中国小儿消化外科的现状

小儿外科专业公认是从1922年Ramstedt幽门狭窄环肌切开手术的推广开始.至1941年Ladd出版了<小儿腹部外科疾病>奠定了以先天性消化道畸形与胃肠疾病为主线的现代小儿外科专业.至今小儿外科专业已发展了很多分专业,但国际小儿外科活动仍以小儿消化外科为主,不少大医院的小儿外科仅限于小儿消化外科.     

Effect of mentally retarded persons' level of stereotypy on their learning

The effect of level of stereotypy on learning a discrimination for 30 mentally retarded persons was examined. A factorial design with high and low levels of stereotypy and three levels of IQ was employed. The number of days to acquire the discrimination differed among the IQ groups, but there was no main effect of stereotypy. An interaction was found indicating that a high level of stereotypy slowed learning only in the lowest IQ group. We concluded that the effects of stereotypy upon learning were different across the IQ levels and that high levels of stereotypy did not uniformly interfere with the acquisition of the discrimination.     

Evaluation of a method for teaching dressing skills to profoundly mentally retarded persons

The present study was a systematic replication of Azrin, Schaeffer, and Wesolowski's (1976) method for teaching dressing skills to mentally retarded persons. Of the 3 profoundly retarded adults trained in this study, 2 attained criterion for independent undressing. No residents reached criterion on dressing despite as much as 108.2 hours of training. These results contrasted with those of Azrin et al. (1976), whose subjects reached criterion on all skills in an average of 12 hours. We also found that treatment gains were generally maintained through 3 months of follow-up. We concluded that although the program improved the clients' self-care skills, more research is needed to identify critical program and subject variables that may have accounted for the contrasting results between this study and the earlier work.     

Non-linear relationships between the BMI and physical fitness in Polish adolescents

Background: Comparisons of physical fitness in normal weight and overweight/obese youth generally highlight the negative consequences of an elevated BMI. In contrast, several studies of children and adolescents highlight the importance of variation in indicators of physical fitness across the full spectrum of BMIs from low through high.

Aim: The purpose of the study was to evaluate relationships between specific physical fitness items and the BMI among youth.

Subjects and methods: Height, weight and six physical fitness tests were measured in 1239 males and 903 females, aged 13–16?years; BMI (kg/m²) was calculated. Fitness tests were compared by weight status using sex-specific MANCOVAs, controlling for age. Sex-specific quadratic regressions of each fitness item on the BMI were also calculated.

Results: The sprint, standing long jump and shuttle run indicated better performances in normal than in thin and overweight/obese boys; the latter groups did not differ. Thin and normal weight boys performed better than overweight/obese boys in sit-ups and distance run. Among girls, sit-ups differed as follows: normal?>?thin?>?overweight/obese. Thin and normal weight girls performed better than overweight/obese girls in the jump, distance run and shuttle run. Normal weight girls were faster in the sprint than the overweight/obese. The quadratic regressions indicated significant non-linear relationships between the BMI and all fitness items among boys and in four items among girls.

Conclusion: Performances on fitness tests varied with weight status. Relationships between performances and the BMI were curvilinear except for the distance run and flexibility in girls.     

The prevalence and impact of migraine headache in bipolar disorder: results from the Canadian Community Health Survey

OBJECTIVE: To report on the prevalence of comorbid migraine in bipolar disorder and the implications for bipolar age of onset, psychiatric comorbidity, illness course, functional outcome, and medical service utilization. BACKGROUND: Migraine comorbidity is differentially reported in bipolar versus unipolar depressed clinical samples. The bipolar disorder-migraine association and its consequences have been infrequently reported in epidemiological studies. METHODS: Data for this analysis were derived from respondents (n = 36 984) to the Canadian Community Health Survey - Mental Health and Well-Being (CCHS). Respondents reporting a lifetime WHO-CIDI-defined manic episode and physician-diagnosed migraine (lifetime) were compared to respondents without migraine on sociodemography, course of illness, and medical service utilization indices. RESULTS: An estimated 2.4% of the sample met criteria for bipolar disorder. Persons with bipolar disorder had a relatively higher prevalence of migraine versus the general population (24.8% vs. 10.3%; P < .05). The sex-specific prevalence of comorbid migraine in bipolar disorder was 14.9% for males and 34.7% for females. Bipolar males with comorbid migraine were more likely to live in a low income household (P < .05); receive welfare and social assistance (P < .05); report an earlier age of onset of bipolar disorder (P < .05); and have a higher lifetime prevalence of comorbid anxiety disorders (P < .05). Bipolar males with comorbid migraine were also more likely to utilize primary (P < .05) and mental health care services (P < .05) . Bipolar females with comorbid migraine had more comorbid medical disorders (P < .05) and were more likely to require help with personal or instrumental activities of daily living when compared to bipolar females without migraine. CONCLUSION: Bipolar disorder with comorbid migraine is prevalent and associated with greater dysfunction and medical service utilization, notable in males. Opportunistic screening and surveillance for bipolar and comorbid migraine is warranted.     

