晋唐方书兴盛的时代背景探析

晋唐经方类著作在总量上远超过医经类著作,使该期医学呈现出"重术轻理"的特征。试图从社会生活、文化、科技、医学教育等大背景入手,揭示方书兴盛的时代原因。在战乱年代,直接从方书中找寻治法,无疑是最快捷有效的自救方式,方书正因通俗的便民特质而易于流通。又因当时印刷术尚未普及,理论性医著的流通极其局限,医学教育又多是师徒之间的秘授,故大多数人无法接触到医学理论,因此理论性著作较少,方书中亦少有病因病机及组方理法的阐释。故不应忽略科技、教育等时代局限而将晋唐时期在方剂学发展史上的地位简单地定位于"经验用方的积累"阶段,若将晋唐经方与《诸病源候论》联系起来解读,或许会对其背后的组方理法收获更深刻的认识。     

西安市某社区居民的文化程度与常见慢性病患病危险性的相关性分析

目的探讨西安市某社区居民文化程度与高血压、糖尿病、脑卒中等慢性病的相关关系,为制定针对性的控制措施提供科学依据。方法采用横断面调查设计,随机整群抽样,结构式问卷居民现场填写的方法,对常住人口的一般状况及慢性病相关危险行为进行调查分析。结果被调查人群中,初中、高中及大专文化程度占75.01%,小学及以下文化程度人群比例8.97%,大学及以上人群占16.02%。受文化程度影响的慢性病相关因素(年龄,收缩压和BMI)差异有统计学意义(P0.001)。随着文化程度升高,平均年龄呈较大幅度下降趋势,收缩压和体质指数则是以初中学历组最高,大学及以上学历组最低;在生活方式上,不同文化程度间主动获取保健知识(P0.001),每天静坐时间(P=0.002)和每次锻炼时间(P0.001)三项差异显著。高学历人群的主动获取保健知识的能力较强,但静坐时间较长,每次锻炼时间相对较短。结论可根据人群受教育程度差别,确定健康教育计划,以确保健康教育的干预效果和可行性。     

Quantitative Assessment of the Hemodynamic Effects of Intra-Arterial Nitroglycerin on Hepatocellular Carcinoma using Two-Dimensional Perfusion Angiography

PurposeTo determine the hemodynamic effects of intra-arterial nitroglycerin on hepatocellular carcinoma (HCC) using 2-dimensional (2D) perfusion angiography.Materials and MethodsTwo-dimensional perfusion angiograms obtained prior to radioembolization from September 2019 to February 2020 were retrospectively reviewed. The inclusion criteria were the presence of Liver Imaging Reporting and Data System-5 tumors and angiographically distinguishable tumor and background liver. The exclusion criteria were previously treated tumors and motion-degraded studies. Thirteen patients with 2D perfusion angiograms obtained before and 2 minutes ± 1 after the administration of intra-arterial nitroglycerin were analyzed. The mean patient age was 72 years ± 9 and 11 of 13 (85%) had cirrhosis. The mean maximum tumor dimension was 4.6 cm ± 2.1. Eight tumors were in the right lobe and 5 were in the left lobe. The tumor and background liver 2D perfusion data were processed and the areas under the time-density curves were calculated. The relative perfusion of HCC to background liver was compared before and after nitroglycerin administration using a 2-tailed paired t-test.ResultsThe mean rate of contrast administration was 1.4 mL/s ± 0.7 and the mean volume administered was 7.1 mL ± 3.3. The mean nitroglycerin dose was 281 μg ± 69. Ten of 13 patients (77%) demonstrated a relative increase in tumor perfusion. The mean HCC to background liver area under the curve ratio was 1.94 ± 0.76 before and 2.40 ± 0.89 after nitroglycerin administration (P < .05).ConclusionsIntra-arterial nitroglycerin increases previously untreated HCC perfusion relative to background liver as measured by 2D perfusion angiography, but this effect is variable among patients and should be validated with 3-dimensional imaging techniques.     

An epidemiological study of eating disorders in a northern area of Japan

Nadaoka T, Oiji A, Takahashi S, Morioka Y, Kashiwakura M, Totsuka S. An epidemiological study of eating disorders in a northern area of Japan. Scand 1996: 93: 305–310. © Munksgaard 1996. A total of 97 patients with eating disorders who visited the Department of Neuro-Psychiatry, Yamagata University Hospital, between 1978 and 1992 were studied. According to the diagnostic criteria of DSM-III-R, there were 48 cases of anorexia nervosa (AN), 38 cases of bulimia nervosa (BN) and 11 cases with both AN and BN. Both the number of patients and the ratio to all out-patients in each year increased four times during the period 1988–1992 compared to the previous period. With regard to their places of residence, the number of patients with AN and with BN from every district appeared to increase at almost the same rate, although the majority of the patients were from medium-sized cities. These findings may indicate that eating disorders are influenced by urbanization.     

