Predictors and Classification of Attitudes to Differing Sentencing Goals in an Australian Sample

Community attitudes can impact on sentencing policy. This study investigated attitudes and beliefs regarding sentencing goals in an Australian sample comprising 128 men and 178 women. Regression analyses showed that endorsement of punishment as a sentencing goal was predicted by lower education, higher authoritarianism and the belief that crime is caused by offenders’ personal characteristics. Support for rehabilitation was predicted by beliefs attributing the causes of crime to economic conditions in society and by higher confidence in the criminal justice system. A more complex picture was obtained by clustering scores on the punishment and rehabilitation dimensions. Respondents clustered into four distinct groups: High Punishment/Low Rehabilitation, High Punishment/High Rehabilitation, Mid Punishment/Mid Rehabilitation and Low Punishment/High Rehabilitation. These groups differed significantly on study variables. Overall, results suggested that not all individuals simply endorse either punishment or rehabilitation as goals of sentencing. The dimensional approach may add to current understanding of people's support for differing goals of sentencing.     

近25年系统性红斑狼疮的死因构成回顾性研究

目的 了解近25年系统性红斑狼疮(SLE)患者主要死因构成的变化.方法 回顾分析1986年1月至2011年5月北京协和医院SLE住院患者的死亡病例.采用x2检验、t检验和Kaplan-Meier 方法进行分析.结果 近25年SLE的住院患者共3554例,死亡252例,女性223例,男性29例,SLE死亡患者占同期SLE住院患者的7.1％;其中女性为7.2％,男性为6.2％,两者差异无统计学意义(P=0.404);感染、狼疮脑病和狼疮肾炎为SLE 3个最常见的主要死因,分别占总死亡人数的38.5％、17.1％和12.3％,弥漫性肺泡出血、肺动脉高压、冠心病、血小板减少继发出血、肺间质病变、狼疮肺炎、消化道出血、肠梗阻和多脏器功能衰竭也是SLE的常见死因,占总死亡人数的4.4％、4.4％、3.2％、2.8％、2.4％、2.0％、2.0％、1.2％和1.2％.1986年1月至1990年12月主要死因为狼疮肾炎、感染和狼疮脑病的患者分别占同期死亡患者的31.4％、25.7％和25.7％;1991年1月至1995年12月主要死因为狼疮肾炎、感染和狼疮脑病的患者分别占同期死亡患者的27.6％、24.1％和24.1％;1996年1月至2000年12月主要死因为感染、狼疮脑病和狼疮肾炎的患者分别占同期死亡患者的31.6％、21.1％和15.8％;2001年1月至2005年12月主要死因为感染、狼疮脑病和狼疮肾炎的患者分别占同期死亡患者的34.9％、20.6％和7.9％;2006年1月至2011年5月感染是最常见的死因,其次为狼疮脑病和肺动脉高压,分别占同期死亡患者的60.3％、11.8％和7.4％,主要死因为狼疮肾炎的患者仅1例,占同期死亡患者的1.5％.SLE患者在发病1年内死亡最常见,占总死亡人数的32.5％;其中狼疮脑病和感染死亡在发病1年内最常见,分别占狼疮脑病和感染死亡人数的41.9％和32.9％;狼疮肾炎死亡在发病10年后最常见,占狼疮肾炎死亡总人数的32.3％.性别和发病年龄与SLE主要死因有关,冠心病男性死亡患者占50.0％,因冠心病死亡的患者发病年龄50岁以上者占75.0％.结论 1986-2005年,感染、狼疮脑病和狼疮肾炎是SLE的3个最常见死因,2006年至今,肺动脉高压取代狼疮肾炎成为SLE第三大死因.SLE死亡患者死于发病1年内比例最高.SLE患者感染死亡逐渐增多,已成为SLE的最常见死因.     

