Erectile Dysfunction and Premature Ejaculation Comorbidity Diagnosis and Treatment by Integrated Traditional Chinese and Western Medicine Chinese Expert Consensus / 中国实验方剂学杂志

At present，there is a lack of consensus on the diagnosis， treatment and management of erectile dysfunction（ED）/premature ejaculation（PE） comorbidity in China. To develop a clinical diagnosis and treatment strategy for ED/PE comorbidity， according to the guidelines for ED/PE comorbidity published in China and abroad in recent years and combined with the clinical practice of many urology and andrology research units in China，the clinical experts organized by the Branch of Sexology of Traditional Chinese Medicine， China Sexology Association formed this consensus through consensus drafting， academic review， expert correspondence interview and full discussion at the review meeting based on the existing evidence-based medical evidence. Based on the clinical experience of doctors，research evidence，patients' wishes and living environment factors，this consensus comprehensively evaluates the diagnosis and treatment norms of ED/PE comorbidity with integrated traditional Chinese and Western medicine，aiming at the diagnosis and treatment orientation and value of integrated traditional Chinese and Western medicine，so as to benefit the whole process management of more patients. Traditional Chinese medicine diagnosis pays attention to the collection of four diagnostic information of inspection， auscultation， inquiry and palpation， and carries out pattern differentiation of six meridians， pattern differentiation of Wei-defence， Qi， Ying nutrients and blood， and pattern differentiation of zang-fu organs as described in the Shanghanlun （《伤寒论》）. Based on the synergy of traditional Chinese and Western medicine， the advantages of the overall regulation of traditional Chinese medicine are brought into play， and the individualized treatment of integrated traditional Chinese and Western medicine is implemented. Internal treatment of traditional Chinese medicine is based on the pattern differentiation of yin and yang described in Section Ⅱ， Chapter Ⅳ Syndrome Differentiation of Surgical Diseases in Surgery of Traditional Chinese Medicine. As stated in Leijing： Yinyanglei （《类经·阴阳类》）， "Human diseases ... must have their roots， either in Yin or in Yang. Although there are many pathological changes， their roots are one." Huangdineijing：Suwen： Yinyangyingxiangdalun（《黄帝内经·素问·阴阳应象大论》） states that "Those who are good at diagnosis should look at the color and pulse， and differentiate Yin and Yang syndromes first." This consensus describes the yang and yin syndromes according to the principle that "Yin and Yang syndromes differentiation should be the priority in the pattern differentiation by the eight principles." In addition， for the syndromes of ED/PE comorbidity， based on the same treatment of different diseases， Chaihu Guizhitang， Wenjingtang and Buzhong Yiqitang are used， which can be referred to.

A STUDY ON INTERNET AWARENESS, INTERNET ATTITUDE AND INTERNET BROWSING BEHAVIOUR AMONG B.ED., TRAINEES IN THANJAVUR DISTRICT.

The main objective of the study is to find the Internet awareness, Internet attitude, Internet browsing behavior among the B.Ed., Trainees in thanjavur district with their different dimensions of Age, Gender, Major subject ,Qualification ,Type of college, Gender of college ,Locality of college and Internet usage time. To analyse Internet awareness, Internet attitude, Internet browsing behavior among the B.Ed., Trainees by collecting the data from thanjavur district B.Ed., college students. For this investigation, a questionnaire developed the scholar to seek the information from the student teachers. we took 300 samples to investigate and the result shows there is no significant difference in the Internet awareness of the B.Ed., trainees and in all dimensions with respect to the variables. The study also showed a significance difference in men and women student teacher related to the Internet attitude. The Internet browsing behavior have significant influence on the B.Ed., trainees in thanjavur district.

A RARE CASE REPORT OF GLOMUS TUMOUR OVER MARGIN OF LOWER LID OF LEFT EYE

Introduction: Glomus tumours are rare, benign tumours of vascular origin, arising from the glomus body. Glomus tumours are neoplasms of mesenchyme derived from glomus bodies. Glomus tumours present as a purple or pink vascular lesion that can be confused with a vascular neoplasm such as hemangioma. In this case we are reporting a rare presentation of glomus tumour over lower lid. A 10 year old female child presented with lesion over left lower Case Report: lid since 3 months which was painless and progressive. On examination a 0.3x0.3 cm subcutaneous pink non encapsulated mass is seen over medial canthus of left eye. Mass was excised and subjected to histopathological examination which confirmed the diagnosis of glomus cell tumour(glomangioma). Postoperative period was uneventful with no recurrence for last 6months. Conclusion: All excised eyelid lesions should undergo detailed Histopathological evaluation and glomus tumour should be considered as one of the differential diagnosis in patients presenting with eyelid mass

