不同对比剂剂量及年龄对肝脏双期增强扫描的技术探讨

目的 :分析多层螺旋CT扫描中使用高压注射器在不同增强剂量以及不同年龄组对肝脏动脉期和静脉期显影效果的影响。方法 :全部病例 (3 60例 )均使用MarconiMx 80 0 0多层螺旋CT和Medrad高压注射器。对比剂剂量按1.0ml/kg和 1.5ml/kg分为 2组行增强扫描 ,1.0ml/kg组 12 2例 ,1.5ml/kg组 2 3 8例 ;每组按照年龄分为 3组 ,18～ 3 9岁共 5 8例、40～ 5 9岁共 160例、60岁以上共 14 2例。结果 :分别测量各组肝脏双期增强CT图像上动脉期腹腔干和门脉期左右门静脉汇合处的CT值。对比分析发现两组对比剂量肝脏双期增强扫描效果均无明显差异 ,但青年组 (18～ 3 9岁 )与老年组 (>60岁 )比较发现门脉期有差异性。结论 :本文所选择对比剂剂量 1.0ml/kg是可行的 ,但是青年组行肝脏双期扫描时间需要提前。     

深圳地区QCT骨密度正常值调查与临床诊断标准的探讨

目的　通过对深圳地区正常人群腰椎骨密度测量 ,获得本地区QCT骨密度正常参考值。方法　采用CT扫描机 ,羟磷灰石固体体模和QCT骨密度测量软件 ,选择了无骨质疏松疾病的正常人 1 0 2 8例 ,扫描第 3、第 4腰椎中层横断面 ,做QCT骨密度测量。对测量结果进行统计处理 ,得到男女人群骨峰值和年龄组均值。通过对年龄组数据进行不同标准的统计处理 ,探讨较为合理的诊断标准。通过不同的测量方法 (单纯松质和包括皮质 )的对比 ,探讨QCT与其他方法的差异。结果　根据 2 1～ 35岁年龄段统计出的骨峰值男性第 3腰椎为 1 65 85± 30 1 7,第 4腰椎为 1 70 95± 31 81。女性第 3腰椎为 1 75 33± 2 6 95 ,第 4腰椎为 1 81 97± 2 7 63。采用 4种不同的骨峰值降低标准统计骨质疏松症检出率 ,发现M 2 5 %组检出率偏高 ,M 30 %与M 2S较接近。包括皮质骨的测量降低敏感性。结论　进行深圳地区骨密度正常值调查 ,获得了男女人群骨峰值和年龄组均值 ,临床诊断建议采用骨峰值 30 %作为QCT测量诊断骨质疏松症的基本界限     

The epidemiology of hyperuricaemia and gout in Taiwan aborigines

To determine the prevalence of hyperuricaemia, gout and gout-related factors in Central Taiwan Atayal aborigines, 342 subjects over 18 yr old were interviewed and examined. A questionnaire was designed to screen for signs and symptoms of gout and gout-related risk factors. Serum uric acid, triglyceride and creatinine were measured in all subjects. The prevalence of hyperuricaemia was 41.4% and that of gout 11.7% in aborigines. The uric acid level was 7.9+/-1.7 mg/dl in males and 5.7+/-1.5 in females, and differed significantly under age 70 yr (P < 0.001). Significantly increased triglyceride, creatinine and alcoholism was found in gouty patients compared with non-gouty patients. In 40 cases with gout, 54% had tophi and 35% of their first- degree relatives had gout. The high prevalence of hyperuricaemia and gout in Taiwan Atayal aborigines, a significant family predisposition, increased creatinine level and alcoholism suggest multiple factors affecting the hyperuricaemia.      

Bronchoscopic management of airway obstruction in pediatric endobronchial tuberculosis

The present report describes a case of severe airway obstruction caused by endobronchial tuberculosis in an 11-year-old girl who was successfully treated by bronchoscopic balloon dilation. This case illustrates the insidious presentation and the increasingly important role of bronchoscopic intervention in the management of endobronchial tuberculosis. In addition, a brief literature review of the condition in the pediatric age group is included.     

冠心病患者的无症状性心肌缺血

本文报道冠心病患者108例在日常活动情况下,采用Holter 24小时监测,发现60例(55.6%)有心肌缺血发作,总计发作244次,其中无症状性心肌缺血198次(81%)。心肌缺血发作时与发作前的心率比较无明显差异。无症状性心肌缺血发作时ST段下降程度与伴随有胸痛发作时比较,亦无明显差异。在上午6时至12时,无症状性心肌缺血发作频率最高,占55.1%。内服缓释硝酸异山梨酯(消心痛)可以减少心肌缺血发作。     

Effects of the Thai Health Improvement Profile intervention on the physical health and health behaviours of people with schizophrenia: A quasi‐experimental study

Physical health problems and unhealthy lifestyle behaviours are common in people with severe mental illness (SMI), leading to high levels of mortality.There is some evidence that nurse‐led interventions involving comprehensive health checks may be effective in improving physical health in people with SMI. This quasi‐experimental before‐and‐after study investigated the impacts of the Thai Health Improvement Profile (HIP‐T) on the physical health and health behaviours of people with schizophrenia over 1‐year. All 105 service‐users who volunteered to participate completed the study. There were significant reductions in mean BMI (?0.78 kg/m², P < .001) and bodyweight (?1.13 kg, P < .001) at post‐test. There was also a significant decrease in the total number of “red‐flagged” HIP‐T items, suggesting lowered potential health risks (P < .001). Overall, 23 patients (22%) were found to have moved to a healthier BMI classification after 1‐year. The findings suggest that the HIP‐T intervention has potential for improving the physical health of people with SMI when integrated into routine community mental health care.