Percutaneous Coronary Intervention in Acute Coronary Syndromes at the Mother-Child University Hospital Luxembourg in Bamako

Introduction: Acute coronary syndromes (ACS) are a diagnostic and therapeutic emergency. Objective: Studying the feasibility, difficulties and results of coronary angioplasty in acute coronary syndromes at the Luxembourg Mother-Child University Hospital in Bamako. Patients and Methods: Cross-sectional, descriptive study with prospective recruitment over 18 months from September 2020 to February 2022. All patients aged at least 18 years old admitted for SCA and having undergone PCI during the study period were included. Result: We collected 249 patients for SCA, of whom 160 underwent angioplasty, either an angioplasty/SCA ratio of 0.64. The average age of the patients was 59.54 ± 11.62 with extremes of 32 and 92 years. The age group of 45 to 65 years was the most representative. The predominance was male, sex ratio of 2.4. The main cardiovascular risk factors were high blood pressure (58.23%) and diabetes (45.78%). Persistent ST-segment elevation on the electrocardiogram was present in 71.48%. The treatment time was more than 12 hours after the first medical contact in 95.5%. The approach was radial in 96.5% of cases. Coronarography was pathological in 91.16% of our patients. The lesions were tri-truncular in 34.13% with the anterior inter ventricular as culprit artery in 72% of cases. The majority of patients (64%) had undergone angioplasty with implantation of an active stent. Angioplasty was performed successfully in 98% and per procedural mortality was 1.87%. Only 6.45% of ACS with ST elevation benefited from primary angioplasty. Conclusion: Percutaneous coronary intervention is performed routinely in our center with satisfactory results. Difficulties exist, related to the diagnostic delay of ACS and the high cost of angioplasty.

Obstacles to the Integrated Care of Children Aged 6 to 59 Months Suffering from Acute and Severe Malnutrition at the Chu-Me and HATC of N’Djamena/Chad

Introduction: the problem of Severe Acute Malnutrition (SAM) and its consequences concern and challenge all social actors worldwide. The objective of the study was to identify the real obstacles that actors face in the integrated management of children aged 6 - 59 months suffering from SAM at the University Hospital of Mother and Child (CHUME) and the Chad-China Friendship Hospital (HATC) of N’Djamena. Methodology: this is a cross-sectional descriptive and interpretative study conducted from January to October 2023 at the CHUME and HATC of N’Djamena. It is based on questionnaires and direct observation of two hundred and thirty-six (236) parents or guardians of malnourished children admitted to these health facilities. All 236 agreed to participate freely in this study. Results: it appears from this study that the obstacles to the integrated management of malnourished children were: poor care-care relationship (26.7%) permanent product breaks (22.9%), the direct costs of services ranged from 30,000 to 60,000 FCFA (41.53%), drugs used for the treatment of patients came from the street (66.10%), malaria and anemia occupy an important place (27.5%), 57.2% respondents had monthly income below 60,000 CFAF. Conclusion: the present study carried out has identified the real bottlenecks to the integrated management of children suffering from SAM in the therapeutic nutritional units of the city of N’Djamena. .

China's Universal Second-Child Policy: Grounds, Effects and Strategies

The 13 th Five-Year Plan(2016─2020), with the balanced development of population being the core element, is crucial for China. The superimposed effect of an aging population and low birthrate leading to a reduction in the labor supply would have a fundamental influence on the long term balanced development of China's population, implying that China's population policy must be adjusted. This paper argues that a gradual relaxation of the family-planning policy adjustments accords with the original intention of the population policy design and development direction. The universal second-child policy is the logical results of the adjustment and improvement of China's family-planning policy, and is designed to bring about positive effects on future demographic and economic development, particularly in sustaining the long term balanced development of China's population, easing the marriage squeeze, extending the demographic dividend, and delaying the population aging process. China needs to develop and improve support and governance systems for fully implementing the universal second-child policy, realizing the policy transition from rewarding one-child families to population security and the modern transition of governance systems and capacity to a universal second-child policy.

