益智活血汤联合拜阿司匹林治疗脑梗死恢复期患者的临床疗效及对神经功能的影响

目的:探讨益智活血汤联合拜阿司匹林治疗脑梗死恢复期的临床疗效及对患者神经功能的影响。方法:选取2017年10月至2019年1月在本院治疗的脑梗死恢复期患者84例,随机分为对照组和观察组各42例。对照组采用拜阿司匹林肠溶片治疗,每次0.2 g,日1次,口服。观察组在对照组治疗的基础上采用益智活血汤治疗,日1剂,早晚温服,两组均治疗8周。结果:对照组有效率为80.95%,观察组有效率为95.24%,两组有效率比较,差异有统计学意义(P<0.05)。两组患者治疗后半身不遂评分、舌謇不语评分、口舌歪斜评分、肢体麻木评分、气短懒言评分均显著低于本组治疗前,差异有统计学意义(P<0.05),组间比较,差异有统计学意义(P<0.05)。两组患者治疗后NIHSS评分、MRS评分均显著低于本组治疗前,BI评分显著高于本组治疗前,差异均有统计学意义(P<0.05),组间比较,差异有统计学意义(P<0.05)。两组患者治疗后全血高切黏度(high bloodshear viscosity,HWBV)、全血低切黏度(low bloodshear viscosity,LWBV)、血浆黏度(plasma viscosity,PV)、血小板聚集率(platelet agglutination test,PAG)水平均显著低于本组治疗前,差异有统计学意义(P<0.05),组间比较,差异有统计学意义(P<0.05)。两组患者治疗后中动脉(middle cerebral artery,MCA)、前动脉(anterior artery,ACA)、后动脉(posterior communicating artery,PCA)血流速度均显著高于本组治疗前,差异有统计学意义(P<0.05),组间比较,差异有统计学意义(P<0.05)。结论:益智活血汤联合拜阿司匹林治疗脑梗死恢复期患者,可明显改善其神经功能、血液循环及日常生活能力。     

重灸中脘穴对脾胃虚寒型糖尿病胃轻瘫患者胃肠激素、胃动力学的影响

目的观察重灸中脘穴对脾胃虚寒型2型糖尿病胃轻瘫患者胃肠激素、胃动力学的影响。方法选取符合纳入标准的88例脾胃虚寒型糖尿病胃轻瘫患者,按随机数字表法分为治疗组和对照组,每组44例。对照组采用常规药物治疗,治疗组采用重灸中脘穴治疗。疗程结束后记录并对比分析两组临床疗效、胃肠激素[胃泌素(GAS)、胃动素(MTL)]、胃动力学(胃收缩频率、胃排空时间、胃排空率)、主要临床症状评分等变化。结果治疗组临床疗效明显优于对照组,差异具有统计学意义(P<0.05);两组治疗后GAS、MTL均明显优于治疗前(P<0.05),且治疗组明显优于对照组(P<0.05);两组治疗后胃收缩频率、胃排空时间、胃排空率均明显优于治疗前(P<0.05),且治疗组明显优于对照组(P<0.05);两组治疗后主要临床症状评分均明显优于治疗前(P<0.05),且治疗组明显优于对照组(P<0.05)。结论在常规药物治疗基础上重灸中脘穴治疗脾胃虚寒型2型糖尿病胃轻瘫,可调节胃肠激素,改善胃肠动力,促进胃肠功能恢复。     

