阴道酵母样真菌感染的3种实验室检测方法比较

目的采用3种方法平行检测阴道酵母样真菌感染，比较它们的优缺点，寻求最佳检测方法。方法对患有阴道炎病人的阴道分泌物同时用改良盐水湿片法、超高倍显微诊断仪（MCMDI）法扣酵母样真菌培养法进行检测，然后作统计分析。结果共检测420例阴道炎病人标本，改良盐水湿片法、MCMDI法扣培养法的阴道酵母样真菌检出阳性率分别为22．38％（94／420）、39．52％（166／420）争40．00％（168／420），后两法栓出总符合率达97．62％。结论改良盐水湿片法、MCMDI法都能快速检测酵母样真菌，但前者比后者阳性率低，容易漏诊；MCMDI法跟培养法的阳性率差不多，可用作早期快速诊断，而培养法虽然阳性率高，且可鉴定到菌种扣做药敏试验，给临床用药提供参考，但耗时长（平均3～5d），不利于快速诊断扣早期治疗。     

对新型农村合作医疗补偿方案中起付线的探讨

在新型农村合作医疗试点过程当中．各个试点县都根据当地情况设置了不同的补偿方案．在试运行一段时间后，大部分县对补偿方案做了调整，对起付线的调整是其中很重要的一个方面，如何调整起付线是新型农村合作医疗管理面临的一个问题。通过对全国159个样本县的起付线情况进行分组观察，运用统计学方法进行实证分析。最终，提出了起付线的设置方式和起付线的大小及相应的建议。     

Cost-effectiveness analysis of a multinational RCT with a binary measure of effectiveness and an interacting covariate

In a recent multinational randomized clinical trial, 1356 patients from 14 countries were randomized between two arms. The primary measure of effectiveness was 30-day survival. Health care utilization was collected on all patients and was combined with a single country's price weights to provide patient-level cost data. The purpose of this paper is to report the results of the cost-effectiveness analysis for the country that provided the cost weights, so as to provide a case study for illustrating recently proposed methodologies that account for skewed cost data, the between-country variation in treatment effects, possible interactions between treatment and baseline covariates, and the difficulty of estimated adjusted risk differences. A hierarchal model is used to account for the two sources of variation (between country and between patients, within a country). The model, which uses gamma distributions for cost data and recent methods for estimating adjusted risk differences, provides overall and country-specific estimates of treatment effects. Model estimation is facilitated by Markov chain Monte Carlo methods using the WinBUGS software. In addition, the theory of expected value of information is used to determine if the data provided by the trial are sufficient for decision making.     

血袋保养液在抗-HCV酶免试剂应用中的影响

目的了解血袋内装保养液在国产抗-HCV酶免试剂应用中,对检测结果的影响程度。方法取效期内使用的CPDA血袋保养液按1:7比例混合抗-HCV低值阳性血清,在同一微板、同样加样手法条件下,平行做未稀释血清、稀释后血清、血袋保养液各20孔,重复及对照试验各做3孔。结果血袋保养液对抗-HCV检测结果本底无影响,对低值阳性血清即弱阳性标本影响较大,在一定范围内可造成结果的漏检。结论采集血液后留取血样标本或重验标本,应考虑到有无血袋内装保养液或其它溶液的影响,以减少结果的不准确性。     

Ranson评分在高脂血症性急性胰腺炎病情严重程度评估中的应用价值

目的探讨Ranson评分在高脂血症性急性胰腺炎病情严重程度评估中的应用价值。方法回顾性选取2016年2月至2021年2月北京中医医院怀柔医院中重度高脂血症性急性胰腺炎患者100例,依据病情严重程度分为中度组(全身或局部并发症2 d以上无持续性器官衰竭或短暂性器官衰竭2 d内消退,n=40)、重度组(2 d以上持续性器官衰竭可能对肾脏、心血管、呼吸等系统至少一个器官造成累及,n=60)两组。统计分析两组患者的临床资料、Ranson评分,并统计分析不同Ranson评分患者的多脏器功能衰竭综合征、感染、局部并发症发生情况、死亡情况。结果两组患者的性别构成比、年龄、血脂最高水平之间的差异均无统计学意义(P> 0.05),重度组患者血糖> 11 mmol/L、血钙≤2 mmol/L、LDH> 350 U/L、白细胞数计数> 16×10⁹/L、Hct降低> 16×10⁹/L、碱缺乏> 6 mmol/L、液体需要量> 6 L的患者比率、Ranson评分均高于中度组,差异均有统计学意义(P <0.05)。重度组...     

