Finite Element Analysis on Treatment Effect of Additive Manufacturing Scoliosis Orthosis / 医用生物力学

Objective To evaluate the efficacy of additive manufacturing scoliosis orthosis, by simulation on interaction of the bone, trunk and orthosis using finite element method. Methods Combined with CT data of the patients, three-dimensional (3D) scanning model of the trunk and full length X-ray of the spine, the bone-trunk-orthosis finite element model was established and proved to be effective. The change and development trend of Cobb angle of the main thoracic scoliosis was calculated under different boundary and load conditions. Results The treatment effect of the additive manufacturing scoliosis orthosis was good. With the increase of orthotic preload, the improvement of Cobb angle and pelvic tilt was more obvious. The Cobb angle was expected to decrease by 6.18° after application of 70 N preload to the orthosis for 6 months. In the case of increasing system stiffness, Cobb angle improvement was not obvious and became even worse. Conclusions Additive manufacturing scoliosis orthosis is effective for treating adolescents with immature bones, while for patients with mature or degenerative bones, its treatment effect is poor.

Content determination of four kinds of alkaloids in Uncaria by HPLC-MS-AIS / 四川精神卫生

ObjectiveTo determine the contents of four kinds of indole alkaloids （rhynchophylline， isorhynchophylline， corynoxeine， isocorynoxeine） in Uncaria by high-performance liquid chromatography-mass spectrometry-automatic internal standard （HPLC-MS-AIS）. MethodsChromatographic separation was performed using C18 column （3.0 mm×50 mm， 3.3 μm）， and the mobile phase， comprising 0.1% formic acid aqueous solution-acetonitrile （82∶18， V/V）， was eluted at a flow rate of 0.5 mL/min and column temperature of 30℃. Mass spectrometric detection was performed using an electrospray ionization source and positive multiple-reaction monitoring mode at a voltage capillary of 4 000 V. The mass-to-charge ratio （m/z） transition was 385.25/160.10 for rhynchophylline， 385.30/160.10 for isorhynchophylline， 383.25/160.15 for corynoxeine and 383.25/160.15 for isocorynoxeine， respectively. The injection volume was kept constant at 2 μL. ResultsThe linear concentration ranges of rhynchophylline， isorhynchophylline， corynoxeine and isocorynoxeine were 2.30~600.00 ng/mL （r=0.999 3）， 2.30~600.00 ng/mL （r=0.999 2）， 2.47~650.00 ng/mL （r=0.999 4） and 2.47~650.00 ng/mL （r=0.999 2）， respectively. The relative standard deviation （RSD） of precision and stability were all lower than 5.00%， the accuracy ranged from 92.40% to 104.10%， and the average recovery was 95.90%~104.60%. ConclusionHPLC-MS-AIS method is simple and accurate for the determination of four kinds of alkaloids in Uncaria， and can be used as a new method for quality control of Uncaria.

Tissue Window versus Time Window? A Review of Patients Receiving Extended Hours Thrombolysis Guided By DWI-FLAIR Mismatch : Case Series

@#Introduction: Intravenous thrombolysis (IVT) is the gold standard for the treatment of patients with acute ischemic stroke (AIS) presenting within four and a half hours of onset. However, development of new thrombolytic agents and advanced imaging has led to extended time for thrombolysis based on advanced imaging. Here we describe four patients who presented in the extended hours; that benefitted from thrombolysis. Case series: We advocate magnetic resonance imaging (MRI) for AIS, that includes diffusion weighted imaging (DWI), apparent diffusion coefficient (ADC), fluid attenuated inversion recovery (FLAIR), susceptibility weighted imaging (SWI), and magnetic resonance angiography (MRA). We included four patients who were more than 18 years old, with National Institute of Health Stroke Scale (NIHSS) of six or more, presenting between four and a half to nine hours after stroke onset with no contraindications for intravenous thrombolysis. The imaging criteria used to determine eligibility for IVT is evidence of DWI-FLAIR mismatch on MRI. If FLAIR detects no signal change in the area of stroke on DWI, it is then termed DWIFLAIR mismatch, or FLAIR-negative – indicating high probability that the brain tissue is still viable, and that patients are good candidates for IVT. Conclusion: For patients with AIS who present within nine hours, DWI-FLAIR mismatch serves as an excellent surrogate marker of salvageable brain tissue, allowing a greater proportion of patients benefiting from this life-saving therapy. Our experience also shows that with careful patient selection, treatment with IVT can safely be given without an increased risk of bleeding or mortality.