Improving outcomes in depression: a focus on somatic symptoms

BACKGROUND: It is hypothesized that somatic symptom alleviation is a significant predictor of overall outcome in depressed primary care patients. METHODS: Depressed primary care patients (N=205) meeting DSM-IV-TR criteria received open-label antidepressant therapy. The primary symptom measurement tool used was the 17-item Hamilton Depression Rating Scale (HAMD-17), with the Montgomery-Asberg Depression Rating Scale (MADRS) and the Clinical Global Impression Improvement/Severity (CGI-I/S) used as secondary measures. As proxies for somatic symptoms, 8 items from the HAMD-17 (HAMD-S) and 3 items from the MADRS (MADRS-S) that measure somatic symptoms were identified and extracted. RESULTS: There was a significant correlation between improvement on the HAMD-S score and overall reduction on the MADRS total score (r=.766, P<.001), response (r=.594, P<.001), and remission (r=.552, P<.001). Improvement on the MADRS-S also correlated with overall HAMD-17 improvement (r=.782, P<.001), along with response (r=.649, P<.001) and remission (r=.539, P<.001) rates. Both the HAMD-S and the MADRS-S correlated with global improvement as measured by the CGI-I/S (P<.001). CONCLUSIONS: A reciprocal interaction between somatic symptoms and other depressive-symptom domains is implied by this analysis. Clinicians are encouraged to identify, track, and target the somatic symptoms of depressive illnesses.     

血管介入治疗妇科恶性肿瘤急性大出血13例

1 临床资料 1996-03/2004-12采用血管性介入疗法治疗妇科恶性肿瘤所致的急性大出血13例,年龄43～65(平均47)岁,均为已婚已育.     

Assessing risk of injury in people with mental retardation living in an intermediate care facility

A brief instrument to assess risk of injury was applied retrospectively for 2 years and prospectively for 1 year to all people living in a large ICF/MR. Results suggest that the percentage of people who experienced an injury significantly increased across the levels of increasing risk indicated by the assessment. Furthermore, people who experienced an injury had significantly higher risk scores than those who did not. Using psychometric analyses, we found a mean correlation of .79 for interrater reliability and .90 for test-retest reliability on individual items and correlations of .91 and .95, respectively, on total score. We conclude that the assessment has promise as a reliable and valid method for predicting injury risk level.     

Tolerability profiles of atypical antipsychotics in the treatment of bipolar disorder

Atypical antipsychotics have unequivocally advanced the pharmacotherapy of bipolar disorder. These broad-spectrum medications offer efficacy against core symptoms of mania, and evidence supports the use of several agents as treatment options in depressed and maintenance phases of the disorder. Atypical antipsychotics also have a reduced propensity for provoking acute or tardive neurologic adverse events compared with their therapeutic predecessors, the conventional antipsychotics. These agents are not, however, a panacea and are associated with several problematic tolerability and safety concerns. Although classified together, atypical antipsychotics are heterogeneous in their tolerability and safety profiles, an issue that is relevant to individualizing treatment selection. This article reviews relevant adverse events attributable to the use of atypical antipsychotic agents, with particular consideration of the bipolar disorder population.     

The implementation of factor analysis for the evaluation of selected blood parameter changes induced by hyperbaric exposure

This paper discusses the application of factor analysis when used to compare selected blood parameter (a three-parameter smear, hematocrit, C3c, C4, IgG, IgA, IgM, CRP, fibrinogen and the level of factor XII) properties, just before, and after exposure to pressure changes, and 24-hours after the completion of decompression. To-date the most popular method of statistical analysis was based only on investigation of the significance of the separated individual parameters. This factor analysis that has not been applied previously in the analysis of such problems, enabled the neutral hierarchic evaluation of the significant parameter changes within their chosen range, and mutual relationships. It seems that the application of this method is purposeful and it can be an objective tool for evaluating the significance of changes in blood constituency induced by pressure.