血府逐瘀汤辅助治疗重症闭合性胸外伤临床观察

目的 观察血府逐瘀汤辅助治疗重症闭合性胸外伤的疗效。方法 将60例重症闭合性胸外伤患者随机分为治疗组和对照组,每组30例。对照组在西医常规对症治疗的基础上进行纤维气管镜肺泡灌洗,治疗组在对照组疗法的基础上加服血府逐瘀汤。采用视觉模拟量表(visual analogue scale,VAS)评价患者的胸痛程度,通过检测外周血白细胞(white blood cell, WBC)及血清C-反应蛋白(C-reactive protein, CRP)水平评价炎症程度,采用血气分析评价肺通气和换气功能。结果 治疗组患者治疗后VAS评分降低程度显著大于对照组（P<0.05）。治疗组患者住院时间较对照组明显缩短（P<0.05）。治疗第3、7、12天末,治疗组患者血pH值、动脉血氧分压、血氧饱和度均显著高于对照组（P<0.05）,动脉血二氧化碳分压、外周血WBC计数、血清CRP水平均显著低于对照组（P<0.05）。治疗组临床疗效明显优于对照组（P<0.05）。结论 血府逐瘀汤能提高重症闭合性胸外伤患者肺泡的通透性,改善肺组织的通气及换气功能,降低炎症反应。     

Memory and forgetting: examining the treatment of traumatic historical memory in Grave of the Fireflies and The Wind Rises

Within Japanese popular culture, manga and anime have played a significant role in mediating responses to the outcome of the Pacific War. Miyazaki Hayao's (possibly) final feature-length film, The Wind Rises, has been an important addition to the preceding body of popular media ‘texts’ that raise such themes. This article aims to address the question of how far cinematic animation can reasonably be obliged to follow the kinds of historiographical concerns that inevitably arise when engaging with Japan's militarist past. To answer this question, considerable space is devoted to examining the historical context of what others have done in the post-war period and integrate that commentary into an analysis of how the works of Takahata Isao and Miyazaki Hayao fit amongst a succession of creative works that have been co-opted in the reshaping of historical perceptions of the Japanese at war amongst the Japanese themselves. This will also require some incidental discussion of methodological issues that arise when dealing with such cases as vehicles for understanding transformations in historical consciousness. Ultimately it is argued that Miyazaki does indeed make an important contribution to the commentary on the Japanese war experience, although it must, perhaps unavoidably, be on highly personal terms so far as The Wind Rises is concerned.     

Troubling frames: Zapiro’s iconography on Oscar Pistorius as traumics

ABSTRACT

This study aims to examine the comics form in relation to its representation of perpetrator trauma. Specifically, the study considers a selection of Jonathan Shapiro’s iconography on Oscar Pistorius as biograph(y)ics, since the artist ‘commixes’ Pistorius’s life from his rise to athletic fame – through the court trials for his alleged murder of Reeva Steenkamp on 14 February 2013 – to his conviction followed by a thirteen-year jail sentence on 24th November 2017. In my reading of the panels, I draw on Hilary Chute’s notion of the ethics of testimony in illustrative art and Jacques Derrida’s theorising on hauntology and the revenant to argue that wrongdoers can also experience their crimes as trauma. This critical engagement enables me to read Shapiro’s panels as not merely reinforcing dominant interpretations of the fallen hero, but also as a means by which the cartoonist destabilises and reconfigures socially accepted notions of the villain.     

Fatal non-accidental pediatric cranial fracture risk and three-layered cranial architecture development

This study examines the influence of three-layered cranial architecture development upon blunt force trauma (BFT) cranial outcomes associated with pediatric non-accidental injury (NAI). Macroscopic and microscopic metric and morphological comparisons of subadult crania ranging from perinatal to 17 years of age chronicle the ontogenetic development and spatial and temporal variability in the emergence of a mature cranial architecture. Cranial vault thickness increases with subadult age, accelerating in the first 2 years of life due to rapid brain growth during this period. Three-layer differentiation of the cranial tables and diploë initiates by 3–6 months but is not consistently observed until 18 months to 2 years; diploë formation is not well developed until after age 4 and does not manifest a mature appearance until after age 8. These results allow topographic documentation of cortical and diploic development and temporal and spatial variability across the growing cranium. The lateral cranial vault is identified as expressing delayed development and reduced expression of the three-layer architecture, a pattern that continues into adulthood. Comparison of fracture locations from known BFT pediatric cases with identified cranial fracture high-risk impact regions shows a concordance and suggests the presence of a higher fracture risk associated with non-accidental BFT in the lateral vault region in subadults below the age of 2. The absence or lesser development of a three-layered architecture in subadults leaves their cranial bones, particularly in the lateral vault, thin and vulnerable to the effects of BFT.     

