中国汉族正常成人岛叶体积的高分辨率MRI测量

Objective To explore the normal range of the insula volume of Chinese adults of the Han nationality and its relationship with age, which provide morphological data for the construction of database for Chinese Standard Brain.Methods This is a clinical multi-center study.One thousand Chinese healthy volunteers (age range = 18 to 70) recruited from 16 hospitals were divided into 5 groups, i.e.,Group A ( age range = 18 to 30), B ( age range = 31 to 40 ), C ( age range = 41 to 50 ), D ( age range =51 to 60), and E (age range =61 to 70).Each group contained 100 males and 100 females.All of the volunteers were scanned by MR using T1 weighted three-dimensional magnetization prepared rapid acquisition gradient echo sequence.After three dimension data reconstruction, the volumes of bilateral insula were manually measured.The volume of bilateral insula were compared by paired sample t test.The insula volumes were compared between male and female by independent sample t test, and the differences among 5 age groups were compared by one-way ANNOVA.The relationship between the volumes of insula and age,sex or cerebral volume were analyzed using bivariate correlation, respectively.Results The left snd right side volume of insula before standarized were (7764±1165) and (7387±1128) mm3 respectively, after standarized were (8413±1201 ) and (7871±1140) mm3 respectively.The left insula volume were significant larger than that of right(t = - 10.565, - 16.014,P <0.01 ).The left and fight volume of insula were (8146±1181 ) and (7735±1113) mm3 for male, and (7393±1022) mm3 and (7050±1038) mm3for female.The left and right insula volumes for male were larger than the female's(t = 10.934,9.945 ,P <0.01 ).The left and right insula volume of male after standarized were (8779±1230 ) and (8224±1081 )mm3, female were (8043±1054) and (7515±1091 ) mm3 ,the left and right insula volume of male were larger than the female's ( t = 4.858,4.632, P < 0.01 ).The left insula volumes among Group A, B, C, D,E before standarized were ( 8268±1221 ), ( 8067±1107 ), ( 7869±1109), ( 7603±1111 ), ( 6997±934 )mm3 respectively,the right were (8028±1156), (7636±1075), (7294±986), (7249±1068), (6717±916) mm3 respectively, there were significant differences among 5 groups between left and right insula volume(F= -0.361,-0.337,P <0.01 ).The left insula volume of A,B,C,D,E after standarized were ( 9093±1105 ), ( 8679±965 ), ( 8810±1136), ( 8202±980), ( 7273±940 )mm3, the right were ( 8694±1005), (8136±1100), (8034±910), (7496±990), (6989±932) mm3, there were significant differences among 5 groups between left and right insula volume(F = -0.490, -0.512,P < 0.01 ).There was significant negative correlation between the volume and age ( before standarizded:r = -0.361, -0.337, after standardized r = -0.490, -0.512, P<0.05).Before and after standardized, there was significant correlation between the volume of right and left insula and cerebral volume ( r = 0.470,0.459, P < 0.05 ).Before and after standardized, there was significant correlation between the volume of right and left insula and weight( r = 0.141, 0.092, P < 0.05 ).Conclusions 1.5 T MR scanner has high resolution, for distinguishing the white matter from the gray matter, and provide morphological data of insula for the construction of database for Chinese Standard Brain.     

多层螺旋CT多期扫描对肝门部胆管癌的诊断与术前评估

目的 探讨肝门部胆管癌的螺旋CT表现,评价多层螺旋CT多期扫描的诊断价值及对手术可切除性的指导意义。方法 对26例经手术和病理证实的肝门部胆管癌的多层螺旋CT平扫及多期增强扫描资料,观察肿块的部位、大小、强化的特征和累及的范围,并与手术结果对照。结果 26例肝门部胆管癌均可见肝门肿块、肝内胆管扩张、肝门部胆管中断,动态增强扫描有12例表现为动脉期强化,15例门脉期强化,26例延时期强化。CI分型与手术分型对比,诊断准确度为76．9％（Kappa〉0．4）;可切除性评估的敏感度66．7％,特异度78、2％,诊断准确度76．9％。结论 多层螺旋CT多期增强扫描可清晰显示病灶的部位、强化特征和范围,对肝门部胆管癌的诊断和鉴别诊断有重要价值．有助于术前治疗方案的选择和可切除性的评估．     

宁夏新冠肺炎流行病学特征分析

目的分析宁夏新型冠状病毒肺炎疫情流行特征,为疫情防控和策略制定提供依据。方法收集现场调查处置资料,采用描述流行病学的方法,分析2020年1月22日-3月31日宁夏新冠肺炎确诊病例的三间分布特征。结果宁夏新冠肺炎报告发病率为1.10/10万,无死亡病例。有2个发病高峰,单日最高报告病例数8例。疫情覆盖宁夏65.21%的县(市、区),主要集中在银川市和吴忠市;发病年龄以20～39岁最多,占46.05%,年龄中位数38岁,男女性别比为1.21∶1。职业分布以农民、商业服务、家务及待业为主,占73.68%。临床分型以普通型为主,占58.67%。潜伏期中位数为6.5 d。疫情早期感染来源以输入为主。聚集性疫情涉及病例占确诊病例总数的68.00%,其中存在家庭聚集的病例占86.27%,通过共同生活或聚餐而具有同屋和同餐传播的病例占86.27%。结论宁夏疫情以输入引起的本土感染和家庭聚集性病例为主,本地疫情已经基本阻断。需继续坚持外防输入、内防反弹的防控策略,持续关注境外陆路口岸入境输入风险,强化无症状感染者的排查管理工作。     