Study of erectile dysfunction in patients of type 2 diabetes mellitus and its association with cardiovascular risk

Background: Diabetes is a chronic metabolic disorder that is characterized by high level of blood glucose levels, which over a period of time can lead to micro-vascular or macro-vascular complications. Erectile dysfunction (ED) is common not much discussed and distressing complication of diabetes. ED in type 2 may be independent marker of coronary artery disease (CAD).Aim and objectives were to assess the ED in subject of type 2 diabetes mellitus (DM). Assessment of correlation of ED with CAD. Methods: The present cross-sectional study consisted total 180 diabetic patients. On basis of international index of erectile function (IIEF) questionnaire EDpatients were assessed.Result: Out of180 diabetic patients 36.11% had varying degree of ED. Out of 65 EDpatients, maximum frequency of moderate ED (47.69%) was found then severe ED (32.30%), mild to moderate ED (12.30%) and mild ED (7.69%). Most of the patients were in the age group of 40-50 years35 (53.84%), 50-60 years22(33.4%), <40 years(9.23%) and 60-70 years 2 (3.07%) showed ED. Fasting blood sugar and postprandial blood sugar showed significant (p<0.05) relation with ED. HbA1c show an insignificant correlation (p>0.05) with ED. In patient with ED was having more value of atherosclerotic cardiovascular disease (ASCVD) (9.11±4.84) than patient without ED (8.82±5.72). There was no significant (p>0.05) difference in term of ASCVD risk score in ED patient’s ED and without ED patients.Conclusions: Poor glycemiccontrol was a strongest risk factor for ED.

STUDIES ON THE PROPOGATION OF ELASTIC WAVES IN BOVINE COMPACT BONES AS A FUNCTION OF TEMPERATURE

To study the physical properties of biomaterials like bony hard tissues through the propagation of elastic waves is one of the most successful method.With the help of internal friction measurement, we can study the processes such as recrystallization, annealing, quenching and tempering, plastic deformation and strain ageing. In the present investigation we calculate and -1 reported the internal friction loss (Q ) for all the six types of bovine compact bones for the first time in a single experiment by using the ultrasonic piezoelectric composite oscillator technique with the help of X-cut crystal in different physiological conditions. Significant variation is observed from bone to bone. This may be attributed to composition and mineral content of the bones. Peak temperature data also is also determined. Temperature variation of logarithmic decrement in X-cut quartz transducer is also verified with mounting of bovine compact bar shaped bone -1 samples. Change of internal friction (Q ) with temperature is also calculated to predict the mechanism of acoustic losses and phase transitions in these bony hard tissues. Internal friction measurements are also useful to obtain the information about imperfections in bony hard tissues. The present investigation constitutes a step towards the application of natural bovine bone ceramic materials for the transducer applications

Systematic mutational analysis of epitope-grafted ED3 immunogenicity reveals a DENV3-DENV4 bi-serospecific ED3 mutant

Objective: To identify the residue determinants of the serospecificity and sero-cross-reactivity of dengue virus (DENV) envelope protein domain 3 (ED3), which contains two major putative epitopes of DENV. Methods: We constructed ED3 from DENV3 (3ED3) and DENV4 (4ED3), and six epitope-grafted variants, where we transferred epitope 1 (L304I, K305D, V309M, and S310A) and/or epitope 2 (D383N, K384S, K387T, and N389H) of 4ED3 onto 3ED3 and vice-versa. Swiss albino mice aged 3-4 weeks were immunized against wildtype and epitope-grafted ED3 variants and anti-ED3 IgG antibody responses were determined using ELISA. Results: Mouse immunization using 3ED3 and 4ED3 generated serotype-specific antisera, as expected. Similarly, most epitopegrafted ED3s produced antisera serospecific to the template ED3 with little or no cross-recognition of ED3 of the serotype from which the epitopes were taken. These indicated that a mere grafting of the epitope was not sufficient to transfer serospecificity, contrary to our expectations. However, one epitope-grafted ED3 mutant, where epitope 1 of 3ED3 was grafted onto 4ED3 (4ED3epi1), generated antisera that was serospecific to both 4ED3 and 3ED3. Conclusions: The 4ED3epi1 is a chimeric ED3 that produces antisera possessing serospecificity to both 3ED3 and 4ED3 onto a common 4ED3 scaffold. The 4ED3epi1, therefore, provides a unique tool for analyzing serospecificity and sero-cross-reactivity in dengue. We believe that chimeric ED3 may provide a template for future recombinant ED3 possessing serospecificity of multiple DENVs onto a single scaffold and may pave a way developing tri-and/or tetravalent anti-DENV antisera.

