对诊断PADAM的游离睾酮指数的评估

目的 评价诊断中老年男子部分雄激素缺乏综合征（PADAM）的游离睾酮指数（FTI）.方法 对129例45岁以上健康男性的FTI进行年龄相关分析.以推算的游离睾酮（CFT）值为依据,对FTI进行有效性检验.结果 男子在中老年期FTI与增龄呈明显的负相关.FTI敏感性97.78%,特异性58.33%.结论 计算简单的FTI可用于PADAM病人的筛选和随访,尤其对70岁以上男子是血清FT较为有效的参数.     

尼麦角林在脑血管病中的应用

尼麦角林是一种麦角生物碱衍生物，广泛应用于脑血管病患者认知障碍的治疗。多项临
床前研究显示，尼麦角林对于认知障碍的改善可能与以下因素有关：尼麦角林除能够改善脑循环，
促进神经递质释放外，还具有营养神经及抗氧化等作用。目前的研究认为，尼麦角林能够改善患者
卒中后抑郁相关的情绪障碍以及有效改善血管性痴呆，提高患者的日常生活能力。同时，尼麦角林具
有良好的安全性，目前暂无尼麦角林治疗导致纤维化或麦角中毒的研究报道。本文就尼麦角林在神
经系统的作用机制、临床疗效及安全性进行综述，以期为临床应用提供参考。     

外刊速览

中国研制出抗禽流感药物——路透社目前,中国已研制出一种与“达菲”相应的抗禽流感病毒药物,但并没有说明该药物何时会投入使用,以及它与“达菲”的可比性。鉴于缺乏禽流感疫苗,世界卫生组织已经建议各国政府储备“达菲”。该药虽然不能治愈禽流感,但可以抑制病毒发展,减缓病毒扩散。全球唯一能够生产“达菲”的瑞士罗氏公司上星期宣布,他们已经停止在中国市场     

Rotational chair (ROTO) instead of electronystagmography (ENG) as the primary vestibular test.

OBJECTIVES: To compare the sensitivity of rotational chair (ROTO) versus electronystagmography (ENG) in peripheral vestibular pathology. METHODS: Retrospective chart review. RESULTS: One thousand consecutive patients undergoing evaluation for dizziness and imbalance at a tertiary care referral balance center were reviewed. ROTO was the primary vestibular study used in all patients with ENG used as a confirmatory test at the discretion of the treating physician. A subgroup of 478 patients underwent both ROTO and ENG. Among the patients diagnosed with peripheral vestibulopathy, sensitivity for peripheral vestibulopathy was 71% for ROTO and 31% for ENG. However, specificity was 54% for ROTO and 86% for ENG. CONCLUSIONS: We conclude that in this retrospective cohort with the authors' clinical diagnoses, ROTO is a more sensitive diagnostic study of peripheral vestibular pathology. The higher sensitivity of ROTO and the higher specificity of ENG may support the use of ROTO as the primary vestibular study and ENG as a supplemental vestibular study. Prospective analysis with distinct diagnostic criteria and defined inclusion criteria are necessary before these results can be widely extrapolated.     

Correlates of lifetime suicide attempts among individuals with affective disorders in a Chinese rural community.

The aim of this study was to compare the demographic and clinical characteristics of individuals with affective disorders who had attempted suicide at some time in their lives and those who had not made a suicide attempt. In a Chinese rural community, individuals with suicide attempt (N = 30) and those without suicide attempt (N = 166) were assessed with Present State Examination (PSE). Attempters had a significantly higher level of family economic status, higher rate of lifetime depressed mood and hopelessness, and delusions than nonattempters. The logistic regression models also indicated that depressed mood and hopelessness were the most important predictors of suicide attempts. No significant difference in treatment condition was found between attempters and non-attempters. Early identification and interventions focusing on reducing depressed mood, hopelessness, and controlling psychotic symptoms may be helpful in reducing the risk of suicide attempts among individuals with affective disorders residing in the community.     

