口腔金属材料磁共振成像伪影的实验研究

研究3种口腔常用金属材料在l3种不同头颈部扫描序列中的伪影。测量伪影大小，并进行统计学分析。得出3种金属在相同序列成像中，纯钛伪影最小，硬质钴铬合金伪影最大；相同金属材料，6种自旋回波及快速自旋回波序列产生伪影最小，3种梯度回波序列产生伪影较大，4种平面回波序列伪影最大且使图像变形。口腔金属材料产生伪影与材料类型及成像技术密切相关，通过合理选择金属材料及成像技术得到最佳MR成像。     

西宁地区窒息新生儿早期干预效果评价

目的 :了解早期干预 (早期教育 )对于防治西宁地区 (高原 )窒息所致脑损伤新生儿智力低下的效果。方法 :对于西宁地区出生在我院的足月窒息儿按收治先后分别随机分配原则 ,分为早期干预组 (30例 ) ,常规育儿组 (2 8例 ) ,并设正常小儿为对照组 (32例 )。早期干预组从新生儿期开始采取早期干预措施。 3组小儿在体格发育、家庭环境、父母文化程度等方面没有明显差别。结果 :6个月时早期干预组和常规育儿组婴儿智力发育差异无显著性 (P>0 .0 5 ) ,早期干预组和正常小儿对照组差异有显著性 (P<0 .0 1) ,18个月时智力发育指数早期干预组明显优于常规育儿组 (P<0 .0 1) ,完全赶上正常小儿发育水平 (P>0 .0 5 )。结论 :早期干预对于防治西宁地区窒息新生儿智力低下是有效的     

L’actualité des rickettsioses

Rickettsiae are strictly intracellular bacteria belonging to the Rickettsiaceae family. They are transmitted by various arthropods species, which are either vectors or reservoirs for the bacteria. The specific association between Rickettsieae and the vector are extensively studied, moreover Rickettsieae associated diseases are part of a continuously evolving field. Nevertheless, some rickettsiosis, such as epidemic typhus, have been described since the 16th century. Emerging diseases related to these bacteria are being investigated as well as new species, the implication of which is not always clear in human pathology when they are discovered. Some of these diseases are benign, others may be potentially fatal. Clinicians must therefore be aware of them. These issues are reviewed.     

新疆阿拉山口口岸2012年入境集装箱空箱卫生状况调查

目的对阿拉山口口岸2012年入境1514个需进行卫生处理集装箱空箱卫生状况和携带微生物情况进行调查分析,为加强入境集装箱空箱卫生检疫及卫生处理工作提供依据。方法对箱内携带垃圾进行分类分析,随机抽取集装箱,对其箱内表面采样,参考国家有关标准,采用显色培养基和生化培养试剂盒做微生物培养、鉴定菌种。结果处理集装箱空箱中,检查结果如下：携带动物尸体集装箱3个;携带动植物残留物集装箱101个;携带生活垃圾集装箱1373个;携带人类或动物传染病病原体集装箱48个;携带病媒生物集装箱37个。微生物检测情况如下：随机抽取处理集装箱空箱采集412份样品,检出金黄色葡萄球菌225株;沙门氏茵20株;大肠埃希氏菌61株;蜡样芽孢杆菌199株;链球菌31株等病原微生物。结论入境集装箱空箱携带垃圾、病原微生物为国际间疫病的传播提供了便利通道,给各国的卫生安全及人体健康带来威胁。应加强阿拉山口口岸入境集装箱空箱的卫生检疫及卫生处理工作。     

新生儿低血糖症91例临床分析

目的：探讨新生儿低血糖的高危因素及临床特点,为临床诊治及预防提供依据。方法：对收治的1254例新生儿进行血糖监测,对91例低血糖症患儿的临床资料进行回顾性分析。结果：①91例低血糖症中足月儿38例,早产儿53例,小于胎龄儿17例,窒息或宫内窘迫37例,感染26例,母患糖尿病或妊高症8例,喂养不当6例。②有症状22例（24.2%）,无症状69例（75.8%）,血糖越低,越容易出现临床症状。结论：对各种低血糖高危因素的新生儿均应常规监测血糖,早期诊断,及时治疗,可降低新生儿低血糖症及其脑损伤的发生。     

The proposal of philosophical basis of the health care system

The studies of health care systems are conducted intensively on various levels. They are important because the systems suffer from numerous pathologies. The health care is analyzed, first of all, in economic aspects but their functionality in the framework of systems theory is studied, as well. There are also attempts to work out some general values on which health care systems should be based. Nevertheless, the aforementioned studies, however, are fragmentary ones. In this paper holistic approach to the philosophical basis of health care is presented. The levels on which the problem can be considered are specified explicitly and relations between them are analyzed, as well. The philosophical basis on which the national health care systems could be based is proposed. Personalism is the basis for the proposal. First of all, the values, that are derived from the personalistic philosophy, are specified as the basic ones for health care systems. Then, general organizational and functional properties of the system are derived from the assumed values. The possibility of adaptation of solutions from other fields of social experiences are also mentioned. The existing health care systems are analyzed within the frame of the introduced proposal.     