健康管理本科人才培养的思考

随着人口老龄化进程的加快,平均期望寿命的延长,慢性非传染病的增加,国民维护和改善健康需求的日益增长,现有的医疗卫生服务模式不能满足国民的健康需求,新兴的健康管理服务将有非常广阔的前景。但目前相关的专业人才培养、健康管理师职业资格认证工作却远远落后于市场的步伐。健康管理学科及人才培养在美国迅速发展,在中国方兴未艾,武汉大学是中国第一家申报健康管理本科专业的双一流高校,在培养目标和专业知识结构、课程设置、教学方法等方面进行了初步探索。     

宁夏甲型H1N1流感流行病学特征分析

目的分析宁夏甲型H1N1流感流行病学特征,掌握其流行规律,为科学防控提供基本数据和依据。方法对全区各级各类医疗卫生机构上报的甲型H1N1流感确诊病例的流行病学相关资料进行分析。结果截至2010年4月16日,全区累计报告甲型H1N1流感确诊病例1246例（发病率20.58/10万）,银川市甲型H1N1流感发病居全区五市之首。男女性别比为1.67：1;30岁以下病例占报告病例的87.08%,职业以学生为主,占65.33%;疫情从2009年第39周和第45周出现了两次发病高峰,此后全区疫情成持续下降趋势。累计报告甲型H1N1流感死亡病例9例,年龄中位数为30岁。全区共报告甲型H1N1流感暴发疫情20起,均发生在学校,小学的罹患率最高。结论宁夏出现疫情较迟,发展迅速,疫情形势和全国疫情趋势基本一致,报告病例主要集中在城区,以学生为主。在应对上应加强流感常规哨点监测,及时掌握病毒的流行病学和病毒学特征变化,做好学生等重点人群、学校等重点场所的防控工作。     

2004-2009年宁夏流行性腮腺炎的流行特征

目的分析近年来流行性腮腺炎流行特征,为防控流行性腮腺炎疫情的策略和措施提供科学依据。方法对国家疾病监测信息报告管理系统和突发公共卫生事件报告管理信息系统报告的流行性腮腺炎病例数据进行描述分析。结果 2004-2009年宁夏流行性腮腺炎报告发病率波动在35.45/10万-89.91/10万,2009年为最高年份,2006年石嘴山市报告发病率高达149.35/10万。该病多发于冬春季节,15岁以下儿童发病占报告病例总数的89.66%,2009年该年龄组报告发病率高达352.43/10万。流行性腮腺炎突发公共卫生事件均发生在学校,累计报告病例占报告病例总数的10.86%。结论宁夏流行性腮腺炎报告发病呈现上升趋势,局部地区发生暴发疫情;3-14岁的托幼儿童和中小学生是主要发病群体,仍然为2-5年一个流行高峰的自然流行规律。     

23例小儿泌尿系先天畸形的多层螺旋CT扫描

目的探讨多层螺旋CT（MSCT）在小儿泌尿系先天畸形检查中合理的扫描方案及扫描技术。方法回顾性分析23例小儿泌尿系先天畸形患者的MSCT扫描资料。结果 23例中单侧肾脏不发育（孤立肾）3例;单侧肾脏发育不全3例;重复肾输尿管畸形8例;肾脏融合畸形5例,其中有马蹄肾3例,肾脏交叉异位并融合畸形2例;肾脏旋转异常2例;肾脏异位2例,均为一侧盆腔异位肾。结论合理的MSCT扫描方案及扫描技术有助于小儿泌尿系先天畸形的诊断及了解并发症的情况,MSCT可做为明确小儿泌尿系先天畸形诊断重要的影像检查方法。     

预吸氧对丙泊酚麻醉在老年患者无痛胃镜检查中的安全性

目的探讨预吸氧对丙泊酚麻醉在老年患者无痛胃镜检查中的安全性与有效性。方法将我院收治的120例无痛胃镜检查的老年患者随机分为实验组和对照组,对照组的患者给予常规不吸氧,实验组的患者给予预吸氧。结果两组患者胃镜操作时间与苏醒时间无显著差异（P〉0．05）;呼吸抑制的发生率低于对照组（P〈0．05）．胃镜检查的过程中Sp02高于对照组及HR低于对照组（P〈0．05）,具有统计学意义。结论对采用丙泊酚麻醉行无痛胃镜检查老年患者给予预吸氧,可有效的对抗检查过程中出现的不同程度呼吸抑制所造成的缺氧,提高无痛胃镜检查的安全性。     

慢性阻塞性肺疾病患者生活质量评估问卷与6分钟步行试验的临床应用

目的探讨老年慢性阻塞性肺疾病（COPD）患者生活质量评估问卷（CAT）、6分钟步行距离（6MWD）与肺功能的相关性及临床应用评估。方法选择62例住院COPD患者,根据肺功能结果分为四组,分别测定肺功能、CAT、6MWD并进行相关性研究。结果 COPDⅠ级、Ⅱ级、Ⅲ级、Ⅳ级四组之间的CAT、步行距离有显著性差异,CAT与6MWD、FEV1%呈负相关,6MWD与FEV1%呈正相关。结论老年人CAT、6MWD与肺功能严重程度相关性良好,作为日常肺功能的评价方法,简便、易行、安全、可靠、可操作性高。