螺旋CT在临床上对于腰椎、骶椎间盘诊断适应症及价值分析

运动处方是指医生根据病人的健康状况而规定的运动方法和运动方式、强度时间和频度,同时指出注意事项.人工全膝关节转换术后的目的是解除患者影响日常生活的膝关节疼痛和功能障碍,是其膝关节恢复正常功能,提高生活质量,凡行人工全膝关节置换术后的病人,如何恢复其膝关节功能显得非常重要.     

推拿加腹肌锻炼治疗小儿遗尿症22例临床疗效观察

从肺、脾、肾、膀胱、三焦辨证,采用分证推拿手法结合自拟腹肌锻炼的方法,治疗小儿遗尿症22例,取得较好的临床疗效.     

Societal Effects Are a Major Factor for the Uptake of the Coronavirus Disease 2019 (COVID-19) Digital Contact Tracing App in The Netherlands

ObjectivesOur study investigates the extent to which uptake of a COVID-19 digital contact-tracing (DCT) app among the Dutch population is affected by its configurations, its societal effects, and government policies toward such an app.MethodsWe performed a discrete choice experiment among Dutch adults including 7 attributes, that is, who gets a notification, waiting time for testing, possibility for shops to refuse customers who have not installed the app, stopping condition for contact tracing, number of people unjustifiably quarantined, number of deaths prevented, and number of households with financial problems prevented. The data were analyzed by means of panel mixed logit models.ResultsThe prevention of deaths and financial problems of households had a very strong influence on the uptake of the app. Predicted app uptake rates ranged from 24% to 78% for the worst and best possible app for these societal effects. We found a strong positive relationship between people’s trust in government and people’s propensity to install the DCT app.ConclusionsThe uptake levels we find are much more volatile than the uptake levels predicted in comparable studies that did not include societal effects in their discrete choice experiments. Our finding that the societal effects are a major factor in the uptake of the DCT app results in a chicken-or-the-egg causality dilemma. That is, the societal effects of the app are severely influenced by the uptake of the app, but the uptake of the app is severely influenced by its societal effects.     

三臣药在蒙医中的应用研究进展

三臣药为蒙医中常用清小儿肺热药，由天竺黄、藏红花和牛黄等量组成，具有清热、止咳功能。本方性凉，临床上常做成散剂或丸剂，在《观者之喜》《甘露四部》《蒙医秘方荟萃》等蒙医药书籍中均有记载，但各书中所记载的配伍剂量及入药药材有所差异。本文对三臣药在蒙医中的用法、性味、功能、临床配伍等方面进行了对比分析，整理出三臣药在蒙医本草中的记载情况，再结合计算机软件分析，对三臣药各组分在蒙医药中的使用频率及用药规律进行分析，并简要介绍三臣药各组分的化学成分及药理活性研究进展，为三臣药在蒙医药领域的应用提供依据。     

Progress in prophylactic human papillomavirus (HPV) vaccination in 2016: A literature review

Prophylactic human papillomavirus (HPV) vaccine represents a revolutionary step forward in preventing HPV-related cancers, especially cervical carcinoma. Alongside appropriate screening, it has the potential to dramatically reduce cervical cancer incidence and even eradicate it. Following extensive evaluations in clinical trials, the first decade of routine HPV vaccine use provides overwhelming evidence of the vaccines’ safety and their real-life effectiveness. In 2016, further clinical trials showed high vaccine efficacy in adult women, especially those that were HPV DNA-negative at baseline, and indicated possible protection from HPV-related diseases after treatment of precancerous cervical lesions. The recommendation for a two-dose schedule in individuals under 15 is further supported for all three licensed vaccines by immunogenicity studies that show non-inferior immune responses and similar clinical efficacy compared to the three-dose schedule. So far, natural competition between HPV types has not been confirmed and therefore vaccine-induced clinically significant type replacement is unlikely. The real-world effectiveness data showed cross-sectional reduction in the prevalence/incidence of vaccine-related HPV types, genital warts and precancerous cervical lesions in countries and regions with HPV vaccination coverage. These declines were evident not only in vaccinated females, but also in unvaccinated females and males, strongly suggesting herd protection. Despite an excellent safety profile consistently demonstrated in clinical trials and confirmed in real-life settings, recently invented controversial syndromes allegedly linked to HPV vaccines temporarily compromised some previously very successful vaccination programs and significantly contributed to the failure of HPV vaccine implementation in some countries with the highest prevalence of cervical cancer. However, several safety studies failed to confirm any association of these syndromes with HPV vaccination in various settings and geographic locations. The main challenges remain implementing HPV vaccination in national vaccination programs, especially in low-and middle-income countries with the highest burden of cervical cancer, and achieving and sustaining high vaccine coverage rates.     

Long‐term effects of health investments and parental favoritism: the case of breastfeeding

This paper re‐examines the effects of breastfeeding on long‐term educational outcomes using longitudinal data on siblings. While family‐fixed effects allow controls for all shared family factors, these estimators are sensitive to compensating or reinforcing behaviors by parents. These biases may be particularly important for estimating the effects of parental investment such as breast feeding, where sibling discordance may be difficult to treat as a random outcome and may result in persistence in differential investments between siblings. This paper uses a unique question asked to adolescent siblings about parental favoritism to adjust for potential reinforcing behavior by parents. Standard fixed effects estimates suggest important long‐term educational effects of breastfeeding; however, these effects are uniformly eliminated after focusing on families who treat siblings equally. These findings shed light on the mechanisms linking associations between breastfeeding and longer term outcomes. Copyright © 2010 John Wiley & Sons, Ltd.     

三种常用皮瓣修复指端软组织缺损疗效比较

目的 探讨手部常用的三种小型皮瓣修复指端软组织缺损的临床疗效.方法 根据损伤的程度、性质、指别以及患者的意愿,选用了三种术式对90例指端软组织缺损进行修复.结果 90例手部小型皮瓣全部成活,皮瓣质地良好,外形及功能满意.两点辨别觉（2PD）检测：术后随访6,12,18个月时,三组间动态两点辨别觉（M2PD）及静态两点辨别觉（S2PD）比较,其差异均无统计学意义（P＞0.05）.结论 三种皮瓣是修复指端软组织缺损的理想皮瓣,且成活率高,感觉功能恢复良好.