如何正确运用χ2检验——横断面设计四格表资料的χ2检验

本文目的是介绍横断面设计四格表资料的χ²检验及SAS和R软件实现。具体介绍了3种方法,即“Pearson?sχ²检验”“校正的Pearson?sχ²检验”和“似然比χ²检验”。内容涉及前述提及的3种统计分析方法的检验假设、计算原理与公式、前提条件、SAS与R软件的实现、结果解释以及结论陈述。     

Suicide verdicts as opposed to accidental deaths in substance-related fatalities (UK, 2001-2007)

Background

Substance-related deaths account for a great number of suicides.

Aim

To investigate levels and characteristics of suicide verdicts, as opposed to accidental deaths, in substance misusers.

Methods

Psychological autopsy study of cases from the UK National Programme on Substance Abuse Deaths (np-SAD) during the period 2001-2007.

Results

Between January 2001 and December 2007, 2108 suicides were reported to the np-SAD. Typical suicide victims were White and older than 50 (respectively 95% and 41% of cases). Medications, especially antidepressants (44%), were prescribed to 87% of victims. Significantly fewer suicide victims than controls presented positive blood toxicological results for illicit drugs (namely: cocaine, heroin, amphetamines, ecstasy-type drugs, cannabis, and GHB/GBL) and alcohol.

Conclusions

Suicide prevention programmes should devote specific attention to deaths among substance misusers who are at high risk of fatal intentional self-harm. Specific characteristics distinguish those at risk; caregivers should be better educated as to what these factors are. Limitations of the current study included lack of provision of comprehensive information relating to the victims' psychosocial variables. Furthermore, no differentiation between different classes of antidepressants in terms of involvement in suicide was here provided.     

非小细胞肺癌患者中Livin蛋白表达及临床意义

[目的]研究凋亡抑制蛋白Livin在非小细胞肺癌(non-small cell lungcancer,NSCLC)组织和正常肺组织中的表达,探讨livin表达水平与临床病理因素的相关性、生物学特点的相关性,为肺癌的临床诊断及治疗提供依据。[方法]将来某院就诊并手术的46例非小细胞肺癌和10例良性肺部病变患者,采用免疫组织化学法检测Livin蛋白在患者癌组织、癌旁组织和良性病变肺组织中的表达,数据结果采用χ2检验、配对样本t检验等统计方法予以分析。[结果]Livin蛋白在NSCLC组织、癌旁组织和良性病变肺组织中表达阳性率分别为67.4%、19.6%和0.0%,差异有统计学意义。不同病理类型和不同分化程度的肺癌Livin蛋白表达情况差异无统计学意义(P﹥0.05)。而有无淋巴结转移肺癌和不同分期程度的肺癌Livin蛋白表达情况差异有统计学意义(P﹤0.05)[结论]Livin在NSCLC组织中特异性地高表达,可能成为NSCLC诊断上新的标记物和治疗上新的靶点和治疗的重要依据。     

如何正确运用χ2检验——χ2分布及相关内容

本文目的是介绍χ²分布及相关内容,包括χ²分布和非中心χ²分布。着重展示了两种χ²分布的定义、概率密度函数的图形和主要性质,其中,两个最重要的性质分别是:①χ²分布的极限分布为正态分布;②(n-1)s²σ²服从自由度为n-1的χ²分布。除此之外,还阐释了χ²分布与正态分布、χ²检验统计量与Z检验统计量之间的关系。最后,基于SAS软件中的两个SAS函数呈现了χ²分布的计算方法。     

体部伽玛刀与三维适形放射治疗原发性肝癌临床疗效比较

目的比较肝动脉介入栓塞化疗(TACE)联合伽玛刀治疗与TACE联合三维适形放射治疗原发性肝癌(HCC)的疗效。方法将50例不能手术的Ⅱa或Ⅱb期HCC患者根据患者意愿和适应证分为TACE+伽玛刀治疗组(A组)25例与TACE+三维适形放射治疗组(B组)25例,两组一般情况无统计学差异。A组先行TACE(40%碘化油+CPDD+5-FU+EADM)治疗2～3次后,再进行体部伽玛刀放射治疗。B组先行2～3次TACE治疗后,再行加速器适形放射治疗。结果治疗后3个月评价疗效,A组RR率(CR+PR)为84%(21/25),1、2、3年生存率分别为76%,45.9%,20.44%。B组的RR率为56%(14/25),与A组比较差异有统计学意义(P<0.05),B组1、2、3年生存率分别为79.6%,30.2%,12.6%,与A组比较差异无统计学意义(P>0.05)。结论与TACE联合适形放射治疗相比,TACE联合伽玛刀治疗HCC具有较高的近期有效率,而两种治疗的1、2、3年生存期差异无统计学意义。     

Differential role of serotonergic polymorphisms in alcohol and heroin dependence

Background

Twin studies suggest that genetic factors account for 40–60% of the variance in alcohol dependence. It has been stated that different drug dependencies may have unique genetic influences. Alterations in serotonin availability and function can affect drinking behaviour. This study aimed to investigate whether three serotonergic polymorphisms (HTR2A A-1438G (rs6311), and SCL6A4 5-HTTLPR and STin2 VNTR) were associated with alcohol dependence, and, whether the serotonergic polymorphisms played a similar role in conferring vulnerability in alcohol and heroin dependence.

Methods

165 alcohol dependent patients, 113 heroin dependent patients, and 420 healthy controls from a homogeneous Spanish Caucasian population were genotyped using standard methods.

