基于MRI的非酒精性脂肪性肝病患者铁沉积的代谢研究

目的通过磁共振成像(MRI)探讨非酒精性脂肪性肝病(NAFLD)患者肝脏铁沉积与脂肪变的关系。方法 163例肝活检患者行肝脏MRI检查, R2*用于测定肝铁含量, 基于Dixon的质子密度分数(PDFF)用于测定肝脏脂肪含量, 根据肝活检病理结果通过单因素方差分析、相关性分析、受试者操作特征(ROC曲线)等分析临床病例资料、血清学指标、影像学结果之间的关系。结果随着病理脂肪变性分级越高, R2*逐步增高, 无脂肪变(<5%), 轻度脂肪变(14.95%±8.55%), 中度脂肪变(46.30%±9.32%), 重度脂肪变(73.86%±6.35%)对应的R2*分别为27.56±4.40, 31.06±5.95, 38.06±4.80, 48.10±5.55(P < 0.001), R2*和肝脏脂肪变含量呈正相关(r=0.769, P < 0.05), ROC曲线下面积为0.88, 截断值为31.77, 与肝脏炎症和纤维化相关性不明显。结论 R2*可以无创量化评估NAFLD患者肝铁沉积含量, 肝脏脂肪变和铁沉积存在明显相关性, 随着脂肪变加重, 铁沉积也呈加重趋势。     

马铃薯片外敷治疗胺碘酮所致静脉炎疗效观察

胺碘酮为抗心绞痛、抗心律失常药物,外周静脉用药常引起局部红肿、疼痛、血管硬化等药物性静脉炎表现,影响患者血管的合理使用,增加患者痛苦。2007—10／2009—10我院CCU采用生马铃薯片外敷治疗胺碘酮所致静脉炎,效果满意,介绍如下。     

维持性透析患者在血液透析后出现急性心力衰竭的分析及防治

目的：分析维持性透析患者在血液透析后出现急性心力衰竭的原因及防治办法.方法：收集15例维持性血液透析患者,分析在透析后24小时内发生急性心力衰竭的情况及原因.结果：10例患者血透后发生急性心力衰竭与血透后血压增高有关,5例与有基础心脏病、重度贫血、严重肺部感染、透析过程不顺利、透析不充分有关.经过硝普钠维持静滴降压、强心、利尿、行持续性肾替代治疗,14例心衰缓解 1例死亡 1例心衰缓解的患者在以后的血透中又反复出现透析中低血压,透后心衰,转行腹膜透析后,无心衰出现.结论：血透后发生急性心力衰竭与血透后血压增高、有基础心脏病、重度贫血、严重肺部感染、心肌、心包炎、透析过程不顺利、透析不充分有关.若及时纠正诱发心衰的危险因素,或根据患者具体情况选择患者可以耐受的血液净化方式,可以避免或减少血液透析后心力衰竭的发生.     

双能X射线骨密度仪测量离体羊股骨骨折端及钢板对接骨折端的骨密度

背景：目前,羊已逐渐成为骨质疏松研究中很有前途的动物模型。 目的：采用双能X射线骨密度仪测量羊股部骨折断端及全部骨密度,探讨双能X射线骨密度仪测量过程中的准确度和精确度。 方法：对双能X射线骨密度仪自带的Lunar腰椎模型扫描10次/d,确定机器准确度,再连续扫描25 d,根据所测数据建立Shewhart控制图。选取3只羊中5根股骨进行7次重复扫描,采用骨密度仪自带的小动物分析软件分析羊股部骨折断端的骨密度、全部的骨密度,计算其精密度。另外选取4只羊8根股骨,用2种钢板对骨折断端固定,分析骨密度及骨矿含量的变化。 结果与结论：双能X线骨密度仪的准确度为-1.0%,离体羊股部骨折断端及全部的骨密度测量精密度为0.005~0.537 g/cm2。股骨全部骨和骨折断端密度的短期精密度分别为0.8%和1.5%,股骨全部和骨折断端骨矿物含量的短期精密度为0.9%和7.5%。不同钢板固定后的羊股骨骨密度、骨矿含量差异无显著性意义。结果证实,双能X射线骨密度仪能准确测量离体羊股骨的骨密度,但在骨折断端骨矿含量精密度分析有一定的误差。     