O que é bem-estar subjetivo? análise crítica do artigo subjective well-being de ed diener / ¿qué es el bienestar subjetivo? análisis crítico del artículo subjective well-being, de ed diener / What is subjective well-being? a critical analysis of the article subjective well-being, by ed diener

Resumo: O artigo de Ed Diener "Bem-Estar Subjetivo", fundamental para a consolidação desse objeto na Psicologia Positiva, foi analisado criticamente em sua consistência interna e em sua influência para essa nova área. Cada bloco textual do artigo foi avaliado quanto a sua fragilidade segundo três categorias: consideração teórico-filosófica, definição do conceito e suas partes, referências bibliográficas. Como resultado, destacamos que Bem-Estar Subjetivo (BES) e Felicidade são fragilmente definidos no artigo, dando margem a ambíguas interpretações que se prolongam até o presente; importantes perguntas, como a diferença entre a melhor vida e a vida boa, são ignoradas; importantes referências bibliográficas são utilizadas inconsistentemente. Todavia, reconhece-se que as fragilidades identificadas no artigo são coerentes com o projeto da Psicologia Positiva: enfatizar aquilo que é mensurável ao custo do rigor. Recomenda-se que pesquisas sobre BES resgatem a história dos conceitos centrais a fim de reconhecer seus próprios limites e solucionar problemas éticos do campo.

Resumen: El artículo de Ed Diener "Bienestar Subjetivo", fundamental para la consolidación de este objeto en la Psicología Positiva, fue analizado críticamente en cuanto a su consistencia interna y su influencia en esta nueva área. Cada bloque textual del artículo fue evaluado por su fragilidad según tres categorías: consideración teórico-filosófica, definición del concepto y sus partes, referencias bibliográficas. Como resultado, destacamos que el Bienestar Subjetivo (BES) y la Felicidad están débilmente definidos en el artículo de Diener, dando lugar a interpretaciones ambiguas que continúan hasta el presente; se ignoran cuestiones importantes, como la diferencia entre la mejor vida y la buena vida; las referencias bibliográficas importantes se usan de manera inconsistente. Sin embargo, se reconoce que las debilidades identificadas en el artículo de Diener son consistentes con el proyecto de Psicología Positiva: enfatizar lo medible a costa del rigor. Se recomienda que la investigación sobre BES recupere la historia de los conceptos centrales para reconocer sus propios límites y resolver problemas éticos en el campo.

Abstract: Ed Diener's article "Subjective Well-Being", fundamental for the consolidation of this objetcin Positive Psychology, was critically analyzed in terms of its internal consistency and its influence on research in this new area. Each textual block of the article was evaluated for its fragility according to three categories: theoretical-philosophical consideration, concept's definition and its parts, bibliographic references. As a result, we emphasize that Subjective Well-Being (SWB) and Happiness are weakly defined in Diener's paper, giving rise to ambiguous interpretations; important questions, such as the difference between the best life and the good life, are ignored; important bibliographical references are used inconsistently or not presented during central argumentation. However, we recognize that the weaknesses identified in the article are consistent with the Positive Psychology project: to emphasize what is measurable at the cost of theoretical rigor. It is recommended that research on Subjective Well-Being recover the history of its central concepts in order to recognize their own limits and solve ethical problems in the field.

Studies on resistance of Schistosoma to praziquantel XVIII Sensitivity to praziquantel in filial generations of praziquantel-resistant and -sensitive Schistosoma japonicum mixed infections / 中国血吸虫病防治杂志

Objective To investigate the sensitivity of adult worms of filial generations from praziquantel-resistant and -sensitive Schistosoma japonicum mixed infections to praziquantel. Methods Mice were infected with the cercariae of an experimentally generated praziquantel-resistant S. japonicum isolate [median effective dose (ED50) = 277.4 mg/kg] and a laboratory-maintained praziquantel-sensitive S. japonicum isolate (ED50 = 99.6 mg/kg) at a mixture ratio of 1:1 and 2:1, which was maintained in the laboratory via the mouse-snail cycle for 8 generations. Then, mice were infected with the cercariae of the 8th filial-generation parasite, and grouped 35 days post-infection. Mice in the 5 treatment groups were given praziquantel treatment by gavage at a single oral dose of 37.5, 75, 150, 300 mg/kg and 600 mg/kg, while animals in the control group was administered orally with 2.5% cremophor EL. All mice were sacrificed 14 days post-treatment and adult worms were collected by perfusion of the portal vein. The worm burden reductions and praziquantel ED50 values were calculated. The praziquantel-resistant S. japonicum isolate generated from experimental induction with 12 rounds of praziquantel treatment with sub-curative doses was maintained in the laboratory via the mouse-snail cycle, and mice were infected with the cercariae of the 8th filial-generation parasite. The praziquantel ED50 value against the 8th filial-generation adults was measured. Results After mice were infected with the mixture of cercariae of PZQ-resistant and -sensitive S. japonicum isolates at a ratio of 1:1, the praziquantel ED50 was 135.2 mg/kg against the adults of the 8th filial-generation parasite. After mice were infected with the mixture of cercariae of PZQ-resistant and -sensitive S. japonicum isolates at a ratio of 2:1, the praziquantel ED50 was 129.2 mg/kg against the adults of the 8th filial-generation parasite. In addition, the praziquantel ED50 was 208.4 mg/kg against the adults of the 8th filial-generation S. japonicum without the selection pressure of praziquantel. Conclusions Compared with the experimentally induced praziquantel-resistant S. japonicum isolate, the adult worms of the filial-generation S. japonicum show a reduced sensitivity to praziquantel in the same host following infection with the mixture of cercariae of praziquantel-resistant and -sensitive S. japonicum isolates. The adult worms of the filial generation of the praziquantel-resistant S. japonicum isolate without the selection pressure of praziquantel may still maintain the resistance to praziquantel.

