Using Adapted Short MASTs for Assessing Parental Alcoholism: Reliability and Validity

In previous research adapted versions of the Short Michigan Alcoholism Screening Test (SMAST) have been employed to assess an individual's father's (F-SMAST) and mother's alcohol abuse (M-SMAST). However, to date psychometric information on these forms has been limited. In order to more broadly assess the psychometric properties of these forms, several critical issues in five related studies were addressed. The samples for the five studies were drawn from a college population at a large midwestern university. Overall, the reliability and validity of the adapted SMASTs appears to be quite good. The F-SMAST demonstrated high reliability (from the standpoint of internal consistency, temporal stability, and reliability across siblings) as well as validity (both in respect to convergence with an interview measure and with father's own report on a parallel instrument). Furthermore, shortening both of these instruments to nine-item versions appears to improve their reliability and validity. For researchers and clinicians interested in assessing parental history of alcoholism, the F-SMAST and M-SMAST would appear to be a reliable and valid paper-and-pencil measure.     

梁氏权重法的建立及其应用探讨

目的建立一种新的权重方法--梁氏权重法.方法以被评价系统中各评价指标值的平均数为基准比较值来进行相互比较.从而确定出被评价系统中各评价指标在该评价系统中的相对重要程度即权重系数.结果应用该方法来确定各指标的权重系数是可行的.该方法的优点是:客观性高,无论评价指标数值为相对数或是绝对数,只要评价指标的量纲相同,都可应用.缺点是:不能用于评价指标量纲不同的评价系统;当某评价指标的基准比较值为零时,需要根据个人的主观看法或经验来确定基准比较值,因而在此种情况下得出的综合评价结果的客观性会降低.结论该方法是一种值得推广使用的权重确定方法.     

3,4—二甲氧基苯乙胺类衍生物构效关系研究

用Palygen软件包中的Charmn软件和集团坐标轮换法,对所合成的14个3,4-二甲氧基苯乙胺类衍生物的构象进行计算机模拟。根据所得各化合物的最低能量构象,计算其VDW、偶极距、N原子上的电荷密度等值,并利用化合物的生物活性1gl/IC_(50)(α_1)值,以逐步回归法建立回归方程:y=5.022—0.106X_6—0.0223X_7—0.7975X_8—2.3256X__(12),R=0.8681,F=6.8844>F(0.01)(4.14)。结果提示:方程相关性显著,该系列化合物体现的生物活性与理化参数之间的关系在于苯乙胺衍生物分子的整体作用。     

The effect of antidiuretic hormone on the distribution of nephron filtration rates in rats with hereditary diabetes insipidus

Summary The effect of antidiuretic hormone on the distribution of nephron filtration rates was studied in rats with hereditary diabetes insipidus using the Hanssen method for determination of nephron filtration rates as modified by de Rouffignacet al. [18]. Conversion of water diuresis to antidiuresis by infusion of ADH resulted in a moderate, but highly significant increase in the filtration rate of the juxtamedullary nephrons, while the nephrons of all other cortex regions filtered at an unaltered rate. A mechanism based on the action of ADH on distal nephron water permeability is proposed as an explanation: water inflow into the medulla very likely decreases when water diuresis is converted to antidiuresis. This occasions a rise in medullary osmolality which then causes an increase in the apparent viscosity of the blood flowing through the vasa recta. This is responsible for a rise in juxtamedullary postglomerular resistance which results in an increase in the effective filtration pressure and thus in the juxtamedullary nephron filtration rate. The results suggest that an increased juxtamedullary filtration rate participates in the establishment and maintenance of the inner medullary solute gradients, possibly as a consequence of an increased solute delivery to the ascending limbs of the long loops of Henle.This work was supported by the Deutsche Forschungsgemeinschaft.On leave from the University of Melbourne as a recipient of a scholarship from the Deutscher Akademischer Austauschdienst.     

The effect of experimental alterations in urine concentration on nephron filtration rate

Summary Experiments were performed to clarify the cause of the dependency of juxtamedullary nephron filtration rate (JN-GFR) on the diuretic state of the animal. Using the ferrocyanide technique of de Rouffignacet. al. [5] the distribution of nephron filtration rates was determined during selective modification of final urine osmolarity by papillary superfusion with concentrated or isotonic solutions. Papillary superfusion with a 2000 mosmolar solution led to a mean urine osmolarity of 1848±78 mOsm/l. JN-GFR displayed a mean increase of 66.6% over the superficial nephron filtration rate (SN-GFR). When the superfusion fluid was isotonic urine osmolarity averaged 754±53 mOsm/l and JN-GFR increased by a mean of only 26.3% over the SN-GFR. Using the micropuncture technique it was shown that SN-GFR in a given animal was not altered when the superfusion fluid was interchanged. We conclude therefore that the change in the percentage increase in GFR from superficial to juxtamedullary nephrons is caused by a change of juxtamedullary nephron filtration rate. Since plasma ADH concentration was not altered this effect appears to be elicited by the changed medullary solute concentration rather than by a vasomotor action of the antidiuretic hormone.This work was supported by the Deutsche Forschungsgemeinschaft.     

