吗氯贝胺与米帕明治疗抑郁症多中心双盲对照试验

目的 :以经典抗抑郁药物米帕明为阳性对照药采用随机双盲双模拟方法对吗氯贝胺和米帕明治疗抑郁症的疗效和安全性进行研究。方法 :共纳入病人 2 0 0例 ,分别口服吗氯贝胺 3 0 0 -60 0mg d或米帕明75 -2 5 0mg d。结果 :两组病人Hamilton抑郁量表 (HAMD)以及Hamilton焦虑量表 (HAMA)总分在治疗结束时均显著下降 (P <0 0 0 1)。两组之间疗效无显著差异 (p >0 0 5 )。治疗结束时HAMD减分率分别为吗氯贝胺组 0 74± 0 2 4,米帕明组 0 74± 0 2 4(P >0 0 5 ) ;有效率吗氯贝胺组 79 4% ,米帕明组 85 4% (P >0 0 5 )。吗氯贝胺组有 10种不良反应发生频率显著低于米帕明组 ,主要是抗胆碱能、中枢神经系统及心血管系统不良反应。吗氯贝胺的疗效指数也显著高于米帕明组。结论 :吗氯贝胺是一种安全有效的抗抑郁药物     

Multiple imputation technique applied to appropriateness ratings in cataract surgery

Missing data such as appropriateness ratings in clinical research are a common problem and this often yields a biased result. This paper aims to introduce the multiple imputation method to handle missing data in clinical research and to suggest that the multiple imputation technique can give more accurate estimates than those of a complete-case analysis. The idea of multiple imputation is that each missing value is replaced with more than one plausible value. The appropriateness method was developed as a pragmatic solution to problem of trying to assess "appropriate" surgical and medical procedures for patients. Cataract surgery was selected as one of four procedures that were evaluated as a part of the Clinical Appropriateness Initiative. We created mild to high missing rates of 10%, 30% and 50% and compared the performance of logistic regression in cataract surgery. We treated the coefficients in the original data as true parameters and compared them with the other results. In the mild missing rate (10%), the deviation from the true coefficients was quite small and ignorable. After removing the missing data, the complete-case analysis did not reveal any serious bias. However, as the missing rate increased, the bias was not ignorable and it distorted the result. This simulation study suggests that a multiple imputation technique can give more accurate estimates than those of a complete-case analysis, especially for moderate to high missing rates (30 - 50%). In addition, the multiple imputation technique yields better accuracy than a single imputation technique. Therefore, multiple imputation is useful and efficient for a situation in clinical research where there is large amounts of missing data.     

中国SCI期刊发展现状及与出版平台合作建议

【目的】 了解目前中国SCI期刊总体表现以及与国外出版平台的合作情况,为中国英文科技期刊平台建设,以及国外出版商的挑选提供参考。【方法】 以同时被SCI和《中科院期刊分区表》收录的中国科技期刊为数据源,对比分析相关学科期刊,以及不同出版平台的SCI期刊的表现。【结果】 总体上,中国大部分SCI期刊的影响因子及发文量较低,其中,与国际出版平台合作的SCI期刊表现相对更好,国内期刊平台建设相对较弱,不少出版社开始由“借船出海”转向“造船出海”,着力打造自己的国际出版平台。【结论】 中国SCI期刊实力总体偏弱且学科覆盖度不高,借船出海仍是目前提升中国科技期刊影响力较为有效的方式,而打造我国自己的国际出版平台的需求日益凸显。     

Comparison of Three Screening Methods for Sarcopenia in Community-Dwelling Older Persons

ObjectiveThe 2019 Asian Working Group on Sarcopenia in Older People (AWGS 2019) recommends using either calf circumference or the strength, assistance in walking, rising from a chair, climbing stairs, and falls (SARC-F) or SARC-F combined with calf circumference (SARC-CalF) questionnaires for sarcopenia screening. The aim of this study was to compare the ability and applicability of calf circumference, SARC-F, and SARC-CalF for screening sarcopenia among community-dwelling older adults.DesignCross-sectional study.Setting and ParticipantsA total of 1050 community-dwelling older people were enrolled.MethodsSarcopenia was diagnosed according to the AWGS 2019 criteria: bioimpedance analysis for appendicular skeletal muscle index, hand grip, and 6-m gait speed test. Participants also completed the SARC-F questionnaire and calf circumference measurement. The screening tools’ performances were evaluated through receiver operating characteristic (ROC) curves, area under the ROC curves (AUC), and sensitivity/specificity analyses.ResultsSarcopenia was identified in 263 (25.0%) participants by the AWGS 2019 criteria. Calf circumference had a sensitivity of 81.4% and a specificity of 77.0%. Sensitivity and specificity of SARC-F for screening sarcopenia were 17.9% and 93.7%, respectively. SARC-CalF improved the sensitivity of SARC-F (47.5%) while keeping similar specificity (92.0%). The AUCs of calf circumference, SARC-F, and SARC-CalF were 0.79 [95% confidence interval (CI), 0.77–0.82], 0.56 (95% CI, 0.52–0.59), and 0.70 (95% CI, 0.67–0.73), respectively. The differences across ROC curves were statistically significant among 3 screening tools (P < .001).Conclusions and ImplicationsThe overall screening ability of calf circumference was better than that of SARC-F and SARC-CalF for sarcopenia in community-dwelling older persons despite gender, age, and cognitive function. SARC-F and SARC-CalF have high specificity but are susceptible to the preceding factors.     

