Assessment of multiple cardiocentesis in ball pythons (Python regius).

This study evaluated the gross and microscopic effects of serial blood collection from six ball pythons (Python regius) by using cardiocentesis. We collected 39 blood samples from each snake over a 120-day period. Cardiocentesis was performed on manually restrained snakes, with each sample requiring approximately 15 sec to collect. No clinically apparent complications were noted in any of the snakes after the cardiocentesis procedures, and all snakes survived until they were euthanized 73 days after the last blood sample. Minimal gross lesions were noted at necropsy; faint brown pigmentation of the pericardium was present in five of six snakes, and three snakes had approximately 0.5 ml dark pigmented fluid in the pericardial space. One snake had a small, organized hematoma in the pericardial space. Microscopic findings were limited to moderate and regularly arranged collagen fibrosis and focal thickening of the epicardium. The pericardial sac in all snakes had a mild infiltrate of hemosiderin-laden macrophages and small numbers of heterophils. The results suggest that serial cardiocentesis is well tolerated in ball pythons.     

Pediatric Acetaminophen Overdose: Assessing the Risk

Micrurus snakes (coral snakes) may produce severe envenomation that can lead to death by peripheral respiratory paralysis. Only few laboratories produce specific antivenoms, and despite the cross‐reactivity found in some Micrurus species venoms, the treatment is not always effective. To test two therapeutic antivenoms against the venom of four species of Micrurus from Southern America, North of South America, Central America, and North America, the determination of the lethal potency of the venoms, the study of some biochemical and immunochemical characteristics, and the determination of the neutralizing activity of both antivenoms were studied. North American and South American antivenoms neutralized well venoms from Micrurus species of the corresponding hemisphere but displayed lower effectiveness against venoms of species from different hemispheres. It was concluded that the neutralization of Micrurus venoms by regional antivenoms could be useful to treat the envenomation by some Micrurus snakes but is necessary to evaluate carefully the antivenoms to be used with the venoms from the snakes of the region. Also, considering the difficulties for coral snake antivenom production, the development of a polyvalent antivenom is useful to treat the envenomation by coral snakes from different regions is necessary.     

中西医结合治疗毒蛇咬伤773例

目的：探讨中西医结合治疗各类型毒蛇咬伤的方法。方法：分析３４例来收治的各类型毒蛇咬伤患者７３例的临床资料,分别采用中草药、西医综合对症治疗及灵活应用抗蛇毒血清治疗,观察其临床疗效。结果：治愈７２５例,显效４０例,总有效率９９．０％,无效８例,病死率１．０％。对于银环蛇咬伤和眼镜蛇咬伤的主要症状改善时间,综合对症治疗组明显优于中医药和抗蛇血清单独治疗。结论：采用中西医结合的综合性治疗方法,可明显临床     

Snake Fear and the Pictorial Emotional Stroop Paradigm

The purpose of this study was to test a novel pictorial emotional Stroop paradigm that required participants to name the colors of filtered images on a computer screen. High (n = 20) and low (n = 20) snake-fearful participants color-named filters covering images of snakes (threat), cows (neutral), bunnies (positive), and blank screens. Each image appeared as if viewed through tinted sunglasses. The results revealed that both groups took longer to name the colors of filters covering bunnies as well as snakes relative to filters covering cows. Intensely snake-fearful individuals (n = 5), however, exhibited additional interference for snake pictures beyond that evoked by bunny pictures. Thus, pictorial cues having positive as well as negative emotional valence disproportionately captured attention. This paradigm shows promise as a nonlexical, ecologically valid approach to evaluating selective processing of emotional cues.     

A SPREADING FACTOR IN CERTAIN SNAKE VENOMS AND ITS RELATION TO THEIR MODE OF ACTION

The venom of several species of poisonous snakes acts to spread India ink through the skin as do the spreading factors procurable from certain tissues and elaborated by invasive bacteria. The factor is most abundant in the venom of the Viperidae (rattlesnake) family and relatively scant in the venom of Colubridae proteroglypha (cobra) family, and it is absent from toad venom. Extracts of the supralabial glands of harmless snakes contain only negligible amounts of the factor. Rattlesnake venom heated at 65° to 100° loses a large proportion of its toxicity but retains the ability to spread ink. Rattlesnake venom that has lost its toxicity on standing or on heating markedly enhances the infection produced by bacterial or virus suspension in the rabbit skin. Antivenine serum inactivates both the toxic and spreading factors of venom.     

