新医改前后我国东中西部卫生监督人员配备比较研究

目的:了解“新医改”前后我国东中西部地区卫生监督人员变化趋势.方法:定量研究.结果:(1)“新医改”后东中西部地区卫生监督人员数量显著增加,但与需求仍有差距；(2)“新医改”后东中西部地区卫生执法人员比例稳中有升,综合业务人员比例下降明显,行政后勤人员比例相对稳定；(3)“新医改”后高学历卫生监督人员比例大幅提升,尤以东部地区最为突出,但仍不能完全满足实际要求.结论:(1)东中西部各区域应因地制宜,缩小地区间差异并进行卫生监督人力管理体制改革；(2)加强卫生监督队伍建设、提高人力资源质量.     

The Development of the Middle Ear in Neonatal Chinchillas II. Two Weeks to Adulthood

Studies of auditory function in the human neonate indicate adult-like hearing sensitivity, mature cochlear function and well-developed responses in the auditory pathway. Paradoxically, measurements of middle ear function are characterized by responses that would be interpreted as abnormal in older subjects. Consequently, there is not an accepted clinical test for middle ear disease in the newborn population. Like human neonates, chinchillas have normal hearing sensitivity at birth, but middle ear function tested by multifrequency tympanometry is abnormal compared to the adult. A previous study from our laboratory indicated that the newborn chinchilla middle ear is free of mesenchyme and other debris. Over the first 2 weeks of life there were no significant changes in tympanic membrane thickness and diameter, tympanic membrane to promontory distance and stapes footplate length. There were small changes in mastoid bulla area and perimeter and in mastoid bulla bone thickness. The most striking difference between the newborn and adult temporal bone was in bone composition, the newborn bone having a less dense, spongy appearance. Impedance characteristics of the newborn chinchilla ear, measured by multifrequency tympanometry, were abnormal relative to adult animals and did not change over the first 2 weeks of life. This investigation is an extension of the previous study, designed to better understand the relationship between middle ear function, hearing sensitivity and the structural changes of the newborn chinchilla middle ear. Twenty animals, aged 2-8 weeks, were studied. Additional adult animals were used as controls. Middle ear function was assessed by a wideband reflectance/impedance system. Hearing sensitivity was measured by auditory brainstem response in 2- and 8-week-old animals. Structural characteristics of the temporal bone were analyzed using histopathologic preparations. There was an orderly progression in middle ear impedance and reflectance characteristics as the chinchilla ear matured from 2 to 8 weeks of age. At 8 weeks of age, impedance and reflectance patterns approached, but did not match, those of the adult animal. Hearing sensitivity was unchanged throughout this maturational period. Finally, histological analysis demonstrated no age-related changes in distance from the tympanic membrane (TM) to the promontory and in stapes footplate length. There was a small significant decrease in the TM thickness from 2 weeks to adulthood. The most significant developmental changes were a reduction in mastoid bone thickness and concomitant increases in the perimeters and areas of the middle ear and posterior bulla.     

A foetal tile from an archaeological site: anthropological investigation of human remains recovered in a medieval cemetery in Northern Italy

Background: The recovery of foetal remains is very sporadic in archaeology, especially due the scarce degree of bone mineralisation. This paper presents the singular archaeological discovery of a foetal tile preserving the bone remains, object of our anthropological examination.

Materials and methods: The foetal tile was discovered during an archaeological excavation in a medieval site (Northern Italy). The tile was analysed by CT scan and later, human remains were anthropologically examined.

Results: The archaeological investigation revealed a special ritual destined to foetuses while forensic anthropological analysis allowed estimating the gestational age near to 21–24?weeks.     

