“The home,the bathroom,the taps,and hot water”: The contextual characteristics of tap water scalds in Australia and New Zealand

IntroductionScalds from hot tap water can have devastating consequences and lifelong impact on survivors. The aims of this study were to (i) describe the frequency, demographic profile, injury event characteristics, and in-hospital outcomes for people with tap water scalds admitted to Australian and New Zealand burn centres; and (ii) determine whether variation was present in the frequency and epidemiological characteristics of tap water scalds between jurisdictions.MethodsData were extracted from the Burns Registry of Australia and New Zealand for people with tap water scalds admitted to Australian or New Zealand burn centres between January 1, 2010 and December 31, 2018. Demographic, injury severity and event characteristics, surgical intervention, and in-hospital outcomes were investigated.ResultsWe included 650 people with tap water scalds admitted to Australian and New Zealand burn centres during the study period. Australians with tap water scalds (median [IQR] 29 [1–69] years) were older than New Zealanders (2 [1–36] years). Most tap water scalds occurred in the home, and 92% of these occurred in the bathroom. More than 55% of injuries occurred due to the accidental alteration of water temperature at the tap fixture. Two thirds of patients underwent a surgical wound procedure. The overall mortality rate was 3.7%, and the median hospital length of stay was 8.8 days.ConclusionTap water scalds remain a public health problem in Australia and New Zealand. Our research highlights where gaps in current heated water regulations in residential homes perpetuate risks of tap water scalds, particularly in high-risk groups at the extremes of age. Extending current heated water regulations to include all Australia and New Zealand homes is urgently needed in conjunction with design safety improvements, and ongoing education of key stakeholders.     

济南市近15年流行性出血热发病热点及流行特征分析

目的 明确济南市流行性出血热发病热点地区,掌握流行特征。方法 利用济南市2005 - 2019年流行性出血热疫情资料,采用ArcGis 10.2进行街道/乡镇层级的热点扫描,并进行可视化展现;采用描述流行病学方法分析流行特征。结果 2005 - 2019年济南市累计报告流行性出血热病例705例,年均发病率为0.71/10万;死亡16人,病死率2.27％。病例以40岁～到70岁～年龄组为主,占病例总数的66.95％;职业以农民为主（75.89％）;热点乡镇、街道主要分布在商河县的禽类养殖区,章丘区、长清区和市中区的部分山区,以及槐荫区和历下区的部分旧村和CBD建设区。结论 济南市流行性出血热处于低流行状态,病死率较高;季节性明显;40岁以上农民是主要发病人群;热点以乡镇为主,也有随拆建向部分城区扩散的趋势,在高发地区及周边应采取持久的综合防制措施。     

Lymph Circulation in the Liver

The liver produces a large amount of lymph, which is estimated to be 25 to 50 % of lymph flowing through the thoracic duct. The hepatic lymphatic system falls into three categories depending on their locations: portal, sublobular, and superficial lymphatic vessels. It is suggested that 80 % or more of hepatic lymph drains into portal lymphatic vessels, while the remainder drains through sublobular and capsular lymphatic vessels. The hepatic lymph primarily comes from the hepatic sinusoids. Our tracer studies, together with electron microscopy, show many channels with collagen fibers traversing through the limiting plate and connecting the space of Disse with the interstitial space either in the portal tracts, or around the sublobular veins. Fluid filtered out of the sinusoids into the space of Disse flows through the channels traversing the limiting plate either independently of blood vessels or along blood vessels and enters the interstitial space of either portal tract or sublobular veins. Fluid in the space of Disse also flows through similar channels traversing the hepatocytes intervening between the space of Disse and the hepatic capsule and drains into the interstitial space of the capsule. Fluid and migrating cells in the interstitial space pass through prelymphatic vessels to finally enter the lymphatic vessels. The area of the portal lymphatic vessels increases in liver fibrosis and cirrhosis and in idiopathic portal hypertension. Lymphatic vessels are abundant in the immediate vicinity of the hepatocellular carcinoma (HCC) and liver metastasis. HCCs expressing vascular endothelial growth factor‐C are more liable to metastasize, indicating that lymphangiogenesis is associated with their enhanced metastasis. Anat Rec, 291:643–652, 2008. © 2008 Wiley‐Liss, Inc.     