T-snakes: topology adaptive snakes

We present a new class of deformable contours (snakes) and apply them to the segmentation of medical images. Our snakes are defined in terms of an affine cell image decomposition (ACID). The 'snakes in ACID' framework significantly extends conventional snakes, enabling topological flexibility among other features. The resulting topology adaptive snakes, or 'T-snakes', can be used to segment some of the most complex-shaped biological structures from medical images in an efficient and highly automated manner.     

浙江省桐乡市曼氏裂头蚴感染情况及人群知识、态度、行为调查

目的 调查浙江省桐乡市裂头蚴感染情况及人群知晓情况,为其感染和防控提供依据。方法 2016-2017年以浙江省桐乡市10个乡（镇）为调查点,在各调查点捕获野生青蛙和蛇及养殖场的牛蛙,逐只（条）解剖并鉴定曼氏裂头蚴感染情况。结果 共捕获野生青蛙521只,曼氏裂头蚴平均感染率为11.71%;各乡（镇）曼氏裂头蚴感染率差异无统计学意义（2=9.840,P0.05）;各体质量组青蛙的感染率差异有统计学意义（2=16.570,P0.01）;共捕获6条野生蛇,自然感染率为83.33%,以濮院镇感染度最高,为143条/只;未发现养殖场牛蛙感染。人群预防知识知晓率仅为33.47%。结论 桐乡市野生蛙和蛇的曼氏裂头蚴感染率较高,人群预防知识知晓率普遍较低,应采取健康教育等有效措施,做好防控工作。     

Most lay people can correctly identify indigenous venomous snakes

We attempted to determine how accurately members of the public can identify venomous snakes. Six different snakes indigenous to southern California were displayed in cages for 265 people to view at a street fair. These included 4 nonvenomous snakes and 2 venomous snakes. People were asked whether the snake was venomous and the name of the snake, if they knew it. Overall, people recognized whether a snake was venomous or nonvenomous 81% of the time. They were most accurate at identifying rattlesnakes as being venomous (95%) but incorrectly identified nonvenomous snakes as being venomous 25% of the time. Men were more accurate than women, and adults were more accurate than children. Subjects were less well able to identify the exact species of snakes. The results suggest that there may be no need to capture, kill, or bring a snake to the hospital for identification, at least in this geographic area.     

杭州市蛙、蛇体内曼氏裂头蚴感染情况调查

目的了解杭州市蛙、蛇类体内曼氏裂头蚴自然感染情况。方法在该市7个农村县（区）捕捉野生蛙、蛇,城区的5个县（区）从辖区农贸市场购买人工养殖牛蛙,进行逐只（条）解剖检查和鉴定曼氏裂头蚴。结果671只野生青蛙裂头蚴感染率为31.15%,感染强度为1～60条;3条野生蛇感染率达100%,感染强度为2～99条;而人工养殖的牛蛙裂头蚴均为阴性。裂头蚴可在蛙体内任何部位的肌肉寄生,其中以腿部肌肉寄生最为常见,占78.99%（391/495）,而在蛇类则以寄生于皮下为主,占61.21%（71/116）,不同大小青蛙曼氏裂头蚴感染率差异有统计学意义（I/Isup2/sup=6.561,IP/I＜0.05）。结论杭州市野生蛙、蛇体内裂头蚴感染率较高,分布广泛,存在曼氏裂头蚴病自然疫源地。因此,改变人们不良的生活方式和饮食习俗,开展曼氏裂头蚴病的预防工作十分必要。     

Suspected snakebite: One year prospective study of emergency department presentations

Aim: Snakebite is an uncommon, but potentially life‐threatening condition. The more common clinical scenario is suspected snake‐bite. Our aim was to characterise the epidemiology, diagnosis and management of patients with suspected snakebites. Methods: Prospective cohort study of patients presenting with suspected snakebites to a tertiary referral hospital serving a large rural region in tropical northern Australia where a standard admission protocol for suspected snakebites is used. Results: Of 70 suspected snakebite cases, there were 45 definite bites: three severe envenomings (two western brown snakes [Pseudonaja nuchalis] and one mulga snake [Pseudechis australis]); seven mild/moderate envenomings by other snakes, two non‐envenomings by identified P. nuchalis, five bites by identified non‐venomous snakes and 28 definite bites without envenoming. The remaining 25 cases were either suspected bites (8), unlikely bites (15) and two people hit by snakes. Definite snake‐bites occurred throughout the year, peaking in May and December. There were three severe envenomings (mainly coagulopathy), requiring antivenom treatment, but no deaths or major complications. Most patients had appropriate investigations. Of 47 venom detection kit swabs collected, 34 were not tested, venom was not detected in nine and was positive in the three envenomings with one false‐positive tiger snake. Whole blood clotting time was highly sensitive for procoagulant coagulopathy and envenoming in this study. Median length of time from the bite to discharge was 20 h (interquartile range: 12–27). Conclusions: The study shows that although suspected snakebite was common, severe envenoming occurred in less than 5% of cases. The study supports the proposition that a structured approach and admission policy of suspected snakebites leads to the appropriate management of severe envenoming, with no cases discharged early and no cases of non‐envenoming treated with antivenom.     