193例感染性眼内炎患者致病原因及临床特点分析

目的　对感染性眼内炎的致病原因、临床诊治及其特点进行分析,为该病的防治提供参考资料。方法　对2014年1月至2017年6月诊治于南昌大学第二附属医院的193例(193眼)感染性眼内炎患者进行回顾性分析,统计患者的致病因素、病原学、治疗及预后等特点。结果　所有患者中外伤性眼内炎137例（71.0%）,铁器类、木制品和物体类是致病的主要原因;眼部手术后感染性眼内炎35例（18.1%）,以白内障和青光眼术后为主;内源性眼内炎15例（7.8%）,以不明原因的病例为主;感染性角膜炎导致者6例（3.1%）。181例患者病原菌培养阳性率为13.3%,以凝固酶阴性葡萄球菌和草绿色链球菌为主要病原菌。眼部手术后及内源性眼内炎患者合并有糖尿病和（或）高血压易感因素的比例较高,玻璃体切割术是主要的治疗方式。感染性眼内炎患者治疗前最佳矫正视力无光感~0.02者占比为86.2%,治疗后无光感~0.02者占比为62.9%、≥0.10者占比为24.9%,差异有统计学意义（P<0.001);其中治疗前后视力有统计学差异的是外伤性及眼部手术后患者,内源性眼内炎患者治疗前后视力比较无统计学差异。感染性角膜炎导致者视力大部分无光感。结论　外伤性和眼部手术后眼内炎是感染性眼内炎的两种主要类型,玻璃体切割术是主要的治疗手段。感染性眼内炎经不同的方式积极治疗后可以控制感染,改善视功能。     

A practitioner's guide to developing critical appraisal skills: observational studies

BACKGROUND: and Overview. Observational investigations provide an opportunity to document the distribution of diseases in various populations and to explore correlations between exposures and outcomes. Interpreting such correlations as causal is challenging and can lead to more harm than good when used as a basis for advising lifestyle changes or interventions to healthy people. The aim of this review is to provide a brief introduction to observational study designs and describe some of their strengths and weaknesses. CONCLUSIONS AND PRACTICE IMPLICATIONS: Observational findings can be useful to guide clinical research, but often they do not provide a reliable basis for clinical decision making. Caution in applying observational findings to clinical practice is particularly important when caring for healthy people.     

Clinical and biochemical spectrum of hypokalemic paralysis in North: East India

Background:

Acute hypokalemic paralysis, characterized by acute flaccid paralysis is primarily a calcium channelopathy, but secondary causes like renal tubular acidosis (RTA), thyrotoxic periodic paralysis (TPP), primary hyperaldosteronism, Gitelman’s syndrome are also frequent.

Objective:

To study the etiology, varied presentations, and outcome after therapy of patients with hypokalemic paralysis.

Materials And Methods:

All patients who presented with acute flaccid paralysis with hypokalemia from October 2009 to September 2011 were included in the study. A detailed physical examination and laboratory tests including serum electrolytes, serum creatine phosphokinase (CPK), urine analysis, arterial blood gas analysis, thyroid hormones estimation, and electrocardiogram were carried out. Patients were further investigated for any secondary causes and treated with potassium supplementation.

Result:

The study included 56 patients aged 15-92 years (mean 36.76 ± 13.72), including 15 female patients. Twenty-four patients had hypokalemic paralysis due to secondary cause, which included 4 with distal RTA, 4 with Gitelman syndrome, 3 with TPP, 2 each with hypothyroidism, gastroenteritis, and Liddle’s syndrome, 1 primary hyperaldosteronism, 3 with alcoholism, and 1 with dengue fever. Two female patients were antinuclear antibody-positive. Eleven patient had atypical presentation (neck muscle weakness in 4, bladder involvement in 3, 1 each with finger drop and foot drop, tetany in 1, and calf hypertrophy in 1), and 2 patient had respiratory paralysis. Five patients had positive family history of similar illness. All patients improved dramatically with potassium supplementation.

