Sequential monitoring of randomization tests: stratified randomization

In many clinical trials, it is desirable to establish a sequential monitoring plan, whereby the test statistic is computed at an interim point or points in the trial and a decision is made whether to stop early due to evidence of treatment efficacy. In this article, we will set up a sequential monitoring plan for randomization-based inference under the permuted block design, stratified block design, and stratified urn design. We will also propose a definition of information fraction in these settings and discuss its calculation under these different designs.     

群落排表分类的两种数学方法

本文描述两种执行群落排表分类的数学方法:X²分类法和信息熵分类法,并以德国西北部草地数据为例进行了应用和分析。结果表明这两个方法都是有效的群落排表分类方法,它们所排的群落表可直接地反映群落类型和种类组成之间的关系,体现了Braun-Blanquet传统排表法的特点。     

Changes of Chlorophyll Metabolism During the Albinic Stage of a Wheat Mutant

Changes of chlorophyll metabolism during the albinic stage including both degreening and regreening processes were studied. The results indicated that an decrease of Cato content was nor the cause of mutant degreening, and that the mutant belonged to the total Chl-dificient type. The changes of Chlase activity level indicated that Chi breakdown was not the main factor which led to degreen of the mutant. A greater changes of content of intermediates of Chl biosynthesis during the albinic period δ-aminolevulinic acid (ALA) and porphohilinogen (PBG) were accumulated, but uroporphyrin Ⅲ (Uro Ⅲ ), protoporphyrin IX (Proto IX ), Mg-protoporphyrin IX (Mg-Proto IX ) and protochlorophyll (ide) (Pchl (lide)) were decreased. Specialy during the degreening process Uro Ⅲ was gradually decreased, but an initiation of regreening, the Uro Ⅲ was markedly accmulated. It was proved that there was a blockage in Chi biosynthesis in the mutant, which could be somewhere in the formation of uroporphyrinogen Ⅲ (Urogen Ⅲ ).     

神经刺激仪经肌间沟定位臂丛神经分支行臂丛麻醉效果分析

目的：比较神经刺激仪经肌间沟定位臂丛神经分支行肌间沟臂丛神经阻滞麻醉的效果及安全性。方法：选择拟行肌间沟臂丛神经阻滞的上肢手术的患者80例,ASAI或II级,随机均分为A组和B组,每组40例患者。两组均给予1％的利多卡因＋0．375％耐乐品20mL。记录完成操作所需时间、感觉神经阻滞起效时间、感觉神经阻滞完善时间、运动神经阻滞起效时间、运动神经阻滞完善时间;评价手术区域麻醉效果（优、良、差、失败）;观察并记录并发症。结果：A组完成操作所需时间（5．01±1．40）min,明显长于B组（2．83＋O．87）min（P〈0．01）。A组感觉阻滞起效时间（4．48±1．36）min,明显短于B组（7．0±2．06）min（P〈0．01）;A组运动阻滞起效时间（4．88＋±1．18）min,明显短于B组（7．0±1．67）min（P〈0．01）。A组感觉阻滞完善时间（11．73±3．62）短于B组（13．33±3．02）min（P=0．033）。A组运动阻滞完善时间（11．18±2．73）短于B组（12．41±2．48）min（P=0．038）;麻醉效果优等率A组为87．5％,B组为67．5％,差异有统计学意义x^2=4．588,P=0．032;优良率A组为97．5％,B组为90．0％,差异无统计学意义x2=1．920,P=0．166;A组、B组均未出现严重麻醉并发症。结论：A组行肌间沟臂丛神经阻滞比B组阻滞操作时间长,但神经阻滞麻醉效果好,神经阻滞完善率高。     

Localization of the K+ lock-In and the Ba2+ binding sites in a voltage-gated calcium-modulated channel. Implications for survival of K+ permeability.