Tuberculosis in Children: Epidemio-Clinical Aspects in the Paediatric Department of the Gabriel TouréUniversity Hospital Center

Introduction: Globally, tuberculosis is the leading cause of death from a single infectious agent ahead of HIV/AIDS. Approximately 10 million people contracted TB in 2017, 10% of whom were children aged 0 - 15 years, or about 1 million with 250,000 deaths in 2016 (including children with HIV-associated TB). The signs of TB in children are not always specific and diagnosis remains difficult unlike in adults. According to a study conducted in 2011 in the paediatric department of the CHU-Gabriel Touré, only seventeen cases of all forms of tuberculosis were found, or approximately 0.2% of hospitalised children. The objective of our study was to investigate the epidemiological and clinical aspects of tuberculosis in children. Materials and Method: This was a prospective, cross-sectional and descriptive study that took place from 24 October 2017 to 23 October 2018, or 12 months in children aged 0-15 years. Data were collected from an individual medical record opened for each patient and an individual survey form established for each child. Results: During the study period, 40,434 children were consulted. Tuberculosis was suspected in 91 children, with a frequency of 0.22%. The age range of 1 to 4 years was 36.3% with a median age of 72 months. The sex ratio was 1.8. Chronic cough with 84.6% and malnutrition with 24.17% were the most frequent symptoms. Chest X-ray revealed bilateral pulmonary lesions in 52.7% and mediastinal adenopathy in 12.1%. TST was positive in 10.9% of patients, microscopy in 26.4%, Gene Xpert in 18.7%, and culture in 16.5%. The biological diagnosis of tuberculosis was retained in 48.4% of the patients, the pulmonary form represented 93.2%. The therapeutic regime (2RHZE/4RH) was used in 81.6% of cases and the evolution was favourable in 65.9% of patients. Conclusion: The diagnosis of tuberculosis in children remains difficult in our context. The clinical signs are not always specific, and further studies are needed to further elucidate this disease.

血清对氧磷酯酶-1活性与肝硬化Child-Pugh分级的关系

目的探讨血清对氧磷酯酶-1(PON1)酶活性与肝硬化Child-Pugh分级的关系。方法以对氧磷(paraoxon)为底物测定76例正常、26例急性肝炎、45例慢性肝炎和72例肝硬化患者血清基础PON-1活性和1mol/L NaCl刺激后PON1活性;PCR扩增PON1基因,Alw I酶切PCR产物,对PON1基因192位多态性进行分型。结果正常对照组、急性肝炎、慢性肝炎和肝硬化患者血清PON-1基础活性水平分别为403±145,312±83,201±114,137±99 U/ml;1mol/L NaCl刺激后PON-1活性分别为673±232,509±139,335±151,233±162 U/ml。与正常对照比较,急性肝炎、慢性肝炎和肝硬化患者血清PON-1活性基础水平和1mol/LNaCl刺激后PON1活性均显著下降(P<0.01),肝硬化组下降最明显。肝硬化Child A,Child B和Child C组患者血清PON-1活性基础水平分别为185.5±98.6,141.6±93.6,86.7±51.2 U/ml;1mol/L NaCl刺激后PON-1活性分别为308.9±161.3,227.1±116.3,124.9±78.1 U/ml。Child B组比A组PON1酶活性显著下降(P<0.05),而Child C组又比B组PON1酶活性显著下降(P<0.01)。在肝硬化Child A,Child B和Child C组患者PON1的192位R-Q多态性分布频率无显著性差异(P>0.05)。结论血清PON1活性下降与肝硬化Child-Pugh分级相关,可反应肝硬化的严重程度,且PON1基因192位多态性不影响肝硬化各组的PON1酶活性。

Application and Realization of Rapid Searching Technology in the RL & SM Universal Fixture System

A searching-machining system of RL & SM (Rapid Location and State Memory) universal fixture is here introduced, and the concept of rapid searching technology and manufacturing information transformation is then described, with the appropriate control methods and key techniques for its realization being proposed and also practically realized. Theoretical analysis and experimental results show that the proposed idea and methods are feasible to serve as in the practical application of the RL & SM system.