阳江天然放射性高本底地区居民1979—1998年肺结核死亡危险分析

目的 探讨天然放射性高本底地区居民肺结核死亡危险.方法 建立一个包括89 694例暴露和35 385例非暴露的观察队列,采用队列研究方法,分阶段回顾性随访收集居民的死亡信息.将性别、到达年龄、随访年份和剂量率组（高、中、低和对照组）等作为分类变量计算人年列表,调整相应变量,计算高本底相对于对照地区各类传染病和寄生虫病,特别是肺结核的死亡相对危险（RR）.结果 高本底地区40岁以上4个年龄组（40～、50～、60～和≥70）居民的肺结核死亡危险均低于对照地区,RR值（95%CI）分别为0.75（0.42～1.34）、0.72（0.49～1.07）、0.71（0.53～0.95）和0.45（0.34～0.59）,其中60～和≥70年龄组两地区间的差异有统计学意义.各随访阶段均可观察到高本底地区居民肺结核死亡危险低于对照地区;两地区的肺结核死亡相对危险与累积剂量呈负向相关（P＜0.001）.肺结核死亡与受照剂量的超额相对危险ERR/Sv（95%CI）=-1.09（-1.34～-0.85）.在高本底的阳东和阳西两地区,不同诊断单位、不同年龄组及不同随访阶段的肺结核死亡危险在两地区一致.结论 高本底地区受低剂量电离辐射照射人群的肺结核死亡危险显著低于对照地区,且观察到了显著的剂量反应关系,这可能与高本底地区居民长期受低水平电离辐射全身照射导致的免疫功能增强有关.     

Epidemiology of childhood respiratory disease in Israel

Second and fifth grade schoolchildren living within 19 km from a 1400 megawatt coal fired power plant are followed up. Their parents filled out an ATS-NHLI health questionnaire and they performed pulmonary function tests (PFT), which included: FVC, FEV,, FEVt/FVC, and PEF. The effects of socioeconomic background, smoking habits and pulmonary diseases in the families on the distribution of respiratory symptoms, respiratory diseases and PFT of the children were analysed. Higher FEV₁/FVC, lower prevalence of respiratory diseases and excess respiratory symptoms were present among children from crowded homes. Mothers' smoking was found to be connected with significantly higher prevalence of bronchitis, non significant higher prevalence of asthma, significant lower FEV₁/FVC and a trend of lower FEV₁ and PEF among their children. House heating did not effect the prevalence of respiratory symptoms and diseases of the children. Significantly higher prevalence of respiratory symptoms and diseases was found among children, whose families reported about a history of pulmonary diseases, but no reduction of PFT parameters could be found among them. Mothers' contribution to respiratory symptoms and diseases of their children seems to be more significant than that of the children's fathers. Most respiratory symptoms were more common among children with a history of pneumonia in childhood, especially those who had pneumonia recently.Corresponding author.     

文化背景知识在阅读信息处理中的作用

本文拟从阅读信息的处理方式、阅读内容重点、程序以及阅读材料缟排等方面阐述文化背景知识对阅读理解的影响，探讨图式理论对医学英语阅读信息处理的启发与指导作用。     

Associations between peer relations in childhood and adversity

The aim of this study was to investigate the relationship between the sociometric status of rejection or popularity of children in the peer group and their family background and life events. The subjects were black South African children aged between 8 years and 12 years and 3 months, living in a semi-urban area in one of the former “homelands”. The children's peer status was assessed using the sociometric method developed by Newcomb and Bukowsky #op1983#cp. Out of six hundred and thirty-one children tested, 29 were nominated as popular and 29 as rejected. The families were interviewed regarding their background and the children's recent life events. Results showed that different family backgrounds were associated with the children's status popularity or rejection in the peer group. It was also shown that the experience of recent stressful life events is associated with peer rejection in childhood. The main findings of this study are that children encountering difficulties in the peer group came from families experiencing multiple chronic and acute stressors and that the effects of multiple adversities on children's peer relationships were cumulative.     

Association of climatic factors with COVID-19 in Pakistan

IntroductionEnvironmental factors such as wind, temperature, humidity, and sun exposure are known to affect influenza and viruses such as severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS) transmissions. COVID-19 is a new pandemic with very little information available about its transmission and association with environmental factors. The goal of this paper is to explore the association of environmental factors on daily incidence rate, mortality rate, and recoveries of COVID-19.MethodsThe environmental data for humidity, temperature, wind, and sun exposure were recorded from metrological websites and COVID-19 data such as the daily incidence rate, death rate, and daily recovery were extracted from the government''s official website available to the general public. The analysis for each outcome was adjusted for factors such as lock down status, nationwide events, and the number of daily tests performed. Analysis was completed with negative binominal regression log link using generalised linear modelling.ResultsDaily temperature, sun exposure, wind, and humidity were not significantly associated with daily incidence rate. Temperature and nationwide social gatherings, although non-significant, showed trends towards a higher chance of incidence. An increase in the number of daily testing was significantly associated with higher COVID-19 incidences (effect size ranged from 2.17–9.96). No factors were significantly associated with daily death rates. Except for the province of Balochistan, a lower daily temperature was associated with a significantly higher daily recovery rate.DiscussionEnvironmental factors such as temperature, humidity, wind, and daily sun exposure were not consistently associated with COVID-19 incidence, death rates, or recovery. More policing about precautionary measures and ensuring diagnostic testing and accuracy are needed.