后装治疗与X刀的现状及其临床比较

目前后装技术与X刀在临床中应用广泛，各有所长，在某些肿瘤治疗中，两者联合应用的疗效比常规治疗好。随着体部定位技术和X刀的发展，X刀分为传统X刀和微型X刀，其中微型X刀具有传统X刀和后装技术的优势，前景看好，在临床应用中疗效肯定。本文就后装治疗与X刀的现状及其临床比较进行讨论。     

移动式X射线诊断机防护措施调查

医用移动式X射线机,是为行动不便的患者进行X射线诊断检查的设备,具有移动灵活,使用方便等特点。但射线防护困难,周围环境无很好的屏蔽设施,增加了受检者及公众不必要的照射。本文对辽宁省部分医院移动式X射线机的防护状况进行了调查。结果 报告如下。移动式X射线机的基本情况共调查7台移动式X射线机,分布在5所省直属医疗单位,X射线机管电流均在50mA以下,其中进口3台,国产4台。使用时将X射线机移动到重症患者病房进行曝光拍片。移动式X射线机的防护现状^〔1〕少数单位的移动式诊断X射线机控制器与X射线机的连接线比较短,达到病房门外墙后的长度不足。     

X刀测量中电离室的影响因素分析

简要介绍立体定向放射外科治疗装置X刀,以及X刀的输出剂量分布特点。对X刀的输出剂量进行测量时,采用不同有效体积的电离室,对测量结果进行了比较、分析,提出了适合X刀的输出剂量测量的电离室。     

徐汇区医用移动式X射线机现状调查

目的 掌握徐汇区医用移动式X射线机的使用和管理情况,探索此类设备放射卫生监督管理模式。方法 对现有的27台医用移动式X射线机(不包括移动式C臂X射线机)进行调研,从前期预防、放射诊疗许可、卫生监督日常管理、受检者防护、公众安全防护、放射诊疗工作人员职业健康监护等方面具体分析医用移动式X射线机的使用状况。结果 通过调查发现了徐汇区医用移动式X射线机的使用管理中的问题,并给出了相关建议。结论 加强医用移动式X射线机使用过程中的监督管理,有利于实现受检者利益的最大化。     

X刀系统等中心的验证和调整方法

X刀治疗时要求加速器等中心的误差在1mm以内，等中心校验是X刀治疗质量保证工作的一项重要内容。本文介绍一种等中心验证和调整的方法，特别强调在实际操作过程需要注意的一些问题。     

移动式C型臂X射线机的性能及放射防护检测结果

目的 调查移动式C型臂X射线机性能状况及其放射场所的防护状况,探讨提高放射诊断质量和放射防护水平的措施。方法 按照国家标准对移动式C型臂X射线机性能及工作场所的放射防护进行检测。结果 大部分移动式C型臂X射线机所测的防护性能指标都能符合国家有关标准。结论 应加强移动式C型臂X射线机性能和放射防护的检测和质量控制,确保移动式C型臂X射线机的应用质量和工作场所的安全。     

X刀的物理参数测量及质量保证

介绍我院用现有直线加速器开展X刀的经验 ,叙述了相关物理参数的测量方法及结果 ,讨论了质量保证的有关问题。物理参数的测量值均达到X刀治疗的质量控制要求     

γ刀、X刀和粒子刀三种放射治疗技术的比较

γ刀、X刀和粒子刀系三种立体定向放射治疗技术(Stereotactic Radiotherapy,SRT)已广泛地应用于临床脑血管畸形、海绵状血管瘤及肿瘤等治疗,本文主要对γ刀、X刀及粒子刀三种放射治疗技术在临床应用过程中性价比做一比较,其中包括设备价格、安装操作难易程度、放射生物效应、对正常组织的损害程度及临床治疗效果等,为临床医生选择最佳治疗方案提供可靠的依据。     

