901例社区2型糖尿病血瘀证的影响因素研究

目的 了解血瘀证在社区2型糖尿病患者中的分布及其相关影响因素。 方法 以社区901例2型糖尿病患者为研究对象,采集其相关临床信息并进行中医辨证分析,采用单因素分析和Logistic回归分析考察血瘀证的影响因素。 结果 901例2型糖尿病患者中,单纯血瘀脉络证165例,阴虚热盛证、湿热困脾证、气阴两虚证、阴阳两虚证分别为137、135、334、130例,分别兼夹血瘀证55、57、200、101例,各证型兼夹血瘀证的比例明显不同（P<0.05）。单因素分析结果显示,年龄、病程、高血压并发症、收缩压、体质量、体型是血瘀证的影响因素,舒张压、血脂水平不是血瘀证的影响因素;二项分类Logistic回归分析结果显示,年龄、高血压并发症、收缩压是血瘀证的影响因素。 结论 血瘀证是社区2型糖尿病患者的主要证型,年龄越大,具有高血压并发症,收缩压较高者易于出现血瘀证,尚不能认为病程、体质量和体型是2型糖尿病血瘀证的影响因素。     

滋阴活血方治疗IgA肾病阴虚血瘀证60例

目的 观察滋阴活血方治疗阴虚血瘀型IgA肾病的临床疗效。方法 将60例IgA肾病阴虚血瘀证患者随机分为治疗组（40例）和对照组（20例）,对照组患者给予血管紧张素转化酶抑制剂或血管紧张素受体阻滞剂类药物等治疗,治疗组在对照组基础上加服自拟滋阴活血方,两组疗程均为12周。治疗后观察并比较两组IgA临床疗效及中医证候疗效,治疗前后分别检测两组尿红细胞（urine red blood cell,URBC）计数、24 h尿蛋白定量（24-hour urinary protein,24hUP）、血清肌酐（serum creatinine,SCr）水平及估算肾小球滤过率（estimated glomerular filtration rate,eGFR）。结果 治疗组临床总有效率显著高于对照组（72.50％ vs 45.00%,P=0.037）,治疗组中医证候疗效显著优于对照组（P=0.015）;治疗组治疗后URBC、24hUP、SCr均较治疗前显著降低（P<0.05）,而eGFR显著升高（P＜0.05）,治疗组在降低URBC、24hUP、SCr及升高eGFR方面显著优于对照组（P＜0.05,或P＜0.01）。结论 滋阴活血方对阴虚血瘀型IgA肾病具有较好的临床疗效,适用于中轻度蛋白尿、早中期肾功能损害的患者。     

复方泽漆颗粒治疗血热型银屑病临床观察及皮肤镜变化

目的 观察复方泽漆颗粒治疗血热型银屑病的疗效及治疗前后银屑病皮损区的皮肤镜表现.方法 将45例银屑病血热证患者随机分成治疗组23例和对照组22例,两组分别口服复方泽漆颗粒和复方青黛胶囊8周.采用银屑病面积与严重性指数(psoriasis area and severity index,PASI)对两组疗效进行评价,采用...     

Finding of Hyperostosis Frontalis Interna During the Autopsy Procedure: Forensic Issues

Hyperostosis frontalis interna is a common phenomenon, which may have been overrated in its significance in the past, and may, currently be underrated in its significance. We present three cases of hyperostosis frontalis interna found during medicolegal autopsies and discuss their forensic considerations. The patients were all middle‐aged women with metabolic and endocrine manifestations and psychiatric ailments; thickening of the inner table of the frontal bone of the skull was found during each autopsy. We describe the relationship between hyperostosis frontalis interna, metabolic manifestations, and neuropsychiatric symptoms as part of Morgagni‐Stewart‐Morel syndrome. There is still considerable disagreement in the scientific community as to whether this syndrome is a clinical entity. Nonetheless, awareness of Morgagni‐Stewart‐Morel syndrome can be of help in understanding the circumstances surrounding death. In some other cases, hyperostosis frontalis interna could be used by forensic pathologists as criteria for sexing and aging a skeleton.     

