社区精神分裂症综合式家庭干预对照研究

目的：了解综合式家庭干预对社区精神分裂症患者和家属的效果。方法：在宝山区随机抽取186例精神分裂症进行一年的综合式家庭干预对照研究,干预组86例接受综合式家庭干预和常规社区服务,对照组100例仅接受常规社区服务。结果：干预组患者年复发率下降47．3％,社区功能明显改善,干预组家庭对有关疾病知识增长,心理状况改善,照料负担减轻,与对照组比较效果显著。结论：综合式家庭干预对精神分裂症患者家属有良好的效果,应纳入常规社区服务。     

脉冲多普勒超声定量检测狭窄管流中流动指标的方法学探讨

目的　探讨狭窄管流中一系列流动指标的定量检测方法 ,包括 Reynolds数、相对频带展宽度(RSB)、层流剪应力、法向雷诺应力 (RNS)等。方法　采用临床使用的脉冲多普勒血流仪在狭窄前后多个位点进行多时点检测 ,得出流场特征 ,再分别评价各项指标。结果　定性评价见狭窄下游呈现鲜亮的“烛焰形”花色镶嵌湍流流型 ,狭窄后 1.0 cm处得到较大的 RSB、RNS等 ,1/ 2 R取样容积处湍流指标大于相应的轴心处。结论　狭窄后1.0 cm1/ 2 R取样容积处存在最大的湍流度 ;狭窄后各位点的数据离散度大于狭窄前。该研究为进一步在不同流场中开展生物力学的在体研究奠定了前期工作基础     

市场均衡就业区间及其对社会就业的影响

现代市场经济运行中 ,厂商将其供给量调整到合理水平所需的费用可称为微观调节成本。由于存在微观调节成本这种特殊的经济运行费用 ,因而传统分析中宏观层面上市场就业均衡点的两侧便分别存在着“低位临界点”与“高位临界点” ,这两点界定了一个“市场均衡就业区间” ,社会就业一旦进入该区间 ,市场机制便不可能再对其作出调节。市场均衡就业区间的主要特点在于 ,其均衡是就区间外部而言的 ,在区间内部仍可以存在一定程度的就业失衡 ;市场均衡就业区间内部的就业失衡是一种特殊的就业失衡 ,市场机制对之无能为力 ,一般的宏观经济政策亦无法对其发生作用。市场均衡就业区间的存在对社会就业有着多方面的重要影响 ,它使社会就业对供求总量波动的反应呈现出一定“粘性” ;使市场机制对社会就业的调节空间减小 ;使政府调控社会就业的重点二元化 ;使个体经济在缓解就业失衡压力、扩大社会就业方面占有了特殊重要的地位。     

Measurement of self-propulsion distance of wheelchair using cycle computer excluding assistance distance by touch switch: A pilot study

Objective: Although the propulsion distance of a wheelchair is measured by some devices, measuring self-propulsion distance, excluding assistance propulsion distance by the caregiver, is difficult. This is a pilot study conducted to verify whether the propulsion distance of wheelchair users, excluding the assistance propulsion distance, can be measured using a cycle computer by attaching the touch switch.Methods: The wheelchair propulsion distance was measured using a cycle computer. We connected the touch switch and the cycle computer to the wheelchair to exclude assistance propulsion distance. We set the cycle computer to stop recording while the caregiver was touching the sensor. To confirm the propulsion distance using the cycle computer, the volunteer propelled the wheelchair on a rectangular facility with a total distance of 181 m, and the examiner confirmed the propulsion distance. The validation test to confirm the accuracy of the touch switch attached to the cycle computer was performed on a 50-m straight runway. The volunteer and caregiver propelled the wheelchair alternately by 10 m and continued until 50 m. The examiner confirmed the distance after 50-m propulsion.Results: In the 181-m rectangular facility, the propulsion distance that the volunteer propelled the wheelchair with the cycle computer was 180 m. In the 50-m straight runway, the propulsion distance was 30 m with caregiver assistance for 20 m.Conclusion: The present study showed that our modified device could measure the self-propulsion distance, excluding assistance propulsion distance in wheelchair users.     

Collaborative working in health and social care: Lessons learned from post-hoc preliminary findings of a young families’ pregnancy to age 2 project in South Wales,United Kingdom

Children of young and socially disadvantaged parents are more likely to experience adverse outcomes. In response to this, a unique young families’ project in Swansea, UK, was created, which drew together a team of multi-agency professionals, to support people aged 16–24 from 17 weeks of pregnancy throughout 1,001 days of the child's life. The aim of the JIGSO (the Welsh word for Jigsaw) project is for young people to reach their potential as parents and to break the cycle of health and social inequality. This evaluation analysed routinely collected data held by the project from January 2017 to December 2018 exploring health and social outcomes, including smoking and alcohol use in pregnancy, breastfeeding, maternal diet and social services outcomes. Outcomes were compared to local and national averages, where available. Data relating to parenting knowledge and skills were available via records of 10-point Likert scales, one collected at the start of the JIGSO involvement and one around 4–6 months later. Findings showed higher than average levels of breastfeeding initiation and lower smoking and alcohol use in pregnancy. Parents also reported enhanced knowledge and confidence in their child care skills, as well as improved family relationships. Parents with high levels of engagement with JIGSO also appeared to have positive outcomes with Social Services (their child's name was removed from child protection register or their case was closed to social services). This was a post-hoc evaluation, not an intervention study or trial, and thus findings must be interpreted with caution. Despite this, the findings are promising and more prospective research exploring similar services is required.     

