中药穴位注射治疗2型糖尿病周围神经病变临床观察

目的 观察中药穴位注射治疗2型糖尿病周围神经病变的临床疗效。方法 将70例2型糖尿病周围神经病变（diabetic peripheral neuropathy,DPN）患者随机分为对照组和治疗组,每组35例。在糖尿病常规治疗基础上,对照组加用弥可保治疗,治疗组在对照组基础上加用红花注射液穴位注射。治疗前、治疗4周后分别进行密西根州糖尿病周围神经病评分（Michigan diabetic neuropathy score,MDNS）。结果 治疗4周后,治疗组临床疗效优于对照组,差异有统计学意义（P＜0.05）。两组患者治疗后MDNS评分和症状、体征评分均较治疗前明显减少（P＜0.05）;两组MDNS评分和症状、体征评分差值比较,差异均有统计学意义（P＜0.05）。结论 中药穴位注射可以显著减少DPN患者MDNS评分和症状、体征评分,提高生活质量。     

清热化湿中药保留灌肠治疗溃疡性结肠炎疗效观察

目的 观察中药保留灌肠对溃疡性结肠炎（ulcerative colitis,UC）的疗效。方法 将60例轻中度UC患者随机分为观察组和对照组,每组30例。对照组采用美沙拉秦栓塞肛,观察组采用中药保留灌肠,治疗时间为8周。评价两组临床疗效,比较两组治疗前、治疗4周末、治疗8周末的疾病活动指数（disease activity index,DAI）、Baron内镜评分和Geboes指数,采用中文版炎症性肠病生存质量问卷（inflammatory bowel disease quality questionnaire,IBDQ）评价两组患者治疗前后的生存质量,观察两组恶心、腹胀、腹痛、便次增多等不良反应的发生。结果 观察组临床总有效率（93.3%）高于对照组（73.3%）,但两组临床疗效分布比较,差异无统计学意义（Z=－1.902,P=0.057）。治疗4周末、8周末两组DAI评分均显著降低（P＜0.05）,且观察组显著低于对照组（P＜0.05）。广义估计方程分析结果显示,对照组与观察组比较,Baron内镜评分和Geboes指数的优势比（odds ratio,OR）分别为2.12、2.30;治疗8周末与治疗4周末、治疗前比较,Baron内镜评分的OR值分别为63.66、6.50,Geboes指数的OR值分别为33.57、9.45。两组治疗后生存质量评分与治疗前相比,肠道症状、情感能力、社会能力、全身症状4个维度上得分均显著提高,且观察组4个维度评分升高值均显著大于对照组（P＜0.05）。治疗期间,对照组共15例患者出现恶心、腹痛、腹胀、大便次数增多,观察组共5例患者出现恶心、腹痛、大便次数增多,观察组不良反应发生率显著低于对照组（P<0.05）。结论 中药保留灌肠能有效治疗UC,降低疾病活动指数,改善内镜评分,提高生存质量。     

运脾化浊法治疗脾虚型高尿酸血症回顾性研究

目的评价运脾化浊法治疗脾虚型高尿酸血症患者的临床疗效。方法使用回顾性研究的方法,检索天津市中医药研究院附属医院的电子病历系统,收集近5年住院的脾虚型高尿酸血症患者,选择接受运脾化浊法治疗的45例患者为运脾化浊组,采用倾向性评分匹配法匹配以接受常规西医治疗的45例患者为常规治疗组,疗程均为2周。比较两组患者治疗前后血尿酸水平、脾虚证症状评分。结果治疗后两组患者血尿酸水平均较治疗前降低(P<0.05),两组患者降尿酸达标率(运脾化浊组40%、常规治疗组55.56%)以及降尿酸疗效相近(P>0.05)。治疗后运脾化浊组脾虚证症状评分较治疗前降低(P<0.05),且降低幅度较常规治疗组更大(P<0.05);两组中医症状疗效比较,差异有统计学意义(P<0.05)。结论采用运脾化浊法治疗脾虚型高尿酸血症,可降低患者的血尿酸水平且明显改善其脾虚证症状。     

参芪健心方治疗射血分数中间值心力衰竭患者临床观察

目的 观察参芪健心方治疗射血分数中间值心力衰竭(heart failure with mid-range ejection fraction, HFmrEF)的临床疗效。方法 将60例HFmrEF患者按随机数字表法平均分为两组,观察组30例患者在西医基础治疗的同时,给予参芪健心方治疗,每日1剂;对照组30例患者仅接受西医基础治疗;疗程均为4周。比较两组患者治疗前后脑钠肽(B-type natriuretic peptid, BNP)、左心室舒张末内径(left ventricular end-diastolic dimension, LVEDD)、左心室射血分数(left ventricular ejection fraction, LVEF)、6分钟步行距离(6 minutes walking distance, 6MWD)、中医证候积分,基于纽约心脏病协会(New York Heart Association, NYHA)心功能分级的临床疗效及主要心血管不良事件(major adverse cardiovascular events, MACE)发生情况。结果 与治疗前比较,两组患...     

