秦战国五郡置年探究

据现有的传世文献及简文系年分析,秦代江胡郡或为颖川郡所并,其后复分颖川置新淮阳郡。结合新出土的里耶秦简和岳麓秦简考证,江胡郡置年至少不晚于秦王政二十五年(前222)。因多数秦郡在同一时期出现于岳麓秦简同一简文,只要能查出除了衡山郡之外的最晚郡置年的郡,即可知衡山郡的郡置年。四川郡、九江郡置年于秦王政二十三年(前224),结合岳麓秦简、里耶秦简分析,衡山郡的置年当与四川郡、九江郡同时,即秦王政二十四年(前223)。陶郡置年于公元前265年,讫年公元前254年,存续仅短短的十一年,所以历来研究者鲜有发现陶郡为秦战国之郡。结合亡楚后薛郡与郯郡地志分析,东晦郡置年最早当于公元前224年秦战国置薛郡之年,至迟应不迟于秦统一之前。州陵郡并非仅仅担任临时“新地守”的角色,属于行政职权及地位与其他新郡平起平坐的秦战国实郡,该郡置年于秦王政二十五年(前222)前后。

《二年律令·置后律》中的若干问题

《二年律令》是吕后二年现行法律的摘抄,其中《置后律》中的一些法律概念和律文,许多 学者已经进行了有益的探讨,但对有些问题或浅尝则止,或歧义互见尚待商榷。本文认为《二年律令》 的《置后律》并非惠帝初年新作,也是承袭秦律旧文而来;妇女在置后制度中可以被确定为“爵后”、“户 后”的合法继承人,但在实际代户的过程中只能继承家庭财产,不能继承爵位,证明古书古注中女子“不 沾爵”的说法是正确的。

《二年律令·置后律》“同产子代户”的合理性考察

律令是社会的产物,张家山汉简《二年律令·置后律》的户主继承顺位没有“同产”,而将“同产子”作为选择,是多方面因素共同作用的结果。“同产”关系源流表明,选择“同产子代户”是父系家长制发展的结果,于政策制定者吕后而言,也是为了维护其子刘盈帝位的合法性。选择“同产子代户”,是遵从礼俗的体现,含有立嗣的意味,可确保亡故之人有后代行使祭祀等礼仪。将“必同居数”作为“同产子代户”的前提条件,则保障了西汉户籍的稳定,利于国家加强对民众的管理,进而促进国家机器的有序运转。《置后律》户主继承可“同产子代户”的合理之处,正反映了中国传统社会律令制定的逻辑理路。

老年髋关节置换术应用不同麻醉方式的价值探析

目的探讨老年髋关节置换术应用不同麻醉方式的价值。方法回顾2016年1月—2017年2月84例老年髋关节置换术患者并分组。对照组用全麻方式,研究组用腰硬联合麻醉方式。比较两组老年髋关节置换术麻醉优良率;麻醉起效时间、麻醉后心率、血压变化;麻醉不良事件出现率。结果研究组老年髋关节置换术麻醉优良率高于对照组,P<0.05;研究组麻醉起效时间、麻醉后心率、血压变化优于对照组,P<0.05;研究组麻醉不良事件出现率低于对照组,P<0.05。结论老年髋关节置换术应用腰硬联合麻醉的价值高,可更快起效,稳定生命体征,减少并发症发生,安全和可行性高。

Capsule endoscopy retention as a helpful tool in the management of a young patient with suspected small-bowel disease

Capsule endoscopy is an easy and painless procedure permitting visualization of the entire small-bowel during its normal peristalsis. However, important problems exist concerning capsule retention in patients at risk of small bowel obstruction. The present report describes a young patient who had recurrent episodes of overt gastrointestinal bleeding of obscure origin, 18 years after small bowel resection in infancy for ileal atresia. Capsule endoscopy was performed, resulting in capsule retention in the distal small bowel. However, this event contributed to patient management by clearly identifying the site of obstruction and can be used to guide surgical intervention, where an anastomotic ulcer is identified.