Epidemiológica del ataque cerebro vascular en un hospital universitario / Epidemiological of cerebrovascular attack in a university hospital / Epidemiologia do ataque cerebrovascular em hospital universitário

Resumen: Introducción: El ataque cerebro vascular es una enfermedad prevalente en nuestro medio con elevada morbimortalidad. El Hospital Pasteur es un centro de tercer nivel, que asiste un elevado número de pacientes con esta patología. Conocer los datos epidemiológicos de esta afección permitirá desarrollar medidas de promoción de salud y prevención primaria. Identificar la forma de presentación clínica y los algoritmos de estudio, permitirán un adecuado diagnóstico, tratamiento precoz y desarrollo de medidas de prevención secundaria. Objetivos: Conocer las características sociodemográficas de la población con diagnóstico de ataque cerebro vascular o accidente isquémico transitorio asistidas en las salas de medicina del Hospital Pasteur, los factores de riesgo asociados, las formas de presentación clínica y precisar si se cumplió con el algoritmo diagnóstico propuesto. Métodos y procedimiento: Estudio descriptivo observacional y transversal realizado en el Hospital Pasteur. La población de estudio fueron pacientes adultos ingresados en sala de medicina con diagnóstico de ataque cerebro vascular o accidente isquémico transitorio que presentaron el evento durante su internación, en el periodo comprendido entre Julio y Setiembre de 2018. Resultados y discusión: Se recabaron datos de 29 pacientes, 20 de sexo femenino. La media de edad fue de 70.34 años. La naturaleza isquémica fue la más prevalente. Los factores de riesgo cardiovascular más frecuentes fueron HTA, sedentarismo, dislipemia y tabaquismo. La principal forma de presentación fue síndrome piramidal. Se cumplió con el algoritmo diagnostico en todos los pacientes. Conclusión: Conocer los factores de riesgo, naturaleza y forma de presentación clínica permite elaborar estrategias de prevención primaria y secundaria para el abordaje integral de estos pacientes, intentando así reducir la incidencia y secuelas de esta enfermedad.

Abstract: Introduction: Acute ischemic stroke is a prevalent condition in our working environment, with high morbility and mortality. Hospital Pasteur is a tertiary level institution, which assists an elevated number of patients with acute ischemic stroke. Getting to know its epidemiologic characteristics will enable the development of health promotion and primary prevention measures. Identifying its clinical presentation form and applying validated study algorithms will allow for a proper diagnosis, early treatment and development of secondary prevention measures. Objectives: To study the sociodemographic characteristics of patients diagnosed with acute ischemic stroke or transient ischemic attack assisted in Hospital Pasteur´s Internal Medicine wards, their associated risk factors, clinical presentation and to determine whether the proposed study algorithm was followed. Methodology and procedure: This is a descriptive, observational and transversal study which took place at Hospital Pasteur. The population consisted of adult patients admitted to Internal Medicine wards with the diagnosis of acute ischemic stroke, transient ischemic attack or who presented the event during their stay, between the months of July and September 2018. Results and discussion: The data of 29 patientes was obtained; 20 were female. The mean age was 70.34 years. Ischemic nature was the most prevalent. The most frequent risk factors were arterial hypertension, sedentary lifestyle, dyslipidemia and smoking. Pyramidal syndrome was the most common clinical presentation. A study algorithm was followed in all patients. Conclusion: Getting to know the risk factors, nature and clinical presentation form of AIS and TIA allows for the creation of primary and secondary prevention strategies for the comprehensive approach of these patients, therefore intending to reduce this disease´s incidence and its terrible consequences.

Resumo: Introdução: O ataque cerebrovascular é uma doença prevalente em nosso meio, com alta morbimortalidade. O Hospital Pasteur é um centro de terceiro nível, que auxilia um grande número de pacientes com essa patologia. Conhecer os dados epidemiológicos dessa condição permitirá o desenvolvimento de ações de promoção da saúde e prevenção primária. Identificar a forma de apresentação clínica e os algoritmos do estudo permitirá um diagnóstico adequado, tratamento precoce e desenvolvimento de medidas de prevenção secundária. Objetivos: Conhecer as características sociodemográficas da população com diagnóstico de ataque cerebrovascular ou ataque isquêmico transitório assistido nas salas médicas do Hospital Pasteur, os fatores de risco associados, as formas de apresentação clínica e determinar se o algoritmo de diagnóstico proposto foi atendido. Métodos e procedimentos: Estudo observacional e transversal descritivo realizado no Hospital Pasteur. A população do estudo foi de pacientes adultos admitidos na enfermaria com diagnóstico de ataque cerebrovascular, ataque isquêmico transitório que apresentaram o evento durante sua internação, no período entre julho e setembro de 2018. Resultados e discussão: Os dados foram coletados de 29 pacientes, sendo 20 do sexo feminino. A idade média foi de 70,34 anos, sendo a natureza isquêmica a mais prevalente. Os fatores de risco cardiovascular mais frequentes foram hipertensão arterial, sedentarismo, dislipidemia e tabagismo. A principal forma de apresentação foi a síndrome piramidal. O algoritmo de diagnóstico foi preenchido em todos os pacientes. Conclusão: Conhecer os fatores de risco, natureza e forma de apresentação clínica permite desenvolver estratégias de prevenção primária e secundária para abordagem abrangente desses pacientes, buscando reduzir a incidência e sequelas da doença.

