双气囊小肠镜诊疗价值

自从2001年初双气囊小肠镜问世以来,此项技术已在世界范围内得到广泛的应用.目前有关双气囊小肠镜临床应用的研究日益增多,主要涉及双气囊小肠镜的临床应用、适应证、对小肠疾病的整体检出率、小肠镜下治疗、操作并发症等[1].2006年8月在日本东京召开的第一届双气囊小肠镜临床应用学术研讨会上,小肠镜的发明者日本的山本博德有鉴于此项技术使用范围的日益扩大,建议将双气囊小肠镜改名为推进式双气囊电子小肠镜.     

无痛双气囊小肠镜检查前后的配合护理

小肠位置特殊,疾病诊断困难,长约600～800cm,疾病诊断困难。传统的检查方法如小肠钡剂、x线检查等对小肠疾病诊断价值低。无痛性双气囊电子小肠镜具有可直视整个小肠的病变情况、图像清晰、操作可控、能取活检及镜下治疗等优点,比传统检查有明显的优越性,是目前小肠疾病检查的新方法”’,现就双气囊小肠镜检查前后护理总结如下：1．临床资料2013年9月至2014年6月,我科为27例患者实行了双气囊小肠镜检查,其中男性16例,女性11例,年龄16～78岁。因消化道症状（便血、腹痛、腹泻、不全性肠梗、不明原因消瘦等）而人住我科,经胃镜、结肠镜、钡餐等检查未发现明显器质性病变。     

研究麻醉双气囊电子小肠镜的临床应用

目的分析气管插管麻醉在双气囊电子小肠镜检查中的临床应用价值。方法收集我院2011年6月—2013年6月期间接收的需要实施双气囊电子小肠镜检查的小肠疾病患者85例作为研究对象,所有患者均应用气管插管麻醉,回顾性分析患者的临床资料,总结其临床应用价值。结果研究结果显示,本组患者在检查过程中,心率、血压、血氧饱和度等生命体征均未出现明显的变化,所有患者均安全完成小肠镜检查。在本次检查过程中,有1例患者由于回盲部狭窄及变形导致小肠镜无法通过狭窄部,有1例患者由于十二指肠水平部狭窄而终止进镜,有3例患者由于回肠末端狭窄中止进镜,另外80名患者经口检查均到达回肠上段或中段,本组患者检查时间60-87min,平均（73.8±10.28）min,无一例严重并发症出现。结论气管插管麻醉应用于双气囊电子小肠镜检查能效提高检查过程的安全性,保障小肠镜检查的顺利实施,具有非常重要的临床应用价值,值得在临床应用上推广。     

推进式双气囊小肠镜和胶囊内镜的比较研究

推进式双气囊电子小肠镜和胶囊内镜是最近几年新出现的诊断小肠疾病的检查方法,针对两者的特点,从适应症、禁忌症、临床应用以及尚存在的问题等方面进行比较,为临床治疗思路提供借鉴。     

探索消化道最后的盲区，诊治小肠疾病有力的武器——双气囊电子小肠镜

本文介绍了最新开发的双气囊电子小肠镜系统的组成、特点，适应症，初步临床应用情况，供临床消化内科及内镜医师参考。     

双气囊推进式小肠镜的临床应用

目的： 双气囊推进式小肠镜的发展使医生能够直接观察小肠,本研究的目的在于探讨该设备在结肠镜和胃镜检查均阴性的55例患者中的诊断和治疗意义.方法： 采用双气囊推进式小肠镜EN-450P,在检查过程中,大部分患者采用清醒镇静,注意观察记录患者的并发症、检查时间、进镜途径及检查阳性率.患者的症状和体征、诊断和预后都有详细记载.结果： 本组患者的检查结果的阳性率为94.5%（52/55）,其中不明原因的小肠出血占43.6%（24/55）,是该项检查的主要适应症,平均检查时间是45分钟.3例患者因为没有获得全肠道的检查而未确诊,从而从相反地方向重新检查.5例患者获得全胃肠检查.在镇静剂的帮助下,患者可以很好的耐受检查.3例患者因为腹腔严重粘连导致进镜困难而放弃检查.所有的患者均有随访.大多数器质性疾病（除了病变部位有活动性出血）的患者均有病理诊断.一位胃大部切除患者发生肠扭转造成肠梗阻,在完成检查后,完全恢复.结论： 双气囊推进式小肠镜能够肉眼观察全小肠,并能够得到病理诊断,并能够大体对病变进行定位.在镇静剂的帮助下,患者能够很好的耐受检查.它的适应症为：不明原因的消化道出血、慢性腹泻、慢性腹痛和不完全肠梗阻.它不仅是一项检查手段,在某种意义上来说,它还可以是一种治疗手段.检查失败的主要原因是腹腔粘连.     

