超声检测血管内皮功能的方法学及观测指标

心血管疾病的发生发展,多以心血管内皮功能障碍开始。对长期接触血管内皮损伤危险因子的人群,进行血管内皮功能的早期检测,发现异常,早期采取对策,对预防及延缓心血管疾病发生发展,具有较为重要的意义。采用高分辨率超声检测血管内皮功能,获得与有创方法相似的结论,但在方法学及观测指标上有所不同,现作一简要综述。     

促甲状腺激素液相芯片检测法的建立和方法学评价

目的建立用液相芯片技术测定促甲状腺激素(TSH)的方法,对其方法学和临床应用价值作评价。方法通过抗TSH的单抗交联单色荧光微球,采用标记有生物素的另一配对抗TSH的单抗以及由藻红蛋白(PE)标记的亲合素组成相应的荧光报告系统,用液相芯片仪Luminex100检测待检标本荧光强度,通过TSH标准浓度绘制出标准TSH浓度荧光强度剂量曲线。用液相芯片技术测定100份临床血清标本的TSH浓度并与拜尔的化学发光法的测定结果做方法学比较。结果液相芯片技术测定TSH的线性范围为0.3~162μIU/mL,高、中、低3个浓度的批内精密度为10.00%、6.91%、17.80%。高、中、低3个浓度的回收率为94.3%、96.7%、95.2%。与拜尔的化学发光法的相关系数为0.965(P=8.77×10-57)。结论本研究建立的液相芯片技术在TSH测定中的主要技术指标与拜尔的化学发光法相近,有临床应用价值。     

天然抗菌肽分离纯化方法的建立

目的寻找高效、广谱的新型天然抗菌肽，建立稳定、有效的分离纯化方法。方法家蝇免疫诱导后制成组织匀浆，经超速离心、分子筛过滤、SephadexG50层析、反相高效液相色谱法（RP-HPLC）、透析浓缩等技术进行分离纯化，用K-B法鉴定抗菌活性。结果组织提取液经超速离心后，用pH6．8Tris-HCI尿素缓冲液作流动相，SephadexG50层析，收集到有明显抗菌活性的成分。再用pH6．8磷酸盐缓冲液作流动相，经RP-HPLC半制备柱进一步纯化，各成分分离效果良好，保留时间为18．008min处的谱峰，有明显的抗菌活性。用RP-HPLC分析柱显示其为单一成分，达到了色谱纯。该抗菌肽对大肠埃希菌ATCC25922、铜绿假单胞菌ATCC27853和耐甲氧西林金黄色葡萄球菌（methicillin-resistantS．aureus，MRSA）均有抗菌活性。结论建立了有效的家蝇抗菌肽分离纯化方法，纯化的家蝇抗菌肽有广谱抗菌活性。     

循证医学术语介绍Ⅱ

作为循证医学术语系列的第2篇文章,我们主要向读者详细介绍循证医学术语定名、定义原则,纳入与筛选标准,规范流程,报告格式及数据库的建设。     

血清游离脂肪酸酶法测定的方法学评价及生物学变异研究

目的评价血清游离脂肪酸(FFA)酶学比色法(简称酶法)的精密度和正确度,并且研究血清FFA个体间和个体内生物学变异。方法采用美国临床和实验室标准化协会(CLSI)EP5-A2和EP15-A文件评价酶法测定血清FFA的精密度和正确度。生物学变异的研究对象为13名健康志愿者,在6周时间内每2周测定1次血清FFA浓度,利用SAS9.1软件中MIXED分析过程计算个体间生物学变异和个体内生物学变异。结果精密度实验样品的血清FFA浓度总均数为0.796 mmol/L,批内、批间、日间和室内不精密度分别为2.15%、3.44%、3.67%和5.46%。测定3个室间质评样品的百分比偏差分别为24.20%、-0.90%、-1.50%。血清FFA个体间和个体内生物学变异分别为8.43%、19.36%。结论酶法测定血清FFA的精密度和正确度能满足相关实验室质量控制要求。血清FFA的个体间和个体内生物学变异可为制定实验室质量规范和临床课题的科研设计提供参考依据。     

循证性临床实践指南的制定程序与方法研究

通过对英国国家卫生与临床优化研究所(NICE)、苏格兰院际间指南协作网(SIGN)以及指南研究和评价国际协作组织(AGREE)等国际临床实践指南开发与评价机构关于指南制定方法学的研究,介绍循证性临床实践指南的制定程序与方法,以期为中医相关指南的制定提供方法学支持.     

