南充市社区中老年人群血脂血糖现状水平分析

【摘要】 目的 了解社区中老年人群的血脂、血糖现状水平，探讨其与性别和年龄的关系，为本地区心脑血管疾病、糖尿病等疾病的防治提供诊疗依据。方法 对我市38078名社区居民采集清晨空腹血清标本，检测血糖（GLU）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL C）和低密度脂蛋白胆固醇（LDL C）的结果，并对其进行年龄、性别分组统计分析。结果 不同性别和年龄组间的血脂、血糖水平差异有统计学意义（P＜005），74~89岁年龄组血脂、血糖总体水平高于其他各年龄组（P＜005）；女性血脂水平普遍高于男性（P＜005）。结论 中老年人群血脂、血糖异常率高，应定期对中老年人进行血脂、血糖监测，开展宣传教育活动，提高自我保健意识，预防高血脂、高血糖的发生和发展。     

Audit of minimally-invasive surgery for submandibular sialolithiasis

Sialolithiasis is one of most common diseases to affect major salivary glands, with a symptomatic incidence of 27 cases per million per annum. The majority form within the submandibular gland where minimally-invasive treatments have all but eliminated adenectomy. All records of patients presenting with submandibular stones between 1997 and 2015 were reviewed. Stones <5 mm were retrieved through endoscopic or radiographic techniques, 5-7 mm stones were initially considered for extra-corporeal shock wave lithotripsy, but after poor results were treated through intraoral surgical removal with those >7 mm. Follow up was performed at 1 week and 3 months with current status performed with postal and telephone questionnaires. 378 patients had 424 stones removed, successful retrieval in 94% (n = 356), with 50 having had previous failures. Median number of stones per patient was 1 (range 1-4), with a mean size of 8.6 mm (SD 4.5 mm) mainly located at the hilum (50.5%), anterior duct (30%) and Genu (17%). 256 patients (65%) treated through intraoral surgical extraction, 92 (24%) endoscopic alone. Inpatient stay was 1.4 days in first third and 0.5 days in final third. Adenectomy occurred in 14 patients, due to failure to retrieve the sialolith or unresolved symptoms. Complications involved 11 patients with permanent paraesthesia, 7 ranulas and 14 strictures. Patients with preoperative strictures were more likely to develop complications (p = 0.002) with paraesthesia being most common. Intraoral minimally-invasive surgery is aesthetic, curative and spares the risk to marginal mandibular nerve and submandibular gland. Length of inpatient stay improved and ranula risk reduced throughout the study.     

Deformation on normal and fused haematopoietic blasts in ac electric fields

Changes in the physical properties of a cell plasma membrane following electrically induced cell fusion have been studied alongside changes in the mechanical properties of the system. This allows direct comparison of the experimental results with the theory of the electromechanical stresses produced in the plasma membrane by electric fields. The geometrical deformation of K-562 cells (Ph⁺ haematopoietic blasts) and their fusates (produced by electric fusion of 2 or 3 K-562 cells) in ac electric fields has been investigated. For electric fields in the range 0–270000 V/m (at a frequency of 370 kHz) the eccentricity of both cells and fusates increased with field strength asymptotically. The effect of field strength on eccentricity was similar for cells and fusates. There was an almost linear relationship between the ratio of the major to the minor semi-axes of cells and fusates and the field strength. Smaller cells underwent larger deformations in an electric field. An increase in electric field intensity caused an increase in the surface area of cells and fusates while the volume of cells and fusates was independent of the field. For a given field strength, cell and fusate deformation increased with excitation frequency over the range 100–450 kHz, with a broad peak in the region 350–450 kHz, and was almost constant at higher frequencies. A time constant of approximately 15 s was obtained for deformation of K-562 cells and two- and three-nuclei fusates. The dynamics of cell and fusate deformation indicates that 50 s after exposure to an electric field no additional changes in geometrical deformation occurred. For small deformations the restoring stress is probably dominated by the mechanical stress set up in the membrane. Employing Maxwell's tensor for the distorting force ensures consistency between theory and the experimental results.     