Analysis Of Prevalence And Factors Influencing Adolescent Idiopathic Scoliosis Among School Students In Thiruvallur District

Background: The occurrence of AIS is on a high, which necessitates preventive measures at the earliest for which screening is essential at the school level. Prevalence of AIS around the world is 0.4- 5.2 %. Scoliosis leads to problems such as cosmetic deformity, quality of life, visible disability, backache, personal growth, autonomy, and reduced respiratory function. These problems can be prevented if scoliosis is diagnosed and treated earlier. To screen for AIS among selected schools and to analyze factors influencing adolescent idiopathic scoliosis. Methods: A total of 3250 Students between age 11 to 15 years were screened for AIS from Thiruvallur district. The screening was performed at two levels using Adam’s forward bend test and scoliometer, respectively. A detailed analysis was performed on symptomatic AIS subjects (n=58) for various influencing factors and determinants. Results: The prevalence of AIS from 11- 15 years was 0.27%, 0.30%, 0.49%, 0.36% and 0.33% respectively. AIS-affected thoracic region (50%) of females (58%) with a predominant right sided curvature (55%). Bag type and weight, sitting posture in a classroom, study posture was found to influence AIS. Conclusion: This study emphasizes early screening of AIS for school children at the age of 11- 15 years based upon the high prevalence rates compared to global standards. Parents and teachers should be aware of the bag type and weight, sitting and studying posture for early prevention of AIS.

Dynamic Characteristics of an Adolescent Idiopathic Scoliotic Spine / 医用生物力学

Objective To establish the three-dimensional (3D) finite element (FE) model of thoracolumbosacral T1-S spine based on the computed tomography (CT) images of patients with scoliosis and study its dynamic characteristics. Methods The established scoliotic model was validated by axial compression and shear loading, and the predicted responses were in good agreement with the experimental data. The modal and harmonic analyses were performed using the ABAQUS software, and during the harmonic analysis, the dynamic response of the model was collected at frequencies 5 Hz and 10 Hz. Results From the modal analysis, the first fourth-order modal was extracted. The first- and second-order resonant frequencies of the model were 1.097 Hz and 1.384 Hz, respectively, and the vibration mode was longitudinal bending and lateral bending, respectively. The distribution of the second- and third-order modal resonant frequencies were 5.688 Hz and 28.090 Hz, and the vibration mode was vertical vibration and twisting around the long axis, respectively. The peak amplitude in the harmonic analysis appeared near the modal frequencies, and the average amplitude of vertebral body of the lateral convex segment was larger than that of other segments of the scoliotic spine. Under the vibration frequencies of 5 Hz and 10 Hz, the stress inhomogeneously concentrated on the concave and convex sides of the segments of the vertebral deformity as well as on the intervertebral disc. Conclusions The segments of the spinal deformity in patients with scoliosis were the weak links of their spines and more vulnerable to damage in a vibrating environment. Patients with scoliosis should avoid a vibrating environment, particularly in a sensitive frequency range. The research outcomes provide methodological assistance and mechanical analysis references for the protection, rehabilitation treatment, and clinical pathological studies of patients with scoliosis.

Comparison of Four Scoring Systems in Predicting Risk of Stroke-associated Pneumonia in Patients with Acute Ischemic Stroke / 中国康复理论与实践

@#Objective To compare the performance of Prestroke Independence, Sex, Age, National Institutes of Health Stroke Scale (ISAN) score, Age, Atrial fibrillation, Dysphagia, Sex, Stroke Severity (A2DS2) score, acute ischemic stroke-as-sociated pneumonia score (AIS-APS), and Preventive ANtibacterial THERapy in Acute Ischemic Stroke (PAN-THERIS) score in predicting the risk of stroke-associated pneumonia (SAP). Methods The baseline characteristics and laboratory data of 338 patients with ischemic stroke in emergency ward from April, 2014 to December, 2017 were retrospectively analyzed. Patients were allocated into SAP group (n=125) and non-SAP group (n=213). Receiver operating characteristic curve (ROC) was used to evaluate the predictive effect of four different scoring systems for ischemic SAP. Results Totally, 125 (37.0%) patients developed SAP. There were significant differences in age, complications (atrial fi-brillation, coronary heart disease and history of stroke), Glasgow Coma Scale (GCS) score, National Institute of Health Stroke Scale (NIHSS) score, ISAN score, A2DS2 score, AIS-APS score and PANTHERIS score between two groups (P<0.05). The A value of PANTHERIS score was 0.818, which was the lowest among four scoring systems (P<0.05). No significant difference was found in the A value between A2DS2 score and ISAN score (P>0.05). Conclusion ISAN, A2DS2 and AIS-APS scoring systems all present good discrimination and calibration in predicting the risk of ischemic SAP. The AIS-APS score calculation is relatively complex, so it is suggested that ISAN and A2DS2 scoring systems be used in emergency.

