Stage line diagram: An age‐conditional reference diagram for tracking development

This paper presents a method for calculating stage line diagrams, a novel type of reference diagram useful for tracking developmental processes over time. Potential fields of applications include: dentistry (tooth eruption), oncology (tumor grading, cancer staging), virology (HIV infection and disease staging), psychology (stages of cognitive development), human development (pubertal stages) and chronic diseases (stages of dementia). Transition probabilities between successive stages are modeled as smoothly varying functions of age. Age‐conditional references are calculated from the modeled probabilities by the mid‐P value. It is possible to eliminate the influence of age by calculating standard deviation scores (SDS). The method is applied to the empirical data to produce reference charts on secondary sexual maturation. The mean of the empirical SDS in the reference population is close to zero, whereas the variance depends on age. The stage line diagram provides quick insight into both status (in SDS) and tempo (in SDS/year) of development of an individual child. Other measures (e.g. height SDS, body mass index SDS) from the same child can be added to the chart. Diagrams for sexual maturation are available as a web application at http://vps.stefvanbuuren.nl/puberty . The stage line diagram expresses status and tempo of discrete changes on a continuous scale. Wider application of these measures scores opens up new analytic possibilities. Copyright © 2009 John Wiley & Sons, Ltd.     

Stage-related increase in the proportion of apoptotic germ cells and altered frequencies of stages in the spermatogenic cycle following gestational, lactational, and direct exposure of male rats to p-nonylphenol.

The cumulative effects of environmental toxicants, for example, the alkylphenol, para-nonylphenol (p-NP) are of concern. Our previous study showed that p-NP reduced several testicular morphometric parameters, including sperm counts. The present study reexamined material collected in that study to determine the mechanistic basis of p-NP action on spermatogenic development in the offspring. Seven-day pregnant Sprague-Dawley rats were treated with vehicle or 100 or 250 mg/kg p-NP through gestation, lactation and afterward directly to all male offspring until 10 weeks of age. Both doses of p-NP significantly (P < 0.02) increased the number of germ cells with in situ end-labeled fragmented DNA (TUNEL positive) by 1.9-fold and 1.7-fold, respectively, and specifically in stages XII-XIV and I-III. TUNEL-labeling was, however, selective, and excluded labeling of basal cells with apoptotic morphology. Cleaved caspase-3 immunohistochemistry strongly labeled basal cells (spermatogonia and early spermatocytes) with condensed marginated chromatin but not degenerate germ cells lacking definitive nuclear material found throughout the epithelium. Only the caspase index (ratio of number of caspase positive to number of degenerate cells) of the 100-mg/kg p-NP group was significantly (p < 0.05) threefold greater than controls. Whereas both doses and either 250 or 100 mg/kg treatment alone significantly (p < 0.002) reduced the frequencies (duration) of stages I-III, VII-VIII, and late VIII-IX (spermiating and recently spermiated tubules), respectively, both doses significantly (p < 0.002) increased the frequencies of stages IV-VI and all stages containing late-stage spermatocytes (XII-XIII) and meiotic cell divisions (XIV). Thus, p-NP, an environmentally persistent xenoestrogen, insidiously alters the spermatogenic cycle and spermatogenic process in male offspring.     

耒阳市1093例不同年龄人群缺锌状况的调查分析

[目的]探讨人体内锌缺乏与年龄是否相关。[方法]采集头发用强酸消化后，利用北京振教科贸有限公司产WL-3微量元素分析仪进行检测。[结果]我们发现儿童的缺锌率高于青少年和成人人群，具有显著的统计学意义（P〈0．05），其中3～5岁时的儿童的缺锌率达到了79．1％。而青少年与成人之间的缺锌率并无差异（P〉0．05），分别为20．5％和18．4％。[结论]因膳食结构不当引起锌缺乏在儿童中常见，由此我们应当根据不同年龄阶段特点进行不同的补锌措施。     

产程中应用杜冷丁对产程及新生儿的影响

目的　观察杜冷丁对产程及新生儿的影响。方法　将 16 0例初产妇随机分为观察组和对照组 ,各 80例 ,观察组在宫口开大 1.2cm时杜冷丁 10 0mg肌肉注射 ,对照组未用药。结果　第一产程用药组与对照组相比明显缩短 ,有显著差异 (P <0 .0 5 ) ,第二、三产程无差异 (P >0 .0 5 ) ,对新生儿影响、产后 2小时内出血量及新生儿体重两组无差异 (P >0 .0 5 )。结论　产程中应用杜冷丁可减轻产妇疼痛 ,缩短第一产程 ,不增加新生儿窒息 ,值得推广应用     

腹腔镜胆囊切除术开展初期质量控制的临床研究

目的探讨如何控制腹腔镜胆囊切除术（LC）开展初期的并发症及中转率。方法制定八条质量控制措施，总结分析568例LC临床资料。结果并发症6例，仅占1．2％，中转手术8例，中转率仅1．6％。结论在开展LC初期只要加强质量控制，完全可以避开高并发症、高中转率这种所谓的自然规律。     

Diversity in Clinical Psychology

Clinical psychology is not as diverse as society, and the generalizability of clinical psychology to diverse groups has largely been untested. Some progress has been made in increasing the number of ethnic minorities receiving PhD degrees in clinical psychology and in increasing ethnic minority representation in clinical trials. Nevertheless, clinical psychologists and clinical psychology research are not diverse. A stages of change model may be useful in motivating clinical psychologists to diversify. A future scenario involving inertia and a second involving change are offered.     

不同海拔高度健康藏汉族青年脉象图研究

本文通过对不同海拔高度藏汉族健康青青年的４００幅脉图分析后认为，健康藏汉族青年的脉象以滑、平、弦、缓为多。结古和西宁的藏汉族青年脉力图的主要生理参数中不同海拔高度上有一定差异，表现为结古青年弦脉较多，而西宁教地区滑脉较多，究其形成原因，主要与高海拔缺氧、寒冷环境有密切关系；在民族间也存在一定差异，表现为汉族弦脉多，藏族滑脉多，它们的形成与移居高原后心血管的反庆和代偿机制有关，在性别间有明星的差异。     

不同方法治疗特殊部位白癜风疗效的比较

目的通过不同方法治疗特殊部位白癜风的疗效观察,以便筛选出对不同部位白癜风的最佳治疗方法.方法随机将l 22例(375区白斑)特殊部位白癜风患者分为5组,移植微型毛胚组42例,磨削去除白斑组52例,毛囊刮取物注射组35例,液氮冷冻起疱去除白斑组30例,外用药物治疗组45例.观察其疗效,对各组病例统一疗效标准判断,统计学处理.结果移植微型毛胚组总有效率97.1 %,磨削去除白斑组总有效率94.7 %,毛囊刮取物注射组总有效率59.7 %,液氮冷冻起疱去除白斑组总有效率57.1%,外用药物治疗组总有效率45.5 %.经统计学处理,各组之间比较,差异有非常显著性意义(χ^2＝111.77,P＜0.005).结论特殊部位白癜风的治疗,目前仍是一个棘手的问题,上述所介绍的方法无疑是在实践中切实可行的方法,各有特色,可以根据不同部位,酌情选择最佳方法,也可以联合应用,相互补充,提高疗效.