Antiphospholipid syndrome: a survey of clinical characters in ten cases

Objective: To gain further understanding of the antiphospholipid syndrome (APS). Methods: Analysing clinical and laboratory data on ten cases of APS. Results: Thrombocytopenia appeared in all cases. Venous thrombi of limbs appeared in five cases and neurological abnormalities in two cases. Renal impairments were found in three cases. One case manifested left renal venous thrombi and the other two cases thrombotic microangiopathy. Budd-Chiari syndrome was found in one case. One of the ten cases was catastrophic APS (CAPS) presented as acute diffuse swelling, cyanosis, pain, ischemia and necrosis in fingers and limbs, recurrent shock, ascites, hepatic and respiratory dysfunction. Anticoagulants and corticosteroids could be effective foctive for dealing with APS. It was critical to treat catastrophic APS with anticoagulants or plasmapheresis as early as possible. Conclusion: APS shows variable manifestations for good prognosis, but catastrophic APS has fatal risk. The main treatment for APS is the use of anticoagulants and immunosuppressives.     

Relationship of public preferences and behavior in residential outdoor spaces using analytic hierarchy process and principal component analysis—— a case study of Hangzhou City, China

INTRODUCTION Nowadays, as a large number of residential blocks and college campuses are being constructed nationwide in China, improvement in the quality of residential community becomes a rising issue of city policy and urban planning. Layouts of open spaces in residential areas are predicated on their ability to deliver both a mechanism to maintain the viability of citizens’ outdoor lives and a treatment to alleviate the high-density of urban constructions. What kinds of residential o…     

用线性稳定性分析研究混合耦合网络的同步态稳定性条件

This paper studies some special networks structured with serf-organized and driven behavior that coexist in a cluster, moreover, the clusters have dominant intra-cluster and inter-cluster couplings. It is called mixed-system （M-S） here. For this study linear stability analysis was used, and stability conditions for the synchronized state were determined. For the coupling function g（x）, the stability state of the network was discussed in two different cases： the linear case with g（x） = x and the nonlinear case with g（x） = f（x）. Furthermore, the condition for the emergence of chaos in the networks was given.     

Investigating the role of ^99mTc-TRODAT-1 SPECT imaging in idiopathic Parkinson＇s disease

Objective: To investigate the role of 99mTc-TRODAT-1 SPECT in diagnosis and assessing severity of idiopathic Parkinson's disease (PD). Methods: Thirty-eight patients with primary, tentative diagnosis of PD and eighteen age-matched normal controls were studied with 99mTc-TRODAT-1 SPECT imaging. The regions of interests (ROIs) were drawn manually on cerebellum (CB), occipital cortex (OC) and three transverse plane slice-views of striatums, the semiquantitative BG (background)/[(OC CB)/2] were then calculated. Results: A lower uptake of 99mTc-TRODAT-Ⅰ in striatums were displayed in thirty-six out of thirty-eight PD patients by visual inspection, compared to controls. In twenty-four PD cases with HYS (Hoehn and Yahr scale) stage I, a greater loss of DAT uptake was found in striatum and its subregions contralateral striatum to the affected limbs than in the same regions of the controls, although the striatal uptake was bilaterally reduced. Using Spearman correlation analysis showed that the reduction of the uptake ratios significantly correlated with the UPDRS in striatum and all its subregions in the PD group (P＜0.05), a similar change was also found in the putamen by using the rating scale of Hoehn and Yahr (P＜0.05).However, analysis of variance (ANOVA) did not show any relationship between the decreasing uptake of 99mTc-TRODAT-1 and increasing severity of PD patients, although the specific uptake of 99mTc-TRODAT-Ⅰ was continuously decreased in the striatum by visual inspection with the progress of PD from HYS stage Ⅰ to Ⅲ. Conclusion: 99mTc-TRODAT- 1 SPECT imaging may serve as a useful method for improving the correct diagnosis of PD. In assessing the role of99mTc-TRODAT- 1 SPECT in disease severity of PD, UPDRS can offer a comprehensive index, although the Hoehn and Yahr assessment may be available in part.     

