中国现代文学中的肺病隐喻与性别象征

中国现代文学中的肺病隐喻和性别象征是相互关联的典型意向,既有疾病隐喻的性别化倾向,又有性别象征的疾病叙事,在性别政治的视野下表现出不同的叙事模式。肺病隐喻既有道德化和社会化倾向,又有审美化、意象化取向。男性的性别政治叙事主要关注男性肺病身份的道德内涵和社会化倾向,女性肺病身份则主要体现为审美化取向,凸显其符码化和想象性特征。女性叙事呈现出层次性,萧红、丁玲等人的女性叙事描写肺病,关注爱情,心系女性;张爱玲等人的女性叙事割断了肺病与女性身体之间的审美想轧以丑怪身体呈现了女性在性别政治中的真实处境。     

肺病隐喻与性别文化象征——中国现代文学中的“肺病”意象探析

肺病是中国现代文学中最典型的疾病意象之一。肺病隐喻的叙事与性别文化象征之间存在着复杂的关联，它有一种性别化倾向，体现为不同的男女两性身体叙事。肺病隐喻的男性叙事在男女两性病患者身上的隐喻变体明显不同，一者主要关注其道德内涵和社会化倾向，一者则主要体现为审美化取向，并从中可以发现性别政治在女性身体上的权力痕迹；肺病隐喻的女性叙事割断了肺病与女性身体之间的审美想象，以丑怪身体呈现了女性在性别政治中的真实处境。     

Isoniazid Completion Rates for Latent Tuberculosis Infection Among College Students Managed by a Community Pharmacist

Objective: The authors' objective was to document 9-month and previously recommended 6-month treatment completion rates for latent tuberculosis infection (LTBI) in a pharmacistmanaged LTBI clinic in a community pharmacy on a college campus, and to describe patient characteristics. Participants: Participants were university students diagnosed with LTBI. Methods: The authors conducted a retrospective review of pharmacy records from 2000 to 2006. Main outcome measures included 6-month and 9-month LTBI treatment completion rates, total isoniazid (INH) tablets taken, characteristics of completers versus noncompleters, average time to treatment completion, and reported adverse drug events. Results: The 9-month completion rate was 59%, and the 6-month completion rate was 67%. Among those not completing treatment, 15.2% experienced fatigue and 2.2% experienced a rash (p = .04 and p = .03, respectively). Conclusion: LTBI clinics are a unique niche for community pharmacies and can provide individualized patient care to ensure LTBI treatment adherence, monitoring for disease progression, and safety of INH.     

A probabilistic transmission and population dynamic model to assess tuberculosis infection risk

The purpose of this study was to examine tuberculosis (TB) population dynamics and to assess potential infection risk in Taiwan. A well‐established mathematical model of TB transmission built on previous models was adopted to study the potential impact of TB transmission. A probabilistic risk model was also developed to estimate site‐specific risks of developing disease soon after recent primary infection, exogenous reinfection, or through endogenous reactivation (latently infected TB) among Taiwan regions. Here, we showed that the proportion of endogenous reactivation (53–67%) was larger than that of exogenous reinfection (32–47%). Our simulations showed that as epidemic reaches a steady state, age distribution of cases would finally shift toward older age groups dominated by latently infected TB cases as a result of endogenous reactivation. A comparison of age‐weighted TB incidence data with our model simulation output with 95% credible intervals revealed that the predictions were in an apparent agreement with observed data. The median value of overall basic reproduction number (R₀) in eastern Taiwan ranged from 1.65 to 1.72, whereas northern Taiwan had the lowest R₀ estimate of 1.50. We found that total TB incidences in eastern Taiwan had 25–27% probabilities of total proportion of infected population exceeding 90%, whereas there were 36–66% probabilities having exceeded 20% of total proportion of infected population attributed to latently infected TB. We suggested that our Taiwan‐based analysis can be extended to the context of developing countries, where TB remains a substantial cause of elderly morbidity and mortality.     