Effects of berberine on serum inflammatory factors and carotid atherosclerotic plaques in patients with acute cerebral ischemic stroke / 中国中药杂志

This study aims to analyze the effect of berberine on serum inflammatory factors and carotid atherosclerotic plaques in ppatients with acute cerebral ischemic stroke(AIS). In the study, 120 patients with AIS were randomly divided into berberine group(n=60) and general group (n=60). The 60 cases in the general group were provided with general therapy according to the latest guidelines of diagnosis and treatment of AIS. The berberine group received berberine 300 mg(tid) in addition to the therapy of the general group. The levels of serum inflammatory factors, the nerve function defect grades and the indexes of carotid atherosclerosis plaques [including the total plaque area(TPA), intima-media thickness(IMT) and the number of unstable carotid atherosclerotic plaques] were measured and compared. The results indicated that the levels of serum inflammatory factors, the NIHSS(national institute of health stroke scales) cores and the indexes of carotid atherosclerosis plaques were not significantly different between the berberine groups of general group, with positive correlation between serum inflammatory factors and NIHSS scores(P<0.05). The levels of serum inflammatory factors and NIHSS scores of the berberine groups on 14 d were significantly lower than those on 1 d(P<0.05). The levels of serum inflammatory factors and NIHSS scores of the berberine group on 14 d were significantly lower than those of the general group(P<0.05). The TPA and the number of unstable carotid atherosclerotic plaques of the berberine groups on 90 d were significantly lower than those of general group, with significant differences(P<0.05). The IMT showed a downward trend, but with significant difference.The mRS(modified rankin scale) scores of the berberine group on 90 d were significantly lower, with a higher rate of short-term favorable prognosis (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups. This study showed that berberine in addition to the general therapy can significantly lower the levels of serum MIF and IL-6, reduce the degree of carotid atherosclerosis to some extent and improve neurological impairment and the prognosis of patients with AIS.

Effects of statin therapy on the outcome of acute ischemic stroke: a meta-analysis / 中华行为医学与脑科学杂志

Objective To analyze quantitatively the safety and efficacy of statin therapy in acute phrase for acute ischemic stroke with the method of meta-analysis.Methods We performed a systematic literature search including the Cochrane Library,MEDLINE and EMBASE for published trials about statin therapy and the outcomes of acute ischemic stroke.Then we performed a meta-analysis with included studies to investigate the association between statin therapy and clinical outcome and mortality.All of the data were pooled and meta-analyzed by Cochrane Collaboration RevMan 5.3 meta-analysis software.Statistical heterogeneity between studies was evaluated by the chi-square and I-square tests.Forest plots were used to summarize study data and Egger tests were used to assess publication bias.Results A total of 27 studies including 52 034 patients,comprising 19 212 statin users and 32 822 non-statin users met the inclusion criteria,4 studies were randomized controlled trials (RCTs),and 23 were observational trials (OTs).Both pre-or post-stroke statin use was associated with reduced mortality.Statin use is associated with favorable functional outcome at hospital discharge and on the ninetieth day regardless of initiation time for pre-stroke group and post-stroke group.The results from observational trials were consistent with randomized controlled trials.There was no evidence of publication bias for all comparisons by Egger tests.Conclusions Statin therapy before or after AIS is safe and effective.

Hypnotic suggestion combined with Guqin music in the treatment of primary insomnia-a 8-week randomized controlled trial / 国际中医中药杂志

Objective To investigate the therapeutic effect and the improvement of sleep quality in applying Hypnotic Suggestion with combination of traditional Chinese culture,Guqin music,for patients with primary insomnia in Hong Kong area.Methods According to the characteristics of speaking language in Hong Kong,Cantonese Hypnotic Suggestion combined with Guqin background music was induced to the patients as the psychological treatment.87 cases of compliance (DSM-Ⅳ) diagnostic criteria for primary insomnia and screened successfully into 3 groups to enter an 8-week intervention in random.Therapeutic effects were assessed on the 0th,4th and 8th at clinics to evaluate efficacy and safety.Patients were assigned in random into the hypnotic suggestion group,the hypnotic suggestion with Guqin music group and the control group for listening of intervention respectively.Athens insomnia scale (AIS),Self-reporting Inventory (SCL-90) and Heart Rate Variability (HRV) were used as the therapeutic indexes.Safety evaluation included change in vital signs,and medical examination before and after treatment.Results Hypnotic suggestion group had lower AIS scores,AIS total (8.70± 4.50),(7.20± 4.40) and the hypnotic suggestion with Guqin music group had lower AIS scores,AIS total (7.30±3.30),(6.80±2.60) were also significantly lowered than the c ontrol group [AIS total (10.30±5.10),(9.80± 5.00) after four-week and eight-week intervention (P＜ 0.05).The hypnotic suggestion group,indicated a decline in terror of SCL-90 scores,SCL-90 total (-0.20±0.60),(0.00±0.60) and the hypnotic suggestion with Guqin music group also indicated a decline in terror of SCL-90 scores,SCL-90 total (-0.20±0.50),(-0.20±0.50) when comparing to the control group,SCL-90 total (0.00±0.20),(0.10±0.30).After four-week and eight-week intervention (P＜0.05).Percentage Very Low Frequency (VLFper),Percentage High Frequency (HFper) and LF/HF indicated an improvement on average (P＜0.05).Conclusion Hypnotic suggestion and combination of hypnotic suggestion with Guqin music in the treatment of primary insomnia,both improve the patient's symptoms such as insomnia and alleviate their terrorpsychological disorders,and can help some insomnia to stop using sleeping pills.

