安徽省大规模白内障防盲手术中人工晶体测量度数的分布特点

目的分析安徽省大规模白内障防盲手术中人工晶体测量度数的分布特点。方法统计2008年安徽省民生工程项目中白内障手术患者10218例,记录人工晶体度数的测量方法、测量值。结果人工晶体测量度数的分布状态：最大值38.90D,最小值-14.00D,中位数21.00D,〈4.00D频率为3.1%,4.00D≤IOL〈10.00D频率为4.1%,10.00D≤IOL〈15.00D频率为4.7%,15.00D≤IOL〈17.00D频率为4.6%,17.00D≤IOL〈19.00D频率为8.7%,19.00D≤IOL〈21.00D频率为21.3%,21.00D≤IOL〈23.00D频率为30.4%,23.00D≤I-OL〈25.00D频率为16.1%,25.00D≤IOL〈27.00D频率为5.3%,27.00D≥频率为1.3%。结论安徽省白内障防盲手术中人工晶体测量度数呈负偏峰分布,有集中趋势,17.00D≤IOL〈25.00D的频率为76.5%。     

Comparison of Reconstruction Intervals in Routine ECG-Pulsed 64-Row-MSCT Coronary Angiography in Frequency Controlled Patients

Purpose In light of the increasing use and acceptance of multislice computed tomography (MSCT) coronary angiography it was the purpose of this study to compare reconstruction intervals used in a routine ECG-pulsed MSCT coronary artery angiography setting with frequency controlled patients. Methods Examinations were performed on a Siemens Somatom Sensation 64 scanner with a total of 110 ml of contrast agent and ECG pulsing (interval from 40% to 70%) after oral application of a β-blocker if the heart rate was higher than 65 bpm. All human subjects were referred for the evaluation of suspected coronary artery disease. Coronary artery segments were evaluated by two experienced radiologists in a consensus reading. A ranking of diagnostic image quality (from 1 (no evaluation possible) to 5 (excellent image quality)) was statistically evaluated by Wilcoxon Signed Rank Test. Results In 45 patients (30 male, 15 female, age 63.8 ± 12.1 years) we detected a significant advantage of the 60% reconstruction interval over 40%, 50%, and 70% (for each p < 0.05). In cases of sudden arrhythmia or movement during the scan, additional reconstruction intervals within the ECG-pulsed reconstruction intervals remained necessary for diagnosis. Conclusion In a routine diagnostic setting with frequency controlled patients and ECG pulsing the 60% reconstruction interval can be considered superior for the initial diagnosis in 64-row multislice computed tomography coronary angiography. However, further information can be derived from various reconstruction intervals such as 40% and 70%.     

2016年我国X射线诊断频度调查的组织和实施

为掌握我国X射线诊断的基本情况及其应用频度与分布，为X射线诊断应用的监督管理提供基础数据，本项目组设计相关调查表并通过预调查进行优化，采用分层配额抽样方法，在全国25省市选择了共557家医疗机构进行基本情况调查，并按照类型、性别、年龄组等分别统计人次数，进行多重线性回归分析估算我国2016年X射线诊断应用频度。估算结果表明，2016年我国10个省份的X射线诊断频度为379~1 228人次/千人口。全国X射线诊断应用发展迅速，与"九五"期间相比明显增加，应进一步加强X射线诊断应用管理。     

基于数据挖掘技术的慢性肾脏病中医症候规律研究

目的:遵循循证医学的原则，对201例肾病患者的中医药临床研究数据进行挖掘，发现慢性肾脏病的中医症状，为慢性肾脏病的诊断和治疗提供有效的参考。方法:运用频数分析法和关联规则分析对201例肾病患者临床数据进行分析。结果：患者的舌质主要是红和淡红，其频率分别为39.7%，33.3%；舌苔主要是白、白腻和薄白，其频率分别为34%，17.6%和15%；脉象主要是细，细滑，沉细脉象，其频率分别为20.5%，13.5%，10.3%。另外，患者的中医辨证主证主要是气阴两虚证和肝肾阴虚证，其频率分别达到46.3%，24.4%；中医兼证中湿热证、湿浊证和血瘀证占比较高，其频率分别为32.6%，29.4%与23%。且由关联规则分析可以得到中医主证和兼证与所对应的舌质、舌苔和脉象的关联性的强弱。结论：频数分析法和关联规则分析能够清楚地展示慢性肾脏病的中医征候规律，有助于慢性肾脏病的精准诊断和个性化治疗。     