为“跩”正名、正形——“跩”的流行义及其误用

"跩"这个词,自从有了"显摆、炫耀"乃至"洒脱、快乐、霸气"的词义后,一直被人们误解和误用:一是误解为方言词——其实它的使用已远远超出了方言的范畴;二是其字形常常被人们误写作"拽"。其实,"显摆,炫耀"的新义是由"跩"的本义"(走路)摇摆"引申而来的。"拽"字不具有"显摆、炫耀"的词义。     

老年急性非结石性胆囊炎临床特点及手术治疗

目的:探讨老年人急性非结石性胆囊炎(AAC)临床特点与手术治疗.方法:通过设立病例对照,对48例老年人AAC和急性结石性胆囊炎(ACC)的并发症、胆囊病理改变及术后结果进行比较.结果:与老年人ACC相比,AAC患者以心血管疾病为主的并发症明显增多(P＜0.01);胆囊化脓、坏疽与穿孔率明显增高(P值＜0.01,＜0.01,＜0.05);术后并发症发生率明显上升(P＜0.01).结论:老年人AAC并存病多、胆囊病变重、术后并发症发生率高;宜在症状出现48h内手术治疗.     

Child protection and justice systems processing of serious child abuse and neglect cases

OBJECTIVE: The aim of this study was to examine the trajectory of cases through four systems: child protection, law enforcement, the dependency courts, and the criminal courts. METHOD: This study focused on a county selected from a 41-county telephone survey conducted for the National Incidence Study of Child Abuse and Neglect (NIS-3). For this analysis prospective samples were drawn from law enforcement (n=225) and the county child protection (CPS) agency (n=225) and followed through in-depth case tracking across all agencies and through both the dependency and criminal court systems. RESULTS: The percentage of CPS cases opened in dependency court was similar to prior studies (29%), but the acceptance and prosecution rates were much higher--92% of the cases referred from CPS, including many cases of physical abuse. Compared to referrals from CPS to law enforcement (93%), few cases were referred from law enforcement to CPS (17%). Anecdotally, case referral patterns appeared to be influenced by communication patterns and mutual positive regard, regardless of the collaborative protocols in place. One of the most instructive findings was the degree of difficulty in tracking cases across organizations and the types of obstacles that impeded success. Disorganization was not an issue, rather internal structures set up to facilitate intra-organizational processing were the same structures that actually impeded cross-organizational case finding. CONCLUSIONS: It is not sufficient to rely on the existence of multi-disciplinary teams or Child Advocacy Centers to ensure collaboration. More attention to daily tasks and activities as well as the nature and quality of communication is warranted. On the technical side, use of common case identifiers on cases that are cross-referred is strongly recommended. Future studies should broaden the scope of inquiry to include the consequences of all case trajectories, rather than solely focusing on the justice system.     

技术性贸易壁垒与入世前后的中国贸易

技术性贸易壁垒(TBT)是国际贸易中新兴的一类贸易限制性措施,已对我国进出口贸易特别是出口贸易构成重大影响,这一方面是由于我国出口产品的标准不能符合国外要求,另一方面也是因为各国TBT措施的复杂性和过于苛刻的标准。目前,我国已成为世界贸易组织的正式成员国,名目繁多的TBT措施将成为影响21世纪我国出口贸易发展的重要因素,因此有必要对TBT对入世前后的中国贸易之影响作比较研究。     

AMI患者PCI术对血浆BNP水平变化的初步临床观察

目的:观察PCI术对AMI患者血浆中BNP的水平变化,初步探讨PCI对AMI患者预后的影响.方法:采用快速荧光免疫测定法对20例AMI患者PCI治疗前后和20例对照组血浆BNP水平进行检测.结果:AMI患者血浆BNP在AMI患者PCI术与对照组比较有显著性差异(P＜0.05),PCI治疗后呈明显下降趋势.结论:AMI患者PCI治疗血浆BNP水平变化说明PCI术能对改善AMI患者的预后有重要意义.     

