Autopsy findings in two siblings with infantile Refsum disease

Summary Recognition of adrenal atrophy during a review of autopsy findings in two sisters who died at 8 months and 3 1/2 years prompted estimation of very long chain fatty acids, phytanic acid and pristanic acid on wet liver fixed in formalin for 12 years. These were shown to be markedly increased and defects in multiple peroxisomal functions and decrease in particulate catalase were shown in cultured fibroblasts, confirming an abnormality of peroxisomal biogenesis. The patients had presented with failure to thrive, recurrent diarrohea and vomiting, poor mental development, retinal pigmentation, blindness and in the older patient deafness, with only mild dysmorphic features. Autopsy in the older patient showed adrenal atrophy, cirrhosis, and foamy histiocytes in multiple organs. The brain showed no demyelination, little cytoarchitectural abnormality, occasional perivascular histiocytes in the grey matter and meninges and prominent Purkinje cells in the molecular layer of the cerebellum. In the younger patient the changes were very subtle in spite of the marked clinical similarity. Despite the young age at death the clinicopathological features are most suggestive of infantile Refsum disease. In many situations anatomical pathology can be very useful in the recognition and study of peroxisomal disorders.     

商州市劳教人员艾滋病认知健康教育效果分析

目的　了解收容劳教人员对艾滋病认知情况和相关态度 ,提高他们对艾滋病的认知。方法　教育前后采取相同问卷 ,以不记名自填式答卷方式对教育前后艾滋病认知状况进行调查。结果　健康教育后 ,收容劳教人员对艾滋病的认知显著提高 (P <0 0 5 )。对婚前、婚外性行为持正确态度的比例有所增加 ,但无显著性差异。选择部分安全行为的趋向显著提高。结论　在收容劳教人员中开展艾滋病健康教育是可行的 ,但扭转有关不正确态度需要长期的过程     

温州市农村贫困人群卫生服务需求和利用分析

通过对近2000份调查表的分析,评价温州市农村贫困人群在就诊过程中对医疗机构的选择、未就诊原因方面的特点,提出提高卫生服务利用的方法。     

白内障扶贫复明手术探讨

目的：探讨山区白内障扶贫复明手术。方法：采用改良现代白内障囊外摘出术或小切口非超声乳化白内障摘除术，对2675只眼白内障施行复明手术。结果：术后第一天矫正视力0．3者57只眼(2．13％)，0．5～0．8者1829只眼(68．37％)，≥0．9者509只眼(19．03％)。角膜水肿71只眼(2.65％)，后囊膜破裂致玻璃体脱出87只眼(3．25％)，全部均可同时植入人工晶体。结论：采用改良的白内障摘除手术，做到开源节流，既能使更多的贫困患者接受复明手术，又保证了手术质量。     

Mortality and suicide rates of involuntarily committed patients

The mortality and suicide rates for involuntarily committed patients in Denmark are presented. Two cohorts of psychiatric patients committed to a mental hospital from January 1, 1971 to December 31, 1975 (8322 people) and January 1, 1981 to December 31, 1985 (5253 people) have been followed. The standard mortality rate (SMR) in relation to the total Danish population were 4.9 (4.5–5.4) and 5.2 (4.7–5.8), respectively, for the two cohorts, during the first year after involuntarily commitment to a mental hospital. During the same period, the SMR for suicide among the committed patients were 44.9 (37.1–53.9) and 30.9 (24.2–38.9), respectively. The crude suicide rates among the committed patients during the first year after the commitment were 14.3 and 14.0, respectively, per 1000 years, unchanged between the cohorts. Short length of stay in hospital (< 14 days), a nonpsychotic main diagnosis, male sex, and age 35 years or more were equally related to high risk of suicide in the 1971 cohort as evaluated to proportional hazard methods (Cox regression), and short length of stay and commitment on the danger indication provided the most information in relation to high suicidal risk in the 1981 cohort. Methodological problems and the reasons for the results are discussed.     

