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Objective: Objective to investigate the health changes of patients with severe trimethyltin chloride (TMT) poisoning in four years. Methods: Six patients with severe TMT poisoning treated in the First Affiliated Hospital of Gannan Medical College in August 2016 were numbered 1, 2, 3, 4, 5 and 6 respectively. The patients were followed up 0.5, 2 and 4 years after poisoning and compared and analyzed. The follow-up contents include: symptom degree, score of simple mental intelligence examination scale (MMSE) and modified Rankin Scale (MRS) , cranial magnetic resonance imaging (MRI) , EEG, etc. Results: The symptoms of dizziness, headache, chest tightness, palpitation, nausea and vomiting decreased gradually in 6 patients. The symptoms of speech disorder and memory decline in No.1, 2 and 3 patients gradually increased, and the scores of MMSE and Mrs gradually decreased; Patients No.4, 5 and 6 had improved speech disorder, but their memory decreased, MMSE and Mrs scores were still flat, and mild cognitive impairment. The brain atrophy of No.1, 2 and 3 patients was aggravated, which showed obvious atrophy of hippocampus, temporal lobe, insular lobe and cerebellum and enlargement of ventricle; There was no significant change in brain atrophy in No.4, 5 and 6 patients. Conclusion: The neurotoxic symptoms in the later stage of severe TMT poisoning are still serious, and the neurotoxic time is long.
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Humanos , Atrofia , Estudios de Seguimiento , Imagen por Resonancia Magnética , Compuestos de TrimetilestañoRESUMEN
Objective:To study the distribution of ischemic stroke treatment with data mining technology and evaluate its clinical efficacy. Method:China National Knowledge Infrastructure Database（CNKI），China Science and Technology Reader's Digest Database（VIP），Wanfang Data，Chinese Biomedical Literature Database（Sino Med）were retrieved from January 1978 to December 2018. The clinical observation and study literatures on the treatment of ischemic stroke with the combination of traditional Chinese medicine and Western medicine were retrieved in the four databases. After standardized and hierarchical collection and processing of all syndromes，treatment methods，prescriptions and other information in the literatures，a database of syndrome elements and treatment of ischemic stroke was established. Syndrome factors and treatment methods were analyzed by scale evaluation and hierarchical classification methods. Kendall's tau-b correlation analysis，principal component analysis and other statistical methods were used to describe the correlation and distribution of syndrome factors and treatment methods of ischemic stroke. Result:The results of heterogeneity analysis showed that the included literatures were homogeneous and could be combined with subsequent statistics. A total of 450 syndromes and treatment methods were included in this study，and 1 287 single syndrome elements and 1 562 single treatment methods were obtained after unified and standardized splitting. Besides the corresponding syndrome elements and treatment methods，phlegm-dampness-invigorating Qi（-0.52） and Qi deficiency-invigorating Qi（-0.56） were also highly correlated. The study team represented the importance of syndrome and treatment elements with class Ⅰ，Ⅱ，Ⅲ from high to low. Qi deficiency，blood stasis and fire heat，phlegm，viscera excess were class Ⅰ syndrome elements；Yin deficiency，endogenous wind were class Ⅱ syndrome elements；Yin deficiency and Yang deficiency were class Ⅲ syndrome elements；Removing phlegm dampness，clearing heat，clearing the hollow viscera and extinguishing wind，promoting blood circulation to remove blood stasis，tonifying Qi were class Ⅰ treatment of ischemic stroke，and removing phlegm dampness，clearing heat，clearing the hollow viscera were more likely to appear simultaneously； and extinguishing wind，activating blood circulation and removing blood stasis，and benefiting Qi were more likely to appear simultaneously. Nourishing Yin and regulating Qi were class Ⅱ therapies of ischemic stroke，which were highly correlated and often appear simultaneously. Inducing resuscitation，tonifying Yang and dredging collaterals were class Ⅲ，Ⅳ，Ⅴ therapies. Conclusion:Qi deficiency，blood stasis，phlegm dampness，fire heat and viscera excess were the main syndromes of ischemic stroke，while Qi deficiency and blood stasis，phlegm heat and viscera excess were the main syndromes. Eliminating phlegm and dampness，clearing heat，clearing the hollow viscera，promoting blood circulation and removing blood stasis，extinguishing wind and benefiting Qi were the main therapies for the treatment of ischemic stroke. In clinical treatment for ischemic stroke，the therapies for relieving phlegm and dampness，clearing heat and relieving organs are often used in combination，and the therapies for promoting blood circulation and removing blood stasis were often used in combination with the therapies for invigorating Qi and extinguishing wind for the synergistic effect.