带您了解小肠镜

<正>随着内镜技术的逐渐成熟,人体某些器官在内镜的直视下进行检查、治疗已成为比较普遍的医学手段。对小肠这一人体最长消化器官的探索也伴随着小肠镜技术的突破而破冰前行。2001年双气囊小肠镜技术研制成功,2003年在全球同步上市,我国也于当年引进此项技术并应用于临床。经过20余年的普及与发展,小肠镜已成为一项成熟的诊疗项目应用于临床。     

双气囊小肠镜 全小肠检查无盲区

张女士今年50岁,反复黑便2年多,被认为是消化道出血,但常规胃镜、肠镜检查一直无法确诊确切原因。近日,浙江大学医学院附属第一医院（简称浙医一院）消化内科专家用双气囊小肠镜经口、十二指肠、空肠、回肠、回盲瓣后进入回盲部和升结肠起始段，成功完成了全小肠检查，确诊为小肠血管畸形，排除了肿瘤可能，张女士心上的石头终于落了地。这种一次肠镜顺利完成全小肠检查，目前国内外只有少数医院能够进行。     

双气囊小肠镜 全小肠检查无盲区

张女士今年50岁,反复黑便2年多,被认为是消化道出血,但常规胃镜、肠镜检查一直无法确诊确切原因。近日,浙江大学医学院附属第一医院（简称浙医一院）消化内科专家用双气囊小肠镜经口、十二指肠、空肠、回肠、回盲瓣后进入回盲部和升结肠起始段，成功完成了全小肠检查，确诊为小肠血管畸形，排除了肿瘤可能，张女士心上的石头终于落了地。这种一次肠镜顺利完成全小肠检查，目前国内外只有少数医院能够进行。     

双气囊内镜在小肠疾病中的诊断价值

目的探讨双气囊内镜在小肠疾病中的诊断价值。方法自2006年10月至2015年5月对疑诊有小肠疾病的45例患者进行双气囊内镜检查，3例患者经口进镜，5例患者经肛进镜，57例患者经口＋经肛进镜。总结该组患者的病变的检出情况、并发症及患者的耐受性。结果45侧患者中54例发现病灶，包括：小肠肿瘤、炎性肠病、小肠息肉、小肠憩室等。所有患者均未出现严重不良反应和消化道出血、穿孔等并发症。29例经病检、手术或治疗效果确诊。结论气囊内镜能安全快速地检查全小肠，对小肠疾病的检出率较高，临床应用价值较高。     

Benzene in blood and phenol in urine in monitoring benzene exposure in industry

Determinations of benzene concentration in blood and of phenol in urine were made by head-space gas chromatography techniques on samples taken near the end of the work day from two groups of workers potentially exposed to low levels of benzene in the work-place atmosphere. Preliminary results suggest that benzene in blood is more reliable than phenol tests for assessing both exposure and uptake of benzene. Normal values of phenol in urine (10 mg/liter or less) were found in nearly all those cases in which benzene was detected in the blood.     

2012年绵阳市蔬菜中农药残留状况

目的 了解绵阳市2012年市售蔬菜中农药残留情况,为食用蔬菜监管提供依据.方法 全部样品均按照GB/T 5009-2003的方法进行农药的残留检测.依据GB 2763-2005《食品中农药最大残留限量》进行判定.结果 2012年共检测蔬菜165份,农药检出率和超标率分别为72.12％和23.64％.豆类、根茎类、叶菜类、瓜果菜类和食用菌类蔬菜检测农药残留超标率分别为8.00％、23.53％、36.00％、5.26％和27.03％,差异有统计学意义(x2=11.41,P＜0.01).不同种类农药超标率差异有统计学意义(x2 =62.42,P＜0.01).夏季和冬季蔬菜农药超标率差异无统计学意义(x2=3.44,P＞0.05).结论 绵阳市叶菜类蔬菜中农药残留情况较为严重,应采取有效措施,加强蔬菜的监督管理,从源头禁止高毒农药的使用,加大蔬菜种植、销售环节的监测,确保市民食用蔬菜的安全.     

2019年中国肿瘤流行病学研究进展

恶性肿瘤已成为中国居民的主要死因之一。近些年来,中国政府积极推进肿瘤预防和控制领域的研究工作,取得了很大的进步。本文简要汇总中国在肿瘤流行病学领域的研究进展,具体包括2019年的肿瘤负担、癌症危险因素及其干预、筛查和早期发现、癌症防治专项行动(2019-2022年)方案等方面,以期为我国肿瘤防治工作的有效开展提供技术支撑和理论依据。     

芜湖地区儿童隐孢子虫病调查

1989年5月~9月,对安徽省芜湖市五所医院儿科就诊的腹泻患儿进行隐孢子虫病调查。粪检腹泻患儿3 498人,卵囊检出率1.9%。男女检出率无差异;6个月内的患儿中未检出卵囊阳性者;86.2%的卵囊阳性者分布于7个月~4岁年龄段;乡村患儿的卵囊检出率2倍于城市患儿;病例呈高度散发状态;卵囊检出率从6月下旬开始上升,在本调查中,92.5%的病例分布于6月下旬~9月。所见病例,从临床表现到大便性状均无特殊,且均呈自限性,病程似较文献报道者为短。     

Correlation among cadmium levels in river sediment, in rice, in daily foods and in urine of residents in 11 prefectures in Japan

