莒县胃癌年龄别死亡率Gompertz曲线拟合的探讨

采用Gompertz曲线对莒县1986～1990年胃瘤年龄别死亡率进行了拟合检验,并与直线、指数曲线、二次抛物线进行了比较,以Gompertz曲线拟合比较理想。描绘了胃癌死亡率年龄分布的理论轨迹,为胃癌死亡预测提供了一种简便科学的方法。     

Anatomic basis of the liver for the development of a perihepatic prosthesis

We studied specimens from 50 cadavers (27 men and 23 women) to obtain anatomical data concerning the liver and its attachments. The results allowed us to develop a polyglactin perihepatic prosthesis for compression of the injured liver. The falciform ligament and a narrowing of the hepatic parenchyma at this level allow attachment of the prosthesis. Separate prostheses were designed for each lobe. Clinical use has demonstrated that our prosthesis can be used to achieve effective control of haemorrhage and bile leakage.

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Etude anatomique du foie. Développement d'une prothèse péri-hépatique

Résumé Sur une série de 50 pièces anatomiques d'adultes (27 hommes, 23 femmes), l'étude morphométrique du foie, de ses attaches dorsales et leurs variations a permis la confection d'une prothèse périhépatique en polyglactine adaptable à chaque lobe et fixée grâce à des artifices anatomiques. Celle-ci assure une compression efficace du parenchyme lésé et donc une hémostase et une bilistase correctes. Le ligament falciforme et le rétrecissement du parenchyme hépatique à son niveau assurent le maintien de la prothèse. Un exemplaire a été réalisé pour chaque lobe.

     

Biometry of infrarenal inferior vena cava measured by cavography

Summary Placement of a transvenous vena cava filter has became a common way to control recurrent pulmonary embolism. However few studies have been reported on the diameter of the infrarenal inferior vena cava (IIVC) where the device is usually placed. This study based upon 100 cavographies has showed the calculated average diameter of IIVC was 20.9 mm (range 12–27 mm) in its middle part and 21.3 mm (range 10–31 mm) in its terminal end. The calculated average IIVC length was 96 mm (range 80.3–142 mm). There was no statistical correlation between caval size and age, sex, height, weight and corporeal area. There was a statistical difference of left renal vein location between patients presenting with lumbar arthrosis and those without. We discuss different methods to measure IIVC in particular tomodensitometry. CT scans reviewed in our department show that the largest diameter of IIVC is not in a frontal plane and that the width seen on cavography is the projection of the largest diameter on the film. Therefore, the range of the real caval diameters is greater than indicated above.

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Biométrie de la v. cave inférieure sous-rénale: mesure par cavographieApplication clinique

Résumé L'utilisation de filtre cave endoveineux pour prévenir une récidive d'embolie pulmonaire est devenue d'un usage courant. Cependant peu de travaux ont été faits sur le diamètre de la veine cave inférieure infrarénale (IIVC) où l'appareil est généralement situé. Cette étude a pour but d'étudier le diamètre transversal de la VCI sousrénale (VCISR) à partir de 100 cavographies réalisées dans des conditions techniques identiques. Le diamètre moyen de la VCISR est de 20.9 mm (extrême 12–27 mm) dans sa partie moyenne et de 21.3 mm (extrême 10–31 mm) au niveau de sa terminaison. La longueur moyenne de la VCISR est de 96 mm (extrême 80,3–142 mm). L'âge, le sexe, la taille, le poids, la surface corporelle n'influencent pas les dimensions de la VCISR. Il existe une différence statistiquement significative de l'abouchement de la v. rénale gauche entre les sujets ayant une arthrose lombaire et ceux qui en sont dépourvus.La cavographie reste un examen de base en matière d'exploration de la VCI. La connaissance des variations des dimensions de la VCISR qu'elle apporte est donc indispensable. L'intérêt de cette étude est cependant limité par le fait que l'image radiologique correspond en réalité à la projection du diamètre transversal réel. Des études complémentaires utilisant en particulier la tomodensitométrie sont donc nécessaire pour préciser une éventuelle relation entre le diamètre réel et le diamètre mesuré par cavographie.

     

Comparison of Preoperative and Postoperative Ocular Biometry in Eyes with Phakic Intraocular Lens Implantations

Purpose

To compare preoperative and postoperative ocular biometry in patients with iris-fixated phakic intraocular lens (pIOLs): Artisan and Artiflex.

Materials and Methods

This study included 40 eyes with Artisan and 36 eyes with Artiflex pIOL implants. Anterior chamber depth (ACD) and axial length (AL) were measured by applanation ultrasonography (A-scan) and partial coherence interferometry (IOLMaster) preoperatively and 3 months after pIOL implantation.

Results

ACD measurements after Artisan or Artiflex pIOL implantation were smaller than preoperative measurements. Specifically, the difference after Artisan pIOL implantation was -1.07±0.17 mm by A-scan and -0.08±0.08 mm by IOLMaster. The difference after Artiflex pIOL implantation was -1.31±0.15 mm by A-scan and -0.05±0.07 mm by IOLMaster. After Artisan pIOL implantation, differences in AL measurements by A-scan were insignificant (difference: -0.03±0.15 mm), whereas postoperative AL measurements by IOLMaster were significantly longer than preoperative measurements (difference: 0.12±0.07 mm). After Artiflex pIOL implantation, AL measurements by both A-scan and IOLMaster were significantly longer than preoperative measurements (difference: 0.09±0.16 mm by A-scan and 0.07±0.10 mm by IOLMaster). In the Artiflex group, differences in AL measurements by A-scan correlated with the central thickness of the Artiflex pIOL.