移动式医用X射线机放射防护的调查分析

目的了解掌握移动式医用诊断X射线机工作时对周围环境的影响,为放射卫生防护提供科学依据。方法对县级医院使用的移动式X射线机10台,依据有关法律、法规、标准、规范进行现场调查、检测及评价。结果 10台移动式医用诊断X射线机工作时未采用任何防护措施,工作场所门、窗外辐射剂量严重超标。结论应加强放射卫生监督,落实放射防护措施,在采用移动式防护设施的同时着重加强个体防护,并加强放射防护管理,使放射工作符合辐射防护三原则,即辐射实践的正当性、辐射防护的最优化、个人剂量限值。     

X刀的质量控制

X刀是在不做开颅手术的情况下对颅内病灶采用一次性大剂量窄射束照射以达到治疗的目的的，稍有不慎，就会给医院和病人造成不可挽回的损失，因此，X刀治疗的质量控制十分重要。本文主要从立体定向、计划设计、治疗实施三个方面简述X刀治疗质量控制的具体方法。     

Cholera in Haiti and other Caribbean regions, 19th century

Medical journals and other sources do not show evidence that cholera occurred in Haiti before 2010, despite the devastating effect of this disease in the Caribbean region in the 19th century. Cholera occurred in Cuba in 1833-1834; in Jamaica, Cuba, Puerto Rico, St. Thomas, St. Lucia, St. Kitts, Nevis, Trinidad, the Bahamas, St. Vincent, Granada, Anguilla, St. John, Tortola, the Turks and Caicos, the Grenadines (Carriacou and Petite Martinique), and possibly Antigua in 1850-1856; and in Guadeloupe, Cuba, St. Thomas, the Dominican Republic, Dominica, Martinique, and Marie Galante in 1865-1872. Conditions associated with slavery and colonial military control were absent in independent Haiti. Clustered populations, regular influx of new persons, and close quarters of barracks living contributed to spread of cholera in other Caribbean locations. We provide historical accounts of the presence and spread of cholera epidemics in Caribbean islands.     

Clinical Update on Nursing Home Medicine: 2013

This is the seventh article in the series of Clinical Updates on Nursing Home Care. The topics covered are antiresorptive drugs, hip fracture, hypertension, orthostatic hypotension, depression, undernutrition, anorexia, cachexia, sarcopenia, exercise, pain, and behavioral and psychological symptoms of dementia.     

Evidence-Based Recommendations for an Optimal Prenatal Supplement for Women in the U.S., Part Two: Minerals

The levels of many essential minerals decrease during pregnancy if un-supplemented, including calcium, iron, magnesium, selenium, zinc, and possibly chromium and iodine. Sub-optimal intake of minerals from preconception through pregnancy increases the risk of many pregnancy complications and infant health problems. In the U.S., dietary intake of minerals is often below the Recommended Dietary Allowance (RDA), especially for iodine and magnesium, and 28% of women develop iron deficiency anemia during their third trimester. The goal of this paper is to propose evidence-based recommendations for the optimal level of prenatal supplementation for each mineral for most women in the United States. Overall, the evidence suggests that optimal mineral supplementation can significantly reduce a wide range of pregnancy complications (including anemia, gestational hypertension, gestational diabetes, hyperthyroidism, miscarriage, and pre-eclampsia) and infant health problems (including anemia, asthma/wheeze, autism, cerebral palsy, hypothyroidism, intellectual disability, low birth weight, neural tube defects, preterm birth, rickets, and wheeze). An evaluation of 180 commercial prenatal supplements found that they varied widely in mineral content, often contained only a subset of essential minerals, and the levels were often below our recommendations. Therefore, there is a need to establish recommendations on the optimal level of mineral supplementation during pregnancy.     