Using Ba2+ as a probe, we performed a detailed characterization of an external K+ binding site located in the pore of a large conductance Ca2+-activated K+ (BKCa) channel from skeletal muscle incorporated into planar lipid bilayers. Internal Ba2+ blocks BKCa channels and decreasing external K+ using a K+ chelator, (+)-18-Crown-6-tetracarboxylic acid, dramatically reduces the duration of the Ba2+-blocked events. Average Ba2+ dwell time changes from 10 s at 10 mM external K+ to 100 ms in the limit of very low [K+]. Using a model where external K+ binds to a site hindering the exit of Ba2+ toward the external side (Neyton, J., and C. Miller. 1988. J. Gen. Physiol. 92:549-568), we calculated a dissociation constant of 2.7 mircoM for K) at this lock-in site. We also found that BK(Ca) channels enter into a long-lasting nonconductive state when the external [K+] is reduced below 4 microM using the crown ether. Channel activity can be recovered by adding K+, Rb+, Cs+, or NH4+ to the external solution. These results suggest that the BK(Ca) channel stability in solutions of very low [K+] is due to K+ binding to a site having a very high affinity. Occupancy of this site by K+ avoids the channel conductance collapse and the exit of Ba2+ toward the external side. External tetraethylammonium also reduced the Ba2+ off rate and impeded the channel from entering into the long-lasting nonconductive state. This effect requires the presence of external K+. It is explained in terms of a model in which the conduction pore contains Ba2+, K+, and tetraethylammonium simultaneously, with the K+ binding site located internal to the tetraethylammonium site. Altogether, these results and the known potassium channel structure (Doyle, D.A., J.M. Cabral, R.A. Pfuetzner, A. Kuo, J.M. Gulbis, S.L. Cohen, B.T. Chait, and R. MacKinnon. 1998. Science. 280:69-77) imply that the lock-in site and the Ba2+ sites are the external and internal ion sites of the selectivity filter, respectively.     

连续股神经阻滞联合帕瑞昔布对全膝置换患者术后镇痛效果观察

目的:探讨连续股神经阻滞(CFNB)联合帕瑞昔布对全膝关节置换术(TKA)患者术后镇痛效果。方法:选择2015年1月至2016年12月间我院行择期单侧TKA治疗的患者100例,按照随机数字表法分为对照组和研究组,每组各50例。两组患者术后分别接受CFNB和CFNB联合帕瑞昔布镇痛,镇痛时间2 d。观察两组患者术后6 h、12 h、24 h、48 h静息状态和运动状态视觉模拟疼痛评分(VAS)以及术后不良反应发生率。并于术前1 d、术后1 d、2 d、3 d应用美国特种外科医院膝关节评分表(HSS)评定两组患者膝关节功能。结果:术后6 h、12 h、24 h、48 h研究组患者静息状态VAS评分和运动状态VAS评分显著低于对照组患者(P0.05)。两组恶心/呕吐、呼吸抑制、导管相关问题、尿潴留发生率比较无统计学差异(P0.05)。两组患者术前1d HSS评分比较无统计学差异(P0.05),术后1 d、术后2 d、术后3 d两组患者HSS评分均较术前1 d显著升高,且研究组患者HSS评分显著高于对照组(P0.05)。结论:CFNB联合帕瑞昔布具有镇痛效果好、安全可靠的优点,应用TKA术后镇痛有利于患者早期进行膝关节功能锻炼,值得临床推广。     

七氟醚联合骶管阻滞麻醉对小儿疝气手术的麻醉效果分析

目的:观察七氟醚联合骶管阻滞麻醉对小儿疝气手术的麻醉效果。方法:选取80例行腹股沟疝气手术患儿,按随机数字表法分为两组,对照组(39例)静脉注射氯胺酮,观察组(41例)先吸入8%七氟醚,然后进行骶管阻滞麻醉,通过观察并记录两组患儿生命体征、麻醉诱导时间、苏醒时间、手术麻醉时间、苏醒期躁动评分(Pediatric anesthesia emergence delirium,PAED)和麻醉诱导期合作量表(Induction Compliance Checklist,ICC)及麻醉期间不良反应情况,评价七氟醚联合骶管阻滞麻醉对小儿疝气手术的麻醉效果。结果:两组切皮后T1、T2时心率(HR)、平均动脉压(MAP)水平均高于T0时的值(P0.05),两组切皮后T1、T2时组间HR、MAP水平相比,无统计学差异(P0.05)。两组切皮后T3时HR、MAP水平基本恢复到T0时的水平。两组切皮前后4个时间点的血氧饱和度(Sp O2)相比,无统计学差异(P0.05)。观察组患儿麻醉诱导时间,苏醒时间均明显短于对照组患儿(P0.05),两组术中麻醉持续时间相比,无统计学差异(P0.05),均能达到期望麻醉时间,观察组患儿PAED评分和ICC评分均低于对照组患儿(P0.05),不良反应组间比较无统计学差异(P0.05)。结论:七氟醚联合骶管阻滞麻醉对小儿疝气手术具有良好的麻醉效果,麻醉诱导快,苏醒快,小儿配合度高,术后躁动少,值得临床推广使用。     