Characteristics and prognostic analysis of 193 patients with special type of lung adenocarcinoma / 中国肿瘤临床

Objective: This work aimed to investigate the negative prognostic factors of bronchioloalveolar carcinoma (BAC) and adenocarcinoma with BAC characteristics, based on the 2004 pathological classification by the World Health Organization (WHO), which were further verified with the new pathological classification of lung adenocarcinoma (WHO 2011), to identify crucial factors that determine the prognosis of BAC and adenocarcinoma with BAC features, and to prove the coherence of the two pathological classi-fications in assessing clinical prognosis. Methods: Upon pathological diagnosis, some of the 193 cases of BAC or adenocarcinoma with BAC features were categorized into adenocarcinoma in situ (AIS) or minimally invasive adenocarcinoma (MIA), based on the 2011 WHO classification. Gender, age, tumor size, familial cancer history, smoking history, TNM stage, symptoms, duration of symp-toms, and the choice of treatment were recorded and analyzed for prognosis. The survival rate was calculated by Kaplan-Meier method. Log-rank test was introduced to compare the survival rate. Univariate and multivariate factors for the survival rate were analyzed by Cox proportional hazards regression model. Results:The overall 1-, 3-and 5-year survival rates were 84.3%, 60.6%, and 45.6%, respec-tively. Cox univariate analysis revealed that the tumor size, symptoms, TNM stage, pathological outcomes, and the choice of treatment were all prognostic factors. Cox multivariate analysis revealed that TNM stage was an independent prognostic factor for patients with BAC. Data from patients with AIS and MIA revealed better survival. Conclusion:The overall survival rate of BAC and adenocarcino-ma with BAC features are superior to that of other non-small cell lung cancer (NSCLC). The clinical symptoms are non-specific com-pared with other types of NSCLC. Clinical stage at diagnosis is a key prognostic factor, such that early correct diagnosis significantly improves survival. The new classification criteria of WHO, released in 2011, is more elaborate and more conducive to clinical practice.

The efficacy and mechanism of Chinese Guqin music intervention for patients with primary insomnia / 国际中医中药杂志

Objective To investigate the efficacy and mechanism of Chinese Guqin music intervention for primary insomnia' s patients.Methods Sixty cases of primary insomnia syndrome patients were randomly divided into two groups.For a total of 8 weeks,a daily intervention of bedtime listening to Guqin music for 30 minutes was applied to 30 patients in the experimental group,while the control group simply rested without any intervention.Psycho-physiological indicators were recorded in the 0th,4th and 8th week.The AIS and SCL-90 were used to assess the patients in the 0th,2nd,4th,and 8th week.Results After four-week intervention,the (VLFper) of HRV had more decrease in the Guqin group than in the control group (P＜0.05).The Guqin group had significantly lower AIS scores,AIS total (8.00±3.90)than the control group.AIS total was (10.30±5.10),after four-week intervention (P＜0.05).Besides,the AIS scores of the Guqin group AIS total (6.40 ± 4.50) were also significantly lowered than the control group [AIS total(9.80± 5.00)after eight-week intervention (P ＜ 0.05)].Meanwhile,after eight-week intervention,the decrease of “obsessive-compulsive symptoms” in SCL-90 had significant difference between the Guqin group (-0.40± 0.50) and the control group (-0.10±0.30,P＜0.05).Besides the significant difference between the Guqin group(-0.10±0.30) and the control group(0.10±0.30)also showed in the decrease of “phobic anxiety” in SCL-90 (P＜0.05).Conclusion Guqin music can relieve psycho-physiological symptoms for patients of insomnia.It is an effective intervention for the creation of “Mind-Body” harmony; it facilitates psychological rehabilitation.

