男女性强直性脊柱炎胸腰椎后凸畸形患者临床特征及生活质量的比较

【摘要】 目的：探讨男女性强直性脊柱炎（ankylosing spondylitis,AS）胸腰椎后凸畸形患者临床特征及生活质量的差异。方法：选取2009年5月~2013年2月在我院手术治疗的51例AS患者,其中男31例,女20例,年龄21~62岁,平均40.6岁。所有患者均填写Oswestry功能障碍指数（Oswestry disability index,ODI）、巴氏AS疾病活动指数（Bath ankylosing spondylitis disease activity index,BASDAI）、巴氏AS功能指数（Bath ankylosing spondylitis functional index,BASFI）、巴氏AS计量指数（Bath ankylosing spondylitis metrology index,BASMI）、巴氏AS总体评分（Bath ankylosing spondylitis global score,BAS-G）、巴氏AS放射指数（Bath ankylosing spondylitis radiology index,BASRI）及SF-36量表;同时记录其发病年龄、病程、血沉（erythrocyte sedimentation rate,ESR）、C反应蛋白（C-reactive protein,CRP）、人类白细胞抗原-B27亚型（HLA-B27）;在立位全脊柱侧位X线片上测量全脊柱最大后凸角（global kyphosis,GK）、腰椎前凸角（lumbar lordosis,LL）、胸椎后凸角（thoracic kyphosis,TK）、矢状面平衡（sagittal vertical axis,SVA）、骨盆投射角（pelvic incidence,PI）、骨盆倾斜角（pelvic tilting,PT）及骶骨倾斜角（sacral slope,SS）。比较男性组与女性组发病年龄、病程、ESR、CRP、HLA-B27阳性率、TK、GK、LL、SVA、PI、PT、SS、ODI、BASDAI、BASFI、BASMI、BAS-G、BASRI及SF-36量表各维度之间的差异。结果：男女比例为1.6∶1。与男性组比较,女性组发病年龄较晚、病程较短、ESR和CRP水平较高及HLA-B27阳性率较低（P<0.05）。与男性组比较,女性组表现出较高的ODI、BASDAI、BASRI评分及较低的BASMI评分（P<0.05）,两组BASFI及BAS-G无统计学差异（P＞0.05）。脊柱-骨盆矢状面参数中,与男性组比较,女性组表现出较大的GK、SVA（P<0.05）,两组TK、LL、PI、PT及SS均无统计学差异（P＞0.05）。SF-36量表各维度中,女性组情感职能得分、精神健康得分低于男性组,而生理功能得分、社会功能得分高于男性组（P<0.05）,两组生理职能、身体疼痛、总体健康状况及活力得分无统计学差异（P＞0.05）。结论：在行手术治疗的AS患者中,男女比例为1.6∶1。与男性AS患者相比,女性患者病情较重,且发病年龄较晚,病程较短。此外,男性AS患者生理功能、社会功能受到明显的限制,而女性AS患者情感职能、精神健康受到明显的损害。     

三种洗手用品洗手效果比较

目的比较临床医护人员使用传统的肥皂、洗手液、无水洗手液三种洗手用品洗手的效果。方法分别对三种洗手用品的效果进行细菌学监测并作统计学分析。结果肥皂、洗手液、无水洗手液洗手后平均菌数分别为10．1cfu／cm^2、8．3cfu／cm^2和3．6cfu／cm^2。结论无水洗手液洗手效果优于传统的肥皂和洗手液,且方便、快速、高效,值得临床广泛推广。     

Covariance adjustment for batch effect in gene expression data

Batch bias has been found in many microarray gene expression studies that involve multiple batches of samples. A serious batch effect can alter not only the distribution of individual genes but also the inter‐gene relationships. Even though some efforts have been made to remove such bias, there has been relatively less development on a multivariate approach, mainly because of the analytical difficulty due to the high‐dimensional nature of gene expression data. We propose a multivariate batch adjustment method that effectively eliminates inter‐gene batch effects. The proposed method utilizes high‐dimensional sparse covariance estimation based on a factor model and a hard thresholding. Another important aspect of the proposed method is that if it is known that one of the batches is produced in a superior condition, the other batches can be adjusted so that they resemble the target batch. We study high‐dimensional asymptotic properties of the proposed estimator and compare the performance of the proposed method with some popular existing methods with simulated data and gene expression data sets. Copyright © 2014 John Wiley & Sons, Ltd.     