Frequency Measures of Behavior for Assistive Technology and Rehabilitation

Documenting assistive technology outcomes has grown in importance, but outcome measurement remains problematic. A new approach uses natural science measures and a model (selectionism) from the field of Behavior Analysis. Selectionism defines behaviors by their effects (functional performance) and the environment (including technology) within which they occur, and explicitly treats variation in patterns of behavior over time for individuals (intervention effects). Its basic metric is frequency of behaviors (count per unit time) which is similar to robust engineering measures like centimeters, grams, and seconds. This approach eliminates many of the problems inherent to more traditional psychometrics. Selectionism based on frequencies also provides an empirical structure or taxonomy to organize efforts and outcomes, unified by the notion of fluency. Composite behaviors are combinations of smaller component behaviors that are required for performance of the composite. A frequency above which a component behavior is readily retained, generalized, and recruited into the more complex composite behavior is called fluency; thus individuals fluent on the critical components easily and efficiently demonstrate the composite. This model suggests that when assistive technology interventions raise component behavior frequencies to fluent levels, they will be integrated usefully into an individual's life. This selectionistic approach has been used successfully in the field of education. It has the added benefit of not only empirically defining measurable outcomes, but also of providing useful ongoing measurement of change during treatment. This paper briefly describes this “Precision Measurement” strategy and its data-driven feedback process and makes suggestions for further research and development efforts. The method provides a basis for better documentation, control, and outcomes of assistive technology and related interventions.     

A Slow Brain Stem Response for Low-Frequency Audiometry

Proper choices of stimuli and of brain stem electric responses allow us to estimate peripheral auditory thresholds at 500,1 000, 2 000 and 4 000 Hz with an accuracy of about ±10 dB. With the help of sedation (secobarbital), such audiograms may be obtained from each ear of a child of any age in a single session.

Tone pips (filtered clicks) or very brief tone bursts give a frequency selectivity that is clinically adequate. The rise time must be adjusted to the center frequency. A rise time of two periods with a plateau from zero to one period gives a good compromise between frequency specificity and a synchronous neural discharge.

The best threshold indicator for tone pips of 2 000 Hz or higher (or unfiltered clicks) is P₆ (Jewett V). At 60 dB nHL its latency is 6.0-7.0 ms (for children of 1 year or older), but near threshold it is 8.0-9.5 ms. An input pass-band of 140-3 000 Hz is appropriate.

The best threshold indicator at 500 or 1 000 Hz is a nearly neglected slower wave with a scalp-negative crest at about 10 ms following a 60-dB click. Latency is 15 ms following a 500-Hz tone pip at 15 dB SL. We call this wave ‘slow negative (ten)’ or SN₁₀. To see it well a wider input pass-band such as 40-3 000 Hz is needed. SN₁₀ is usually obscured by P₆ or by frequency-following response at stimulus levels above 35 dB SL.

The details are given of a clinical routine that allows the determination (±10 dB) of 8 threshold endpoints within about 80 min. Several precautions and limitations are discussed, and also the origin of the SN₁₀ wave.

En choisissant des stimuli appropriés, il est désormais possible, grâce aux réponses auditives rapides (réponse du tronc cérébral), d'établir, avec une précision de ± 10 dB, les seuils auditifs périphériques pour les fréquences de 500, 1 000, 2 000 et 4 000 Hz. En utilisant un sédatif (sécobarbital) intramusculaire, les seuils auditifs d'enfants de tous âges peuvent être déterminés pour chaque oreille au cours d'une seule séance. Pour l'application clinique, les »tone pips« (clics filtrés) ou les »tone bursts« de très courte durée donnent une sélectivité de fréquence suffisante. La pente d'attaque doit être adaptée à la fréquence du stimulus. Une pente d'attaque de deux périodes avec un plateau variant de zéro à 1 période constitue un bon compromis entre la spécificité fréquentielle et une décharge neurale synchronisée.

Le meilleur indicateur du seuil tant avec des clics non-filtrés qu'avec les »tone pips« (pour les fréquences de 2 000 Hz ou plus) est l'onde P₆ (Jewett V). Sa latence à 60 dB nHL varie de 6,0 à 7,0 ms (chez l'enfant âgé de 1 an ou plus); près du seuil cependant, la latence varie de 8,0 à 9,5 ms. Nous recommandons l'utilisation d'un filtre rejetant les fréquences inférieures à 140 Hz et supérieures à 3 000 Hz.

