血清多肿瘤标志物判别方程建立及其对肺癌诊断及分类的意义

目的 探讨多肿瘤标志物联合检测系统在肺癌诊断及分类中的意义,并建立判别方程,以提高诊断正确率.方法 对601例肺癌患者、88例肺部良性疾病患者及1 203例正常体检者的12种常见肿瘤标志物检测结果及临床资料进行回顾性研究,通过Fisher二分类判别分析建立判别诊断及三种主要病理学类型分类方程.结果 单项指标中CEA、CA125和CA242阳性率分别为40.93%、29.78%和13.48%,与肺部良性疾病组和正常人群阳性率差异有统计学意义(P＜0.001),其中CEA对肺癌诊断差异有统计学意义(P＜0.001).建立肺癌诊断判别方程及分类诊断方程,其中肺癌诊断符合率为89.10%,同时分类诊断符合率为86.10%(鳞癌),92.10%(腺癌)和95.60%(小细胞肺癌)均显著高于其对应的多项指标累加的诊断正确率及CEA单项诊断正确率(P＜0.01).结论 肺癌诊断及分类方程有助于临床对多肿瘤标志物意义的理解,能够有效提高肺癌及分类诊断的正确率,有推广应用价值.     

基于多成分定量及化学计量学的4种郁金特征性成分识别与质量评价

目的 测定分别来自四川、浙江、广西3个产地的4种郁金共20批中的12种成分含量,并评价其质量。方法 采用HPLC法测定4种郁金的化学成分谱,并通过主成分分析法（principal component analysis,PCA）和正交偏最小二乘分析法（orthogonal partial least squares-discriminate analysis,OPLS-DA）进行分析,识别4种郁金的特征成分,建立综合评价模式。结果 4种郁金的化学成分谱各具特征,通过PCA得到3个新变量累计方差贡献率达90.476%,在组间差异成份的基础上采用因子得分表达式综合评价郁金质量：黄丝郁金>温郁金>绿丝郁金>桂郁金,并根据郁金主要药理作用相关的化合物评价4种郁金,验证了评价模型的有效性。通过OPLS-DA模型的变量重要性投影（variable importance projection,VIP）值确定莪术二酮、吉马酮为种间差异的关键化合物,并应用模型的回归系数识别了4种郁金各自的特征性成分。结论 建立的郁金多成分测定方法线性关系良好、稳定可靠,通过化学计量学方法可以更全面、准确...     

健康老龄化：内涵辨析、测量方式与中国趋势

本研究通过辨析“成功老龄化”“健康老龄化”“积极老龄化”几个易混淆概念,梳理“健康老龄化”概念演变与内涵特点。对比当前各种“健康老龄化”测量工具对“健康老龄化”概念的契合与测量的优劣势,选取了基于项目反应理论的健康老龄化测量方式,应用2011—2018年四期中国健康养老与追踪调查数据,分别选择至少参与1期和4期全部参与的60岁及以上老年人,对健康老龄化变化趋势展开分析。研究发现,至少参与1期的老年人健康老龄化水平在2011—2015年有所上升,2015—2018年下降(“时期效应”);4期全部参与的老年人健康老龄化水平也先升后降,且降幅明显(“年龄效应”);我国老年人健康老龄化水平低于全球平均水平,西部地区明显低于东部地区,农村低于城市。提升我国健康老龄化水平,缓解区域间、城乡间的健康老龄化不平等对于促进健康公平、有效应对人口老龄化意义重大。     

HPLC测定贝母中尿嘧啶和3种核苷的含量及其在品种鉴定中的应用

目的建立测定浙贝、川贝、平贝和新疆贝母中尿嘧啶、尿苷、乌苷、腺苷含量和鉴定该4种药材品种的高效液相色谱法。方法色谱柱为Alltima C18（4．6mm×250mm,5μm）;流动相为甲醇-水溶液;梯度洗脱,洗脱条件为0．0min→5．0min→10．0min→20．0min→30．0min→40．0min,甲醇：1％→1％→5％→12％→24％→31％;流速为0．8mL·min^-1;检测波长为260nm;柱温为25℃。进样体积为20μL。结果尿嘧啶和3种核苷均达到基线分离,线性良好,4种贝母中指标成分含量差异明显。结论该方法快速、准确、重复性好,可作为贝母类药材的核苷类成分的含量测定方法,同时亦可用于准确、可靠的鉴定该4种贝母药材。     

Once covered,forever covered: The actuarial challenges of the Belgian private health insurance system

The Belgian Law of 20 July 2007 has drastically changed the Belgian private health insurance sector by making individual contracts lifelong with the technical basis (i.e. actuarial assumptions) fixed at policy issue. The goal of the Law is to ensure the accessibility to supplementary health coverage in order to protect policyholders from discrimination and exclusion, essentially when these operate on the basis of age. Due to the unpredictable nature of medical inflation risk and the difficulty to model future increases of health claims, the legislator introduced medical indices together with a specific updating mechanism, which aim at establishing standardized and fair premium adjustments across the sector. This paper considers two major issues of the current Belgian system. The first one is related to the transferability of the reserves, whereas the second one is related to age-discrimination. We discuss these issues and their interplay, and we address the conflict between the goal of the Law and the practical problems arising in the light of the actuarial techniques.     

Weight stigma and discrimination: Time for change!

The pervasiveness and negative impact of weight stigma and discrimination has highlighted the need to intervene across many levels of society. Instances of discrimination impinge on peoples’ human rights and societal values of equality, raising important questions for policymakers and legislators. The ingrained nature of weight stigma and discrimination throughout society means the systemic change that is warranted will not be easy or rapid. Within this article, several actions are suggested to reduce weight stigma and discrimination and in doing so, address this social justice issue. The article represents a long overdue call to end weight stigma and discrimination for the betterment of society.     

Probability discrimination learning in hippocampectomized rats

Rats with hippocampal lesions or neocortical lesions and normal rats were trained on a spatial probability discrimination task where one side of a T maze was reinforced on 70% of the trials and the other side on the remaining 30% of the trials. Training was to a criterion of 39 correct trials out of 40 using a noncorrection procedure. There was no difference between the learning rates of normal rats and with neocortical lesions, but the rats with hippocampal lesions learned the discriminiation more rapidly than the other two groups. These results indicated that the hippocampus does not function as a stimulus gating system, but is probably concerned in the selection and rejection of hypothese (central-sets).