基于耻骨的成人年龄推断研究进展

耻骨作为成人年龄推断最为重要的骨骼之一,基于耻骨开发的成人年龄推断方法在国内外得到了广泛应用和不断发展。近年来,随着医学影像技术、三维成像技术以及计算机技术在法医学领域的应用,基于耻骨的成人年龄推断研究逐渐从传统形态学定性或半定量研究转变为客观定量研究,分析方法也从简单的统计分析发展到高功效统计分析方法、甚至是人工智能的应用。本文综述了近年来国内外在耻骨成人年龄推断中的相关研究进展,简述并评价了各方法的准确性和可靠性,以期为相关研究人员提供参考,为耻骨成人年龄推断的客观准确评估指明研究方向。

Hepatocellular carcinoma in Egypt: A single center study over a decade

AIM： To identify the trend, possible risk factors and any pattern change of hepatocellular carcinoma （HCC） in Egypt over a decade. METHODS： All HCC patients attending Cairo Liver Center between January 1993 and December 2002, were enrolled in the study. Diagnosis of HCC was based on histopathological examination and/or detection of hepatic focal lesions by two imaging techniques plus α-fetoprotein level above 200 ng/mL. The duration of the study was divided into two periods of 5 years each; period Ⅰ （1993-1997） and period Ⅱ （1998-2002）. Trend, demographic features of patients （age, gender, and residence）, risk factors （HBsAg, HCV-Ab, schistosomiasis and others） and pattern of the focal lesions were compared between the two periods. Logistic regression model was fitted to calculate the adjusted odds ratios for the potential risk factors. The population attributable risk percentage was calculated to estimate the proportion of HCC attributed to hepatitis B and C viral infections. RESULTS： Over a decade, 1 328 HCC patients out of 22 450 chronic liver disease （CLD） patients were diagnosed with an overall proportion of 5.9%. The annual proportion of HCC showed a significant rising trend from 4.0% in 1993 to 7.2% in 2002 （P = 0.000）. A significant increase in male proportion from 82.5% to 87.6% （P = 0.009）; M/F from 5：1 to 7：1 and a slight increase of the predominant age group （40-59 years） from 62.6% to 66.8% （P = 0.387）in periods Ⅰ and Ⅱ respectively, reflecting a shift to younger age group. In the bivariate analysis, HCC was significantly higher in rural residents, patients with history of schistosomiasis and/or blood transfusion. Yet, after adjustment, these variables did not have a significant risk for development of HCC. There was a significant decline of HBsAg from 38.6% to 20.5% （P = 0.000）, and a slight increase of HCV-Ab from 85.6% to 87.9% in periods I and II respectively. HBV conferred a higher risk to develop HCC more than HCV in period Ⅰ （OR 1.9 vsl.6） and period Ⅱ （OR 2.7 vs 2.0）, but the relative contribution of HBV for development of HCC declined in period Ⅱ compared to period Ⅰ （PAR% 4.2%, 21.32%）. At presentation, diagnostic α-fetoprotein level （≥200 ng/mL） was demonstrated in 15.6% vs28.9% and small HCC （≤3 cm） represented 14,9% vs 22,7% （P = 0,0002） in periods Ⅰ and Ⅱ respectively. CONCLUSION： Over a decade, there was neady a twofold increase of the proportion of HCC among CLD patients in Egypt with a significant decline of HBV and slight increase of HCV as risk factors. α-Fetoprotein played a limited role in diagnosis of HCC, compared to imaging techniques. Increased detection of small lesions at presentation reflects increased awareness of the condition.

Acute lymphocytic myocarditis

Myocarditis is an inflammatory disease of the myocardium. The clinical presentation of myocarditis may range from subclinical to sudden death. The incidence of fatal myocarditis, which often presents with sudden or rapid death, has been estimated at 0.15/100.000 in the general population and is highest in infants and young adults （but may affect any age group）. However, diffuse myocarditis in autopsies of sudden death is 〈 2% in adult.

Performance on the Functional Movement Screen in older active adults

Background:The Functional Movement Screen(FMS^(TM)) has become increasingly popular for identifying functional limitations in basic functional movements.This exploratory and descriptive study was undertaken to confirm feasibility of performing the FMS^(TM) in older active adults,assess prevalence of asymmetries and to evaluate the relationship between functional movement ability,age,physical activity levels and body mass index(BMI).Methods:This is an observational study;97 men(n = 53) and women(n = 44) between the ages of 52 and 83 participated.BMI was computed and self-reported physical activity levels were obtained.Subjects were grouped by age(5-year intervals),BMI(normal,over-weight,and obese)and sex.Each participant's performance on the FMS^(TM) was digitally recorded for later analysis.Results:The youngest age group(50–54 years) scored highest in all seven tests and the oldest age group(75+) scored lowest in most of the tests compared to all other age groups.The subjects in the 'normal weight' group performed no different than those who were in the 'overweight' group;both groups performed better than the 'obese' group.Of the 97 participants 54 had at least one asymmetry.The pairwise correlations between the total FMS^(TM) score and age(r =-0.531),BMI(r =-0.270),and the measure of activity level(r = 0.287) were significant(p < 0.01 for all).Conclusion:FMS^(TM) scores decline with increased BMI,increased age,and decreased activity level.The screen identifies range of motion-and strength-related asymmetries.The FMS^(TM) can be used to assess functional limitations and asymmetries.Future research should evaluate if a higher total FMS^(TM) score is related to fewer falls or injuries in the older population.