Preferences predict who commits crime among young men

Understanding who commits crime and why is a key topic in social science and important for the design of crime prevention policy. In theory, people who commit crime face different social and economic incentives for criminal activity than other people, or they evaluate the costs and benefits of crime differently because they have different preferences. Empirical evidence on the role of preferences is scarce. Theoretically, risk-tolerant, impatient, and self-interested people are more prone to commit crime than risk-averse, patient, and altruistic people. We test these predictions with a unique combination of data where we use incentivized experiments to elicit the preferences of young men and link these experimental data to their criminal records. In addition, our data allow us to control extensively for other characteristics such as cognitive skills, socioeconomic background, and self-control problems. We find that preferences are strongly associated with actual criminal behavior. Impatience and, in particular, risk tolerance are still strong predictors when we include the full battery of controls. Crime propensities are 8 to 10 percentage points higher for the most risk-tolerant individuals compared to the most risk averse. This effect is half the size of the effect of cognitive skills, which is known to be a very strong predictor of criminal behavior. Looking into different types of crime, we find that preferences significantly predict property offenses, while self-control problems significantly predict violent, drug, and sexual offenses.

In choice theory of crime, individuals trade off their benefits from criminal activity against the opportunity costs of legitimate activity and the risks of future costs due to apprehension and punishment (1–3). People can face different trade-offs, for instance, due to differences in how much they can otherwise earn in the labor market, or they can evaluate the trade-offs differently due to differences in preferences. A large empirical literature documents that variation in the trade-off people face predicts who commits crime (3–6). In contrast, little is known about the role of preferences.Key preference parameters are risk tolerance and impatience. Intuitively, crime provides a benefit now but at the risk of a cost in the future which makes crime less attractive for people who dislike risk and care more about future well-being (3). Thus, more risk-tolerant and more impatient people are more prone to commit crime than others (see SI Appendix, SI Text, for a formal derivation in a basic model of criminal behavior). In standard choice theory, people are entirely driven by self-interest, but the theory can be extended to allow for altruistic motives or more sophisticated, other-regarding preferences (7–9). More altruistic people will commit less crime because they care about the costs they inflict on others.In this paper, we ask whether preferences predict who commits crime among young men. We focus on young men (age 18 to 19) who are known to have much higher crime rates than women and older people (3, 10, 11). To answer the question, we leverage a unique combination of data where we use incentivized experiments to elicit the preferences of young men in Denmark and link this experimental data to administrative records with information about all criminal offenses.We examine the association between preferences and crime while also controlling for other differences across people that can explain criminal behavior. The link between experimental data and administrative records enables us to include an extraordinary rich set of relevant control variables. This includes school performance, area of residence, immigrant status, family size, birth order, parental socioeconomic status, criminal records of parents, and family stress as measured by parental divorce or unemployment. Moreover, when we collected the experimental data on preferences, we also asked about self-control which is known to be a strong predictor of crime (12–14). We use this information to control for behavioral factors other than risk, time, and social preferences. We also investigate the relation between preferences and different types of criminal offenses. Arguably, the hypothesis that cost-benefit considerations help explain crime seems more appropriate for property crimes than violent, drug, and sexual offenses where lack of self-control may be a more important driver.This study links experimentally elicited risk, time, and social preferences to actual criminal behavior. We follow a large literature in experimental economics that elicits people’s preferences using incentivized choice experiments, where participants receive payments according to their decisions in the experiment. This literature documents pervasive variation in preferences including that some people are more risk tolerant, impatient, and motivated by self-interest than others (15–17). Studies also show that these parameters are correlated with real-life behavior and outcomes in accordance with theoretical predictions, for example, savings, high school graduation, disciplinary referrals of school children, entrepreneurship, body mass index, and smoking (18–25). The number of participants in our elicitation experiment is large compared to previous studies, and the participants are sampled randomly from the population in contrast to many previous studies which are based on samples of students (26). A large population sample is important for our purpose because crime frequency is low and because students differ significantly from the population at large with respect to their crime propensity.Most closely related to our work is a recent study that finds a significant relationship between patience and criminal offenses (27). The study uses a nonincentivized survey question to measure patience and demonstrates that this predicts crime. Interestingly, the authors find that the predictive power of patience is about one-third of the power of cognitive skills and that patience is most predictive of property crime, which is similar to our findings. Our study differs 1) by providing a more comprehensive and experimentally elicited set of preference measures that include risk preferences and social preferences and 2) by including a self-control measure in the set of predictors. This enables us to 1) show that risk tolerance is the strongest predictor of crime among the preference parameters and 2) document that risk and time preferences significantly predict property crime where self-control is not a significant predictor, whereas in the domain of violent, drug, and sexual offenses, self-control is a key predictor, while risk and time preferences are not significantly predictive.     