Unprecedented Retreat in a 50-Year Observational Record for Petermann Glacier, North Greenland

Petermann Glacier is a marine-terminating outlet glacier that had a 70 km-long floating ice tongue prior to a ～ 270 km2 calving event that was observed from satellite sensors in August 2010,shortening the ice tongue by ～ 27 km.Further,in July 2012,another 10 km was lost through calving.In order to understand these events in perspective,here the authors perform a long-term data analysis of Petermann Glacier calving-front variability and ice velocity for each year in the 1990s-2000s,supplemented by available observations from the previous three decades.Five major （on the order of 100 krm2） calving events are identified,with ～ 153 km2 calved from 1959 to 1961,～ 168 km2 in 1991,～ 71 km2 in 2001,～ 270 km2 in 2010,and ～ 130 km2 in 2012-as well as ～ 31 k m2 calved in 2008.The increased frequency of major calving events in recent years has left the front terminus position retreated nearly 25 km beyond the range of observed in previous decades.In contrast,stable ice-dynamics are suggested from ice-velocity measurements made each year between 1993-2012,which are on average 1063 m yr-1,with limited interannual variability and no significant trend; moreover,there is no apparent relationship between ice-velocity variability and calving events.The degree to which the massive calving events in 2010 and 2012 represent natural episodic variability or a response to atmospheric and/or oceanic changes remains speculative; however,melt-induced weakening of the floating ice tongue in recent years is strongly suggested.

Transcatheter aortic valve replacement in elderly patients

Aortic stenosis is the most common native valve disease, affecting up to 5% of the elderly population. Surgical aortic valve replacement reduces symptoms and improves survival, and is the definitive therapy in patients with symptomatic severe aortic stenosis. However, despite the good results of classic surgery, risk is markedly increased in elderly patients with co-morbidities. Transcatheter aortic valve replacement （TAVR） allows implantation of a prosthetic heart valve within the diseased native aortic valve without the need for open heart surgery and cardiopulmonary bypass, offering a new therapeutic option to elderly patients considered at high surgical risk or with contraindications to surgery. To date, several multicenter registries and a randomized trial have confirmed the safety and efficacy of TAVR in those patients. In this chapter, we review the background and clinical applications of TAVR in elderly patients.

Dilemmas and Countermeasures of Pension Service Marketization in China

The irreversible trend is that China is accelerating into the aging society. The old-age services provided by the government has been unable to meet the growing needs of the elderly, So there is a huge supply of pension services need to make up for space. As the market can play a role in optimizing the allocation of resources.

Earthquake-generating Structure Revealed by 1999 Sichuan Mianzhu Earthquake Sequence with M_S=5.0

Through the accurate determination of hypocenter location, the measurement of the main focal mechanism solutions and the analyses of time dependent processes for Sichuan Mianzhu earthquake sequence with M S=5 0 occurred along the middle segment of Longmenshan fault zone on November 30, 1999, the distribution of focal depth section, the stress release and seismicity features are given to reveal the earthquake-generating structure of the earthquake sequence. The obtained results show the activity features for this sequence as follows: ① There is no obvious foreshock, the accumulated strain energy releases in nearly pulse way, fluctuation of the seismic activity level is not quite evident during the duration of the sequence, and the statistical relation between the large events and the small events is less compatible with the traditional G-R estimation; ② The epicenters of the earthquake sequence are not distributed on the main Longmenshan piedmont faults emerging out ground, but near the hidden Longmenshan piedmont faults. The direction of epicenter distribution is not very coincident with the fault strikes. The microscopic epicenters are relatively far from the macroscopic epicenters. The focal depths range from 5km to 16km; ③ The fractures of focal fault plane with the NE strike appear out the strike-slip displacement with a few overthrust components under the major principal compressive stress of NNE direction. From these, we consider it should be paid more attentions to the underground hidden faults near the ground fault zone on a large scale for their generating earthquake risk.