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Abstract This article deals with the paradox of school inclusion in the basic education evaluation policy of the state of Ceará, a federative unit that stands out among the state education systems of the country in terms of proficiency indicators in basic education, although there is within its system a normative device that deduces from the evaluation calculation the performance of students with disabilities, generating a state of "internal exclusion" to the school system. Based on the debate about evaluation policies as a mechanism of educational management in the national context and on the observation of studies that point to the exclusionary trend of large-scale evaluation in relation to inclusive education, a law provision is addressed that promotes the exclusion of special education from the results of the evaluations of the Permanent Evaluation System of Ceará Basic Education [Sistema Permanente de Avaliação da Educação Básica do Ceará] (Spaece).
Résumé Cet article traite du paradoxe de l'inclusion scolaire dans la politique d'évaluation de l'éducation de base dans l'état du Ceará, au Brésil. Le système d'éducation de cet état se distingue de ceux des autres états du pays par les indicateurs de compétence qu'on y utilise dans l'enseignement primaire, bien qu'il y ait un dispositif normatif déduisant la performance des élèves handicapés du calcul de l'évaluation, provoquant ainsi un état d'"exclusion interne" du système scolaire. À partir du débat sur les politiques d'évaluation comme mécanisme de gestion de l'éducation au Brésil et de recherches reflétant une tendance à l'exclusion des évaluations à grande échelle allant à l'encontre d'une éducation inclusive, ce travail aborde un dispositif de loi favorisant l'exclusion de l'éducation spécialisée des résultats issus des évaluations du Système d'Évaluation Permanente de l'Éducation de Base du Ceará [Sistema Permanente de Avaliação da Educação Básica do Ceará] (Spaece).
Resumen Este artículo aborda la paradoja de la inclusión escolar en la política de evaluación de la educación básica en el estado de Ceará, una unidad federativa que se destaca entre los sistemas educativos del estado en el país en términos de indicadores de competencia en educación primaria, aunque no exista dentro de su sistema un dispositivo normativo que deduzca del cálculo de la evaluación, el rendimiento de los estudiantes discapacitados, generando un estado de "exclusión interna" al sistema escolar. A partir del debate sobre las políticas de evaluación como mecanismo de gestión educativa en el contexto nacional y la observación de estudios que apuntan a la tendencia excluyente de la evaluación a gran escala en relación con la educación inclusiva, se aborda un dispositivo legal que promueve la exclusión de la educación especial de los resultados procedentes de las evaluaciones del Sistema de Permanente de Evaluación de Educación Básica de Ceará (Spaece).
Resumo Este artigo trata do paradoxo da inclusão escolar na política de avaliação da educação básica do estado do Ceará, unidade federativa que se destaca entre os sistemas estaduais de ensino do país em termos de indicadores de proficiência no ensino fundamental, embora haja no interior de seu sistema um dispositivo normativo que deduz do cálculo da avaliação o desempenho dos estudantes deficientes, gerando um estado de "exclusão interna" ao sistema escolar. A partir do debate acerca das políticas de avaliação como mecanismo de gestão educacional no contexto nacional e da observação de estudos que apontam a tendência excludente da avaliação em larga escala em relação à educação inclusiva, aborda-se um dispositivo de lei que promove a exclusão da educação especial dos resultados provenientes das avaliações do Sistema Permanente de Avaliação da Educação Básica do Ceará (Spaece).
