肝动脉缺血对犬肝细胞损害的实验研究

摘要：目的:探讨肝动脉缺血对犬肝细胞的损害。方法:对２０只犬进行肝动脉阻断，不阻断门静脉，分别于阻断前、阻断后２０，４０，６０min取肝组织进行活检，用常规ＨＥ染色和ＢＣＬ-２免疫组化染色并进行灰度测定。结果:肝动脉阻断２０min，肝细胞已有明显损害，阻断６０min有不可逆性严重损害，ＢＣＬ-２免疫组化灰度测定，阻断前与阻断后各时点差异均有高度显著性（P<0.0001），其中２０min和４０min与６０min之间差异有高度显著性(P<0.001)。结论:肝动脉阻断20min，肝细胞有明显损害，肝动脉阻断60 min，肝细胞有不可逆性损害。     

颜面部表浅软组织损伤的急诊美容修复

目的　按美容外科技术和原则急诊修复颜面部表浅软组织损伤。方法　对 4 8例颜面部表浅软组织损伤的患者行急诊美容修复。结果　所有手术均获成功 ,疗效满意 ,瘢痕细小 ,有的患者半年手术痕迹已不明显。结论　颜面部表浅软组织损伤按美容外科技术及原则修复可减少后期畸形 ,减少瘢痕。     

儿童意外伤害与心理行为关系分析

意外伤害使儿童，青少年早死或残疾，给家庭和社会带来巨大负担，为了解儿童意外伤害与心理行为关系，采取分层整群随体机抽样的方法，对武汉市部分城区儿童意外伤害的发生情况展开了现场调查研究，结果显示，儿童行为特征，心理发展因素与儿童意外伤害的发生存在明显相关，提示应重视加强对儿童有针对性的心理健康教育及安全训练，预防和控制儿童意外伤害的发生。     

电针对脑缺血再灌注损伤的治疗作用

目的探讨电针对脑缺血再灌注损伤的治疗作用。方法用改良的血管内栓线技术制造大鼠局灶性脑缺血与再灌注模型,应用免疫组织化学技术检测脑组织中的nNOS阳性神经元的表达。电针穴位选择“水沟”“承浆”穴。结果①脑缺血再灌注组nNOS阳性神经元在大脑皮层和海马CA1区、CA3区大量表达,与正常对照组相同脑区比较有显著性差异(P<0.05);②电针能显著减少脑缺血再灌注损伤中nNOS阳性神经元在大脑皮层和海马CA1区、CA3区的表达,与缺血再灌注组相同脑区比较有显著性差异(P<0.05)。结论电针能显著减少脑缺血再灌注损伤中神经元的丢失。     

Selective use of blood cultures in emergency department pneumonia patients

Our objectives were to identify factors associated with positive blood cultures and to evaluate blood culture use in the management of hospitalized pneumonia patients to limit their use. A retrospective chart review was conducted at a community teaching hospital. Emergency Department patients with an admission diagnosis of pneumonia during calendar years 2001-2002 were included. Patients younger than age 18 years and those with a non-pneumonia discharge diagnosis were excluded. Of 684 eligible patients, 23 (3.4%) had true positive blood cultures. All organisms were sensitive to empiric antibiotics. Three risk factors were associated with positive blood cultures: oxygen saturation < 90%, serum sodium < 130 and respiratory rate > 30 breaths/min. No patient had antibiotic coverage broadened based on blood culture results. Positive blood culture rates were low and did not affect the clinical management of pneumonia patients. We recommend eliminating blood cultures in community-acquired pneumonia (CAP) patients, but obtaining blood cultures in patients at risk for multi-drug resistant pathogens, such as health-care-associated pneumonia (HCAP) patients.     

Development and Validity Testing of the School Health Score Card

BACKGROUND

The objective of this study was to develop the School Health Score Card (SHSC) and validate its psychometric properties.

METHODS

The development of the SHSC questionnaire included 3 phases: item generation, construction of domains and items, and field testing with validation. To assess the instrument's reliability and validity, we recruited 15 middle schools and 15 high schools in the Republic of Korea.

RESULTS

We developed the SHSC questionnaire of 158 items categorized into 5 domains: (1) Governance and Infrastructure, (2) Need Assessment, (3) Planning, (4) Health Prevention and Promotion Program, and (5) Monitoring and Feedback. All SHSC domains and subdomains demonstrated acceptable reliability with good internal consistency. Each domain and subdomain except for “Planning” was associated significantly with students' health status. Most subdomains, including school health philosophy, school policy, communication, the evaluation system, and monitoring, were significantly and negatively associated with student absence.

CONCLUSIONS

The SHSC shows significant association with the overall student health and can be useful in assessing comprehensive school health programs.

     

ARIMA模型在海南省2014－2017年居民自杀死亡率中的应用

目的 分析海南省居民自杀报告死亡率变化趋势,探索时间序列模型在自杀死亡率预测中的应用。方法 应用时间序列模型拟合海南省2014年1月至2016年12月自杀死亡率资料,并预测该地区2017年1－6月的自杀死亡率。结果 海南省2014年1月至2017年6月该地区报告自杀死亡576人,平均死亡率为1.5/10万;所建立的ARIMA模型较好地拟合了既往时间序列的自杀死亡率,预测值的动态趋势与实际值基本一致,2017年1－6月的实际值均在预测值95%的可信区间范围内。结论 确定海南省自杀死亡率的时间序列模型为“ARIMA（0,1,0）（0,0,0）₁₂”,且模型的预测效果较好,可以用来预测海南省因自杀导致的死亡情况。     

Post‐CPAP sleepiness – a specific syndrome?

Following treatment with continuous positive airway pressure (CPAP), some patients with obstructive sleep apnoea (OSA) remain sleepy despite effective CPAP and attention to other diagnoses that can provoke sleepiness. It is unclear if this residual sleepiness is an irreversible result of their previous OSA and merits consideration for pharmacological treatment or simply because of the many and varied causes of sleepiness normally found in the community. We have measured levels of sleepiness, using the Epworth Sleepiness Score (ESS), in 572 patients on CPAP and compared them with a control group of 525 subjects from a community survey, which would have included the usual lifestyle reasons for sleepiness as well as any undiagnosed sleep disorders. There was no difference in the percentage of patients with an ESS >10 in the CPAP group compared with the controls (16.1 versus 14.3, P = 0.54). Thus, although there clearly are sleepy patients within the CPAP group, the prevalence is no higher than in the community. We question whether so-called 'post-CPAP sleepiness' should be regarded as any more abnormal and worthy of treatment than a 'normal' population. Post-CPAP sleepiness as a specific disorder may not exist.