血管移植在四肢创伤中的疗效及影响因素

目的:对四肢主要血管损伤的诊治进行性回顾性分析。方法:对1994年￣2003年收治四肢血管损伤行自体血管和人造血管移植并得到随访的44例病例进行总结,分析其疗效及影响因素。结果:截肢3例,肢体缺血挛缩6例。神经功能恢复不完全7例。其余移植血管均通畅,远端肢体血循环良好。结论:血管移植治疗血管损伤保肢成功率高;血管移植应有明确指征,尽量采用自体静脉移植,必要时可使用人造血管;早诊断是前提、快救治是关键;须注意积极防治血管感染。     

Drainage after total thyroidectomy or lobectomy for benign thyroidal disorders

Objective: This prospective randomized clinical trial was conducted to evaluate the necessity of drainage after total thyroidectomy or lobectomy for benign thyroidal disorders. Methods: A total of 116 patients who underwent total thyroidectomy or lobectomy for benign thyroidal disorders were randomly allocated to be drained or not. Operative and postoperative outcomes including operating time, postoperative pain assessed by visual analogue scale (VAS), total amount of intramuscular analgesic administration, hospital stay, complications, necessity for re-operation and satisfaction of patients were all assessed. Results: The mean operating time was similar between two groups (the drained and non-drained groups). The mean VAS score was found to be significantly low in the non-drained group patients in postoperative day (POD) 0 and POD 1. The mean amount of intramuscular analgesic requirement was significantly less in the non-drained group. One case of hematoma, two cases of seroma and three cases of transient hypoparathyroidism occurred in the non-drained group, whereas one case of hematoma, two cases of seroma, two cases of wound infections and two cases of transient hypoparathyroidism occurred in the drained group. No patient needed re-operation for any complication. The mean hospital stay was significantly shorter and the satisfaction of patients was superior in the non-drained group. Conclusion: These findings suggest that postoperative complications cannot be prevented by using drains after total thyroidectomy or lobectomy for benign thyroid disorders. Furthermore, the use of drains may increase postoperative pain and the analgesic requirement, and prolong the hospital stay. In the light of these findings, the routine use of drains might not be necessary after thyroid surgery for benign disorders.     

Neural decoding based on probabilistic neural network

Brain-machine interface (BMI) has been developed due to its possibility to cure severe body paralysis. This technology has been used to realize the direct control of prosthetic devices,such as robot arms,computer cursors,and paralyzed muscles. A variety of neural decoding algorithms have been designed to explore relationships between neural activities and movements of the limbs. In this paper,two novel neural decoding methods based on probabilistic neural network (PNN) in rats were introduced,the PNN decode...     

原发性中枢神经系统血管炎

[目的]探讨原发性中枢神经系统血管炎(PACNS)的临床与影像学表现,提出诊断及鉴别诊断要点.[方法]对2例疑诊PACNS的病例进行常规MR I、MRA扫描,分析常规MR I病变部位、信号特点、强化特征及MRA情况.[结果]2例均有头痛症状,无语言障碍,表现为肢体轻度无力,体检左肢肌力5级减,轻度中枢性面瘫.MR I显示病灶位于单侧,主要位于白质内,可累及灰质,分布以额叶、顶叶为主,小脑、胼胝体、丘脑亦受累,T1呈略低信号,T2呈略高信号,增强后两例均有多发斑片状或脑回样强化.MRA 2例均正常.1例腰穿CSF-OB(+)、CSF-24 h IgG鞘内合成率增高,1例脑脊液髓鞘碱性蛋白增高,未见寡克隆区带,24 h IgG合成率正常.1例免疫全套:抗组蛋白抗体及抗核抗体筛检试验阳性,以上提示病变与自身免疫性相关,但不具有特异性.2例ANCA均正常.[结论]PACNS临床和影像学表现多样,MR I、MRA、DSA对诊断有一定价值.     

急性脑出血的低场MRI及CT影像特征

目的:探讨急性脑出血的CT与低场MRI影像特征,并分析二者的优缺点,以便更合理的应用.方法:本文收集了近两年经临床确诊的典型的急性脑出血病例48例,其中行CT检查30例,行MRI检查18例,分析两组检查的影象特征,并进行比较.结果:急性脑出血在低场MRI主要表现为T1等或稍高信号,T2均表现为高信号,病灶周围可伴环行水肿;CT主要表现为脑内边界清楚,密度均匀的高密度灶,部分病例表现为高等混杂密度灶,周围伴不规则低密度环形水肿带,给诊断带来困难.结论:CT,MRI诊断急性脑出血各有优缺点,CT快捷,方便,基本满足诊断需要;MRI定位定性准确,二者结合起来,可提高诊断的正确率,更好的为患者服务.     

