The goniomaxillar length/goniomandibular length ratio in normal newborn infants: A clinical tool for defining chin position abnormalities

Retrognathia (recessed chin) and prognathism (prominent chin) often present as signs of an underlying condition. Accurate clinical definitions are important. Yet their definitions were according to “clinical impression”, or to seldom used X‐ray criteria. We propose a statistical and anthropometric definition of retrognathia and prognathism based upon the ratio between the goniomaxillar length (distance between the gonion at the mandible angle and the subnasale and the goniomandibular length (distance between the mandible angle and the most anterior point of the bony chin). We assumed that an increase in the ratio indicates retrognathia and a decrease reflects prognathism. We conducted a prospective, observational, anthropometric study in 204 consecutive healthy term infants. Measurements took place on the second day of life, using sliding calipers. Mean ± SD of goniomandibular length (5.1 ± 0.3 cm), goniomaxillar length (5.4 ± 0.3 cm), were calculated. All measurements correlated significantly with gestational age, and with infant birthweight. The mean ± SD goniomaxillar length/goniomandibular length ratio was 1.06 ± 0.05. We defined a normal ratio as being within 2 SD of the mean, that is, between 0.96 and and 1.16. This ratio correlated with neither gestational age nor with birthweight. We conclude that the goniomaxillar length/goniomandibular length ratio can be calculated whenever retro ‐ or prognathism is suspected. A ratio outside of the 95% confidence interval should help in making this diagnosis. An increase in this ratio beyond 2 SD above the mean (1.16) could be interpreted as retrognathia and a decrease beyond 2 SD below the mean (0.96) as prognathism.     

Emergency department visits for asthma: the role of frequent symptoms and delay in care.

BACKGROUND: Use of the emergency department (ED) for asthma care is a costly form of health care that is largely preventable. However, little is known about how to reduce the number of people using the ED for asthma care. OBJECTIVE: To identify modifiable factors related to ED visits for asthma among a diverse nonelderly adult population. METHODS: This study used cross-sectional data from the 2001 California Health Interview Survey. A total of 4,359 adult respondents ages 18 to 64 years who reported being diagnosed as having asthma and experiencing symptoms in the past year were included. Any ED visits due to asthma in the previous 12 months among all nonelderly respondents with asthma, with stratification by those with daily or weekly symptoms and with less frequent symptoms, were examined. RESULTS: Adults with daily or weekly asthma symptoms, with fair or poor health status, and who delayed care for asthma because of cost or insurance issues were more likely to visit the ED for asthma. Stratification of the study population into those with daily or weekly symptoms and those with less frequent symptoms revealed that delay in care due to cost or insurance issues and fair or poor health status remained significant for both groups. Latinos and women were more likely to visit the ED in the severe asthma group, whereas Asian, African American, and uninsured adults were more likely to visit the ED in the group with less severe asthma. CONCLUSIONS: Results suggest that to prevent ED visits for asthma, it is important to control asthma symptoms. However, it is equally if not more important to reduce delays in receiving asthma care.     

Holter系统的技术要求及神经网络方法

为了长时间、准确的记录分分析体表ＥＣＧ，从各个方面满足基础研究、临床、康复以及特殊生理需要，对Ｈｏｌｔｅｒ系统提出了愈来愈高的要求。作者从技术实现的角度讨论了Ｈｏｌｔｅｒ的主要技术要求，包括记录部分和分析部分；还介绍了几种用神经网络模型满足Ｈｏｌｔｅｒ系统技术要求的原理，包括用多层感知器实现数据压缩及分类，用高阶神经网络实现ＥＣＧ的分类，以及用ＡＲＴ模型识别ＥＣＧ中的Ｐ波与Ｔ波。     

胆总管的矢状断层解剖研究

在３０套成人腹部连续矢状断层标本上，胆总管与下腔静脉主要出现于Ｒ２－Ｒ３断层；胆总管胰腺段与胰头的关系有部分包埋，完全包埋及胰腺后型；十二指肠大乳头集中出现于Ｒ３断层；胆总管的行程有４种形式。文内还探讨了矢状断层里胆总管各段的毗邻及识别标志。     