Change in quality of life after transcatheter aortic valve implantation and aortic valve replacement surgery in Australian patients aged ≥ 75 years： the effects of EuroSCORE and patient operability

Objective To determine the extent to which differences in generic quality of life （QOL） between transcatheter aortic valve implanta- tion （TAVI） and surgical aortic valve replacement （AVR） patients explained by EuroSCORE and heart-team operability assessment. Methods A total of 146 high-risk patients with EuroSCORE 〉 6 and aged 〉 75 years underwent TAVI （n = 80） or aortic valve replacement （n = 66） between February 2010 and July 2013. A total of 75 patients also completed preoperative and six month SF-12 QOL measures. Analyses examined incident major morbidity, compared six month QOL between groups adjusted for EUroSCORE and operability, and quantified rates of clinically significant QOL improvement and deterioration. Results The AVR group required longer ventilation （〉 24 h） （TAVI 5.0% vs. AVR 20.6%, P = 0.004） and more units of red blood cells [TAVI 0 （0-1） vs. AVR 2 （0-3）, P = 0.01]. New renal failure was higher in TAVI （TAVI 5.0% vs. AVR 0%, P = 0.06）. TAVI patients reported significantly lower vitality （P = 0.01） by comparison to AVR patients, however these findings were no longer significant after adjustment for operability. In both procedures, clinically significant QOL improvement was common [range 25.0% （general health） - 62.9% （physical role）] whereas deterioration in QOL occurred less frequently [range 9.3% （physical role） - 33.3% （mental health）]. Conclusions Clinically significant improvement and deterioration in QOL was evident at six months in high risk elderly aortic valve replacement patients. Overall QOL did not differ between TAVI and AVR once operability was taken into consideration.

Study the Concentrations of Radon Indoor at Different Times of the Day and Seasons of the Year in AI-Najaf and AI-Kufacities

In this work, concentrations of radon indoor were measured at 10 locations in Al-Kufa and Al-Najaf cities, using RAD-7 radon monitoring system of Durridge Company USA. Some factors affecting on the radon factor have been studied such as times of day （morning, aitemoon and evening） and seasons of year （winter, spring, summer and autumn）. This study show that the radon concentration indoor increases at mornings, evenings, decreases at afternoon, also increases in winter and autumn, decreases in spring and summer.

Determinants Analysis on Adolescents

Determinants analysis is a pretty recent approach in social research and policy reviews, so that one cannot speak about generally/largely agreed definition of concepts yet. The paper endeavors to propose a framework for analyzing the factors that, at structural, proximity, and individual levels, impede the realization of adolescents＇ rights to education, health, and protection. This framework was first conceived for the purpose of being used within a study on the state of adolescents in Romania, commissioned by the United Nations International Children＇s Emergency Fund （UNICEF） Romania and carried out by the Centre for Urban and Regional Sociology and Institute for Educational Sciences, which fmally used a slightly different approach, in a view to observe the determinants＇ framework already in use by UNICEF. The proposed framework is based on the structure-agency approach embraced by several international youth researches, which argue that individual actions and behaviors are in most cases the results of an interplay between structural constraints （institutional settings and rules） and individual agency. This approach is important for a determinants＇ analysis because it requires due consideration of individual features as well while discussing the role of social determinants in setting choice constraints and shaping pathways for adolescents＇ achievement of their rights. It is also important when approaching vulnerable adolescents, since vulnerability is often associated not only with structural and/or proximity determinants, but also with individual features.

Improvements in quality of life in septuagenarians versus octogenarians undergoing trans-catheter aortic valve replacement

Background Very elderly patients represent a distinct patient group in clinical setting in terms of a decision for trans-catheter aortic valve replacement （TAVR） when one considers the potential improvement in the quality of life （QoL） on one hand and the benefit to risk ratio on the other. This study aimed to compare functional and QoL outcomes of TAVR between octogenarians and septuagenarians. Methods This prospective cohort study included 136 elderly patients （70 to 89 years of age）, who tmderwent Wansfemoral TAVR due to degenerative aortic stenosis. Patients were allocated into one of the following age groups： septuagenarians （n = 67） and octogenarians （n = 69）. Preoperative and early postoperative clinical parameteT：s were recorded. In addition, QoL of the patients was evaluated using SF-36 questionnaire preoperatively and six month postoperatively. Results Groups were similar in terms of early postoperative mortality and morbidity parameters. The mean New York Heart Association （NYHA） class improved after TAVR in both groups. In addition, all SF-36 norm-based scale and SF-36 summary scale scores improved significantly in both groups during the postoperative period. Postoperatively, physical functioning, general health and physical component summary scores were significantly better in the septuagenarian group （P = 0.02, 0.01, 0.03, respectively）. ConcLusion Although the improvement in the QoL in terms of physical health was more marked in septuagenarians than in octogenarians, substantial benefits on the QoL and particularly on mental health seem to justify re-consideration of TAVR indications in the very elderly.