新式剖宫产术后留置导尿放尿时机对膀胱功能影响的研究

目的探讨新式剖宫产术后留置导尿者的最佳放尿时机。方法将150例采用新式剖宫产术后留置尿管者随机分成液体余量放尿组(观察组)70例和传统放尿组(对照组)80例,比较两组第1次尿量、排尿成功率、拔除尿管时间及泌尿系统感染情况。结果观察组第1次排尿量为(420±36)m l,明显多于对照组;自行排尿成功率为100%,明显高于对照组;观察组多在24 h内拔除尿管,明显早于对照组;泌尿系感染率(10%)明显低于对照组(50%),P值均小于0.05。结论剖宫产术后放尿时机选择对于产妇预后的影响较大,采用液体余量放尿法较传统放尿方法理想。     

Setting Times of Early-Age Mortars Determined from Evolution Curves of Poisson’s Ratio

Setting times, as the early-age properties of cement-based materials, are important properties to ensure the quality and long-term performance of engineering structures. To determine the initial and final setting times of cementitious materials, the compressive wave velocity and shear wave velocity of six early-age mortar samples were monitored. Their time evolution curves of Young’s modulus, shear modulus, bulk modulus, and Poisson’s ratio were then calculated and analyzed. The signature times of the derivatives of the Poisson’s ratio evolution curves correlate well with the initial and final setting times, and the remarkably high coefficient of determination values relative to the data from this study are higher than those presented in the current literature. The proposed derivative method on the Poisson’s ratio evolution curve is as good as the derivative methods from vs. evolution curves used by prior studies for the estimation of both the initial and final setting times of the early-age properties of cement-based materials. The formation and subsequent disappearance of ettringite of low Poisson’s ratio were postulated to cause the initial dip in the Poisson’s ratio evolution curves.     

The Performance of Graphene-Enhanced THz Grating: Impact of the Gold Layer Imperfectness

We report the performance of a graphene-enhanced THz grating fabricated by depositing a gold layer on the femtosecond micromachined SiO₂ substrate. The morphology of the gold plated patterned substrate was studied by scanning electron microscopy (SEM) and atomic force microscopy (AFM), while the quality of the chemical vapor deposition (CVD) graphene was evaluated by Raman spectroscopy. The electromagnetic (EM) response of the metasurface comprising the graphene sheet and the gold plated substrate was studied by THz time domain spectroscopy in the 100 GHz–1 THz frequency range. We employed the finite elements method (FEM) to model the metasurface EM response by adjusting the ac conductivity of the gold layer covering the patterned SiO₂ substrate to reproduce the measured transmission/reflection spectra. The results of the numerical simulation reveal the impact of the imperfectness of the gold layer on the performance of the THz metasurface. The experimental results are well described in terms of the Drude–Smith model of metal conductivity that takes into account the anisotropic scattering of the carriers in thin metal films.     

隔姜灸对结直肠癌行腹腔镜根治术后凝血功能的影响

目的 探讨隔姜灸对结直肠癌行腹腔镜根治术后凝血功能的影响。方法 采用随机数字表法,将96例结直肠癌行腹腔镜根治术患者分为2组,对照组、观察组各48例。2组患者术后均给予胃肠外科术后常规护理,观察组施以隔姜灸,比较2组术前第1天、术后第1天及术后第7天凝血功能指标的变化。结果 与对照组相比,观察组的凝血酶原时间、活化部分凝血活酶时间在组间效应、时间效应、交互作用的比较,差异具有统计学意义（P<0.05）;血浆抗凝血酶Ⅲ活性测定在组间效应、时间效应的比较,差异具有统计学意义（P<0.05）,在交互作用的比较,差异无统计学意义（P>0.05）;2组凝血酶时间、纤维蛋白原、D-二聚体在时间效应的比较,差异具有统计学意义（P<0.05）,在治疗效应、交互作用的比较,差异均无统计学意义（P>0.05）。结论 隔姜灸能够影响凝血功能指标,有效改善结直肠癌行腹腔镜根治术后患者的血液高凝状态。     