Objective: The objective of this study is to examine if overall correlation exists among cadmium levels (Cd) in the general environment, dietary Cd intake, and Cd body burden of local residents. Methods: Eleven prefectures in Japan were selected as the areas where large-scale data on Cd levels in urine of adult women (40–49 and 50–59 years of age, respectively) were available to calculate geometric mean (GM) values for each of the prefecture. Other data were cited from published or previously established databases on Cd in the sediments of river bottoms (as a representative of Cd in the environment), Cd in rice for local consumption, and Cd in daily food duplicate samples collected from local women populations, and calculated for GM values for the prefectures. The GM values were subjected to correlation matrix and regression analysis. Results: Marginally significant (P<0.10) correlation was detected between Cd in sediment and Cd in rice. Furthermore, correlation of Cd in sediment was significant with Cd in total foods (P<0.05) and possibly with Cd in urine (P<0.05–0.10). Importance of data on Cd in rice paddy soil as a missing link is discussed. Conclusions: Correlation was demonstrated in the flow of Cd transport from the environment (expressed as Cd contents in river sediments) to humans (in terms of Cd in urine) among general populations in Japan.     

谈神经内科医院感染危险因素及护理对策

目的：了解引起神经内科住院患者医院感染的危险因素，采取有效的护理措施，以降低医院感染的发生率和死亡率。方法：结合多年临床经验，对医院感染不同的危险因素进行分析及提出护理对策。结论：神经内科医院感染发病率较高，获得途径以外源为主，针对主要危险因素的发生原因，我们应加强病房管理，严格执行消毒隔离制度，合理应用抗生素，加强基础护理和健康教育，缩短住院天数，以降低神经内科医院感染的发病率。     

2003年汕头市住院婴儿住院情况分析

目的调查住院婴儿疾病分布情况。方法利用SAS8．0对汕头市2003年住院婴儿2923例病例进行统计分析。结果婴儿住院的病因包括：早产、新生儿窒息、呼吸道及消化道感染、新生儿黄疸以及先天性疾病等；造成婴儿死亡的前5位病因主要是出生窒息、窘迫、先天性肺炎、新生儿吸人性肺炎以及先天性心脏畸形；婴儿的住院时间越长，入院情况越危急，受到医院感染的机会越大；入院婴儿平均住院日为7．089天，平均住院费用3717．834元。结论婴儿发病入院主要由于先天性疾病以及后天感染，这是家庭及社会进行婴儿健康干预与促进的重点。     

Musculoskeletal pain in ragpickers in a southern city in Brazil

BACKGROUND: Ragpickers are informal workers who collect recyclable materials to earn a small wage. Their life and working conditions are extremely precarious. The ergonomic hazards and musculoskeletal pain in a sample of ragpickers in Pelotas, a city in southern Brazil are examined. METHODS: Two comparison groups were available: a matched sample of non-ragpickers from the same poor neighborhoods, and a random sample of the general population of the city. The cross-sectional study gathered data by interview on 990 individuals in 2004. Musculoskeletal pain was assessed using the Standardized Nordic Questionnaire. RESULTS: Ragpickers reported higher prevalences for most awkward postures and ergonomic exposures compared to neighbors with other demanding manual jobs. The prevalence within the last 12 months of low back pain (LBP), lower extremity pain (LEP), and upper extremity pain (UEP) among ragpickers were 49.2%, 45.1%, and 34.9%, respectively; levels similar to those reported by neighborhood controls. Both ragpickers and non-ragpickers reported considerably higher ergonomic exposures, and more prevalent LBP, than the general population. CONCLUSIONS: Ragpickers experience many occupational hazards and ergonomic stressors. Their overall prevalence of musculoskeletal pain was similar to a comparison group with other physically demanding manual jobs. For LBP, this prevalence was substantially higher (49% vs. 35%) than in the general population.     

Changes in social inequalities in health in the Basque Country

STUDY OBJECTIVE: To determine the extent of the inequalities in self reported health between socioeconomic groups and its changes over time in the Basque Country (Spain). DESIGN: Cross sectional data on the association between occupation, education and income and three health indicators was obtained from the Basque Health Surveys of 1986 and 1992. Representative population samples were analysed. In 1986 the number of respondents was 24 657 and in 1992, 13 277. SETTING: Basque Country, Spain. MAIN OUTCOME MEASURES: The effect of socioeconomic position on health and the magnitude of social inequalities in health were quantified using the odds ratios based on logistic regression analysis, and the Relative Index of Inequality. RESULTS: As was expected, social inequalities in self reported health existed in both surveys, but the social gradient was greater in 1992. Social differences varied according to gender and health indicator. According to education an increase in social inequalities was observed consistently in all the health indicators except long term conditions in women. A consistent increase in inequalities in limiting longstanding illness was also observed according to all socioeconomic indicators. CONCLUSIONS: These results agree to a large extent with those of previous studies in other countries. In this context the unequal distribution of material circumstances and working conditions between socioeconomic groups seem to play a major part in health inequalities. The worsening of the labour market during this period and the onset of a new economic recession may explain the increase in social inequalities over time.