Detección de problemas alimentarios y su relación con hábitos alimentarios en adolescentes / Detection of eating problems and their relationship with eating habits in adolescents

Resumen El propósito de este trabajo fue hacer la detección de probables casos de trastornos de la conducta alimentaria (TCA) en adolescentes, así como analizar su relación con los hábitos alimentarios (HA) dentro del contexto escolar. Participaron 3,144 alumnos/as (49.7% chicas y 50.3% chicos), con edades entre 13 y 17 años (M = 14.41, DE = 0.79). Fueron registradas distintas variables: sociodemográficas, índice de masa corporal (IMC) e ingesta alimentaria, además de aplicar el Cuestionario de Actitudes Alimentarias (EAT-40) y el Cuestionario de Imagen Corporal (BSQ). Se identificaron diferencias significativas en EAT-40 y BSQ, con una mayor proporción de chicas vs. chicos que superaron el punto de corte. Respecto al IMC, aunque la mayoría estaba en normopeso, el 17.6% tuvo infrapeso, 20.4% sobrepeso y 7.1% obesidad. El 5.6% de todos los participantes fueron identificados como probables casos de TCA, con una mayor proporción de mujeres (9.6%) que de hombres (1.8%). No hubo correlación con los HA, pero sí mayor proporción de chicas que consumían menos alimentos y bebidas durante el desayuno y el recreo. Un dato alarmante es que 5.6% de las chicas y 2.5% de los chicos no consumían nada durante toda la mañana escolar.

Abstract A study of detection of probable cases of eating disorders (ED) in teenagers, studying their possible relationship with their dietary habits (DH) in the school context has been carried out. The participants were 3,144 students (49.7 % girls and 50.3 % boys) aged between 13 and 17 years old (M = 14.41, SD = 0.79). Different variables were recorded: sociodemographic, body mass index (BMI) and dietary intake, in addition to applying the Eating Attitudes Questionnaire (EAT-40) and the Body Shape Questionnaire (BSQ). Significant differences were identified in EAT-40 and BSQ, with a greater proportion of girls vs. boys exceeding the cut-off point. Regarding the BMI, although most were in normal weight, the 17.6% were underweight, 20.4% overweight and 7.1% obese. Based on all the data, 5.6% of all participants were identified as probable cases of ED, with a higher proportion of women (9.6%) that men (1.8%). There was no correlation with DH, but there were a higher proportion of girls who consumed less food and beverages during breakfast and recess. An alarming fact is that 5.6% of girls and 2.5% of boys did not consume anything during the whole school time.

Genetic authentication of Eclipta prostrate (Asteraceae) from Penthorum chinense (Penthoraceae) by Sequence Characterized Amplified Region (SCAR) markers

Introduction: For the rapid and accurate genetic identification and authentication of living organisms, improved random amplified polymorphic DNA (RAPD) fragment based development of sequence-characterized amplified region (SCAR) markers is an important genetic technique. Objective: This study aimed to develop SCAR markers for perennial herb Eclipta prostrate (E. prostrate). Methods: Here the RAPD fragments by improved RAPD amplification with primers A11 and N-7 for E. prostrate were cloned into pGEX-T vector, and PCR amplification identified the positive clones. After the enzymatic digestion, they were sequenced with Sanger sequencing. Results: Two SCAR markers were developed, which were very specific to E. prostrate, not found in Penthorum chinense Pursh(P. chinense). The nucleotide sequence search by BLAST GenBank database showed that they are novel in E. prostrate, therefore they were deposited in Genbank with accession number KX671034, KX671035. The markers did not show any identity to other species. Conclusions: Thus, in this study two specific SCAR markers were developed for genetically distinguishing and identifying the plant species E. prostrate from herb P. chinense and others.