体重指数和慢性阻塞性肺疾病患者肺功能及呼吸困难的研究

目的研究慢性阻塞性肺疾病(COPD)患者肺功能及呼吸困难程度与体重指数的关系。方法 76例COPD稳定期患者按体重指数(BMI)分为2组,BMI<21kg/m2为低体重组,BMI23kg/m2～25kg/m2为正常体重组,每组各为38例,比较两组肺功能障碍和呼吸困难的发生率,分析BMI和肺功能及呼吸困难的相关性。结果低体重患者比正常体重患者呼吸困难发生率高,两者统计学有差异(P<0.05);两组肺功能FEV1(%)Pred,FEV1/FVC(%),MVV差异有显著性(P<0.05),正常体重组明显高于低体重组。结论 COPD患者的体重指数和肺功能及呼吸困难有一定的相关性,改善COPD患者的营养状况,有利于COPD患者改善肺功能和呼吸困难,提高生活质量。     

氧雾化吸入博利康尼、布地奈德治疗慢性阻塞性肺病急性加重期临床分析

目的观察博利康尼、布地奈德氧雾化治疗慢性阻塞性肺疾病急性加重期（AECOPD）的临床疗效。方法30例AECOPD住院患者随机分为三组,分别给予布地奈德,博利康尼＋布地奈德氧雾化吸入治疗和空白对照组治疗。观察三组疗效、临床表现、肺功能,动脉血气变化及副作用发生情况。结果博利康尼＋布地奈德组临床表现FEV1和动脉血气的改善显著优于空白对照组,略优于布地奈德组,布地奈德组显著优于空白对照组。结论氧雾化吸入博利康尼、布地奈德治疗AE—COPD有效、安全、易行,可作为AECOPD常规治疗措施     

A Probabilistic Transmission Model to Assess Infection Risk from Mycobacterium Tuberculosis in Commercial Passenger Trains

The objective of this article is to characterize the risk of infection from airborne Mycobacterium tuberculosis bacilli exposure in commercial passenger trains based on a risk‐based probabilistic transmission modeling. We investigated the tuberculosis (TB) infection risks among commercial passengers by inhaled aerosol M. tuberculosis bacilli and quantify the patterns of TB transmission in Taiwan High Speed Rail (THSR). A deterministic Wells‐Riley mathematical model was used to account for the probability of infection risk from M. tuberculosis bacilli by linking the cough‐generated aerosol M. tuberculosis bacilli concentration and particle size distribution. We found that (i) the quantum generation rate of TB was estimated with a lognormal distribution of geometric mean (GM) of 54.29 and geometric standard deviation (GSD) of 3.05 quantum/h at particle size ≤ 5 μm and (ii) the basic reproduction numbers (R₀) were estimated to be 0.69 (0.06–6.79), 2.82 (0.32–20.97), and 2.31 (0.25–17.69) for business, standard, and nonreserved cabins, respectively. The results indicate that commercial passengers taking standard and nonreserved cabins had higher transmission risk than those in business cabins based on conservatism. Our results also reveal that even a brief exposure, as in the bronchoscopy cases, can also result in a transmission when the quantum generation rate is high. This study could contribute to a better understanding of the dynamics of TB transmission in commercial passenger trains by assessing the relationship between TB infectiousness, passenger mobility, and key model parameters such as seat occupancy, ventilation rate, and exposure duration.     

A simple in-host model for Mycobacterium tuberculosis that captures all infection outcomes

ABSTRACT

Tuberculosis infection can result in clearance, latent infection, or active disease, with slow or fast progression. A four-dimensional model of in-host tuberculosis infection includes macrophages, T lymphocytes, tuberculosis bacteria, and their interactions. Changes in the infection rate, cell-mediated immunity rate, macrophage loss rate, and bacteria killing rate most affect disease outcomes. Simulations show that a periodic solution can occur. When the infected macrophage killing rate is constant, a backward bifurcation exists and the system is globally stable.     

Efficacy of screening and treatment of latent tuberculosis infection

ABSTRACT

Sixty-three percent of the total active tuberculosis cases in Canada were diagnosed among foreign-born individuals, representing 20% of the total population. The majority of these cases occur from the reactivation of tuberculosis infections acquired prior to immigration. A preventive policy consisting of screening and treating new immigrants for latent tuberculosis infection is evaluated on its efficacy for reducing the total number of tuberculosis cases, using tuberculosis incidence data between 1986 and 1995 from the Canadian tuberculosis reporting system. The most effective intervention is to screen for and treat latent tuberculosis infection among arriving immigrants from countries of birth with a tuberculosis incidence rate greater than 15 cases per 100,000.     

Tuberculosis with relapse: A model

ABSTRACT

In a model of tuberculosis with relapse, the basic reproduction number R₀ includes new and relapse infections. Lyapunov functions help to prove that the global dynamic is completely determined by R₀. Replicated Latin hypercube sampling shows that early diagnosis and treatment are more efficient when relapse cases are considered.