中国西部两省(市)农村0?6岁儿童忽视现状及影响因素分析

目的 了解中国西部陕西省、重庆市农村0~6岁儿童受忽视的程度及影响因素。方法 采用分层多级整群随机抽样方法, 对两省(市)部分地区0~6岁农村儿童受忽视状况进行调查。结果 两省(市)共调查农村0~6岁儿童1488名, 儿童总忽视率和总忽视度分别为31.59%、48.32。男女童忽视率和忽视度组间差异无统计学意义(z2=0.86, t/=1.51, P>0.05)。高年龄组儿童受忽视程度显著高于低年龄组儿童(f=13.36, F=33.45, P<0.05)。三代同堂、核心家庭儿童受忽视程度显著低于单亲家庭和再婚家庭儿童(7/=10.03, F=2.83, P<0.05);留守儿童受忽视程度显著高于非留守儿童(Z2=30.30, f/=6.76, P<0.05);而陕西省儿童忽视程度低于重庆市儿童(%2=9.42, U=8.40, P<0.05)。多因素非条件logistic回归分析结果显示:是否留守(0R=1.54;95%C/：1.20~1.97)、家庭类型(Ofl=1.38;95%C/:1.16~1.65)、父亲职业(0ft=0.87;95%c/:0.78~0.97)、母亲的文化程度(0尺=1.27;95%C/:1.07~1.52)、父子间关系(Ofl=1.43;95%C/:1.07~1.91)5个因素是儿童受忽视的主要影响因素。结论 陕西省和重庆市农村0~6岁儿童受忽视程度比较严重, 应重视儿童忽视问题。     

膳食干预对围绝经期妇女围绝经期症状的影响

目的探讨围绝经期妇女增加膳食中的大豆及其大豆制品含量对改善围绝经期症状的效果。方法对2008年1至2月来本院进行健康查体的30～45岁女性,由医疗确诊已存在围绝经期症状的156例妇女,随机分为膳食干预组、结合雌激素组和对照组,对膳食干预组给予量化进食大豆或大豆制品,结合雌激素组给予结合雌激素口服,对照组保持原饮食习惯不变。经一年干预,采用Kuppennun评分观察各组症状改善情况。结果对照组干预后Kuppermun评分为（20．54±7．94）分,膳食干预组为（15．10±6．20）分,雌激素组为（15．31±6．62）分;对照组与膳食干预组比较差异有统计学意义（P〈0．05）;结合雌激素组与膳食干预组比较,差异无统计学意义（P〉0．05）。结论围绝经期妇女经增加膳食中的大豆或大豆制品的含量可以替代激素作用,能有效地改善围绝经期症状。     

维生素C对大鼠实验性根尖周炎影响的初步研究

目的：探讨维生素 C 对大鼠实验性根尖周炎形成过程的影响。方法：选用100只8周龄 Wistar雄性大鼠,髓腔直接暴露法建立根尖周炎模型,将大鼠分成维生素 C 干预组（0．1、0．5、1．0 mg/mL 维生素 C 灌胃）及对照组,术后1、3、7、14、21 d处死,通过 X线测量法和 HE 染色观察根尖周病变的大小和组织学变化。结果：维生素 C 干预组和对照组根尖透射区的面积从3 d开始增大,呈时间依赖性,21 d时透射面积到达高峰。术后7、14、21 d维生素C 干预组的根尖透射区的面积均小于对照组,差异具有统计学意义（P＜0．05）,其中0．1 mg/mL组根尖透射区的面积明显小于其它各组（P＜0．05）。术后7、14、21 d 维生素 C 干预各组骨吸收陷窝数及牙槽骨破坏范围均小于对照组。结论：全身应用维生素 C 对抑制大鼠根尖周炎的进展有一定的作用。     

Anemia and blood transfusion and outcome on the intensive care unit

The observation of Sakr and colleagues that transfusion may be beneficial in certain subgroups of intensive care unit (ICU) patients [1] is interesting, since large observational studies demonstrate that transfusion is independently associated with an increased risk of death [2]. Also, a systematic review showed that the benefits of transfusion in the ICU do not outweigh the risks [3]. Sakr and colleagues ascribe their discrepant results to the fact that transfused blood was leukoreduced. Of the 17 randomized controlled trials on the association of nonleukoreduced blood with mortality, however, a benefit of leukoreduction was found only in cardiac surgery patients [4]. A meta-analysis confirmed that available evidence does not justify universal leukoreduction [5].     

高频宽景成像超声在战士训练伤中的诊断意义

目的：探讨高频宽景成像超声在战士训练伤中的诊断意义。方法：对驻地120名因训练伤前来就诊的战士进行超声检查,其影像结果均经MR或临床证实。结果：高频超声对液性病变的诊断符合率为100%,具有独特的优势;在肌肉及肌腱的损伤诊断中,符合率分别为77.4%和92.6%。结论：超声检查操作简单,携带方便,在战时、野外或无昂贵检查设备的条件下,超声成为应急诊断的重要手段之一。     