Mexican Identity on YouTube： A Youngsters＇ User Approach

The work at hand analyzes the visibility of cultural identity of＂Mexico＂ on the YouTube platform （Retrieved from http：//www.youtube.com）. It is focused on qualitative and quantitative analyses of a sampling of 80 videos that appear when the word ＂Mexico＂ is applied in various search formats within the site itself. User profile is also analyzed, along with video title, labels, date of upload, length, view count, thematic category, and commentaries. From this sampling of videos, an analysis is made upon the cultural identity of ＂Mexico＂ within a postmodernist framework of multicultural, fragmented, and decentralized identities （Friedman, 1994）, parting from the theory of cultural hybridization （Pieterse, 2004）, and under the logic of a media convergent culture （Jenkins, 2004a）.

Informally Established Relations Between the Superior and the Subordinate： Turkey＇s Example

Turkish people display deep consideration for the concept of hierarchy. Historically, they had been always calculating and measuring the relative positions of authority symbols with respect to one another; because they had their own dealings with those who held political power. Should they render their young sons to the service of the feudal lords or the state？ Should they consent to the say of the local forces or that of the central state power, when it comes to fixing the amounts and/or the kinds of taxes？ Sometimes, the ordinary subjects of the Ottoman state were even openly torn apart in dilemmas whereby local powers were revolting against the central government of the Sultan placed at the capitol. Even the anoymous folk tales, which reflect people＇s opinions and mentalities in a manner very close to the truth, involve comparisons among the levels of power represented by certain officials/figures. When confronted with authority, the usual feeling contains a tint of respect, even though it is mainly a kind of resignition mixed with acceptance, leading to obedience in the end. A true, internalized respect itself is solely that which is directed toward the elderly people of the society. On the other hand, traditionally and conventionally, old age was closely associated with official or informal power and authority, anyhow. However, nowadays, in a very confusing manner, this former social understanding is undergoing rather fast changes with the advent of younger contemporary political figures.

Assessment of the Wind Field in the East Coast Algerian Regions for the Installation of Wind Farms

The available electricity generated by a wind power generation system depends on mean wind speed, standard deviation of wind speed and the location of installation. Since year-to-year variation on annual mean wind speed is hard to predict, wind speed variations during a year can be well characterized in terms of a probability distribution function, as well Weibull distribution has been one of the most commonly used, accepted and recommended distribution to determine wind energy potential. In this study, the two Weibull parameters of the wind speed distribution function （the shape parameter k （dimensionless） and the scale parameter c （m/s））, were computed from the wind speed data for Algerian east coastal regions, recording over a 1 l-year period （1995-2005）. It was found that the numerical values of both Weibull parameters （k and c） vary over a wide range. The yearly values ofk range from 1.20 to 1.94, while those of c are in the range from 4.31 to 1.94. To minimize the uncertainties of statistical calculation, a spatial representation indicating distribution and occurrence frequency the direction from which the wind comes, appears a very primordial step. Over the whole valid data during the study period, the compass shows that there is no dominant direction marked. However, we can identify a preferred wind direction. The statistical results correspond to the analysis of the rose compass.

The effect of electroacupuncture preconditioning on cognitive impairments following knee replacement among elderly:A randomized controlled trial

