琥珀熔石饮合总攻疗法治疗尿路结石55例

目的：采用中西医结合的方法治疗泌尿路结石,观察其临床疗效。方法：确诊后的患者110例,随机分为治疗组和对照组各55例,治疗组服用琥,自熔石饮,同时配合西医总攻疗法,对照组仅用西医总攻疗法。结果：治疗组疗效优于对照组（P〈0．05）。结论：结果表明此中西医结合的疗法,疗效确切,既缩短病程,又加强疗效,值得推广。     

The impact of tort reform on intensity of treatment: Evidence from heart patients

This paper analyzes the effect of non-economic damage caps on the treatment intensity of heart attack victims. We focus on whether a patient receives a major intervention in the form of either a coronary artery by-pass or angioplasty. We find strong evidence that treatment intensity declines after a cap on non-economic damages. The probability of receiving a major intervention in the form of either an angioplasty or bypass declines by 1.25–2 percentage points after non-economic damage caps are enacted, and this effect is larger a year or two after reform. However, we also find clear evidence of substitution between major interventions. When doctors have discretion to perform a by-pass and patients have insurance coverage, caps on non-economic damages increase the probability that a by-pass is performed. The effect of non-economic damage caps on costs is not always statistically significant, but in models with state-specific trends, total costs decline by as much as four percent. We conclude that tort reform reduces treatment intensity overall, even though it changes the mix of treatments. Using the Center for Disease Control's Vital Statistics data, we find that tort reform is not associated with an increase in mortality from coronary heart disease; if anything, mortality declines.     

Paliperidone suppresses the development of the aggressive phenotype in a developmentally sensitive animal model of escalated aggression

Rationale  Atypical antipsychotics are commonly prescribed to clinically referred youngsters for treatment of heightened aggressive behavior associated with various psychiatric disorders. Previously, we demonstrated risperidone’s anti-aggressive effects using a well-validated animal model of offensive aggression. Paliperidone, the main active metabolite of risperidone, is a potent serotonin-2A and dopamine-2 receptor antagonist with slightly different pharmacodynamic properties compared to risperidone. Given that much of risperidone’s therapeutic efficacy is due to its active metabolite, paliperidone may effectively suppress aggression with fewer adverse side effects. Objectives  Investigate whether paliperidone administration would reduce heightened aggressive behavior induced by low-dose cocaine exposure in a developmentally sensitive model of offensive aggression. Materials and methods  Male Syrian hamsters (n = 12/group) were administered an acute dose of paliperidone (0.05, 0.1, 0.2, and 0.3 mg/kg) and then tested for aggressive behavior using the resident–intruder paradigm. To investigate the effects of chronic paliperidone administration, a separate set of animals (n = 12/group) was exposed to repeated paliperidone administration (0.1 mg kg⁻¹ day⁻¹) during different developmental periods and varying lengths of time (1–4 weeks). Results  Experiment 1 results revealed a dose-dependent decrease in bite and attack behaviors with an effective dose observed at 0.1 mg/kg. In Experiment 2, the maximal reduction in aggressive behavior in response to chronic paliperidone treatment was observed in animals treated during the third week of adolescence, and this reduction occurred without concomitant alterations in non-aggressive behaviors. Conclusions  These results support the specific aggression-suppressing properties of paliperidone and the potential use of this compound in the treatment of maladaptive aggression in clinical settings.     

Specific anti-aggressive effects of fluprazine hydrochloride

Two experiments were performed with adult male rats of the Long-Evans strain to determine the specificity of fluprizine hydrochloride in decreasing offensive attack. Both 4 and 8 mg/kg doses (IP) significantly reduced offense by resident males selected for high or medium levels of aggression when tested with intruders 30 min postinjection. No reliable differences in other social or nonsocial behaviors were observed. Drug treatment resulted in an overall reduction in offensive behavior of more than 70% in both groups. Actual biting and wounding of intruders by treated subjects was decreased by as much as 98%. A second experiment assessed the drug's influence on defense in the shockelicited aggression paradigm. While duration of boxing to multiple intermittent shocks was significantly suppressed by drug administration (4 and 8 mg/kg), the same doses had no effect on postshock duration of boxing, or sonic and ultrasonic vocalizations following several high intensity (1.5 mA) shocks. These findings are consistent with other research on this and related phenylpiperazine compounds, indicating that its action is specific in reducing offense with minimal influence on social or defensive behavior.     

Is MVD the effective treatment for poorly controlled hypertension?

BackgroundStudies have shown that microvascular decompression (MVD) surgery could improve the clinical symptoms of hemifacial spasm (HFS) and decrease the blood pressure (BP) in patients with refractory hypertension. More positive long-term results are required to establish MVD as a treatment option for high blood pressure (HBP) and to refine the patient selection criteria.MethodsFrom October 2015 to September 2018, based on patient selection for cases with both HFS and poorly controlled HBP of nervous origin, MVD surgeries were performed on 12 patients aiming for better BP control. The patients were followed-up for at least 2 years. The surgical outcomes and associated factors were analyzed.ResultsWith respect to neurovascular compression (NVC) of facial nerve, the intra-operative findings concurred with pre-operative radiological findings except that in one case. Intra-operatively ipsilateral cranial nerve (CN) IX–X root exit zone (REZ) and rostral ventrolateral medulla (RVLM) NVCs were confirmed and concordant with pre-operative radiological findings in all 12 cases. 9 Of the 12 cases were completely free of facial spasm after surgery. 2 patients achieved partial relief. 1 patient still suffered from frequent facial spasm. 10 out of 12 patients achieved BP lowering after surgery. The BP of those 10 patients stayed at a relatively stable scale over the follow-up period. Although statistical significance was not obtained, for patients who are operated on the left side and those who have only 1 offensive artery, the surgery might lead to better BP control.ConclusionsMVD is a safe and effective treatment for hypertension due to central nervous system (CNS) NVC in patients with both HBP and HFS. Further studies are required to examine long-term outcomes and establish criteria for patient selection.     

