Passenger seating position and the risk of passenger death in traffic crashes: a matched cohort study

OBJECTIVE: To estimate the association of passenger seating position with the risk of death for passengers in traffic crashes. Design, setting, PARTICIPANTS: Matched cohort analysis of data from the National Highway Traffic Safety Administration Fatality Analysis Reporting System regarding 56 644 passengers in 23 308 passenger cars, light trucks, vans, and sport utility vehicles that crashed during 1990-2001. MAIN OUTCOME MEASURE: The adjusted risk ratio (aRR) for death of a rear seat passenger compared with a front seat passenger within 30 days of a crash. RESULTS: The aRR for all passengers in the rear seat in a crash was 0.79 (95% CI 0.77 to 0.82). This estimate varied by age, restraint use, and the presence of a front passenger airbag (p<0.001). For restrained passengers in cars with a front passenger airbag, the aRR was 0.62 (95% CI 0.48 to 0.81) for children 0-12 years, 0.96 (95% CI 0.88 to 1.06) for passengers 13-29 years, 1.03 (95% CI 0.93 to 1.15) for passengers 30-59 years, and 1.06 (95% CI 0.90 to 1.26) for passengers 60 years or older. The rear seat was associated with more protection in cars without front airbags and more protection for unrestrained passengers compared with restrained passengers. CONCLUSIONS: Previous studies have reported that the rear seat was safer for persons of all ages; thus seating a young child in the rear has often meant that older children and adults had to assume an increased risk of death by sitting in the front. These results suggest that when front passenger airbags are present and passengers are restrained, putting adults in front and children in back enhances child safety without sacrificing adult safety.     

小鼠吗啡依赖纳洛酮催促戒断跳跃反应模型的建立

目的建立稳定的小鼠吗啡依赖纳洛酮催促戒断跳跃反应模型。方法小鼠连续皮下注射吗啡,以纳洛酮催促戒断跳跃反应为指标,调整吗啡给予天数(5,6,7,10d)、吗啡累积剂量(360,560,640,945,1100,1105,1200mg/kg)、每日给予吗啡的频数[一天二次(bid),一天三次(tid)]、纳洛酮催促紧前给予吗啡与否、以及纳洛酮剂量(10,20mg/kg),建立四个造模方案包括八个子方案。结果方案A、B2、C2吗啡组小鼠跳跃反应率未达100%;方案B1、C1、D2、D3、D4吗啡组小鼠跳跃次数变异系数较大。方案D1采用小鼠连续皮下注射倍增剂量的吗啡,tid×6d,每日每次剂量分别为5,10,20,40,80,160mg/kg;第7天皮下注射吗啡160mg/kg,3h后腹腔注射纳洛酮10mg/kg,吗啡组小鼠可产生显著的跳跃反应,与对照组比较差异有显著性(P<0.01),且变异系数小(CV为0.22),该方案吗啡依赖小鼠跳跃反应次数适度,离散度小。结论选用方案D1可建立稳定的小鼠戒断跳跃反应模型。     

Overview: Beyond guidelines and guidance—psychosocial perspectives on treatment interventions for young people with substance problems in the United Kingdom

Over the last two decades there has been accumulating evidence that both psychosocial and pharmacological treatment interventions can effect change in substance-misusing adults. Thus, treatment interventions implemented for young people with substance problems largely draw on the adult addiction experience and that of child and adolescent psychiatry and psychology. As young people with problematic drug use have different treatment needs, and require different interventions and services to those of adults, results of adult studies cannot necessarily be directly extrapolated to young people.

Over the last five years evidence has been rapidly mounting that treatment may potentially work in young people, but as yet it is not as extensive as that for adults. The interventions that appear most fruitful are those based on learning theory, e.g. cognitive behavioural therapy and family therapy. Outcome studies in young people demonstrate substantial variability in substance use and misuse following treatment. From the UK perspective, the evidence is almost entirely USA based, and these evaluations of non-UK treatment programmes for young people cannot be simply transferred or transported to UK healthcare settings. This has significant implications for practice and policy.

At this stage, 'guidelines' or 'guidance' that is available is either not directed at young people and/or is largely gleaned from the USA literature. In addition, it does not adequately capture the complexity of cases at front-line specialist settings. The management of young substance misusers in the UK is, in the main, 'beyond guidelines and guidance'.

The restricted treatment service network for young people in the UK makes the potential for undertaking studies on treatment effectiveness extremely limited, but because there is evidence of a growing number of young people requiring treatment, such specialist drug services require evaluation. Serious consideration of the establishment and funding of evaluation of treatment interventions to be delivered to young substance misusers in the UK is urgently needed.     

Sociodemographic Differences in the Prevalence of Self-Reported Headache in Icelandic School-Children

SYNOPSIS
The study considers the prevalence of headache experiences in a random national sample of 2140 Icelandic 11-12 and 15-16 year-old school-children. The study finds an overall 21.9% prevalence of "at least weekly" headache. The prevalence is significantly higher among younger children end among girls. The gender difference is found to be related to the fact that older boys have a markedly lower prevalence than younger boys. No gender difference is observed in the younger group. Social class interacts with gender, with the gender difference leveling out in the upper class. The frequency of headache experiences correlates with last months use of medication to relieve headache. The high overall prevalence of headache found in this study agrees with earlier findings, and is a matter of concern since little is being done to counter this problem of discomfort among school-children.     

复方强的松龙治疗混合型血管瘤

复方强的松龙液局部注射治疗混合型血管瘤70例,治愈60例。本法操作简便,值得推广。     

重视药物利用评价研究,开展药物利用评价活动

药物利用评价是当前医院合理用药的深入发展的重要体现,也是临床药学的重要工作之一。本文论述了药物利用评价的目的、意义、方法和进展,以及药物利用评价在医院药房中的应用,以期引起有关人员的重视。     

心包疾病的CT诊断

对６１例心包疾病的ＣＴ表现进行了分析。少量心包积液主要聚集在前、左象限，中、大量积液则主要向左或左后象限扩展。根据积液厚度及分布象限可作积液量的评估。缩窄性心包炎ＣＴ均显壁层心包增厚，以心包腹侧面增厚为主，部分病人伴有心包钙化、房室扩大及腔静脉扩张。心包肿瘤侵犯或转移表现为心包不规则增厚或呈结节状改变。     

眼镜蛇人蛰前、蛰眠期和出蛰后血清激素与能量物质代谢的关系

本文研究眼镜蛇入蛰前、蛰眠期及出蛰后血清 T_3,T_4和皮质醇水平与体内能量物质的含量变化关系,探讨其与蛰眠行为的关系。结果表明入蛰前眼镜蛇大量摄食储能过冬,由于血清激素水平降低,控制了体内组织器官的氧化代谢系统,使新陈代谢逐渐下降。蛰眠期血糖血脂明显下降,耗氧量显著减少,呈节能低代谢状态。此期血清激素水平已升高,但低温抑制了体内代谢。出蛰后血清激素水平明显升高且在春暖升温季节使眼镜蛇代谢率升高。     

针药并用治疗男性不育297例疗效分析

本文采用针刺加鹿茸精注射液穴位注射及中药治疗男性不育297例,痊愈142例,占47.8％,显效81例,占27.3％,有效53例,占17.8％,无效21例,占7.1％,三者联合运用效果较满意。