Epidemiologic Features of the First Flare of Ne-phrotic Syndrome in Children in Bamako Pedi-atric Hospitals

Introduction: The most frequent glomerular pathology in children, nephrotic syndrome (NS) is a cosmopolitan affection. It is an immunological disease and certain environmental factors, in particular viral infections and allergens, influence its occurrence. The climatic and environmental differences coupled with the frequency of infectious pathologies signing the African particularity and the absence of data in Mali on this affection, motivated us to carry out this work. Objective: To study the epidemiological aspects of nephrotic syndrome in hospitalized children aged 0 - 15 years. Patients and Methods: This was a descriptive prospective study from January 1 to December 31, 2021 in the Pediatrics Department of the University Teaching Hospital (UTH) Gabriel Touré, anational pediatric reference service in Mali. Diagnostic confirmation was provided by biology. Results: In one year, 120 children were hospitalized for nephrotic syndrome with a sex ratio of 2.75. Male exclusivity was observed at the ages of one year, eight years and 14 years and a reversal at 13 years (sex-ratio = 0.33). The median age was 6 years for an average age of 6.4 years ± 2.4 years with extremes ranging from one year to 14 years. The first attack of nephrotic syndrome occurred outside the classic age (>10 years) in 16.67%. Nephrotic syndrome is observed throughout the year with two peaks in summer (July to September) and winter (December to February). Many ethnic groups were affected by this condition with a high frequency among ethnic groups where endogamy is common. All patients were melanoderms. No cases of NS were recorded in Caucasian children from Northern Mali. The patients came from Bamako in 47.5% of cases. Two brothers from the same siblings had had their first attack of nephrotic syndrome the same year, ten months apart. Conclusion: Nephrotic syndrome in pediatric hospitals of Bamako occurs at a median age of six years all along the year with a summer and winter peaks. It is more observed in ethnic groups where the practice of endogamy is common and concerns melanoderm children.

Rhombic Cell Analysis - A New Way of Probing the Large- Scale Structure of the Universe. I.General Considerations

A new way of probing the large-scale structure of the universe is proposed. Space is partitioned into cells the shape of rhombic dodecahedron. The cells are labelled 'filled' or 'empty' according as they contain galaxies or not. The cell size is so chosen as to have nearly equal numbers of filled and empty cells for the given galaxy sample. Two observables on each cell are definable: the number of its like neighbors, n1, and a two-suffixed topological type τ, the suffixes being the numbers of its like and unlike neighbor-groups. The frequency distributions of n1 and T in the observed set of filled (empty) cells are then considered as indicators of the morphology of the set. The method is applied to the CfA catalogue of galaxies as an illustration. Despite its limited size, the data offers evidence 1) that the empty cells are more strongly clustered than the filled cells, and 2) that the filled cells, but not the empty cells, have a tendency to occur in sheets. Further directions of development both in theory and application are indicated.

M.A. AND PH.D. DISSERTATIONS 1994-95 INSTITUTE FOR THE HISTORY OF ANCIENT CIVILIZATIONS NORTHEAST NORMAL UNIVERSITY, CHANGCHUN

Ma Xiaoying, Assyriology, Ph.D., 1994.12 "Women’s Social Status in Old Babylonia Reflected in Marital Property" (Supervisors: Professors Lin Zhichun, Thomas Lee, Tova Meltzer, Wu Yuhong) Wang Liying, Classics, Ph.D., 1995.6 "Sallust’s Bellum Catilinae" (Supervisors: Porfessors Wang Dunshu, P.Ruth Taylor-Briggs, F. Ahlheid, Lin Zhichun)

“一所看得见未来的儿童大学”:教授校长治校理念的创生与探索

为发挥大学服务基础教育均衡发展的作用,2021年,上海师范大学委派笔者担任上海师范大学附属第五实验学校的创校校长。基于多年的基础教育研究和管理经验,笔者确立了“一所看得见未来的儿童大学”的办学理念,以及“为未来而教,为未来而学”的教学目标,树立儿童主体性地位,培养服务儿童未来发展的教师,开发服务儿童未来生活的课程,旨在培养与未来同行的大格局、宽视野、优表达、精实践、强创造的儿童。