Predictors of re-entry into the child protection system in Singapore: A cumulative ecological–transactional risk model

This study examines the risk factors of re-entry for 1,750 child protection cases in Singapore using a cumulative ecological–transactional risk model. Using administrative data, the present study found that the overall percentage of Child Protection Service (CPS) re-entry in Singapore is 10.5% based on 1,750 cases, with a range from 3.9% (within 1 year) to 16.5% (within 8 years after case closure). One quarter of the re-entry cases were observed to occur within 9 months from case closure. Seventeen risk factors, as identified from the extant literature, were tested for their utility to predict CPS re-entry in this study using a series of Cox regression analyses. A final list of seven risk factors (i.e., children's age at entry, case type, case closure result, duration of case, household income, family size, and mother's employment status) was used to create a cumulative risk score. The results supported the cumulative risk model in that higher risk score is related to higher risk of CPS re-entry. Understanding the prevalence of CPS re-entry and the risk factors associated with re-entry is the key to informing practice and policy in a culturally relevant way. The results from this study could then be used to facilitate critical case management decisions in order to enhance positive outcomes of families and children in Singapore's care system.     

Serious response during tilt-table test in elderly and its prophylactic management

INTRODUCTION Tilt-table test (TTT) has been widely accepted asone of the main measures for diagnosing vasovagalsyncope (VVS), with 30%?90% positive rate andabove 90% specificity (Ren et al., 1998). Althoughnon-invasive, TTT may have risks, especially to theelders or in isoproterenol-provocative test. Evensudden deaths were reported in TTT by Grubb andKosinski (1997). This article summarizes the seriousresponses in TTT.OBJECTS AND METHODSObjects Seventy-six elder…     

聚乙烯醇—聚苯胺复合膜的制备及其电致变色性能研究

在聚苯胺复合膜的制备过程中以成膜剂聚乙烯醇(PVA),掺杂剂十二烷基苯磺酸(DBSA)及氧化剂过硫酸铵(APS)．在非有机溶剂的两相体系中用乳液聚合法合成了电致变色的聚苯胺PAn/PVA乳液．并以玻片为载体,采用提拉法制备了(PAn)/PVA复合膜．研究了PVA含量、苯胺(An)与DBSA的量比、过硫酸铵(APS)与An的量比及反应温度对膜的电致变色性、导电性的影响．并用循环伏安法对其电化学进行表征．实验结果表明：在w(PVA)=4．3％,n(DBSA)∶n(An)∶n(APs)=1．25∶1∶0．42、反应温度为25℃时,所制得的PAn/PVA复合膜具有良好电致变色性和粘结性能．     

基于事例推理的夹具设计研究与应用

根据基于事例的设计方法,提出采用工序件的特征信息和夹具的结构特征信息来描述夹具的相似性,并建立了包括这2方面主要特征信息为基础的事例索引码,设计了事例库的结构形式,创建了层次化的事例组织方式;同时,提出了基于知识引导的夹具事例检索算法,以及事例的修改和采用同族事例码进行相似事例的存贮,形成了基于事例推理的夹具设计.所开发的原型系统在型号工程夹具设计等项目的设计过程中得到了应用,并取得了令人满意的使用效果.     

Using Argumentation to Investigate Science Teachers' Teaching Practices: The Perspective of Instructional Decisions and Justifications

Adopting the concept that “decisions can be seen as argument-driven actions,” the purpose of this study was to apply the argumentation structure raised by Stephen Toulmin (1958) to capture two science teachers' instructional decision-making mechanisms in their teaching practices. The two case teachers were chosen because of their close estimations of their students' achievement outcomes and both were in their transition stages from competent teachers to proficient ones. A science teaching observation coding schedule (STOCS) was designed to be used in classroom observations, and all these quantitative data were collected to be converted into four issues for the two teachers to justify their ways of teaching. A semi-structure interview was conducted to analyze why and how these two case teachers made their instructional decisions. The results indicate that although they knew that their students could not fully understand what they taught in the class, their teaching strategies were still teacher-dominated modes. What really influenced their instructional decisions included external context factors (e.g., examination pressure, subject contents, limited time and classroom management) and internal experiential factors (e.g., personal educated experiences, beliefs and understandings of constructivism and inquiry). Finally, the authors suggest that science teachers' instructional decision making mechanisms can be appropriately represented by case teachers' argumentations structure.