of the ventricular cavity.The same principles may be applied to the interpretation of the curves obtained by placing the exploring electrode upon a portion of the ventricular surface of the dog's heart that has been injured. Pure monophasic curves may be obtained by means of such leads if the region injured is one where the intrinsic deflection occurs late and does not rise far above the zero level.     

Comparing the performance of propensity score methods in healthcare database studies with rare outcomes

Nonrandomized studies of treatments from electronic healthcare databases are critical for producing the evidence necessary to making informed treatment decisions, but often rely on comparing rates of events observed in a small number of patients. In addition, studies constructed from electronic healthcare databases, for example, administrative claims data, often adjust for many, possibly hundreds, of potential confounders. Despite the importance of maximizing efficiency when there are many confounders and few observed outcome events, there has been relatively little research on the relative performance of different propensity score methods in this context. In this paper, we compare a wide variety of propensity‐based estimators of the marginal relative risk. In contrast to prior research that has focused on specific statistical methods in isolation of other analytic choices, we instead consider a method to be defined by the complete multistep process from propensity score modeling to final treatment effect estimation. Propensity score model estimation methods considered include ordinary logistic regression, Bayesian logistic regression, lasso, and boosted regression trees. Methods for utilizing the propensity score include pair matching, full matching, decile strata, fine strata, regression adjustment using one or two nonlinear splines, inverse propensity weighting, and matching weights. We evaluate methods via a ‘plasmode’ simulation study, which creates simulated datasets on the basis of a real cohort study of two treatments constructed from administrative claims data. Our results suggest that regression adjustment and matching weights, regardless of the propensity score model estimation method, provide lower bias and mean squared error in the context of rare binary outcomes. Copyright © 2017 John Wiley & Sons, Ltd.     

儿童急性淋巴细胞和非淋巴细胞白血病诊断治疗

高怡瑾教授很荣幸邀请到Smith教授访问复旦大学附属儿科医院,并借此机会在上海医学会儿科学分会血液学组的学术活动中做儿童急性髓系白血病学术报告,Smith教授是美国辛辛那提儿童医院儿科学系教授,血液肿瘤科临床主任,并在美国儿童肿瘤协作组织(COG)担任儿童急性非淋巴细胞白血病(AML)临床试验组主席.以下是在征得Smith教授同意的情况下,根据这次学术活动中与其对话的部分内容整理而成,以飨读者.     

Combined effects of brachial pulse pressure and sialic acid for risk of cardiovascular events during 40 years of follow-up in 37 843 individuals

OBJECTIVE:: Pulse pressure (PP) is a risk marker for cardiovascular disease (CVD) in individuals 50 years and older. Inflammation is suggested to influence atherosclerosis, but could also increase PP. We aimed to examine the combined effects of PP and the inflammatory marker sialic acid, and their independent roles on CVD risk. METHODS:: From a population-based study in Sweden between 1962 and 1965, 18?429 men and 19?414 women at the age of 50 or older were selected and followed for first CVD event until 2005. We investigated the biological interactions between sialic acid and PP. The associations of PP and sialic acid with risk of CVD were calculated by using Cox proportional hazards model. Adjustments were made for conventional risk factors, mean arterial pressure (MAP) and socioeconomic status. RESULTS:: The mean age was 59.5 (SD 6.5) years and the number of incident CVD events in men and women were 3641 and 3227, respectively. No biological interaction was seen between PP and sialic acid. In men, the adjusted hazard ratio for PP was 0.92 [95% confidence interval (CI) 0.88-0.96, P?相似文献