The primary runoff as a remnant of the old South

During the Jim Crow era, the American South developed a distinctive one-party political structure. One important feature of that structure was the primary runoff, which was adopted to require candidates to generate majority support in the nomination process and to stimulate competition within the Democratic Party (thus keeping the Republican Party irrelevant). In this piece, I argue that although the South has become a two-party region and the runoff has lived beyond its original purposes, it continues to do many of the things it was put into place to do. As in decades past, the runoff still has an impact on such things as candidate emergence, the competitiveness of primaries, and the ability for voters to reevaluate their choices.     

原发性高血压患者颈动脉粥样硬化与中医证型的关系

目的:探讨原发性高血压患者颈动脉粥样硬化程度与中医辨证分型的关系。方法:用高频(11.4 MHz)彩色多普勒超声检测了130例原发性高血压及心脑血管并发症患者的颈动脉,与37例非高血压心脑血管病患者作对照。结果:高血压各组颈动脉内中膜厚度及斑块检出率均高于对照组,以合并脑血管疾病组内中膜厚度高于单纯高血压组。高血压中医证型之间比较,以痰湿壅盛型内中膜厚度明显高于其他证型,斑块检出率以阴虚阳亢和痰湿壅盛型明显高于其他证型。结论:高血压是引起颈动脉内中膜厚度增加的重要因素。颈动脉粥样硬化程度可作为预测心脑血管病存在的参考指标。动脉硬化的病因病机与痰、瘀密切相关。     

A Case of Sudden Death Due to Persistent Severe Pulmonary Arterial Hypertension After Late Atrial Septal Defect Closure

Atrial septal defects (ASDs) are one of the most prevalent congenital cardiac anomalies in adults. These interatrial communications can produce changes in the right heart (remodeling and failure) and the lungs (pulmonary hypertension). Most adults with ASDs are surgically treated with excellent results. However, a small fraction of patients is at risk for postoperative complications, particularly the persistence of pulmonary hypertension. A case of a 47‐year‐old woman who was found unresponsive in the bathroom of her house and died despite resuscitative efforts is described. According to medical records, the woman underwent a surgical repair of an atrial septal defect at the age of 37. At the autopsy, macroscopic and microscopic signs of advanced pulmonary hypertension were detected, highlighting the importance for the forensic pathologists to recognize pulmonary hypertension as a cause of sudden death in adults with a history of late surgical closure of an atrial septal defect.     

Sudden Unexpected Deaths Due to Intracranial Meningioma: Presentation of Six Fatal Cases,Review of the Literature,and A Discussion of the Mechanisms of Death

Deaths due to meningiomas are routinely diagnosed in clinical practice because this neoplasm tends to present with the typical progression of neurological deficits. On the other hand, sudden unexpected deaths due to meningiomas are rarely described in the literature. The study presents six fatal cases of previously undiagnosed intracranial meningiomas from the Cook County Medical Examiner's Office from 1998 to 2014. The most common explanation of the mechanism of sudden death due to intracranial neoplasms is a rapid increase in intracranial pressure produced by the mass effect of the neoplasm. Other mechanisms of death include acute intracranial and intratumoral hemorrhage, and benign neoplasms that grow in the vicinity of vital centers altering neural discharge in autonomic pathways leading to cardiac suppression or lethal arrhythmia. Forensic pathologists must keep in mind that sudden unexpected death caused by intracranial meningiomas, although extremely rare, may be encountered in the forensic setting.     

初级关系变迁与民间纠纷解决

初级关系是初级群体内成员间基于血缘、姻亲和邻里等形成的人际关系.在初级关系密切的传统社会里,许多民间纠纷,都是借助初级关系来解决的.中国社会结构转型和现代化进程导致了初级关系的弱化和功能的转移,进而对民间纠纷的解决产生了复杂的影响.     

美国中小学校园安全策略研究

美国在中小学校园安全管理方面,注重校园安全立法,强调校园安全管理的系统性、有序性和事故防范的主动性。美国的各级教育行政部门都将学校安全保障作为自己的一项重要职责,为学校在人力、物力、财力等方面提供较为充分的支持,对中小学生的安全教育已经成为一种常态教育和生存技能教育。除开展演习之外,美国中小学校会聘请常驻校园警察,以帮助学校制订适合其自身特点的校园安全计划,处理校园安全事故,开展对学生的安全教育和技能培训。此外,美国的中小学校还重视发挥社区、家长和志愿者在维护校园安全中的作用。     

天麻钩藤饮联合卡托普利治疗原发性高血压的系统评价和Meta分析

目的 评价天麻钩藤饮联合卡托普利治疗原发性高血压的有效性和安全性,为动物实验和临床推广提供科学依据。方法 纳入天麻钩藤饮联合卡托普利与单纯卡托普利治疗原发性高血压的随机对照试验（randomised control trails,RCTs）文献,用Jadad量表对文献的质量进行评分,进行Meta分析。结果 共纳入8篇RCTs文献,均是Jadad评分小于3分的低质量研究。两组临床疗效、原发性高血压症状的合并效应量比值比（odds ratio,RR）分别为1.15、1.41;治疗后收缩压、舒张压的合并效应量分别为-5.37、-4.85 mmHg,差异均有统计学意义(P<0.05)。两组的不良反应均较少。结论 与单纯卡托普利比较,天麻钩藤饮联合卡托普利治疗原发性高血压有更好的临床疗效,可改善症状,降压效果更佳,具有较好的安全性,适合临床的推广使用。由于纳入文献的质量不高,仍需要高质量的大样本双盲RCTs的支持。