Introducción: Verificación genética del arbusto Eclipta prostrate (Asteraceae) (Para la identificación y verificación genética rápida y precisa de organismos vivos, el uso de fragmentos de ADN polimórfico amplificado aleatoriamente (RAPD) mejorado de marcadores de región amplificada caracterizada por secuencia (SCAR) es una técnica genética importante. Objetivo: Este estudio tuvo como objetivo desarrollar marcadores SCAR para la hierba perenne Eclipta postrate (E. postrate). Métodos: En este estudio os fragmentos RAPD mediante amplificación RAPD mejorada con los cebadores A11 y N-7 para E. postrate se clonaron en el vector pGEX-T, y la amplificación por PCR identificó los clones positivos. Después de la digestión enzimática, se realizó una secuenciación Sanger. Resultados: Se desarrollaron dos marcadores SCAR, muy específicos para E. postrate, que no se encuentran en Penthorum chinense Pursh (P. chinense). La búsqueda de las secuencias de nucleótidos con BLAST en GenBank mostró que son nuevos en E. postrate, por lo que fueron depositados en Genbank con los números de acceso: KX671034 y KX671035. Los marcadores no mostraron ninguna identidad a otras especies. Conclusiones: En este estudio se desarrollaron dos marcadores SCAR específicos para distinguir e identificar genéticamente la especie de planta E. postrate de la hierba P. chinense y otras.

Phytochemicals and antioxidant activity of alcoholic/hydroalcoholic extract of Trifolium pratense / 中草药·英文版

Objective: Trifolium pratense has many healing properties, including fewer complications of menopause, cancer cell suppression, reducing blood glucose and lipids, as well as cardiovascular beneficial effects. The purpose of this study was to identify the phytochemical and mineral composition of T. pratense. Methods: Plant aerial parts were harvested and dried, and then hydroalcoholic and alcoholic extracts were prepared. Gas chromatography–mass spectrometry (GC–MS) analytical method was used to identify volatile compounds then liquid chromatography-electrospray ionization mass spectrometry (LC-ESI-MS) was used to identify polyphenols and the mineral elements were identify by inductively coupled plasma atomic emission spectrometer/ICP-AES and scanning electron microscope-energy-dispersive X-ray spectroscopy (SEM-EDS) methods. Total phenolic content (TPC) was determined based on colorimetric method, and total flavonoid content (TFC) was established based on the folin-chiocalteau reagent. Furthermore, two assays (DPPH and FRAP) were used to measure the antioxidant capacity of T. pratense ethanolic extract. Results: A total of 37 polyphenols and 107 peaks were identified by LC-ESI-MS analysis, and the GC/MS method also detected 21 volatile compounds, the most important of which were methylcyclopentane, dimethylpentanal and hexadecanol. A total of 18 mineral elements, including K, Mg, Al, Si, Zn, Ni, Cu, Se, Co, Fe, Mn, and Ca in the plant, were identified ICP-AES and SEM-EDS analysis. Conclusion: T. pratense has many therapeutic compounds such as polyphenol (isoflavone and flavonoids), volatile compounds, and essential mineral elements, which can be formulated purely and used in the pharmaceutical and traditional medicine industries.

A study on the role of paediatric assessment triangle, clinical scoring and serum lactate in the management of septic shock in children

Background: There is dearth of studies in India on the management of paediatric septic shock. So it is prudent to do a study on paediatric septic shock management. The objective of the study is to determine the correlation between Paediatric Assessment Triangle and serum lactate levels., to determine the role Paediatric Assessment Triangle in predicting mortality in septic shock and to the determine the role of elevated lactate levels in predicting mortality in septic shock.Methods: Descriptive study of 100 children from 31 days to 12 years of age who are admitted with septic shock in a tertiary care hospital are assessed with paediatric assessment triangle and clinical score and serum lactate was tested along with other standard tests and the children are managed as per the standard protocols. Outcome is analysed.Results: In this study, septic shock children with total clinical score >22 are having statistically significant low levels of diastolic blood pressure and low mean arterial pressure. There was a significant difference in median serum lactate levels between the survivors (28.08 mg/dl) and non-survivors (40.92 mg/dl).Conclusions: Paediatric assessment triangle and clinical scoring based on it more than 22 and serum lactate levels of more than 2mmol/L or 18mg/dl predict the mortality.

