护理干预对重型颅脑损伤合并应激性高血糖病人预后的影响

目的:探讨重度颅脑损伤合并应激性高血糖患者的护理干预方法及预后观察。方法:将120例患者随机分为观察组和对照组,每组60人,对照组采用常规控制血糖,观察组采用胰岛素强化治疗方案,营养支持,维持水、电解质平衡,做好基础护理和健康教育,观察两组预后情况。结果:观察组的良好率78.3%,对照组36.7%,差异有统计意义(p<0.05);观察组患者使用胰岛素天数、院内感染率及住院天数明显低于对照组(P<0.01)。结论:在重度颅脑损伤合并应激性高血糖患者中采用护理干预方法对其预后非常重要,安全有效。     

Aging with Chinese Characteristics: A Public Policy Perspective

This article reflects on the meaning of aging in China by reviewing issues of population change centering on the baby boomer generation. Family structure, living arrangements, and long-term care needs of the aged as well as societal responses are re-visited under the general public policy framework of an “economic state in transition.” The development of income support, health care, and personal social services for the elderly is examined by reviewing the 2006 government White Paper and the research literature. Employment, education, and lifestyle issues are further investigated under the United Nations policy framework on active aging. Policy, practical, and theoretical issues in achieving the country’s articulated goals are discussed. Adequate preparation for aging is emphasized by considering the roles of individuals, families, practitioners, and policy makers.     

Do Ambivalent Women Have an Unmet Need for Family Planning? A Longitudinal Study from Bali,Indonesia

IntroductionFertility intentions often can predict contraceptive demand and fertility outcomes. Little is known about women reporting ambivalent fertility intentions, who are usually classified as having an unmet need for contraception. This study’s objectives were to determine 1) which fertility intention group ambivalent women more closely resemble and 2) whether ambivalent women seem to have an unmet contraceptive need.MethodsWe analyzed longitudinal data from 1,018 married Balinese women aged 15 to 45, of whom 33% desired more children, 52% wanted no more, and 14% were ambivalent. Ambivalent women were compared with those with definitive intentions using bivariate analyses. Regression analysis was used to determine the predictors of birth avoidance.ResultsAlthough ambivalent women were significantly older, and had less education and more children than women who wanted more children, ambivalent women were more similar in their contraceptive use to those who wanted more children than those who wanted no more. However, in terms of birth outcomes, ambivalent women resembled more the women who intended to avoid childbearing: After 4 years, 33% of ambivalent women had another birth compared with 29% of women who wanted no more and 57% of women who desired more children. Contraceptive use at baseline did not predict ambivalent women’s fertility outcomes, unlike the other groups.ConclusionDespite their relatively low rates of contraceptive use at baseline, ambivalent women generally avoided giving birth during the study period. This suggests that ambivalent women may not have a high unmet need for family planning.     

A rare mutation in the primer binding region of the Amelogenin X homologue gene

Use of Amelogenin locus typing as a gender marker incorporated in STR multiplexes is common practice in forensic genetics analysis. Among 5534 Polish male individuals tested using the SGMPlus kit, one was found to lack the amelogenin X-specific homologue (0.02%). The same result was obtained with other commercial kits which also amplify the amelogenin locus, namely ProfilerPlus and PowerPlex16. When alternative amelogenin primers external to but encompassing the initial amplicon were applied, an X homologue product was seen. Sequencing of the X homologue amelogenin allele revealed C to G mutation located at the most 3′ base of the commonly used amelogenin reverse primer. To our knowledge, this mutation and failure to amplify the X homologue of the amelogenin gene has not been reported for the European population.     

Clinical Effect of Acute Complete Acromioclavicular Joint Dislocation Treated with Micro-Movable and Anatomical Acromioclavicular Plate

Objectives: We evaluated the long-term clinical results of acute complete acromioclavicular dislocations treated with micro-movable and anatomical acromioclavicular plate.Methods: Open reduction and internal fixation was performed using the MAAP in 16 patients (10 males, 6 females; mean age 36 years; range16 to 63 years) with acute complete acromioclavicular joint dislocation. Radiographic evaluations were routinely conducted every 3 weeks until 3 months postoperatively. The MAAP were removed under local anesthesia after 3 months postoperatively. We evaluated the functional results by using the constant scoring system and radiological results in the last follow-up time. The mean follow up was 26 months (range 16 to 38 months).Results: The mean Constant score was 94 (range, 78 to 100). The results were excellent in 12 patients (75.0%), good in 3 patients (18.8%) and satisfactory in 1patient (6.2%). Three patients with scores of 80 to 90 had mild pain during activity, but have not affected the shoulder range of motion. One patient has both some pain and limited range of motion of shoulder joint. All patients but one have returned to their preoperative work without any limitations. Compared to the contralateral side, radiography showed anatomical reposition in the vertical plane in 14 cases, slight loss of reduction in 2 older patients.Conclusion: We recommend the MAAP fixation for surgical treatment of acute complete acromioclavicular joint dislocation as it could provide satisfactory shoulder functions and clinical results, with lower complication rate. However, it is necessary to continue to observe the clinical effects of this fixation technique.     

Dynamics of learning near singularities in radial basis function networks

The radial basis function (RBF) networks are one of the most widely used models for function approximation in the regression problem. In the learning paradigm, the best approximation is recursively or iteratively searched for based on observed data (teacher signals). One encounters difficulties in such a process when two component basis functions become identical, or when the magnitude of one component becomes null. In this case, the number of the components reduces by one, and then the reduced component recovers as the learning process proceeds further, provided such a component is necessary for the best approximation. Strange behaviors, especially the plateau phenomena, have been observed in dynamics of learning when such reduction occurs. There exist singularities in the space of parameters, and the above reduction takes place at the singular regions. This paper focuses on a detailed analysis of the dynamical behaviors of learning near the overlap and elimination singularities in RBF networks, based on the averaged learning equation that is applicable to both on-line and batch mode learning. We analyze the stability on the overlap singularity by solving the eigenvalues of the Hessian explicitly. Based on the stability analysis, we plot the analytical dynamic vector fields near the singularity, which are then compared to those real trajectories obtained by a numeric method. We also confirm the existence of the plateaus in both batch and on-line learning by simulation.