重型颅脑损伤病人的临床评估

对６８例重型脑外伤患者的评分和预后评估进行分析，提出以重型脑外伤病人的血压、脉搏、呼吸、神智（ＧＣＳ）、瞳孔５项指标作为评估指数进行评分（简称重型脑外伤评估指数），总分为２５分，最低分５分。结果表明：评分在７分以下，持续２～４ｈ者，抢救意义不大；８～１３分，抢救４～６ｈ无效者，其死亡、残废率很高；计分在１４分以上者，有抢救意义，尤以１８分以上者，抢救意义明显增大     

大鼠岛状皮瓣再血管化的观察

本文采用X线造影和墨汁灌注透明方法,对大鼠岛状皮瓣再植后的血管变化进行了动态观察。结果表明:术后8天,皮瓣和受区之间即可见毛细血管吻台,受区血管长入皮瓣。之后,血管吻接数目逐渐增多,管径增大。皮瓣与受区是否良好贴合是影响再血管化的重要因素之一。皮瓣和受区的血管都经历了一个明显的增生过程。     

Prognostic Factors in Endodontic Surgery Using an Endoscope: A 1 Year Retrospective Cohort Study

This retrospective study clarified the success rate of endoscopic endodontic surgeries and identified predictors accounting for successful surgeries. In this retrospective study, 242 patients (90 males, 152 females) who underwent endoscopic endodontic surgery at a single general hospital and were diagnosed through follow-up one year later were included. Risk factors were categorized into attributes, general health, anatomy, and surgery. Then, the correlation coefficient was calculated for the success or failure of endodontic surgery for each variable, the odds ratio was calculated for the upper variable, and factors related to the surgical prognosis factor were identified. The success rate of endodontic surgery was 95.3%, showing that it was a highly predictable treatment. The top three correlation coefficients were post, age, and perilesional sclerotic signs. Among them, the presence of posts was the highest, compared with the odds ratio, which was 9.592. This retrospective study revealed the success rate and risk factors accounting for endoscopic endodontic surgeries. Among the selected clinical variables, the presence of posts was the most decisive risk factor determining the success of endodontic surgeries.     

腔镜辅助与完全腔镜下甲状腺手术创伤应激反应的对照研究

目的:分析对比完全腔镜甲状腺手术与腔镜辅助甲状腺手术的创伤应激反应及微创效果。方法:95例患者行腔镜辅助甲状腺手术(辅助组),58例行完全腔镜甲状腺手术(完全组),观察对比两组患者手术前后的应激创伤指标IL-6、TNF-α、CRP。结果:手术后第1天,两组患者IL-6、TNF-α、CRP均明显上升,与术前相比差异有统计学意义(P<0.05);第3天明显下降,但仍高于术前水平,差异有统计学意义(P<0.05)。但两组手术前后各指标差异无统计学意义(P>0.05)。结论:腔镜辅助与完全腔镜甲状腺手术并发症发生率相似,微创效果均较好,术者应根据患者具体情况选择相应术式。     

Pregnancy outcomes in women with type 1 diabetes in China during 2004 to 2014: A retrospective study (the CARNATION Study)

BackgroundWe aimed to report pregnancy outcomes of women with type 1 diabetes (T1D) in China, on which data were sparse.MethodsThis is a nationwide retrospective study conducted in 11 general medical centers in 8 cities across China. We investigated the clinical data of all women who attended these centers with a singleton pregnancy and whose pregnancy ended between 1 January 2004 and 31 December 2014. Pregnancies of women with pregestational T1D were ascertained and compared with those of women without T1D.ResultsFrom over 300 000 pregnancies over the 11‐year study period, we identified 265 singleton pregnancies of women with T1D. One maternal death was documented among 265 (0.37%) women with T1D and 83 among 318 486 (0.03%) women without T1D. Women with T1D suffered from higher rates of pregnancy loss (13.21% vs 2.92%, crude risk ratio [cRR] 5.08 [95% CI, 3.56‐7.26]) and preeclampsia (17.74% vs 4.20%, cRR 4.94 [95% CI, 3.60‐6.77]) compared with those without T1D. Infants of these women with T1D had elevated rates of neonatal death (5.65% vs 0.16%, cRR 37.36 [95% CI, 21.21‐65.82]) and congenital malformation(s) (8.26% vs 3.53%, cRR 2.46 [95% CI, 1.54‐3.93]) compared with those of women without T1D. No significant improvement in pregnancy outcomes in women with T1D was observed over the period 2004 to 2014.ConclusionsPregnancy outcomes were persistently poor in women with T1D during 2004 to 2014 in China. Pregnancy care needs to be improved to reduce adverse pregnancy outcomes among Chinese women with T1D.     

