两个“半荷包”缝合的PPH加外痔切除术治疗重度痔疗效观察

目的探讨采用两个半荷包缝合的pph（吻合器痔上黏膜切除术）加外痔切除术治疗重度痔的疗效。方法对70例重痔患者,采用两个半荷包缝合的pph加外痔切除手术,分析手术效果和总结手术经验。结果 70例手术患者症状缓解率100%,无复发,术后并发症明显减少,患者满意率高。结论两个半荷包缝合的pph加外痔切除术操作简单、手术时间短、住院时间短、复发少、恢复快,能最大限度保留了肛门的生理功能,是一种切实可行的一种治疗混合痔的新术式,手术效果好,值得临床推广。     

Young people with high‐functioning autism and Asperger's syndrome planning for and anticipating the move to college: what supports a positive transition?

For many young people in England, the move into continuing education involves a transfer from the school where they were educated to a further education college. For those with high‐functioning autism or Asperger's syndrome, this can be a challenging process. Past research has demonstrated some of the problems that these young people can encounter. This article by Wendy Mitchell and Bryony Beresford, both based in the Social Policy Research Unit at the University of York, adds to the evidence base by describing how best to support these young people, focusing specifically on ‘young person endorsed’ practice. Data are gleaned from qualitative interviews with 18 young people with high‐functioning autism/Asperger's syndrome. Findings reveal that young people welcomed the involvement of practitioners; however, specific forms of help and knowledge were particularly valued. In addition, it was parents, as opposed to professionals, who typically emerged as the most significant and valued source of support. Implications for practice are discussed, including the support needs of parents.     

What does ‘inclusion’ mean for pupils on the autistic spectrum in mainstream secondary schools?

The last decade has seen a groundswell of developments in educational policy in the UK relating to inclusive education for students with special educational needs (SEN). However, whether government policy has been fully implemented in schools remains a concern. The experience of students with autistic spectrum disorders (ASDs) provides an excellent case in point. An increasing number of such students are now educated in mainstream schools, but the limited research in this area has indicated that their experience of school is often marked by bullying, social isolation and anxiety. In light of this, the aim of the current study was to examine the extent to which inclusive educational policy was actually reflected in the practices of four mainstream secondary schools. An exploratory case study approach was adopted, utilising interviews with pupils, teachers, other school staff (e.g., senior managers, learning support assistants) and parents, observations of lessons and other contexts (e.g., lunch time), and document analysis. Our findings highlighted a number of school practices which acted as facilitators or barriers to students’ learning and participation, some of which were generic to SEN provision, and some of which appeared to be specific to those on the autistic spectrum. A discussion of these is presented to enable further understanding of, and inform practice relating to, the inclusion process for students with ASDs.     

肉鸡猝死的病因分析与防制措施

1肉鸡猝死综合症的临床诊断1.1临床症状本病多发生于3—5周龄的雏鸡。患病鸡突然发病,平衡失调,两翅猛烈扑打,肌肉强痉挛,尖叫翻滚,呈仰卧姿势,头颈扭曲而亡。从发病到死亡经过不足一分钟。多发于生长快、外表健康、体状良好的鸡只。1.2病理变化对患病死亡后的鸡只剖检,发现冠髯和泄殖粘膜及脾脏充血,全身肌肉苍白,消化道内充满食物,肝脏肿大、质地易碎;肺肿大,弥漫淤血水肿,呈暗红色,气管内有泡沫状渗出物;心脏明显增大2—4倍,心肌松软,心包渗出液增多,静脉怒张。采集病料进行微生物培养阴性。1.3鉴别诊断本病与澳大利亚报道的肉鸡峰型死亡…     

Training reading and phoneme awareness skills in children with Down syndrome

The authors report a short-term reading intervention study involving 15 children with Down syndrome (DS) who attended mainstream schools. The intervention programme taught children phoneme segmentation and blending skills in the context of learning letter-sounds and working with words in books. The children were taught by their learning support assistants, who received special training for this purpose. Compared to a waiting group, a group of eight children with DS improved significantly on measures of early literacy skills (letter-sound knowledge, Early Word Recognition) following eight weeks of intervention. The waiting group started to make progress once they received the intervention. Both groups maintained progress on the literacy measures five months after the intervention had finished. The results suggest that children with DS can benefit from structured, phonics-based reading intervention.     

