应用脉冲电磁场刺激人骨髓间充质干细胞体外培养的生物学特性的研究

目的　应用脉冲电磁场 (PEMFs)刺激体外分离培养的人骨髓间充质干细胞 (hMSCs) ,对其生物学特性进行研究。方法　PEMFs (1 2Hz、 1 1mT、 8h/d)刺激hMSCs体外培养 ,计算细胞的倍增时间 ,观察细胞超微结构 ,放免法测定骨钙素的分泌情况和钙化结节VonKossa染色。结果　脉冲电磁场作用后的细胞增殖能力提高 ,细胞形态发生变化 ,透射电镜观察提示细胞成熟 ,VonKossa钙染色阳性 ,骨钙素的分泌活性增高。结论　hMSCs经合理的PEMFs体外刺激培养后 ,不仅能够大量扩增细胞 ,同时能够向成骨细胞转化 ,具有一定的成骨活性 ,是一种较为理想的骨种子细胞来源     

A segmented attenuation correction for PET

A segmented attenuation correction technique has been developed for positron emission tomography which computes attenuation correction factors automatically from transmission images for use in the final image reconstruction. The technique segments the transmission image into anatomic regions by thresholding the histogram of the attenuation values corresponding to different regions such as soft tissue and lungs. Average values of attenuation are derived from these regions and new attenuation correction factors are computed by forward projection of these regions into sinograms for correction of emission images. The technique has been tested with phantom studies and with clinical cardiac studies in patients for 30- and 10-min attenuation scan times. This method for attenuation correction was linearly correlated (slope = 0.937 and r2 = 0.935) with the standard directly measured method, reducing noise in the final image, and reducing the attenuation scan time.     

Data compression: effect on diagnostic accuracy in digital chest radiography

High-resolution digital images make up very large data sets that are relatively slow to transmit and expensive to store. Data compression techniques are being developed to address this problem, but significant image deterioration can occur at high compression ratios. In this study, the authors evaluated a form of adaptive block cosine transform coding, a new compression technique that allows considerable compression of digital radiographs with minimal degradation of image quality. To determine the effect of data compression on diagnostic accuracy, observer tests were performed with 60 digitized chest radiographs (2,048 x 2,048 matrix, 1,024 shades of gray) containing subtle examples of pneumothorax, interstitial infiltrate, nodules, and bone lesions. Radiographs with no compression, with 25:1 compression, and with 50:1 compression ratios were presented in randomized order to 12 radiologists. The results suggest that, with this compression scheme, compression ratios as high as 25:1 may be acceptable for primary diagnosis in chest radiology.     

父母教养方式与护理本科生自强意识的相关性研究

目的了解护理本科生的自强意识水平及父母教养方式,探讨两者的关系,为发展护理本科生自强意识提供参考。方法采用自强意识问卷和父母教养方式问卷对220名全日制本科在校护生进行调查分析。结果护生的自强意识得分为100.78±11.23。护生的自强意识与父母的情感温暖理解呈显著正相关(均P<0.01),与父母的惩罚严厉、拒绝否认、过度干涉和保护呈显著负相关(均P<0.05)。自强意识在性别和年级方面存在统计学差异(P<0.05,P<0.01)。独生子女与非独生子女的父母教养方式在情感温暖与理解、过干涉过保护、偏爱被试等因子得分存在统计学差异(P<0.05,P<0.01),不同自强意识水平护生的父母教养方式在情感温暖与理解、惩罚严厉、拒绝否认等因子得分存在统计学差异(均P<0.01)。结论护生的自强意识处于中等水平,父母教养方式趋于过干涉过保护。学校应结合护生父母教养方式的特点和护理专业的特殊性对护生进行专业教育和心理指导,以提高护生的自强意识水平。     

Age trends of bone mineral density and percentile curves in healthy Chinese children and adolescents

The clinical utility of dual-energy X-ray absorptiometry (DXA) measurement requires appropriate normative values, designed to be diverse with respect to age, gender and ethnic background. The purpose of this study was to generate age-related trends for bone density in Chinese children and adolescents, and to establish a gender-specific reference database. A total of 1,541 Chinese children and adolescents aged from 5 to 19-years were recruited from southern China. Bone mineral density (BMD), bone mineral content (BMC), and bone area (BA) were measured for the total body (TB) and total body less head (TBLH). The height-for-age, height-for-BA, and BMC-for-BA percentile curves were developed using the least mean square method. TB BMD and TBLH BMD were highly correlated. After 18 years, TB BMD was significantly higher in boys than girls. For TB BMC and TBLH BMC, gender differences were found in age groups 12 years and 16–19 years; however, the TBLH BMD was significantly different between genders >16 years. The head region accounted for 13–52 and 16–49 % of the TB BMC in boys and girls, respectively. Furthermore, the percentages were negatively correlated with age and height. This study describes a gender-specific reference database for Chinese children and adolescents aged 5–19 years. These normative values could be used for clinical assessment in this population.     