Pour 500 ou 1 000 Hz, le meilleur indicateur de seuil est une onde lente jusqu'ici négligée et ayant une crête front-négative; elle apparaît a environ 10 ms à la suite de la présentation d'un clic de 60 dB; sa latence est de 15 ms pour un »tone pip« de 500 Hz à 15 dB SL. Nous avons nommé cette onde »slow negative (ten)« ou SN₁₀. Afin de mieux la voir, il est nécessaire d'avoir un filtre passe-bande d'entrée de 40 à 3 000 Hz. La SN₁₀ est habituellement voilée par l'onde P₆ (Jewett V) ou par la réponse en frequence (FFR) lorsque le stimulus dépasse 35 dB SL.

Nous donnons ici les details d'un test clinique permettant de déterminer 8 seuils au cours d'une séance de 80 min; plusieurs précautions et limitations de cette procédure sont mentionnées. Nous discutons aussi l'origine de l'onde SN₁₀.     

Netherlands' Society of Audiology

Δ_i and Δ_r repetitive stimuli superimposed on continuous 0.5-, 1- and 4-kHz carrier tones were administered to 20 normally hearing persons, 8 adults with sensorineural hearing loss, 10 adults with conductive hearing loss and 22 childrean subjected to evoked response audiometry (ERA) for assessment of hearing acuity. The intensity modulation depth ranged from +1 to 10 dB. In the subject with normal hearing and in the adult patients, three carrier tone levels were used whenever possible: 20, 40, and 60 dB SL. The frequency modulation depth ranged from –1 to –10% of the carrier tone frequency. The same leveles for the carrier tone were used: 20, 40, and 60 dB SL. With a carrier tone level of 20 dB SL, a clear-cut vertex responsewas noted in 80% of the teste carried out in the normal adults with 5-dB Δ_i stimuli and with Δ_r stimuli of –3 to –5% in magnitude; the same figure are valid for the patients with sensorineural and conductive hearing loss. The patients with sensorineural hearing loss showed a tendency to give vertex responses with lower Δ_i stimuli than subject with normal hearing. However, this difference was not statistically significant. According to our results, the children tested can be roughly divided into two groups, the first including subjects with responses to Δt stimuli of +5 and +10 dB and Δ_r stimuli of –5% and –10%; the second group including subjects with no clear-cut responses to these stimuli.     

Prevalence of gastroesophageal reflux disease symptoms and related factors in patients with rheumatoid arthritis

Gastroesophageal reflux disease (GERD) is common in patients with many chronic diseases, but has not been well recognized in rheumatoid arthritis (RA). We investigated the prevalence of GERD symptoms in 278 outpatients with RA and their association with such clinical factors as age, sex, height, weight, body mass index, medications drugs, and functional status evaluated by the Modified Health Assessment Questionnaire (MHAQ). GERD symptoms were evaluated by Frequency Scale for the Symptoms of GERD (FSSG). The mean FSSG score for all patients was 5.6, and 82 patients were considered to have GERD symptoms (FSSG score ≥8), thus the overall prevalence of GERD symptoms was 29.5%. MHAQ score and height were significantly higher and lower, respectively, and prednisolone usage was significantly more in the patients with GERD symptoms than those without. These three clinical factors were also significantly associated with GERD symptoms by univariate logistic regression. Multivariate logistic regression analysis demonstrated that MHAQ was the only clinical factor related to GERD symptoms. In conclusion, the prevalence of GERD symptoms in RA patients was high and strongly associated with decreased functional status, suggesting that physicians should pay attention to GERD symptoms in RA management, especially for patients with low functional status.     

Frequency spectrum analysis for spectrum stabilization in airborne gamma-ray spectrometer

Abnormal multi-crystal spectral drifts often can be observed when power on the airborne gamma-ray spectrometer. Currently, these spectral drifts of each crystal are generally eliminated through manual adjustment, which is time-consuming and labor-ineffective. To realize this quick automatic spectrum stabilization of multi-crystal, a frequency spectrum analysis method for natural gamma-ray background spectrum is put forward in this paper to replace traditional spectrum stabilization method used characteristic peak. Based on the polynomial fitting of high harmonics in frequency spectrum and gamma-ray spectral drift, it calculates overall spectral drift of natural gamma-ray spectrum and adjusts the gain of spectrometer by this spectral drift value, thus completing quick spectrum stabilization in the power on stage of spectrometer. This method requires no manual intervention and can obtain the overall spectral drift value automatically under no time-domain pre-processing to the natural gamma-ray spectra. The spectral drift value calculated by this method has an absolute error less than five channels (1024 resolution) and a relative error smaller than 0.80%, which can satisfy the quick automatic spectrum stabilization requirement when power on the airborne gamma-ray spectrometer instead of manual operation.