综合干预对农村自杀影响研究

目的 :探讨农村自杀综合干预的效果。方法 :实施综合性农村自杀干预措施 ,使用相同的调查工具和调查流程 ,对 1989年与 1999年同一样本人群自杀率及其相关因素进行比较及评估。结果 :1989年与 1999年滕州市某镇自杀率分别为 48 5 6/ 10万和 5 98/ 10万。自杀未遂分别为 10 4 0 6/ 10万和 46 67/ 10万 ,差异显著 (χ2 =40 70及 χ2 =15 4 0 8,P均 <0 0 0 1)。综合干预后家庭矛盾导致的自杀显著下降 ,相对精神病性的自杀率明显上升。结论 :农村自杀综合干预措施效果明显 ,自杀重点人群得到有效的保护     

183例在急诊室就诊的自杀患者特征

目的：分析综合医院就诊的自杀患者，为自杀的预防和干预提供依据。方法：对我院急诊科2004年1月1日-2004年12月31日收治的183例自杀患者进行调查。结果：自杀患者20-29岁8l例（占44．3％），女性（147例）明显多于男性（36例），男女比例为1：4．1；口服药物是最常见的自杀方式（170例，92、8％），其中口服安眠药和农药119例，占口服药物70％，总死亡率3．3％；男性自杀死亡率（3／36）高于女性（3／147）；自杀发生于18～24时7l例（38．8％），与其他时间段相比有显著性差异（P〈0．005）。结论：急诊自杀病例以年轻人、女性居多，采用安眠药、农药为主要手段。经抢救大部分生命得以挽救，但男性死亡率高于女性。，     

湖南某镇农村居民自杀意念影响因素

目的:探讨农村居民自杀意念的影响因素,为自杀干预提供依据。方法:对湖南浏阳市永安镇常住农村居民,采用分层随机整群抽样法确定样本人群,使用自行设计的调查表,采取入户、单独面谈的方式进行调查。结果:共851名调查对象接受了面谈并完成调查问卷。终生自杀意念发生率为23．6％,经多因素logistic嘲归分析,自评心理健康状况、自评经济水平、性别、自评躯体健康状况为自杀意念的影响因素(OR值分别为2．107、1．910、1．630、1．596)。结论:农村常住居民自杀意念发生率处于较高水平。自评心理健康状况差、自评经济水平低、女性、自评躯体健康状况差是产生自杀意念的危险因素。应针对危险因素予以积极的干预。     

住院精神病患者自杀行为的5年回顾分析

目的：了解住院精神病患者自杀行为的临床特征。方法：对2002年1月1日－2006年12月31日在我院住院治疗期间发生自杀行为的患者，以查阅病历、访谈和实地考察自杀环境获取资料进行回顾性分析。结果：共收集到住院期间发生自杀行为患者3l人。男性16人，女性15人，年龄24～68岁，平均年龄45岁。住院时间＜1个月者13人（41．9％），1～3个月者4人（12．9％），＞3个月者14人（45．2％）。诊断精神分裂症者最多（64．5％），其次为情感障碍（13．0％）。自杀方式以上吊最多（41．9％），其次是吞服异物（25．8％）。自杀地点以普通病室及洗手间最多见。自杀发生在0am～8am时间段12人（38．7％），8am～4pm时间段11人（35．5％），4pm～12pm时间段8人（25．8％）。休息日发生自杀多于工作日发生自杀（χ2＝13．520，P＝0．000），差异有统计学意义。自杀死亡1人（3．2％）。年均自杀行为发生率为24．98‰。结论：发生自杀的住院精神病患者罹患精神分裂症及情感障碍最常见，新住院及长期住院患者为高危人群。自杀方式以上吊最多见。自杀地点以普通病室及洗手间最多见。休息日发生自杀的比例较高。     