中医证候规范研究思路和方法概况

证候是中医药理论核心内容之一,其理论大多以学术流派形式分布于多种著作和文献中,如何进行有效的规范,是一项极富于挑战性的工作。现从方法学研究入手,探讨了证候规范研究的设计、测量和评价方法问题,希望对中医证候规范研究有所启发。     

A menopause-specific quality of life questionnaire: development and psychometric properties

Objective:

to develop a condition-specific quality of life questionnaire for the menopause with documented psychometric properties, based on women's experience. Methods: Subjects: Women 2–7 years post-menopause with a uterus and not currently on hormone replacement therapy. Questionnaire development: A list of 106 menopause symptoms was reduced using the importance score method. Replies to the item-reduction questionnaire from 88 women resulted in a 30-item questionnaire with four domains, vasomotor, physical, psychosocial and sexual, and a global quality of life question. Psychometric properties: A separate sample of 20 women was used to determine face validity, and a panel of experts was used to confirm content validity. Reliability, responsiveness and construct validity were determined within the context of a randomized controlled trial.Construct validation involved comparison with the Neugarten and Kraines' Somatic, Psychosomatic and Psychologic subscales, the reported intensity of hot flushes, the General Well-Being Schedule, Channon and Ballinger's Vaginal Symptoms Score and Libido Index, and the Life Satisfaction Index.

Results:

The face validity score was 4.7 out of a possible 5. Content validity was confirmed. Test-retest reliability measures, using intraclass correlation coefficients were 0.81, 0.79, 0.70 and 0.55 for the physical, psychosocial, sexual domains and the quality of life question. The intraclass correlation coefficient for the vasomotor domain was 0.37 but there is evidence of systematic change. Discriminative construct validity showed correlation coefficients of 0.69 for the physical domain, 0.66 and 0.40 for the vasomotor domain, 0.65 and −0.71 for the psychosocial domain, 0.48 and 0.38 for the sexual domain, and 0.57 for the quality of life question. Evaluative construct validity showed correlation coefficients of 0.60 for the physical domain, 0.28 for the vasomotor domain, 0.55 and −0.54 for the psychosocial domain, 0.54 and 0.32 for the sexual domain, and 0.12 for the quality of life question. Responsiveness scores ranged from 0.78 to 1.34.

Conclusions:

The MENQOL (Menopause-Specific Quality of Life) questionnaire is a self-administered instrument which functions well in differentiating between women according to their quality of life and in measuring changes in their quality of life.     

Why computer models help to understand developmental processes

It is argued that simulating psychological processes by means of computer models is a valuable technique to increase our understanding of adolescent developmental processes. Modelling offers possibilities to test hypotheses that cannot be reached by designing empirical studies only and it allows us to investigate adolescent development as the complex and non-linear process that it is.     

Calculating clinical progression rates in Parkinson's disease: Methods matter

IntroductionDisease progression in Parkinson's disease is often calculated in data from cross-sectional studies, where a severity score (e.g. UPDRS-motor score) is divided by disease duration. While this intuitively may seem a plausible approach, it is uncertain if these rates are similar to those calculated from longitudinal data. The aim of this study is to examine if progression rates calculated according to both methods yield the same results.MethodsWe calculated two progression rates in data from the PROPARK study: one where last follow-up SPES/SCOPA motor and activities-of-daily-living scores were divided by disease duration, and one in which baseline motor and activities-of-daily-living scores were subtracted from data collected at last follow-up, and where the difference was divided by the time that passed between both assessments. We subsequently calculated the rank order correlation between both approaches.ResultsWe found that progression rates calculated from cross-sectional data are 1.5–2 times higher than those calculated from longitudinal data, and that the correlation between both methods is <0.50.ConclusionProgression rates calculated from cross-sectional data not only overestimate actual progression, but also yield a different rank order. We also discuss potential explanations for the discrepancy between both methods and argue that the method of calculating progression rates in data from cross-sectional studies in PD should not be used.