The electric net trap for the venomous snake, Habu, Trimeresurus flavoviridis

The electric net trap made of 3 rows of polyethylene net fence with the high voltage electric pulse was examined in the field for capturing the venomous snake, Trimeresurus flavoviridis. The bottom of the center row of the net fence was buried in the ground and that of other two outer rows was partially free from the ground so that snakes were allowed to invade one way into the spaces at both sides of the center net. The examination using a 90 m net trap set for 116 days resulted in the capture of 44 snakes, i.e., 7 T. flavoviridis, 7 Dinodon semicarinatus and 33 Opheodrys semicarinatus, of which the latter two were nonvenomous. The result indicated that the net trap was an efficient tool for capturing snakes and in identifying the direction of snake movement. In the other studies conducted in 1982 and 1983, a 178.5 m net trap was set at a part of a 2,000 m electric net barrier, which surrounded a 12.8 ha sugar cane field and thereby prevented snake invasion. The number of venomous snakes captured by the inner net trap was remarkably reduced from 13 in 1982 to 0 in 1983, in contrast to 8 and 9, respectively, observed in the outer trap. The decrease of snake population was also observed in 100 box traps baited with a live rat set inside the enclosed area. The ratio of immature snakes captured by the net trap was significantly higher than that by the box trap.(ABSTRACT TRUNCATED AT 250 WORDS)     

急救护理路径在银环蛇咬伤患者急救护理中的应用

目的探讨急救护理路径在银环蛇咬伤急救护理中的应用效果。方法选择2005年8月-2009年9月本院急诊32例银环蛇咬伤患者为观察组,选择2000年1月-2005年7月36例患者为对照组。对照组采用常规毒蛇咬伤护理,观察组采用银环蛇咬伤急救护理路径,比较两组患者入院处置完成时间、机械通气时间、住院时间以及预见性气管插管、紧急气管插管、肺部感染和气管插管意外拔管的发生率。结果观察组预见性气管插管发生率高于对照组(P<0.01),入院处置完成时间、机械通气时间、住院时间短于对照组(均P<0.05),紧急气管插管、肺部感染、气管插管意外拔管发生率低于对照组(均P<0.05)。结论急救护理路径能及早对患者实施救治,缩短患者的住院时间,减少并发症,提高患者的救治质量。     

Exotic snake bites in the Czech Republic—Epidemiological and clinical aspects during 15-year period (1999–2013)

Only one natural venomous snake—the adder viper—lives in the central European region and its bite is usually associated only with mild course of envenoming. Cases of envenoming caused by exotic snakes among their breeders are clinically more important. Objective. The aim of this study was to analyze the epidemiological and clinical aspects of registered venomous bites caused by exotic snakes in the Czech Republic over a period of 15 years (1999–2013). Materials and methods. This is an observational case series. Data have been collected retrospectively from a database and medical charts of the Toxinology Center belonging to the General University Hospital in Prague. Results. In total, 87 cases of exotic snakebites caused by 34 venomous snake species were registered during the study period, coming from 18 genera of Elapinae, Viperinae, and Crotalinae subfamilies. In the cohort, 29 patients (33.3%) developed systemic envenoming and 17 (19.5%) were treated with antivenom. Ten cases of envenoming (11.5%) were considered as potentially life threatening. No patient died due to envenoming caused by exotic snake bites during the study period. Four illustrative cases of envenoming (Echis pyramidum, Dendroaspis polylepis, Protobothrops mangshanensis, and Proatheris superciliaris) are described in detail. Conclusion. Bites caused by exotic snakes resulted in serious and life-threatening envenomings in some patients. Early transfer to the Center, antivenom administration, and support of failing organ functions contributed to favorable outcome of victims.     