由山莨菪碱的寒热性质浅谈西药中药化

西药中药化是指用中医药理论研究西药,使之兼备中药的理论、特性和功效。临床上观察到常用的平滑肌解痉药山莨菪碱的副作用虽较阿托品轻,但仍常见口干、面红、潮热、烦躁等,因其表现类似中医的阴虚证型,故猜想山莨菪碱属于中医中药理论中的热性药,因而会产生此类副作用,且多发生于阴虚体质者。现考虑用中医寒热药性理论分析其寒热性质,并据此指导临床用药,以期提高疗效、减少副作用。     

平衡理筋推拿结合热敷治疗臀上皮神经卡压综合征68例疗效观察

目的：观察平衡理筋推拿结合热敷治疗臀上皮神经卡压综合征的临床效果。方法：68例臀上皮神经卡压综合征患者随机分为治疗组和对照组。治疗组运用平衡理筋推拿手法结合中药热敷治疗,对照组运用常规推拿治疗,各组治疗1个疗程后,以VAS痛觉评分系统及《中医病症诊断疗效标准》作为评定标准进行评价,观察两组的治疗疗效。结果：治疗组总有效率为94.3%,对照组总有效率为76.5%,差异有统计学意义（P<0.05）。结论：通过对比可以发现平衡理筋推拿结合热敷治疗臀上皮神经卡压综合征疗效显著,值得推广。     

国际宫颈癌放疗领域研究热点探析

放疗是一种重要的宫颈癌治疗方式,对宫颈癌放疗进行研究对改善宫颈癌患者的预后具有重要的意义。主要对PubMed收录的近10年宫颈癌放疗领域文献的高频主要主题词/副主题词进行共现聚类分析,探究该领域的研究热点,并绘制战略坐标图,展示研究热点的发展现状和趋势,为该领域的研究人员了解宫颈癌放疗的现状及开展相关研究提供参考。     

更年期潮热的单胺类神经递质学说

潮热是更年期女性最常见的症状,并且其症状与心血管疾病的发生密切相关,严重影响着更年期女性的身心健康,因此,避免和减轻更年期潮热的发生已经成为当今倍受关注的课题。目前,普遍认为潮热是由下丘脑体温调节中枢功能紊乱所致,但其确切的发病机制尚未阐明。最近的研究相继表明,更年期潮热是雌激素与多种神经递质交互作用的结果,其中单胺类神经递质去甲肾上腺素、5 羟色胺和多巴胺等起到了核心作用,现将其综述如下。     

温泉上行浴及氦——氖激光治疗痔疮的疗效观察

目的　观察温泉上行喷浴及氦—氖激光治疗痔疮的疗效。方法　采用温泉上行浴及氦—氖激光治疗痔疮 65例与单纯用氦—氖激光治疗 60例 ,进行对比观察。结果　温泉上行浴及氦—氖激光联合治疗痔疮疗效优于单纯性的氦—氖激光治疗。结论　温泉上行浴及氦—氖激光联合应用能更好地使痔疮的临床症状得到改善。     

干热沙漠环境石油工人血、尿、发中16种元素水平的研究

采用法国产ＪＹ－７０型电感耦合等离子体光源光量计（ＩＣＰ）测定抽样人群血、尿、发中１６种元素水平,研究干热环境对石油工人体内元素水平的影响。结果显示,野外石油工人和对照组人群夏季血中Ｌｉ,Ｃａ,Ｚｎ,Ｓｅ明显降低,钻井工人夏季血中Ｌｉ、Ｆｅ含量明显低于对照组,抽样人群夏季尿中Ｌｉ、Ｎａ、Ｋ、Ｍｇ、Ｃａ、Ｓｒ明显高于冬季, 蝇工人尿中Ｌｉ、Ｎａ、Ｍｇ、Ｃａ、Ａｌ量低于对照组,ＥＧ Ｃａ、Ｆｅ、Ｚｎ、