拉萨藏族青少年手腕部骨龄发育评价

目的：由于个体营养发育的不同以及种族、遗传、地理环境和性别的不同，导致骨龄也会有所不同，对拉萨地区藏族青少年的骨发育状况作切合实际的评价，探讨其骨发育水平变化趋势的特征。方法：于2003-04／09采用分层整群抽样调查，从拉萨市6所大、中、小学随机选取父母为藏族，本人在拉萨生活，经体检证明健康的7～21岁青少年为调查对象。按性别分组，每岁为1组，共调查1496人，男743人，女753人。使用X射线机做左手手腕部后前位投照，受试者左手掌面向下和暗盒紧贴，中指轴与前臂轴成直线，球管中心线正对第3掌骨头，管片距约90cm。根据《中国人手腕骨发育标准CHN法》对手腕部14块骨进行评分，然后输入相应的计算机软件计算出骨龄，并进行骨龄与生活年龄的相关分析和骨龄性别差异分析。结果：共调查l496人．数据均进入结果分析。@)CHN法评价手腕部骨龄结果：各年龄组骨龄均值均小于生活年龄，男性7～21岁8个年龄组生活年龄与骨龄差值变化分别为：0．17&;#177;1．51，0．11&;#177;1．26，0.21&;#177;0．92，0．88&;#177;0．81，0．90&;#177;1．94．1．36&;#177;1．33，0．88&;#177;1．75，0．99&;#177;1．70，．54&;#177;1．19，0．59&;#177;1．12，0．47&;#177;1．33，0．79&;#177;1．13，1．32&;#177;0．58，2．10&;#177;0．36；女性7～21岁8个年龄组生活年龄与骨龄差值变化分别为：0.21&;#177;0．92，0．89&;#177;1．06，0．80&;#177;0．97，1．06&;#177;1.04，0．82&;#177;1.32，0．67&;#177;1．61，0．89&;#177;1．52，1．00&;#177;1．67，0.16&;#177;1．56，0．53&;#177;1．16，0．97&;#177;1．29，1．42&;#177;0．61，2．34&;#177;0．42．3．21&;#177;0．26。骨龄性别差异分析：7～11岁年龄组男性大于女性，12～16岁年龄组男性小于女性，而后男性又大于女性。②骨龄与生活年龄的相关分析：骨龄与生活年龄呈高度正相关(男性r=0．940，女性r=0．939，总体r=0．939)。结论：各年龄组骨龄均值均小于生活年龄，说明拉萨藏族青少年骨发育具有延缓的特点。这可能是西藏典型的高寒、缺氧等高原环境造成的，当然还有与这些自然环境伴随的混杂因素，诸如家庭生活水平、饮食习惯、营养摄入等的干扰作用，也可能存在种族的差异。因此有必要制定藏族地区儿童青少年骨发育水平的骨龄标准。     

女性青少年颈椎骨龄与腕骨骨龄的相关性研究

目的探讨女性青少年颈椎骨龄、腕骨骨龄与年龄之间的关系,评价颈椎骨龄在判断女性青少年生长发育方面的精确度,以期为颈椎骨龄的进一步临床应用提供更多的理论依据。方法对61名8～13周岁女性初诊患者的同期颈椎骨龄和腕骨骨龄进行测定,运用统计学分析的方法探讨颈椎骨龄、腕骨骨龄和年龄之间的关系。结果颈椎骨龄、腕骨骨龄、年龄各变量之间均呈显著相关性(P<0.01),其中腕骨骨龄与颈椎骨龄相关程度大于腕骨骨龄与年龄之间的相关程度。年龄与腕骨骨龄、颈椎骨龄之间存在显著性差异,腕骨骨龄与颈椎骨龄之间无显著性差异。结论颈椎骨龄与腕骨骨龄在评价女性青少年的生长发育阶段时具有相同的准确性,但评价个体生长发育潜力时,仍应紧密结合临床实际,才能做出正确诊断。     

