16层螺旋CT小视野血管容积成像对脑动脉瘤的诊断研究

目的 探讨16层螺旋CT小视野血管容积成像技术的应用及其对脑动脉瘤的诊断价值.方法 应用16层螺旋CT小视野血管容积成像技术对50例临床怀疑为脑动脉瘤的患者行CT脑血管造影(CTA)检查,并与数字减影血管造影术(DSA)对照,前瞻性分析16层螺旋CT小视野血管容积成像技术对脑动脉瘤的诊断准确度及灵敏度.结果 CTA检查50例患者,检出43例脑动脉瘤,共46个病灶,采用16层螺旋CT小视野血管容积成像技术能清晰显示瘤体、瘤颈、载瘤动脉与周围血管及颅骨的关系以及病灶与颅骨结构间的关系;50例患者中DSA检查最后确诊为脑动脉瘤42例,共45个病灶,其中3例为多发(2个病灶),有8例结果为阴性,其中7例与CTA结果相符.16层螺旋CT小视野血管容积成像技术在显示脑动脉瘤的形态特征及其与周围结构关系方面明显优于DSA,两者比较差异有统计学意义(P＜0.01).结论 16层螺旋CT小视野血管容积成像技术诊断脑动脉瘤灵敏度高,在显示脑动脉瘤形态特征及其与周围结构关系方面优于DSA.     

螺旋CT与核磁脑血管成像的临床价值

目的探讨64排螺旋CT血管成像（CTA）与3T核磁血管成像（MRA）在脑血管疾病中的临床应用价值。方法对46例脑血管疾病患者均行64排螺旋CT血管成像与3T核磁血管成像检查。结果 64排螺旋CT血管成像检出脑动脉瘤38例,脑动脉畸形2例,3T核磁血管成像检出脑动脉瘤34例,脑动脉畸形2例,且瘤体的大小存在差异;脑动脉狭窄或闭塞64排螺旋CT血管成像检出21例,3T核磁血管成像检查26例,血管狭窄的程度也不一致。结论在脑血管疾病检查中,64排螺旋CT血管成像技术与3T核磁血管成像技术均为无创性血管检查,CTA对于脑动脉瘤准确率较高,但颅底位置容易漏诊。MRA对于过小动脉瘤容易漏诊;CTA对钙化和软斑块显示比较好,M RA可以较好的显示血流方向以及血管功能方面的信息。     

三维CT血管造影在破裂动脉瘤筛查中的应用价值

目的 探讨16排螺旋三维CT血管造影（3D—CTA）在诊断破裂动脉瘤中的应用价值。方法 对38例可疑动脉瘤性蛛网膜下腔出血（SAH）患者行3D—CTA检查，应用表面遮盖、最大密度投影等重建技术，15例行数字减影血管造影（DSA）检查，将得到的影像学资料与手术所见进行对比分析。结果 34例患者确诊为动脉瘤，共发现动脉瘤38个，其中多发性动脉瘤4例。3D—CTA可以清晰显示瘤体、瘤颈、载瘤动脉与周围结构的关系。将3D—CTA与DSA检查测量的瘤体及瘤颈数据进行比较，差异无统计学意义（P〉0．05）。显微手术治疗23例，介入栓塞治疗7例。结论 16排螺旋3D—CTA图像质量高，可作为SAH及可疑动脉瘤患者的首选筛查方法，DSA可作为必要的补充检查手段。     

CTA、MRA诊断脑动脉瘤的临床应用

[目的]探讨CTA(多层螺旋CT血管成像)MRA(磁共振血管造影术)在诊断脑动脉瘤的临床意义。[方法]对37例脑动脉瘤患者的CTA/MRA资料和DSA/手术资料进行回顾性比对分析,其中19例行了CTA检查,18例行了MRA检查。[结果]对于本组37例经DSA或手术确诊的动脉瘤均能够被CTA或MRA发现,运用多种方法重建后的CTA/MRA可以显示脑动脉瘤的部位、形态、大小及与载瘤动脉的关系,并且与DSA或手术所见结果高度吻合。[结论]CTA和MRA可作为脑动脉瘤诊断、治疗方案的选择、术后随访的首选检查手段。     

双能量脑动脉CT血管造影在脑动脉瘤诊断中的应用

目的 探讨双能量脑动脉CT血管造影（CTA）在脑动脉瘤诊断中的价值.方法 以数字减影血管造影（DSA）结果为金标准,回顾性分析30例经DSA证实为脑动脉瘤患者的双能量脑动脉CTA影像学特点,比较双能量脑动脉CTA和DSA检查对脑动脉瘤诊断准确性.结果 双能量脑动脉CTA能较好地显示脑动脉瘤的直接征象,对颈内动脉虹吸段的动脉瘤征象显示优于常规脑动脉CTA扫描.对瘤体及瘤颈的测量与DSA有较高的一致性,两种方法比较差异无统计学意义（P＞0.05）.双能量脑动脉CTA辐射剂量为19.1～25.4（21.7±0.5） mSv.结论 双能量脑动脉CTA能够清晰显示脑动脉瘤的瘤体大小及瘤颈,对脑动脉瘤的诊断有较高的临床应用价值.     