A Knowledge Authoring Tool for Clinical Decision Support

Anesthesiologists in the operating room are unable to constantly monitor all data generated by physiological monitors. They are further distracted by clinical and educational tasks. An expert system would ideally provide assistance to the anesthesiologist in this data-rich environment. Clinical monitoring expert systems have not been widely adopted, as traditional methods of knowledge encoding require both expert medical and programming skills, making knowledge acquisition difficult. A software application was developed for use as a knowledge authoring tool for physiological monitoring. This application enables clinicians to create knowledge rules without the need of a knowledge engineer or programmer. These rules are designed to provide clinical diagnosis, explanations and treatment advice for optimal patient care to the clinician in real time. By intelligently combining data from physiological monitors and demographical data sources the expert system can use these rules to assist in monitoring the patient. The knowledge authoring process is simplified by limiting connective relationships between rules. The application is designed to allow open collaboration between communities of clinicians to build a library of rules for clinical use. This design provides clinicians with a system for parameter surveillance and expert advice with a transparent pathway of reasoning. A usability evaluation demonstrated that anesthesiologists can rapidly develop useful rules for use in a predefined clinical scenario.     

睡眠质量评价的现状与展望

睡眠质量评价分为客观评价和主观评价,其中主观评价又分为夜间功能与白天功能。客观评价方面,目前公认的金标准是多导联睡眠监测,另外还有夜帽、便携睡眠检测仪、微动敏感床垫等,但关于这些仪器的文献研究报道不多,其准确性等尚有待验证。主观评价方面,国内外失眠相关性量表共约76种,需要根据量表特征与研究需要具体选择。中医在睡眠质量评价方面更为关注失眠患者整体症状,整体生理机能。中西医在睡眠质量评价方面均有各自关注的重点,在"互联网+"的时代,如何使到睡眠质量评价工具更为便携,可穿戴,简易居家操作是重要的发展方向。     

The fatty acid content and drug binding characteristics of commercial albumin preparations

The fatty acid contents of thirteen commercial preparations of human albumin were found to be in the range 0.03 to 9 mol of fatty acid/mol albumin. Marked differences were found between the preparations in the binding of the fluorescent probes, 5-dimethylamino-naphthalene-1-sulfonamide (DNSA) and dansylsarcosine. The displacement of these probes by ibuprofen and phenylbutazone also showed marked differences between preparations. The differences between the commercial albumin samples correlated well with their fatty acid contents and were abolished by treatment with charcoal. They were similar to the changes observed when oleic acid was added to fatty acid free albumin. The source and fatty acid content of commercial albumin preparations should be considered when comparing studies of the binding of drugs to human albumin.     

Preliminary evidence of disparities in physical activity among adolescents with bipolar disorder

Physical activity can potentially mitigate the symptomatic burden and cardiovascular risk associated with bipolar disorder (BD). Studies have found that adults with BD are less physically active than controls. However, no previous study has examined this topic among adolescents with BD. This study compares physical activity among adolescents with BD vs. healthy controls without major psychiatric disorders, and examines characteristics associated with physical activity among adolescents with BD. Subjects were 86 adolescents with a diagnosis of BD via gold-standard psychiatric interviews, and 50 controls. The Quick Weight, Activity & Excess Screener (WAVE) was used to assess physical activity. Between-group analyses examined for differences in achieving recommended benchmarks for three types of physical activity: working out, “working in” (incidental physical activity), and screen time. Exploratory within-group analyses were based on a median split (high vs. low) of the total physical activity scores among BD adolescents. Adolescents with BD were significantly less likely to report working out regularly (6%) as compared to controls (22%; χ² = 7.98, p = 0.005). There were no significant between-group differences in working in or screen time. BD adolescents with low levels of physical activity were less likely to have a family history of substance use disorder (p = 0.03). Adolescents with BD are less likely than their peers to achieve the recommended benchmark for regular working out. Future studies are warranted to determine what factors explain this difference, and to identify strategies for optimizing physical activity among adolescents with BD.     

课堂教学中的情境创设

课堂教学是以课堂的形式组织教学活动,并按照课程标准来完成课程目标的过程,教学情境创设是通过设计一定的教学情境,使老师和学生进行思想的交换和心灵的交融,达到激活学生已有经验、产生认知冲突和探究的欲望的操作。教师在充分研究教学内容、教学方法、学生认知水平和思维特点的基础上,在课堂教学的各个环节,创设适宜的教学情境,启迪学生思维,提高课堂教学效率,达成学习目标。     

四川省南充市儿科医疗现状调查分析

目的:分析南充地区儿科医疗现状。方法:采用调查问卷对南充市具有儿科资质的二级及以上单位进行调查。结果:南充市儿科发展初具规模,但儿科医务人员数量严重不足,设备缺乏,业务水平低下,儿科发展中面临很多问题。结论:南充市儿科医疗现状不容乐观。