采用对比剂团注追踪技术进行头颅CTA时的监测扫描启动时间研究

目的:探讨采用对比剂团注追踪技术进行头颅CT血管成像(CT angiography,CTA)时的最佳监测扫描启动时间.方法:前瞻性收集某院行头颅CTA检查的患者400例,按预约先后顺序分为A、B 2组,前200例为A组,后200例为B组.A组在对比剂注射后8 s开始启动监测扫描.记录监测扫描的触发时间、触发时CT值、曝...     

头颅CT原始数据对颞骨区重建的可行性研究

目的:探讨利用头颅CT的原始数据进行颞骨区重建的可行性。方法:分析40例同期接受头颅CT及颞骨高分辨率CT(HRCT)检查患者的影像资料,利用头颅CT的原始数据,通过选择适当的重建参数对颞骨区进行重建,以重建的颞骨图像与颞骨HRCT直接扫描图像分别进行图像质量评分,并进行统计学分析。结果:利用头颅CT原始数据对颞骨区进行重建能清晰显示颞骨各观察结构,重建图像与颞骨HRCT直接扫描图像质量评价得分比较,差异无统计学意义。结论:利用头颅CT的原始数据进行颞骨区重建可以得到满意的颞骨区图像,应用于临床可以避免患者重复扫描,降低辐射风险。     

螺旋CT对腕关节骨折诊断价值分析与研究

目的:研究分析螺旋CT对腕关节骨折的临床价值.方法:选取我院2014年8月至2016年8月间收治的腕关节骨外伤患者28例,患者先进行X线片检查,再应用螺旋CT对患者进行扫描,记录患者应用X线片检查及螺旋CT扫描检查在腕关节骨折诊断中的作用,评价两种检查方法的诊断准确率.结果:临床确诊28例患者为腕关节骨折,其中裂纹骨折11例、粉碎性骨折9例、枝状骨折6例、星状骨折2例.两种方法的诊断准确率进行比较,螺旋CT检查诊断准确率78.5%高于X线检查诊断准确率32.1%(P<0.05).结论:腕关节骨折患者应用螺旋CT检查有利于提高临床诊断准确率,可在临床推广应用.     

全模型迭代重建技术在脑部CT图像中的应用研究

目的:观察不同级别全模型迭代重建(iterative model reconstruction,IMR)技术对脑部CT图像质量和噪声的影响,找到同等摄影条件下能够取得脑部扫描最佳图像质量的迭代重建级别.方法:回顾性分析2020年1-4月以头晕、头疼等症状到某院急诊就诊,且行头部CT平扫检查的36例患者的临床资料.对36...     

CT三维重建技术在腰椎骨折诊断中的应用

目的探究CT三维重建技术应用于腰椎骨折患者,观察分析临床诊断中的应用价值。方法选取2016年8月-2017年8月在天津市第一中心医院治疗的35例腰椎骨折患者,分别应用X线检查和CT三维重建技术检查,比较不同检查方式的诊断结果与手术病理结果符合率。结果螺旋CT是连续的容积扫描,不会丢失层与层之间的小病灶,从而提高了病灶的检出率和CT值测量的准确性。螺旋CT扫描速度快,可进行连续扫描成像没能够在患者一次屏气的时间内完成,这样可减少呼吸伪影,同时也提高了图像质量和工作效率。CT三维重建技术检查临床诊断结果的符合率明显高于X线检查,差异有统计学意义(P0.05)。结论 CT三维重建技术应用于临床腰椎骨折患者,可以有效的提高临床诊断结果的符合率,增加临床诊断的准确率,临床应用价值高。     

16排多层螺旋CT后处理技术诊断胸部骨骼骨折的临床应用价值

目的:对胸部骨骼骨折患者应用16排多层螺旋CT后处理技术进行检查的临床诊断价值展开分析.方法:选取我院收治的53例胸部外伤患者为研究对象,结束胸部X线检查以后,以病情为依据,采用16排多层螺旋CT进行检查,并采取CPR(曲面重建)、MPR(三维重建多平面重组)以及VR(容积再现)等后处理技术,将患者骨折情况显示出来.结果:经16排多层螺旋CT检查,本组53例患者中,肋骨骨折有38例,胸骨骨折有6例,锁骨、肩胛骨、肱骨骨折的有9例.结论:对于胸部骨骼骨折患者,通过应用16排多层螺旋CT后处理技术对其进行扫描并成像,可进行准确诊断,具有重要的临床应用价值.     

低剂量CT扫描技术在脑出血检查中的应用价值

目的：探讨低剂量CT扫描技术在脑出血检查中的应用价值。方法对40例脑出血患者行头颅低剂量CT扫描,分析评价其图像质量,记录CT容积剂量指数（CTDIvol）,并与传统扫描的辐射剂量进行比较。结果图像清晰无伪影,对比度、分辨率均符合诊断要求;应用低剂量技术,40例患者的平均CTDIvol为37.25 mGy,较传统扫描方式的46.08 mGy,降低约19.1%。结论低剂量CT扫描技术可降低患者的辐射剂量,具有良好的应用前景。     

双源64层螺旋CT在肺动脉成像中的扫描技术及应用

目的:探讨双源64层螺旋CT在肺动脉成像(CTPA)中的扫描技术。方法:对184例临床拟诊为肺动脉栓塞患者进行CTPA检查,采用团注实验法(bolustest)测试循环峰值时间,以峰值时间加1s作为肺动脉扫描的延迟时间,再对肺动脉进行成像扫描。结果:184例均成功完成CTPA扫描检查,肺动脉主干及其分支强化均匀,通过后处理技术均清晰显示肺动脉主干及其分支。结论:双源64层螺旋CT进行CTPA检查,选择恰当的延迟时间至关重要,而恰当的延迟时间又能使对比剂的用量减到最低。此方法简便快捷,达到延迟时间个体化,可作为CTPA的首选检查方法。     

64排容积CT重建技术在颞骨骨折诊断中的价值

目的:探讨64排容积CT颞骨区重建技术在颞骨骨折诊断中的价值。方法:收集28例头颅CT诊断为可疑颞骨骨折患者的影像学资料,做回顾性分析,利用头颅CT的原始数据通过改变兴趣区(ROI)大小、层厚、层间距及图像算法等对颞骨区进行放大重建,总结分析头颅CT颞骨区重建在颞骨骨折诊断中的应用价值。结果:利用头颅CT原始数据对颞骨区进行放大重建能清晰显示颞骨各主要组成结构。其中17例明确诊断颞骨骨折,8例未见骨折,3例为可疑骨折。结论:利用头颅CT原始数据对颞骨区放大重建可对CT图像进行优化,提高颞骨区图像质量;可为颞骨骨折诊断提供更多信息而避免患者二次扫描,以减少对人体的辐射损伤。     

全腹CT扫描前两种胃肠道准备方法的应用研究

目的 比较全腹CT扫描前两种胃肠道准备方法的应用效果。方法 将93例全腹CT扫描检查的患者按照进院检查顺序随机分组,观察组47例,对照组46例,对照组采用常规方法,口服泛影葡胺准备肠道进行全腹CT扫描检查,对照组采用口服并灌肠泛影葡胺用于全腹CT扫描检查。结果 观察组患者肠道造影剂充盈时间平均(1.01±0.20) h,成功率100%,对照组患者肠道造影剂充盈时间平均(2.93±0.32) h,成功率82.6%。两组对比差异有统计学意义(P < 0.01)。结论 表明口服并灌肠泛影葡胺用于全腹CT扫描的准备时间大大缩短。提高了影像检查质量和正确诊断率。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.