高海拔地区特钢行业体力劳动强度分级调查研究

本文对海拔２３００ｍ中度高原特钢行业１３个生产单位１７３个岗位的９４７人进行了体力劳动强度分级的调查研究。结果表明：体力劳动强度Ⅰ级的岗位占３５．８４％；Ⅱ级的岗位占４２．２０％；Ⅲ级的岗位占１３．９８％；Ⅳ级的岗位占８．０９％，工作日平均能量代谢率为８．９８２２ｋｊ／ｍｉｎ。ｍ￣２，劳动时间率平均为６６．３％，与平原资料比较劳动强度增加２３．６％。作者认为对高原地区不同海拔高度体力劳动强度好别应有不同划分，以加强高海拔地区工人的劳动保护。     

高原养路工体力劳动强度调查研究

目的：通过对高原地区不同海拔高度养路工劳动强度的调查分析，从而提出合理的劳动生产定额和劳动作业制度；方法：选择本省不同海拔（察尔汗、都兰、花石峡）养路工人，分别进行工时利用率、肺通气量、能量代谢率和心率测定，按照国家标准（GB－3869－83）的要求进行分级；结果：在同一海拔高度，随着劳动强度增加，肺通气量、能量代谢率和心率均有增加，特别是在重体力劳动时肺通气量变化明显，察尔汗、都兰、花石峡3个地区工作日总能量消耗超过国家规定的卫生学限度，劳动强度分别为Ⅱ级、Ⅱ级、Ⅲ级；结论：人体在高原从事体力劳动时，随着海拔的升高，生理负荷加重，劳动能力下降。     

体力劳动强度二十二个工种分级调查研究

一九九一年六月对西飞公司所属十八个单位，二十二个工种，根据能量消耗，劳动时的生理负荷强度大小，生产环境因素等，应用国家标准（ＧＢ３８６－８３）《体力劳动强度分级》规定方法进行了劳动强度分级测定的应用研究。     

相邻两年内尘肺病X线胸片对比分析

本文对接尘二年以上的３４９名工人，相邻两年内的两次Ｘ线胸片６９８张，进行了对比分析，两次Ｘ线表现比较肺纹理增多好转２３５人，占６７．３％；肺内网状阴影好转２４８人，占７１．１％；类圆形小阴影好转１５３人，占４３．８％；不规则形小阴影好转５３人，占１５．８％。作者认为Ｘ线胸片的改变可能是由于肺部感染所致。     

飞行人员胆囊结石特点（4218名飞行人员临床调查）

为了了解飞行人员胆囊结石发病、诊治情况、临床特点以及对飞行安全影响等，我们于１９９５年５ 月至 １９９７ 年５ 月随机对４２１８ 名飞行人员进行了临床调查。结果：４２１８ 名中发现胆囊结石患者１８９例，患病率为 ４．５％ 。临床特点：男性多（１８５ 例占 ９７．８％ ）；４０ 岁以上者多（１４３ 例占７５．７％ ）；单纯胆囊结石多（１６８ 例占８８．８％ ）；胆囊多发结石多（１４４ 例占 ７６．２％ ）；有症状胆囊结石多（１１０ 例占 ５８．２％ ）；带石飞行多（１０４ 例占５５．０２％ ）；手术治疗少（７０ 例占３７．０３％ ）。临床调查证实：胆囊切除术是治疗飞行人员胆囊结石安全、可靠、有效的方法，术后能够达到飞行合格标准。结论：对空军飞行人员和民航驾驶员的胆囊结石不论有无症状，在恢复飞行之前必须施行航空医学性胆囊切除术以保障飞行安全     

普瑞博思在胃肠道钡餐检查中的应用

目的：总结和评价普瑞博思在胃肠钡餐检查中的应用效果。资料与方法：２０３例患者在胃肠钡餐检查中服用普瑞博思，其中１９５例是全胃肠道钡餐检查，采用常规服药法；８例在上消化道 中采取机动服药法。结果：在１９５例全胃肠钡餐检查中，服普瑞博思后３０～６０分钟检查，钡剂抵达回盲部１６５例，占８４．６％。９０分钟检查钡剂通过回盲瓣达右半结肠。胃内排空１９２例占９８．４％，其中２例钡剂充盈诸结肠段，占１．０３％。     

87例胸腹多发伤救治分析

我院１９８７年８月～１９９７年８月救治胸腹多发伤８７例，现分析如下。临床资料８７例中男６７例，女２０例；年龄１４～６８岁。伤后就诊时间０．５～６小时。开放性损伤５６例，其中刀刺伤５１例，占９１．１％。闭合性损伤３１例，其中车祸伤２４例，占７７．５％。...     