Interobserver Agreement for the Diagnosis of Venous Thromboembolism on Computed Tomography Chest Angiography and Indirect Venography of the Lower Extremities in Emergency Department Patients

Objectives: To determine interobserver agreement between radiologists for computed tomography (CT) angiography and venography. CT venography of the lower extremities combined with standard CT angiography of the chest may result in an increased overall diagnosis rate of venous thromboembolism (pulmonary embolism or deep venous thrombosis).
Methods: The study had a retrospective cohort design. The population consisted of emergency department patients who were evaluated for suspected pulmonary embolism. A random sample of 50 patients diagnosed and treated for venous thromboembolism and 50 age- and gender-matched patients whose CT angiograms and venograms were read as negative were enrolled. The original reading (R1) was compared with readings of two study radiologists: R2, a general radiologist, and R3, a radiologist with fellowship training in cross-sectional imaging. All readers were blinded to each other.
Results: Both R2 and R3 found both CT angiogram and venogram components technically adequate in 95% (95% CI = 89% to 98%) and 86% (95% CI = 78% to 92%) of studies, respectively. The agreement was very good for CT angiography (lowest agreement = 92%; lowest κ = 0.83) and was good for CT venography (85%, κ = 0.65). In nine cases, R1 read the CT angiogram as negative but the venogram as positive for DVT, whereas both R2 and R3 read both components as negative in four of these nine, suggesting a false-positive isolated DVT rate of 44% (95% CI = 19% to 73%). In no case did R1 read both scan components as negative when R2 and R3 agreed on presence of pulmonary embolism or DVT.
Conclusions: Diagnosis of pulmonary embolism on CT angiography is more reliable than diagnosis of isolated DVT on CT venography.     

Fat and water separation in balanced steady-state free precession using the Dixon method.

In this work the feasibility of separating fat and water signals using the balanced steady-state free precession (SSFP) technique is demonstrated. The technique is based on the observation (Scheffler and Hennig, Magnetic Resonance in Medicine 2003;49:395-397) that at the nominal values of TE = TR/2 in SSFP imaging, phase coherence can be achieved at essentially only two orientations (0 degrees and 180 degrees ) relative to the RF pulses in the rotating frame, under the assumption of TR < T2, and independently of the SSFP angle. This property allows in-phase and out-of-phase SSFP images to be obtained by proper choices of the center frequency offset, and thus allows the Dixon subtraction method to be utilized for effective fat-water separation. The TR and frequency offset for optimal fat-water separation are derived from theories. Experimental results from healthy subjects, using a 3.0 Tesla system, show that nearly complete fat suppression can be accomplished.     

纸本与数字的交互：手机阅读的最佳效果

随着全球3G商用的推进和拥有大容量存储能力的智能终端的日益普及,手机正逐步演变成为一个新型的数字阅读终端。利用手机进行电子阅读的全新模式,正以前所未有的普及速度冲击着人们的阅读习惯。而这趋势也逐渐为"阅读"进行重新的定义。对于每一个读者而言,在这样一个信息化的时代里,手机阅读和纸本阅读的交互使用、取长补短,才是获得最佳阅读效果的最有效方式。     

奥沙利铂为主的静脉化疗联合腹腔温热灌注和体外高频透热治疗晚期大肠癌的临床观察

目的 探讨奥沙利铂为主的化疗联合腹腔温热灌注治疗晚期肠癌的临床效果.方法 对42例晚期大肠癌患者,予腹腔温热灌洗化疗及体外高频透热治疗,联合以奥沙利铂为主的静脉化疗,至少2个周期,观察疗效及不良反应.结果 全组患者完成169个周期治疗,CR 5例,PR 22例,SD 8例,PD 7例,总有效率66.3%.完全缓解率11.9%.不良反应以白细胞下降及消化道反应多见,少数患者出现周围性神经毒性,以I-Ⅱ 度为主.结论 以奥沙利铂为主的静脉化疗联合腹腔温热灌注和体外高频透热治疗,对晚期大肠癌具有一定的疗效,毒副作用小;腹腔局部化疗是一种值得关注的治疗途径.