盆腔磁共振成像技术的临床应用研究

目的：探讨盆腔磁共振扫描成像技术的临床应用。方法：采用GE公司3．0T磁共振仪,对58例患者做盆腔磁共振成像,扫描方法及脉冲序列为横轴位FSE T2WI、FSE T1WI,冠状位及矢状位FSE T2WI,所有T2WI采用脂肪抑制技术。结果：横轴位能清晰显示病变与周围解剖结构的关系,冠状位、矢状斜位能清晰显示病变的大体轮廓及与相邻组织的关系。结论：正确的扫描方法、合理的参数和脉冲序列的正确使用有助于显示正常的盆腔解剖结构及病变,对定位和诊断可提供一定的参考价值。     

膝关节磁共振成像技术临床应用研究

目的:探讨膝关节磁共振扫描成像技术.方法:50例患者MR扫描序列包括斜矢状位PDW[、SET1WI;冠状位PDWI、SET1WI;横轴位FSET2WI.所有PDW[采用化学饱和法脂肪抑制技术.结果:本组病例中膝关节挫伤25例;20例半月板退变,其中3例伴半月板撕裂;韧带损伤5例.结论:磁共振扫描参数的优化组合和选择正确的扫描方法、恰当的线圈及应用脂肪抑制技术更有助于显示正常膝关节解剖结构及病变的定位和诊断.     

磁共振三维FIESTA技术在脊柱畸形疾病的初步临床应用

目的:探讨磁共振三维FIESTA技术在脊柱畸形疾病的初步临床应用价值。方法:搜集脊柱畸形患者70例,35例后凸畸形,35例侧凸畸形。均采用GE1.5T超导磁共振机。扫描序列包括:二维横轴位,冠状位,矢状位分别行FSET2WI扫描及三维冠状位,矢状位FIESTA扫描。结果:35例后凸畸形的患者得到矢状位,并以其为定位像扫描得到横轴位后才能显示出标准脊髓。35例侧凸畸形的患者得到冠状位,并以其为定位像扫描得到横轴位后才能显示出标准脊髓。70例又行三维矢或冠状位FIESTA扫描,依脊柱为后凸或侧凸的畸形特点而定,选择FIESTA扫描方式,可重建得到多层面多角度的冠或矢状位像、横轴位像及清晰真实的矢或冠状位像。结论:磁共振扫描可清晰显示脊柱畸形的脊髓,磁共振三维FIESTA扫描可快速、多角度、多层面连续显示脊柱畸形的脊髓,更好指导临床手术。     

甲状腺磁共振扫描技术研究

目的：探讨甲状腺磁共振的扫描技术、扫描参数。方法：对35例临床疑似甲状腺的患者行磁共振检查,扫描序列包括横轴位、冠状位IDEAL—FRFSET2WI,横轴位、冠状位FSET1WI,其中20例加扫横轴位FRFSET2WI及脂肪抑制、横轴住STIR序列,以便和IDEAL序列对比。结果：所有图像的质量均较高,特别是IDEAL—FRFSET2WI序列扫描的甲状腺脂肪抑制的效果均匀,图像清晰。结论：合理的组合及优化序列有助于显示正常甲状腺的解剖结构及病变的定位、诊断。     

骶髂关节磁共振成像技术研究

目的：探讨骶髂关节磁共振扫描成像技术。方法：33例患者MR扫描序列包括：横轴位FSET2WI、SET1M，冠状住FSET2WI及2个冠状位FSPGR in phase。结果：7例检查者骶髂关节正常，各扫描序列均能直接显示正常骶髂关节软骨。其余26例全为AS患者，52个关节中42个骶髂关节可见软骨异常，表现为T1WI和T2WI上正常线形中等信号的软骨影像消失，取而代之的是不规则增粗或扭曲样中等信号。结论：磁共振扫描参数的优化组合和选择正确的扫描方法、恰当的线圈，以及T2WI和FSPGR in phase脂肪抑制技术的应用，更有助于显示正常骶髂关节解剖结构及病变的定位和诊断。     

