牙体牙髓病科患者特点的2次调查结果比较

目的了解江苏省口腔医院牙体牙髓病科患者近8年来的变化。方法对同一位牙体牙髓病科医生2002年、2010年间接诊的患者台面记录情况进行汇总和统计描述,进行对比分析。结果第1次(2002年)诊治的患者人数和牙数分别为1 912和3 447,第2次(2010年)诊治的患者人数和牙数分别为880和1 269。两次结果相比,只有患牙的牙位构成没有变化(P>0.05),其余方面差别均有统计学意义:男性就诊比例从29.43%上升为35.46%;青少年和成年人的比例分别从12.50%和74.20%降低为8.53%和69.61%;"收入不稳定"人群和"低、无收入"人群的比例分别从8.52%和14.09%上升到26.41%和24.06%;实施"复杂治疗"者的比例从39.40%上升到44.36%;治疗后对疗效"很满意"者的比例从38.75%下降到19.56%;患者人均费用从95元升为180元,上升幅度为89.47%,低于同城居民人均可支配收入的增长幅度(209.18%);享受医保者的比例从7.9%上升至30.8%。结论 8年来,牙体牙髓病科的患者特点,除了患牙构成之外,其余方面均有变化。     

CAD/CAM氧化锆及Empress全瓷冠修复三年临床效果比较

目的:比较CAD/CAM氧化锆及Empress全瓷冠修复3年的临床效果。方法:选择350例患者共838个全冠修复体(其中CAD/CAM氧化锆全冠428颗、Empress铸瓷全冠410颗),平均观察期36.2±5月,随访检查基牙和修复体情况,分别对两组全瓷冠的存留率和修复成功率进行统计学分析。结果:观察期内共有41颗全瓷冠(19颗为氧化锆,22颗为Empress铸瓷)完全失败,需重新制作。氧化锆全瓷冠和Empress铸瓷全冠的存留率分别为95.1%和95.8%,成功率分别为90.7%和91.2%,其差异均无统计学意义。结论:CAD/CAM氧化锆和Empres铸瓷全冠均能满足临床需要,有较好的修复效果。     

三种诊断标准对药物性肝损害诊断的比较与分析

目的 分析和比较三种药物性肝损害常见的诊断标准的差异性和准确性,以验证其临床实用价值.方法 采用回顾性研究的方法,对以“药物性肝损害”为第一诊断的119例患者按国际药物性肝损害分型标准进行临床分型,分析总结其致病药物种类,并运用ICM标准(RUCAM/CIOMS/Danan)、Maria标准、我国常用标准等诊断评分系统对其进行重新诊断,以比较不同诊断方法的差异性.结果 119例患者中肝细胞型共71例,占59.7％,胆汁淤积型28例,占23.5％,混合型20例,占16.8％.致病药物种类依次为:中药、抗结核类药物、抗生素、降脂类药物、保健品、解热镇痛类药、降压药、免疫抑制剂、他巴唑、肿瘤化疗类药物、降糖药物、胃药、藏药.在119例患者中,ICM标准的五项量化评分等级中,非常可能、很可能及可能三个评分等级累计共有115例(95.8％).我国常用标准中,有77例(64.7％)被纳入考虑范围.而Maria标准的五项评分等级中,无一例患者确诊为药物性肝损害.可能性大及有可能的两个评分等级累计仅14例(11.8％).结论 ICM标准对于药物性肝损害诊断符合率最高;我国常用标准对于亚洲人群诊断符合率尚可,应用简便,可操作性强;Maria标准与临床诊断符合率相对较低.     

