咳喘患儿气管支气管异物的检出

气管支气管异物是引起小儿咳喘的重要原因之一。本文就X线诊断中的几点体会作了详细介绍,认为X线检查对气管支气管异物的诊断和治疗有极为重要的价值。     

Foreign body aspiration in children. The diagnostic value of signs,symptoms and pre-operative examination

One hundred and fifteen patients, between 6 months and 12 years of age, had bronchoscopy on suspicion of foreign body aspiration. The histories of these patients were studied to examine the diagnostic value of signs, symptoms and examinations, and to determine the time that passed between aspiration and removal of the foreign body. The sensitivity of the symptoms choking and coughing was fairly high (81 and 78%), but the specificity was poor. The sensitivity of a chest radiograph was 82%, the specificity 44%. The sensitivity of radiographs on inspiration and expiration was 80%, the specificity 55%. The patients had been referred with the initial diagnosis foreign body aspiration (80), pneumonia (34), or subglottic laryngitis (1). In 85 patients a foreign body was identified and extracted. The other 30 patients had respiratory tract infections. The initial diagnosis of foreign body aspiration was correct in 61 out of 85 patients. In these cases, the period between aspiration and extraction of the foreign body was a mean 6 days, compared with 55 days, if the initial diagnosis was pneumonia or sub-glottic laryngitis. We conclude that the diagnosis of foreign body aspiration is too often missed, and that, apart from bronchoscopy, diagnostic tools are of little value.     

Body Image Changes in Adolescents II Comparison among Patients with Eating Disorders and Controls with Thin, Normal and Obese Body Shapes

Abstract: The Self-Rating Body Image (SRBI) test was used to determine whether the patients with eating disorders such as anorexia nervosa or bulimia showed their body image disturbance or not. The SRBI was completed by 120 subjects who consisted of 30 low weight (LW) controls, 30 normal weight (NW) controls, 30 high weight (HW) controls, 18 anorexic patients (AN) and 12 bulimic patients (BN). The AN group had a significantly greater dissatisfaction with the scales of the body shape, visceral organ and face image of the SRBI than the weight-matched LW group. The BN group had a significantly greater dissatisfaction with the visceral organ image than the weight-matched NW group. However, no significant difference in the body shape and face images between the BN and NW groups was found. Our results suggest that the anorexic patients may disturb more parts of the body image than the bulimic patients though both the anorexic and bulimic patients showed the disturbance of body image.     

褪黑素在鸡脊柱侧凸模型中的影响

目的　通过鸡松果体蒂部切断的方法 ,研究褪黑素在松果体切除鸡脊柱侧凸动物模型中的作用。方法　 10只刚孵育出的WhiteLeghorn鸡作为对照组 ,未行任何处理 ,控制白天 12h光照 (强度 5 0 0Lux)、夜间 12h完全黑暗 (强度 0 - 5lux)条件下饲养 ;2 0只WhiteLeghorn鸡在鸡龄 3d时行松果体切除 ,控制光照条件同对照组 ;2 0只WhiteLeghorn鸡 3d时行松果体蒂部切断术 ,控制光照同对照组。 5周时留取所有鸡白天 (mid -day)和夜间 (mid -night)的血清 ,用RIA试剂盒测定血清中褪黑素含量。所有的鸡处死后 ,取骨骼标本 ,行脊柱前后位平片检查。结果　 5周时 ,对照组褪黑素含量呈现明显白天低 (5 7.2 5± 7.4 3)pg/ml,夜间高 (2 5 7.92± 2 6 .0 9)pg/ml的周期性变化。松果体切除组褪黑素含量 ,白天为 (6 0 .0 5± 5 .4 8)pg/ml,夜间为 (5 5 .0 9± 8.35 )pg/ml,其分泌维持低水平。松果体蒂部切断组褪黑素含量 ,白天为 (5 8.77± 8.4 4 )pg/ml,夜间为 (2 4 8.4 7± 2 7.2 1)pg/ml,仍呈白天低 ,夜间高的周期性变化。X线检查 :对照组 10只鸡无脊柱侧凸发生 ;松果体切除组 2 0只鸡中 9只鸡发生了脊柱侧凸 ,发生率为 4 5 % ;松果体蒂部切断组 2 0只鸡中有 11只发生了侧弯 ,发生率为 5 5 %。结论　松果体切除和松果体蒂部     

Elevated body mass index and mortality risk in the elderly

The purpose of this report was to perform a systematic review and meta-analysis of the studies examining the impact of an elevated body mass index (BMI) on mortality risk in elderly (> or =65 years) men and women. A variance-based method of meta-analysis was used to summarize the relationships from available studies. The summary relative risk of all-cause mortality from the 26 analyses that included a risk estimate for a BMI within the overweight range was 1.00 (95% confidence intervals, 0.97-1.03). The summary relative risk of all-cause mortality for the 28 analyses that included a risk estimate for a BMI within the obese range was 1.10 (1.06-1.13). These calculations indicate that a BMI in the overweight range is not associated with a significantly increased risk of mortality in the elderly, while a BMI in the moderately obese range is only associated with a modest increase in mortality risk.     

