胰腺分裂与慢性胰腺炎的病因学关系及发病机制

目的:探讨胰腺分裂(PD)在慢性胰腺炎病因学中的作用及其发病机制。方法:将32只犬随机分为4组(每组8只)。Ⅰ组:部分结扎背-腹胰管间的交通支。Ⅱa组:切断并结扎交通支。Ⅱb组:在背胰管注入小乳头前2mm处将其切断并结扎断端。Ⅲ组:假手术对照组,除不结扎交通支外,其余操作同上。于手术前检测各组犬血清磷脂酶(PLA2)和淀粉酶(Ams)活性及背、腹胰管基础压并在胰泌素激发后15、30、45、60和90分钟各测压一次。于术后180天再行胰胆管测压和造影并观察背、腹胰和十二指肠乳头的病理改变。结果:⑴Ⅰ、Ⅱa组和Ⅱb组术后5-80天血清PLA2和Ams活性显著升高。⑵处死时Ⅰ、Ⅱa组腹胰管和Ⅱb组背、腹胰管压力在激发后30-60分钟显著高于注药前(P<0.01);在60分钟后,前两组压力恢复到术前水平(P>0.05),而Ⅱb组仍较高(P<0.05),该组压力在90分钟后恢复正常。⑶光镜:Ⅱb组犬背、腹胰小叶间或/和胰管周围显著纤维组织增生,腺细胞结构破坏和炎细胞浸润。Ⅰ和Ⅱa组腹胰见轻度上述改变。⑷电镜:Ⅰ、Ⅱa组腹胰和Ⅱb组背、腹胰腺细胞粗面内质网脱颗粒、融合和扩张。酶原颗粒减少,线粒体肿张。Ⅰ和Ⅱa组背胰及Ⅲ组背、腹胰未见异常。结论:PD是慢性胰腺炎的病因学因素之一,其引发胰腺炎的机制是在胰液分泌的高峰期副乳头功能性梗阻。     

我对子午流注阴阳盛衰转换的认识

阐述了时相与阴阳的关系，阴阳昼夜的盛衰转换与经脉循行、气血流注密切相关；对传统流注说和任督为主的阴阳循环说进行了分析，认为子午流注阴阳盛衰转换在妇科学中有重要意义，子午流注所指出的4个较重要的时期与月经周期中的4期(行经期、经后期、经间排卵期、经前期)相关。重视研究日相阴阳太极钟的变化，将能更加深入地认识月经周期中阴阳消长转化的规律变化，从而推动中医妇科学向前发展。     

小包装全氟丙烷气体动力学实验研究

为检验塑料小包装全氟丙烷气体（C3F8）在不同包装和储存方法时浓度变化，将装有5～7mlC3F8的聚氯乙烯小袋，根据不同储藏温度和外包装方法随机分成四组：（1）22℃聚乙烯外包装，（2）36℃聚乙烯外包装，（3）22℃铝箔真空外包装，（4）-29℃聚乙烯外包装；每一组C3F8小袋气体存放一定时间后，应用气相色谱分析方法进行浓度测量。结果：第3组C3F8浓度最高和稳定，第2组浓度随放置时间降低最明显，第4组是临床应用气体的储藏和包装方法，其30天样本浓度和第3组相等，但放置一年时浓度降低。结果显示：塑料小包装C3F8予以铝箔真空外包装是一种可行的方法，利于C3F8运输和普及；聚乙烯外包装的C3F8，应放在-29℃保存，时间不超过一年。     

The epidemiology and surveillance of blood lead in Taiwan (R.O.C.): A report on the PRESS-BLL project

 To monitor the lead hazards in industries and to investigate the prevalence of elevated blood lead levels (BLLs) in lead-exposed workers, a lead surveillance system (PRESS-BLLs) has been established and operated in Taiwan, Republic of China, since July 1993. A cohort of lead-exposed workers who received a periodic annual health examination at 55 accredited hospital laboratories was constructed. A total of 9807 separate BLL measurements were reported to the system in 1994. The mean BLL was 15.8 μg/dl in male workers and 11.6 μg/dl in female workers. The mean BLL of lead-exposed workers was significantly (P<0.05, z-test) higher than that of the general Taiwanese population (8.6 μg/dl for males and 6.7 μg/dl for females). In addition, the BLLs of 983 (10.0%) workers exceeded the regulatory action level (40 μg/dl for males; 30 μg/dl for females). The workplaces and homes of 57% of the workers with elevated BLLs were thoroughly investigated to determine the sources of lead contamination. These actions identified the causes of elevated BLLs and set up strategies to reduce workers’ lead exposure. The establishment of this occupational lead surveillance system represents a method for monitoring of lead hazards from occupational and environmental settings to prevent lead poisoning. The information acquired from the system can help in the setting up of a priority of prevention and the development of control measures. It is also useful for further monitoring of changes in the BLLs of the lead-exposed-worker cohort. The Health Department of Taiwan can use this information to evaluate the effectiveness of current industrial hygiene practice. Subjects with elevated BLLs have been medically treated and placed on long-term follow-up for sequelae. Received: 2 September 1996/Accepted: 29 November 1996     