新冠肺炎流行期社会公众的疫情防控知识调查研究

目的:分析社会公众对新型冠状肺炎防护知识知晓情况,为卫生相关部门有针对性地开展人群健康教育提供实证依据.方法:采用方便抽样法在问卷星平台上招募18岁及以上人员开展调查.结果:90％以上的调查对象能准确判断出新型冠状肺炎的有效预防措施,89.58％的人能判断出非有效预防措施.但仍有38.39％的人误以为"头痛"属于新冠症状,分别有41.32％、49.18％和68.56％的人认为"婴幼儿"、"儿童"和"青少年"不属于新型冠状肺炎易感人群.结论:社会公众对新型冠状肺炎疫情关注度高,但仍存在知识误区.疫情防控常态化期间应加强社会公众疫情防控教育,尤其要对农村、男性、高中以下教育程度及未婚者等人群重点进行健康教育.     

两种新的HCC抗原的特异性

目的：检测两种新的人肝细胞癌(HCC)抗原(编号为HCC-1-8a和HCC-3-13)对HCC的特异性。方法：应用重组克隆表达抗原的血清学技术(SEREX),用异体HCC血清和非HCC血清检测两种新的HCC抗原的特异性。结果：相应的抗体主要见于HCC患者,检测10例HCC血清,阳性反应例数分别为8例及9例;胃癌5例,阳性反应分别为0例及1例;正常人28例各有阳性2例;乳癌10例,无阳性例数。结论：两种新的HCC抗原对HCC有高度特异性,可考虑作为HCC血清学诊断的指标之一。     

急性白血病患者血清sFas，TNFα水平及其与疗效的关系

目的 :探讨急性白血病患者血清可溶性跨膜蛋白 (s Fas)和肿瘤坏死因子 α(TNFα)的变化及意义。方法 :采用 EL ISA法测定 30例急性白血病患者血清 s Fas,放免法测定 32例急性白血病患者血清 TNFα含量 ,并与正常对照组比较。结果 :急淋白血病患者未完全缓解组 s Fas为 (7.14± 2 .18) μg/L,急非淋白血病未完全缓解组为 (9.6 9± 3.5 1) μg/L,均明显高于正常对照组的 (3.49± 2 .36 ) μg/L,亦明显高于其相应的完全缓解组。s Fas比正常对照组高出 2倍的患者化疗获得完全缓解的机会明显下降。急性白血病患者初发未治时血清 TNFα为 (6 .0 7± 1.32 ) nmol/L,化疗后未完全缓解者为 (5 .79± 1.2 7) nm ol/L,复发者为 (7.5 0± 1.6 7) nm ol/L,均明显高于正常对照组的 (2 .32± 0 .90 ) nm ol/L 和化疗后完全缓解者的 (4 .14±1.5 ) nm ol/L。结论 :血清 s Fas,TNFα在急性白血病患者均明显升高 ,是预后不良的因素。监测二者变化有助于疗效判断     

IBA损伤老化鼠脑Meynert核的AD模型动物研究

目的研究定位损伤脑胆碱能系Alzheimer病(AD)模型大鼠学习能力及相关脑神经肽免疫组化改变.方法用兴奋性毒素鹅膏蕈氨酸(IBA)定位损伤大鼠脑右侧Meynert核,观察模型动物学习能力改变(Y型迷宫法),并用分光光度法和免疫组化染色法观察动物脑胆碱酯酶(AchE)活性和皮层及海马β-淀粉样肽前体(β-APP)、生长抑素(SOM)及P物质(SP)的表达情况.结果模型组老化大鼠经损伤后,学习能力及脑AchE活性显著低于对照组(P均＜0.05).β-APP在额叶皮层和海马的表达均升高,而S()M表达则显著减少,用IBA及β-AP25-35同时损伤鼠脑时,可显示脑皮质区SP表达增加(P均＜0. 01).单独用IBA注射无效.结论IBA损伤老化大鼠脑Meynert核建立的动物模型,显示胆碱能系统损伤,学习能力障碍,β-APP过表达而神经肽SOM表达降低,一定条件下SP表达增加,与AD病人某些临床和病理特征基本一致.     

重组血管生成抑制因子r—K4K5的分离纯化与功能鉴定

目的 分离纯化r-K4K5,探讨r-K4K5对牛毛血管内皮（BCE）细胞、鸡胚绒毛尿囊膜（CAM）新生血管生成及实验性人肺腺癌SPC-A1生长的抑制作用。方法 通过盐析、凝胶过滤提纯r-K4K5,BCE细胞在含r-K4K5的DMEM中培养24、48、72h后分别计数;孵化7d的鸡胚加r-K4K5后继续孵育72h,观察新生血管生成;已经接种入SPC-A1肺腺癌组织的荷瘤裸小鼠（Balb/c,nu/nu）,瘤旁注射r-K4K5继续饲养,观察肿瘤生长变化。结果 r-K4K5抑制BCE细胞增殖,48～72h作用明显;r-K4K5处理的CAM组中直径小于50um的小血管明显减少;高剂量r-K4K5治疗的荷瘤裸小鼠组,平均瘤重与对照组比较有统计学意义。结论 r-K4K5能够抑制BCE细胞增殖,抑制鸡胚CAM新生血管生成,抑制实验性人SPC-A1肺腺瘤生长。     

人文关怀护理在合作医院的推进及成效

目的 探讨合作医院人文关怀护理推进策略及效果.方法 选派护理专家至合作医院进行驻点指导,建立人文关怀护理组织架构,制定人文关怀护理标准和制度,强化护理管理和服务理念,实施人文关怀培训、试点病房人文关怀护理,督导推进人文关怀护理规范化,全面推进合作医院人文关怀护理.结果 合作医院建立首批人文关怀试点病房12个,实施后护士关怀能力显著高于实施前(P＜0.01),患者对关怀护理满意度及护士工作满意度逐步提升.结论 人文关怀护理推进策略在合作医院的推进,促进了护士对患者的关怀、护理管理者对护士的关怀,可有效提高患者满意度、护士的关怀能力和工作满意度.