山东省改水降氟工程使用现状

目的：了解山东省改水降氟工程运转使用的现状。方法：对山东省所有改水降氟工程的运转使用情况按统一表格进行调查。结果：自1980年至2001年，山东省共建设改水降氟工程5934处，以打低氟井为主；运转基本正常的工程4159处，占70．09％，不正常的工程26处，占0．44％，停用报废的工程1749处，占29．47％。5934处改水降氟工程共涵盖病村7880个。已改水病村中，有5689个村的工程运转基本正常，占73．54％；有2110个村的工程运转不正常和停用报废，占26．46％。停用报废的主要原因是管理不善、工程质量差、管道断裂和水氟超标。在改水工程运转基本正常的病村中，有4050个村的饮水氟≤1．00mg/L，占改水村的51％，占全部病村的35％；改水实际受益人口324万余人，占病区总人口的1/3。结论：山东省改水降氟工程的水氟超标和停用报废现象严重，急需改进。     

Concealed left atrial membrane: Pitfalls in the diagnosis of cor triatriatum and supravalve mitral ring

Cor triatriatum and supravalve mitral ring are forms of congenital left ventricular inflow obstruction produced by membranes within the left atrium. Typically, these defects occur as isolated anomalies with manifestations of pulmonary venous obstruction. Four children are presented whose left atrial membrane was associated with other significant cardiac defects, including, in one patient each, simple coarctation of the aorta, sinus venosus atrial septal defect, tricuspid atresia and complex coarctation of the aorta syndrome. The patient with the latter defect had undergone previous pulmonary arterial banding. None of these patients demonstrated significant pulmonary venous obstruction at cardiac catheterization. All patients had a normal value for either pulmonary arterial diastolic or pulmonary arterial wedge pressure. Three mechanisms explained the lack of pulmonary venous obstruction: (1) a large cross-sectional area of membrane openings, (2) an atrial septal defect that was confined to the pulmonary venous chamber and decompressed it by allowing blood to escape into the right atrium, and (3) decreased pulmonary blood flow. The diagnosis was facilitated by two dimensional echocardiography. Accurate diagnosis of left atrial membrane in the setting of other cardiac defects is of practical significance because pulmonary venous obstruction may occur after surgery for the associated defects.     

Effects of sidestream smoke exposure and age on pulmonary function and airway reactivity in developing rats

Children exposed to environmental tobacco smoke (ETS) in their homes have in- creased cough, respiratory illness, airway obstruction, and hyperreactivity. Since an animal model is needed to understand the mechanism by which this occurs, our study was designed to determine if immature rats develop airway obstruction and increased airway reactivity when exposed to sidestream smoke (SSS, respirable suspended particulate concentration 1.00±0.03 mg/m³, CO concentration 6.48±0.29 ppm). In the first of 3 studies, rats were exposed to filtered air (FA) or SSS for 6 hr/day, 5 days/week from day 2 to week 8 or week 15 of life (n = 6-8 in each group). SSS exposure did not change lung resistance (RJ, dynamic lung compliance (C_ldyn), lung weighthody weight ratio (LW/BW), pulmonary artery pressure (P_PA), body weight, or airway reactivity to methacholine (all P > 0.2, 2-way ANOVA). Regardless of exposure, lungs from younger rats were relatively heavier and more reactive to methacholine than lungs from older rats (P < 0.05, 2-way ANOVA). In the second study, 15-week-old rats were exposed to FA or SSS for 3 hr or for 4 days (6 hr/day, n = 6 in each group). SSS exposure again had no effect on C_ldym RL, LW/BW, P_pa, or airway reactivity to methacholine (all P > 0.2, ANOVA). In the third study, rats were exposed to FA or SSS from day 2 to week 11 of life (n = 7 in each group). SSS exposure reduced airway (P = 0.004) but not pulmonary artery (P = 0.63) reactivity to serotonin. We conclude that (1) SSS exposure to the immature rats did not mimic the effects of ETS seen in children, (2) younger rats had greater muscarinic airway reactivity than older rats, and (3) serotonin may play a role in ETS-induced lung problems.Pediatr Pulmonol. 1993; 16:281–288. © 1993 Wiley-Liss, Inc.     

人工智能在医学的应用研究进展

人工智能技术的快速发展,得益于大数据、数据库、算法、算力的巨大进步,医学研究是人工智能的重要应用方向。人工智能与医学的融合发展,提高了医疗技术水平与医疗服务效率,为医生与医疗设备有效赋能,更好地服务于患者。特别在此次新冠肺炎疫情中取得的巨大成效,足见人工智能在医疗领域中发挥巨大作用,因此吸引了许多研究者不断深入探索。本文对近年来人工智能在医学方面应用的相关文献进行梳理,基于人工智能技术与医学研究的发展背景,重点论述人工智能在药物研发、辅助诊疗、语音识别和语义理解、健康管理、医院管理等领域的应用进展,分析人工智能在医疗领域应用存在的挑战,最后讨论人工智能在医疗领域的发展趋势。 【关键词】人工智能;医学应用;技术挑战;综述