289名住院病人对医疗服务状况认同程度的调查与分析

问卷调查289名住院病人对医疗服务状况的认同程度,结果显示医疗护理质量、服务质量、设备环境条件倍受重视,医疗费用、投诉仍是人们关注的热点、焦点。医疗服务的社会定位、市场定位、产品定位应是“病人至上”、“服务为本”、“质量第一”,它是医院可持续发展的根本之所在。     

Host range and emerging and reemerging pathogens

An updated literature survey identified 1,407 recognized species of human pathogen, 58% of which are zoonotic. Of the total, 177 are regarded as emerging or reemerging. Zoonotic pathogens are twice as likely to be in this category as are nonzoonotic pathogens. Emerging and reemerging pathogens are not strongly associated with particular types of nonhuman hosts, but they are most likely to have the broadest host ranges. Emerging and reemerging zoonoses are associated with a wide range of drivers, but changes in land use and agriculture and demographic and societal changes are most commonly cited. However, although zoonotic pathogens do represent the most likely source of emerging and reemerging infectious disease, only a small minority have proved capable of causing major epidemics in the human population.     

Tuberculosis in Peru: identification,treatment

The incidence of tuberculosis in Peru is estimated at 171.3 per 100,000, but regional differentials are significant. The government has administered a decentralized tuberculosis control program for the past several years. Diagnosis, follow-up, and treatment are free. Vaccinations are provided for newborns and at the age of six. Health promoters at the health posts are responsible for screening individuals with coughs lasting longer than two weeks. Sputum samples are analyzed, with the test repeated as necessary. Chest X-rays and tuberculin tests are sometimes useful for diagnosis of tuberculosis, but are difficult to use in many areas of Peru. Cases are treated with a combination of four drugs for the first two months, after which two of the drugs are continued for another four months. The protocol is for most patients regardless of whether the tuberculosis is pulmonary or extrapulmonary. A second and more difficult protocol is used for patients with positive sputum tests after six months of treatment. Hospitalization is reserved for very serious forms of tuberculosis or for complications. Patients receive their medications daily at the health post in the first treatment phase and twice weekly in the second. Tolerance has been good and no routine laboratory tests are performed. Possible side effects are diagnosed clinically. Chemoprophylaxis with isoniazide is provided for children under five years of age who are in contact with tuberculosis carriers. Educational talks are given to patients and their families to impress upon them the importance of proper treatment and follow-up.     

Chipping away at health: more on the relationship between income and child health

Low-income children are in worse health than other children are. This paper explores the extent to which insults to health and activity limitations are responsible. In the most recent National Health Interview Survey (NHIS) data, low-income children are more likely than other children to have virtually every measured chronic or acute condition and are more likely to be limited by these conditions. Mental health conditions are particularly common and limiting. But the higher incidence of measured conditions and limits does not explain all of the relationships between income and overall health status, which suggests that unmeasured illnesses and injuries are also involved.     

Rank-based tests for non-inferiority and equivalence hypotheses in multi-centre clinical trials using mixed models

Rank-based procedures for testing non-inferiority and equivalence hypotheses for data (continuous) arising from multi-centre clinical trials are developed using mixed models. The centres are presumed to be a random sample from the population of centres which might conceivably use the treatments under investigation, and the treatment effects are assumed to be fixed. It is assumed that there are no interactions between treatments and centres. Non-inferiority and equivalence hypotheses are tested using rank (R) estimators. The R-estimators are obtained by minimizing a combined dispersion function. The combined dispersion function is a sum of separate dispersion functions from each centre. Both the combined dispersion function and the centre-specific dispersion functions are piecewise linear functions. As a result, the R-estimates are expected to be less influenced by outliers. Large sample properties of the R-estimators including efficiencies are developed. A small scale simulation study is conducted to compare the performances (empirical levels and powers) of the non-parametric procedures and the normal theory based procedures.     

我国省级区域医疗卫生与经济协调发展的时空演变研究

目的:探索我国省级区域医疗卫生与经济协调发展状况及其时空演变,为医疗卫生与经济增长关系研究提供新思路。方法:借鉴物理学概念及有关成果,构建协调发展评价模型,对我国省级区域医疗卫生与经济协调发展状况进行分析,并运用探索性空间数据分析方法分析其时空演变。结果:我国省级区域医疗卫生与经济协调发展取得了一定进展,各省级区域呈现出"中间重(过渡类较多)、两头轻(协调类、失衡类较少)"的状态,和"东高西低"的阶梯特征;在空间上集聚,高值集聚和低值集聚均比较明显,热点和次热点区域主要集中在东、中部地区,而冷点和次冷点区域主要集中在西部地区。结论:协调发展评价模型适用于区域医疗卫生与经济协调发展研究,为医疗卫生与经济增长协调关系研究提供了新基础。     

Program evaluation techniques in the health services.