分次切除在皮肤病损治疗中的应用价值

目的探讨分次切除在皮肤病损治疗中的应用价值。方法通过10年来对498例皮肤病损患者接受分次切除治疗的观察和分析,评估了皮肤病损分次切除的疾病适应证、部位适应证、切口的合理安排和优缺点等。结果所有病例中切除次数为2次的病例457例,治疗时间5~13月,平均(8.06±3.45)月;3次及以上41例,平均(3.12±0.32)次,治疗时间12~21月,平均(13.76±1.34)月。术后随访6~13月,复发5例,其中色素痣3例,疤痕疙瘩2例。色素痣再次手术切除后无复发,疤痕疙瘩采取切除加放疗后无复发。结论分次切除在较大面积及特殊部位的皮肤病灶切除术中有其特有的优点和临床应用价值。     

非生殖系统肿瘤卵巢转移的误诊原因及外科治疗

目的：探讨非生殖系统肿瘤卵巢转移的诊断和治疗方法.方法：回顾分析我院1990～2004年收治的41例经手术治疗及病理学确诊的非生殖系统肿瘤卵巢转移患者的临床资料.结果：患者平均年龄47.3岁,其中29（70.7%）例尚未绝经.原发灶为胃癌者17例,大肠18例,小肠2例,肺1例,肾上腺 1例,输尿管1例,膀胱1例.41例患者均行手术治疗.结论：该病90.24%（37/41）来源胃肠肿瘤,因此对于双侧卵巢肿瘤患者应注意胃肠检查.     

Machine Learning Approaches for Monitoring of Tool Wear during Grey Cast-Iron Turning

The dynamic development of new technologies enables the optimal computer technique choice to improve the required quality in today’s manufacturing industries. One of the methods of improving the determining process is machine learning. This paper compares different intelligent system methods to identify the tool wear during the turning of gray cast-iron EN-GJL-250 using carbide cutting inserts. During these studies, the experimental investigation was conducted with three various cutting speeds vc (216, 314, and 433 m/min) and the exact value of depth of cut a_p and federate f. Furthermore, based on the vibration acceleration signals, appropriate measures were developed that were correlated with the tool condition. In this work, machine learning methods were used to predict tool condition; therefore, two tool classes were proposed, namely usable and unsuitable, and tool corner wear VBc = 0.3 mm was assumed as a wear criterium. The diagnostic measures based on acceleration vibration signals were selected as input to the models. Additionally, the assessment of significant features in the division into usable and unsuitable class was caried out. Finally, this study evaluated chosen methods (classification and regression tree, induced fuzzy rules, and artificial neural network) and selected the most effective model.     

Correlation between C-reactive protein/albumin ratio and prognosis in patients with lung adenocarcinoma

ObjectiveThis study was performed to examine the relationship between the C-reactive protein/albumin ratio (CAR) and the prognosis of patients with lung adenocarcinoma and thus provide a reference for evaluating the prognosis of lung adenocarcinoma.MethodsThe clinical data of 130 patients with lung adenocarcinoma were retrospectively collected and analyzed. The patients’ overall survival (OS) time was calculated, and the factors affecting OS were statistically analyzed.ResultsThe CAR was correlated with sex, clinical stage, brain metastasis, S100 calcium-binding protein B (S100B), interleukin 17, myelin basic protein, squamous cell carcinoma antigen (SCC-Ag), and the lymphocyte count. The median OS was significantly shorter in the high- than low-CAR group (18 vs. 64 months, respectively). The CAR, clinical stage, brain metastasis, S100B, interleukin 17, SCC-Ag, C-reactive protein, albumin, and neutrophil count affected the OS of patients with lung adenocarcinoma. The CAR and clinical stage were independent risk factors for a poor prognosis in patients with lung adenocarcinoma.ConclusionsThe CAR and clinical stage are independent risk factors for OS in patients with lung adenocarcinoma.