Variations of relative anteversion of the femoral neck during walking

Summary Based on the geometric model developed by Netter [11], we determined the different positions of the femoral neck during monopodal support in walking in relation to a fixed frontal plane of reference (relative anteversion). This relative anteversion ranges on average from 24° of retroversion at the beginning of support to 15° of anterversion at the end if loading. We then studied the relations possibly existing between relative anteversion and acetabular orientation on the one hand, and the orientation of the resultant of the articular stresses on the other (both being variables during monopodal support in walking). The results showed that relative anteversion is well correlated with variations of position of the acetabulum since, at most, the deviation between the respective axes did not exceed the anatomic deviation due to absolute anteversion of the femoral neck and acetabulum. Lastly, analysis of the relations obtained with the orientation of the resultant of the articular stresses allowed a better comprehension of the functional distribution of forces.

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Variations de l'antéversion relative du col fémoral au cours de la marche

Résumé Nous inspirant de la modélisation géométrique développée par R. Netter dans sa thèse, nous avons déterminé les différentes positions du col fémoral au cours de l'appui monopodal de la marche par rapport à un plan frontal fixe de référence (antéversion relative). Cette «antéversion relative» s'échelonne en moyenne de 24° de rétroversion en début d'appui à 15° d'antéversion en fin d'appui. Nous avons alors étudié les relations pouvant exister entre l'antéversion relative et l'orientation de l'acétabulum, d'une part, et, d'autre part, l'orientation de la résultante des sollicitations articulaires (toutes deux variables au cours de l'appui monopodal de la marche). Les résultats nous ont montré que l'antéversion relative est bien corrélée aux variations de position de l'acétabulum puisque, au maximum, l'écart entre leurs axes respectifs ne dépasse pas l'écart anatomique du à l'antéversion absolue du col et de l'acétabulum. Enfin, l'analyse des rapports existant avec l'orientation de la résultante des sollicitations articulaires nous permet de mieux entrevoir la répartition fonctionnelle des contraintes.

     

穿心莲内酯对TBHP诱导的椎间盘髓核细胞凋亡的作用及机制研究

目的：探讨穿心莲内酯（andrographolide,ANDRO）对叔丁基过氧化氢（tert-butyl hydroperoxide,TBHP）诱导的椎间盘髓核细胞（nucleus pulposus cells,NPC）凋亡的作用及其机制。方法：用TBHP诱导NPC建立细胞模型。将NPC分为5组：对照组、模型组（100μmol/L TBHP）、ANDRO低剂量组（100μmol/L TBHP+9μmol/L ANDRO）、ANDRO中剂量组（100μmol/L TBHP+18μmol/L ANDRO）和ANDRO高剂量组（100μmol/L TBHP+36μmol/L ANDRO）。流式细胞术检测细胞凋亡和活性氧（reactive oxygen species,ROS）水平,ELISA试剂盒检测氧化应激相关指标超氧化物歧化酶（superoxide dismutase,SOD）、谷胱甘肽过氧化物酶（glutathione peroxidase,GSH-PX）和过氧化氢酶（catalase,CAT）水平,JC-1探针法检测线粒体膜电位,Western blot检测动力相关蛋白1(dynam...     

Effect of distance and population size on patient trips in a prefecture of Japan: Application of a transportation distribution model to the demand for and supply of health services

The gravity model, a method for analyzing transportation distribution in transportation engineering, was used to explain patient trips between ten health service regions in a Japanese prefecture. The OD (Origin-Destination) tables were constructed with zoning by regions, distinguishing between out- and inpatients. The observed trips were determined from the data of a survey conducted in 1992 that reported the locations of patient residences and chosen medical facilities. The base values used in the model calculations were the population size of each region and the road distance between the centers of regions. Problems of intrazonal trip were avoided by setting a mean intrazonal movement distance. This model was calibrated by the linear regression method with simultaneous validation by the index of correlation coefficients. The model was found to accurately simulate the effect of distance on the choice of medical facilities and the differences between the characteristics of in- and out-patients. The population value in use showed the relation not only with demand but also the supply of clinical services. It was suggested that the model presented here was useful in the allocation of medical resources and would help explain the relationship between suppliers and consumers of medical services.     

Periventricular- intraventricular hemorrhage in the premature infant- A historical perspective

The objective of this chapter is to trace the evolution of intraventricular hemorrhage in the premature infant highlighting the importance of the germinal matrix, a critical role for cerebral blood flow changes in the genesis of hemorrhage, clinical factors that increase the bleeding risk, and potential preventative strategies. In 1976, neuropathological studies demonstrated capillary rupture within the germinal matrix as the precursor of hemorrhage. In 1980, introduction of cranial ultrasound facilitated diagnosis of intraventricular hemorrhage. In 1979, loss of cerebral autoregulation in sick newborn infants was demonstrated. In the 1980’s, studies demonstrated the importance of intravascular factors in provoking hemorrhage. In 1983, the association of cerebral blood flow velocity fluctuations and subsequent hemorrhage was demonstrated. In 1994, antenatal steroids use to accelerate lung development was recommended. This was associated with an unanticipated reduction in hemorrhage. In the mid 1990’s early indomethacin administration was associated with a reduction of severe hemorrhage.     

153例"摇头丸"滥用者社会学特征及相关因素分析

目的：分析“摇头丸”滥用者社会学特征及相关因素，为进行有效心理干预提供依据。方法：采用自行设计的《“摇头丸”滥用者心理社会学特征调查表》对北京市安康医院强制戒毒所2002年6月5日-2003年4月14日收治的153例“摇头丸”滥用者进行逐项登记，并对“摇头丸”服用方式、服用场所、对“摇头丸”认知情况以及经济状况进行比较。结果：“摇头丸”滥用者多以好奇为主，服用场所以迪厅、歌厅等娱乐场所为主、对“摇头丸”认知欠缺，经济状况尚好。结论：“摇头丸”滥用者虽然知识结构和经济状况尚好，但毒品知识欠缺，并以群体服用为主。