B超诊断上消化道溃疡穿孔的探讨

Ｂ超诊断上消化道溃疡穿孔的探讨顾乃俊手术证实胃、十二指肠溃疡穿孔３４例，术前Ｂ超观察腹腔游离气体、液体作出明确提示３０例，诊断符合率８８．２％。１资料与方法本组３４例，为１９８９－０３～１９９６－０３急诊住院手术患者，其中男２６例，女８例，年龄１８～...     

右室双出口的影像学诊断(附8例报告)

右室双出口的影像学诊断（附８例报告）魏龙晓黄进贾大军右心室双出口（ＤＯＲＶ）是一种少见的复杂性先天性心脏病，约占小儿先天性心血管畸形的１．６７％。正确诊断对术式选择及预后关系甚大〔１〕。现将我院自１９９０－０３～１９９５－０５共收治的８例报告如下。其...     

重型病毒性肝炎临床分裂新探

２１５例重型病毒性肝为，依肝衰进程分成暴发型、亚暴发型和缓发型。急性重肝４２例，３型分别占１４．３％、７３．８％和１１．９％，；慢性重肝１７３例，３型分别占８．７％、７６．３％和１５．０％。     

手指触按颈动脉对安静时心电图的影响

<正> 在体育教学与运动训练中,心率指标的应用十分广泛,如判断运动量的大小、确定间歇训练的间歇时间及评定运动员的机能状态等。在一般人进行体育锻炼时,如长跑、游泳、骑自行车等,也常以心率变化作为评定最适强度及负荷的依据。     

高原篮球竞赛对■O_2max和心功能的影响

作者观察了在拉萨参加篮球比赛的队员(?)O_2max、STI等呼吸,循环方面的指标,认为在高原地区参加比赛至少应有8天的习服时间,否则运动员的有氧能力将下降。     

Exercise guidelines in pregnancy: new perspectives

In 2002, the American College of Obstetricians and Gynecologists published exercise guidelines for pregnancy, which suggested that in the absence of medical or obstetric complications, 30 minutes or more of moderate exercise a day on most, if not all, days of the week is recommended for pregnant women. However, these guidelines did not define 'moderate intensity' or the specific amount of weekly caloric expenditure from physical activity required. Recent research has determined that increasing physical activity energy expenditure to a minimum of 16 metabolic equivalent task (MET) hours per week, or preferably 28 MET hours per week, and increasing exercise intensity to ≥60% of heart rate reserve during pregnancy, reduces the risk of gestational diabetes mellitus and perhaps hypertensive disorders of pregnancy (i.e. gestational hypertension and pre-eclampsia) compared with less vigorous exercise. To achieve the target expenditure of 28 MET hours per week, one could walk at 3.2?km per hour for 11.2 hours per week (2.5 METs, light intensity), or preferably exercise on a stationary bicycle for 4.7 hours per week (～6-7 METs, vigorous intensity). The more vigorous the exercise, the less total time of exercise is required per week, resulting in ≥60% reduction in total exercise time compared with light intensity exercise. Light muscle strengthening performed over the second and third trimester of pregnancy has minimal effects on a newborn infant's body size and overall health. On the basis of this and other information, updated recommendations for exercise in pregnancy are suggested.     

