社区“5+1”糖尿病分阶段达标管理对2型糖尿病患者生存质量干预效果分析

目的 分析社区"5+1"糖尿病分阶段达标管理对2型糖尿病患者生存质量的干预效果及其影响因素，为提高患者生存质量提供依据。方法 采用分层整群抽样的方法在山西省、江苏省和宁夏回族自治区选择12个社区卫生服务中心，分别作为干预组（管理方式：社区"5+1"糖尿病分阶段达标管理）、对照组[管理方式：依据《国家基本公共卫生服务规范（2011年版）》的相关要求]，进行为期2年的随访观察。采用面对面问卷调查的方式，收集患者的人口学信息等基本信息；采用健康调查简表（SF-36）对患者在干预前后测量生存质量。采用SAS 9.4软件进行双重差分法以及多重线性回归模型分析。结果 基线时共纳入2 467名研究对象，终末时共1 924人接受了为期2年完整的随访管理。干预后，干预组、对照组患者生理健康维度（PCS）、心理健康维度（MCS）评分变化净差值分别为13.6分、29.8分。多重线性回归分析结果显示，影响患者PCS得分的主要因素有年龄、医保类型、基线PCS得分以及所在地区，影响患者MCS得分的主要因素有年龄、医保类型、基线MCS得分、是否合并高血压以及所在地区。结论 社区"5+1"糖尿病分阶段达标管理对2型糖尿病患者生存质量的干预效果较好。     

Electronic properties of PbCl2 and PbBr2 using Compton scattering technique

We present the electron momentum densities of PbCl₂ and PbBr₂ using 661.65 keV γ-rays from 20 Ci ¹³⁷Cs source. To supplement our experimental investigations, we also report energy bands, density of states, Mulliken's population and Compton profiles of PbCl₂ and PbBr₂ using linear combination of atomic orbitals within Hartree–Fock and density functional theories. The energy bands are also computed employing full potential linearized augmented plane wave (FP-LAPW) method. Compton profiles are also analyzed in terms of equal-valence-electron-density scale. It shows that PbCl₂ is more covalent than PbBr₂, which is in agreement with the Mulliken's population analysis. It is seen that the Hartree–Fock and density functional theory based Compton line shapes show similar type of deviations from the experimental data. The luminescence properties of these halides are explained on the basis of energy band and density of states.     

Comparative assesment of gingival thickness using transgingival probing and ultrasonographic method.

A decided attitude of expectation among many patients has given a new perspective to regenerative and plastic periodonta surgery. With authors emphasizing on the importance of gingival thickness, attempts are being made to obtain necessary information atraumatically and rapidly. Hence in the present study an attempt has been made to compare the two methods of assessing gingival thickness i.e transgingival probing and ultrasonographic method and also assess the gingival thickness in relation to central incisor lateral incisor and canine in Indian population. The gingival thickness was assessed in patients with healthy gingiva by both the methods. It was observed that transgingival probing method significantly over estimated the thickness of gingiva than the ultrasonographic method and the thickness of gingiva varies with morphology of the crown. It was concluded that compared to transgingival probing ultrasonographic method assesses gingiva thickness more accurately, rapidly and atraumatically.     

Postembryonic development of tapeworms — source of novel phylogenetic characters for analysis of cestode evolution: comparative TEM studies

Summary Ultrastructural features of juvenile cestodes (metacestodes) can provide useful characters for phylogenetic and evolutionary analyses. Until now, however, they have been relatively little utilised (Beveridge 2001, Chervy 2002). The postembryonic development and structure of fully formed metacestodes were examined in two cyclophyllideans: Taenia parva Baer, 1926 (Taeniidae); and Sobolevitaenia verulamii (Mettrick, 1958) Korniushin, 1972 (Dilepididae). In T. parva, three developmental stages were recognized: (1) an early stage of exogenous budding at the surface of the central vesicle; (2) a stage of polycephalic cyst development accompanied by segmentation of the growing metacestode strobila and an obvious decrease in the size of the central vesicle; (3) a fully formed metacestode of the strobilocercus type with 14–24 invaginated scoleces. The tegument, scolex, subtegumental musculature of the strobilar segments, protonephridial system, calcareous corpuscles and medullary parenchyma of larvae exhibit general similarity to the same structures in adults at both LM and TEM levels. The morphogenesis of the metacestode of T. parva is compared with that of polycephalic metacestodes of other Taenia spp. (T. krepkogorski, T. twitchelli and T. endothoracica) and with other asexually multiplying metacestodes (Mesocestoides vogae, hymenolepidids and dilepidids). In S. verulamii, the body of the cysticercoid with invaginated scolex armed with a double crown of rostellar hooks was completely surrounded by the cercomer, which appears to be separated from the cyst and scolex. The surface of the suckers is covered with a thick layer of glycocalyx. Five cell types were distinguished in the sections: (1) perikarya of metacestode tegument; (2) glycolgen-storing parenchymal cells; (3) glandular-type cells with large, electron-dense secretory-like granules; (4) flame cells; and (5) calcareous corpuscle-forming cells. The surface of the cercomer is covered by elongated microvilli, which evidently differ from characteristic microtriches covering all other parts of the metacestode surface. The ultrastructure of S. verulamii evidently differs from that of the other dilepidid cestode examined to date, Lateriporus geographicus, the cyst wall of which more resembles cysticercoids of Hymenolepididae than those of Dilepididae. Concluding remarks: Ultrastructural studies on metacestodes have considerable promise for providing important new characters for phylogenetic analysis. New TEM data on a great variety of cestode species are urgently needed. Until now, this field has not been exploited in a systematic fashion. Until more comprehensive studies become available, the current data are not yet amenable to analysis.     

Giant splenic artery mycotic aneurysm presenting with massive hematemesis.

We report a 40-year-old man with rheumatic heart disease who presented with abdominal pain for three weeks and hematemesis for 24 hours. CT scan showed a large splenic artery aneurysm without evidence of pancreatitis. Mycotic aneurysm due to infective endocarditis was considered and confirmed by echocardiogram, which showed aortic and mitral valve regurgitation and vegetations. He was managed successfully with coil embolization of the aneurysm and antibiotics.     

艺术嗓音歌声客观评价初探

目的探讨客观评价艺术嗓音歌声的方法。方法对48名声乐专业青年大学生录制专业训练歌声信号,提取歌声平均能量、频率误差、音域误差作为评价参数,使用神经网络方法和多元线性回归方法客观评价歌声质量,并与资深专业教师的主观评价进行比较。结果客观评价歌声质量的方法中,神经网络方法误差在4%之内,而线性回归方法误差在6%之内,前者较优。结论神经网络方法利用评价参数能正确客观评价歌声质量,有助于科学地指导选拔和训练艺术嗓音人才。