Specific Sagittal Curve Patterns of Cervical Spine in Adolescent Idiopathic Scoliosis (AIS)

STUDY DESIGN: A retrospective study. OBJECTIVES: To evaluate the sagittal alignment of cervical spine in AIS. SUMMARY OF LITERATURE REVIEW: Little has been known about the sagittal curve patterns of cervical spine in AIS patients. MATERIALS AND METHODS: One-hundred-thirty-three AIS patients were checked by scanographs and followed up for more than 2 years were divided into cervical kyphosis (> or =+5degrees), lordosis (< or =-5degrees) and straight (-4degrees~+4degrees) groups according to the sagittal curves of cervical spine (C2~C7). Each group was evaluated for thoracic kyphosis, lumbar lordosis, sagittal balance and Cobb's angle on coronal plane. Of the patients, 49 were treated by braces, 84 were surgically corrected (rod derotation in 52, direct vertebral rotation (DVR) in 32). RESULTS: At the initial radiographs, cervical kyphosis was found in 97, lordosis in 23 and straight in 13 patients. In the kyphosis group, cervical kyphosis showed typical patterns of angular kyphosis. Thoracic and upper T-kyphosis (T1~T5) were lower than those in the cervical lordosis group (p=0.000, 0.001, respectively.) Other factors showed no significant differences between the groups. Patients treated by conservative management or by rod derotation had no significant differences in cervical kyphosis during the follow-up periods, though the thoracic hypokyphosis was surgically corrected. On the contrary, patients who were treated by DVR restored cervical lordosis (14/32=43.8%) from initial state showed significant differences in both conservative and rod derotation groups (p=0.008, 0.002, respectively). CONCLUSIONS: Cervical kyphosis in AIS was a compensatory curve correlated with both thoracic hypokyphosis and rotational deformity. Rotational corrections should be considered during the surgical treatment.

Os limbos felizes da não-identidade: tensões e implicações / The happy limbo of non-identity: tensions and implications / El limbo feliz de la no-identidad: tensiones y consecuencias / Les limbes heureux de non-identité: tensions et implications

Esse artigo compõe-se de reflexões a respeito de conceitos, teorias, epistemologias e políticas identitárias. O objetivo é o de tencionar em tais políticas o uso da concepção de identidade, partindo de nossas inserções/implicações acadêmicas, políticas e afetivas. Para tanto, servimo-nos de narrativas e cenas analisadoras que experienciamos em alguns pontos de nossos per-cursos acadêmicos, profissionais e militantes dentro do movimento de lésbicas, gays, bissexuais e transgêneros (LGBT) bem como na luta antimanicomial. Nesses espaços, a concepção de identidade costuma ser usada como possuindo o que se pode denominar de "produtividade polí-tica". Para nós, é importante por em análise o primado da identidade enquanto ferramenta de pensamento, de produção de conhecimento e de luta política. Quando essa palavra é utilizada, quais enunciados a fazem possível? Quando se opera com o conceito de identidade, ou mesmo o de identificação, quais limites se impõem, quais engessamentos, quais capturas se produzem? Perguntamo-nos se as identidades culturais/sexuais/raciais fazem mesmo frente à globalização e homogeneização dos territórios existenciais e culturais ou se as ondas de reivindicação identitária das chamadas "minorias" seriam uma resposta mal colocada, apostando que é a própria referência identitária que deveria ser discutida/problematizada. Tentamos esboçar caminhos para uma nova política: assinalamos com que política queremos compor e apontamos a política de que queremos diferir...

This article consists of reflections about concepts, theories, epistemologies and identity politics. The goal is to discuss how the concept of identity is being used in such polices, from our inser-tions/implications academic, political and affective. For that, we used narratives and scenes ana-lyzers that we have experienced in some areas of our academic, professional and militant action within the lesbian, gay, bisexual and transgender movement (LGBT), as well as in the antima-nicomial movement. In these spaces, the concept of identity is often used as having what can be called a "political productivity". For us, it is important to analyze the primacy of identity as an in-strument for thinking, production of knowledge and political struggle. When this word is used, which enunciations make it possible? When one operates with the concept of identity, or even of identification, which limits are imposed, which rigidities and which capture of senses occur? We wonder if the cultural/sexual/racial identities do really face the globalization and the homogeniza-tion of the cultural and existential territories, or if the waves of identity claims of the so called "minorities" would be poorly placed as a response, indicating that is exactly the identity reference that should be discussed...

Este trabajo consiste en reflexiones sobre conceptos, teorías, la epistemología y la política de la identidad. El objetivo es poner en duda el concepto de la identidad de estas políticas, partir de nuestras inserciones y las implicaciones académicas, políticas y afectivas. Para ello, utilizamos las narraciones y escenas de los analizadores que se han experimentado en algunas partes de nuestros cursos académicos, profesionales y activistas dentro del movimiento de lesbianas, gays, bisexuales y transgénero (LGBT), así como en la lucha anti-asilos. En estos espacios, el concepto de identidad se utiliza a menudo como poseedor de lo que podríamos llamar "política de la productividad". Para nosotros, es importante para el análisis en la primacía de la identidad como una herramienta de producción de conocimiento pensamiento, y la lucha política. i Cuando se usa esta palabra, que se creó para que esto sea posible? iCuando se opera con el concepto de identidad o de identificación, incluso, que se imponen límites, que capturas se producen? Nos preguntamos si las identidades culturales o sexuales / raciales que aun frente a la globalización y la homogeneización de los territorios culturales y existenciales o las olas de las reivindicaciones de identidad de las llamadas "minorías" sería una respuesta fuera de lugar, está apostando a que la referencia de identidad debe se discutirá / tela de juicio...