TrFIA检测CA242对结直肠癌的临床价值

目的：观察采用时间分辨荧光免疫分析检测的CA242在恶性肿瘤普查、诊断和预后的应用价值。方法：收集我院2004年10月～2006年3月的住院病例。包括恶性肿瘤组共226例,良性病变组共74例,正常组50例。采集患者静脉血,常规离心分离血清进行检测。CA242采用TrFIA,CA242正常值为〈20U／ml。结果：使用TrFIA检测CA242在恶性肿瘤组表达水平较良性病变组与正常对照组的表达水平及阳性例数明显升高,其差别明显,P〈0．05,有统计学意义。CA242与其他肿瘤标记物比较,以CEA的灵敏度（45．21％）和CA242的特异度（92．86％）最高。当CA242与另外一项肿瘤标志物联用时,采用平行联检CA242-CEA诊断的灵敏度（59．57％）最高,而采用系列联检CA242-CAl99和CA242-CA50的特异度可以达到100％。当CA242与其他其二项肿瘤标志物联用时,CA242-CEA-CA50平行联检灵敏度最高达67．74％。三项联合应用时,系列联检特异度都是100％。当CA242与其他三项指标联合时,平行联检在本文所用方法中灵敏度最高（69．23％）,系列联检特异度是100％。结论：采用TrFIA检测糖链抗原CA242对直肠癌等的普查、诊断、预后的判断提供了一定的应用价值。     

Challenges and satisfaction in Cardiothoracic Surgery Residency Programmes: insights from a Europe-wide survey

Open in a separate window OBJECTIVESThe increasing complexity of surgical patients and working time constraints represent challenges for training. In this study, the European Association for Cardio-Thoracic Surgery Residents’ Committee aimed to evaluate satisfaction with current training programmes across Europe. METHODSWe conducted an online survey between October 2018 and April 2019, completed by a total of 219 participants from 24 countries.RESULTSThe average respondent was in the fourth or fifth year of training, mostly on a cardiac surgery pathway. Most trainees follow a 5–6-year programme, with a compulsory final certification exam, but no regular skills evaluation. Only a minority are expected to take the examination by the European Board of Cardiothoracic Surgery. Participants work on average 61.0 ± 13.1 h per week, including 27.1 ± 20.2 on-call. In total, only 19.7% confirmed the implementation of the European Working Time Directive, with 42.0% being unaware that European regulations existed. Having designated time for research was reported by 13.0%, despite 47.0% having a postgraduate degree. On average, respondents rated their satisfaction 7.9 out of 10, although 56.2% of participants were not satisfied with their training opportunities. We found an association between trainee satisfaction and regular skills evaluation, first operator experience and protected research time.CONCLUSIONSOn average, residents are satisfied with their training, despite significant disparities in the quality and structure of cardiothoracic surgery training across Europe. Areas for potential improvement include increasing structured feedback, research time integration and better working hours compliance. The development of European guidelines on training standards may support this.     

电针疗法联合手法灸治疗Meige综合征1例并文献复习

目的 观察电针疗法联合手法灸治疗Meige综合征的疗效及优势。方法 整理1例Meige综合征患者资料,辨证取穴,针刺得气后连接电针仪。留针30 min后出针施以手法灸10～15 min。1次/d, 7 d为1疗程,5个疗程结束后观察患者症状改善情况。结果 5个疗程结束后患者症状基本消失,无复发。结论 电针联合手法灸治疗Meige综合征疗效及优势显著。