“Those Are Our People and That's Our Family”: Wabanaki Perspectives on Child Welfare Practice in Their Communities

In collaboration with the Maine Wabanaki-State Child Welfare Truth and Reconciliation Commission Convening Group, this study explored perspectives of Wabanaki community members and tribal child welfare staff on state child welfare involvement in Wabanaki communities. Qualitative analysis of three focus groups found that participants perceived fundamental differences between what guides the work of tribal child welfare staff and state child welfare staff, as well as differences in understanding the profound impact of removing a child from the community. These findings are suggested to be elements of a Wabanaki counter-narrative that contrasts with the historical dominant narrative about Native families and children.     

158例"周围神经损伤"法医学鉴定分析

目的 研究"周围神经损伤"法医学鉴定案件的特点,探讨如何运用临床资料、法医检查和神经电生理检测结果等对周围神经损伤者进行法医学鉴定.方法收集临床诊断为"周围神经损伤"的158例法医学鉴定案件,对其个体特征、损伤情况、鉴定结果、夸大与伪装情况等进行统计分析.结果 在158例"周围神经损伤"案件中以男性、青壮年及无业人员多...     

Cervical soft tissue emphysema in hanging--a prospective autopsy study

The underlying mechanism of cervical soft tissue emphysema (CSTE) in hanging remains unclear. The aim of this study was to determine the frequency of CSTE in cases of hanging. The sample included 83 deceased persons, average age 55.3 ± 17.9 years. CSTE was established in 44 cases. CSTE is presented as frothy air, soap bubble-like formations in superficial and/or deep connective tissue between the neck muscles up to the ligature mark, visible during gross neck examination, using special neck autopsy technique-preparation of the neck organs in layers. The interpretation of positive CSTE must be taken with caution: it could be an antemortem phenomenon possibly because of either Macklin Effect or direct or indirect trauma to the cervical airways, as well as an ante- or postmortem artifact.     

交通肇事眼损伤鉴定及其VEP检查特征分析

对 30例交通肇事眼损伤鉴定及其VEP检查结果进行回顾性分析 ,旨在探讨交通肇事眼损伤鉴定的特征 ;结果表明 :与普通伤害案件相比 ,(1)交通肇事眼损伤鉴定时合并颅脑损伤 (83% )及多颅神经损伤 (53% )的比例较高 ;导致复视及眼球运动受限 (30 % )的情况较多 ;视神经损伤 (2 0 % )及眶壁骨折 (2 0 % )的发生率较高 ;鉴定时应注重这些方面的检查。 (2 )交通肇事眼损伤鉴定当事人主诉双眼视力下降 (53% )的比例较高 ,雾视法进行伪盲试验受到限制 ,VEP检查显得更为主要。VEP检查是确证视神经损伤的良好方法 ,不同程度的视功能障碍其VEP表现为波形熄灭、波形离散、波幅降低、潜伏期延长不等。另一方面 ,交通肇事后弥漫性脑组织损伤也在眼底及VEP上有一定表现。     

The Relationship Between Traumatization and Pain: What is the Role of Emotion?

The role of emotion in the relationship between traumatic experiences and physical pain was examined via path modeling by using a sample of hospital outpatients (N = 138). Most of the participants reported being traumatized (77%) and experiencing chronic pain (69%). Trauma survivors and nontraumatized individuals did not differ significantly on mean symptom scale scores (i.e., depression, anxiety, anger, dissociation, somatization and pain). However, a moderate effect size was found for dissociation. There were also significant associations found between trauma levels and levels of adult symptomatology. Interestingly, sexual abuse was less highly correlated with symptomatology than other types of traumatization, such as neglect. None of the three proposed path models describing the relationship between trauma, pain, and emotion fit the data successfully. Implications are discussed.     

参与度在与精神损害有关的司法鉴定中的应用

纠纷事件与其伴发的精神障碍之间的因果关系是民事纠纷司法精神鉴定中的难点,鉴定结论往往存在争议,对同一结论的描述也有所不同。本文介绍了参与度的概念,试从事件参与度的角度论述精神损害案中纠纷事件与伴发的精神障碍之间的因果关系。