Awareness of Saudi Population about the Role of the Emergency Rooms

Background: The hospital Emergency department (ED) is one of the most important components of the health delivery system. Objectives: To investigate the public awareness of the ERs in KSA, what the public knows about the provided services, and if they know the difference between the outpatient clinic and ERs. Methods: It is a cross-sectional descriptive community-based study carried out on 977 male and female, young and adult participants from all age groups, in different areas of the Kingdom of Saudi Arabia, during the period from 1st January to 31st July 2019. Data was collected through filling the pre-designed online questionnaire which guided us to the needed data. We utilized the SPSS program version 16. The X2 test was used as a test of significance, and differences considered significant at p-value less than 0.05. Results: Most of the participants (87.5%) reported that they know the difference between the outpatient clinic and ER. The majority (68.1%) of subjects said that ERs is meaning rapid and unplanned medical care, 17.3% said any needed health care is available there, 12.2% said that it means insufficient medical care and only 2.5% said it means availability of physician at any time for any purpose. As regards evaluation to the provided services in ERs; 32.5% of cases said it was very good followed by 28.5% good, 19.8% excellent, 10.2% accepted and 10% reported it was bad services. There were significant relations between the awareness and age (p=0.03) and education level (p=0.003), but no relation was found with the gender of the participant (p>0.5). Conclusion: In our study, Most of the participants reported that they know the difference between the outpatient clinic and ERs. The majority of subjects said that ERs is meaning rapid and unplanned medical care and/or availability of physician at any time for any purpose. There were significant relations between the awareness and age and education level, but insignificant relation was found with the gender of the participant.

Intubation Performed In The Emergency Department Is Associated With Increased Pulmonary Complications

Ventilator Associated Pneumonia (VAP) is among the most common hospital acquired infections. Trauma patients are known to have a unique predisposition to the development of pneumonia. At our urban level 1 trauma center, we noticed variability in the incidence of aspiration and pneumonia among intubated patients with similar levels of injury severity. In an attempt to discern why, we hypothesized that location of intubation was a risk factor for development of in-hospital complications. We performed a retrospective cohort study over a 6 month period using adult patients admitted to our trauma service. Intubations performed were reported from four different locations: Emergency Department (ED), operating room (OR), intensive care unit (ICU) and the surgical floor. Data obtained included location of intubation, age, Acute Injury Score (AIS), days on a ventilator, incidence of pulmonary infection, incidence of aspiration, intubation difficulty, ICU length of stay (ICU-LOS), hospital length of stay (HLOS), and survival. One way analysis of variance (ANOVA) was then performed. Our study included 96 enrolled patients consisting of 13 women and 83 men with a mean age of 49.5. Patients intubated in the ED, in comparison to patients intubated on the surgical floor, ICU or OR, were noted to have a statically significant increase in ventilator days (10.9 days), ICU length of stay (12.1 days), HLOS (18.8 days). Additionally, incidence of pulmonary infection (63.9%) and incidence of aspiration (37.7%) were noted to be increased with no statistically significant change in survival. In conclusion, trauma patients requiring emergent intubation in the ED are uniquely predisposed towards development of pneumonia and inhospital morbidity. These patients should be aggressively managed with strategies aimed at VAPprevention.

Objective Clinical Pain Assessment By Independent Service Identifies Significant Gaps In Pain Assessment And Control.

Pain is highly subjective. Standardized measurements are necessary to ensure adequate analgesia. Our objective was to examine whether an independent objective clinical assessment differs from existing provider documented assessment of pain levels. We performed a retrospective analysis of randomly selected patients admitted to the trauma service at our Urban level I Trauma Ctr. (448 bed), over the course of 2 months. During this time period an independent team headed by the trauma medical director (AC) performed pain assessments on these patients using an objective numeric scale, (with 0 being no pain and 10 being the worst possible pain) within 1 hour of scheduled assessment by the primary care givers be they ED, Nursing or Physician. Medical records were reviewed for type of injury, objective pain level as documented on nursing, physician, and emergency department (ED) notes, objective pain level as documented by the independent team, and analgesic treatment. A total of 101 patients were included. Types of injury included fall (n= 38), fall with fracture (n=21), motor vehicle collision (n=19), fracture (n=12), assault (n=8), and miscellaneous (n=3). The mean overall pain level as documented by the independent team was 4.35 ± 0.76; 36 patients reported no pain, 7 patients reported mild pain (level 1-3), 17 patients reported moderate pain (level 4-6), 30 patients reported severe pain (level 7- 9), and 11 patients reported experiencing the worst possible pain (level 10). Pain assessment documentation was missing in 36.6 % of emergency department notes (n=37), 31.1 % of nursing notes (n=32) and 64.4% of physician notes (n=65). Mean pain level varied by ED (5.37 0.85), nursing (1.98 ± 0.67) and physician (2.94 ± 0.96) notes. Analgesic treatment was composed of morphine (n=23), Oxycodone/acetaminophen (n=10), Ibuprofen (n=10), acetaminophen (n=9), acetaminophen/codeine (n=2), ketorolac (n=3), or any combination thereof (n=41). Three patients did not receive analgesic medication. The assessment of pain level was absent in over 30 % of all clinical documentation, with physicians being the worst offenders. Despite receiving pain medication 57.4% of patients reported experiencing moderate to excruciating pain on an objective assessment. Further prospective research is necessary to examine the utility of these ndings on a large scale basis. The utilization of independent objective clinical assessment is valuable to ensure appropriate pain management in trauma patients.