北京地区减少中枢神经系统缺陷综合干预模式效果评价

目的探索实施减少中枢神经系统缺陷的干预模式，旨在本市有重点、有步骤地减少中枢神经系统缺陷（CNS）的发生。方法于1998年7月至2001年6月期间，对北京地区接受婚前保健、孕早期、孕中期及孕28w至产后7天内的妇女。实施减少中枢神经系统缺陷的一级和二级综合干预措施。通过问卷调查、配对研究及出生结局监测等方法进行对比研究，干预效果的评价。结果中枢神经系统缺陷率明显下降，本市1997年CNS发病率为1．62‰，2000年降至0．88‰，下降幅度为46％。年均下降幅度为18％，相当于干预研究前自然年均下降幅度的2．2倍。远县更为明显，是自然年均下降幅度的4倍。育龄妇女孕前、孕早期服用叶酸的依从率1998年为15．29％，1999年上升到至38．41％，孕中期B超检查率达90％以上。通过一级和二级干预，使中枢神经系统缺陷的发生和出生，下降幅度分别为19％和27％。综合干预的实施，得到了各级卫生行政部门的支持，并在妇幼保健三级网络中运做，充分体现了干预工作低投入、高产出的医疗保健理念。为在全国进一步推行中枢神经系统缺陷综合干预可持续发展打下了基础。通过综合干预，仅减少203例脊柱裂发生，节约修复费4060万人民币，同时节约因中枢神经系统缺陷死亡而消耗的费用668万，社会效益及经济效益显著。结论通过健康教育提高群众对干预措施的依从性，是进一步减少中枢神经系统缺陷的关键。     

自杀及其危机干预

自杀不是一种疾病，也不是一种诊断名称，而是一种特有的死亡原因。据统计，在某些医院有7％的病人是因自杀抢救入院的。自杀行为在美国和大多数欧州国家是十种最常见的致死原因之一，在大学生中自杀是仅次于意外事故的死亡原因。在我国自杀身亡的情况并非少见，但人们对自杀问题的严重性认识不足，许多；临床工作者也缺乏对自杀问题的了解，如何对自杀者进行危机干预缺乏足够的知识。本文对自杀的一般问题和自杀危机的干预进行探讨。1自杀的一般问题1．1自杀原因：引起自杀的原因是多方面的，基本上可分为社会心理因素和生物学因素。1．1．…     

山东省自杀死亡率流行病学研究

目的： 调查山东省自杀死亡率、自杀原因和自杀方式。方法： 在全省范围内采用分层整群随机抽样方法抽取８４６７６ 人, 对样本人群中１９８９年～１９９４年间自杀死亡者进行线索和逐户调查。结果： 调查人群６年中共自杀死亡６６人, 全人口年平均自杀死亡率为１３．３５／１０万, ≥１５岁人群年平均自杀死亡率为１６．６６／１０万。农村自杀死亡率高于城市。主要自杀诱因为家庭纠纷（４５．４５％ ）和精神疾病（２４．２４％ ）,主要自杀方式为服毒（６６．６７％ ）和自缢（１９．７０％ ）。结论： 山东省自杀死亡率与国内资料一致, 与国外资料相比处于中等水平。     

情感笥障碍患者出院后30年死亡随访调查

报导１０２例情感性障碍患者出院后３０年死亡随访调查。结果自杀率为１３．７２％，病死率为１８．６３％，总死亡率３２．３５％。对与死亡相关的问题进行了分析讨论。     

情感性障碍患者出院后30年死亡随访调查

报导１０２例情感性障碍患者出院后３０年死亡随访调查。结果自杀率为１３．７２％，病死率为１８．６３％，总死亡率３２．３５％。对与死亡相关的问题进行了分析讨论。     

青少年自杀原因分析

自杀是一个重要的医学和社会问题。1990年全世界有140万人自杀，青少年自杀比例更高[1]。我国青少年自杀现象也相当严重。胡泽卿等1987～1988年对四川省部分地区调查表明，20岁左右的青壮年自杀人数约占整个自杀人数的五分之一；李建华、万文鹏调查云南省，1981～1986年16～35岁的自杀者竟占总数的61．6％。成都市1983～1986年青少年自杀占总数的26．6％[2]。方明昭调查首都7所重点大学及1所普通大学．表明大学生自杀年均死亡率为9～24／10万[3]。青少年的自杀行为，与青少年的特殊生理现象及由此带来的心理特点紧密相连。青少年成长过程中…     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

Class II HLA in Georgia Caucasus Tbilisi Georgians and their Mediterranean ancestry: The Usko Mediterranean languages

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers “Kura” and “Ebro” or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.