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Objective@#Clinical analysis of sequelae of 16 patients with trimethyltin chloride (TMT) poisoning after 2 years.@*Methods@#Sixteen patients with TMT poisoning from a waste recycling company in Ganzhou City in August 2016 were enrolled. They were investigated by questionnaires and assessed by various scales after two years. 6 cases of severe poisoning were examined by head MRI. The scale includes Hamilton Anxiety Scale (HAMA) , Depression Scale (HAMD) , Simple Mental State Examination Scale (MMSE) , Activity of Daily Living (ADL) , International Cooperative Ataxia Rating Scale (ICARS) .@*Results@#16 cases of TMT poisoning still have headache, dizziness and other symptoms. Instability of walking in 4 patients with severe poisoning, and the brain MRI manifestations included obvious atrophy of temporal lobe, hippocampus, insula lobe, cerebellum and ventricle enlargement. Two patients were rated as severe mixed anxiety and depression, one as moderate mixed anxiety and depression, and one as mild anxiety. 3 cases were diagnosed as dementia and 1 case as mild cognitive impairment. Two cases were totally dependent on living ability. ICARS scores were 66 points and 63 points respectively. Two cases were mildly dependent on living ability. ICARS scores were 28 points and 6 points respectively. There were 2 cases of mild mixed anxiety and depression in mild and moderate poisoning patients, and 1 case of mild cognitive impairment in each patient. They could live independently. ICARS scores were 0.@*Conclusion@#After 2 years of TMT poisoning, some patients still have general clinical symptoms such as dizziness, headache and so on. There are also mental and intellectual symptoms such as anxiety, depression and cognitive impairment. Some of patients with severe poisoning presented with dementia and cerebellar ataxia, and even lost independent living ability.
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@#Presented in this paper is a preliminary report on reliability study of comprehensive function evaluation.One hundred and five normal persons were evaluated twice in the interval of one month.The result revealed significant statistical difference,Kappa=0.79,u=7.938>2.56,P<0.01,demonstrating the substantial agreement of these two evaluations.The result suggests that the scale has substantial intra observer agreement and high reliability.The personal comprehensive function could be evaluated completely in the scale.It would be significant not only in practice but also in theory to improve the rehabilitation evaluation and rehabilitation medical level.
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BACKGROUND: Although warts are known to be caused by viruses, one of their peculiarities is that they may be treated by suggestion therspy or hypnosis. This suggests that psychologic or emotional factors influence the hosts response to the virus lesions. OBJECTIVE: The purpose of the study was to analyze the role of psychologic factors in the therapeutic response of warts. METHODS: The self-concept scale test(Korean Testing Center) was done in all 61 patients with common wsrts before the cryot.herapy from September 1991 to June 1993. Clinical follow-up data were obtained on 50 patients after 2 months, and then were evaluated usir g the self-eoncept scale in treated vs untreated group. RESULTS: 1. The overall cure rate was 56.0%, being higher in females and patients with high education, 1-3 in number of lesions and no previous treatment history as well as in those with less than 1 year of duration. 2. In the comparison of self-concept scale between treated(n=18) and untreated(n=22) groups, the treated group had remarksble results in moral ethical self, personal self and family self scores (p<0.05). Only 14 items were significantly different between two groups(p<0.05 by Wilcoxon rank sum test). 3. Patients of 20 years or more showed a high cure rate(67.79%, p<0.05 by t-test) and demonstrated significance in total positive self score and its self identity, and satisfaction, self behavior, physical self, moral ethical self and family self scores(p<0.05, by t-test). CONCLUSION: The self-cancept significantly related to the positive aersonality, harmonious family, stable self-esteem and high normal ethics, may influence at least the therapy to the warts in the treated patients in contradistintion to the untreated ones.