Use of human liver and EpiSkin™ S9 subcellular fractions as a screening assays to compare the in vitro hepatic and dermal metabolism of 47 cosmetics-relevant chemicals

The abundance of xenobiotic metabolizing enzymes (XMEs) is different in the skin and liver; therefore, it is important to differentiate between liver and skin metabolism when applying the information to safety assessment of topically applied ingredients in cosmetics. Here, we have employed EpiSkin™ S9 and human liver S9 to investigate the organ-specific metabolic stability of 47 cosmetic-relevant chemicals. The rank order of the metabolic rate of six chemicals in primary human hepatocytes and liver S9 matched relatively well. XME pathways in liver S9 were also present in EpiSkin S9; however, the rate of metabolism tended to be lower in the latter. It was possible to rank chemicals into low-, medium- and high-clearance chemicals and compare rates of metabolism across chemicals with similar structures. The determination of the half-life for 21 chemicals was affected by one or more factors such as spontaneous reaction with cofactors or non-specific binding, but these technical issues could be accounted for in most cases. There were seven chemicals that were metabolized by liver S9 but not by EpiSkin S9: 4-amino-3-nitrophenol, resorcinol, cinnamyl alcohol and 2-acetylaminofluorene (slowly metabolized); and cyclophosphamide, benzophenone, and 6-methylcoumarin. These data support the use of human liver and EpiSkin S9 as screening assays to indicate the liver and skin metabolic stability of a chemical and to allow for comparisons across structurally similar chemicals. Moreover, these data can be used to estimate the systemic bioavailability and clearance of chemicals applied topically, which will ultimately help with the safety assessment of cosmetics ingredients.     

Sex and ancestry assessment of Brazilian crania using semi-automatic mesh processing tools

The present paper aims to test performances of semi-automatic tools for mesh-to-mesh processing while assessing sex and ancestry in documented human crania. The studied sample of 80 human crania, which originated in two documented Brazilian collections (São Paulo, Brazil) was digitized using photogrammetry and laser scanning. 3D cranial morphology was quantified by computing inter-mesh dissimilarity measures using in-house freeware FIDENTIS Analyst (www.fidentis.com). Numerical outputs were further processed using Discriminant Function Analysis and Canonical Variant Analysis in order to classify models into sex and ancestry groups. In addition, cranial morphology was described by a set of 37 landmarks, processed by a Procrustes analysis and confronted with the inter-mesh comparison. Patterns of sexual dimorphism and ancestral group-specific variation were interpreted using average meshes and further emphasized by employing advanced visualization graphics. The mesh-to-mesh processing was capable to detect shape differences related to sex and ancestry. The highest accuracy levels for sex determination were obtained for meshes representing the facial skeleton and the supraorbital region. For both, analysis correctly assigned 82.5% of the crania. Ancestry-related differences were manifested primarily in the global cranial features (observed accuracy rates reaching 63%). The advanced visualization tools provided a highly informative insight into sexual dimorphism and ancestry-related variation. While in the current state the technique cannot be considered suitable for being implemented into the everyday forensic practice, the extent of automatization proved to be perspective, especially for assessing skeletal features that cannot be properly quantified using discrete variables.     

贵州地区少数民族与汉族茶碱血药浓度与临床疗效对比研究

目的:通过血药浓度检测对比分析贵州地区少数民族与汉族人群茶碱体内代谢与临床疗效特点的差异。方法:分别测定少数民族与汉族患者达稳态血药浓度后的茶碱及其代谢物1,3-二甲基尿酸的血清浓度;使用SPSS 19.0统计软件进行分析,比较2组患者茶碱及其代谢物1,3-二甲基尿酸血药浓度的差异以及2组患者用药前后肺功能检查、血气分析检查等量化指标改变值的差异。结果:少数民族与汉族患者茶碱血药浓度的差异、用药前后肺功能检查中FEV1/FVC的改变值以及用药前后血气分析检查中SpO2的改变值都具有统计学意义,汉族患者组茶碱血药浓度要普遍高于少数民族患者组,且以上临床检查指标的改变值也高于少数民族患者组。结论:贵州地区少数民族与汉族患者使用氨茶碱后临床症状均有改善,但改善程度各有不同,汉族患者的茶碱血药浓度更高,肺通气功能的改善情况更好,能取得更好的临床疗效。提示不同民族人群中茶碱在体内经肝药酶CYP1A2代谢可能存在基因多态性差异。     