Objective: To investigate if electroacupuncture(EA) preconditioning can mitigate cognitive impairments and reduce the incidence of postoperative cognitive dysfunction(POCD) following knee replacement and its safety among elderly.Methods: Totally 60 participants met the inclusion criteria were enrolled in a randomized controlled trial a ratio of 1:1, with 30 cases allocated to the treatment group and 30 cases allocated to the control group, respectively. The participants in the treatment group were provided with real-EA therapy whereas participants in control group were provided with placebo-EA therapy(Streitberger Placebo-needle). In both groups, Tou sanshen(头三神)acupoints, including Sìshéncōng(四神聪EX-HN1), Sh6 ntíng(神庭 GV24),and bilateral Běnsh6 n(本神GB13) were adopted as the main acupoints, while Bǎihui(百会GV20), bilateral Hégǔ(合谷Ll4), and bilateral Tàich6 ng(太冲LR3) were adopted as matching acupoints. Interventions were offered 5 days prior to the surgery, once daily, and continued for total 5 days. The global scores of MiniMental State Examination(MMSE), and levels of serum inflammatory cytokines including interleukin 1β(IL-1β) and tumor necrosis factor-α(TNF-α), and S100-β protein were observed at 24 h prior to the surgery, and postoperative 24 and 72 h respectively for assessing the incidence of POCD and the severity of cognitive impairments among patients. Meanwhile, adverse effects were monitored and recorded.Results:(1) Compared with baseline, MMSE global scores in both treatment and control groups markedly decreased at postoperative 24 h. MMSE global scores in treatment group decreased from 29.43 ±0.97 to27.10 ±1.95 while that in control group decreased from 29.27 ± 1.01 to 26.83 ± 2.25(all ?P< 0.05), and this trend continued until postoperative 72 h(at postoperative 72 h, MMSE global scores in treatment group was 26.53 ±2.26 versus 24.79 ±3.03 in control group). Moreover, decline in control group was more significant than that in treatment group at postoperative 72 h(P<0.05).(2) Compared with baseline, levels of serum IL-1β, TNF-α and S100-β in both groups increased markedly at postoperative 24 and 72 h. IL-1β in treatment group increased from 43.13 ±5.51 to 73.13 ±2.32 at postoperative 24 h and reached 83.17 士 5.95 at postoperative 72 h, while IL-1β in control group increased from 44.87 土 5.83 to91.10 ±3.55 at postoperative 24 h and reached 111.93 ±9.18 at postoperative 72 h;TNF-α in treatment group increased from 51.27 士 6.48 to 88.80 ± 3.55 at postoperative 24 h and reached 94.37 ± 5.22 at postoperative 72 h, while TNF-α in control group increased from 52.07 ±7.48 to 116.37 ±3.14 at postoperative24 h and reached 121.40 ±3.68 at postoperative 72 h(both ?P< 0.05), furthermore, increases of IL-1β and TNF-α levels in control group were more significant(P<0.05). Statistical difference in level of S100-β was not observed(P>0.05).(3) There was no statistical difference in POCD incidence at postoperative 24 h and postoperative 72 h between two groups(P> 0.05), though the incidence of POCD in patients receiving real-EA therapy was indeed much lower than that in patients receiving placebo-EA therapy, particularly at postoperative 72 h(POCD incidence rate at postoperative 24 h in treatment group was 26.67%, 30.00%in control group;POCD incidence rate at postoperative 72 h in treatment group was 30.00%, 46.67% in control group).(4) No serious adverse events were reported in this trial. No one dropped out from this trial.Conclusion: EA preconditioning can mitigate cognitive impairments at post-knee replacement surgery 24 and 72 h in elderly through inhibiting expression of inflammation. However, there is insufficient evidence to support that EA pretreatment can reduce the incidence of POCD.

Analysis of prosthetic replacement in treatment of femoral neck fracture on the hemiplegia side in the elderly

Objective: To study the effect of prosthetic replacement in treatment of femoral neck fractures on the hemiplegia side in the elderly. Methods: From May 1990 to May 2000, 189 elderly patients with femoral neck fractures were treated with prosthetic replacement in my hospital. Twenty-nine hemiplegia patients, who suffered from stroke previously, had Garden type III and type IV femoral neck fractures on the hemiplegia side. Thirty non-hemiplegia patients were chosen randomly. The two groups were followed-up for 27-98 months (average: 59 months). The age, hospitalization days, operating time, blood loss, blood transfusion, complications during perioperative period and long-term complications were compared between the two groups and the results of femoral head replacement and total hip replacement in the hemiplegia group were also compared. Results: All the patients of the two groups survived the perioperative period. No significant difference was found in the age, hospitalization days, operation time, blood loss and blood transfusion and long-term complications between the two groups (P> 0.05). However there was significant difference in complications during perioperative period between the two groups (P< 0.05). Five patients died in the hemiplegia group with the mortality of 17.2% and two died in the non-hemiplegia group with the mortality of 6.7% 11 months to 5 years after operation. There was significant difference in long-term complications between the femoral head replacement and the total hip replacement in the hemiplegia group (P< 0.05). The result of the total hip replacement was better than that of the femoral head replacement. Conclusions: Prosthetic replacement is a reliable method in treatment of Garden type III and type IV femoral neck fractures on the hemiplegia side in the elderly, and patients are safe during perioperative period. More complications during perioperative period occur in the hemiplegia group, and long-term complications are insignificantly different between the two groups. The mortality rate is higher in the hemiplegia group than in the non-hemiplegia group within 5 years after operation. Since the result of the total hip replacement is better than that of the femoral head replacement, total hip replacement should be chosen firstly to treat Garden type III and type IV femoral neck fractures on the hemiplegia side in the elderly if the muscular strength of the hip is beyond IV degree.