Comparison of Protocols for Measuring and Calculating Postmortem Submersion Intervals for Human Analogs in Fresh Water

Protocols for determining postmortem submersion interval (PMSI) have long been problematic for forensic investigators due to the wide variety of factors affecting the rate of decomposition of submerged carrion. Likewise, it has been equally problematic for researchers to develop standardized experimental protocols to monitor underwater decomposition without artificially affecting the decomposition rate. This study compares two experimental protocols: (i) underwater in situ evaluation with photographic documentation utilizing the Heaton et al. total aquatic decomposition (TAD) score and (ii) weighing the carrion before and after submersion. Complete forensic necropsies were performed as a control. Perinatal piglets were used as human analogs. The results of this study indicate that in order to objectively measure decomposition over time, the human analog should be examined at depth using the TAD scoring system rather than utilizing a carrion weight evaluation. The acquired TAD score can be used to calculate an approximate PMSI.     

当代大学生漠视生命价值的诱因探析

对生命的敬畏与对生命价值的珍视,是现代社会健康人格的一个重要标识。当前我国大学生漠视生命、无视生命价值的现象屡屡见诸各类媒体,引起了全社会的普遍关注。主体价值认知的偏差,终极价值信仰的迷失,社会环境形成的心理困境以及现行教育制度的错位,是当代大学生漠视生命价值的主要诱因。引导大学生认真思考生命的意义,积极寻求生命的内在价值,珍惜和尊重生命,促进其人格的健全和完善,对实现社会和谐发展具有重要意义。     

涉诉信访法治化的路径选择

涉诉信访已成为困扰我国司法与行政的一大顽疾,解决的根本在于将其纳入法治的轨道。重塑涉诉信访,首先要从"权限"和"程序"两个方面对其进行规制,规范信访机构的受理与处理行为;其次要对现有的"四级两审"诉讼制度进行改革,完善法的可诉性;最后,构建真正的以司法独立为根基的多元纠纷解决机制,彻底实现当事人的息诉罢访目的。     

TRANSFERRED JUVENILES IN THE ERA OF SENTENCING GUIDELINES: EXAMINING JUDICIAL DEPARTURES FOR JUVENILE OFFENDERS IN ADULT CRIMINAL COURT*

This study contributes to contemporary research on the punishment of juvenile offenders in adult court by analyzing the use of guidelines departures for transferred juveniles in two states, one with presumptive sentencing guidelines (Pennsylvania) and one with voluntary guidelines (Maryland). Propensity score matching is first used to create more comparable samples of juvenile and young adult offenders, and then Tobit regressions are employed to estimate the effect of juvenile status on the likelihood and length of departures. Our findings indicate that juvenile status significantly affects the use of upward departures in Pennsylvania, and the use of both downward and upward departures in Maryland. Judicial reasons for departure are examined to provide additional insight into the complex dynamics surrounding exceptional sentences for juvenile offenders sentenced in adult court.     

For Whom Do Sanctions Deter and Label?

Deterrence and labeling theories make opposing predictions regarding the effect of sanctions on subsequent crime. Deterrence anticipates that sanctions deter, while labeling anticipates that sanctions amplify future crime. The knowledge base with respect to this question is vast, and while a handful of studies provide evidence of a deterrent effect, the majority of studies indicate a null effect. Our study examines whether an arrest leads to an increase in subsequent crime, but extends the knowledge base by considering whether an arrest has the same effect across offender trajectories and by employing techniques that deal with sample selection bias. Thus, we assess for whom sanctions deter or exacerbate subsequent offending. Results indicate that for greater risk youth, arrest amplifies subsequent delinquency, net of other effects, but not among lower risk youth. Thus, experiencing an arrest aggravates subsequent delinquency among some but not all persons. Implications and directions for future research are identified.     

Data processing by police and criminal justice authorities in Europe – The influence of the Commission's draft on the national police laws and laws of criminal procedure

The proposal for a fundamental reform of the European data protection law, published by the EU Commission on 25 January 2012 is composed of two elements. Apart from a General Data Protection Regulation, the Commission proposes a second regulatory instrument, namely a Directive with regard to data processing by police and criminal justice authorities that shall supersede the Council Framework Decision 2008/977/JHA. This paper seeks to analyse the draft Directive in the context of the entire reform approach and scrutinizes a number of specific issues in regard to the scope, the requirements of data processing, notification duties and data transfer to third countries.