Ultrasound measurements of intraabdominal fat estimate the metabolic syndrome better than do measurements of waist circumference

BACKGROUND: We recently developed an ultrasound technique to estimate intraabdominal fat (IAF). This method is more accurate than measurement of waist and hip circumferences and is simpler and less expensive than computed tomography or magnetic resonance imaging. OBJECTIVE: We compared the associations of ultrasound and waist-circumference (WC) measurements of IAF with other components of the metabolic syndrome. DESIGN: IAF was determined in 600 consecutive participants in the Secondary Manifestations of Arterial Disease (SMART) study. The mean (+/- SD) age was 56.1 +/- 12.6 y, 30.0% of participants were women, and the mean body mass index (BMI; in kg/m2) was 26.6+/- 4.1. RESULTS: IAF increased with age (ultrasound: r = 0.28; WC: r = 0.25; P < 0.001 for both). Higher IAF, as measured by ultrasound but not by WC, was independently associated with higher metabolic risk factors. The correlation coefficients between IAF measured by ultrasound and plasma glucose, total cholesterol, HDL cholesterol, and triacylglycerol were 0.13, 0.16, -0.13, and 0.25, respectively (all P < 0.001; adjusted for age, sex, and BMI). The corresponding coefficients for IAF measured by WC were 0.17 (P < 0.001) and 0.01, -0.06, and 0.05 (all NS). CONCLUSIONS: These results confirm the findings of computed tomography and magnetic resonance imaging investigations. When IAF is measured by ultrasound, the associations are more pronounced than when WC measurements are used and are independent of BMI. This suggests that IAF can be more reliably assessed by ultrasound measurements than by WC measurements.     

Reduction of patient motion artifacts in digital subtraction angiography: evaluation of a fast and fully automatic technique

The performance of an automatic technique for the reduction of patient motion artifacts in digital subtraction angiography was evaluated. Four observers assessed the quality of 104 cerebral digital subtraction angiographic images that were processed by means of both the automatic technique and manual pixel shifting. The automatic technique resulted in better image quality and was considerably less time-consuming.     

脐部给药的多塞平栓研制及应用

目的：研制透皮制剂多塞平栓,考察其治疗各型急、慢性荨麻疹的临床疗效。方法：多塞平以甘油明胶为质,氮酮为促透剂,制成栓剂,经脐部给药,观察５０个病例,与口服多塞平片作对照,观察临床疗效。结果：多塞平栓治疗各型急、慢性荨麻疹,总有效率为９４．０％,经统计学分析,Ｐ〈０．０５,差异具显著性。结论：本品制备工艺可行,疗效确切,用药剂量小,无副作用,具有进一步研究、开发的价值。     

MR-guided balloon angioplasty: In vitro demonstration of the potential of MRI for guiding,monitoring, and evaluating endovascular interventions

The purpose of this study was to demonstrate the potential of MRI for guiding, monitoring, and evaluating endovascular interventions. This was done by investigating the feasibility of MR-guided balloon angioplasty in a stenosed vessel model. Catheters and guidewires were prepared for susceptibility-based MR visualization by incorporating paramagnetic markers into their walls. Near real-time monitoring (up to 1 image/sec) of the interventional procedure was achieved by using a dynamic two-dimensional gradient-echo technique. Devices were localized by on-the-fly subtraction of a baseline image from consecutive dynamic images and by merging the subtraction images with a previously acquired road map. All steps involved in balloon angioplasty, from the introduction and placement of a guidewire to the positioning of a catheter across the stenosis, inflation of the balloon, and dilatation of the stenosis could adequately be monitored with MR fluoroscopy. The beneficial effect of dilatation could be substantiated by a reduction of stenosis-related hypointensities and hyperintensities in the posttreatment MR angiogram as compared to the pretreatment angiogram and by a posttreatment increase of the volumetric flow rate.     