Conclusion:

A high percentage (42.9%) of secondary cause for hypokalemic paralysis warrants that the underlying cause must be adequately addressed to prevent the persistence or recurrence of paralysis.     

Children suspected of having intracranial infection with normal brain magnetic resonance imaging may be associated with the myelin oligodendrocyte glycoprotein antibody

PurposeTo confirm whether encephalitis due to unknown causes but with normal brain magnetic resonance imaging (MRI) may be associated with the myelin oligodendrocyte glycoprotein (MOG) antibody.MethodsWe retrospectively analyzed and summarized the characteristics of three patients initially suspected of having intracranial infections with normal brain MRI, and ultimately tested positive for anti-MOG antibody.ResultsThe three patients mainly presented with long-term fever accompanied by headaches and drowsiness. Auxiliary examinations showed obvious leukocytosis in peripheral blood and leukocytosis and increased protein expression in cerebrospinal fluid (CSF); furthermore, brain MRI was normal. These findings suggested intracranial infection, especially bacterial meningitis. No patient showed a response to prolonged anti-bacterial therapy; however, they recovered with glucocorticoid therapy, which was prescribed after anti-MOG antibodies were detected in the serum and CSF samples.ConclusionAnti-MOG antibody detection should be performed early for patients with suspected encephalitis due to unknown causes with normal brain MRI, to identify whether they have MOG antibody-associated diseases (MOGAD).     

2012-2016年郴州市居民死因监测分析

目的 分析郴州市居民死因构成及变化趋势,为制定郴州市疾病预防控制政策和策略提供科学依据。方法 采用描述性统计学方法,统计分析2012-2016年郴州市居民死亡率、死因构成和死因顺位。结果 2012-2016年郴州市共报告居民死亡103 533例,年均粗死亡率为444.23/10万,标化死亡率为451.33/10万;男性死亡率高于女性(χ²=8 390.51,P<0.01);粗死亡率最高的是苏仙区,最低的是桂东县,两者差异有统计学意义(χ²=3 567.47,P<0.01);城市与农村居民粗死亡率差异无统计学意义(χ²=0.05,P>0.05);死因疾病前5位依次为:心脏病、恶性肿瘤、脑血管病、呼吸系统疾病、损伤及中毒;死亡疾病中主要为慢性病,其合计死亡率为388.98/10万,占全部死亡疾病的87.56%。结论 心脏病、恶性肿瘤、脑血管病、呼吸系统疾病等慢性病是郴州市居民的主要死因,也是影响郴州市居民健康的主要公共卫生问题。     

从伏邪理论探讨宫颈HPV感染的防治

[目的] 从“伏邪”理论为切入点,深入探究伏邪理论在宫颈人乳头瘤病毒(human papilloma virus,HPV)感染中的应用,为中医防治宫颈HPV感染提供新的临床思路。[方法] 从伏邪的源流、致病特点出发,结合宫颈HPV感染的发病机制,探讨伏邪理论与HPV感染的相关性,并附医案一则加以验证。[结果] 宫颈HPV感染具有隐匿性、迁延难愈性、易火化等特点,受内、外两方面因素的影响,与中医“伏邪”有相似之处。宫颈HPV感染的根本病机是正虚邪实,以肾气亏虚、脾失健运、肝失所养为本,伏毒、痰、瘀为标。在具体治疗上,应本着扶正祛邪的原则,扶正以固肾培元、调补阴阳,兼以健脾养肝为要,祛邪以祛湿解毒、化痰消瘀为法;同时运用中医学“治未病”思想,从“未病先防、既病防变、瘥后防复”三方面对宫颈HPV感染进行分期论治。所举医案中患者辨为肝郁脾肾虚、浊瘀阻滞型,以疏肝健脾补肾、活血利湿止带为主要治法,临床效果明显。[结论] 从“伏邪”理论论治宫颈HPV感染,为中医药防治宫颈HPV感染提供了更为广阔的思路和方法。     

