基于隐结构模型和聚类分析的2 907例支气管扩张症中医证型研究

目的 对支气管扩张症的中医证候特征进行探究。方法 基于2 907例支气管扩张症住院患者的电子病历数据,运用Lantern 5.0和SPSS 20.0软件分别进行频次描述性统计、隐结构及系统聚类分析,综合判断潜在证型,为提出支气管扩张症的临床常见中医证型提供依据。结果 纳入的2 907份病历记录中涉及43个证型,其中频率大于5%的有痰热蕴肺证（52%）、痰湿阻肺证（25.5%）、肺气阴两虚证（9.1%）、痰瘀阻肺证（7.8%）、肺脾气虚证（7.1%）、肺肾气虚证（6.6%）;共记录有219个症状,将出现频次＞30次的67个症状作为显变量,综合聚类成风热犯肺证、痰热蕴肺证、痰湿阻肺证、痰瘀阻肺证、阴虚肺热证、肺肾气虚证、肺脾气虚证、肺气阴两虚证共8个证候;对频次＞60次的52个症状进行系统聚类分析,得到风热犯肺证、痰热蕴肺证、痰湿阻肺证、肺气阴两虚证、肺脾气虚兼外感证、阴虚内热兼血瘀证、肺肾气虚证、脾气虚证、兼证络伤咳血证共10个证候。以上3种方法推断出的证型中,重复出现至少两次的证型共有8个,即可认定为支气管扩张症常见证型。结论 支气管扩张症8个常见的证型为风热犯肺证、痰热蕴肺证、痰湿阻肺证、痰瘀阻肺证、阴虚肺热证、肺肾气虚证、肺脾气虚证、肺气阴两虚证。     

肩袖损伤法医学鉴定研究进展

肩袖损伤是一种临床常见的肩关节病,成因复杂且症状有时不甚明显,缺乏特征性表现,容易被漏诊及误诊。在法医学鉴定中,时常遇到肩袖损伤的案例,判定该类案例是创伤所致、自身疾病抑或属于伤病共同作用导致是目前摆在法医鉴定人面前的难点问题。但因找不到客观的鉴别指标,容易使鉴定工作进入盲区,也时常引起当事人对鉴定意见的质疑,甚至长期的上访缠诉,引发社会的不稳定。基于此,从肩袖解剖结构、损伤机制、临床表现、鉴别诊断及法医学鉴定等方面展开论述,有助于为此类案件的鉴定提供参考。     

Self‐Strangulation Through A Sphygmomanometer: An Uncommon Suicide

Suicide by asphyxia is quite a common event in forensic practice and may be implemented in different ways. The authors report a unique case of a 16‐year‐old youth who committed suicide by means of a standard mercury sphygmomanometer. This manner of suicide has never been described in the literature reviewed. A complete forensic investigation led to the conclusion that the cause of death was mechanical asphyxia, ascribed to self‐strangulation by means of an atypical item. The victim suffered from attention‐deficit/hyperactivity disorder (ADHD) syndrome and was assisted by support teachers. He had a solitary and depressive personality. The exceptional nature of this case suggests that sphygmomanometers may be regarded as possible means of self‐strangulation. The case also highlights the importance of managing patients with psychiatric or cognitive disorders; indeed, particular caution is required to keep them away from objects that, although apparently harmless, can become lethal.     

Ecosocialisms,Past, Present and Future: From the Metabolic Rift to a Reconstructive,Dynamic and Hybrid Ecosocialism

John Bellamy Foster and his colleagues have recently argued that the project of ecosocialism should be understood in terms of a “prefigurative” and “first stage” of red-green thinkers whose insights have largely been transcended by their own work on the metabolic rift. Rift scholars have further argued that “second-stage” ecosocialists should push back against “idealist” deviations occurring amongst historical materialists concerned with the production of nature, socionatures and “hybridity,” as well as more or less all engagements with literatures on eco-technological transitions, industrial ecology and the like, which are implicated in supporting “green capitalism.” This paper critically evaluates these claims. In each case, it is argued, rift scholarship is narrowing the possibilities for interdisciplinary engagement and for thinking in dynamic and reconstructive terms about red-green futures. It is our sense that an ecosocialist vision of just transitions has to be conceptualized as a diverse, dynamic, iterative and always incomplete affair. Anthropocene ecosocialisms are inevitably going to involve co-producing, making and remaking hybrid social ecologies on an irreducibly restless, turbulent and warming planet. We argue that what follows from this is the necessity to both critique and recuperate the better insights of hybrid political ecology and ecological modernities.     