Ethnomethodological studies of nurse-patient and nurse-relative interactions: A scoping review

ObjectivesResearchers in nursing science interested in the study of nurse-patient and nurse-relative interactions have displayed an ever increasing interest in ethnomethodology and conversation analysis. This review assesses the scope of this literature. We categorize the papers in thematic categories determined both inductively and deductively and synthesize the main findings of this literature within category. Finally we discuss the interactional determinants of the lack patient participation, the limitations of the field, and focus on implications.DesignA scoping review on nurse-patient and nurse-relative interactions.Data sourcesForty articles focusing on nurse-patient interactions and nurse-relative interactions. All the articles relied on ethnomethodology and/or conversation analysis.Review methodsA literature search has been carried out on Medline (all articles until June 2016; keywords were: nurs*.ab. and “conversation analysis”; nurs*.ab. and ethnomethodology). A similar search was performed on other platforms. The scope of the literature was identified by inductively and deductively analyzing the themes of the relevant articles.ResultsSix thematic categories emerged: Organization of nurse-patient interaction (eleven articles); Organization of mediated nurse-patient interaction (seven articles); Information, explanation and advice (eight articles); Negotiation and influence asymmetry (six articles); Managing emotions in critical illness (two articles); and Interacting with patients presenting reduced interactional competences (six articles).ConclusionsAcross most thematic categories it appeared that patient participation is far from ideal as interactional asymmetry was most observed in favor of nurses. When the encounters occurred at the patients’ homes this pattern was reversed. Computer-mediated interactions were often reported as non-optimal as the standardized process constrained communication and delayed patients’ presentation of their ailments. Micro-analyses of interaction present a clear potential for the development of guidelines for nurse-patient interactions. Implications for practice are described.     

Newspaper coverage of complementary and alternative therapies for cancer—UK 2002–2004

Background Complementary and alternative therapies (CATs) are increasingly being used by cancer patients. These patients often rely on information retrieved from the lay press, which can affect their choices towards unconventional treatments for their disease. In this study, we aimed at assessing UK newspapers’ coverage of CATs for cancer.Methods The “Lexis Nexis” database was searched for 3-month periods in 2002, 2003 and 2004. The search terms were combined: “complementary OR alternative AND medicine OR therapy AND cancer”. CATs were grouped and articles’ contents were assessed according to predefined criteria.Results A total of 310 articles were found: 117 came from national newspapers; 193 came from local newspaper issues. The UK press showed an increasing interest towards CATs for cancer (in 2002, 81 articles; in 2003, 82 articles and in 2004, 147 articles). The most frequently mentioned alternative therapies were diets and supplements (17.7%). Articles mainly focused on CATs as possible cancer treatments (44.8%), and 53.4% of all CATs mentioned were not backed up by trial data. The tone of the articles was generally positive towards CATs. Promotional articles increased over the years, especially for cancer centres and clinics.Conclusion UK national newspapers frequently publish articles on CATs for cancer. Much of this information seems to be uncritical with a potential for misleading patients.     

毒蛇伤害126例流行病学分析

目的通过流行病学分析，总结提高毒蛇咬伤的综合防治经验。方法2002—01，2005—12共收治126例毒蛇咬伤患者，对所有蛇伤患者均记录其性别、年龄、职业状况、受伤时间及就诊时间、受伤部位、受伤后的局部症状及全身反应情况、治疗过程及预后，并进行综合分析。结果毒蛇咬伤病例集中于夏秋湿热季节，以青壮年发生率最高（占69．0％），50．8％的病例延迟至受伤6h后就诊，毒蛇种类认知率很低（4．8％），按照Downey系统分类，3、4类重型蛇伤患者所占比重较大（占60．3％）。毒蛇咬伤后，局部可出现伤口感染（7例）、血栓性静脉炎（1例）、横纹肌溶解（3例）、局部坏死伴组织缺失（4例）、骨筋膜室综合征（9例）、截肢或截指（3例）等并发症，也可导致全身并发症如意识障碍（7例）、急性肾衰竭（2例）、心肌损害（6例）、呼吸衰竭（5例）、低蛋白血症（7例）以及凝血功能障碍（2例）；均进行了针对性的综合治疗，无死亡病例。结论加强知识教育，早期诊断，强化监测，早期综合对症处理可有效降低毒蛇咬伤的病残率和死亡率。     

急救护理路径在毒蛇咬伤患者中的应用

目的：探讨急救护理路径在毒蛇咬伤患者救治中的应用效果。方法：将2009年7月～2011年10月在本院急诊救治毒蛇咬伤患者67例随机分为对照组和观察组,对照组34例入院后实施常规护理,观察组33例根据制定的急救护理路径进行护理,对比两组患者入院处置完成时间、治疗效果及插管情况的差异。结果：观察组患者入院初步急救措施完成时间显著少于对照组（P〈0.05）;观察组患者预见性气管插管显著高于对照组（P〈0.01）;观察组患者紧急气管插管显著少于对照组（P〈0.01）;观察组患者对护理工作满意度显著高于对照组（P〈0.05）。结论：急救护理路径能够有效缩短患者入院初步急救措施完成时间,提高毒蛇咬伤患者的治疗效果和对护理工作的满意度。     