Electroencephalograph network connectivity of working memory disorder in frontal lobe epilepsy pa-tients / 中华行为医学与脑科学杂志

Objective To investigate the possible electroencephalograph network connectivity mech-anism of working memory disorder in patients with frontal lobe epilepsy ( FLE). Methods Seventeen adult FLE patients were enrolled as the case group and 22 normal adults were selected as the control group. The behavioral data and 34-channel electroencephalographs were recorded in the working memory behavioral par-adigm. The directed transfer function was used to construct the causal connectivity brain network of theta band of working memory delay period. Two-sample t-test or tˊ-test was used to analyze the differences in be-havioral and frontal causal connectivity between the two groups. Results (1) Compared with control group, working memory behavioral data of FLE group showed significantly lower correct rate ((92. 778±4. 399)%, (96. 258±2. 470)%,tˊ=-2. 925,P<0. 01),and significantly longer reaction time ((978. 586± 65. 161) ms,(798. 671±196. 207)ms,tˊ=4. 023,P<0. 001). (2) Compared with control group,causal connectivity of FLE group showed significantly reduced whole brain ( tˊ=-6. 008, P<0. 001), Fz channel ( tˊ=-7. 703,P<0. 001),frontal region (tˊ=-14. 667,P<0. 001),frontal-temporal interval ( t=-14. 467,P<0. 001),and frontal-central interval (t=-3. 501,P<0. 001). The causal connectivity of frontal-occipital in-terval had no significant difference( t=1. 056,P=0. 281). Conclusions Working memory disorders were found in FLE patients. The abnormal causal connectivity of frontal brain network in theta band may be one of its potential neurophysiological mechanisms.

Body image disturbance in eating disorders: concept and development / 上海交通大学学报（医学版）

Body image disturbance (BID) in eating disorders (ED) has always been a focus of intense investigations and debates since its concept was brought out. Experimental studies conducted in clinical ED patients have not only provided insights into the components, mechanisms and roles of BID in ED psychopathology, but also brought changes to relevant theories and concepts. This article provided a review of theoretical and empirical literatures on BID in ED, as well as a summary and analysis of recent developments and future prospects in this field.

Controlled delivery of ibuprofen from poly(vinyl alcohol)-poly (ethylene glycol) interpenetrating polymeric network hydrogels / 药物分析学报

Hydrogels composed of poly(vinyl alcohol) (PVA) and poly(ethylene glycol) (PEG) were synthesized using glutaraldehyde as crosslinker and investigated for controlled delivery of the common anti-inflammatory drug, ibuprofen (IBF). To regulate the drug delivery, solid inclusion complexes (ICs) of IBF in β–cyclodextrin (β–CD) were prepared and added to the hydrogels. The ICs were prepared by the microwave irradiation method, which is more environmentally benign. The formation of IC was confirmed by various analytical techniques and the synthesized hydrogels were also characterized. Controlled release of drug was achieved from the hydrogels containing the ICs in comparison to the rapid release from hydrogels containing free IBF. The preliminary kinetic analysis emphasized the crucial role of β–CD in the drug release process that in-fluences the polymer relaxation, thereby leading to prolonged release. The cytotoxicity assay validated the hydrogels as non-toxic in nature and hence can be utilized for controlled delivery of IBF.