血塞通对 MCAO 大鼠不同恢复时间点Nogo-A 蛋白表达的影响

目的：探讨血塞通冻干粉注射液对大鼠局灶性脑缺血模型不同恢复时间点7d，14d，28d大脑皮层的主要抑制因子Nogo-A表达的影响。方法健康雄性SD大鼠，随机分为手术组和非手术组，手术组采用改良Longa方法建立大脑中动脉阻塞（ MCAO）模型，待大鼠术后清醒2h后，进行EZLonga评分，根据评分和体重随机分为血塞通大剂量组（7．2mg／100g）、小剂量组（3．6mg／100g）、尼莫地平组（1．44mg／100g）、模型组（生理盐水），于手术当日开始给药。待7d，14d，28d时，各组取6～8只动物，迅速取脑，于视交叉处将大脑前后分开，前端脑放入10％的甲醛中固定，48h后用PBS将脑组织洗净，石蜡包埋切片，用免疫组织化学染色方法观察不同时间点Nogo-A的表达变化，分别对梗死区、梗死周边区进行平均光密度分析。结果梗死区随着时间的延长，Nogo-A的表达逐渐减弱，在各时间点内，血塞通组和尼莫地平组Nogo-A的表达高于模型组。梗死周边区，模型组Nogo-A的表达趋势是7 d时已经高表达，14 d达到高峰，28 d比14 d略低，但仍保持较高水平，在各时间点，血塞通组比同时间点内的模型组表达低，与模型组差异显著（P＜0．05）。结论血塞通可以保护大鼠梗死区及梗死周边区的神经细胞，可以下调梗死周边区不同恢复时间点Nogo-A的表达。血塞通可能是通过下调Nogo-A的表达来实现大脑神经功能的重塑重建作用。     

A Review of Dietary Selenium Intake and Selenium Status in Europe and the Middle East

This is a systematic review of existing data on dietary selenium (Se) intake and status for various population groups in Europe (including the United Kingdom (UK)) and the Middle East. It includes English language systematic reviews, meta-analyses, randomised controlled trials, cohort studies, cross-sectional and case-control studies obtained through PUBMED searches from January, 2002, to November, 2014, for European data and from 1990 to November 2014, for Middle Eastern data. Reports were selected if they included data on Se intake and status. The search identified 19 European/UK studies and 15 investigations in the Middle East that reported Se intake and Se concentration in water and/or food and 48 European/UK studies and 44 investigations in the Middle East reporting Se status. Suboptimal Se status was reported to be widespread throughout Europe, the UK and the Middle East, and these results agreed with previous reports highlighting the problem. Eastern European countries had lower Se intake than Western European countries. Middle Eastern studies provided varying results, possibly due to varying food habits and imports in different regions and within differing socioeconomic groups. In conclusion, Se intake and status is suboptimal in European and Middle Eastern countries, with less consistency in the Middle East.     

Collateral augmentation treatment with a combination of acetazolamide and head-down tilt in a rat ischemic stroke model

Cerebral collaterals is crucially important in the pathophysiology of acute ischemic stroke and associated with outcome after reperfusion therapy. We explored the effectiveness of collateral augmentation treatment with a combination of acetazolamide (ACZ) and head-down tilt (HDT) in the transient middle cerebral artery occlusion (MCAO) rat model. Transient MCAO was induced in all animals for 1.5 h, followed by reperfusion for 22.5 h. Seventy-two male Wistar rats were divided into four treatment groups: control, ACZ, HDT, and combination. Twenty sham rats, which underwent surgery, were randomly allocated to these groups. Twenty-four hours after MCAO or sham surgery, we measured the infarction volume, brain edema (aquaporin-4 [AQP4], and brain water content), and neurological deficits (Garcia and Longa tests). Collateral augmentation treatments were associated with reduced infarction volume, less brain edema, and better neurological outcomes compared with untreated animals. More specifically, ACZ and HDT treatments resulted in small infarction volumes, and HDT was associated with a low AQP4 expression and improved neurological score, while the combination of ACZ and HDT improved neurological scores and reduced brain water content. This study shows that collateral augmentation treatments are associated with a better stroke prognosis compared with untreated animals after transient MCAO. The combination of ACZ and HDT seems to have some synergistic effect, but was not proven to be superior to HDT treatment alone.     