老年人健康行为与心理健康关系的调查

目的探讨老年人的健康行为与心理健康之间的关系。方法采用候玉波等编制的健康行为量表和症状自评量表（SCL-90）对300名老年人进行测试,并进行相关分析。结果不同年龄和文化程度老年人在健康行为与心理健康方面有显著性差异（P〈0.05）;参与活动与心理健康水平呈显著正相关（P〈0.05）;心理应激、不良生活习惯与心理健康呈显著负相关（P〈0.05）。结论积极参与各项活动、减少各种心理应激和建立良好的生活习惯有利于提高老年人的心理健康水平。     

The social sciences and successful aging: Issues for Asia–Oceania

Aim:   This paper presents social science understandings of successful aging for a broad audience in multidisciplinary gerontology in Asia–Oceania.
Methods:   The international literature on social science aspects of successful aging is reviewed with a focus on Asia and social improvement.
Results:   New positive approaches to aging research are identifying opportunities for maintaining capacities and well-being over the life course. Successful aging, productive aging, and active aging are key concepts. Increasing life expectancy and fertility control are major social achievements that underpin population aging as the mainstream social transformation facing the world. Asia will be at the forefront of this change and the consequences will vary greatly between cultures, nations, and subgroups within them. Older people generally maintain good quality of life and the capacity to 'age well' is influenced by life-long maturation and emotional, social, and economic resources. Good health can be enhanced through positive actions such as physical activity, good nutrition, and not smoking. Mental capacities can also be improved and maintained throughout old age. In advanced old age, the 'fourth age', the focus turns to ameliorating the effects of loss and to maintaining dignity.
Conclusions:   The social sciences contribute knowledge useful for improving life experiences for older people and aging societies. Population aging is central to national economic development. Public policy and individual action concerning aging can benefit all age groups. To better inform these developments it is important to address the serious shortfall of social science research on aging in the Asia–Oceania region.     

“AIDS is rape!” gender and sexuality in children's responses to HIV and AIDS

This paper examines young African school children's understanding of HIV and AIDS. Based on focus group interviews with children aged 7–8 in KwaZulu-Natal province, South Africa, it explores the ways in which gender and sexuality feature in their responses to the disease. Data were collected between 2003 and 2004 through 26 focus groups involving 55 boys and 64 girls. The paper argues that younger children are active agents in giving meaning to the disease. Their agency is negotiated within complex social processes involving sexual violence, highly unequal gender/age inequalities, but also sexual expression. Those expressions are subsumed however under a regime of violence and fear catapulting men, albeit with contestation, as chief vectors in the spread of the disease and a source of girls' anxieties. Children's responses to the disease are the effects of material, symbolic and discursive forces effectively constraining the opportunities available to them and creating patterns of vulnerability especially for young girls. Interventions aimed at scaling up efforts to address young children responses to the disease must be situated in parallel efforts to end poverty, sexual violence and pervasive gender inequalities in order to foster more comprehensively the exercise of young children's agency.     

老年股骨颈骨折围手术期的治疗分析

目的探讨老年人股骨颈骨折的治疗及围手术期的处理。方法回顾性分析2003年1月～2006年12月手术治疗的201例老年股骨颈骨折患者资料，其中男51例，女150例，年龄60～98岁，平均78．2岁。按Garden分型，Ⅱ型20例，Ⅲ型86例，Ⅳ型95例。采用多枚中空螺钉固定、Morre型人工股骨头置换术或双极人工股骨头置换手术进行治疗。结果本组患者平均住院10～14d，5～7d即能早期下床活动，住院期间及术后1年内无一例死亡。85％患者获得8个月～4年（平均2年）的随访，功能恢复按Harris评分，优良率为85％。结论老年人各脏器机能衰退，多同时合并各种内科疾病，手术治疗存在风险，但老年人股骨颈骨折的手术治疗仍能取得满意疗效。