Fingerprint Change: Not Visible,But Tangible

Hand–foot syndrome, a chemotherapy‐induced cutaneous toxicity, can cause an alteration in fingerprints causing a setback for cancer patients due to the occurrence of false rejections. A colon cancer patient was fingerprinted after not having been able to use fingerprint recognition devices after 6 months of adjuvant chemotherapy. The fingerprint images were digitally processed to improve fingerprint definition without altering the papillary design. No evidence of skin toxicity was present. Two months later, the situation returned to normal. The fingerprint evaluation conducted on 15 identification points highlighted the quantitative and qualitative fingerprint alteration details detected after the end of chemotherapy and 2 months later. Fingerprint alteration during chemotherapy has been reported, but to our knowledge, this particular case is the first ever reported without evident clinical signs. Alternative fingerprint identification methods as well as improved biometric identification systems are needed in case of unexpected situations.     

温病湿热证湿重于热动物模型舌的病理观察

目的：观察温病湿热证湿重于热动物模型舌的病理改变。方法：复制温病湿热证湿重于热动物模型,观察大鼠舌的病理改变,并设湿热组、脾虚组、正常组进行比较。结果：湿重于热组、湿热组固有层乳头密度及核分裂相频数显著增多,与正常组及脾虚组比较差异有显著性;湿重于热组和湿热组固有层均出现炎症、充血及水肿,前者水肿更甚,后者则充血明显。结论：舌的病理改变,可能是湿热证型中舌苔变化的病理基础,并可作为判定湿热轻重的指标之一。     

Fatal acute intracranial injury, subdural hematoma, and retinal hemorrhages caused by stairway fall

We describe an infant with an acute subdural hematoma, a fatal head injury, and severe hemorrhagic retinopathy caused by a stairway fall. His cerebral and ocular findings are considered diagnostic of abusive head trauma by many authors. Our literature search of serious injuries or fatalities from stairway or low-height falls involving young children yielded 19 articles of primary data. These articles are discrepant, making the classification of a young child's death following a reported short fall problematic. This case report contradicts the prevalent belief of many physicians dealing with suspected child abuse that low-height falls by young children are without exception benign occurrences and cannot cause fatal intracranial injuries and severe retinal hemorrhages. The irreparable harm to a caregiver facing an erroneous allegation of child abuse requires physicians to thoroughly investigate and correctly classify pediatric accidental head injuries.     

原因不明性不孕症中医证候分析

目的 探讨原因不明性不孕症的中医证候特点,为中药治疗原因不明性不孕症提供辨证依据.方法 根据不孕症诊断标准,将219例不孕症患者分为研究组(原因不明性不孕症)108例和对照组(配偶不育症导致的不孕症)111例,分析并比较两组中医证候分布特征,采用二项分类Logistic回归分析原因不明性不孕症的危险证候,以及中医证候与...     

Child Abuse-Related Homicides in New Mexico: A 6-year Retrospective Review

Abstract:  We retrospectively reviewed autopsy records at a statewide medical examiner's office in order to identify and characterize deaths due to child abuse. In a 6-year period in New Mexico, the medical examiner investigated 45 deaths determined to be child abuse-related. Decedents were predominantly male (68.9%), Hispanic White (53.3%), and all were 5 years of age or younger, with a median age of 1 year. Head injuries were the most common cause of death (44.4%), followed by battered baby syndrome (15.6%). Relatives were involved as alleged perpetrators in 80% of the cases, with the father most often implicated (36.1% of cases), and 88.9% of child abuse injuries resulting in death occurred in the family's residence. Toxicology was positive in 26.7% of cases, but only two cases had substances of abuse present. Information on risk factors such as prematurity, parental age, and history of abuse was also collected.     

The legal geographies of transnational cyber-prosecutions: extradition,human rights and forum shifting

This article describes legal and human rights issues in three cases of transnational online offending involving extradition requests by the United States (US). These cases were selected as all suspects claimed the negative impacts of autism spectrum disorders (ASDs) were sufficient to deny extradition on human rights grounds. We demonstrate how recent developments in UK and Irish extradition law raise human rights and prosecutorial challenges specific to online offending that are not met by established protections under domestic and internationally sanctioned approaches to extradition or human rights law. In these cases, although the allegedly unlawful conduct occurred exclusively online and concurrent jurisdiction enables prosecution at both the source and location of harm, we demonstrate why national courts hearing extradition challenges are extremely reluctant to shift the trial forum. We conclude by discussing the implications of the new geographies of online offending for future criminological research and transnational criminal justice.