多分类有序反应变量logistic回归应用条件的检验

目的 对多分类有序反应变量logistic回归的应用条件寻求科学合理的检验方法。方法 使用卡方分布的理论，SAS软件及抽样调查方法。结果 设计出多分类有序反应变量logistic回归应用条件的卡方检验方法，推导出反应变量取各水平的概率计算公式及卡方检验中理论值、自由度的计算公式，并在作者主持的国家医师资格临床实践技能考试研究中取得了成功效果。结论 多分类有序反应变量logistic回归得到完善和补充，具有较大的理论和实际意义。     

外固定器治疗肱骨外科颈粉碎骨折

肱骨近端粉碎性骨折的治疗目前仍是骨外科的一大难题，手法复位后以石膏或夹板固定常不能持续复位，影响肩关节功能；尺骨鹰嘴牵引，卧床时间长，老年人易出现其他并发症。自2001年6月-2003年6月，我们应用透视下闭合复位或切开复位外固定器固定治疗肱骨近端粉碎骨折20例，取得满意疗效。     

利培酮、氯氮平治疗精神分裂症患者生活质量的长期随访对照研究

目的　探讨长期服用利培酮对精神分裂症患者生活质量的影响作用。方法　对 1997年 7月～ 2 0 0 0年 6月住院服用利培酮或氯氮平治疗达痊愈或显著进步、出院后回归社会达 18个月及以上的 174例精神分裂症患者 (利培酮 89例、氯氮平 75例 )的生活质量进行了分别于 2 0 0 0年 7月和 2 0 0 1年 7月进行了两次追踪随访对照研究。结果　第二次随访利培酮组患者的随访成功率高于氯氮平组 (χ2 =34.11,P <0 .0 0 0 1) ;利培酮组患者的生活质量两次随访结果均极显著高于氯氮平组 ,且利培酮组患者的生活质量较之一年前随访又有新的提高 ,多元逐步回归分析表明 :出院时服用药物剂量和种类是影响患者生活质量的较强因素。结论　利培酮能够提高精神分裂症患者的生活质量 ,远期疗效更突出     

基于实验均方误差F值的基因表达数据最佳聚类评判方法研究

目的 近年来产生了一些用于分析基因表达数据的聚类算法，却很少有关于评价聚类算法方法的研究。本研究的目的是尝试建立一个定量的评价基因表达数据聚类结果的方法。方法 本研究提供了一个系统的评价聚类结果的方法，利用我们提出的实验均方误差F值对几个常见的聚类算法进行比较。结果 利用F值对类质量的评价和利用已有的生物学知识对类进行分析的结果一致。结论 实验均方误差F值可以定量地评判用于基因表达数据的聚类算法。     

特异性神经元抗体对神经系统副肿瘤综合征筛检价值的研究

目的　探讨特异性神经元抗体 (尤其是抗 Hu抗体 )对国内人群神经系统副肿瘤综合征 (paraneoplasticsyndromesofnervoussystem ,PNSNS)筛检诊断的特异性和灵敏性。方法　采用免疫组织化学ABC法和Westernblot对 2 0例PNSNS和 12 0例非PNSNS患者的血清进行检测 ,并采用流行病学筛检公式计算出特异度和灵敏度。结果　PNSNS组和非PNSNS组ABC法阳性结果差异有统计学意义 (χ2 =33 4 5 ,P <0 0 1) ,特异性神经元抗体筛检诊断PNSNS的灵敏度为 95 % ,特异度为 72 5 % ;PNSNS组和非PNSNS组Westernblot法阳性率差异有统计学意义 (χ2 =117 12 ,P <0 0 1) ,抗 Hu抗体筛检诊断的PNSNS的灵敏度为 95 % ,特异度为 98 3%。结论　血清特异性神经元抗体 (尤其是抗 Hu抗体 )是国内人群中PNSNS患者较敏感和特异性的血清标志物 ,在神经元的免疫损伤中具有重要作用     