Developments of prolonged exposure in treatment effect of post‐traumatic stress disorder and controlling dropout rate: A meta‐analytic review

Prolonged exposure (PE) has been proved as an efficacious psychological treatment for post‐traumatic stress disorder (PTSD). There are mainly two changed formats of PE: the modified PE (mPE) and the PE combined with drug (PE/d). Symptom reduction following these two PE training formats has been reported in the patients with PTSD. However, very little is focusing on the direct comparison of mPE + PE/d and PE. Therefore, this paper aims to compare the mPE + PE/d with PE on the PTSD treatment effect and the dropout rate directly through the meta‐analysis. Eighteen studies with total sample size of 1,397 met the final inclusion criteria. The results showed that mPE + PE/d had significantly lower posttreatment PTSD severity than control group (relaxation, wait list, etc.). There was no significant difference between mPE + PE/d and PE on the posttreatment, the follow‐up PTSD score, and the posttreatment dropout rate. Compared with PE, lower PTSD symptoms and marginally lower dropout rate following the treatment were observed in the PE/d group. PE/d yielded a significantly larger effect size than mPE when compared with PE on the posttreatment PTSD symptom severity. The significance of the above results would not be changed even if studies causing high heterogeneity were removed. Although PE/d enhanced treatment effect and lowered dropout rate when compared with PE, it was still insufficient to draw the conclusion that formats of adjustments would specifically improve the implementation of PE. Further studies are warranted to develop an easily accomplished and efficacy‐guaranteeing PE programme for PTSD patients.     

Therapeutic effects of exon skipping and losartan on skeletal muscle of mdx mice

Various attempts have been made to find treatments for Duchenne muscular dystrophy (DMD) patients. Exon skipping is one of the promising technologies for DMD treatment by restoring dystropin protein, which is one of the muscle components. It is well known that losartan, an angiotensin II type1 receptor blocker, promotes muscle regeneration and differentiation by lowering the level of transforming growth factor–beta1 signaling. In this study, we illustrated the combined effects of exon skipping and losartan on skeletal muscle of mdx mice. We supplied mdx mice with losartan for 2 weeks before exon skipping treatment. The losartan with the exon skipping group showed less expression of myf5 than the losartan treated group. Also the losartan with exon skipping group recovered normal muscle architecture, in contrast to the losartan group which still showed many central nuclei. However, the exon skipping efficiency and the restoration of dystrophin protein were lower in the losartan with exon skipping group compared to the exon skipping group. We reveal that losartan promotes muscle regeneration and shortens the time taken to restore normal muscle structure when combined with exon skipping. However, combined treatment of exon skipping and losartan decreases the restoration of dystrophin protein meaning decrease of exon skipping efficiency.     

89例儿童孤独症语训练效果分析

目的：本文主要是探讨言语对孤独症儿童训练的效果。方法：对89例随机抽样的孤独症儿童,采用应用行为分析法（Applied Behavior Analysis,ABA）进行语言训练,比较孤独症儿童训练前后言语沟通的康复效果,包括发音吐词、词语表达、情感交流。结果：孤独症患儿系统接受综合康复训练后,言语水平明显优于未接受训练者,且越早干预,效果越好,两者具有非常显著的统计学差异（P〈0.01）。结论：语言培训尤其是早期系统语言干预可明显改善孤独症儿童言语沟通、人际交往及刻板、冲动行为。     

改良森田疗法对精神分裂症患者的疗效观察

目的探讨改良森田疗法与康复疗法对精神分裂症患者的康复效果。方法将符合条件的80例精神分裂症患者随机分为改良森田治疗组和一般康复治疗组(以下简称改良组和康复组),治疗6周,于治疗前、治疗后第6周分别用阴性症状评定量表(SANS)、住院精神病人康复疗效评定量表(IPROS)和自知力量表进行疗效评定。结果改良组在阴性症状、康复效果、自知力的改善均明显优于康复组,两组比较差异有统计学意义(t=9.946,16.324,5.245;P0.001)。结论改良组和康复组对改善缓解期精神分裂症患者的阴性症状、提高社会功能、恢复自知力均有效,但改良组的疗效更明显。     

高职生大五人格与生活满意度:情绪调节效能感的中介作用

目的探讨高职生大五人格与生活满意度的关系,检验情绪调节自我效能感在其中的中介作用,为改善高职生心理健康教育提供依据。方法采用大五人格量表,生活满意度量表和情绪调节自我效能感量表(修订版),对分层整群抽取的575名高职生进行问卷调查。结果 1神经质、外倾性、宜人性、责任心与情绪调节自我效能感、生活满意度显著相关(P0.01);2表达积极情绪效能感、管理消极情绪效能感、外倾性、责任心、宜人性(β=0.16,0.18,0.25,0.25,0.18;P0.01)可有效预测个体的生活满意度;3外倾性、责任心和宜人性对生活满意度的影响部分是通过情绪调节自我效能感为中介的。结论高职生人格特质不仅直接影响生活满意度,还会间接通过情绪调节自我效能感发挥作用。