支气管哮喘与行为特征的关系

目的：了解支气管哮喘患儿的行为特征,找出行为特征与支气管哮喘相互关系的规律。方法：使用Rutter行为量表对小儿支气管哮喘病人做心理测验,先将男女在一组比较,再将男女分成两组分别比较,将每组的总分数、神经质（N）和焦虑（A）比较,进行统计学处理,最后再分析检验组具体的行为问题的发生率。结果：总体比较检验组的总分及神经质和焦虑的分数均高于对照组;男患儿组的总分与N分数明显高于对照组;女患儿组的总分与A分数明显高于对照组。结论：支气管哮喘患儿较普通儿童有较多的行为问题,在生物学治疗的同时也需要考虑行为问题的矫正。     

儿童抗N-甲基-D-天冬氨酸受体脑炎的临床特征

目的： 分析抗N-甲基-D-天冬氨酸受体(N-methyl-D-aspartate receptor,NMDAR)脑炎患儿的临床特点及 预后,为临床早期识别本病提供依据。方法： 回顾性分析2015 年1 月至2018 年3 月在中南大学湘雅二医院儿科住院 的42 例抗NMDAR脑炎患儿的临床资料及随访情况,总结其临床特点、治疗效果及预后情况。结果： 42 例患儿中男 15 例(35.7%),女27 例(64.3%),男女比例1?1.8,年龄(9.20±4.66)岁(最小4 个月,最大17 岁)。首发症状以癫痫发作 (47.6%,20/42)和精神行为异常(35.7%,15/42)最为常见;患儿在病程中累积出现精神行为异常(36/42,85.7%)、癫痫 发作(36/42,85.7%)、言语障碍(32/42,76.2%)、运动障碍(28/42,66.7%)、意识障碍(28/42,66.7%)、自主神经功能 紊乱(26/42,61.9%)及睡眠障碍(24/42,57.1%)等症状。42 例患儿脑脊液抗NMDAR抗体均为阳性;50.0%(21/42)的患 儿头颅MRI检查结果异常,病变累及顶叶、额叶、颞叶、枕叶、基底节及视神经等部位,1 例患儿病变累及视神经 合并髓鞘少突胶质细胞糖蛋白(myelin oligodendrocyte glycoprotein,MOG)抗体阳性;40 例患儿行脑电图检查,92.5% (37/40)出现异常,以弥漫性慢波为主要表现,1 例可见δ 刷;合并肠系膜畸胎瘤1 例,占2.4%(1/42)。出院时mRS评 分为2.14±1.46,较住院期间最高mRS评分(3.88±1.38)显著降低(P<0.05),疗效显著;随访3~39 个月,出院后3 个月 时mRS评分仅为0.81±1.29,与出院时mRS评分比较仍有显著改善,其中76.2%(32/42)mRS评分≤2,预后良好;4.8% (2/42)的患儿复发,无死亡病例。开始免疫治疗时间和病程中最高mRS评分是影响预后的因素,开始免疫治疗时间越 早、病程中mRS评分越低,预后越好。结论： 癫痫发作、精神行为异常、运动障碍、言语障碍及自主神经功能紊乱 是儿童抗NMDAR脑炎的常见临床表现;免疫治疗效果显著,开始免疫治疗的时间和病情严重程度是影响预后的重 要因素;抗NMDAR脑炎可合并其他自身抗体,其临床意义及机制有待深入研究。     

浅谈汉语影响汉民族表达方式的几点因素

汉语的特性主要表现在汉语的三要素上 ,它们影响着汉民族表情达意的方式。我们民族含蓄委婉、幽默风趣、灵活多变的传情方式也都因有汉语的支持而畅通无阻。汉语以自己独特的个性造就了我们民族的形象。     

《得心集医案》辨治急难证的思路与方法

总结分析了清代医家谢星焕《得心集医案》辨治急难证的特点：在辨证方面注重天人合一,善于辨别真假错杂之证,尤长于以脉诊决疑释难,妇科难证多求诸奇经八脉;在治疗方面法度严谨,善于化裁古方,急救方法多变,涌吐、针灸、鼻饲、敷脐等多有采用。     

高原鼠兔人工饲育初探

目的 为在东北地区开发饲育高原鼠兔提供基础资料。方法 在室内人工饲育条件下,对高原鼠兔的外观、习性及食性等方面进行观察与研究。结果 高原鼠兔具有体型小、性情温顺、繁殖力强及饲料简单等特点,对低质饲料的利用率和对植物纤维的需求较高,超过家兔,更易饲养,结论 高原鼠兔在东北地区室内饲养是可以适应的。将高原鼠兔作为实验动物,有利于节省饲养空间和经费。     

Characterization and phylogenetic analysis of a neurovirulent Zika virus isolated from Cambodia in 2019

The geographic range of Zika virus (ZIKV) has expanded from Asia to the Americas, leading to the 2015–2016 pandemic with enhanced neurovirulence. At present, ZIKV is continuously circulating in many Southeast Asian countries. Unfortunately, the persistent evolution of ZIKV in Southeast Asia and its influence on the biological characteristics of the virus remain incompletely understood. In this study, the in vitro and in vivo properties of a new ZIKV isolate obtained from Cambodia in 2019 (CAM/2019) were characterized and compared with those of the Cambodian strain (CAM/2010). Compared with CAM/2010, the CAM/2019 virus showed similar plaque morphology and growth curves in cell cultures and induced comparable viremia and organ viral loads profiles in both BALB/c and A129 (IFNAR1^−/−) mice upon intraperitoneal (i.p.) inoculation. Remarkably, the CAM/2019 virus exhibited enhanced neurovirulence in neonatal mice compared with CAM/2010, with a 74-fold reduction in the 50% lethal dose (LD₅₀). Consistently, CAM/2019 produced higher viral loads in the brains of BALB/c neonatal mice than CAM/2010 did. Sequence alignment showed that the CAM/2019 virus has acquired 12 amino acid substitutions, several of which were found to be associated with neurovirulence. In particular, the CAM/2019 virus shared an A1204T substitution in NS2A with the Thai isolate SI-BKK02 that was isolated from a microcephaly case. Taken together, our results indicate that a ZIKV strain isolated with specific mutations has emerged in Cambodia, highlighting the need for extensive molecular and disease surveillance in Cambodia and other Asian countries.     