Ce document se compose de réflexions sur les concepts, théories, l'épistémologie et la politique identitaire. L'objectif est de contester l'utilisation de la conception de l'identité par ces politiques à partir de nos inserts et implications académique, politique et affectif. Pour ce faire, nous servir avec des histoires et des scènes analyseurs ont connu dans certaines parties de nos voyages, des universitaires et des militants professionnels au sein du mouvement pour les lesbiennes, gays, bisexuels et transgenres (LGBT), ainsi que des anti-asiles. Dans ces espaces, la notion d'identité est souvent utilisé comme possédant ce qu'on pourrait appeler ®la politique de la productivité¼. Pour nous, il est important pour l'analyse de la primauté de l'identité comme un outil de production de connaissances pensée, et la lutte politique. Quand ce mot est utilisé, qui visait à rendre cela possible? Lorsque vous travaillezavec la notion d'identité, ou même d'identification, quels sont les limites imposées, quelles plâtreries, quelles les captures sont produites? Nous nous demandons si les identités culturelles ou sexuelles / raciale de même le visage de la mondialisation et l'homogénéisation des territoires culturels et existentiels ou des vagues pour revendiquer une identité des minorités serait une réponse mal placée, fait le pari que la référence identitaire très qui devrait être discutée / problématique. Nous avons essayé d'exposer les moyens d'une nouvelle politique: nous l'avons souligné que l'écriture politique et a souligné la politique que nous différons...

Partial Androgen Insensitivity Syndrome.

Androgen insensitivity syndrome (AIS) present at several differentiation from genetic defects to end organ resistance thereby producing gender dilema dispelled by sex hormones signature.It is quite traumatic for the patients and family of the affected baby. Extreme sensitivity and awareness on the part of the caring doctor is necessary for early diagnosis of case of AIS &for successful outcome.

Androgen insensitivity / Philippine Journal of Obstetrics and Gynecology

Intersex is a general term used for a variety of conditions in which a person is born with a reproductive or sexual anatomy that doesn't fit the typical definitions of male or female. Androgen Insensitivity Syndrome (AIS), formerly known as testicular ferminization, is one that falls into this category. AIS is an X-linked recessive condition resulting in a failure of normal masculinization of the external genitalia in chromosomally male individuals. This paper presents the first recorded case of Androgen Insensitivity Syndrome in our institution in a phenotypically female patient with primary amenorrhea, physical examination findings of inguinal mass, full breast development, blind ending vagina, scanty pubic hair, absent uterus, absent ovaries, absent axillary hair and an XY karyotype. This paper also aims to discuss steps in the diagnosis and management of the condition, its legal impacts and the importance of psychological counseling for patients.

Effect of Alcohol Ingestion on the Severity and Outcome in Trauma Patients

PURPOSE: Although alcohol is frequently present in injury patients, whether it exacerbates injury and whether tolerance to alcohol changes such a relationship is less clear. We investigated alcohol's role in injury and the effect of alcohol on the severity of injury. METHODS: This prospective study was performed from July 20, 2004, to October 20, 2004, at five university hospital emergency departments (ED). We studied trauma patients, excluding pediatric patients (15 year old and under), alcohol consumption over the 6 hours prior to visiting the ED and continuous drinking after injury. Patients were screened by blood tests for the presence of alcohol and were classified into two groups by alcohol consumption. The injury severity was measured by using the Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS). RESULTS: The study enrolled 361 injured patients, of whom 105 were intoxicated and 256 were not intoxicated. Alcohol consumption was significantly larger in males than in females and in cases involving violence. The injury severities were not correlated with alcohol consumption significantly between intoxicated patients and not intoxicated patients. were not significantly different. However, the number of days in the intensive care unit and the mortality correlated with alcohol consumption. In patients with severe injuries (ISS> or =15, AIS> or =3), alcohol consumption was correlated with severity of the injury. CONCLUSION: Alcohol intoxication is not associated with injury severity. But in patients with severe injuries (ISS> or =15, head AIS> or =3), alcohol consumption was correlated with injury severity.

