Mandatory Procedures and Fairness in Mental Impairment Hearings

Uncertainty has attended procedures for adjudging unfitness to stand trial in Victoria pursuant to the Crimes (Mental Impairment and Unfitness to be Tried) Act 1997 (Vic) and how “special hearings” should be conducted when a person is determined to be unfit to stand trial but does not wish to pursue the defence of not guilty because of mental impairment. In R v Langley [2008] VSCA 81, (2009) 19 VR 90 the Victorian Court of Appeal clarified the procedures to be employed at jury trials on such matters and quashed a decision not in conformity with proper procedures, making clear that denial of fairness to such accused persons has the potential to result in appealable error.     

新生儿出生信息样本分析

目的:了解和探讨新生儿出生信息的分布态势及规律。方法:对本院2006年1~6月间所有新生儿出生信息进行样本分析。结果:半年间分娩的新生儿共1075例,其中死亡19例,双胞胎15例,以1028例单胎活产新生儿的出生体重、胎龄及产妇年龄作为研究样本进行分析,统计数据与传统意义上的正常胎龄和新生儿体重基本相符,胎龄、体重均值均有所提高。结论:孕产妇的健康状况和新生儿的体质均有所改善,随胎龄的增加,新生儿出生体重亦随之增加,并且,目前新生儿的整体统计体重要大于现有的临床指标,因此,应对现有的临床指标进行适当调整,重新确定低出生体重儿和巨大儿的临床指标。     

病理复查并前列腺癌根治术后早期前列腺特异抗原监测的临床意义

目的：结合病理复查结果，监测前列腺癌根治术后早期的前列腺特异抗原(PSA)水平，指导术后的进一步治疗。方法：对25例前列腺癌根治术患者于术后1、2、4周时测定PSA水平，尔后每个月测定一次，随访5～17个月，平均11个月；并对术后标本的手术切缘及包膜浸润程度行病理复查。结果：病理报告T1～T2期17例，15例获根治，PSA水平均降至0．2μg／L以下，随访12个月无复发；2例PSA一直未降至正常，2个月后复升高而加用辅助治疗，其病理观察发现手术切缘有肿瘤残留。T3a或T3b期8例，4例获根治，PSA在3个月内降至0．2μg／L以下，随访9个月无复发，病理特征为肿瘤浸润包膜但未穿透；4例在1个月后因PSA回升分别加用辅助治疗，病理示肿瘤均穿透包膜。结论：T1～T2期患者，因手术切缘残留等原因，肿瘤可能早期复发；T3期患者，特别是那些侵犯包膜但未穿透者，手术可能达到根治，并可以延迟应用雄激素阻断治疗，延长治疗的有效时间。     

Developmental toxicity of nicotine: A transdisciplinary synthesis and implications for emerging tobacco products

While the health risks associated with adult cigarette smoking have been well described, effects of nicotine exposure during periods of developmental vulnerability are often overlooked. Using MEDLINE and PubMed literature searches, books, reports and expert opinion, a transdisciplinary group of scientists reviewed human and animal research on the health effects of exposure to nicotine during pregnancy and adolescence. A synthesis of this research supports that nicotine contributes critically to adverse effects of gestational tobacco exposure, including reduced pulmonary function, auditory processing defects, impaired infant cardiorespiratory function, and may contribute to cognitive and behavioral deficits in later life. Nicotine exposure during adolescence is associated with deficits in working memory, attention, and auditory processing, as well as increased impulsivity and anxiety. Finally, recent animal studies suggest that nicotine has a priming effect that increases addiction liability for other drugs. The evidence that nicotine adversely affects fetal and adolescent development is sufficient to warrant public health measures to protect pregnant women, children, and adolescents from nicotine exposure.     

可调控眉毛密度的眉再造术同期治疗瘢痕性秃发的临床护理

目的:探索专项护理在眉再造同期治疗瘢痕性秃发术中的应用效果。方法:根据手术过程分两期进行专项临床护理。扩张器一期置入术后进行扩张器相关专项护理,严密监测扩张注水情况,密切观察扩张部位,防止扩张皮瓣坏死或感染;眉再造和瘢痕性秃发修复二期术后密切观察再造眉毛头皮条的颜色,避免静脉回流不畅发生。结果:本组12例患者进行了眉再造的全方位密切护理,岛状头皮瓣全部存活,头皮瘢痕全部修复,无一例皮瓣坏死。随访6~24个月,再造眉毛毛发密度与健侧非常接近,眉形自然逼真,手术效果满意。结论:在可调控眉毛密度的眉再造同期治疗瘢痕性秃发术中进行全方位护理是手术成功的重要保障。     