拉萨藏族青少年手腕部骨龄的Fels法评价

目的：探讨拉萨藏族青少年骨发育水平的变化趋势，为临床应用骨龄提供科学依据。 方法：于2003—07／09采用分层整群抽样调查，从拉萨市6所大、中、小学随机选取父母为藏族，本人在拉萨生活，经体检证明健康的7-21岁青少年为调查对象。按性别分组，每岁为1组，共调查1496名，男743名，女753名。按Fels法进行手腕部骨龄评价，并进行骨龄与年龄的相关分析和骨龄性别差异分析. 结果：共调查1496名，数据均进入结果分析。①Fels法评价手腕部骨龄结果：各年龄组骨龄均小于年龄，男性7-21岁各年龄组年龄与骨龄差值变化分别为：1.17&;#177;1．18，1．28&;#177;1．06，1．79&;#177;1．13，1．99&;#177;1．05,1．87&;#177;1．73，1．72&;#177;1．80．1．22&;#177;1．68．1．20&;#177;1.43，1．29&;#177;1．02，1．37&;#177;1．27，14.9 &;#177;0．98，1.71&;#177;1.11，2．05&;#177;0．79．2．72&;#177;0．55；女性分别为：1．18&;#177;1．00，1．40&;#177;1．28．1．17&;#177;1．46，0．95&;#177;141, 0.43&;#177;1．34．0．55&;#177;1．23，1.29&;#177;1．16，1．59&;#177;0．95，1.48&;#177;1．19，2．15&;#177;0．98．2．46&;#177;1．06，2．92&;#177;0．75,3.60&;#177;0．33，4．48&;#177;0．26。骨龄性别差异表现为：7-8岁年龄组骨龄男性大于女性，9～12岁年龄组骨龄男性小于女性，而后呈现男性又大于女性。②骨龄与年龄的相关分析：骨龄与年龄呈高度正相关（男性r=0.947，女性r=-0．928．总体r=-0．934）。 结论：各年龄组骨龄均小于年龄．提示拉萨藏族青少年骨发育具有延缓的特点．这可能是西藏典型的高寒、缺氧等高原环境造成的。Fels法可以用于评价拉萨藏族青少年手腕部骨龄，但不完全适用，因此有必要制定西藏藏族儿童青少年的骨龄标准。     

拉萨藏族青少年手腕部骨龄发育评价

目的:由于个体营养发育的不同以及种族、遗传、地理环境和性别的不同,导致骨龄也会有所不同,对拉萨地区藏族青少年的骨发育状况作切合实际的评价,探讨其骨发育水平变化趋势的特征。方法:于2003-04/09采用分层整群抽样调查,从拉萨市6所大、中、小学随机选取父母为藏族,本人在拉萨生活,经体检证明健康的7～21岁青少年为调查对象。按性别分组,每岁为1组,共调查1496人,男743人,女753人。使用X射线机做左手手腕部后前位投照,受试者左手掌面向下和暗盒紧贴,中指轴与前臂轴成直线,球管中心线正对第3掌骨头,管片距约90cm。根据《中国人手腕骨发育标准CHN法》对手腕部14块骨进行评分,然后输入相应的计算机软件计算出骨龄,并进行骨龄与生活年龄的相关分析和骨龄性别差异分析。结果:共调查1496人,数据均进入结果分析。①CHN法评价手腕部骨龄结果:各年龄组骨龄均值均小于生活年龄,男性7～21岁8个年龄组生活年龄与骨龄差值变化分别为:0.17±1.51,0.11±1.26,0.21±0.92,0.88±0.81,0.90±1.94,1.36±1.33,0.88±1.75,0.99±1.70,0.54±1.19,0.59±1.12,0.47±1.33,0.79±1.13,1.32±0.58,2.10±0.36;女性7～21岁8个年龄组生活年龄与骨龄差值变化分别为:0.21±0.92,0.89±1.06,0.80±0.97,1.06±1.04,0.82±1.32,0.67±1.61,0.89±1.52,1.00±1.67,0.16±1.56,0.53±1.16,0.97±1.29,1.42±0.61,2.34±0.42,3.21±0.26。骨龄性别差异分析:7～11岁年龄组男性大于女性,12～16岁年龄组男性小于女性,而后男性又大于女性。②骨龄与生活年龄的相关分析:骨龄与生活年龄呈高度正相关(男性r=0.940,女性r=0.939,总体r=0.939)。结论:各年龄组骨龄均值均小于生活年龄,说明拉萨藏族青少年骨发育具有延缓的特点。这可能是西藏典型的高寒、缺氧等高原环境造成的,当然还有与这些自然环境伴随的混杂因素,诸如家庭生活水平、饮食习惯、营养摄入等的干扰作用,也可能存在种族的差异。因此有必要制定藏族地区儿童青少年骨发育水平的骨龄标准。     