连续股神经阻滞与静脉自控镇痛对全膝关节置换术后患者凝血功能的影响

目的:比较连续股神经阻滞(CFNB)与静脉自控镇痛(PCIA)在全膝关节置换术中的应用效果及对患者凝血功能的影响。方法:选取2014年1月至2015年12月间我院行单侧全膝关节置换术的患者80例,按照随机数字表法分为CFNB组和PCIA组,每组各40例,两组患者分别接受CFNB和PCIA治疗。观察两组患者术后6 h、12 h、24 h、48 h视觉模拟疼痛评分(VAS),两组患者分别于麻醉前(T1)、术毕(T2)、术后1 d(T3)、术后2 d(T4)进行血栓弹力图检查,观察两组凝血功能变化。并于术后随访1年,比较两组患者膝关节功能。结果:术后6 h、12 h、24 h、48 h CFNB组患者VAS评分显著低于PCIA组患者(P0.05)。T2、T3、T4时点CFNB组患者凝血反应时间(R)、血凝块形成时间(K)较T1升高,血凝块聚合形成速率(α角)、血凝块最大振幅(MA)较T1降低,PCIA组患者R、K较T1降低,α角、MA较T1升高,T2、T3、T4时点CFNB组患者R、K高于PCIA组患者,α角、MA低于PCIA组患者,差异均有统计学意义(P0.05)。两组患者术后均完成1年的随访,两组患者KSS评分、膝关节最大屈曲度、膝关节最大伸直度比较无统计学差异(P0.05)。结论:CFNB对于全膝关节置换术术后患者镇痛效果优于PCIA,有利于改善患者凝血功能,不影响术后患者膝关节功能的恢复。     

腰椎旁神经阻滞联合超短波对腰椎间盘突出症患者疼痛及腰背肌生物力学性能的影响

目的:探讨腰椎旁神经阻滞联合超短波对腰椎间盘突出症疼痛及腰背肌生物力学性能的影响。方法:选择我院2014年2月~2016年8月收治的98例腰椎间盘突出症患者,按抽签法分组对照组与研究组。对照组采用腰椎旁神经阻滞治疗,研究组基于对照组加用超短波治疗。观察两组的临床疗效、治疗前后视觉模拟评分(VAS)、60°/s角速、120°/s角速平均功率(AP)、峰力矩(PT)、腰背屈/伸比值(F/E)、血清P物质(SP)、β-内啡肽(β-EP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平的变化及不良反应的发生情况。结果:研究组总有效率为95.91%,显著高于对照组,差异有统计学意义(P0.05)。治疗后,两组F/E值、血清SP、IL-6、TNF-α水平均较治疗前显著降低,且研究组以上指标均明显低于对照组,两组AP、PT、血清β-EP水平均较治疗前明显上升,且研究组以上指标显著高于对照组,差异均有统计学意义(P0.05)。两组不良反应的发生率比较差异无统计学意义(P0.05)。结论:腰椎旁神经阻滞联合超短波治疗腰椎间盘突出症的效果明显优于单用腰椎旁神经阻滞治疗,其可有效缓解疼痛及改善腰背肌生物力学性能,并减轻炎症反应。     

人类基因组单核苷酸多态性和单体型的分析及应用

单核苷酸多态性是人类基因组中最丰富的遗传变异。单体型是指位于一条染色体上或某一区域的一组相关联的SNP等位位点,单体型已经成为近年来人类遗传研究的组成部分。人类基因组单体型图（HapMap）计划的目标就是构建人类DNA序列中多态位点的常见模式,找出代表整个人类基因图谱之中的SNP集合的标签SNP。在复杂性疾病研究中,由多个变异位点组合构成的单体型分析优于单个SNP的分析。文章论述了SNPs、基因型、表现型的定义与HapMap计划的一些情况,综述了单体型的3种推断算法和单体域的不同定义与构建方法,同时介绍了标签SNP的选择及单体型与复杂疾病关联分析的方法,可利用公共SNP数据库的情况以及SNPs与单体型在复杂疾病与药物反应方面的应用。