The variation of skinfold thickness of Mulam adults in China

The skinfold thickness of six items （facial skinfold, subscapular skinfold, suprailiac skinfold, biceps skinfold, triceps skinfold and calf skinfold） were measured in 465 Mulam adults （232 male and 233 female）. The results were as follows： （1） The average skinfold thickness are higher in female at every age group. （2） As a whole, the skinfold thickness in the body of trunk is bigger than that in the limbs in both male and female. The curves of biceps skinfold thickness and calf skinfold thickness of male doesn＇t fluctuate with age. Body fat percentage of male was the lowest in the 30s group. In female, the skinfold thickness of trunk and triceps increase with age while calf skinfold decreases. Body fat percentage of female increases with age but then decreases after 50 years old. （3） The mean vales of Mulam skinfold thickness are relatively low compared with Daur, Uzbek and Han nationality.

The oldest patient with takotsubo cardiomyopathy

Takotsubo cardiomyopathy （TTC） is a rare condition that affects mainly aging women. According to a retrospective review, patients with TTC accounted for approximately 2% of all the patients with suspected acute coronary syndrome （ACS）. A few reports indicated that the average age of TTC patients was 68 years, although children or young adults may also be affected. In US and Europe, a number of contemporary TTC studies report that 90% of patients with TTC are women aged 65-70 years. Meta analysis showed that the age ranged from 10 to 89 years.

Can Adults Attain a Native-Like Accent in Their Second Language？

Second Language Acquisition （SLA） is influenced by many different factors. This paper attempts to discuss the age factor in SLA, particularly explores the learners＇ acquisition of accent. The author firstly introduces the topic and reviews the literature on Critical Period Hypothesis （CPH）. Then, the optimal age to attain the native-like accent is discussed. Finally, the author describes some other elements that influence the acquisition of accent and draws a natural conclusion that the topic in this paper needs more profound research.

香港的拾荒老人

香港志愿团体邻舍辅导会日前调查了香港60岁以上拾荒老人的生计,发现他们的收入来源大部分靠捡拾纸箱和汽水罐。 这份调查在香港深水步区进行,调查人员从每日进出废纸收集店铺的370多人次的拾荒者中,抽取了37人作为调查对象。调查显示,老人拾荒主要为赚取更多的金钱,其次为生活所迫,金钱是其生活中感到最担忧的事。近七成拾荒老人的收入在400港元以下,有四成老人每月支出在1500港元以下,反映出拾荒老人的生活捉襟见肘。受访老人中七成人年龄在70岁以上。

Selection of approach and fixation in the treatment of type C fracture of distal humerus in adults

Objective：To study the surgical treatment for distal humeral fractures in adults according to the follow-up results.Methods： Twenty-one cases （16 males and 5 females）of distal humeral fracture were included in this study. The average age was 42.5 years （range： 37-52 years）. Fractures were classified according to the AO classification system.Nine cases of C1,8 C2 and 4 C3-type fractures were identified.Open reduction and internal fixation were performed in all cases. A tricep-reflecting approach was adopted, and either the AO orthogonal plating or parallel plating technique was chosen,based on the fracture type. The plaster cast was removed 3 weeks after operation. Rehabilitation was encouraged during this period and afterwards. The average follow-up time was 12.2 months （range： 8-28 months）. The outcome was scored according to Aitken and Rorabeek system.Results：No nerve injury,nonunion or failure of fixation was encountered during the operation and follow-up.However, ossifying myosifis occurred in one case.Conclusions：A triceps-reflecting approach can provide adequate exposure to the joint. The use of AO orthogohal plating or parallel plating techniques based on the type of fractures can provide rigid fixation for the fracture.

Outcome of surgical treatment of type Ⅳ capitellum frac- tures in adults

Objective： Fractures of the capitellum and trochlea constitute less than 1% of all elbow fractures and a shear fracture involving the capitellum and extending medially into most of the trochlea is rarely reported. Type Ⅳ capitellum fracture is still controversial in regard to its ra- diographic appearance, surgical approach and osteosynthesis. We report 10 cases of type Ⅳ capitellum fracture with a view to elucidating its clinical features and treatment outcome. Methods： We treated 10 patients of type Ⅳ capitellum fracture with a mean age of 32 years. A uniform surgical approach and postoperative rehabilitation were followed. Results： Nine patients presented to us after a mean of 4 days of injury and one patient was nonunion after 6 months of injury who had been treated conservatively by a bone setter. Double arc sign was absent in 6 cases. Intraopera- tively 6 capitellotrochlear fragments were devoid of soft tissue attachments. By Mayo Elbow Performance Score evaluation, 7 patients got excellent, 2 good and 1 fair results. One patient with associated elbow dislocation developed heterotopic ossification. There was no case of avascular necrosis, osteoarthrosis or fixation failures. Conclusions： Type Ⅳ capitellum fractures are rare and belong to complex articular injuries. A good functional out- come can only be achieved with open reduction and stable internal fixation followed by early mobilization. Preopera- tive radiographic assessment and computed tomography help surgeons in choosing the right surgical approach and implants. Good surgical technique and stable internal fixa- tion are the keys to early mobilization and good functional outcome.