Comparison of spontaneous correction in thoracic curves after selective anterior versus posterior fusion in Lenke5 adolescent idiopathic scoliosis / 中国矫形外科杂志

[Objective]To compare spontaneous correction of the unfused thoracic curves after selective anterior versus posterior fusion in Lenke5 adolescent idiopathic scoliosis(AIS). [Method]A total of 72 Lenke5 AIS patients were rescruited from May 1997 to October 2005.Out of them,40 received selective anterior fusion(group A) and 32 received selective posterior fusion(group B).All had a minimum of 2-year follow-up.[Result] No complication were found in both groups at the latest follow-up.The thoracic curve was corrected from 30? to 16? for group A,33? to 18? for group B.Both groups had a better spontaneous correction of the unfused thoracic curves.The correction rate had no significant difference between groups.However,the thoracic curve was increased in four patients(2 in each group;group C),which resulted in trunk imbalance.The thoracolumbar/lumbar thoracic(TL/L:T) Cobb's ratio averaged 1.09 in the four patients whereas 1.59 in other 68 patients(group D).The flexibility of the thoracic curve had significant difference in group C and D(34.2% vs 57.3%).[Conclusion]Both of the surgical treatments can get a better spontaneous correction of the unfused thoracic curves.It is important to evaluate the.thoracolumbar/lumbar–thoracic(TL/L:T) Cobb's ratio and the flexibility of the thoracic curve before selective fusion.

Comparative analysis of three radiographic way in prediction of correction of adolescent idiopathic scoliosis / 中国矫形外科杂志

[Objective]To evaluate the role of three radiographic ways in patients undergoing spinal three-dimensional correction and fusion for adolescent idiopathic scoliosis.[Method]Sixty-three cases of adolescent idiopathic scoliosis(AIS)with 79 structural curves were studied.Preoperative X-ray of standing,gravity-suspendig traction,supine bending and fulcrum bending were compared with postoperative standing X-ray one week after surgery,Cobbs angle of all X-ray were measured and statistical significance was evaluated.[Result]In structural thoracic group and lumbar group the mean Cobbs angle were 40?and 21?in gravity-suspendig traction X-ray,41?and 23?in supine bending X-ray,35?and 19?in fulcrum bending X-ray,36?and 18?in postoperative standing X-ray respectively.In severe group and moderate group the mean Cobbs angle were 52?and 23?in gravity-suspendig traction X-ray,53?and 24?in supine bending X-ray,47?and 20?in fulcrum bending X-ray,44?and 19?in postoperative standing X-ray respectively.In rigid group and flexible group the mean Cobbs angle were 51?and 22?in gravity-suspendig traction X-ray,52?and 22?in supine bending X-ray,48?and 18?in fulcrum bending X-ray,45?and 17?in postoperative standing X-ray respectively.In anterior approach group and posterior approach group the mean Cobbs angle were 47?and 15?in gravity-suspendig traction X-ray,49?and 16?in supine bending X-ray,43?and 11?in fulcrum bending X-ray,42?and 10?in postoperative standing X-ray respectively.All above Cobbs angle were mean numerical value,the mean follow-up period was 1.5 years(range:1~3 years).[Conclusion]The fulcrum bending X-ray are more predicting of correctability of AIS patients than the gravity-suspendig traction and supine bending X-ray.It can provide reference for chosing anterior or posterior approach and chosing fusion levels.

Madeiras tropicais: análise econômica das principais espécies florestais exportadas

This work analyses Brazilian tropical wood exports for principal forest species, over the period of 1980-98. Tendency models were built to estimate the growth rate and to explain the export performance for each species. The results pointed out that the principal tropical species exported were, in decreasing order, mahogany, jatoba, virola, cedar, angelim, ipe, andiroba, sucupira, tatajuba, cedrorana, assacu, cerejeira, pau-marfim, freijo and jacaranda. Only six species represented 40% of volume and total exported revenue. The species said less known increased their exports from 1991. The exported volume of mahogany, virola, andiroba, sucupira and freijo decreased, on the other hand jatoba, cedar, ipe and cerejeira have increased their share in the international market. About price, all studied species showed a positive tendency along studied period and value relatively low in comparison to the mahogany price..

Este trabalho trata do comportamento das exportações brasileiras de madeiras tropicais por espécie, no período de 1980-98. O desenvolvimento de modelos de tendência foi utilizado para estimar a taxa de crescimento e explicar o comportamento das exportações. As principais espécies tropicais exportadas nesse período foram, em ordem decrescente, mogno, jatobá, virola, cedro, angelim, ipê, andiroba, sucupira, tatajuba, cedrorana, assacu, cerejeira, pau-marfim, freijó e jacarandá. Apenas seis espécies representaram 40% do volume e do valor total exportado. As espécies classificadas como outras aumentaram suas exportações na década de 90. Espécies como mogno, virola, andiroba, sucupira e freijó apresentaram taxas decrescentes, ao passo que jatobá, cedro, ipê e cerejeira expandiram sua participação no mercado internacional de madeiras tropicais. O preço de todas as espécies mostra uma tendência positiva ao longo do período estudado e valores relativamente baixos, quando comparados ao preço do mogno.