彩色多普勒超声诊断结节性甲状腺肿的价值探讨

目的探讨应用彩色多普勒超声诊断结节性甲状腺肿的临床价值。方法应用高频探头,对69例结节性甲状腺肿与33例甲状腺腺瘤患者进行彩色多普勒超声检查,对声像图表现进行分析,并应用脉冲多普勒进行血流动力学参数测定。结果结节性甲状腺肿的结节为多发,形态欠规则,边界欠清晰,部分有不完整包膜,无晕环,多伴有囊性变;结节周边及内部血供不丰富。甲状腺腺瘤常单发,形态规则,边界清楚,包膜完整,有晕环;结节周边及内部血供较丰富。结论彩色多普勒超声的应用有助于临床对结节性甲状腺肿的诊断。     

彩色多普勒超声在诊断结节性甲状腺肿的应用价值

目的:探讨高频超声声像图和彩色多普勒血流图对结节性甲状腺肿的诊断价值.方法:对31例甲状腺肿的结节进行仔细观察,评价二维图象和彩色多普勒血流图的表现.结果:超声诊断与病理诊断的符合率为68%,实质性及囊实性结节性甲状腺肿的结节表现无包膜或包膜不完整,周边无明显的晕环.结节内部及周边血供不丰富,边缘无环形血流,呈星点状或结节间穿行血流,彩色多普勒能量图,在结节血流显示上优于彩色多普勒血流图.结论:应用彩色多普勒超声对结节性甲状腺肿能够提供重要的血流信息,有助于结节性甲状腺肿的诊断及鉴别诊断,对提高超声诊断正确率有重要意义.     

彩色多普勒超声对甲状腺腺瘤和结节性甲状腺肿的鉴别诊断

目的探讨彩色多普勒超声对甲状腺腺瘤和结节性甲状腺肿的鉴别诊断价值。方法回顾性分析138例甲状腺疾病患者病历资料中彩色多普勒超声检查资料,分析彩色多普勒超声对甲状腺腺瘤和结节性甲状腺肿的鉴别诊断价值。结果 138例甲状腺疾病患者中,超声鉴别诊断显示甲状腺腺瘤76例,结节性甲状腺肿52例,超声对甲状腺大小,结节大小形态回声差异均无显著性差异(P>0.05);超声图像对结节边缘晕环及周边血流信号差异有显著性(P<0.05),准确率92.75%,误诊10例,误诊率7.25%。结论彩色多普勒超声对甲状腺腺瘤和结节性甲状腺肿鉴别诊断具有较高的诊断价值,但仍有影像学的局限性,临床应用中应结合病理学等检查方法,提高阳性准确度。     

彩色多普勒超声对结节性甲状腺肿与甲状腺腺瘤的诊断价值分析

目的探讨彩色多普勒超声对结节性甲状腺肿与甲状腺腺瘤的诊断价值。方法选择2015年7月至2017年7月我院收治的40例结节性甲状腺肿患者(甲状腺肿组)和40例甲状腺腺瘤患者(甲状腺腺瘤组)进行研究,所有患者均进行彩色多普勒超声检查,比较分析两组患者的检测结果。结果甲状腺腺瘤组患者的单发病灶比例、边界清晰比例、内部回声均匀比例、包膜比例、晕环比例均显著高于甲状腺肿组患者,甲状腺腺瘤组患者的RI、PSVmax以及血流丰富比例均显著高于甲状腺肿组患者,差异均有统计学意义(P<0.05)。结论彩色多普勒超声对结节性甲状腺肿与甲状腺腺瘤具有显著的诊断价值。     

彩超对结节性甲状腺肿的诊断与鉴别

目的分析结节性甲状腺肿声像图特征，探讨超声结节性甲状腺肿与甲状腺瘤及甲状腺癌的鉴别诊断价值。方法分析比较68例结节性甲状腺肿与60例甲状腺瘤、21例甲状腺癌的二维及彩色多普勒超声声像图。结果68例结节性甲状腺肿与60例甲状腺瘤、21例甲状腺癌比较，甲状腺大小、结节大小、结节内回声及周围回声差异无统计学意义（P〉0．05）；而结节边缘晕环及结节内部和周边血流信号差异有统计学意义（P〈0．05）。结论结节性甲状腺肿较易误诊为甲状腺癌，结节边缘晕环及结节内部和周边血流信号可鉴别诊断，为临床治疗提供一定的帮助。     