青年与老年急性心肌梗塞临床差异性探讨

目的 :探讨青年与老年急性心肌梗塞 (AMI)的临床特点。方法 :对 1 5例青年组 (年龄≤ 40岁 )与 1 4 3例老年组 (年龄≥ 6 5岁 ) AMI的临床资料进行了对比分析。结果 :青年组 AMI吸烟者占 73.3% ,明显高于老年组 (P<0 .0 1 )。老年组 AMI发病率 38.9% ,无心绞痛者占 37.8% ,合并心力衰竭、心源性休克及病死率分别为 2 9.4%、2 2 .4%及 2 7.3% ,均明显高于青年组 (P<0 .0 5 )。结论 :青年组 AMI吸烟者明显高于老年组 ,老年组 AMI发病率、无心绞痛者、合并心力衰竭、心源性休克及死亡率均明显高于青年组     

The Effects of Race,Socioeconomic Status,and Household Structure on Injury Mortality in Children and Young Adults

Objectives: Injuries are the leading killer of young persons in the United States, yet significant gaps in our understanding of this cause of death remain. By examining the independent influences of race, education, income, household structure, and residential location on injury mortality in young persons, this study addresses these gaps. Method: Using data from the National Longitudinal Mortality Study, survival analysis is used to examine the injury mortality risk faced by 0 to 17 year olds over a nine-year follow-up period. Separate models are estimated for homicide, suicide, unintentional injury deaths, and all injury deaths. Results: Household head's education has an independent effect on youth homicide and unintentional injury mortality risk. By contrast, family income and household structure do not have independent effects on any of the injury outcomes. Finally, much of the excess homicide risk faced by young African-Americans is explained by underlying racial differentials in socioeco-nomic status, household structure, and residential location. Conclusions: By finding an independent effect of household head's education on youth mortality risk from homicide and unintentional injuries, this study adds to the large body of evidence linking socioeconomic differentials to inequality in life chances.     

Comparison of serum fluoride levels after administration of monofluorophosphate-calcium carbonate or sodium fluoride: differences in peak serum concentrations

Fluoride salts are widely used in Europe in the treatment of established osteoporosis with crush fractures for their ability to increase trabecular bone mass. However, in the United States fluorides are still regarded as an experimental drug. In a prospective, randomized study we compared the fluoride pharmacokinetics of enteric-coated sodium fluoride and disodium monofluorophosphate calcium carbonate (MFP-Ca) over the period of 76 h. Twenty subjects (12 females, 8 males), aged 35–80 years, free of gastrointestinal disorders, renal impairment, and liver disease and without prior fluoride intake entered the study. Ten subjects received NaF (11.3 mg fluoride) twice a day and the other ten MFP-Ca (13.2 mg fluoride) twice a day. During the study period of 76 h the patient's usual food intake was not changed. Serum fluoride levels were determined using an ion sensitive electrode. After intake of a single drug preparation of MFPCa or NaF, MFP-Ca showed a significantly shorter lag time of absorption and a significantly higher maximal serum fluoride concentration than NaF (P<0.01). A comparison of fluoride cumulative characteristics of both drugs showed virtually identical serum fluoride levels before intake of the morning dose on all 4 study days, whereas serum fluoride concentrations measured 4 h afterwards were significantly higher for MFP-Ca than for NaF. These data provide evidence of high peak serum fluoride levels for MFP-Ca, whereas only small peak-to-trough fluctuations are seen for NaF.Abbreviations MFP-Ca disodium monofluorophosphate-calcium carbonate - C _max maximum drug concentration - T _max lag time of maximum drug concentration - AUC area under the serum concentration versus time curve Correspondence to: L. Erlacher     

云南富源县阿依村肺癌的流行病学特征及环境致癌因素研究

本文对富源县阿依村特定人群肺癌的流行病学特征及环境致癌因素进行调查研究。研究了该村1986～1996年肺癌调整死亡率的水平,变化趋势、死亡专率及性别比值。该村肺癌死亡率高、波动性大。男性肺癌调整死亡率高于宣威肺癌高发区1．9倍,女性肺癌调整死亡率接近宣威肺癌高发区的水平,男女合计肺癌调整死亡率高于我国重庆、上海、沈阳、大连、南京、天津、广州等工业城市9．7～12．0倍。男性高于女性2．4倍。死亡高峰年龄男女性均始于30～岁年龄组。以居民群体为暴露单位,采集了该村火塘燃烧室、地炉燃烧室、室外空气中颗粒物及有害气体样品,检测其TSP、IP、BaP、SO2浓度,结果显示上述4项污染物的浓度均是火塘燃烧室高于地炉燃烧室而室外最低。γ辐射火塘燃烧室显著高于地炉燃烧室。IP提取物的致突变活性,火塘燃烧室高于地炉燃烧室高于室外。对该村居民改炉改灶降低室内空气中污染物的浓度及致突变活性的效果进行了评定。