Beverage and water intake of healthy adults in some European countries

Abstract

Introduction: Nutritional surveys frequently collect some data of consumption of beverages; however, information from different sources and different methodologies raises issues of comparability. The main objective of this review was to examine the available techniques used for assessing beverage intake in European epidemiological studies and to describe the most frequent method applied to assess it. Materials and methods: Information of beverage intake available from European surveys and nutritional epidemiological investigations was obtained from gray literature. Results: Twelve articles were included and relevant data were extracted. The studies were carried out on healthy adults by different types of assessments. The most frequent tool used was a 7-d dietary record. Only Germany used a specific beverage assessment tool (Beverage Dietary History). Conclusion: From the limited data available and the diversity of the methodology used, the results show that consumption of beverages is different between countries. Current epidemiological studies in Europe focusing on beverage intake are scarce. Further research is needed to clarify the amount of beverage intake in European population.     

Associations of coffee consumption with circulating level of adiponectin and leptin. A meta-analysis of observational studies

Abstract

The association between coffee consumption and the circulating level of adiponectin and leptin has been evaluated in several epidemiological studies with conflicting results. Therefore, the aim of this study was to examine the associations of coffee consumption with the circulating level of adiponectin and leptin. A comprehensive literature search up to January 2018, using PUBMED, EMBASE and Web of Science databases, was conducted to identify the relevant observational studies that examined the associations of coffee consumption with the circulating level of adiponectin and leptin. A total of twelve cross-sectional studies were included in this meta-analysis. According to the combined standard mean difference (SMD) between the highest and the lowest coffee intake category, coffee consumption was associated with a higher circulating adiponectin level (SMD?=?0.11, 95%CI: 0.06–0.17; P?<?.001). Subgroup analysis confirmed such findings in females (SMD?=?0.11, 95%CI: 0.02–0.20; P?=?.01), but not in males (SMD?=?0.03, 95%CI: ?0.08 to 0.14; P?=?.59). In addition, the combined SMD showed that coffee consumption was negatively associated with the circulating level of leptin (SMD?=??0.19, 95%CI: ?0.28 to ?0.10; P?<?.001). The results of this meta-analysis suggested that coffee consumption was associated with a higher circulating level of adiponectin. Additionally, we showed that coffee consumption was inversely associated with the circulating level of leptin. More well-designed prospective cohort studies and randomised controlled trials are needed to further elaborate the concerned issues.     

Residential radon and lung cancer characteristics in never smokers

Abstract

Purpose: The aim of this study is to assess if there is a relationship between residential radon and lung cancer histological types and patients’ age at diagnosis.

Materials and methods: We conducted a multicenter hospital-based case-control study with eight participating hospitals. We included 216 never-smoking cases with primary lung cancer and 329 never-smoking controls. Controls were frequency matched with cases on age and sex distribution. Of them, 198 cases (91.7%) and 275 controls (83.5%) had residential radon measurements.

Results: Lung cancer risk reached statistical significance only for adenocarcinoma (Odds ratio [OR] 2.19; 95% Confidence interval [CI] 1.44–3.33), for other histologies the results were marginally significant. Residential radon level was higher for patients diagnosed before 50 and 60 years old than for older lung cancer cases.

Conclusions: Residential radon in never smokers seems to be a risk factor for all lung cancer histologies. Individuals diagnosed at a younger age have a higher residential radon concentration, suggesting an accumulative effect on lung cancer appearance.     

Media experiences in community-driven rural areas: exploring children’s media cultures in rural Gujarat,India

ABSTRACT

In this paper, we examine how social structures of gender, caste, and religion, within which children in India operate, inform their engagements with media technologies/narratives. We demonstrate our approach using the case of three villages in the Ahmedabad district of Gujarat, India. We examine children’s media cultures using ethnographic methods which occasion long-term immersion and paying attention to children’s narratives. We also argue that children experience and enact their agency while engaging with media from within the limitations or norms imposed by the social structures. This is evident in the simple negotiation strategies they have developed to challenge social structures and norms prevalent in their societies. Based on empirical evidence we conclude that the children’s exposure to and consumption of media narratives under adult management allow the families and communities to reinforce the dominant rationality of patriarchy, caste hierarchy, and religious prejudice.