Conclusion

ACD and AL measurements were influenced by iris-fixated phakic IOL implantation.     

Quantification of training in obstetrical ultrasound: a study of family practice residents.

This study was done to determine how rapidly physicians in training could become competent in performing obstetrical ultrasound for the purposes of routine evaluations (i.e., the standard examination as defined by AIUM). The scan measurements and results of organ surveys of 12 family medicine residents were compared with the results obtained by faculty members experienced in obstetrical ultrasound. Residents rapidly became proficient in biometry. The mean menstrual age calculated from BPD, AC, HC, and FL differed from faculty values by 0.381 weeks after residents had performed 40 supervised scans. Organ survey success rates demonstrated similar high concordance between resident and faculty scans.     

缺碘牲地甲肿防治效果的指数曲线y=ae~(bx)的模拟

采用指数曲线方程y=aeb(?)对临沂地区1979年～1989年10年的碘盐防治地甲肿效果资料进行了数学模拟,并建立了地甲肿防治效果数学模型。该模型探讨了地甲肿人群患病率、肿大率与碘盐防治年限的定量关系。利用该模型可对地甲肿防治效果进行预测预报和评价工作,可描绘出地甲肿患病率、肿大率在不同防治年限的理论分布轨迹。     

A超分段测量法在硅油填充眼并发白内障三联手术中应用

目的 评价A超分段测量法对硅油填充眼进行生物测量的准确性,以及“白内障超乳摘除、硅油取出联合人工晶状体植入术”治疗硅油填充眼并发白内障的安全性及手术效果.方法 临床病例系列研究.对2009年1月至2010年12月在襄阳市第一人民医院眼科选取硅油填充眼并发性白内障患者11例11只眼,术前使用A超分段测量法进行生物测量.术中经巩膜隧道切口行白内障超乳摘除,经睫状体平坦部穿刺口置入20G套管针抽吸出玻璃体腔内硅油,囊袋内植入PMMA或丙烯酸酯折叠人工晶状体.随诊至术后6个月.结果 术前硅油填充眼眼轴长度为22.17 ～ 29.38 mm,平均(25.46±2.20) mm.所有患者手术经过顺利,人工晶状体植入囊袋,随访至术后6月无特殊并发症发生.裸眼视力0.1～0.3者8例8只眼,0.4～0.6者3例3只眼.屈光状态(等效球镜度)介于-1.5 ～+0.25 D之间,与目标屈光状态的平均绝对屈光误差值为(0.77±0.32)D(0.25～1.25D).结论 “三联手术”治疗硅油填充眼并发白内障安全、可靠,效果良好,“A超分段测量法”可对并发白内障的硅油填充眼进行准确的生物测量,并计算出合适的人工晶状体度数.     

Correction of logistic regression relative risk estimates and confidence intervals for systematic within-person measurement error

Errors in the measurement of exposure that are independent of disease status tend to bias relative risk estimates and other measures of effect in epidemiologic studies toward the null value. Two methods are provided to correct relative risk estimates obtained from logistic regression models for measurement errors in continuous exposures within cohort studies that may be due to either random (unbiased) within-person variation or to systematic errors for individual subjects. These methods require a separate validation study to estimate the regression coefficient lambda relating the surrogate measure to true exposure. In the linear approximation method, the true logistic regression coefficient beta* is estimated by beta/lambda, where beta is the observed logistic regression coefficient based on the surrogate measure. In the likelihood approximation method, a second-order Taylor series expansion is used to approximate the logistic function, enabling closed-form likelihood estimation of beta*. Confidence intervals for the corrected relative risks are provided that include a component representing error in the estimation of lambda. Based on simulation studies, both methods perform well for true odds ratios up to 3.0; for higher odds ratios the likelihood approximation method was superior with respect to both bias and coverage probability. An example is provided based on data from a prospective study of dietary fat intake and risk of breast cancer and a validation study of the questionnaire used to assess dietary fat intake.     

Adjustment of risk ratios in case-base studies (hybrid epidemiologic designs)

The recent growth of occupational epidemiology has led to a resurgence of interest in the hybrid epidemiologic study design of Kupper et al., which has come to be termed a 'case-base' or 'case-cohort' design. This paper shows how the adjustment method for the risk ratio estimate given by Kupper et al. may have substantial bias, and also shows how one must modify conventional adjustment techniques (such as the Miettinen, Woolf and Mantel-Haenszel methods) when used with hybrid designs. This paper also provides the necessary modifications for tests and confidence intervals.     

Malformations in infants of diabetic mothers: problems in study design

Infants of diabetic mothers have a two- to threefold increased risk of having congenital malformations. Primary prevention of these malformations may be possible if the teratogenic mechanisms in diabetes can be identified. The Diabetes in Early Pregnancy Study (DIEP) addresses the questions of high malformation rates and fetal losses using an innovative study design. Women are recruited prior to pregnancy, monitored to ensure prompt diagnosis of pregnancy, and followed carefully for diabetic problems or fetal losses. To date, 450 diabetic and 550 normal control prepregnant women have been recruited. A basal body temperature monitoring system has been successful in identifying pregnant women within 21 days of conception. Before initiating such a study, problems of feasibility, study design, and possible bias had to be solved. This report summarizes our experience in designing and conducting a prospective pregnancy study. The DIEP demonstrates that a truly prospective pregnancy study is feasible.