社区糖尿病患者糖尿病足运动锻炼行为调查分析

目的了解社区糖尿病患者糖尿病足相关运动锻炼行为状况,分析影响因素。方法采用糖尿病足知识问卷、糖尿病足自我锻炼健康信念问卷、糖尿病足自我锻炼行为问卷,对上海市某社区糖尿病患者209例进行调查。结果社区糖尿病患者糖尿病足相关运动锻炼行为得分率60.53%～72.48%;糖尿病足相关知识和健康信念是运动锻炼的主要影响因素(P<0.05,P<0.01)。结论社区糖尿病患者的运动锻炼行为不理想,需加强健康教育,提高其知识水平及健康信念,促进其锻炼的健康行为,有效预防糖尿病足。     

锚钉固定缝合治疗三角韧带陈旧性损伤

 目的 探讨锚钉固定重叠缝合治疗三角韧带陈旧性损伤的疗效。方法 回顾性分析2007年1月至2011年12月,治疗17例三角韧带陈旧性损伤患者资料,男11例,女6例;年龄18～58岁,平均32.1岁;均有踝关节扭伤史,病程为7～25个月,平均14.2个月。患者术前均行踝关节负重正、侧位X线片、双足正、斜位X线片、MRI及B超检查。确诊为内侧三角韧带损伤后,患肢行踝关节镜检查再次明确诊断并清理关节内增生的滑膜及合并损伤的关节软骨。切开踝关节内侧间隙,清理韧带残端瘢痕组织,其中2例同时清理陈旧性内踝尖撕脱骨折片。将三角韧带深层断端缝合于内踝尖,三角韧带浅层重叠缝合于内踝骨膜,使用锚钉固定。采用美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝与后足评分评价手术前后踝关节。结果 17例患者均获得随访,随访时间12～34个月,平均20.1个月。影像学与术中检查均发现三角韧带损伤且已瘢痕化。距骨-第一跖骨角及Saltzman位后足力线角分别从术前5.4°±1.8°和8.2°±2.6°降至术后4.0°±0.9°和5.3°±1.3°。AOFAS踝与后足评分,术前为平均(76.8±7.0)分 ,末次随访时为平均(94.1±3.3)分;其中优10例,良6例,可1例,优良率为94.1%(16/17)。17例患者疼痛均有效缓解。末次随访时,无一例患者出现三角韧带再损伤。结论 锚钉固定缝合治疗三角韧带陈旧性损伤可以获得良好的效果。     

血液透析患者永久性双腔导管的操作流程改良

目的 探讨永久性双腔导管的操作流程改良对预防透析导管堵管和感染的效果.方法 将透析中心置入长期透析导管的21例患者,随机分对照组10例按照2010版血液净化标准进行导管使用和护理,观察组11例强化双腔导管的细节管理,即整个操作过程不让血液在导管内停留,同时操作环节没有导管口的暴露机会.结果 对照组1 200个导管日,导管不全堵塞71例次,完全堵塞12例次,感染6例次;观察组1 200个导管日,导管不全堵塞11例次,完全堵塞2例次,感染0次,两组比较,差异有统计学意义(P＜0.05,P＜0.01).结论 在导管使用和维护中,注重细节管理,可有效防范导管护理不良事件的发生.     

后路矫形手术对青少年特发性脊柱侧凸患者脊柱高度的影响

要】 目的：评估后路矫形手术对青少年特发性脊柱侧凸（adolescent idiopathic scoliosis,AIS）患者脊柱高度的矫正程度及其影响因素。方法：2010年1月~2011年6月接受后路矫形内固定术的AIS患者277例,单弯（single curve,SC）173例,双弯（double curve,DC）104例,站立位主弯Cobb角平均53.63°±15.38°（40°~140°）,仰卧位主弯Cobb角43.87°±15.01°（20°~124°）。脊柱高度（spinal height,SH）定义为仰卧位全脊柱正位X线片上T1椎体上终板中点至S1椎体上终板中点之间的垂直距离。测量术前、术后SH,ΔSH为手术矫正SH值。评估不同Cobb角侧凸患者的ΔSH,并采用偏相关分析评估脊柱侧凸术前Cobb角、Cobb角矫正值、Cobb角矫正率、术前SH及术后SH与ΔSH的相关性。结果：SC组仰卧位Cobb角术后矫正至15.69°±9.21°（4°~79°）,DC组仰卧位主弯Cobb角术后矫正至19.50°±13.07°（3°~95°）,矫正率分别为69.7%和65.5%。SC组和DC组术前SH分别为41.29±2.96cm和39.97±3.26cm,术后SH分别为43.77±2.71cm和42.86±3.04cm。SC组术前仰卧位Cobb角分别为≤30°、31°~40°、41°~50°、51°~60°、61°~70°、71°~80°、>80°时,ΔSH分别为1.97±0.79cm、2.14±0.63cm、2.52±0.65cm、2.77±0.51cm、3.92±0.61cm、4.33±0.22cm、4.85±0.22cm;而在DC组中,ΔSH分别为2.37±0.60cm、2.35±0.69cm、2.56±0.53cm、3.27±0.40cm、3.79±0.94cm、3.89±1.11cm、5.46±0.91cm。ΔSH与术前Cobb角[SC：r=0.702,P<0.001;DC（主弯+次发弯）：r=0.718,P<0.001]、Cobb角矫正值[SC：r=0.659,P<0.001;DC（主弯+次发弯）：r=0.698,P<0.001]和术后SH[SC：r=0.182,P=0.017;DC（主弯+次发弯）：r=0.213,P=0.033]呈显著相关性,但与Cobb角矫正率[SC：r=0.083,P>0.05;DC（主弯+次发弯）：r=0.039,P>0.05]和术前SH[SC：r=-0.082,P>0.05;DC（主弯+次发弯）：r=-0.047,P>0.05]无明显相关性。结论：后路矫形手术可显著改善AIS患者的SH,术前Cobb角和Cobb角矫正值是影响SH矫正程度的主要因素,术后SH是次要影响因素,而Cobb角矫正率则影响不大。