Clinical abnormalities of the nipple-areola complex: The role of imaging

Clinical examination of the nipple is part of normal breast screening procedures. Abnormal processes of benign or malignant nature may be reflected by erythema, erosion, swelling or acquired inversion. In patients presenting with a persistent unilateral nipple lesion, it is advisable to collect a sample to exclude Paget's disease of the nipple, a rare form of ductal carcinoma in situ (DCIS). Imaging should be performed to detect breast cancer, which is found in more than 80% of cases, and determine its possible multifocal nature. Breast MRI is indicated if breast-conserving surgery is planned. The main differential diagnoses are erosive adenomatosis and eczema of the nipple. Acquired inverted nipple is generally of inflammatory origin. It is usually diagnosed by conventional breast examination but breast MRI can be helpful when in doubt about possible underlying neoplasia.     

“魔鬼周”极限训练对武警特战队员生化指标的影响

 

目的 了解“魔鬼周”极限训练对武警特战队员身体状况的影响,以便更有效地预防和减少运动损伤,提高体能训练效果。方法 选取90例来自武警某部参加2017年第三季度“魔鬼周” 极限训练的特战队员作为研究对象,分别于“魔鬼周”的第1天及第7天进行肝功能、肾功能、血糖、血脂四项指标的检测,包括丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(T-Bil)、直接胆红素(D-Bil)、间接胆红素(IBIL)、尿素(UREA)、肌酐(CREA)、尿酸(UA)、血糖(Glu)、甘油三酯(TG)、胆固醇(TC)、高密度胆固醇(HDL-C)、低密度胆固醇(LDL-C)。应用SPSS 18.0统计软件进行数据处理。结果 训练后血清ALT、AST、UREA、CREA、UA、Glu、TG较训练前明显升高(P＜0.05),UREA、TC、LDL-C低于训练前(P＜0.05),T-Bil、D-Bil、IBIL、HDL-C训练前后无明显变化。结论 “魔鬼周”极限训练对武警特战队员的生理功能可产生一定的影响,进而可能影响其训练水平。

     

“魔鬼周”极限训练对武警特战队员睾酮、心肌酶谱及血液分析的影响

 目的 了解“魔鬼周”极限训练对武警特战队员身体状况的影响,以便更有效地预防和减少运动损伤,提高体能训练效果。方法 选取79例来自武警某部参加2017年第三季度“魔鬼周” 极限训练的特战队员作为研究对象,分别于“魔鬼周”的第1天及第7天进行相关血液指标的检测,包括睾酮(T)、天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶 (LDH)、肌酸激酶(CK)、肌酸激酶MB型同工酶(CK-MB)、白细胞数目(WBC)、中性粒细胞百分比(N)、淋巴细胞百分比(L)、红细胞数目(RBC)、血红蛋白浓度(HB)、血小板数目(PLT)。应用SPSS 18.0统计软件进行数据处理。结果 参加“魔鬼周”极限训练的武警特战队员训练后的血清AST、LDH、CK、CK-MB分别为(46.15±43.21)U/L、(285.14±62.76)U/L、(505.17±359.73)U/L、(26.42±16.03)U/L,较训练前(19.67±4.05)U/L、(214.38±31.84)U/L、(222.50±116.09)U/L、(15.85±3.02)U/L明显升高,差异有统计学意义(P＜0.05),T、WBC、L、RBC、HB、PLT低于训练前[(21.10±5.58)nmol/L、(5.64±1.24)×10⁹/L、(34.53±7.10)%、(4.82±0.34)×10¹²/L 、(147.20±7.58)g/L、(216.53±45.35)×10⁹/L vs(22.41±5.00)nmol/L、(6.00±1.42)×10⁹/L、(36.01±8.15)%、(4.93±0.35)×10¹²/L、(150.75±7.30)g/L、(258.96±47.26)×10⁹/L,P＜0.05],N训练前后无明显变化[(57.19±7.26)% vs (56.66±8.62)%]。结论 “魔鬼周”极限训练对武警特战队员的生理功能可产生一定的影响,进而可能影响其训练水平。     

南方地区某特种部队营养状况评价

对南方地区某特种部队官兵随机抽样,进行以膳食调查、生化检查及体格检查为主要内容的营养调查,结果发现:体格检查,约1/4的战士BMI<20,反映其营养状况欠佳.膳食调查:Vit A,Vit B_1、B_2及钙的摄取量均低于我军膳食营养素供给量标准;能量分配不合理,早餐偏低.晚餐偏高;蛋白质质量不高.4h负荷试验,发现Vit B_1、B_2严重缺乏或不足.血红蛋白测定,贫血发生率为2.3%.以上结果说明该部队营养状况存在不足,应及时采取相应措施加以改善.