隆乳术后并非“高枕无忧”

隆乳术后并非“高枕无忧”沈阳军区总医院副教授孟庆延隆乳术是现在美容整形外科施行较多的手术。通过乳房假体的植入，可以增加乳房的体积，改善其形状和对称性，使胸部更加丰满，以创造青年女性的人体美，深受青年妇女的欢迎。但是隆乳术后并非“高枕无忧”。首先应当知...     

双平面隆乳在聚丙烯酰胺水凝胶取出后假体隆乳术中的应用

目的：探讨双平面隆乳术在聚丙烯酰胺水凝胶取出后假体隆乳术中的应用.方法：应用双平面隆乳术,取出注射填充物后同期植入假体.结果：术后外形满意,仅1 例两只乳房术后并发假体腔隙内血清样渗出,非感染性,经引流换药痊愈,假体得以保留,现外形手感均良好,未出现其他严重并发症.结论：双平面隆乳术式适应范围广,可针对聚丙烯酰胺水凝胶取出后不同的乳房条件灵活选用,方法优于其他单一平面的隆乳术式,值得在临床推广使用.     

乳房整形从不完美到完美

丰胸手术 丰胸术也称隆乳术（或乳房扩大整形），但该术式绝不是简单的使乳房增大隆起，其中包含着医生通过对双乳的触诊，排除乳房肿物的存在；望诊查出双乳的大小和对称性是否存在差异；还包括根据胸部及身体的测量数值，测算出理想、科学的乳房体积量，隆乳材料的选择，手术切口的设计，假体位置的确定；对受术者心理的评价；术者与受术者要求隆起的乳房大小的意见一致等。     

注射隆乳术后并发症的超声声像图及临床表现对比研究

目的:探讨注射隆乳术后并发症超声声像图及临床表现的异同点。方法:对51例注射隆乳术后出现乳房异常的患者进行超声检查,对假体的部位、形态、内部回声、有否包膜情况进行观察,并与术后结果进行对比。结果:超声诊断与手术病理诊断符合率达98%。结论:高频超声是诊断隆乳术后并发症简便有效的方法。     

乳腺癌术后Ⅱ期假体植入患者围手术期感染的相关因素分析

目的探讨乳腺癌术后Ⅱ期假体植入患者围手术期感染的相关因素及相应预防对策,为降低患者围手术期感染率、提高患者植入手术成功率提供科学依据。方法选择2012年1月-2017年6月医院进行乳腺癌术后Ⅱ期假体植入手术患者182例为研究对象,将Ⅱ期乳房假体植入术围手术期内出现感染的患者纳入感染组,未出现感染的患者纳入对照组,将年龄、体质指数、手术时间、术中出血量、术后引流时间、TNM分期、合并糖尿病情况、术前贫血情况、假体类型、保留乳头乳晕情况、腋下淋巴结清扫情况等可能影响两组患者Ⅱ期乳房假体植入围手术期感染的相关临床资料进行单因素及多因素Logistic回归分析。结果 182例进行乳房再造患者Ⅱ期假体植入术后共有21例患者出现围手术期感染,感染的发生率为11.54%。单因素及多因素Logistic回归分析结果显示手术时间、术后引流时间、体质指数≥28kg/m2、清扫腋下淋巴结、保留乳头乳晕是乳腺癌术后Ⅱ期假体植入患者围手术期感染的独立相关因素。结论乳腺癌术后Ⅱ期假体植入患者围手术期感染的相关因素较多,应全面评估患者状态,针对围手术期感染的高危人群,应加强围手术期感染的监测以及术后预防性抗感染治疗,最大程度地减少患者的感染发生,提高乳房重造的安全性和成功率。     

硅胶假体隆乳术后包膜挛缩的预防

女性乳房不仅是一功能器官更是一形体器官,是女性形体美最显著的标志。丰满而富有弹性的乳房,是女性充满青春活力和妩媚的象征。对乳房美的追求是女性的本能特性。对各种原因引起的乳房发育不良或后天乳房萎缩、体积变小,进行乳房扩大整形,俗称隆乳术。自1963年发明了利用硅橡胶囊假体进行隆乳后,此项技术一直延用至今,硅胶假体普遍认为是一     

不同术式隆乳术后并发症的超声诊断

目的 探讨高频超声在隆孔术后并发症诊断中的价值。方法 对101例隆乳术后出现乳房异常的患者进行检查，分假体置入组和注射组对假体的部位、形态、内部回声、有否包膜情况进行观察。结果 发现包膜挛缩和硬化的乳腺91只，变形移位24只，破漏38只，感染4只，出血1只，均经手术治疗证实。结论 高频超声是诊断隆乳术后并发症简便有效的方法。     

背阔肌瓣前移在乳癌根治假体植入术中的应用研究

目的探讨乳腺癌改良根治术I期假体植入、背阔肌瓣前移覆盖裸露假体新手术方法的特点，以及手术后患者的心理状态等。方法对行上述新的手术方法的20例乳腺癌患者与单纯改良根治术I期假体植入的22例乳腺癌患者作为对比研究。结果研究组患者术后伤152愈合佳，双侧乳房基本对称，患者对人造乳房外形很满意。而对照组中有6例术后出现皮瓣坏死，导致假体移位或外露，手感欠佳。两组患者对乳房外形的满意程度差异有统计学意义（P〈0．01）。结论在乳腺癌改良根治术即时假体植入时，行背阔肌瓣前移覆盖裸露的假体，能使术后伤152愈合更佳，人造乳房外形更美观，更好地满足肿瘤治疗和形体美容的要求。     

曲线美与乳房整形术

女子的乳房不仅是哺乳器官,还是女性美的一项重要体现。目前,众多女性对自身胸部的种种缺憾已不单是靠衣着来弥补,很多人是求助于美容整形外科医生,接受乳房美容整形手术,以达到使形体优美的目的。 乳房整形手术适用于胸部扁平、乳房巨大、乳房下垂以及乳房缺失等情况。 胸部扁平者可接受隆胸术(又称丰胸术、隆乳术)。目前,广为流行的是通过手术切口植入预制的硅橡胶囊(即人工乳房假体)使乳峰挺起,硅橡胶囊内盛有液态硅凝胶或生理盐水。有的是     

答读者问:硅胶假体隆乳会引起不良反应吗?

答读者问：硅胶假体隆乳会引起不良反应吗尊敬的编辑：您好！我是一位年逾三十的已婚女性。小孩现已上小学一年级。哺乳前乳房外形还算可以，较丰满、挺拔；可哺乳后，整个乳房下降且干瘪，影响美观。听说隆乳可以使乳房达到既丰满又挺拔之目的。可是还听说，隆乳会引起不...     

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.     

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.     

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.     

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.     

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.     

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.