川崎病休克综合征合并心力衰竭1例临床病例分析及文献复习

目的 探讨川崎病休克综合征 (Kawasaki Disease Shock Syndrome,KDSS) 合并心力衰竭的临床特征。方法 分析 1例KDSS合并心力衰竭患儿的临床资料,并复习相关文献。结果 KDSS在川崎病中不常见,但表现严重,在急性期可以导致循环衰竭,表现为心动过速、毛细血管充盈时间延长、四肢末端发凉、脉搏细弱、尿量减少或意识障碍等而发生全身循环衰竭,早期识别,及时给予人免疫球蛋白和激素等综合治疗可明显改善患者休克的状况。结论 KDSS是川崎病中少见但较为严重的临床并发症,早期识别及综合的临床治疗方法是减少KDSS的有效措施。     

Development of a Western Blot Assay for Detection of Antibodies against Coronavirus Causing Severe Acute Respiratory Syndrome

To identify a major antigenic determinant for use in the development of a rapid serological diagnostic test for severe acute respiratory syndrome (SARS) coronavirus infection and to study the immune response during SARS coronavirus infection in humans, we cloned the full length and six truncated fragments of the nucleocapsid gene, expressed them, and purified them as glutathione S-transferase-tagged recombinant proteins. The reactivities of the recombinant proteins to a panel of antibodies containing 33 SARS coronavirus-positive sera and 66 negative sera and to antibodies against other animal coronaviruses were screened. A truncated 195-amino-acid fragment from the C terminus of the nucleocapsid protein (N195) was identified that had a strong ability to detect antibodies against SARS coronavirus. No cross-reaction was found between the N195 protein and antibodies against chicken, pig, and canine coronaviruses. The N195 protein was used to develop a Western blot assay to detect antibodies against SARS coronavirus in 274 clinically blinded samples. The specificity and sensitivity of this test were 98.3 and 90.9%, respectively. The correlation between our Western blotting assay and an immunofluorescence assay (IFA) was also analyzed. The results of our Western blot assay and IFA for the detection of SARS coronavirus-positive sera were the same. Thus, the N195 protein was identified as a suitable protein to be used as an antigen in Western blot and other possible assays for the detection of SARS coronavirus infection.     

一种低成本、低本底的免疫细胞化学反应方法

为了探讨一种适合培养细胞的低本底、低成本免疫细胞化学方法 ,本研究将低浓度的 Triton X-10 0加入抗体稀释液和洗液中 ,观察了其对 ABC反应时的抗体和 ABC的使用浓度和反应效果的影响。结果证明 ,在抗体稀释液和洗液中加入 0 .1%Triton X-10 0可以增强细胞对抗体的通透性 ,在不减弱阳性信号的状况下使 -抗的使用浓度明显降低 ,使生物素化二抗和 ABC的使用浓度达到 1/ 10 0 0～ 1/ 40 0 0 ,并大大减弱染色本底。本研究结果提示 ,在这一稀释度明显低于目前试剂盒建议的使用浓度。在充分显示阳性信号的前提下 ,使抗体的使用浓度和量大幅度减少 ,从而实现了降低本底和实验成本的目的     

Assault injury rates,social capital,and fear of neighborhood crime

This study develops an explanatory framework for fear of neighborhood crime based on respondents' social context and local rates of assault injuries. Rates of assault injuries within zip codes are based on hospital discharge records. We find that only four variables have a significant unique contribution to fear of crime: respondent's sex, perceptions of neighborhood social capital, and the rates of struck by/against assault injuries for the 10–24 and 50+ age groups. We also find that the perception of neighborhood social capital moderates the impact of assault injury rates on fear of crime; those who perceive a high level of neighborhood social capital exhibit less sensitivity to assault injury rates. We include a map of assault injury rates and fear of crime by ZIP Code and describe the community context related to our results. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 483–498, 2007.