精神疲劳与运动疲劳状态下心率变异性的不同特征(英文)

目的以心率(HR)与心率变异性(HRV)作为应激水平的评价指标,分别探讨精神疲劳与运动疲劳时应激水平的变化规律。方法基于读书任务和笔算作业,研究精神疲劳时HR与HRV的变化;基于上肢力竭型运动,研究运动疲劳时HR的变化。结果高强度精神负荷过程中,受试者在实验伊始就达到了较高的应激水平,随着精神疲劳程度的增加,HR减小而HRV增大,表明精神疲劳程度与应激水平反相关,可能与生理抑制性保护有关;随着运动疲劳程度的增加,HR增加,表明运动疲劳程度与运动应激水平通常正相关,体现了机体的补偿性调整。结论精神疲劳与运动疲劳过程中,自主神经系统的活动存在较大差异,这可以从精神应激与运动应激的机理、主要承载器官和负荷强度的差别来解释。     

PET／CT对多发性骨髓瘤的诊断价值

目的探讨多发性骨髓瘤的PET／CT影像学特点,评价其在多发性骨髓瘤诊断中的价值。方法15例按2001年WHO诊断标准确诊为多发性骨髓瘤患者,均在治疗前行PET／CT显像。15例患者经骨髓穿刺和（或）手术病理检查测浆细胞,实验室检查显示有9例患者血清IgG明显升高（〉35g／L）,有8例24h尿本周蛋白增高（〉1g）,15例患者均有溶骨性病变。结果CT所示骨质破坏区域及PET示代谢变化骨髓瘤病灶137个。多发性骨髓瘤病变部位以颅骨37．2％（51／137）、肋骨26．3％（36／137）、椎体12．4％（17／137）为多发,其次为髂骨7．3％（10／137）、骶骨5．8％（8／137）、四肢骨4．4％（6／137）、锁骨3．6％（5／137）、肩胛骨2．9％（4／137）。在137个病灶中,有71个病灶PET显示放射性摄取增高,阳性率为51．8％;有66个病灶表现为放射性摄取稀疏及缺损。而CT主要表现为多发性穿凿样或虫蚀样骨质破坏。结论PET／CT显像对多发性骨髓瘤的临床诊断有较高的价值。     

Clinical and economic evaluation of the Trellis-8 infusion catheter for deep vein thrombosis

PURPOSE: To summarize the preliminary experience with the Trellis-8 infusion catheter (TIC) in the treatment of deep venous thrombosis (DVT) and compare the outcome to that with catheter-directed thrombolysis (CDT) by using a meta-analysis of published reports. MATERIALS AND METHODS: Technical success, bleeding complications, and costs for patients treated with the TIC for DVT were reported through a voluntary, company-sponsored registry. Technical success was classified by using the National Venous Registry grading scale for DVT lysis (<50% lysis = grade I, 50%-99% lysis = grade II, and 100% lysis = grade III). The cost of treatment with the TIC was based on equipment (catheters) needed to perform the intervention, thrombolytic agents used, bleeding episodes, procedure time in the angiography and/or interventional suite, and monitoring time in a critical care unit. Outcomes with the TIC were compared against outcomes with CDT by using literature-derived outcomes derived from a meta-analysis. RESULTS: Thrombolytic doses and infusion durations were less with TIC than with conventional CDT. Grade II and III lysis was achieved in 93% of patients treated with the TIC and 79% of patients treated with CDT (P = .03). Major hemorrhage was reported in none of the TIC patients and in 8.5% of patients treated with CDT (P < .001). The per-patient cost of therapy was $3,697 for TIC and $5,473 for CDT (P = .03). CONCLUSIONS: Thrombolysis in DVT with the TIC is associated with a greater technical success rate, a lower rate of bleeding, and a lower cost than that reported for CDT. These preliminary results indicate that further evaluation of the TIC in the treatment of DVT is warranted.     

Ga-67 scan to detect intra-abdominal infection in patients after colorectal surgery