Delayed sleep phase syndrome: A placebo-controlled cross-over study on the effects of melatonin administered five hours before the individual dim light melatonin onset

In a double-blind placebo-controlled cross-over study, 30 patients with Delayed Sleep Phase Syndrome (DSPS) were included, of whom 25 finished the study. Melatonin 5 mg was administered during two weeks in a double-blind setting and two weeks in an open setting successively or interrupted by two weeks of placebo. The study's impact was assessed by measurements of the 24-h curves of endogenous melatonin production and rectal temperature (n=14), polysomnography (n=22), actigraphy (n=13), sleep log (n=22), and subjective sleep quality (n=25). Mean dim light melatonin onset (DLMO) (±SD), before treatment, occurred at 23.17 hours (±138 min). Melatonin was administered five hours before the individual DLMO. After treatment, the onset of the nocturnal melatonin profile was significantly advanced by approximately 1.5 hour. Body temperature trough did not advance significantly. During melatonin use, actigraphy showed a significant advance of sleep onset and polysomnography, a significant decreased sleep latency. Sleep architecture was not influenced. During melatonin treatment patients felt significantly more refreshed in the morning. These results show that analysis of DLMO of patients suffering from DSPS is important both for diagnosis and therapy. These results are discussed in terms of the biochemistry of the pineal.     

Maintenance of body temperature in elderly patients who have joint replacement surgery A comparison between the heat and moisture exchanger and heated humidifier

The effect of a heat and moisture exchanger on intra-operative aural canal (core) and mean skin temperatures was investigated in elderly patients who had elective total hip arthroplasty under general anaesthesia with artificial ventilation of the lungs. Group 1 (n = 20) did not receive any form of artificial humidification while in group 2 (n = 20) a heat and moisture exchanger was inserted in the breathing system and in group 3 (n = 20) the inspired gases were humidified and warmed at 40 degrees C by means of a heated humidifier. Time of surgery, intravenous fluid administration and operating theatre temperature were standardised. Mean (SD) aural canal (core) temperature decreased significantly in groups 1 and 2 (p less than 0.001), while there was a fall of 0.3 degrees C (0.6) in group 3, which was not significant. Mean skin temperature decreased during anaesthesia and surgery in both groups 1 and 2 (p less than 0.05), while it increased in group 3. There was a significantly greater loss of body heat in groups 1 and 2 compared with group 3 intra-operatively (p less than 0.001). We conclude tha a heat and moisture exchanger did not prevent the decrease in intra-operative body temperature in elderly patients.     

Body piercing: issues in adolescent health.

Ask the Expert provides research‐based answers to practice questions submitted by JSPN readers.     

Tenotomy prevents the functional improvement of a muscle reinnervated with a chronically severed nerve

During the early stages of nerve implantation, we followed the dynamic properties of the lateral gastrocnemius muscle of the rat, reinnervated with an acutely or chronically severed peroneal nerve. The aim of this study was to ascertain whether (1) the better functional recovery of a muscle reinnervated by a chronically severed foreign nerve is present from the onset of reinnervation, and (2) whether such functional improvement is due to the conditioning lesion effect. Our results indicate that better functional recovery is already apparent one week after nerve implantation, and it is due to the conditioning lesion effect, since tenotomy prevents such improvement. The tenotomy effect underlines the fact that some environmental factors concerning the target tissue, and not only the predegenerated nerve, are involved in the conditioning effect. © 1995 Wiley-Liss, Inc.     

步行量和体成分的中日比较研究

目的 为了解中日儿童及成人的步行和体成分及其相互关系.方法 以中国上海市和日本琦玉县的小学生和成人为对象,采用西铁城 TW02-001电子式步数计测定步行量,FUTREX-5000A体成分测定仪测量体脂百分比.结果 1.中国男女小学生的平均每日步行量分别为12426步和10387步,低于日本小学生(男15 340步,女11 617步),体脂百分比中国男女生分别为21.2%和15.8%,高于日本(男18.9%,女13.1%).中国男女成人的平均每日步行量分别为9826步和8748步,高于日本成人(男:8411步,女7599步);体脂百分比分别为17.5%(男)和25.8%(女),而日本男性为19.8%,女性为26.0%.2.不同活动水平的小学生和成人,其血压和体成分均有差异,步行量高者的血压和体脂百分比都较低.本研究还计算出以肱三头肌皮脂厚度以(X)推测儿童体脂百分比(Y)的回归方程为:Y=10.6646+0.5856X.结论 作为日常生活的步行可促进肥胖发生率的降低.