电针对局灶性脑缺血再灌注大鼠脑细胞凋亡及神经功能恢复的影响

Objective To investigate the influence of acpuncture on free calcium in rat brain cells after focal cerebral ischemia reperfusion.Methods 145 adult male SD rats were randomly divided into control group,simple ischemia reperfusion group and acupuncture with ischemia reperfusion group.The middle cerebral artery occlusion/reperfusion (MCAO/R) rat model was established by the modified Longa occlusion method. ①The part of free calcium in rat brain cells,focal cevebral ischemia model of rats were made by thread locking up the blood vessel for 15 min.30 min later after reperfusion, the Baihui and Shuigou Point in Du meridian were acupunctured electrically 30 min.After 3h, 6h and 12h, the rat was killed and its brain cells were made into single cell suspension,marked by Fluo-3/AM.The fluorescence optical density was recorded by laser confocal microscopy.②The part of nerve functional reconstruction, focal cevebral ischemia model of rats were made by thread locking up the blood vessel for 12 hours.30 min later after reperfusion, the Baihui and Shuigou Point in Du meridian were acupunctured electrically 30 min.After 7 d, 14 d,30 d,60 d and 90 d, the rat was forced to detect it's strength of the dog.Results ①Free calcium in rats of acupuncture therapy group(6h:10.96±1.18;2h:20.9±4.37) was significantly less than that in control group in 6 h and 12 h after reperfusion (6 h: 16.87 ± 3.56,12 h: 34.10 ±1.06)(P<0.05).②The dog in rats of acupuncture therapy group was significantly more than that in control group in 7 d, 14 d after reperfusion (P＜ 0.05 ).No difference of the dog was detected in 30 d ,60 d and 90 d after reperfusion between the two groups.Conclusion Acupunture could decreases the concentration of free calcium and the expression of Caspase-3 mRNA in rat brain cells after focal cerebral ischemia reperfusion, and it can facilitate the recovery of nerve function.     

双能X射线骨密度仪测量离体羊股骨骨折端及钢板对接骨折端的骨密度

背景：目前,羊已逐渐成为骨质疏松研究中很有前途的动物模型。 目的：采用双能X射线骨密度仪测量羊股部骨折断端及全部骨密度,探讨双能X射线骨密度仪测量过程中的准确度和精确度。 方法：对双能X射线骨密度仪自带的Lunar腰椎模型扫描10次/d,确定机器准确度,再连续扫描25 d,根据所测数据建立Shewhart控制图。选取3只羊中5根股骨进行7次重复扫描,采用骨密度仪自带的小动物分析软件分析羊股部骨折断端的骨密度、全部的骨密度,计算其精密度。另外选取4只羊8根股骨,用2种钢板对骨折断端固定,分析骨密度及骨矿含量的变化。 结果与结论：双能X线骨密度仪的准确度为-1.0%,离体羊股部骨折断端及全部的骨密度测量精密度为0.005~0.537 g/cm²。股骨全部骨和骨折断端密度的短期精密度分别为0.8%和1.5%,股骨全部和骨折断端骨矿物含量的短期精密度为0.9%和7.5%。不同钢板固定后的羊股骨骨密度、骨矿含量差异无显著性意义。结果证实,双能X射线骨密度仪能准确测量离体羊股骨的骨密度,但在骨折断端骨矿含量精密度分析有一定的误差。     