Intraarterial pressure gradients after randomized angioplasty or stenting of iliac artery lesions

Purpose To determine initial technical results of percutaneous transluminal angioplasty (PTA) and stent procedures in the iliac artery, mean intraarterial pressure gradients were recorded before and after each procedure. Methods We randomly assigned 213 patients with typical intermittent claudication to primary stent placement (n=107) or primary PTA (n=106), with subsequent stenting in the case of a residual mean pressure gradient of >10 mmHg (n=45). Eligibility criteria included angiographic iliac artery stenosis (>50% diameter reduction) and/or a peak systolic velocity ratio >2.5 on duplex examination. Mean intraarterial pressures were simultaneously recorded above and below the lesion, at rest and also durign vasodilatation in the case of a resting gradient ≤10 mmHg. Results Pressure gradients in the primary stent group were 14.9±10.4 mmHg before and 2.9±3.5 mmHg after stenting. Pressure gradients in the primary PTA group were 17.3±11.3 mmHg pre-PTA, 4.2±5.4 mmHg post-PTA, and 2.5±2.8 mmHg after selective stenting. Compared with primary stent placement, PTA plus selective stent placement avoided application of a stent in 63% (86/137) of cases, resulting in a considerable cost saving. Conclusion Technical results of primary stenting and PTA plus selective stenting are similar in terms of residual pressure gradients.     

Methods of early detection： would clinical breastexamination and breast ultrasonography be a good alternative to mammography？

Breast cancer is one of the leading causes of cancer deaths among women[1].In the past 40 years,breast cancer incidence has doubled or even tripled in developed countries such as South Korea and Japan; whereas it is about 20% to 30% in China and India in the past decade[2-4]. An increasing incidence rate of 3%     

Comparison of structured observation and pictorial 24 h recall of household activities to measure the prevalence of handwashing with soap in the community

This study compared structured observation with a 24 h pictorial recall of household activities (‘sticker diary’) to measure the prevalence of handwashing with soap (HWWS) in the community. The study was done within a cluster-randomised trial evaluating a handwashing promotion programme in Bihar, India. HWWS at key occasions in mothers and school children was measured by structured observation in 299 households from 32 villages. Sticker diaries recalling common activities, including personal hygiene, were used to measure HWWS in 299 households from a further 20 villages. Sticker diary HWWS prevalence estimates were about 13% points higher than structured observation estimates, but the differences varied by the type of handwashing occasion. This study confirms structured observation as the method of choice for the study of handwashing behaviours. The sticker diary method may be useful in large-scale surveys. Sticker diaries may overestimate HWWS at important occasions, but probably less so than conventional questionnaire tools.     

小切口非超声乳化白内障摘除人工晶体植入术中辅助切口的应用

目的 探讨小切口非超声乳化白内障及人工晶体植入术中辅助切口的应用效果.方法 随机选自2006-2010年期间行小切口非超声乳化白内障及人工晶体植入术的年龄相关性白内障患者200例(200只眼).将患者随机分为加做辅助切口(观察组)和不加做辅助切口(对照组)两组,并对其术中、术后在后囊破裂、虹膜脱出、皮质残留、高眼压及术后1、90 d视力情况进行比较.结果 观察组与对照组在虹膜脱出、角膜水肿、皮质残留、术后早期视力方面差异有统计学意义.在后囊破裂、高眼压及长期视力方面差异无统计学意义.结论 小切口非超声乳化白内障及人工晶体植入术中采用辅助切口,可以有效降低对眼内组织的损伤,减少并发症,是一种安全有效地手术模式.     

A philosophy underlying excellence in teaching

This article discusses nursing education and changing paradigms of knowledge, emphasizing critical thinking, nursing praxis, and the place of the educator as a role model who provides knowledge, facilitates critical thinking, and teaches students how to cope with the knowledge. It interprets the connection between knowledge and power as a potential source of injustice and inequality in the student–teacher relationship; and tries to solve this problematic issue by annulling the differences in power. Examples from clinical areas are presented to illustrate differential power the educator‐teacher‐researcher has in different clinical areas.