The role of output speech in literacy acquisition: Evidence from congenital anarthria

A case study of literacy acquisition in acongenitally speechless child (SM) isreported. In spite of a complete oral apraxia(due to bilateral focal brain damage), SMdeveloped normal intelligence and acquired complete mastery of reading and writing skills.Furthermore, both his verbal memory andmetaphonological skills were surprisinglypreserved. However, he showed a relativeimpairment in writing non-words. Theimplications of these findings for thedevelopmental interactions between language andliteracy are discussed.     

Serum Ischemia-Modified Albumin in Preterm Babies with Respiratory Distress Syndrome

Infants with respiratory distress syndrome (RDS) may suffer from severe hypoxia, asphyxia. In this study, we aimed to evaluate serum ischemia-modified albumin (IMA) level as a diagnostic marker for hypoxia in preterm infants with RDS. Thirty-seven premature newborns with RDS were allocated as the study group and 42 healthy preterm neonates were selected as the control group. IMA was measured as absorbance unit (ABSU) in human serum with colorimetric assay method which is based on reduction in albumin cobalt binding. IMA levels were significantly higher in neonates with RDS as compared to the control group (P < 0.001). Cut-off value of IMA (ABSU) was 0.72, the sensitivity level was 91.9 %, the specificity was 78.6 %, positive predictive value was 79.1 % and negative predictive value was 91.7 % at RDS. Area under curve values was 0.93 (P < 0.001; 95 % CI, 0.88–0.98) in the receiver operating characteristic curve. We concluded that elevated blood IMA levels might be accepted as a useful marker for hypoxia in newborn with RDS.     

裂隙与症候——论四十年代"不合时宜"的孙犁

孙犁在20世纪40年代解放区的文学创作总体上呈现出一种明丽、向上的诗意风貌,表达了他对一个大时代的激情参与和诗意传达,凸显一个应和时代脉动的战士作家形象。但是在其40年代的一些抗战叙事中,也可以让人感受到蕴含其中的个人性感受。《琴和箫》和《钟》是孙犁在不同时期遭到非议甚至批判的两部"不合时宜"的作品,从对文本本身及其本事的解读,可以在诸多症候中触摸到创作主体与其激情参与的时代之间所存有的裂隙。     

A deficit in rime awareness in children with Down syndrome

This paper reports 3 studies comparing thereading and phonological skills of childrenwith Down syndrome (DS) and younger normallydeveloping children of similar reading level.In Study 1, the two groups did not differ insight word or nonword reading, but the childrenwith DS did marginally less well on syllablesegmentation, rhyme and phoneme detectiontasks. Group differences in syllable andphoneme awareness appeared attributable todifferences in verbal ability (BPVS, vocabularyknowledge); however, a significant impairmentin rhyme detection remained in an analysis ofsub-groups equated in vocabulary knowledge. Thedeficit in rhyme observed in DS was replicatedin Studies 2 and 3 using simplified tests ofrhyme judgement, with the majority of childrenwith DS performing at chance on the rhymemeasures. In contrast, the two groups did notdiffer in their ability to detect phonemes inany of the 3 studies and performed above chancein initial phoneme detection and alliterationjudgement tasks, although the identification offinal phonemes was at a much lower level. Correlational analyses indicated a relationshipbetween phonological skills and reading inboth groups. However, for children with DS,letter-sound knowledge did not predict readingwhereas it did for normal controls. It issuggested that children with DS do not possessfull phoneme awareness; although they canidentify initial phonemes in words, they do notunderstand phoneme invariance and may rely lesson phonological skills for reading thancontrols.     

Challenging behaviour: the perceptions of teachers of children and young people with severe learning disabilities

This paper reports the findings of a study which aimed to elicit teachers' perceptions of pupils' challenging behaviour. Teachers were asked to indicate: which aspects of challenging behaviour concerned them; their responses to it; which strategies they found effective; what they believed to be the causes of it; how stressed they felt; and how effective they felt when dealing with it. They were also asked to identify sources of information, advice and help and to rate different types of challenging behaviour in terms of severity of challenge. Results indicate that teachers are concerned about challenging behaviour and find it stressful. Whilst considering themselves to be effective in dealing with it, a proportion report feeling frustrated by it, angry, upset and/or at a loss. The most frequently cited challenging behaviour was aggression, although self-injury was found to be the most challenging. Whilst recognising the communicative basis of many forms of challenging behaviour teachers nevertheless tended to select strategies which were concerned with diffusion rather than prevention. The most likely source of information, advice and help was other teachers. Some differences in responses were noted according to experience and whether or not additional qualifications were held.