对16家制鞋企业工人职业危害及其防护知识知晓情况的调查

为了解我国重点制鞋企业工人对职业危害及其防护知识知晓情况,选择辽宁、河北、江苏、广东和北京地区16家制鞋企业进行问卷调查。企业调查结果表明,有机溶剂(主要是苯及其同系物)是制鞋业最为严重的职业病危害因素,其次是粉尘和噪声。通风排毒设施、抽风装置和换气扇的定期检测率均达到90.0%以上,但通风排毒设施和换气扇的相关岗位超标率均超过60.0%。在个人防护用品的选择、配置和管理上,16家制鞋企业均存在不合格方面。提示,企业应规范职业危害防护设施的日常维护、检修与评价制度。个人问卷调查结果表明,制鞋企业劳动者对《中华人民共和国职业病防治法》就职业卫生防护方面的要求认知度存在一定的错误,占10.3%;劳动者对个人防护标准知之甚少,尤其呼吸防护用品相关标准,9.8%的人认为使用的个人防护用品不耐用,有20.0%~30.0%的使用者认为其使用的个人防护用品未达到满意的效果。提示,应加强职业病防治知识的宣传,制鞋企业应建立个人防护用品使用状况的定期评价机制和管理制度,监督管理部门应对个人防护用品使用市场监督管理。     

早产儿视网膜病变的筛查分析

Objective To investigate the incidence of retinopathy of prematurity(ROP)in Dongguan People's Hospital. Methods Records of premature infants who had undergone ROP screening in our hospital between June 2009 and October 2010 were analyzed retrospectively. Results Twenty-one cases out of 126 screened infants had developed ROP. Both eyes suffered from ROP in all the cases. The incidence of ROP was 16.67%. Of 19 cases(15.08%)developed ROP less than prethreshold and 2 cases(1.59%)developed threshold ROP. Among the 126 screened infants, 13(31.71%)out of 41 premature infants with birth weight(BW)<1500g and 8(9.41%)out of 85 with 1500g≤BW<2000g developed ROP, 15(30.61%)out of 49 with gestational age (GA)<32W and 6(7.79%)out of 77 with GA≥ 32W developed ROP. The incidence of ROP either among the groups of BW<1500g andl500g≤BW<2000g(x2=9.899, P <0.01), or among the groups of GA<32W and GA≥32W(x2=11.227, P<0.01)had statistical differences. Conclusions The incidence of ROP is 16.67% in Dongguan People's Hospital in present study. The incidence of severe ROP is low. Birth weight and gestational age are important factors to affect ROP incidence.     

某铅锌冶炼企业接铅作业人员关键控制点的调查

通过对某铅锌冶炼企业的生产工艺、生产活动、作业环境、作业场所中铅浓度、接铅作业工人血铅值等进行现场调查,根据现场铅浓度以及接铅作业工人血铅值,确定关键控制点。该铅锌冶炼企业接铅作业岗位超标率为66.6%,各车间铅烟平均检测结果和接铅作业人员平均血铅值也均超标。提示该企业应针对铅烟浓度超标严重的电铅反射炉、供料干燥窑巡检、烧结配料、电铅熔铅锅等岗位作为关键控制点进行技术改造,加强密闭和通风,使铅烟的浓度控制在国家职业接触限值以下,防止铅中毒的发生。 更多还原     

中医疗法在系统性红斑狼疮皮肤病变中的应用

目的探讨中医药治疗系统性红斑狼疮（SLE）皮肤病变的效果。方法74例SLE皮肤病变患者随机分为观察组与对照组各37例,所有患者给予补钙、胃黏膜保护剂、控制血压等常规治疗,对照组在常规治疗基础上加用醋酸泼尼松及硫酸羟氯喹治疗,观察组则在常规治疗基础上给予中药方剂治疗,对比2组患者治疗效果。结果观察组总有效率为95％（35／37）,对照组总有效率为70％（26／37）,观察组总有效率显著高于对照组（P〈0．01）。结论中医药治疗SLE皮肤病变疗效可靠,但在临床实际应用中应注意辨证施治,对于不同病情应给予个体化、最优化的方剂组合及配伍．以获取最佳效果。