生物信息学在基因组和蛋白质研究中的应用

目的：人类基因组计划在世界范围内的开展促进了生命科学的进步，在此过程中产生了大量的基因组与蛋白质结构和序列数据库资源，促进了生物信息学的发展；同时生物信息学在基因组和蛋白质研究中也起着重要的作用。 资料来源：应用计算机检索Medline1990—01／2006—01文章，检索词“bioinfonnatics”，并限定语言种类为English；同时手工检索2000—01／2006—01的相关文章，限定语言为中文，检索词为“生物信息学；基因组；蛋白质结构”以及基因组相关方面的书籍。 资料选择：对资料进行初审，纳入标准：生物信息学的发展及其在基因组和蛋白质研究中的应用：排除标准：重复性研究。 资料提炼：从检索资料选取34篇（含2篇中文文献或书籍）关于生物信息学及其应用的文章，进行综述：其中与基因组研究相关的文献4篇，与蛋白质研究相关的文献20篇，其他文献10篇。 资料综合：随着人们对基因组和蛋白质研究的深入，对基因表达模式、蛋白质结构、蛋白质-蛋白质相互作用等分析得到的数据越来越多．为生物信息学提供了丰富的资源，促进了生物信息学的发展；同时生物信息学在基因序列比对、大规模基因功能表达谱的分析、新基因的发现与鉴定等方面以及蛋白质序列比较分析、蛋白质空间结构和功能预测等研究中也起着重要的作用，促进了DNA和蛋白质的研究。 结论：基因组和蛋白质组研究与生物信息学技术互相推动，并行发展；生物信息学在基因组和蛋白质研究中发挥着重要的作用。     

United snakes

Since their debut in 1987, snakes (active contour models) have become a standard image analysis technique with several variants now in common use. We present a framework called "United Snakes", which has two key features. First, it unifies the most popular snake variants, including finite difference, B-spline, and Hermite polynomial snakes in a consistent finite element formulation, thus expanding the range of object modeling capabilities within a uniform snake construction process. Second, it embodies the idea that the heretofore presumed competing technique known as "live wire" or "intelligent scissors" is in fact complementary to snakes and that the two techniques can advantageously be combined by introducing an effective hard constraint mechanism. The United Snakes framework amplifies the efficiency and reproducibility of the component techniques, and it offers more flexible interactive control while further minimizing user interactions. We apply United Snakes to several different medical image analysis tasks, including the segmentation of neuronal dendrites in EM images, dynamic chest image analysis, the quantification of growth plates in MR images and the isolation of the breast region in mammograms, demonstrating the generality, accuracy and robustness of the tool.     

Recent trends in acupuncture for chronic pain: A bibliometric analysis and review of the literature

BackgroundAcupuncture has been increasingly used in patients with chronic pain, yet no bibliometric analysis of acupuncture studies for chronic pain exists.ObjectivesTo investigate the characteristics, hotspots and frontiers of global scientific output in acupuncture research for chronic pain over the past decade.MethodsWe retrieved publications on acupuncture for chronic pain published from 2011 to 2022 from the Science Citation Index Expanded (SCI-expanded) of the Web of Science Core Collection (WoSCC). The co-occurrence relationships of journals/countries/institutions/authors/keywords were performed using VOSviewer V6.1.2, and CiteSpace V1.6.18 analyzed the clustering and burst analysis of keywords and co-cited references.ResultsA total of 1616 articles were retrieved. The results showed that the number of annual publications on acupuncture for chronic pain has increased over time, with the main types of literature being original articles (1091 articles, 67.5 %) and review articles (351 articles, 21.7 %). China had the most publications (598 articles, 37 %), with Beijing University of Traditional Chinese Medicine (93 articles, 5.8 %) and Evidence-based Complementary and Alternative Medicine ranked first (169 articles, 10.45 %) as the most prolific affiliate and journal, respectively. Liang FR was the most productive author (43 articles), and the article published by Vickers Andrew J in 2012 had the highest number of citations (625 citations). Recently, "acupuncture" and "pain" appeared most frequently. The hot topics in acupuncture for chronic pain based on keywords clustering analysis were experimental design, hot diseases, interventions, and mechanism studies. According to burst analysis, the main research frontiers were functional connectivity (FC), depression, and risk.ConclusionThis study provides an in-depth perspective on acupuncture for chronic painstudies, revealing pivotal points, research hotspots, and research trends. Valuable ideas are provided for future research activities.