人工智能骨龄评测系统评估儿童腕骨骨龄

目的 探讨人工智能（AI）系统评测儿童腕骨骨龄的可行性。方法 回顾性分析130幅1~13岁儿童左手骨龄X线片。以3名中高年资放射科医师腕骨骨龄评测结果为参考标准,计算并对比AI系统（简称模型）及3名低年资放射科医师（医师1、2、3,简称医师）与参考标准之间腕骨骨龄和腕骨成熟度分值的均方根误差（RMSE）及平均绝对误差（MAE）;采用组内相关系数（ICC）评价模型、医师与参考标准之间评测骨龄结果的一致性;比较模型与医师间骨龄测评时间。结果 模型与参考标准之间腕骨骨龄的MAE、RMSE与医师1、2与参考标准之间MAE、RMSE差异均有统计学意义（P均<0.05）,与医师3的MAE、RMSE差异无统计学意义（P均>0.05）。模型与参考标准之间腕骨成熟度分值的MAE、RMSE与医师1、参考标准之间MAE、RMSE差异均有统计学意义（P均<0.05）,与医师2、3的MAE、RMSE差异均无统计学意义（P均>0.05）。模型与参考标准之间腕骨骨龄评测结果的ICC=0.997,医师1、2、3与参考标准之间ICC分别为0.994、0.996、0.997。模型对骨龄的测评时间均小于医师（P均<0.001）。结论 AI骨龄评测系统能够准确、快速评估儿童腕骨骨龄。     

拉萨藏族青少年手腕部骨龄的Fels法评价

目的:探讨拉萨藏族青少年骨发育水平的变化趋势,为临床应用骨龄提供科学依据。方法:于2003-07/09采用分层整群抽样调查,从拉萨市6所大、中、小学随机选取父母为藏族,本人在拉萨生活,经体检证明健康的7～21岁青少年为调查对象。按性别分组,每岁为1组,共调查1496名,男743名,女753名。按Fels法进行手腕部骨龄评价,并进行骨龄与年龄的相关分析和骨龄性别差异分析。结果:共调查1496名,数据均进入结果分析。①Fels法评价手腕部骨龄结果:各年龄组骨龄均小于年龄,男性7～21岁各年龄组年龄与骨龄差值变化分别为:1.17±1.18,1.28±1.06,1.79±1.13,1.99±1.05,1.87±1.73,1.72±1.80,1.22±1.68,1.20±1.43,1.29±1.02,1.37±1.27,1.49±0.98,1.71±1.11,2.05±0.79,2.72±0.55;女性分别为:1.18±1.00,1.40±1.28,1.17±1.46,0.95±1.41,0.43±1.34,0.55±1.23,1.29±1.16,1.59±0.95,1.48±1.19,2.15±0.98,2.46±1.06,2.92±0.75,3.60±0.33,4.48±0.26。骨龄性别差异表现为:7～8岁年龄组骨龄男性大于女性,9～12岁年龄组骨龄男性小于女性,而后呈现男性又大于女性。②骨龄与年龄的相关分析:骨龄与年龄呈高度正相关(男性r=0.947,女性r=0.928,总体r=0.934)。结论:各年龄组骨龄均小于年龄,提示拉萨藏族青少年骨发育具有延缓的特点,这可能是西藏典型的高寒、缺氧等高原环境造成的。Fels法可以用于评价拉萨藏族青少年手腕部骨龄,但不完全适用,因此有必要制定西藏藏族儿童青少年的骨龄标准。     

基于深度学习人工智能骨龄测评系统临床应用

目的 观察基于深度学习的人工智能骨龄测评(BAA)系统临床应用及其对低年资儿科放射医师的辅助作用.方法 收集80名5?12岁儿童手腕骨X线正位片,对掌指骨进行骨龄测评,由高年资儿科放射医师借助BAA系统建立研究所用参考骨龄.根据中华-05法中的TW3-RUS标准,分别以BAA系统、低年资儿科放射医师及BAA系统辅助低年...     