艾迪注射液治疗中晚期妇科肿瘤60例疗效探讨

目的：分析评价艾迪注射液治疗中晚期妇科肿瘤的临床疗效。方法方便选取2015年3—8月期间该院收治中晚期妇科肿瘤患者共120例，随机分组。对照组用常规方法治疗，实验组联合艾迪注射液治疗。对比治疗效果。结果实验组总有效率为95.00%(57/60），明显高于对照组(P<0.05）。两组用药期间均未见明显不良反应。结论艾迪注射液对改善中晚期妇科肿瘤患者临床疗效有确切价值，且未在用药期间出现不良反应，值得推广应用。     

The stinging Apidae and Vespidae (Hymenoptera: Apocrita) in Iranian islands,Qeshm, Abu–Musa,Great Tunb and Lesser Tunb on the Persian Gulf

ObjectiveTo study the stinging flying Hymenoptera (Apidae and Vespidae) fauna in four Iranian Islands, Qeshm, Greater Tunb, Lesser Tunb and Abu-Musa on the Persian Gulf.MethodsThe flies were captured by used of Malaise trap, fly trap, bottle trap and insect net-hashing from March 2011 to July 2012.ResultsIn this study, 11 species of stinging Hymenoptera were reported for the first time in Persian Gulf region.ConclusionsSome of this species such as Vespa orientalis and Polistes olivaceus are more common in the Persian Gulf islands and can cause clinical problem to islands resident and travelers.     

Ischemic stroke in Morocco: Prehospital delay and associated factors

ObjectivesThis study aimed to estimate prehospital delay and to identify the factors associated with the late arrival of patients with ischemic stroke at the Souss Massa Regional Hospital Center in Morocco.Patients and methodsAn observational, prospective, cross-sectional study was conducted from March 2019 to September 2019 in the Souss Massa regional hospital center, which is a public hospital structure. A questionnaire was administered to patients with ischemic stroke and to bystanders (family or others), while clinical and paraclinical data were collected from medical records. Univariate and multivariate logistic regression analyses were used to identify the factors associated with delayed arrival at emergency department.ResultsA total of 197 patients and 197 bystanders who fulfilled the criteria for the study were included. The median time from symptom onset to hospital arrival was 6 hours (IQR, 4–16). Multiple regression analysis showed that illiteracy (OR 38.58; CI_95%: 3.40–437.27), waiting for symptoms to disappear (patient behavior) (OR 11.24; CI_95%: 1.57–80.45), deciding to go directly to the hospital (patient behavior) (OR 0.07; CI_95%: 0.01–0.57), bystander's knowledge that stroke is a disease requiring urgent care within a limited therapeutic window (OR 0.005; CI_95%: 0.00–0.36), and direct admission without reference (OR 0.005; CI_95%: 0.00–0.07), were independently associated with late arrival (> 4.5 hours) of patients with acute ischemic stroke. In addition, illiteracy (OR 24.62; CI_95%: 4.37–138.69), vertigo and disturbance of balance or coordination (OR 0.14; CI_95%: 0.03–0.73), the relative's knowledge that stroke is a disease requiring urgent care and within a limited therapeutic window (OR 0.03; CI_95%: 0.00–0.22), calling for an ambulance (relative's behavior) (OR 0.16; CI_95%: 0.03–0.80), distance between 50 and 100 km (OR 10.16; CI_95%: 1.16–89.33), and direct admission without reference (OR 0.03; CI_95%: 0.00–0.14), were independently associated with late arrival (> 6 hours) of patients with acute ischemic stroke.ConclusionPatient behavior, bystander knowledge and direct admission to the competent hospital for stroke care are modifiable factors potentially useful for reducing onset-to-door time, and thereby increasing the implementation rates of acute stroke therapies.