药物流产与手术流产对再次妊娠的影响

目的　比较药物流产与手术流产对妇女再次妊娠孕期和分娩期的母儿影响 ,为临床选择恰当的人工流产方式提供依据。方法　按知情同意的原则 ,在曾经作过一次药物流产的健康孕妇中 ,随机选择 1 5 0例作为研究组 ;在曾经作过一次手术流产的健康孕妇中选择对照组 1 5 0例 ,研究组与对照组病例资料的基线的差异没有统计学意义 (P>0 .0 5 ) ,具有可比性。观察两组病例的孕期和分娩期母儿的并发症发生情况 ,并随访到分娩后 1周。结果药物流产后再次妊娠的先兆流产发生率、分娩期胎盘异常、早产儿和产后出血发生率比手术流产都低 (P<0 .0 5 ) ,其他结果在两组间的差异没有统计学意义。结论　药物流产对再次妊娠母儿的影响可能小于手术流产 ,故可以作为终止非意愿妊娠的首选 ,尤其是对未育妇女     

胫骨滋养动脉筋膜皮支游离皮瓣在手部皮肤缺损中的应用

目的介绍胫骨滋养动脉筋膜皮支皮瓣的临床应用。方法胫骨滋养动脉筋膜支发自胫骨滋养动脉，其外径为０．８～２．０ｍｍ，皮瓣可取面积不能超过１４ｃｍ×８ｃｍ，可携带隐神经。１９９５年８月～１９９７年３月，对８例手部皮肤缺损选用胫骨滋养动脉筋膜皮支游离皮瓣修复。结果８例皮瓣全部成活，皮瓣不臃肿，质地和手部相近。修复神经者皮瓣刺痛觉恢复满意。结论该皮瓣具有质地好、厚度适中并可修复感觉神经，不牺牲供区主要动脉等优点。其最佳适应证是修复手部重要功能区的皮肤缺损。     

Multiple cancer type classification by small RNA expression profiles with plasma samples from multiple facilities

Liquid biopsy is expected to be a promising cancer screening method because of its low invasiveness and the possibility of detecting multiple types in a single test. In the last decade, many studies on cancer detection using small RNAs in blood have been reported. To put small RNA tests into practical use as a multiple cancer type screening test, it is necessary to develop a method that can be applied to multiple facilities. We collected samples of eight cancer types and healthy controls from 20 facilities to evaluate the performance of cancer type classification. A total of 2,475 cancer samples and 496 healthy control samples were collected using a standardized protocol. After obtaining a small RNA expression profile, we constructed a classification model and evaluated its performance. First, we investigated the classification performance using samples from five single facilities. Each model showed areas under the receiver curve (AUC) ranging from 0.67 to 0.89. Second, we performed principal component analysis (PCA) to examine the characteristics of the facilities. The degree of hemolysis and the data acquisition period affected the expression profiles. Finally, we constructed the classification model by reducing the influence of these factors, and its performance had an AUC of 0.76. The results reveal that small RNA can be used for the classification of cancer types in samples from a single facility. However, interfacility biases will affect the classification of samples from multiple facilities. These findings will provide important insights to improve the performance of multiple cancer type classifications using small RNA expression profiles acquired from multiple facilities.     

基于数据挖掘技术探析针灸治疗中风后遗症的经穴特点

运用数据挖掘技术分析现代针灸治疗中风后遗症的经穴使用特点和规律.在收集针灸治疗中风后遗症的现代文献基础上,建立针灸处方数据库,主要采用数据挖掘技术中的关联规则方法,分析针灸治疗中风后遗症的经穴运用特点和规律.共纳入中风后遗症的针灸处方682条,共使用腧穴253个,总频次5395次,选用的腧穴遍布十四经脉,四肢和头颈部分别占76.5％(4128/5395)和13.8％(744/5395),阳经的使用总频率为74.7％(4029/5395),特定穴占83.8％(4522/5395).表明针灸治疗中风后遗症选穴以循经为基础,重视局部取穴,配合远端用穴.首选阳经腧穴,分布主要在四肢,阳明经与少阳经的配伍关系最为常用;特定穴为选穴的主体,特别重视交会穴及肘膝关节以下的特定穴.     

Coffee and green tea consumption and subsequent risk of acute myeloid leukemia and myelodysplastic syndromes in Japan

Although coffee and green tea are suggested to reduce the risk of some types of cancers, only a few epidemiological studies have investigated their effect on the risk of acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS). Here, we investigated the association of coffee and green tea consumption and the risk of AML and MDS in a large‐scale population‐based cohort study in Japan. A total of 95,807 Japanese subjects (45,937 men and 49,870 women; age 40–69 years at baseline) were followed to the end of 2012, for an average of 18 years. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the association between coffee and green tea consumption at baseline and the risk of AML and MDS were assessed using a Cox proportional hazards model with adjustment for potential confounders. During 1,751.956 person‐years, we identified 85 AML cases and 70 MDS cases. Our findings showed no significant association between coffee consumption and the risk of AML, or between green tea consumption and the risk of AML or MDS. In contrast, we observed a decreasing dose‐response relationship between coffee consumption and the risk of MDS among men (almost none: reference, 1–4 times/week: HR = 0.83, 95% CI: 0.43–1.62; ≥1cups/day: HR = 0.47, 0.22–0.99, p for trend = 0.049). Stratified analysis by smoking status suggested that the observed relative risk for AML and MDS of coffee drinkers relative to non‐coffee drinkers might be due to residual confounding by smoking. These findings deserve further investigation in future studies.     

基于CS/结构的商品交易系统的设计与实现

本文介绍了一个基于CS/结构、以MicrosoftVisualC 6.0为开发平台的商品交易系统的设计与实现。该系统由VC 6.0开发程序界面、以SQLServer2000数据库作为后台信息存储。本文在实践的基础上,详述了该系统的系统设计、程序开发、ADO访问数据库等关键技术。     

Mortality risk among screened subjects of the specific health check and guidance program in Japan 2008–2012

Background

In Japan, the Specific Health Check and Guidance (Tokutei-Kenshin) has started in 2008. However, the relationship between the baseline characteristics and mortality has not been examined.

Methods

Subjects were those who participated at the 2008 Tokutei-Kenshin in six districts with baseline data of serum creatinine. Using National database of death certificate from 2008 to 2012, we identified those who might have died and confirmed further with the collaborations of the regional National Health Insurance agency and public health nurses. The data was released to the research team supported by the Ministry of Health, Labor, and Welfare of Japan, and is governed by strict regulation and is completely encrypted with the individual’s name and residence. Causes of death were classified by ICD-10.

Results

Among the total of 295,297 subjects, we identified 3764 fatal cases by end of 2012. The median BMI was 23.8 kg/m² in men and 22.5 kg/m² in women, respectively. Proteinuria, dipstick 1+ and over, was positive in 5.3%. The median eGFR was 73.8 ml/min/1.73 m² among those with data available in 81% of the total cohort (N?=?239,274). The leading cause of death was neoplasm in both genders. It was 51.6% of the total, 50.4% in men and 53.7% in women. The second cause of death was circulatory; 20.4% of the total, 21.1% in men and 19.2% in women.

Conclusion

Half of the causes of death was related to neoplasm among the cohort of the Tokutei-Kenshin. Effects of baseline demographics such as lifestyle and CKD remained to be studied.