Interdisciplinary health professional education: a historical review

A historical review was conducted to examine the advances made, nationally and internationally, in interdisciplinary health professional education since the mid-1960s. One hundred and nineteen articles were reviewed and divided by decade into the following subheadings: models, courses, communication/group process issues, and international perspectives. Twenty-seven articles, categorized as models, defined the conceptual field, described curriculum and program development, or provided a framework for evaluation.Thirty-two articles dealt with interdisciplinary courses, focusing on objectives, content areas, or innovative methods. Nine articles contributed contenton interdisciplinary communication and group process issues, from which guidelines were abstracted. Fifty-one articles contributed an international perspective, leading to the recognition that interdisciplinary health professional education, practice, and research is a global movement.This revised version was published online in October 2005 with corrections to the Cover Date.     

Heavy Metals in Aquatic Macrophytes from Two Small Rivers Polluted by Urban,Agricultural and Textile Industry Sewages SW Poland

This article presents the results from a study of the comparison of 2 lowland rivers: the Olobok and the Pilawa in southwest Poland polluted by urban, agricultural, and textile industry sewages. pH and concentrations of Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, Ni, Pb, Zn, nitrate, nitrite, ammonia, phosphate, and sulfate were measured in water samples and concentrations of Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, N, Na, Ni, P, Pb, S, and Zn were measured in stream bottom sediments and in the aquatic macrophytes Elodea canadensis, Callitriche verna, Potamogeton crispus, Potamogeton natans, and Ceratophyllum demersum from the river Olobok and Elodea canadensis, Polygonum amphibium, Potamogeton crispus, and Veronica beccabunga from the river Pilawa. The matrix of concentrations of 16 elements in 27 plant samples of 7 species from 15 sampling sites of 2 rivers and concentrations of 15 elements and pH in water samples and 16 elements and pH in bottom sediment samples of these sites was submitted to numerical classification, which revealed that sampling sites from the rivers were differentiated by the value of factor 1 of principal component analysis (PCA), which was related to the pH of water, Ca, Cu, Mg, Mn, and Ni in water and Cd, Cr, Cu, Fe, K, Mg, Na, Ni, P, and S in bottom sediments. More polluted parts of both rivers were differentiated from less polluted parts by the value of factor 2 of PCA, which was related to Pb, Zn, and sulfates in water and Ca and Zn in bottom sediments. Macrophytes from the Olobok and Pilawa rivers were differentiated by the value of factor 1, which was related to Ca, Co, Cr, Cu, Fe, Mg, Ni, N, Na, Pb, and S. Groups of macrophytes of more and less polluted parts of both rivers differed by the value of factor 2, which was related to P, K, and Mn. Downstream of the sewage outputs in both rivers, a significantly increased level of pollution occurs with elements correlated with factor 1: Among others were Cu and Cr, typical for the textile industry along the river Pilawa, and among others were Mn and Ni, typical for the urban and agricultural activities in the river Olobok.     

Self-efficacy and health behaviors toward the prevention of diabetes among high risk individuals living in appalachia

Recent clinical trials indicate that type 2 diabetes can largely be prevented through lifestyle factors. In order to identify important modalities for the prevention of diabetes in medically underserved counties of Virginia (Appalachia), a questionnaire was administered to 135 at-risk individuals, having reported at least one risk factor for diabetes. The questionnaire assessed attitudes, self-efficacy, diet, and physical activity toward the prevention of type 2 diabetes. Overall, none of the respondents reported being told by a physician that they were at risk for diabetes. Overweight was the most frequently reported risk factor (87.0%), followed by physical inactivity (67.3%). More than one-third (38.9%) reported at least three diabetes symptoms. When stratified by low and high risk level, there were no significant differences in self-efficacy, control, and healthy dietary behaviors (p < .05). High risk individuals did report having lower rates of full health insurance coverage, being less active and running out of food more frequently than low risk individuals, however. The findings suggest that cost-effective prevention efforts should incorporate physician education, include screenings, and address self-efficacy enhancing strategies toward preventing type 2 diabetes. Elena Serrano, Department of Human Nutrition, Foods, and Exercise, Virginia Tech 201 Wallace Annex Blacksburg, VA 24061-0430, USA; Jennifer Leiferman, Rocky Mountain Prevention Research Center, University of Colorado Health Sciences Center, 4200 East Ninth Avenue, Box C-245, Denver, CO 80262, USA; Sarah Dauber, Center for Pediatric Research, Eastern Virginia Medical School, Norfolk, VA, USA. Requests for reprints should be addressed to Elena Serrano, PhD, Department of Human Nutrition, Foods, and Exercise, Virginia Tech 201 Wallace Annex Blacksburg, VA 24061-0430, USA;e-mail: serrano@vt.edu     

