脑血管性痴呆的辨证治疗经验

大脑动脉粥样硬化引起的脑血管性痴呆,以神智痴呆、记忆力减退、表情淡漠、呆滞或欣快感、头晕肢麻、手足瞤动等为特点,属于祖国医学的“文痴”、“语言颠倒”、“癫狂”、“善忘”等病症。中老年以后,肝血衰少,肾精亏损,脑失所养,大病久病,热灼真阴,心肝肾阴阳失调,肝阳化风,挟火挟痰,冲犯脑髓,元神失聪。因此,本病是本虚标实之证。虚者,治以培补真阴,补髓填精;实者,则平肝泻火,涤痰醒神,调气化瘀。文中附病案两例,经两个多月治疗,智力提高、记忆增强、精神活动基本恢复正常、生活自理,好转出院。     

Effects of the Family Check-Up 4 Health on Parenting and Child Behavioral Health: A Randomized Clinical Trial in Primary Care

The Family Check-Up 4 Health (FCU4Health) is an adaptation of the Family Check-Up (FCU) for delivery in primary care settings. While maintaining the original FCU’s focus on parenting and child behavioral health, we added content targeting health behaviors. This study evaluated whether the adapted FCU maintained positive effects on parenting (positive behavior support, limit setting, parental warmth) and child behavioral health (self-regulation, conduct problems, emotional problems). Pediatric (6–12 years) primary care patients with a BMI?≥?85^th%ile (n?=?240) were recruited from primary care clinics in Phoenix. Children were 75% Latino, 49% female, and 73% Medicaid recipients. This type 2 effectiveness-implementation hybrid trial compared families randomized to FCU4Health (n?=?141) or usual care (n?=?99). FCU4Health was delivered over a period of 6 months. This study focuses on a priori secondary outcomes included parenting and child behavioral health targets of the original FCU, assessed at baseline and 3, 6, and 12 months. Significant improvements were found for the FCU4Health condition, compared to usual care, in parenting from baseline to the 3-month assessment [β?=?.17 (.01; .32)]. Parenting predicted improvements in child self-regulation at 6-months [β?=?.17 (.03; .30)], which in turn predicted reductions in conduct problems [β?=?? .38 (? .51; ? .23)] and emotional problems [β?=?? .24 (? .38; ? .09)] at 12 months. Ethnicity and language of delivery (English or Spanish) did not moderate these effects. The FCU4Health can improve parenting and child behavioral health outcomes when delivered in primary care.

Trial Registration Trial registration number: NCT03013309 ClinicalTrials.gov

     

高效液相色谱-电感耦合等离子体质谱法测定海鱼中无机砷

目的建立测定海鱼中无机砷含量的高效液相色谱-电感耦合等离子体质谱法。方法海鱼样品经稀硝酸超声热水浴提取后,AS7阴离子交换色谱柱分离,3.5 mmol/L(NH4)2CO3+1%甲醇与100 mmol/L(NH4)2CO3+1%甲醇流动相梯度洗脱,电感耦合等离子体质谱仪测定,以保留时间定性,外标法定量。结果在1~100μg/L的线性范围,6种砷形态化合物的回归方程均呈良好的线性关系,相关系数均优于0.9996,检出限为0.05~0.25μg/L,定量限为0.17~0.84μg/L,3个浓度加标回收率为88.5%~106.4%,相对标准偏差为2.5%~4.9%。结论本方法满足海鱼中无机砷含量的测定要求,提取快速,稳定,操作简单,检出限低,方法的重现性好,灵敏度高。     

Undocumented Migrants Reintroducing COVID-19, Yunnan Province,China

To limit the spread of severe acute respiratory syndrome coronavirus 2, the government of China has been monitoring infected travelers and minimizing cold-chain contamination. However, other factors might contribute to recurring outbreaks. We analyze the role of undocumented migrants as potential transmitters of severe acute respiratory syndrome coronavirus 2 in China.     

产科急症子宫切除术16例分析

回顾分析近12a产科急症子宫切除术16例,16例均为子宫出血,其中剖宫产13例,阴道产3例,子宫出血的主要原因是各种胎盘异常,其发生与多次流产及宫腔操作史有关,阴道产后子宫切除失血量往往多于剖宫产者,提示在产后血失代偿期经导迅速治疗处理后,子宫出血仍不能有效控制,应当机立断行子宫切除术,以挽救产妇的生命。     

健侧血管桥接背阔肌皮瓣修复小腿严重毁损伤14例报告

目的 :探索应用健侧胫后血管皮瓣蒂桥式携带背阔肌皮瓣游离移植修复对侧小腿严重毁损伤所致大面积皮肤软组织、骨缺损或外露 ,免除截肢所造成重大残废。方法 :临床治疗 14例 ,切取 12cm× 18cm -2 4cm× 38cm背阔肌皮瓣 ,通过暂借健侧胫后血管桥式携带修复小腿巨大缺损 ,断蒂时同时修复健侧胫后动脉。结果 :14例暂借桥式背阔肌皮瓣全部成功 ,3例皮瓣轻度感染 ,1例皮瓣下血肿 ,经及时处理均一期愈合。随访 1～ 8年 ,肌皮瓣外观饱满 ,质地均匀。远端肢体供血明显改善 ,最大限度的恢复功能 ,避免截肢残废。结论 :对于小腿巨大软组织骨缺损外露 ,应用暂借对侧胫后血管桥式携带背阔肌皮瓣移植修复是一种行之有效的好方法     

酸性神经肽1对小鼠大脑氨基酸类神经递质及cGMP影响的实验研究

目的 :探讨酸性神经肽 (bovineacidicneuropeptide 1BANP 1)对小鼠脑内氨基酸类递质 (谷氨酸和γ 氨基丁酸 )及cGMP的影响。方法 :将小鼠随机分为 6组 (每组 15只 ) ,其中 5组按 15mg/kg腹腔注射BANP 1,将小鼠在注射后 0 5h ,1h ,2h ,3h ,4h处死并取脑匀浆 ,另一组为注射生理盐水对照组 ,在注射盐水后 1h处死并取脑匀浆 ,用 75 %冰乙醇抽提氨基酸类物质及cGMP并沉淀蛋白质。应用滤纸电泳法对小鼠大脑谷氨酸 (glutamicacid ,Glu)和γ 氨基丁酸 (γ aminobutyricacid ,GABA)进行测定 ,应用放射免疫法对小鼠大脑环磷酸鸟苷 (cyclicmonophos phateguanosine ,cGMP)进行测定。结果 :腹腔注射BANP 1后 ,各项指标在不同时间的结果分别与对照组比较 :Glu浓度在 1h、2h时明显高于对照组 (P <0 0 1) ,0 5h、3h、4h时差异无显著性 (P >0 0 5 )。GABA浓度在 2h、3h时显著高于对照组 (P <0 0 1) ,0 5h、1h、4h时差异无显著性 (P >0 0 1)。cGMP浓度有一定升高 ,1h 2h时显著升高 (P <0 0 1) ,其余各时间组差异无显著性 (P >0 0 5 )。结论 :BANP 1急性用药后在一定时间可升高脑内Glu、GABA及cGMP水平