Prosthetic replacement in treatment of subcapital femoral neck fractures in the elderly

Objective: To compare the results of femoral head replacement (FHR) and total hip replacement (THR) in treatment of subcapital femoral neck fractures (SFNF). Methods: Between May 1987 and July 1998, 56 elderly patients (65-90 years; average 73.5 years) with SFNF were treated with prosthetic replacement. Six cases were treated with unipolar FHR, 18 cases with Bateman bipolar FHR, and 32 cases with Bateman bipolar THR. All domestic prostheses were installed with cement. Results: There was no significant difference between the 2 groups in operating time and blood transfusion. Forty-nine patients were followed-up for an average of 5 years and 10 months. No wound infection or death was related to surgery. Complications in Group FHR were significantly higher than that in Group THR. Conclusions: Since FHR is difficult to fit the bony acetabulum, it is only indicated for senile cases with poor conditions. However, the bipolar THR installed with cement is indicated for most elderly patients. Since the femoral head and acetabulum can fit each other completely, it is more stable for taking weight-bearing earlier with less complications.

Comparative study of anterolateral approach versus posterior approach for total hip replacement in the treatment of femoral neck fractures in elderly patients

Objective： To compare the clinical outcome of anterolateral minimally invasive approach versus conventional posterior approach for total hip replacement against femoral neck fractures in elderly patients. Methods： The retrospective study was carried out on 42 patients who suffered from displaced femoral neck fractures （19 cases of Garden type Ⅲ, 23 cases of Garden type Ⅳ） treated by total hip replacement via anterolateral minimally invasive approach or conventional posterior approach by the same experienced surgeon. The average age of the patients was 78.1 years （range： 65-89 years）. They were divided into anterolateral mini-invasive group （22 cases） and posterior group （20 cases）. The mean time of follow-up was 13 months （range： 6-36 months）. The anterolateral approach described by Hardinge goes through between anterior 1/3 and posterior 2/3 of the gluteus medius muscle, reaching the femoral neck from anterior capsule. The traditional posterior approach described by Moore （Southern incision） goes through the insertions of short external rotation muscles, reaching the femoral neck from posterior capsule. The related variables under observation were length of incision, operation time, postoperative limp, length of hospital stay and bed stay and dislolcation rate. Results： The length of the skin incision varied between 7 cm and 12 cm with the anterolateral minimally invasive technique, compared to 15-22 cm in the conventional procedure. It took less time （average 15 minutes） to complete the anterolateral minimally invasive approach （72 15 min）, compared with the conventional approach （87 min ±10 min）. The average Harris hip score was 91.23±10.20 in anterolateral approach, 90.03±11.05 in the posterior approach. The average length of hospital stay for patients with the anterolateral approach was （6.4±2.2） days （range： 4-9 days）, while that in posterior approach was （9.2 ±3.1） days （range： 6-13 days）. The average length of bed stay was （3.4±1.1） days （range： 2-5 days） in anterolateral group and （6.2±2.8） days （range： 3-10 days） in posterior group. No patients in anterolateral group experienced dislocation. One （5%） hip in posterior approach had dislocation. Conclusions： Anterolateral mini-invasive approach can decrease trauma, operation time, length of hospital stay and bed stay and rehabilitation time. The stability and minimal muscular damage permit the acceleration of postoperative rehabilitation, which can subsequently reduce the perioperative risk in the treatment of femoral neck fractures in the elderly undergoing total hip replacement.