常规超声定量评估骨龄

目的 与X线评估骨化率（OR）对比,评价常规超声评估标准骨龄（BA）的价值及其简易方法。方法 对215例患者（男88例,女127例）于1周内先后行左手及腕部X线检查和超声检查,测量桡骨、尺骨,第1、3、5掌骨,第1、3、5近节指骨,第3、5中节指骨及第1、3、5远节指骨共13块骨骼的骨化中心及骨骺长径,计算各目标骨骨化中心与骨骺长径之比,获得其OR及BA,分析OR与BA的相关性。结果 男、女性患者各目标骨的OR与BA呈中-高度相关（r_男为0.77~0.94,r_女为0.77~0.93,P均<0.001）,13块骨骼的OR总和与BA呈高度相关（r_男=0.96,r_女=0.96,P均<0.001）,桡骨、尺骨OR总和与BA呈高度相关（r_男=0.95,r_女=0.95,P均<0.001）。结论 常规超声具有定量评估BA的潜在价值;仅测量桡骨及尺骨或可作为超声评估BA的简易方法。     

口内数字化成像技术在口腔临床中的应用评价

口腔X线检查是重要的辅助检查手段，可以协助诊断病变发生的部位、进程，还可以用来推断预后并评价治疗效果。常规X线检查操作较为复杂，影像显现周期较长，临床治疗中一旦需要多次进行检查，不但会增加口腔治疗区域污染的机会，降低医生的工作效率，而且会增加临床医生和患者暴露的机会；同时口内片体积较小，照片本身存在变质的问题，不便于长期保存。随着计算机技术的发展，数字成像技术在医学上得到了广泛的应用。     

融合中华-05注意力与叠加纹理构建残差网络智能模型评估骨龄

目的 融合中华-05注意力机制与多层纹理叠加建立残差网络模型,观察其评估骨龄的价值。方法 通过组合寻优引入多层叠加纹理增强处理层,以更少信息量更好地表征手骨X线片全局特征,减少杂质信息干扰并释放算力。设计中华-05空间注意力机制,引入我国人群手骨发育标准,使模型智能化聚焦ROI,并自动定位、学习图像关键信息。建立50层深度残差网络,集成融合叠加增强层与注意力机制,观察其评估骨龄的价值。结果 构建的混合式改进的深度残差网络模型ZH05-DL-ResNet50评估骨龄准确率达98.14%,平均绝对误差为0.312岁。结论 成功建立了我国人群中华-05注意力与叠加纹理残差网络智能模型,用于评估骨龄准确率高。     

Relationships between suicide attitudes and indicators of mental health among adolescents

Abstract

A growing body of research literature suggests a relationship between mental health status and attitudes toward suicide among adolescents. This paper reports two studies which explored opposite ends of the mental health continuum as they relate to suicide attitudes among young people. The first study compared attitudes toward suicide between a group of institutionalized 15–24 year olds and a group of college students. The second study assessed suicide attitudes among a group of college students with differing levels of mental health. Two major findings of these studies were that (a) young women with mental health problems severe enough to require institutionalization agree more with all reasons for suicide than do institutionalized males or males and females in a non-institutionalized group, and (b) students who score higher on one measure of self-actualization (inner-directedness) sympathize, empathize, and agree less with all reasons for suicide than do students who score lower on the same measure. Gender, and, to some extent, sex roles were found to be influential in determining sympathetic attitudes toward suicide. Females and feminine males sympathize more than other groups with all reasons for suicide, while males and masculine females sympathize less. The findings are discussed from mental health and sex roles perspectives.     

Relationships between suicide attitudes and indicators of mental health among adolescents

A growing body of research literature suggests a relationship between mental health status and attitudes toward suicide among adolescents. This paper reports two studies which explored opposite ends of the mental health continuum as they relate to suicide attitudes among young people. The first study compared attitudes toward suicide between a group of institutionalized 15-24 year olds and a group of college students. The second study assessed suicide attitudes among a group of college students with differing levels of mental health. Two major findings of these studies were that (a) young women with mental health problems severe enough to require institutionalization agree more with all reasons for suicide than do institutionalized males or males and females in a non-institutionalized group, and (b) students who score higher on one measure of self-actualization (inner-directedness) sympathize, empathize, and agree less with all reasons for suicide than do students who score lower on the same measure. Gender, and, to some extent, sex roles were found to be influential in determining sympathetic attitudes toward suicide. Females and feminine males sympathize more than other groups with all reasons for suicide, while males and masculine females sympathize less. The findings are discussed from mental health and sex roles perspectives.     

Relationships of age and gender to hope and spiritual well-being among adolescents with cancer.

The purpose of this study was to examine hope and spiritual well-being, with its 2 dimensions of religious well-being and existential well-being, as they relate to age and gender among adolescents with cancer. A cross-sectional design was guided by the conceptual framework, Adolescent Psychosocial Adaptation to the Cancer Experience. A total of 78 adolescents with a diagnosis of cancer were enrolled from 2 pediatric oncology clinics. Middle adolescents (15-17 years of age) reported higher religious well-being than late adolescents (18-20 years of age). Middle-adolescent boys were more hopeful than were early adolescent boys (13- 14 years of age). Also, girls were more hopeful and reported higher spiritual well-being than age the boys. Developmental phase and/or gender may influence adolescents' levels of hope, spiritual well-being, religious well-being, and existential well-being as they cope during the cancer experience. The nurse should consider developmental phase and gender when planning interventions to foster hope and spiritual well-being in adolescents' adaptations to the cancer experience.     