The adventure of capital with nature: from the metabolic rift to the value theory of nature

This paper suggests that the concept of metabolic rift situated in ‘the labor theory of value’ is not an adequate theoretical tool to historically explore capitalist development as a socio-ecological process and socio-historical domination of ecology. It situates the concept of nature in Marx’s critique of political economy and the concept of the metabolic rift in relation to his theory of value. Then, it explores two distinctive historical approaches to the relationship between ecology and capitalist development within the world-historical studies, i.e. the world-ecology perspective and the uneven ecological exchange perspective, in relation to their theoretical and epistemological premises. How they operationalize or recast Marx’s theory of value in understanding this relationship opens a realm to rethink the value theory in relation to nature and the socio-ecological nature of capitalist relations of production. Based on this, it proposes to reconsider the value theory as a value theory of nature in order to recognize the historical specificity of socio-ecological relations, and their historical transformation and alienation, as an integral constituent of the historical narrative of capitalist development.     

Repairing rifts or reproducing inequalities? Agroecology,food sovereignty,and gender justice in Malawi

ABSTRACT

This Malawi study examines whether agroecology can be effectively used by smallholders to address food sovereignty. We build on the concept of the metabolic rift, arguing that repairing this rift includes social relations. Agroecological methods can be important strategies, but are labour and knowledge intensive, and require addressing power dynamics within and beyond households in order to address food sovereignty. The case study included participatory methods of dialogue, experimentation and horizontal learning to foster change. We argue that feminist concepts of intersectionality and participatory praxis are central to mobilizing agroecology to build food sovereignty and work to transform social relations.     

真武汤对肉鸡腹水综合征的预防效果

选用肉仔鸡256只,随机分成正常对照、腹水征对照、真武汤预防和维生素C E预防4个组,研究了真武汤对肉鸡腹水综合征的预防效果。结果显示,真武汤预防组和正常对照组腹水发病率极显著低于腹水征对照组(P<0.01),真武汤预防组腹水发病率显著低于腹水征对照组(P<0.05);腹水征对照组AHI极显著高于正常对照组(P<0.01),显著高于真武汤预防组(P<0.05);腹水征对照组PCV、RBC和Hb均显著高于真武汤预防组和正常对照组(P<0.05);真武汤预防组血浆、心、肝和肺组织中SOD活性显著高于腹水征对照组(P<0.05),同时真武汤预防组血浆、心、肝和肺组织中的MDA含量显著低于腹水征对照组(P<0.05)。结果表明,饮水中加真武汤口服液,能提高机体抗氧化能力,改善血液组织中的理化参数,提高机体抗冷应激能力,降低AS的发病率。     

用多种探针药物评价穿心莲对鸡药物代谢酶活性的影响

采用咖啡因、氨苯砜、氯唑沙宗、奥美拉唑药物探针法,测定这些探针药物在鸡体内的消除半衰期,以探讨穿心莲超微粉对鸡的药物代谢酶的影响,结果显示,对照组和试验组的咖啡因t1/2β分别为632min、415 min,表明两组的t1/2β之间有显著差异(P<0.05).对照组与试验组的氨苯砜t1/2β分别为55.4 min、48.4 min,二者之间差异不显著(P>0.05).对照组和试验组的奥美拉唑t1/2β分别为16.5 min、7.6 min,表明两组的消除半衰期差异极显著(P<0.01);氯唑沙宗t1/2β分别为26.3 min、20.5 min,两组差异显著(P<0.05).结果表明,穿心莲超微粉对CYP3A4、CYP1A2、CYP2E1和CYP2C19的活性都有诱导作用,但与对照组相比,对CYP3A4的诱导作用差异不显著,而对CYP2C19的诱导作用差异极显著.     

肩袖损伤的研究进展及其法医学意义

肩袖位于肩峰、肩锁关节和肱骨头骨性结构之间,是由冈上肌、冈下肌、肩胛下肌及小圆肌包绕在肱骨头周围并与肩关节囊相混合围绕肩关节形成袖套状结构的一组肌腱复合体,在肩关节活动功能中起重要作用.常见的损伤原因包括肩峰下撞击综合征、血管异常相关因素、关节功能退行变和外伤暴力因素等,是一类多因素参与的复杂病理生理过程.通过对肩袖的...     

Double balloon enteroscopy in children:Diagnosis,treatment,and safety

AIM:To assess the feasibility and utility of double balloon enteroscopy(DBE)in the management of small bowel diseases in children. METHODS:Fourteen patients(10 males)with a median age of 12.9 years(range 8.1-16.7)underwent DBE; 5 for Peutz-Jeghers syndrome(PJ syndrome),2 for chronic abdominal pain,4 for obscure gastrointestinal (GI)bleeding,2 with angiomatous malformations(1 blue rubber bleb nevus syndrome)having persistent GI bleeding,and 1 with Cowden‘s syndrome with multiple polyps and previous intussusc...