Results

Genotypic frequencies of the A-1438G, 5-HTTLPR, and STin2 VNTR polymorphisms did not differ significantly across the three groups. None of the three polymorphisms contributed to distinguishing alcoholic patients from healthy controls. There was an excess of −1438G and 5-HTTLPR L carriers in alcoholic patients in comparison to the heroin dependent group (OR (95% CI) = 1.98 (1.13–3.45) and 1.92 (1.07–3.44), respectively). The A-1438G and 5-HTTLPR polymorphisms also interacted in distinguishing alcohol from heroin dependent patients (Wald (df) = 10.21 (4), p = 0.037). The association of −1438A/G with alcohol dependence was especially pronounced in the presence of 5-HTTLPR S/S, less evident with 5-HTTLPR L/S and not present with 5-HTTLPR L/L. SCL6A4 polymorphism haplotypes were similarly distributed in all three groups.

Conclusions

Our data do not support a role of serotonergic polymorphisms in alcohol dependence but suggest a differential genetic background to alcohol and heroin dependence.     

Periventricular white matter hyperintensities as predictors of suicide attempts in bipolar disorders and unipolar depression

The aim of this study was to evaluate whether deep white matter hyperintensities (DWMH) and periventricular white matter hyperintensities (PVH) are associated with suicidal behavior in patients with major affective disorders. Subjects were 99 consecutively admitted inpatients (42 men; 57 women; mean age: 46.5 years [SD=15.2; Min./Max.=19/79]) with a diagnosis of major affective disorder (bipolar disorder type I, bipolar disorder type-II and unipolar major depressive disorder). 44.4% of the participants had made at least one previous suicide attempt. T2-weighted brain magnetic resonance images were rated for the presence and extension of WMH using the modified Fazekas scale. Patients were interviewed for clinical data on average 5 days after admission. Bivariate analyses, corrected for multiple-testing, and logistic regression analysis were used to test the association between suicide attempts and clinical variables. Attempters and nonattempters differed only in the presence of PVH--the former were more likely to have PVH. The logistic regression indicated that the presence of PVH was robustly associated with suicidal behaviors after controlling for age (OR: 8.08). In conclusion, neuroimaging measures may be markers of risk for suicidal attempts in patients with major affective disorders.     

Association study between obsessive-compulsive disorder and serotonergic candidate genes

BACKGROUND: To date, research examining the relationship between serotonergic genes and obsessive-compulsive disorder (OCD) has yielded conflicting results. The purpose of this study is to investigate the association between four serotonergic polymorphisms (STin2 VNTR and 5-HTTLPR of the SLC6A4 gene, and A-1438G (rs6311) and T102C (rs6313) of the HTR2A gene) and OCD. METHODS: 99 OCD patients, 456 non-OCD psychiatric patients, and 420 healthy controls from a homogeneous Spanish Caucasian population were genotyped using standard methods. RESULTS: All groups showed Hardy-Weinberg equilibrium for the analyzed genetic variability. A-1438G and T102C polymorphisms were in complete linkage disequilibrium. OCD patients showed an excess of STin2.12 carriers (12/12, 12/10, and 12/9 genotypes) compared with healthy controls (chi(2) (1)=7.21, corrected p=0.021; OR=3.38, 95% CI=1.32-8.62) and non-OCD psychiatric patients (chi(2) (1)=6.70, corrected p=0.030; OR=3.24, 95% CI=1.27-8.26). However, no differences were found between non-OCD patients and healthy controls (chi(2) (1)=0.05, corrected p>1; OR=1.04, 95% CI=0.72-1.51). No significant differences were found with respect to A-1438G and 5-HTTLPR polymorphisms. CONCLUSIONS: Our data provide supporting evidence of an association between the STin2 VNTR polymorphism of the SLC6A4 gene and OCD.     

某院2004年-2012年病案利用情况分析

目的 对某院病案利用情况进行回顾性的分析,了解病案利用情况的变化趋势,探讨病案对外服务模式的优化.方法 以病案室的病案利用登记本的记录为基础,用SPASS软件进行对比和χ^ 2 趋势检验分析.结果 病案利用率由2004年的469份占当年出院病人的9.19%,上升至2012年的11,219份占当年出院病人的76.51%.院内利用率由2004年的374份占当年病案利用率79.74%,至2012年院内利用3636份利用率下降至32.4%,院外利用率由2004年95份占当年病案利用率20.45%,上升至2012年7583份占当年病案利用率67.59%.结论 加大病案室的硬件投入,改善服务态度,简化服务流程,更好地服务于日益增长的病案的利用人员.     

沈阳市1992～2006年女性乳腺癌死亡趋势分析

目的:探讨1992～2006年沈阳市女性乳腺癌死亡率水平及变化趋势、特点。方法:用SAS6.12软件对乳腺癌死亡率、死亡构成等指标进行分析,并进行χ2趋势检验。结果:沈阳市女性乳腺癌死亡率呈上升趋势,15年间上升了57.37%,年均增长速度为3.29%。乳腺癌年均死亡率为9.11/10万,标化死亡率为6.69/10万。乳腺癌在恶性肿瘤中的顺位从2006年开始,由原来的第5位上升至第3位。乳腺癌死亡率从35～岁组开始随年龄增加而明显上升,年龄越大,死亡率越高。45～64岁年龄段乳腺癌死亡率随时间推移,呈明显上升趋势,经χ2趋势检验,有高度统计学意义(χ2=22.43,P<0.0001)。结论:沈阳市乳腺癌死亡率上升速度较快,应重点加强45～64岁年龄段女性乳腺癌的防治。