Visits to Physicians after the Oxygenation of Gasoline in Philadelphia

During the period between 1992 and 1997, there was an increase in levels of methyl tertiary butyl ether (MTBE) in gasoline in the Philadelphia, Pennsylvania, area. In this study, the authors analyzed billing records from clinical practices that were extensions of the University of Pennsylvania. The authors based their selections on the International Classification of Diseases-9 diagnostic codes, which were determined from (1) previous studies of methyl tertiary butyl ether conducted by the Centers for Disease Control; (2) respiratory symptoms, including asthma and wheezing; and (3) symptoms associated anecdotally with methyl tertiary butyl ether levels in gasoline. The authors normalized all data by the total number of office visits. The incidences of headache, throat irritation, allergic rhinitis, cough, nausea, dizziness, upper respiratory infections, wheezing, otitis media, skin rash, anxiety, insomnia, palpitations, generalized allergy, and malaise were increased during the period studied. Large increases occurred during the winters of 1993–1994 and 1994–1995 (during which there were high levels of MTBE), but not in the preceding summers (during which there were low levels of MTBE). This was especially true for asthma and wheezing. During the summers of 1995, 1996, and 1997, the incidences of the aforementioned symptoms increased greatly.     

妊娠期糖尿病与妊娠期高血压疾病病理机制的相关性

妊娠期糖尿病(GDM)为妊娠期特有疾病,易造成孕产妇难产、产褥期感染、酮症酸中毒,胎儿窘迫、胎儿畸形甚至胎死宫内等不良妊娠结局。妊娠期高血压疾病(HDP)包括妊娠期高血压、子痫前期(preeclampsia)、子痫,以及慢性高血压并发子痫前期和妊娠合并慢性高血压,临床表现为高血压、蛋白尿及水肿,严重影响孕妇体内各脏器功能,是孕产妇及围生儿死亡的主要原因。HDP中子痫前期,尤其是重度子痫前期,是造成新生儿不良妊娠结局的重要原因,通常需要及时剖宫产终止妊娠。近年国内外许多研究已经证实GDM和HDP在内皮功能紊乱、血脂异常、炎症因子、肾素-血管紧张素-醛固酮系统(RAAS)等多方面有相关性。现就两种疾病在上述相关性方面进行综述。     

A six country study of young children’s media exposure,logo recognition,and dietary preferences

Childhood obesity is a global public health concern. Previous research, mainly conducted in developed countries, suggests that marketing and media exposure is associated with unhealthy eating behaviors. This cross-sectional study was done with 2422 children, mean age 5.5 years, SD = .5, from six low- and middle-income counties (LMICs) (Brazil, China, India, Nigeria, Pakistan, and Russia). The analyses investigated media exposure, logo recognition, and preferences for international foods and beverages, such as globally distributed items like McDonald’s hamburgers and Coca-Cola soft drinks. Overall and in each country, path analysis models showed that media exposure and logo recognition directly and indirectly predicted the selection of international foods and beverages, controlling for child’s sex, age, home location, and parental education. Public health and communication experts must continue to investigate and understand these relationships, so as to inform regulations around food and beverage marketing.     

抽动障碍儿童血清锌、铁、铅、铜、镁、钙含量的Meta分析

目的 探究抽动障碍儿童血清微量元素含量与正常健康儿童的差异,为抽动障碍的防治提供参考.方法检索中国知网数据库(CNKI)、重庆维普中文科技期刊数据库(VIP)、万方数据库(Wanfang Data)、临床试验注册中心、Pubmed、Embase、Cochrane Library及Web of Science等数据库,检...