止消通脉宁对糖尿病微血管合并症患者心功能影响的临床研究

为了探讨中药复方止消通脉宁对有微血管合并症的亚临床期糖尿病心脏病患者心功能的影响 ,我们选择了 63例 2型有微血管合并症的糖尿病患者 ,分为对照组 (2 0例 )和治疗组 (4 3例 ) ,分别使用常规疗法和加用止消通脉宁的治疗方法 ,疗程 4周 ,着重观察心功能、眼底和 2 4h尿白蛋白定量的改变。结果 :止消通脉宁可以明显改善心功能、减少尿白蛋白定量 ,而常规治疗对照组则无明显作用。表明止消通脉宁干预治疗可以改善有微血管合并症的亚临床期糖尿病心脏病患者心功能的异常 ,从而预防和治疗糖尿病心脏病。     

200例更年期综合征妇女精神心理及社会因素现况调查

目的：了解更年期综合征患者精神和心理障碍,探讨社会因素对其的影响,方法：通过问卷式表格填写的方法,对200例更年期综合征妇女进行进行躯体表现、精神和心理障碍,应激反应、性生活、应激事件等现况调查,结果：更年期货征妇女普遍存在精神心理障碍,65％应激反应下降,50％性功能下降,生活中应激事件与更年期的综合征互为影响,结论：提高这一人群的生命质量,激素替代治疗须配合心理支持治疗。     

中药中金属元素的生化作用机理

机体内环境是一个多层次纵横交错的大系统 ,有一套复杂的调控体系 ,金属元素与此调控体系有密切联系。机体内所有复杂的生化反应都离不开酶 ,而金属元素有的是酶的辅助因子参与酶的组成 ,有的是酶的激活剂 ,是酶活性的主要调节者。深入研究中药中金属元素对酶活性的影响 ,将有利于提高药效。此外肾虚病人血清中金属元素与正常人相比有显著差异 ,若能比较准确地测得肾虚不同阶段的金属元素图谱 ,并结合中药中各金属元素含量的不同加以针对性地治疗 ,将对提高药物对疾病的治疗效果及延缓衰老有重要意义。     

Retrospective study of functional outcomes and disability after non-ischaemic vascular causes of spinal cord dysfunction

Objective: Describe demographic characteristics, functional outcomes and disability following rehabilitation for non-ischemic vascular spinal cord dysfunction (SCDys).Design: Retrospective, open cohort, case series.Setting: Tertiary rehabilitation unit, Victoria, Australia.Participants: Patients with non-ischemic vascular SCDys admitted over a 21-year-period (01/01/1995–31/12/2015) were identified using International Classification of Diseases codes.Outcome Measures: Demographic characteristics, etiology, neurologic classification, length of stay (LOS), and complications. On admission and discharge, the following were collected: functional independence measure (FIM) motor subscale, details on bowel, bladder, mobility, living arrangement, and support services.Results: 36 patients (female 58%; mean age 69 ± 16 years) were identified. The main causes of non-ischemic vascular SCDys were epidural hematoma (39%), dural arteriovenous fistula (17%), and arteriovenous malformation (11%). 22 cases (61%) were iatrogenic. Most (86%) had incomplete paraplegia. Urinary tract infection was the most common complication (64%). Median LOS in rehabilitation was 68 days. Significant improvement in FIM motor scores was observed from admission (median 25, interquartile range [IQR] 20–38) to discharge (median 69, IQR 38–77) (P < 0.001). On discharge, 4 patients (11%) walked >100 m unaided, 6 (17%) walked >100 m with assistive device, 10 (28%) walked >10 m with assistive device, 15 (41%) were wheelchair dependent and 1 (3%) patient remained non-mobile. 20 patients (56%) were discharged home, 8 (22%) to nursing home, and 8 (22%) transferred to another hospital.Conclusion: Most patients returned home with significantly improved functional outcomes compared to rehabilitation admission, but with the majority having ongoing major disabilities based on FIM motor scores.     

Identifying gaps in COVID-19 health equity data reporting in Canada using a scorecard approach

ObjectiveTo assess health equity-oriented COVID-19 reporting across Canadian provinces and territories, using a scorecard approach.MethodsA scan was performed of provincial and territorial reporting of five data elements (cumulative totals of tests, cases, hospitalizations, deaths, and population size) across three units of aggregation (province or territory level, health regions, and local areas) (15 “overall” indicators), and for four vulnerable settings (long-term care and detention facilities, schools, and homeless shelters) and eight social markers (age, sex, immigration status, race/ethnicity, healthcare worker status, occupational sector, income, and education) (180 “equity-related” indicators) as of December 31, 2020. Per indicator, one point was awarded if case-delimited data were released, 0.7 points if only summary statistics were reported, and 0 if neither was provided. Results were presented using a scorecard approach.ResultsOverall, information was more complete for cases and deaths than for tests, hospitalizations, and population size denominators needed for rate estimation. Information provided on jurisdictions and their regions, overall, tended to be more available (average score of 58%, “D”) than that for equity-related indicators (average score of 17%, “F”). Only British Columbia, Alberta, and Ontario provided case-delimited data, with Ontario and Alberta providing case information for local areas. No jurisdiction reported on outcomes according to patients’ immigration status, race/ethnicity, income, or education. Though several provinces reported on cases in long-term care facilities, only Ontario and Quebec provided detailed information for detention facilities and schools, and only Ontario reported on cases within homeless shelters and across occupational sectors.ConclusionOne year into the pandemic, socially stratified reporting for COVID-19 outcomes remains sparse in Canada. However, several “best practices” in health equity-oriented reporting were observed and set a relevant precedent for all jurisdictions to follow for this pandemic and future ones.Supplementary InformationThe online version contains supplementary material available at 10.17269/s41997-021-00496-6.     

Sobre la pornografía y la educación sexual: ¿puede «el sexo» legitimar la humillación y la violencia?

The aim of this article is to argue for the need and urgency to open an interdisciplinary debate on the goals of critical sexual education. From a philosophical and gender approach, the consequences of generalized online access to pornography, a profitable business, are analyzed as a school of sexuality for youth. The article deals with the violence and misogyny of many of the most visited contents and poses two hypothesis to debate. Firstly, pornography is subject to a process of erotizing violence, which may become a new space of legitimization of inequality between female and male teenagers. Secondly, a mismatch exists between the expectations of female and male teenagers regarding what a good sexual life is. Movements such as Me too and Cuéntalo as well as social polarization over trials like that of “the herd” would confirm such a mismatch. The conclusions reflect on the contradictions in societies, committed to equality, which increasingly tolerate less sexual abuse and aggression and at the same time are becoming more tolerant towards pornographic contents freely accessed by young people as a school of misogyny and violence. Some of the most serious consequences of those contradictions are dealt with by way of three current examples.