利用主客体分子包结现象选择分离蛇床子有效成分的方法

利用1,1,6-四苯基-2,4-已二炔-1,6-二醇(I)的包结能力,可简单而迅速地从蛇床子中选择分离出有效成分欧前胡素(2)和花椒毒素(3),收率分别为0.054%(2)和0.002%(3)。本文用UV,IR,¹HNMR和¹³CNMR验证了2和3的化学结构,并用HPLC检验了2和3的纯度。X-射线衍射晶体结构分析表明主体分子I与组分2靠氢键形成包结物,它们的摩尔比为1:2,氢键长为2.8612A。包结物晶体属单斜晶系,空间群为已P₂₁/C,晶胞参数:a=15.468(5)A,b=8.595(3)A,c=18.663(7)A,β=93.64(5)°,Z=4和R=0.088。     

Acute subcortical stroke and early serotonergic modification: a IDAP study

The intensity dependence of the auditory-evoked potentials (IDAP) is inversely related to serotonergic tone. Depression is frequently observed after stroke, associated with cognitive impairment and increased mortality. Aim of this study was to investigate the serotonergic tone in acute stroke patients by IDAP. Consecutive patients with an acute stroke admitted in our stroke unit were evaluated using clinical and instrumental examinations and compared with healthy controls. The IDAP was calculated as the linear amplitude/stimulus intensity function (ASF) slope, by measuring the peak-to-peak amplitude of Nl-P2 on four blocks of different stimulus intensities. Twenty patients were enrolled; 11 had a right brain infarction; nine had depressive symptoms (DS). The ASF slope of the auditory-evoked potentials was markedly increased in stroke patients compared with controls ( P  = 0.021). Stroke patients with DS had a significant steeper ASF slope than controls ( P  = 0.017). There was no statistical difference in ASF slope between stroke patients without DS and controls. Post-stroke depression pathophysiology is still debated. Our study suggests that in acute stroke patients with DS, there is a direct involvement of the serotonergic system, regardless the degree of disability and the site of the lesion.     

口外弓配合唇档远移磨牙的临床研究

目的:研究口外弓配合唇档远移磨牙的临床应用及其疗效。方法:选择15例恒牙早期上颌轻度牙性前突或轻、中度拥挤的安氏II类患者,应用口外弓配合唇档,通过X线头影测量观察其上颌磨牙及前牙治疗前后变化情况。结果:应用口外弓配合唇档推磨牙向远中3～6个月后,II类咬合关系恢复至安氏I类关系。上颌第一磨牙向远中平均移动4.14mm,上颌中切牙向唇侧移动0.66mm。结论:只要病例选择合适,方法运用得当,口外弓配合唇档就能获得较满意的远移磨牙的疗效。     

Identifying the affected hemisphere by 1H-MR spectroscopy in patients with temporal lobe epilepsy and no pathological findings in high resolution MRI

Up to 30% of patients with temporal lobe epilepsy (TLE) remain without remarkable changes in MRI. In this study we investigated the role of (1)H-MR spectroscopy ((1)H-MRS) in lateralizing the affected hemisphere in the mentioned patient group. Twenty-two consecutive patients diagnosed with TLE were investigated by high resolution MRI and (1)H-MRS. We examined the incidence and diagnostic accuracy of temporal metabolite alterations determined by Linear Combination of Model Spectra (L C Model) via water reference. Metabolite values of each hemisphere of TLE patients were compared with healthy controls. Results of metabolite alterations were related to intensive video EEG focus localization. Reduction of N-acetylaspartate + N-acetylaspartyl-glutamate (tNAA) in the affected hemisphere revealed identification in six of nine patients (66%) with unilateral TLE. Group comparison revealed a significant reduction of tNAA (6.1+/-0.8*) in the involved temporal lobe compared with controls (6.67+/-0.4*, P=0.026). Choline levels were significantly increased in the affected hemisphere (1.42+/-0.17*) compared with healthy controls (1.22+/-0.17*, P=0.035). The results of our study show that (1)H-MRS is able to identify the affected hemisphere of MRI negative TLE patients and can be used as an additive tool in multimodal focus localization.