健康洁面的24种选择

洁面是我们每天都要做的事情。在1天至少两次的洁面过程中，你的肌肤享受到了最好的呵护吗？     

MRI of muscular hamartoma of the breast

Muscular hamartoma is a well‐demarcated tumour composed of smooth muscle and adipose tissue. We report the MRI findings of a patient with benign breast neoplasm. To the best of our knowledge, its appearance has not been previously reported.     

Children with malignant disorders: the health and life situation of their parents examined over a 7-year interval

The parents of 31 children with malignant disorders were clinically examined and interviewed to characterize their life situation and somatic health during treatment of their child. The follow-up was for 7 years. Comparison groups were from the mean Finnish population matched for age, sex and occupation. The parents were generally healthy. Hypertension, headache and abdominal pain were the main symptoms. Sick leave and contact with a physician were less common than in the control population. The frequency of paramedical drug use was high but tranquilizers were used rarely. At the beginning the mothers had many symptoms indicating stress. Their attitude about their own state of health improved during the follow-up in spite of ageing. The spare-time physical activities of the parents increased during follow-up. Few marital conflicts and problems with the siblings were reported. The increment in economic burden caused by the child's disease was not regarded as essentially changing the family life.     

Time trends of human papillomavirus types in invasive cervical cancer,from 1940 to 2007

Contribution over time of human papillomavirus (HPV) types in human cancers has been poorly documented. Such data is fundamental to measure current HPV vaccines impact in the years to come. We estimated the HPV type‐specific distribution in a large international series of invasive cervical cancer (ICC) over 70 years prior to vaccination. Paraffin embedded ICC cases diagnosed between 1940 and 2007 were retrieved from eleven countries in Central‐South America, Asia and Europe. Included countries reported to have low‐medium cervical cancer screening uptake. Information on age at and year of diagnosis was collected from medical records. After histological confirmation, HPV DNA detection was performed by SPF‐10/DEIA/LiPA25 (version1). Logistic regression models were used for estimating the adjusted relative contributions (RC) of HPV16 and of HPV18 over time. Among 4,771 HPV DNA positive ICC cases, HPV16 and HPV18 were the two most common HPVs in all the decades with no statistically significant variations of their adjusted‐RC from 1940–59 to 2000–07 (HPV16—from 61.5 to 62.1%, and HPV18—from 6.9 to 7.2%). As well, the RC of other HPV types did not varied over time. In the stratified analysis by histology, HPV16 adjusted‐RC significantly increased across decades in adenocarcinomas. Regarding age, cases associated to either HPV16, 18 or 45 were younger than those with other HPV types in all the evaluated decades. The observed stability on the HPV type distribution predicts a high and stable impact of HPV vaccination in reducing the cervical cancer burden in future vaccinated generations.     

Improved design of cementless hip stems using two-dimensional functionally graded materials

Increasingly, it is acknowledged that bone resorption around cementless hip implants may cause future problems. The solution is frequently sought in reducing implant stiffness. However, this confronts the designer with a true design conflict: how to reduce the stiffness without excessively loading the proximal bone/prosthesis interface? The aim of this work is to improve the design of cementless hip stem material, using two-dimensional (2D) functionally graded material (FGM) concept in order to solve the above problems. Two models were used in this analysis, using three materials with different elastic moduli, E(1), E(2), and E(3). In model I, the elastic moduli E(1) and E(2) gradually change along the upper stem surface, while E(3) is maintained constant along all the lower surface of the stem. However, in model II, the elastic moduli E(1) and E(2) gradually change along the lower stem surface, while E(3) is maintained constant all along the upper stem surface. It is found that the recommended model is model I, which has three distinct materials of hydroxyapatite, Bioglass, and collagen. The recommended design of 2D FGM is expected to reduce the stress shielding by 91% and 12%, respectively, compared with titanium stem and model II of FGM. It is found that this new design reduces the maximum interface shear stress at the lateral and medial sides of the femur by about 50%, compared with titanium stem. Furthermore, the maximum interface shear stress is reduced by about 17% and 11% at the lateral and medial sides of the femur, respectively, compared with that of model II of FGM.     

Trajectories of depression in adolescents and young adults in Vietnam during rapid urbanisation: evidence from a longitudinal study

Objectives: This paper investigates the trajectories of depression symptoms in adolescents and young adults, and explores factors associated with their depression.

Method: For each respondent, three waves of data were collected in 2006, 2009 and 2013 from adolescents and young adults aged 10 to 24 years. The modified Center for Epidemiological Studies Depression Scale was used to interview participants, while the generalised estimating equation (GEE) model was used to identify whether certain factors were associated with depression.

Results: The mean depression scores in 2006, 2009 and 2013 were 29.76, 30.80 and 30.51 respectively. Compared to boys, girls reported higher initial levels of depressive symptoms. The depression score was found to be highest among adolescents aged 15 to 17 years. Depression among young people was associated with age, gender, marital status, education levels, general health and living location.

Conclusion: Using longitudinal design, this research demonstrated the different trajectories of depression scores between boys and girls over time and provided evidence for interventions improving adolescent mental health in a semi-urban area of Vietnam.     

Acute stroke: detection of changes in cerebral perfusion with dynamic CT scanning

Fifteen patients with acute cerebral infarct in the territory of the middle cerebral artery were examined with dynamic computed tomography (CT) to evaluate cerebral perfusion changes. Perfusion changes could be detected in 93% of the patients within a short period after the attack (the earliest instance was within 2 hours) and before any detectable morphologic change. The attenuation coefficient of the area of infarction showed a statistically significant difference in peak amplitude compared with that in the contralateral unaffected brain or with that in the control group (P less than .05). A delay in the time to peak in the affected side versus in the contralateral side was observed in six patients with stroke and ranged from 4.2 to 49.2 seconds with or without a change in peak amplitude. The clinical outcome in the patients correlated well with the initial perfusion change measured with dynamic CT scanning. The greater the difference in peak amplitude, the worse the residual neurologic defect. Patients with a prolonged time to peak (greater than 8 seconds) usually had poor clinical outcome. The whole dynamic study took 10-15 minutes more than a conventional CT study but provided more complete information as a basis for clinical treatment and an indication of clinical outcome.     

Epidural steroid injection for sciatica: An analysis of 526 consecutive cases with measurements and the whistle test

The effects of epidural injections of triamcinolone acetonide and bupivacaine in the treatment of sciatica were analyzed in a retrospective series of 526 consecutive cases with measurements. A new test (the whistle test) is described. There is a paucity of measureable parameters in reports on the subject in the literature, and many are not specific or symptom-oriented to sciatica. The procedure was performed by the same operator and reviewed one week post-operatively with measurements. 491 patients (93.35%) achieved excellent to good pain relief, backed by appropriate increases of straight-leg-raise measurements. But 17 patients (3.46%) of this group required surgery later. It is concluded that epidural steroid injection is a simple, cost-effective and minimally invasive treatment for sciatica, especially in the acute. It also serves as a method for crisis intervention and as a prognosticator.