二孩时代生还是不生?--独生父母家庭二孩生育意愿及影响因素探析

以北京市2334个已育一孩的独生父母家庭作为研究对象,通过问卷调查法了解北京市独生父母家庭二孩生育意愿,并深入分析其影响因素。结果表明,北京市独生父母家庭在理想子女个数和性别上,期待儿女成双,且女孩偏好在逐步增强。在具体生育意向和生育计划上,由于受到生育观念、生育成本、母亲个体因素(年龄、受教育程度)的制约,表现出了较低的生育意愿。此外,在更接近于生育行为的生育计划上,独生父母家庭会有更多的经济考量。建议:政府及相关部门加大生育宣传力度;关注高龄产妇生殖健康,完善生育补偿制度;提供充足的公共服务资源;有效提高独生父母家庭的二孩生育意愿。

肝硬化患者血清PGⅠ、PGⅡ及G-17水平变化及临床意义

目的探索肝硬化患者血清中胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)及胃泌素-17(G-17)的水平变化及临床意义。方法选取自2013年7月至2014年11月我院接收的肝硬化患者97例,作为观察组;另选取同期未患胃病的肝硬化患者92例,作为对照组。采用ELISA法分析肝硬化患者血清中PGⅠ、PGⅡ及G-17的水平变化。结果与对照组相比,观察组患者血清中PGⅠ、PGⅡ和G-17水平明显高于对照组,且差异具有统计学意义(P<0.05)。另外,与Child-Paugh A级相比,Child-Paugh C级患者血清中PGⅠ、PGⅡ和G-17的水平显著升高;Child-Paugh B级患者血清中PGⅠ和G-17的水平明显升高,差异具有统计学意义(P<0.05)。结论肝硬化患者血清中PGⅠ、PGⅡ及G-17可以作为指标来表征胃部疾病,且三个指标的水平与Child-Paugh分级有一定的联系。

肝硬化患者血清中γ-谷氨酰转移酶、胆碱酯酶、总胆汁酸水平及凝血功能对肝功能分级的价值评价

目的探讨肝硬化患者γ-谷氨酰转移酶(GGT)、胆碱酯酶(CHE)、总胆汁酸(TBA)水平及凝血功能的变化在Child-Pugh分级中的价值。方法测定40例肝硬化患者血清GGT、CHE、TBA及血浆中凝血酶原时间(PT)、激活部分凝血激酶时间(APTT)、凝血酶时间(TT)和纤维蛋白原(FIB)含量。与对照组30例比较。同时比较在肝硬化不同Child-Pugh分级状态时这7项指标的差异。结果与对照组比较,肝硬化组GGT、TBA血清含量明显升高,PT、APTT、TT时间延长,而CHE、FIB血清含量明显下降,差异均有显著性(P<0.001),且在不同肝功能分级时,各项指标均有统计学意义(P<0.05或P<0.01或P<0.001)。结论肝硬化患者GGT、CHE、TBA、PT、APTT、FIB、TT值与正常对照组比较存在明显差异,且不同肝功能分级的上述指标变化相异,故联合检测上述各值可为临床评价肝硬化患者的肝功能及预后提供客观依据。

生育二孩对家庭收入的影响--兼论全面二孩政策的效果

生育二孩后家庭收入可能产生的长短期变动对二孩生育意愿具有重要影响。基于城镇居民家庭收入变化的动态视角,研究不同阶层生育二孩的内在规律。通过中国家庭营养与健康调查(CHNS)提供的中国9省份调查数据,运用工具变量回归方程和工具变量分位数模型发现:第一,生育二孩对家庭收入的负面效应远大于一孩,生育当年导致家庭收入下降38.7%,显著抑制家庭收入的提升;第二,生育二孩对家庭收入的作用机制存在阶层差异性,中等收入阶层家庭收入水平受生育二孩影响最为严重,低收入阶层次之,高收入阶层最小,二孩生育机会在阶层之间缺乏公平性和公正性;第三,中等收入阶层可能成为全面二孩政策发挥积极效应的重要障碍。优化具有阶层差异性的生育政策和收入分配政策的协同效应已刻不容缓。