3D-DSA技术在脑动脉瘤诊断中的应用

目的 分析数字造影旋转三维成像（3D-DSA）技术在脑动脉瘤诊断中的应用价值，为提高临床诊疗能力提供参考。方法 选取2020年8月—2021年7月于高唐县人民医院实施检查的30例脑动脉瘤患者纳入本次研究，患者均接受数字减影血管造影（DSA）以及3D-DSA检查。回顾性分析3D-DSA在对脑动脉瘤显示、动脉瘤大小、形状、瘤颈、周围血管等情况的显示程度，及时发现其他脑动脉病变，为临床诊疗提供科学依据。通过对比分析3D-DSA技术在脑动脉瘤中的诊断价值。结果 3D-DSA检查脑动脉瘤对前交通动脉、后交通动脉、颈内动脉、基底动脉、大脑中动脉、脉络膜前动脉部位的总诊断率为96.67%，高于DSA检查方式的80.00%，差异有统计学意义（P<0.05）。3D-DSA检查脑动脉瘤在动脉瘤显示、动脉瘤形态、动脉瘤瘤颈、动脉瘤同毗邻血管关系方面的成像质量评分高于DSA检查，差异均有统计学意义（P<0.05）。结论 在脑动脉瘤的临床诊疗过程中，3D-DSA在诊断脑动脉瘤方面比DSA更准确，能够为临床医师进一步明确病情，开展系统化治疗提供确切依据。3D-DSA技术的应用是DSA技术的进一步发展，...     

64层螺旋CT血管成像在脑动脉瘤术前评价中的临床应用

目的：探讨64层螺旋CT血管成像在脑动脉瘤术前评价中的临床应用价值。方法：对52例患者行64层螺旋CT血管成像检查。运用容积再现、最大密度投影及多平面重组评价动脉瘤的大小、形态和位置。结果：52例患者共发现动脉瘤59个,其中6例患者为多发;后交通动脉瘤31个,前交通动脉瘤16个,基底动脉瘤9个,前动脉动脉瘤3个。59个动脉瘤呈囊状41个,梭形5个,不规则形13个。动脉瘤平均直径为7.2 mm,瘤体大小平均为6.5 mm,瘤颈平均宽度为4.1 mm。29例患者伴有蛛网膜下腔出血。结论：64层螺旋CT血管成像能能准确提供关于脑动脉瘤的信息,指导外科手术夹闭及栓塞治疗,降低治疗风险,提高治疗成功率。     

脑CTA的成像技术及对脑血管病变的诊断价值

目的:探讨螺旋CT脑血管成像(CTA)技术及其对脑血管病变的诊断价值。方法:选择26例脑血管病变患者行CTA检查,共检出23个病变,发现脑动脉瘤8例,12个AVM(动静脉畸形),脑动脉狭窄3个。采用高压注射器以2.5-3。0m1/s速率行外周静脉注射,行螺旋CT容积扫描,在工作站进行多种三维成像后处理,得到脑血管立体图像。结果:发现扫描技术是CTA成功的关键,CTA可清楚地显示较粗大的脑动脉,对Willis环及大脑前、中、后动脉主干及其分支显示良好,对于脑动脉瘤、脑动静脉畸形及脑动脉狭窄的诊断较有意义。结论:CTA可全脑多支血管同时显示,多方位观察,属微创检查,可用于脑血管病变的诊断。     

多层螺旋CT血管成像在脑动脉瘤检查中技术参数探讨

脑动脉血管瘤是指颅内动脉瘤,病程隐匿,起病突然,临床表现为严重的蛛网膜下腔出血,一旦发病,死、残率极高,早期诊断和治疗有重要意义.CT血管造影术(CTA)对脑动脉瘤的诊断准确率高,能够清晰显示脑动脉瘤与周围血管结构关系以及动脑瘤的位置,大小,形态[1],可以任意角度观察瘤颈情况.与有创DSA血管成像比较, CTA操作简便,价格低廉,是早期诊断和治疗颅内动脉瘤的首选筛选方法之一[2].我们开展这项检查以来,经过不断积累经验,总结和探讨CTA检查的技术要领及技术参数.     

多层螺旋CT在上肢血管疾病中应用与数字减影血管造影术对比研究

目的探讨多层螺旋CT在上肢血管疾病中成像技术及临床应用。方法对21例临床怀疑上肢动脉及静脉阻塞性疾病的患者行多层螺旋CT扫描，采集到的原始图像重建1．25mm传至工作站进行后处理，并与数字减影血管造影术（DSA）对照，分析多层螺旋CT在诊断上肢血管疾病中的灵敏度及准确度。结果18例上肢中CT血管成像有3例右侧肱动脉闭塞，7例锁骨下动脉狭窄，2例左侧腋动脉瘤，2例前臂动静脉瘘，4例未见明显异常，CT静脉成像中3例多发静脉石；其中18例同时进行DSA检查，2例未见明显异常，CT血管成像敏感度为87．5％（14／16），准确度为88．9％（16／18）。结论多层螺旋CT在上肢血管造影是上肢动脉病变的一种新的无创伤检查方法，诊断上肢血管疾病的灵敏度较高，比DSA方便，快捷，可作为血管造影筛选及替代DSA方法。     

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.     

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.     

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.     

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.