一侧大脑中动脉高密度征对脑梗塞早期诊断价值的探讨

目的提高对一侧大脑中动脉高密度征的认识,探讨其在早期脑梗死诊断中的价值.方法9例患者均做了发病早期(1～6 h)CT扫描及发病后24小时CT扫描,其中男性7例,女性2例,年龄46～68岁,平均58岁,所有病例均经临床诊断.结果9例一侧大脑中动脉梗死患者回顾性CT资料分析,发现发病早期(1～6 h)CT检查均见一侧大脑中动脉高密度征,发病后24 h复查,该侧大脑中动脉血供区均呈大片状低密度灶.结论一侧大脑中动脉高密度征,结合典型的临床表现,在早期脑动脉梗死诊断中具有重要意义.     

CT与MRI对成人型环状胰腺诊断的对比分析

目的：探讨成人型环状胰腺的计算机体层成像（computed tomography,CT）及磁共振成像（magnetic resonance imaging,MRI）表现,以提高对该病的认识。方法：回顾性分析我院6例成人型环状胰腺病例,其中3例行CT腹部平扫及增强扫描;另外3例行MRI腹部平扫及增强扫描,1例结合磁共振胰胆管成像（magnetic resonance cholangiopancreatography,MRCP）检查。详细分析每例影像学图像表现,最终诊断由2位高年资医师盲法观察,得出共同结果。结果：CT及MRI能显示环状胰腺直接征象和间接征象,6例均能显示直接征象,即胰头增大,呈环形包绕十二指肠,2例能清楚显示环状部胰管走行。间接征象包括肝内胆管扩张（2例）、胆总管扩张（3例）、胰管扩张（4例）、胰腺炎（1例）、胆囊炎（1例）。结论：CT平扫及增强检查显示成人型环状胰腺图像清晰。     

Close relations to parents and emotional symptoms among adolescents: beyond socio-economic impact?

Objectives

This study examined the relationship between trustful communication with parents and frequency of emotional symptoms in schoolchildren and whether this relationship was modified by the family’s socio-economic position.

Methods

Pooled data (n = 15,646) from the Danish Health Behaviour in School-aged Children surveys 2002, 2006 and 2010 were analysed by multilevel multivariable logistic regression.

Results

8 % of all schoolchildren reported emotional symptoms almost daily. Odds ratio for daily symptoms was 2.1 (1.8–2.4) for children without trustful communication with parents compared to children with trustful communication. This association appears unaffected by family occupational class. A substantial socio-economic gradient in emotional symptoms persisted, independent of parent–child communication.

Conclusions

Trustful communication with parents might have a fundamental importance, regardless of socio-economic position.     

CT引导经皮穿刺治疗腰椎间盘突出症所致坐骨神经痛的疗效分析

目的 探讨CT引导下经皮穿刺治疗腰椎间盘突出症引起坐骨神经痛的疗效。方法 CT检查发现有腰椎间突出症伴明确临床体征75例,CT引导下经皮穿刺至相应椎间孔神经根处注射由得宝松、维生素B12和利我卡因组成混合药液,使药液分面到椎管内硬膜外。结果 CT引导穿刺注药成改善,9.3%治疗无效,症状无明显改善。结论 CT引导治疗腰椎间盘突出症所臻坐骨神经痛的方法是一种安全、可靠、有效且无并发症的新疗法,其无期疗效有待进一步观察。     

Pituicytoma with pleomorphism: A case report with cytological findings

Pituicytoma is a rare neoplasm, arising in the posterior pituitary or in the hypophyseal stalk, and its cytological findings have not yet been well-described. We have experienced a case of pituicytoma, which was difficult to diagnose intraoperatively, because of its cellular pleomorphism. A tumor measuring 18 mm in maximum diameter was found at the sella turcica in a Japanese woman in her forties. Both intraoperative crush cytology and histology of the resected tumor showed pleomorphic spindle or round cells, including multinucleated cells. Tumor cells were positive for TTF-1, S-100 protein, and vimentin, partially positive for glial fibrillary acidic protein and epithelial membrane antigen, and negative for synaptophysin, hormones of the anterior pituitary gland, CD34, Olig2, PAX8, and napsin A. Ki-67 labeling index was 2.0%. Tumors included in the differential diagnosis in general are pituitary adenoma, craniopharyngioma, germinoma, and metastatic tumor on the radiological standpoint, and pilocytic astrocytoma and meningioma on the cytological standpoint. However, our case was difficult to differentiate especially from high-grade glioma only by morphology, and immunohistochemistry including TTF-1 was helpful.     

Embodied relational research: How can researchers' competences in exploring existential aspects be enhanced?

Background

This methodological essay discusses the following question: How can researchers' competences in exploring existential aspects related to healthcare be enhanced? Exploring this novel perspective on caring practice may help us better understand and communicate about experiences and issues that matter to others (e.g. patients/users). Two things are needed: firstly, a vocabulary mirroring an “aesthetic-holistic” research approach allowing us to capture the essence of “what it is like” and secondly, the development of skills and competences allowing us to understand complex aspects of caring that are embodied, ethically sensitive and sustainable.

Aim

To identify personal competences and approaches underpinning research exploring “what it is like”—understanding human existence.

Discussion

The discussion addresses three questions: (A) What does human science exploring human existence search for? (B) Which researcher competences are required? (C) Which theoretical and practical approaches and dimensions may enhance the researchers' competences? We argue that we should find “ourselves” not only grasped through language and a qualitative research-methodological approach but also in what is reflected in the relation between self, language (dialogue) and the other. It is crucial to listen to the world in an ontological way. Emotions, feelings and bodily sensed understandings can, in some situations, bar us from stepping further into meta-physical listening and from adopting a being-in-the-world stance. In this relational perspective, the researcher may adopt an attentive pace and aesthetical attunement that transcend what cannot be reached through the language of logical, rigorous, precise and rational words, tuning into the ontological mood that exists as the tacit backdrop of our existence. This approach we dub “Embodied Relational Research.”

Conclusion

Researchers who explore humanity may benefit from cultivating awareness, sensitivity and understanding while displaying openness towards the other (the patients' or users' experiences). In this context, contemplative and creative dimensions are important to apply.     

Ethnic disparities in the use of restrictive practices in adult mental health inpatient settings: a scoping review

Social Psychiatry and Psychiatric Epidemiology - To identify and summarise extant knowledge about patient ethnicity and the use of various types of restrictive practices in adult mental health...