60例甲状腺腺瘤与结节性甲状腺肿的超声鉴别诊断

目的分析甲状腺腺瘤与结节性甲状腺肿的声像图特征,探讨超声对二者的诊断及鉴别诊断价值。方法回顾性分析经手术病理证实的21例甲状腺腺瘤患者和39例结节性甲状腺肿患者的声像图资料,对这两组的二维声像图、彩色多普勒（CDFI）血流图像特点进行比较分析。结果两组比较在甲状腺大小、结节内部回声、结节周围包膜差异无统计学意义（P〉0.05）,在结节数目、结节大小、结节边缘晕环差异有统计学意义（P〈0.05）,两组在结节内部及周边血流信号差异有统计学意义（P〈0.05）。结论根据二维声像图特征甲状腺结节的大小、数目、形态、位置、囊实性变及内部与周围组织回声等,结合彩色多普勒特点,可对结节性甲状腺肿和甲状腺腺瘤做出较准确的诊断及鉴别诊断。     

单发结节性甲状腺肿与甲状腺腺瘤的超声诊断价值

目的探讨彩超对单发结节性甲状腺肿与甲状腺腺瘤的诊断价值,并对误诊原因进行分析。方法对经手术病理证实的42例单发结节性甲状腺肿（观察组）与27例甲状腺腺瘤（对照组）的二维及彩色多普勒声像图进行比较分析。结果甲状腺和结节大小、结节内部与周围组织回声等指标,两组比较差异均无统计学意义（P〉0．05）;在结节边缘晕环、结节内部血流信号、结节周边血流信号及其血流参数等方面,两组比较差异均有显著性意义（P〈0．05）。结论结节性甲状腺肿和腺瘤不同的病理构成不同的声像图及彩色多普勒血流特征,可为诊断提供有价值的帮助。     

B超在甲状腺结节性病变诊断中的应用及其超声特征

目的探讨B超在甲状腺结节性病变诊断中的应用价值及其超声特征。方法选取2017年1月至2018年1月都昌县人民医院收治的甲状腺结节性病变患者80例,均接受B超检查,计算B超诊断符合率,并分析超声特征。结果 B超检查诊断符合率为82.5%,其中桥本甲状腺炎的诊断符合率最高,其次分别为结节性甲状腺肿、甲状腺腺瘤、甲状腺囊肿和甲状腺癌。B超检查结果显示,单发性结节表现为不规则的病灶组织形状,不存在清晰的肿块边界,结节组织内部具备不均匀低回声征,部分伴有钙化点,形状为沙粒状;多发性结节病灶具备规则形状,存在清晰边界,结节组织内部回声较为均匀,伴有粗大钙化征,周边存在完整晕环。结论甲状腺结节性病变采用B超诊断的效果较好,可对病灶良恶性进行有效判断。     

应用彩色超声多普勒诊断结节型甲状腺炎

目的 应用彩色超声多普勒对诊断结节型甲状腺炎价值的探讨.方法 本文回顾性总结和分析了应用彩色超声多普勒诊断的78例163个结节型甲状腺炎患者,并与手术、血清学抗体、及临床最后诊断结果进行对照.结果 临床方面证实的163个结节型甲状腺炎中,有150个为结节型桥本氏甲状腺炎、有13个为结节型亚甲炎;经彩色超声多普勒诊断125个结节型桥本氏甲状腺炎、8个结节型亚甲炎,总符合率为82%.超声误诊为甲状腺癌的8个、结节性甲状腺肿的10个、甲状腺腺瘤的12个,误诊率为18%.结论 尽管结节型甲状腺炎、甲状腺癌、结节性甲状腺肿、甲状腺腺瘤都呈结节形改变,但只有掌握它们在形态、纵横比、边界、内部回声等方面各自的特征表现,可以比较准确地对结节性甲状腺炎做出诊断.     

甲状腺恶性结节的彩色多普勒超声的特征研究

目的：分析甲状腺恶性结节彩色多普勒超声特征,探讨彩色多普勒超声对甲状腺恶性结节的诊断价值。方法：收集近期在笔者所在医院选择手术治疗的甲状腺恶性结节患者79例,对其临床资料进行统计分析,回顾性分析甲状腺恶性结节彩色多普勒超声特征,探讨彩色多普勒超声对甲状腺恶性结节的诊断价值。结果：超声对甲状腺恶性结节的诊断率为72.2%,误诊率为27.8%;其中误诊为结节性甲状腺肿17例（77.3%）,甲状腺腺瘤3例（13.6%）,其他2例（9.1%）。甲状腺恶性结节超声检查主要依赖于对结节形态特征的评价,主要包括：边界、回声、内部回声结构、钙化特点以及结节内部血流情况等,恶性结节的主要特点为边界不清、低回声、内部为实性结构、无钙化或微钙化、结节内部血流丰富。结论：彩色多普勒超声对于甲状腺恶性肿瘤的诊断具有一定的价值,根据各项超声检查特征进行综合分析可以提高诊断率。     

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.