Trastorno de alimentación: identificación y primeras intervenciones para los profesionales de salud / Eating disorders early identification and management: guidelines for health practitioners

Introducción: los trastornos de la alimentación e ingesta (TAI) son un complejo conjunto interdimensional de enfermedades mentales que afectan el rendimiento corporal, mental y social. El núcleo de la enfermedad es el miedo a ganar peso. Las estrategias de control de ingesta varían entre: restricción, selección y purga alimentaria. Afectan diferentes sexos, razas, etnias y edades. Con mayor frecuencia en adolescentes y mujeres jóvenes (9: 1). Presentan alta mortalidad, comorbilidad mental y conflictos familiares asociados. Método: integrar información disponible y útil según criterio de experto, orientada al manejo clínico de los TAI. Resultado: debido a que los profesionales de salud de diferentes áreas podrían ser el único contacto que el/la paciente busca para aliviar alguna dolencia aparentemente no relacionada con TAI, es necesario lograr identificar y diagnosticar los estadios patológicos e indicar las primeras conductas, así como hacer una referencia exitosa. El retraso en el diagnóstico causa alteraciones severas y crónicas en la fisiología, el comportamiento, la cognición y el funcionamiento psicosocial. Los objetivos de este estudio son: a. Presentar, en forma integrada, la información disponible de modo de facilitar a los profesionales de la salud la detección precoz de los TAI; b. Ofrecer un conjunto de acciones útiles que faciliten el diagnóstico TAI; c. Organizar la comprensión del riesgo TAI en un diagrama que facilite la construcción de la derivación utilizando las dimensiones: cuerpo, mente, relaciones; d. Mostrar las alternativas psicoterapéuticas en uso e. Proveer información para realizar las primeras intervenciones. Conclusión: reconocer tempranamente el cuadro TAI puede detener el curso patológico y los potenciales daños.(AU)

Introduction: eating disorders (ED) are a complex interdimensional set of mental disorders that affect social, bodily and mental performance. The core issue of the illness is the fear of weight gain. Food intake control strategies are displayed among eating restriction,selection and purging foods. ED affect people despite their sex, ethnicity or age often in adolescents and young women (9:1). EDhave been associated with high mortality, mental disorders comorbidity, and family conflicts. Method: to integrate expert selectedrelevant information to improve ED clinical management by health practitioners. Results: because health practitioners from differentareas may be the only contact the patient is looking for to alleviate an ailment apparently not related to ED, it is necessary to identifyand diagnose the pathological stages and indicate the first behaviors, as well as make a successful reference. Diagnosis delay causes severe and chronic alterations in physiology, behavior, cognition and psychosocial functioning. The objectives of this study are: a.To present integrated information about ED I order to facilitate early detection and diagnosis to health practitioners; b. To offer a setof useful actions that facilitate early ED detection; c. To organize the understanding of ED risk in a diagram that facilitates derivationusing the dimensions: body, mind, relationships; d. To show the current psychotherapies e. To provide information to perform the first interventions. Conclusion: early ED recognition can stop the pathological course and potential damage of the disease.(AU)

Financiamento dos três níveis de governo do Brasil: análise da série histórica em 12 anos de evolução / Financing of the three levels of government of Brazil: analysis of the historical series in 12 years of evolution

O estudo avaliou financiamento dos três níveis de governo do Brasil como proposta de promover a saúde pelo Sistema Único de Saúde, com base em uma análise descritiva e espacial dos seguintes indicadores: despesas do SUS com ações e serviços públicos de saúde; razão entre horas semanais de médicos na atenção primária e razão entre internações clínicas de média complexidade sensíveis à atenção primária. Os resultados demonstraram que houve crescimento do gasto real em saúde por habitante/ano, nas três esferas de governo, 2002 e 2014, a esfera federal apresentou-se como a principal financiadora da saúde pública, no período estudado. Observou-se aumento da carga horária semanal de médicos da AP por habitantes em todas as regiões, destacando-se a região norte do país. Para o período analisado, houve redução nas internações hospitalares por 100 mil/hab, embora agravos que produzam hospitalizações necessitam de um período de análise maior para se elucidar melhor os resultados. Objetivou-se no estudo retratar um conjunto de indicadores que refletissem acesso a serviços com financiamento público. A análise aqui apresentada não pretendeu ser conclusiva, mas buscou trazer algumas evidências sobre os meandros da produção das desigualdades sociais e a relação com a política de saúde. (AU)

The study evaluated the evolution financing of the three levels of government of Brazil as a proposal to promote health through the Unified Health System, based on a descriptive and spatial analysis of the following indicators: SUS expenditures with actions and public health services; ratio between weekly hours of primary care physicians and the ratio of medium complexity clinics sensitive to primary care. The results showed that there was a growth in real health expenditure per capita / year, in the three levels of government, in 2002 and 2014, the federal sphere was the main public health fund during the period studied. There was an increase in the weekly workload of PA physicians by inhabitants in all regions, especially in the northern region of the country. For the period analyzed, there was a reduction in hospital admissions per 100,000 / inhab, although hospitalizations require a longer period of analysis to better elucidate the results. The objective of this study was to present a set of indicators reflecting access to publicly funded services. This analysis not intended to be conclusive, but sought to bring some evidence about the intricacies of the production of social inequalities and the relationship with the health policy. (AU)