I Am Quite Mellow But I Wouldn't Say Everyone Else Is”: How UK Students Compare Their Drinking Behavior to Their Peers'

Background: Excessive drinking is commonplace at UK Universities. Individuals may misperceive how much they drink compared to others and are less likely to think that they will suffer adverse consequences. Young people often distance themselves and their friends from ‘problem drinkers’. Objectives: The aim of the study was to explore how student drinkers compared their own drinking behaviors to the drinking behaviors of others. Methods: An online survey was completed by 416 students aged 18–30 (68.5% female). They were asked ‘how do you think your drinking compares with other people like you?' and ‘how do you think your behavior when you drink compares with other people like you?’ Answers were subjected to thematic analysis. Results: The first main theme was about ‘identification as a ‘good’ drinker’. Participants suggested their own behavior when drinking was similar to their sober behavior. Further, they viewed themselves as more able to maintain a balance between staying in control and having fun while drinking. The second main theme was about ‘distancing from being a ‘bad’ drinker. Participants distanced themselves from negative prototypical drinkers, such compulsive or anti-social drinkers. They also attributed their own drinking behaviors to situational factors, but described other people as intentionally violent or aggressive. Conclusions/Importance: These findings may explain the failure of some health messages to change drinking behaviors. If drinkers perceive that their behavior when they drink is better than other people's then they may discount intervention messages. Targeting these biases could be incorporated into future interventions.     

Multisample adjusted U‐statistics that account for confounding covariates

Multisample U‐statistics encompass a wide class of test statistics that allow the comparison of 2 or more distributions. U‐statistics are especially powerful because they can be applied to both numeric and nonnumeric data, eg, ordinal and categorical data where a pairwise similarity or distance‐like measure between categories is available. However, when comparing the distribution of a variable across 2 or more groups, observed differences may be due to confounding covariates. For example, in a case‐control study, the distribution of exposure in cases may differ from that in controls entirely because of variables that are related to both exposure and case status and are distributed differently among case and control participants. We propose to use individually reweighted data (ie, using the stratification score for retrospective data or the propensity score for prospective data) to construct adjusted U‐statistics that can test the equality of distributions across 2 (or more) groups in the presence of confounding covariates. Asymptotic normality of our adjusted U‐statistics is established and a closed form expression of their asymptotic variance is presented. The utility of our approach is demonstrated through simulation studies, as well as in an analysis of data from a case‐control study conducted among African‐Americans, comparing whether the similarity in haplotypes (ie, sets of adjacent genetic loci inherited from the same parent) occurring in a case and a control participant differs from the similarity in haplotypes occurring in 2 control participants.     

Sequential parallel comparison design with binary and time‐to‐event outcomes

Sequential parallel comparison design (SPCD) has been proposed to increase the likelihood of success of clinical trials especially trials with possibly high placebo effect. Sequential parallel comparison design is conducted with 2 stages. Participants are randomized between active therapy and placebo in stage 1. Then, stage 1 placebo nonresponders are rerandomized between active therapy and placebo. Data from the 2 stages are pooled to yield a single P value. We consider SPCD with binary and with time‐to‐event outcomes. For time‐to‐event outcomes, response is defined as a favorable event prior to the end of follow‐up for a given stage of SPCD. We show that for these cases, the usual test statistics from stages 1 and 2 are asymptotically normal and uncorrelated under the null hypothesis, leading to a straightforward combined testing procedure. In addition, we show that the estimators of the treatment effects from the 2 stages are asymptotically normal and uncorrelated under the null and alternative hypothesis, yielding confidence interval procedures with correct coverage. Simulations and real data analysis demonstrate the utility of the binary and time‐to‐event SPCD.