Validation of 5 routine assays for serum free testosterone with a candidate reference measurement procedure based on ultrafiltration and isotope dilution-gas chromatography-mass spectrometry

BACKGROUND/METHOD: The analytical validity of free testosterone (FTe) analog immunoassays is subject to much controversy. We revisited the validation of 4 analog assays and 1 FTe calculation procedure with a metrologically traceable reference measurement procedure (RMP) based on ultrafiltration and isotope dilution-mass spectrometry for direct measurement of Te in the ultrafiltrate. To this end, we performed split-sample measurements of 40 male sera. RESULTS: Deming regression showed that 3 of the immunoassays had moderate to good correlation (0.8474 < or = r < or = 0.9241) with the RMP; however, the slope was markedly below 1. The FTe calculation procedure was in good agreement with this result. The Sy/x values for all assays were higher than the combined imprecision values, which indicate their susceptibility to matrix-related effects. CONCLUSIONS: The study demonstrated substantial differences in analytical quality of FTe assays; however, the results suggested that after extending the validation with a larger variety of samples, recalibration of some analog assays might be worth further investigation.     

Scoring method for early prediction of neonatal chronic lung disease using modified respiratory parameters

In our previous study, we have demonstrated that peak inspiratory pressure over birth weight (PIP/kg) and mean airway pressure over birth weight (MAP/kg) were more significant risk factors for the development of neonatal chronic lung disease (CLD) than PIP and MAP. We aimed to develop a scoring method using the modified respiratory variables (SMUMRV) to predict CLD at early postnatal period. From 1997 to 1999, a retrospective review was performed for 197 infants <1,500 g for the development of the SMUMRV based on statistical analysis. From 2000 to 2001, calculated scores on day 4, 7 and 10 of life were obtained prospectively for 107 infants <1,500 g. Predictive values and the area under the receiver operator characteristic curve (AUC) were determined and compared with the result of the previous regression model. Gestational age, birth weight, 5 min Apgar score, PIP/kg at 12 hr of age, fractional inspired oxygen (FiO2), MAP/kg, modified oxygenation index and ventilatory mode were selected as parameters of SMUMRV. No significant differences of AUCs were found between the SMUMRV and the Yoder model. It is likely that our scoring method provides reliable values for predicting the development of CLD in very low birth weight infants.     

Anatomical considerations for surgery of the anterolateral abdominal wall

Closure of large incisional hernias with the Components Separation Method (CSM) could be explained by medial-caudal rotation of the internal and transverse oblique muscles around their centres of origin. In eight human cadavers, the CSM was performed, and translation of the rectus abdominis muscle was measured. Mean unilateral translation of the rectus abdominis in the lateral-medial direction measured 2.2, 3.7, and 3.5 cm. This was 2.7, 4.5, and 4.0 cm after release of the posterior rectus sheath. Mean translation in a caudal direction was 0.5 cm, but seven cadavers showed a mean translation of 1 cm of the uppermost measuring point in a cranial direction. The hypothesis that rotation of separate tissue layers of the abdominal wall largely accounts for the translation effect of the CSM must be rejected. Release of the external oblique muscle produces more benefit to abdominal wall closure than release of the posterior rectus sheath.     

Application of simple fertility awareness-based methods of family planning to breastfeeding women

OBJECTIVE: To determine the potential efficacy of two simple fertility awareness-based methods of family planning-the Standard Days Method and the TwoDay Method-among breastfeeding women. DESIGN: Analysis of pre-existing data set, collected in 1986-1990. SETTING: Pre-existing data from Australia, Britain, and Canada. PATIENT(S): Seventy-three breastfeeding women in Australia, Britain, and Canada, who were followed starting 42 days postpartum, until they had at least two potentially fertile cycles (defined as cycles with adequate levels of urinary estrogens (E) and pregnanediol glucuronide and a long enough luteal phase to support a pregnancy). We examine this existing data set. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Probability of pregnancy from intercourse on different days of the cycle relative to ovulation for breastfeeding women following the instructions of the Standard Days Method or the TwoDay Method. RESULT(S): These two methods may be appropriate for different groups of breastfeeding women at different times. The Standard Days Method may be appropriate after cycle regularity is established, whereas the TwoDay Method may be a more effective option earlier in the postpartum period. CONCLUSION: A need remains for a more appropriate simple fertility awareness-based method during this early period.     

张景岳补肾阴阳观之探析

明代医学张景岳善用温补,重视补肾,并从理论的深度与实践的要求,认为：补肾之法,真阴为本,育阴之用,涵阳为度;扶阳之炒,培阴生阳,形成了独特的补肾阴阳观的学术思想。