肩关节磁共振扫描技术的研究

目的:探讨肩关节磁共振扫描技术、扫描参数。方法:30例肩关节患者行磁共振检查,扫描序列包括横轴位、冠状位T2WI、T1WI及矢状位T2WI,所有T2WI采用质子加权加脂肪抑制(PDW-FS)。结果:所有图像质量较高,特别是质子加权加脂肪抑制图像,对关节软骨、骨髓内信号改变,关节囊、软骨面下病变、周围软组织及肌肉内病变等显示清楚。结论:磁共振扫描参数的优化组合和脂肪抑制技术的应用有助于显示正常肩关节解剖结构及病变的定位,有助于临床诊断。     

16层CT冠状MPR在支气管内膜结核中的应用

目的研究胸部16层螺旋CT冠状多平面重组（MPR）在支气管内膜结核中的应用价值。方法选用58例胸部病例,采用GE公司lightspeed 16层螺旋CT机进行扫描,扫描参数采用准直0．75mm,Feed／Rotation 12mm,扫描层厚0．75mm,重建间隔0．75mm,于CT主机或Volume Wizard工作站进行图像后处理。以正中矢状面为参考截面,气管的长轴作为冠状轴,行冠状多平面重组．重组层厚为0．8mm,重组间隔为0．5mm。结果冠状MPR可以良好显示支气管内膜结核的形态、程度和范同。周围病变可清晰显示其位置、形态、大小、周围结构的受累情况。结论胸部16层CT冠状MPR是横轴位的重要补充,在支气管内膜结核的诊断中有着广泛的应用前景。     

磁共振不同扫描方法对膝关节前后交叉韧带显示效果的探讨

目的:探讨磁共振不同扫描方法对膝关节前交叉韧带(anterior curciate ligament,ACL)及后交叉韧带(posterior curciate ligament,PCL)的显示情况,探讨MRI检查在膝关节交叉韧带损伤中的显示价值。方法:选取50例膝关节正常扫描图像,包括常规矢状位、常规冠状位。在此基础上增加斜矢状位(向内侧倾斜15°-20°)、斜冠状位(在斜矢状位图像基础上平行于ACL方向)以及3D序列,观察韧带显示情况,以能否在一幅图像内完整显示作为评价标准。结果:3D序列由于可多方向重建,对于各韧带显示情况均较优秀,能够100%显示各韧带。在对ACL的检查中,常规矢状位显示率为62%,斜矢状位显示率为84%,斜冠状位显示率为100%,常规冠状位无法完整显示;在对PCL的检查中,常规矢状位显示率为100%,斜矢状位显示率为100%,常规冠状位无法完整显示。结论:有条件进行3D序列检查的MRI仪器,3D序列可明显提高韧带显示率,对于各韧带损伤的诊断能提供很好的帮助。无条件做3D序列的,ACL在斜冠状位显示最清,PCL可于任意矢状位清晰观察。     

磁共振膝关节前后交叉韧带扫描方法的探讨

目的探讨关于磁共振膝关节矢状位、斜矢状位、冠状位扫描对前、后交叉韧带的显示。方法对30例正常膝关节均进行常规矢状位、斜矢状位、冠状位扫描。分析矢状位、斜矢状位、冠状位扫描对正常前、后交叉韧带的显示情况。结果正常膝关节于一幅图像上能清楚显示后交叉韧带,矢状位、斜矢状位显示率为100%;而前交叉韧带,矢状位显示率为66%,斜矢状位显示率为90%,冠状位为部分显示前、后交叉韧带。     

髋关节磁共振成像技术的临床应用研究

目的：探讨髋关节磁共振扫描成像技术的临床应用.方法：对30例患者行MR扫描,扫描序列包括横轴位PDWI＋FS、SET1WI,冠状位STIR、SET1WI.结果：本组30例患者中,14例有股骨头缺血性坏死表现,在横轴位PDWI＋FS及冠状位STIRT表现为“双线征”,在SET1WI表现为可见匐行线的低信号;3例患者考虑为髋臼唇损伤,可见髋臼唇信号连续性中断;2例患者股骨颈骨折,能清晰看见骨折线;11例患者未见明显异常.结论：磁共振扫描参数的优化组合有助于显示正常髋关节的解剖结构及病变的定位和诊断.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.