Relationships between prolonged neck/shoulder pain and sitting spinal posture in male and female adolescents

Neck/shoulder pain (NSP) is a common problem for adolescents and posture has been suggested as an important risk factor. The aim of this cross sectional study was to examine the relationship between prolonged NSP and habitual sitting posture in adolescents. The habitual sitting postures of 1593, 14-year-old adolescents with and without prolonged NSP were assessed using sagittal plane digital photographs. Cervicothoracic and lumbopelvic posture angles were calculated from the digital images using motion analysis software. Adolescents reported experience of NSP by questionnaire. Differences between postures of males and females and those with and without prolonged NSP were examined using independent t-tests. The relationships between cervicothoracic and lumbopelvic postures and presence of prolonged NSP were investigated using logistic regression models controlling for gender. Prolonged NSP was reported by 5.3% of the adolescents, with females reporting a higher prevalence rate (6.5%) than males (4.2%). Females also sat more erect with a more lordotic lumbar posture than males. Adolescents with prolonged NSP had more flexed cervicothoracic posture, more erect trunk and more lumbar lordosis. When gender was controlled, only lumbar lordosis was related to the presence of prolonged NSP.     

Normal values of cervical vertebral measurements according to age and sex in CT

Introduction

Atlantodental interval (ADI), basion-dental interval (BDI) and the thickness of prevertebral soft tissue (TOPST) measured in lateral cervical radiographs were reported to be useful indicators and indirect signs of underlying cervical spine injuries. However, cervical computed tomography (MDCT) is the first method of imaging used in all trauma patients and upper normal limits (UNLs) of cervical distances according to age and sex are undetermined. Therefore, we aimed to calculate these metrics.

女性服刑人员人际信任自尊与孤独感关系研究

目的探讨女性服刑人员的人际信任、自尊与孤独感的关系,为提高她们的心理健康水平提供依据。方法采用人际信任量表、自尊量表和UCLA孤独感量表对某女子监狱的292名女性服刑人员进行调查分析。结果女性服刑人员自尊量表评分与人际信任量表评分呈显著正相关（P〈0．01）,UCLA孤独感量表评分与人际信任量表、自尊量表评分呈显著负相关（P〈0．01）。女性服刑人员的自尊是人际信任和孤独感的中介变量,且有部分中介效应。结论女性服刑人员的自尊水平较低,存在明显的孤独感,其人际信任和自尊水平对孤独感有显著预测作用。     

比较纳米羟基磷灰石/聚酰胺66人工椎体与自体髂骨在颈椎前路减压融合中的应用

背景:目前用于颈椎前路重建的材料较多,如自体髂骨、同种异体骨、钛网等,但各种材料均存在一定的不足.纳米羟基磷灰石/聚酰胺66人工椎体具有良好的生物相容性及生物安全性,是一种比较理想的椎体植骨替代材料.目的:评估纳米羟基磷灰石/聚酰胺66人工椎体应用于颈椎前路减压融合治疗脊髓型颈椎病的临床效果,并与自体髂骨进行对比.方法:2009-01/2010-03对40例脊髓型颈椎病患者行颈前路椎体次全切减压融合钛板内固定.22例行纳米羟基磷灰石/聚酰胺66人工椎体植骨,18例行自体髂骨块植骨,采用JOA评分法评价神经功能的恢复情况,测量Cobb角评价融合节段曲度以及融合节段椎体前缘、后缘高度.结果与结论:患者均获得 6～14个月随访,JOA评分较治疗前明显改善.人工椎体组及自体髂骨组融合节段后缘高度和前凸Cobb角治疗后3个月与治疗后即刻差值、治疗后6个月与治疗后3个月差值差异均有显著性意义(P < 0.01).根据融合标准,治疗后6个月两组融合情况差异无显著性意义(P > 0.05).提示纳米羟基磷灰石/聚酰胺66人工椎体作为颈椎前路植骨材料,融合率同自体髂骨相似,可以有效保持颈椎生理曲度及椎间高度,长期效果有待进一步观察.