超声监测联合宫腔镜诊治子宫内膜异常的价值

目的:探讨经阴道超声联合宫腔镜诊治子宫内膜异常的价值。方法:经阴道超声记录患者自然月经周期、排卵期内膜厚度、回声、三线征情况。根据内膜情况分为异常组(观察组)和正常组(对照组),进行宫腔镜检查和诊治术,观察术后内膜恢复情况,分析治疗后一年内的妊娠率和妊娠结局。结果:观察组40例患者宫腔镜检查结果异常35例,与B超结果符合率87.5%;对照组22例宫腔镜检查结果正常21例,符合率95.45%。观察组中确诊内膜异常者35例,妊娠率48.57%(17/35),对照组确诊为内膜正常者21例,妊娠率71.43%(15/21),P<0.05,两组比较差异有显著意义,行宫腔镜检查和诊治术后复查内膜恢复正常者观察组占4096(14/35)。其妊娠率为64.29%(9/14),继续异常组妊娠率38.10%(8/21),两者间无统计学差异。观察组和对照组足月分娩率相比,P>0.05,两组间无差异。内膜厚度<6mm的6例患者中2例妊娠,均有早期先兆流产症状,经保胎治疗,1例足月分娩,1例孕早期流产。结论:超声监测联合宫腔镜有助于诊断子宫内膜病变。子宫内膜厚度≥8mm<16mm、三线征明显且回声均匀对妊娠有利;内膜厚度<6mm仍有妊娠机会,但要及时保胎治疗。     

Functional anatomy of the retro- and suprahepatic portions of the human inferior vena cava and their main affluents

Summary The arrangement of muscle, collagen and elastic fibers was studied in the retro- and suprahepatic (subdiaphragmatic) portions of the inferior vena cava, the hepatic veins and their main affluents. Distinctive features of the longitudinal and transverse muscle bundles are described. In these portions of the vena cava, both bundle systems are clearly separate and any continuity was observed only at the entrances of the hepatic veins. A musculo-venulolymphatic complex was noted in spurs formed by the vascular junctions. The hepatic veins and their main affluents exhibit an elliptical contour in transverse section, which apparently results from cranial and caudal thickenings of the longitudinal muscle layer. Many of these bundles are in continuity with those of the transverse muscle layer. Terminal elastic tendons were rarely observed in connection with muscle fibers of the inferior vena cava and are not present in the hepatic veins and their main affluents. In terms of form and function, the relatively thin muscular layer has a dilating action on the hepatic venous system because of the external fixed insertion point of the muscle bundles. Such an arrangement and a polar disposition of the muscle bundles in the hepatic venous system may assists in suction of the blood toward the heart. A sphincteric control of the ostia by means of crossed muscular loops supported by venulo-lymphatic micropads is a possibility.

---

Anatomie fonctionnelle des segments rétro et supra-hépatiques de la veine cave inférieure et de leurs principaux affluents

Résumé La disposition des fibres collagènes et élastiques des muscles de la paroi veineuse a été étudiée dans les segments rétro et suprahépatiques (sub-diaphragmatique) de la veine cave inférieure, des veines hépatiques et de leurs principaux affluents. Des caractéristiques de groupes musculaires longitudinaux et transversaux sont décrits. Dans ces portions de la veine cave, les deux groupes sont distinctement séparés et une continuité n'a pu etre observée qu'aux abouchements des veines hépatiques. Un complexe musculoveino-lymphatique a été décrit sous forme d'éperons aux jonctions vasculaires. Les veines hépatiques et leurs principaux affluents présentent un contour elliptique en section transversale, qui résulte apparemment d'épaississements crânio-caudaux de la couche musculaire longitudinale. De nombreux groupes sont en continuité avec ceux de la couche musculaire transversale. Des tendons élastiques terminaux ont été rarement observés en connection avec les fibres musculaires de la veine cave. Ils sont absents dans les veines hépatiques et leurs principaux affluents. Les analyses morpho-fonctionnelles confèrent à la couche musculaire relativement fine une action d'expansion sur le système de veines hépatiques en fonction du point d'insertion fixe externe des groupes musculaires. Un tel arrangement et une disposition polaire de groupes de muscles dans le système veineux hépatique peut favoriser une aspiration du sang vers le coeur. Un contrôle sphinctérien au niveau des abouchements par un système d'anneaux musculaires croisés supportés par des microbourrelets veinolymphatiques est analysé.

     

Analysis of antibodies against components of the autonomic nervous system in diabetes mellitus

Antibodies to autonomic nervous system structures have previously been detected using a complement fixation immunofluorescence test in the sera of patients with insulin-dependent diabetes mellitus (IDDM) and non-insulin dependent diabetes mellitus (NIDDM). These antibodies might play a role in the aetiology of autonomic neuropathy. Sera from 45 IDDM, 40 NIDDM and 52 control subjects were tested by immunofluorescence for antibodies to human sympathetic ganglia, human adrenal medulla and rabbit vagus nerve. The use of human sympathetic ganglia was compared with rabbit tissue for the detection of sympathetic ganglia antibodies; the results for these autonomic nervous system antibodies were also compared with results using an ELISA. There was no relationship between the presence of antibodies detected by ELISA and those detected by immunofluorescence, but of 14 IDDM patients with thyroid antibodies, 12 had autonomic nervous system antibodies detected by either immunofluorescence or ELISA (p < 0.005 compared to patients without thyroid antibodies). To further characterize the autoantigen(s), immunoblotting was performed. An adrenal antigen corresponding to 74 kDa was detected in sera from three patients, only one of whom had antibodies detectable by ELISA and immunofluorescence. One IDDM serum showed specific binding to a vagus nerve antigen corresponding to 33 kDa. No specific binding to sympathetic ganglia antigen was demonstrated. Antibodies against autonomic nervous system antigens are an inconsistent feature of diabetes, and appear more associated with coincidental autoimmunity against other organs such as the thyroid.