Clinical correlates of changes in self-perceived oral health in older adults

Abstract Although numerous investigators have reported on self-perceived oral health status in adult and older adult populations, few have examined how these perceptions change over time. This paper uses data from a longitudinal oral health survey of community-dwelling Canadians aged 50 years and over to explore this issue. Data were collected at baseline and after 3 years. Change was assessed using a global transition judgement and change scores on four subjective oral health status indicators. These indicators addressed chewing capacity, oral and facial pain symptoms, other oral symptoms, and the psychosocial impact of oral disorders. Overall, 23.0% reported that their oral health had worsened over this period, 66.5% that it had remained the same and 10.5% that it had improved. Change scores on the four indicators showed a similar pattern and were significantly associated with these global judgements. Over the same period, substantial proportions lost one or more teeth, acquired new coronal or root DPS increments or experienced loss of periodontal attachment. An additional 17% complained of dry mouth. However, the only clinical indicator associated with changing perceptions of oral health was tooth loss. Of interest was the fact that rates of tooth loss were equally high among those who reported a worsening of oral health and those who reported an improvement. This suggests that the impact of tooth loss on health status may be positive or negative depending upon the condition of the teeth lost.     

The Hampshire Depression Project: development and piloting of clinical practice guidelines and education about depression in primary health care

This paper describes the development and piloting of a comprehensive educational programme about recognition and management of depressive illness in primary care. Full evaluation of the effectiveness of the programme is currently underway in a randomized controlled trial, the Hampshire Depression Project (HDP), involving 56 general practices. The programme consists of clinical practice guidelines, practice-based seminars and follow-up sessions. Each part of the programme has been designed to be flexible, clinically oriented and relevant to all members of the multidisciplinary primary care team. The pilot study established the need for a systematic approach to the access of practices and practice teams, and the organization and process of the seminars. Application of this approach was associated with excellent attendance in the main programme.     

B超诊断腰椎间盘突出症的临床价值(附64例分析)

报告经CT检查和临床治疗证实的64倒腰椎间盘突出症的B超检查结果,B超检出70个突出之椎间盘,CT检出73个,阳性率之比为70/73。70个突出椎间盘中,中央型5个,偏中央型20个,后外侧型44个,极外侧型1个;轻度30个,中度28个,重度12个。分型分度与临床表现及治疗选择有密切关系。B超检查与CT相此较,具有近似的诊断价值,但经济、实用,操作简单方便,值得推广。     

Patterns of sexual arousal of accused child molesters involved in custody disputes

Penile plethysmography was used to examine sexual preferences of individuals accused of child molestation in the course of custody conflicts. Information regarding the alleged offenders, victims, and sex offense was gathered. In comparison to accused offenders who are not engaged in custody disputes, the subjects were more often accused of sexually abusing a younger child who was a biological relative. The source of accusations was usually the mother. Additionally, the custody-dispute subjects were less likely to have a prior criminal history. Penile tumescence data suggested that the subjects involved in custody disputes were less sexually aroused by children than those subjects who were not involved in custody conflicts. However, the results revealed that in both groups a substantial number of subjects responded equally or more to the child stimuli. In sum, the alleged offenders involved in custody disputes appeared less deviant on several measures.     

The Fort McMurray demonstration project in social marketing: health- and safety-related behaviour among oil sands workers

This is the first round in a series of surveys conducted inFort McMurray as part of the Fort McMurray Demonstration Projectin social marketing. This component of the survey was intendedto focus on the most prominent group of employed workers inthe community and to compare their patterns of response withthe community as a whole. Respondents to the survey were overwhelminglymale (96%), married (72.9%) and living in households of twoto five persons (87.9%). They were predominantly aged 30–44(55%) and graduates of high school (53.5%). Younger male workers(below age 30) were more likely to have a high school diploma(78.3%) or some additional technical or vocational training(21.7% compared to 12.5% overall) and to be unmarried or separated.Attitudes toward safety-related behaviours were stronger thanfor respondents from the community as a whole. Approximately70–100% of all age groups and both sexes showed strongagreement with attitudes involving child car seats and the unacceptabilityof drinking and driving. These attitudes include strong advocacyof vigorous enforcement of occupational health and safety standards.However, they showed a variability similar to the communityas a whole in behaviour at home compared to work, generallyreporting more consistent use of personal protection on thejob than in their own homes, particularly hearing protection.Even so, they were much less likely to perform stretching andwarm-up exercises prior to exertion than community residentsin general. The potential may exist to transfer the technologyand attitudes from workplace health and safety to communitysafety. One possible strategy to accomplish this is to involveworkers in this industry directly in community initiatives.This strategy may be generalizable to any community in whichthere are major employers who place a heavy emphasis on riskcontrol and occupational health and safety.