PURPOSE: Intra-abdominal infection is still an important issue in colorectal surgery. The Ga-67 scan is relatively inexpensive, but the delay in diagnosis and the intense physiologic bowel activity are considerable drawbacks to its use in abdominal investigations. In this study, the authors performed 24-hour Ga-67 scans and read the images with the surgeon to detect abdominal infection in patients who underwent colorectal surgery. METHODS: Sixty-one patients who underwent colorectal surgery were enrolled in this study. Ga-67 scintigraphy was performed 24 hours, and later as needed, after the injection of 111 MBq (3 mCi) Ga-67 citrate. All scans were interpreted together by a nuclear medicine specialist and the surgeon. The intensity of Ga-67 uptake was recorded as grade 0: no uptake; grade 1: less than liver uptake; grade 2: equal to liver uptake; or grade 3: greater than liver uptake. When the intensity of Ga-67 uptake was equal to or greater than grade 2, the pattern of Ga-67 uptake was classified as changing or unchanging. A positive Ga-67 scan was defined as having an intensity of grade 2 or 3 with an unchanging pattern. RESULTS: Nineteen abdominal infections were diagnosed, all by Ga-67 scans, for a diagnostic sensitivity rate of 100%. Of the 42 patients with no intra-abdominal infection, only 2 had positive Ga-67 scans. This resulted in a specificity rate of 95.2%. The overall accuracy of the Ga-67 scan in the detection of intra-abdominal infection after colorectal surgery was 96.7%. CONCLUSIONS: The Ga-67 scan is useful for detecting intra-abdominal infection after colorectal surgery. Reading the images with the surgeon and using a lateral view can decrease the false-positive rate. A negative Ga-67 scan can rule out intra-abdominal infection, whereas a positive Ga-67 scan indicates the need for further patient evaluation after colorectal surgery.     

125Ⅰ粒子植入治疗脊椎转移瘤的临床价值

目的 探讨125Ⅰ粒子植入治疗脊椎转移瘤的初步疗效.方法　对15例转移瘤患者的22处病灶于术前制订125Ⅰ粒子植入计划,确定粒子数量和分布.在CT引导下植入125Ⅰ粒子,治疗后3~6个月观察疼痛缓解情况和瘤灶大小变化.结果22处脊椎和椎旁转移瘤植入粒子后,疼痛完全缓解(0级)14处,部分缓解(Ⅰ级)6处,轻微缓解(Ⅱ级...     

SilverHawk斑块切除系统治疗下肢动脉硬化闭塞症的初步临床应用

目的 评价SilverHawk直接斑块切除术治疗下肢动脉硬化闭塞症(ASO)的临床疗效及安全性.方法 应用SilverHawk斑块切除系统治疗7例ASO患者,管腔闭塞或狭窄≥80%,病变长度1.8～14.5 cm.临床表现(Fontaine分类):Ⅱb级4例、Ⅲ级1例、Ⅳ级2例.踝肱指数(ABI)0.28~0.65.术后随访观察疗效,观察指标包括临床症状、彩色超声或CTA检测管腔通畅情况.随访和观察指标用中位数表示,统计方法 用两样本的Kolmogorov-Smirnov检验.结果 7例患者的7个闭塞病变均经腔内开通成功(残余狭窄<30%).临床症状均消失或明显改善;Fontaine分类:Ⅰ级6例、Ⅱ a级1例.ABI为0.82～1.18,与术前比较差异有统计学意义(P=0.002).随访1~6个月,ABI仍为0.75～1.14,与术后比较差异无统计学意义(P=0.938),Fontaine分类同术后.结论 SiLverHawk直接斑块切除术是治疗下肢动脉硬化闭塞症的一种安全有效的新方法.

Abstract：

Objective To evaluate the clinical efficiency and seeurity of SilverHawk directional atherectomy device in treating arteriosclerosis obliterans of lower extremity.Methods Seyen patients with lower extremity ischemia were treated with SilverHawk directional atherectomy.The lesions length varied from 1.8 to 14.5 cm.Clinical symptoms(Fontaine classification)included 4 cases of grade Ⅱ b,1 case of grade Ⅲ,2 cases of grade Ⅳ.The ABI varied from 0.28 to 0.65.Patency was evaluated with color duplex sonography or CTA besides clinical examination during follow-up.Results Seven occlusive lesions were recanalizated successfully.The technical success(residual stenosis<30%)rate was 100%. Clinical symptoms were obviously improved or disappeared.The ABI varied from 0.82 to 1.18(P=0.002),and Fontaine classification included 6 cases of Ⅰ:1 case of Ⅱ a.Patency rate was 100%and the ABI varied from 0.75 to 1.14(P=0.938).Fontaine classifications keep consistent l-6 nonths after operation.Conclusion SilverHawk drectional atherectomy Was a safe and effective way for treatment of lower arteriosclerosis obliteran.