This article addresses the issue of program evaluation in the area of health services; examples are drawn from the field of mental health. Current arguments concerning the goals, characteristics, and methodologies of program evaluation are discussed and two generally useful quantitative evaluation models are presented. The models are compared and their advantages for clinicians and administrators are detailed.     

Obesity in Mauritania: epidemiologic aspects

666 patients are observed at the external consultation of cardiology from january to june 1996: 227 are obese (34.08%), 187 (82.38%) of whom are women, and 40 men (17.62%), the age average of patients is 40.97 years (between 14 years and 91 years) and the weight average is 84.63 Kg (between 61 Kg and 154 Kg). The body mass index is more than 35 (morbid obesity) in 24.67% of cases (22.91% of whom are women, and 1.76% are men. The other risk factors found are: High blood pressure = 72 cases (31.72%) are obese and having high blood pressure 53 (23.35%) of whom female and 19 (8.37%) are male. 104 (23.69%) cases of high blood pressure are lean (9.11% women, 14.58% men). There is a significantly statistic between the two groups. Diabetes: 9 obese patients are diabetic (2.64% female, and 1.32% male. 1.94% of lean patient are diabetic. We notice a significantly statistic differences between the two groups. For other risk factors we find: 1.76% of tobacco dependent patients are obese where as 3.64% are lean. 0.88% of hypercholesterolemia and 0.44% of hyper uricemia.     

Standards of performance developed for clinical dietitians

Although standards of performance are common to industry, they are relatively new to health care professions. The development of standards of performance for registered dietitians in a clinical capacity are described. Changes made after a one year review of the program are listed. The benefits and costs of the program also are explained in the article.     

Alternative methods for testing treatment effects on the basis of multiple outcomes: simulation and case study

In clinical trials multiple outcomes are often used to assess treatment interventions. This paper presents an evaluation of likelihood-based methods for jointly testing treatment effects in clinical trials with multiple continuous outcomes. Specifically, we compare the power of joint tests of treatment effects obtained from joint models for the multiple outcomes with univariate tests based on modeling the outcomes separately. We also consider the power and bias of tests when data are missing, a common feature of many trials, especially in psychiatry. Our results suggest that joint tests capitalize on the correlation of multiple outcomes and are more powerful than standard univariate methods, especially when outcomes are missing completely at random. When outcomes are missing at random, test procedures based on correctly specified joint models are unbiased, while standard univariate procedures are not. Results of a simulation study are reported, and the methods are illustrated in an example from the Clinical Antipsychotic Trials of Intervention Effectiveness for schizophrenia.     

Design Factors and Use of Ear Protection

The problems of protecting the ear against hazardous noise are the subject of a general review, supported where relevant by data from the authors' own researches. Ear protectors are classified into two main types−plugs and muffs—and the general principles of their function and limitations are stated. Examples of representative ear protectors are given in more detail, with particular respect to their relative merits and pure-tone attenuation characteristics. The effects of earplugs on speech communication are considered and the relationships between pure-tone attenuation and protection against continuous noise are discussed in some detail. The results of temporary threshold shift (T.T.S.) reduction studies of the efficiency of V.51R and Selectone-K earplugs in protecting against reverberant and non-reverberant impulsive noises are presented. The design requirements of ear protectors and some of the problems created by them are also outlined.     

Layoffs at hospitals: a challenge for health care managers

Like other organizations that are directly impacted by the state of the economy, some hospitals and other health care providers are discovering that staff reductions are realities that heretofore have been rare during recessionary periods. Consequently, health care managers are increasingly required to notify affected workers of layoff and convey to them critical information in meetings that are often fraught with anxiety and anger. Nevertheless, there are steps that the organization's managers can take to ensure that layoffs are addressed in a professional manner that maintains the trust and respect of the workforce.     

The sanitary status of natural waters on the territory of Moscow (according to the results of the examination of chemical and radionuclide composition)

The paper presents the results of examination of the chemical and radionuclide composition of natural waters and snow cover in Moscow. Areas with abnormal contents of tritium are found in the underground and surface waters and snow cover. The high concentrations of strontium, boron, fluorine, and barium are ascertained to be associated with natural factors. Areas of technogenically polluted underground waters are identified. Recommendations are given for further studies. Particular emphasis is laid on that the artesian wells that are a reservoir source of water supply under emergency are to be revised.     

Noise immunity evaluation and optimization of structure of systems for multichannel detection of electrophysiological information

Engineering solutions for optimal design of high-performance multichannel systems for detection of electrophysiological information are compared. The design techniques considered in this work are based on mathematical simulation of the detection channel functioning. The main characteristics of the detection channels are described. The main noise sources are considered. Recommendations for constructing multichannel detection systems are given and methods for capacity improvement and noise reduction are considered. Some of the engineering solutions considered in this work have been implemented in practical systems used by the manufacturers.