2004—2015年中国循环系统疾病死亡谱特征分析

背景 循环系统疾病中的心脑血管疾病已成为影响中国人寿命的"第一杀手",患病率和死亡率仍处于上升阶段。揭示循环系统疾病城乡别、性别、地区别死因顺序及其变化趋势,将为预防和控制循环系统疾病的发生发展提供科学依据。 目的 分析我国2004—2015年循环系统疾病中以心脑血管为主的疾病死亡谱特征,即城乡别、性别、地区别死因顺序及其变化趋势。 方法 利用2004—2015年"全国疾病监测系统死因监测数据集"所定义的"循环系统疾病"资料,选取其中各类别疾病的死亡数和死亡率资料,应用SPSS 13.0统计软件,采用χ2检验方法分析各类别循环系统疾病的城乡别、性别、地区别死亡率的差异及变化趋势。 结果 2004—2013年各年的死因顺位排序为脑血管病→缺血性心脏病→循环系统的其他疾病→高血压心脏病/肾脏病→风湿热和风湿性心脏病;2014—2015年各年死因顺位排序为脑血管病→缺血性心脏病→高血压心脏病/肾脏病→循环系统的其他疾病→风湿热和风湿性心脏病。2006—2015年,脑血管病、缺血性心脏病死亡率呈逐年上升趋势;2004—2015年,高血压心脏病/肾脏病死亡率逐年缓慢上升;风湿热和风湿性心脏病死亡率各年变化不大;循环系统的其他疾病死亡率呈双波浪变化,其中2006年和2013年为波峰。城乡别死亡率：脑血管病各年差异均有统计学意义（P<0.05）,风湿热和风湿性心脏病除2006、2015年外,高血压心脏病/肾脏病除2005年外,缺血性心脏病除2015年外,循环系统的其他疾病除2004、2005、2011、2012年外,其余年份间差异均有统计学意义（P<0.05）。性别死亡率：各年份风湿热和风湿性心脏病、缺血性心脏病和脑血管病死亡率性别差异均有统计学意义（P<0.05）,循环系统的其他疾病除2005年外,其余各年性别差异有统计学意义（P<0.05）,高血压心脏病/肾脏病死亡率仅2005年和2015年性别差异有统计学意义（P<0.05）。地区别死亡率：各年份各类别疾病死亡率地区别差异均有统计学意义（P<0.05）。 结论 循环系统疾病死亡率具有明显的城乡别、性别、地区别差异。缺血性心脏病城市高发,其他各类疾病乡村高发;女性风湿热和风湿性心脏病高发,其他各类疾病均为男性高发;风湿热和风湿性心脏病、高血压心脏病/肾脏病、缺血性心脏病、脑血管病、循环系统的其他疾病死亡率地区别差异明显,应根据地区别的差异确定不同的循环系统疾病的防治重点和采取不同的防治措施。 该文的微信推文请扫描下方二维码查看！     

基于“脾肾为本、血瘀为标”论绝经后骨质疏松症的病机及防治

绝经后骨质疏松症主要是由于绝经后妇女卵巢功能逐渐衰退,雌激素水平下降,使破骨细胞骨吸收的速度快于成骨细胞骨形成,从而引发进行性骨质流失。肾主骨生髓,为先天之本;脾主肉,为后天之本,运化水谷精微,共同促进骨骼的生长,绝经后骨质疏松症（postmenopausal osteoporosis,PMOP）多以脾肾渐虚为本,又因元气亏虚、肝气郁结、久病入络而致血行瘀滞,形成本虚标实之证。因此,笔者基于“脾虚为本、血瘀为标”思想探讨PMOP的病因病机,并凝练出“补肾-健脾-活血化瘀”之治则,从现代医学角度探讨这一治则的合理性,并在此治则的指导下探讨治未病3个阶段的防治思路,最后对中药和针灸防治PMOP进行综述,以期扩展临床思维。