Comparison of intellectually disabled offenders with a combined history of sexual offenses and other offenses versus intellectually disabled offenders without a history of sexual offenses on dynamic client and environmental factors

Sexually offensive behavior is prevalent among individuals with intellectual disabilities (ID) and many sex offenders also commit other offenses such as vandalism or assault. We examined the differences between sex offenders with ID and a history of combined sex and other types of offenses (mixed sex offenders) versus offenders with no history of sexual offenses (non-sex offenders). Dynamic client and environmental factors were measured using the Adult Behaviour Checklist (ABCL) and the Risk Inventarization Scale on Sexually Offensive Behavior of Clients with intellectual disabilities (RISC-V). Item, subscale, and total scores were then compared for the two groups. Most of the comparisons did not reveal significant differences between the two groups. The findings call for a general theory of offending behavior to explain the absence of differences between the mixed sex offenders and non-sex offenders with ID.     

茂名市恶臭污染对居民影响的主观感觉询问调查

本文对茂名市因大气恶臭污染而直、间接影响居民健康进行了询问调查,结果表明:居民因闻及恶臭而产生不良反应率污染区明显高于相对清洁区,差别有统计学意义(P<0.05)。对资料的多元逐步回归分析显示与居民产生不良反应关系较密切的几个影响因素,可作为今后重点调查项目。     

Aggression during morphine withdrawal: Effects of method of withdrawal,fighting experience,and social role

Offensive and defensive components of aggressive behavior were determined in resident and intruder mice. Withdrawal aggression was measured after the removal of a subcutaneous morphine pellet or after precipitation by naloxone in naive mice and after removal of a morphine pellet in mice with prior fighting experience. In naive mice, removal of a morphine pellet led to increases in attack bites and threats but naloxone-precipitated withdrawal led to decreases in these behaviors and to increases in defensive posturing, escape attempts and vocalizations. Prior fighting experience abolished the enhanced attack behaviors of resident mice following morphine pellet removal, but led to heightened defensive behavior in intruder mice. The behavior of intruder mice appeared more sensitive to naloxone administration than the behavior of resident mice; naloxone influenced not only intruder defensive behavior, but also other non-aggressive behaviors. The social role of the drug recipient and his prior history of aggressive behavior are important determinants of morphine and naloxone effects on aggression.     

Building a Healthcare Alliance for Resourceful Medicine Offensive Against Neoplasms in Hematology Added Value Framework for Hematologic Malignancies: A Comparative Analysis of Existing Tools

ObjectivesThe Innovative Medicines Initiative–funded, multistakeholders project Healthcare Alliance for Resourceful Medicine Offensive Against Neoplasms in Hematology (HARMONY) created a task force involving patient organizations, medical associations, pharmaceutical companies, and health technology assessment/regulator agencies’ representatives to evaluate the suitability of previously established value frameworks (VFs) for assessing the clinical and societal impact of new interventions for hematologic malignancies (HMs).MethodsSince the HARMONY stakeholders identified the inclusion of patients’ points of view on evaluating VFs as a priority, surveys were conducted with the patient organizations active in HMs and part of the HARMONY network, together with key opinion leaders, pharmaceutical companies, and regulators, to establish which outcomes were important for each HM. Next, to evaluate VFs against the sources of information taken into account (randomized clinical trials, registries, real-world data), structured questionnaires were created and filled by HARMONY health professionals to specify preferred data sources per malignancy. Finally, a framework evaluation module was built to analyze existing clinical VFs (American Society of Clinical Oncology, European Society of Medical Oncology, Magnitude of Clinical Benefit Scale, Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, Institute for Clinical and Economic Review, National Comprehensive Cancer Network Evidence Blocks, and patient-perspective VF).ResultsThe comparative analysis describes challenges and opportunities for the use of each framework in the context of HMs and drafts possible lines of action for creating or integrating a more specific, patient-focused clinical VF for HMs.ConclusionsNone of the frameworks meets the HARMONY goals for a tool that applies to HMs and assesses in a transparent, reproducible, and systematic way the therapeutic value of innovative health technologies versus available alternatives, taking a patient-centered approach and using real-world evidence.     

城市养鸭场对周围环境空气的影响

本文通过对太原鸭场周围空气氨、化学耗氧量、恶臭、细菌、真菌的现场调查表明，鸭场对上述指标均有影响，其中以恶臭和化学耗氧量反应较为敏感，拥有１．５万只鸭的饲养场，对周围空气的影响距离在２００ｍ范围内。