恒河猴视觉分辨的反应抑制任务的行为训练及其应用

目的 训练恒河猴学习视觉分辨的go/no go任务（反应抑制任务的一种），以便进行认知神经科学、心理药理学、精神病学等领域的研究。方法 训练恒河猴一手不动，另一只手按压微动开关启动训练，并对屏幕上呈现的“□”做持续按压开关1s的反应，对“△”做松开开关的反应。应用该方法对两只恒河猴分三步进行训练（no go反应训练、go反应训练和go/no go反应训练。结果 经过30天左右的训练，两只猴正确反应率均可达85％以上，go反应的反应时为0．3－0．6秒。结论 此行为训练的方法简单、易行，是一种较好的go/no go任务的行为训练方法。     

Development of a novel method to measure the elastic properties of skin including subcutaneous tissue: New age‐related parameters and scope of application

Background/purpose: We have developed a new apparatus to measure the elastic properties of skin without contact using an air blown technique. Methods: Real‐time measurements of skin movement induced by air blown on the surface were measured at various times. We investigated age‐related changes in the displacement of the skin surface caused by air using various parameters. Ninety‐eight female Japanese volunteers, aged from 10 to 70 years, were used in this study. Results: The maximum distance (the denting state) that cheek skin moved reached 2–5 mm within 10–15 ms. After that, the skin generally recovered to its original state within 40–50 ms. The average maximum speed of movement was 0.49±0.08 (average±SD) m/s and the average recovery speed was 0.25±0.06 m/s. Significant changes with age were not observed in the denting state, but significant correlations with age were observed in the recovery state. The maximum recovery speed decreased significantly with age and the time required for recovery increased significantly with age. Although similar results were obtained at the corner of the mouth or the inner upper arm, different results were obtained at the below eyes and the forehead. Conclusions: This apparatus differs from other conventional instruments in that it measures the elastic properties of skin including subcutaneous tissue without contact.     

Fio‐guia perdido – lições aprendidas

Central venous catheter placement is a relatively common procedure in current practice, but it is not devoid of risks. Utmost care must be taken to follow a correct technique, and only appropriately trained and/or supervised medical professionals should perform this invasive act. One of the possible complications, completely avoidable by appropriate care, is the intravascular loss of the guide wire during insertion, which is a potentially serious complication. We describe one such case.     

Bloqueio do quadrado lombar tipo II para uma gastrectomia subtotal em um paciente séptico

Introduction and objectives

Quadratus Lumborum block was recently described and has already shown good results as an analgesic technique in abdominal surgeries, having the potential to significantly reduce opioids consumption and be a valid alternative to epidural catheter. We performed a type II Quadratus Lumborum block for analgesia in a septic patient having a sub‐total gastrectomy.

An Analysis: To Code or Not to Code��That Is the Question

Most blood glucose monitoring systems need coding to correct for variation in lots of enzyme, which leads to differences in lots of strips. About 16% of patients miscode the meters, although the magnitude of the miscoding is unstudied. This miscoding has the potential to cause errors as high as 30% and to cause errors in adjusting insulin therapy that could lead to hypoglycemia at least 10% of the time. Studies of these systems suggest that they have accuracy similar to other current meters and have similar physical characteristics. Because they do not require coding, they are often easier to use. No-coding systems have the potential to avoid some errors in blood glucose.     

Emulating a trial of joint dynamic strategies: An application to monitoring and treatment of HIV-positive individuals

Decisions about when to start or switch a therapy often depend on the frequency with which individuals are monitored or tested. For example, the optimal time to switch antiretroviral therapy depends on the frequency with which HIV-positive individuals have HIV RNA measured. This paper describes an approach to use observational data for the comparison of joint monitoring and treatment strategies and applies the method to a clinically relevant question in HIV research: when can monitoring frequency be decreased and when should individuals switch from a first-line treatment regimen to a new regimen? We outline the target trial that would compare the dynamic strategies of interest and then describe how to emulate it using data from HIV-positive individuals included in the HIV-CAUSAL Collaboration and the Centers for AIDS Research Network of Integrated Clinical Systems. When, as in our example, few individuals follow the dynamic strategies of interest over long periods of follow-up, we describe how to leverage an additional assumption: no direct effect of monitoring on the outcome of interest. We compare our results with and without the “no direct effect” assumption. We found little differences on survival and AIDS-free survival between strategies where monitoring frequency was decreased at a CD4 threshold of 350 cells/μl compared with 500 cells/μl and where treatment was switched at an HIV-RNA threshold of 1000 copies/ml compared with 200 copies/ml. The “no direct effect” assumption resulted in efficiency improvements for the risk difference estimates ranging from an 7- to 53-fold increase in the effective sample size.     

Prevalent high‐risk respiratory hygiene practices in urban and rural Bangladesh

Objectives To identify existing respiratory hygiene risk practices, and guide the development of interventions for improving respiratory hygiene. Methods We selected a convenience sample of 80 households and 20 schools in two densely populated communities in Bangladesh, one urban and one rural. We observed and recorded respiratory hygiene events with potential to spread viruses such as coughing, sneezing, spitting and nasal cleaning using a standardized assessment tool. Results In 907 (81%) of 1122 observed events, households’ participants coughed or sneezed into the air (i.e. uncovered), 119 (11%) into their hands and 83 (7%) into their clothing. Twenty‐two per cent of women covered their coughs and sneezes compared to 13% of men (OR 2.6, 95% CI 1.6–4.3). Twenty‐seven per cent of persons living in households with a reported monthly income of >72.6 US$ covered their coughs or sneezes compared to 13% of persons living in households with lower income (OR 3.2, 95% CI 1.6–6.2). In 956 (85%) of 1126 events, school participants coughed or sneezed into the air and 142 (13%) into their hands. Twenty‐seven per cent of coughs/sneezes in rural schools were covered compared to 10% of coughs/sneezes in urban schools (OR 2.3, 95% CI 1.5–3.6). Hand washing was never observed after participants coughed or sneezed into their hands. Conclusion There is an urgent need to develop culturally appropriate, cost‐effective and scalable interventions to improve respiratory hygiene practices and to assess their effectiveness in reducing respiratory pathogen transmission.     

中医骨伤科50年的历史与展望

纵观中西结合发展这五十余年的历史,认为无论是中医的还是西医的方法,只要是对能提高临床疗效,就要实行＂拿来主义＂,取其所长,补己之短;同时要坚定不移的发扬自己的长处,时刻保持与国内外研究前沿同步,体现中西结合疗法的科学性、先进性和实用性。