下体负压联合体育锻炼对运动耐力及体能的影响

目的：研究制定适合疗养期间高性能战斗机飞行员进行专项下体负压和体能训练方案。方法：24名健康男性随机分为3组。体育锻炼组连续2周进行力量锻炼;下体负压锻炼组利用倾斜床进行下体负压锻炼。联合锻炼组每天以上述两种不同的锻炼方式进行复合锻炼。锻炼前后进行运动耐力及体能测试。结果：体育锻炼联合下体负压锻炼组锻炼10d后PWC170／kg、最大耗氧量显著提高,肌肉爆发力及静肌力指标较锻炼前显著提高（P〈0．05）;单纯体育锻炼组平板卧推、负重蹲起、30m冲刺跑、15m蛙跳成绩较锻炼前显著提高（P〈0．05）,单纯下体负压组仅平板卧推及15m蛙跳成绩较锻炼前显著提高（P〈0．05）。结论：体育锻炼联合下体负压锻炼10d后可明显提高受试者运动耐力及下肢、腰腹肌肉爆发力及静肌力。     

Dosimetric comparison of vaginal vault brachytherapy vs applicator-guided stereotactic body radiotherapy with volumetric modulated arc therapy and helical tomotherapy for endometrium cancer patients

We performed this dosimetric study to compare a nonstandard volumetric modulated arc therapy (VMAT) and helical tomotherapy (HT) techniques with high-dose rate (HDR) brachytherapy (BRT) plan of vaginal vault in patients with postoperative endometrial cancer (EC). Twelve postoperative patients with early stage EC were included in this study. Three plans were performed for each patient; dosimetric and radiobiological comparisons were made using dose-volume histograms and equivalent dose for determining the planning target volume (PTV) coverages in brachytherapy and external beam radiotherapy, and organs-at-risk (OARs) doses between three different delivery techniques. All the plans achieved adequate dose coverage for PTV; however, the VMAT plan yielded better dose conformity, and the HT plan showed better homogeneity for target volume. With respect to the OARs, the bladder D_2cc was significantly lower in the BRT plan than in the VMAT and HT plans, with the highest bladder D_2cc value being observed in the HT plan. However, no difference was observed in the rectum D_2cc of the three plans. Other major advantages of the BRT plan over the VMAT and HT plans were the relatively lower body integral doses and femoral head doses as well as the fact that the integral doses were significantly lower in the BRT plan than in the VMAT and HT plans. This is the first dosimetric comparison of vaginal vault treatment for EC with BRT, VMAT, and HT plans. Our analyses showed the feasibility of stereotactic body radiotherapy technique as an alternative to HDR-BRT for postoperative management of EC patients.     

多学科协作模式在血流动力学不稳定闭合性骨盆骨折 早期救治的临床研究

目的探讨多学科协作(multidisciplinary team,MDT)模式在血流动力学不稳定闭合性骨盆骨折早期救治中的临床疗效。方法回顾性分析MDT模式实施后救治的23例血流动力学不稳定骨盆骨折患者临床资料(MDT组),以及MDT诊疗模式实施前传统分诊会诊制一体化模式救治的20例患者(一体化组),其中MDT组男性15例,女性8例;年龄19～70岁,平均38. 82岁;骨盆骨折侧方挤压型(LC型) 4例、前后挤压型(APC型) 11例、纵向剪切型(VS型) 5例、复合应力型(CM型) 3例。一体化组男性13例,女性7例;年龄18～62岁,平均41. 45岁; LC型3例、APC型9例、VS型4例、CM型4例。记录两组患者围手术期心率、收缩压、术后24h尿量、总输血量、ICU平均住院时间以及病死率。结果与一体化组相比,MDT组术后6h心率明显降低(P <0. 05),术后6h收缩压升高(P <0. 01),术后24h尿量明显增多(P <0. 01);一体化组总输血量高于MDT组(P <0. 05);一体化组ICU平均住院时间高于MDT组,但差异无明显统计学意义(P=0. 272);患者病死率一体化组为15. 0%,MDT组为8. 7%,差异无明显统计学意义(χ2=0. 551,P=0. 392)。结论 MDT模式在血流动力学不稳定骨盆骨折早期救治中能稳定血流动力学,有效提高患者救治成功率。     

超声心动图评价缬沙坦对高血压病左室重构的逆转作用

目的应用超声心动图技术评价缬沙坦对原发性高血压病左室重构的影响。方法原发性高血压痛患者178例应用缬沙坦80mg／d口服治疗,疗程12个月。观察治疗过程中患者血压及症状体征的变化情况,并分别在治疗前及治疗后每3个月分阶段应用超声心动图观察心脏形态学变化情况。结果缬沙坦在治疗二周后血压开始下降,五周后趋于平稳;心腔径、室壁厚度及左室质量指数等在治疗3月后开始降低（P〈0．05）,6个月～1年后明显下降（P〈0．01）并趋于稳定。结论缬沙坦能够有效逆转原发性高血压病所导致的左室重构,超声心动图能够全面、客观地定量评价心脏结构、室壁运动状态。     

The importance of population-specific normal database for quantification of myocardial ischemia: comparison between Japanese 360 and 180-degree databases and a US database

Objectives  We aimed to develop a Japanese normal database for specific acquisition conditions, to compare US and Japanese normal populations, and to examine effects of camera rotation angle range on the normal limits. Methods and Results  Stress-rest ^99mTc myocardial perfusion databases for 360° (Jp360) and 180° (Jp180) acquisitions were created by the working group activity of the Japanese Society of Nuclear Medicine using Japanese patients. A standard 180° database (US180) had been previously generated by the Cedars Sinai Medical Center based on American patients. Additionally, 90 Japanese patients underwent coronary arteriography and stress-rest ^99mTc perfusion study with 360° acquisition for validation purposes, and quantitative evaluation was performed by QPS software using the above three normal database sets. Major differences between US180 and Jp360 databases were found in the apex and in the anterior wall in females and in the inferior wall in males. When the diagnostic performance was evaluated by receiver-operating characteristic analysis, area under the curve was the highest for Jp360 (0.842), followed by Jp180 (0.758) and US180 (0.728) databases (P = .019, Jp360 vs US180; P = .035, Jp360 vs Jp180). The coronary territory score at stress was highest with the Jp360 database in male patients with right coronary artery stenosis (n = 26, Jp360: 4.92 ± 4.61 [mean ± SD], Jp180: 4.23 ± 4.29, US180: 2.92 ± 3.53; P < .0001 between Jp360 and US180) and in female patients with left anterior descending artery stenosis (n = 12, Jp360: 6.33 ± 4.76, Jp180: 5.25 ± 4.83, US180: 4.50 ± 4.15; P = .0076 between Jp360 and US180). Conclusion  Because of the differences between US and Japanese normal databases, it is essential to use population- and acquisition-specific databases when using quantitative perfusion SPECT software.     

Double Fellowships in Radiology: A Survey of 2014 Graduating Fellows

Purpose

Radiology fellowship training has evolved from being an uncommon option to being a near requisite for post-training employment in the United States. A subset of fellows elect to pursue second fellowships with potentially substantial implications on both the private sector and academic radiology workforce. The purpose of this study was to assess the proportion of current radiology fellows pursuing multiple years of post-residency fellowship training.

运动方式对人体骨峰值的影响

为了探讨运动方式对人体骨健康的作用效果和机理,随机选取华南师范大学体育系和化学系171名在校男生作为研究对象,应用单光子吸收法（SPA）和标准体质测量法对其骨密度（BMD）和体质指标进行了检测。采用SPSS8.0软件包对数据进行分析处理。结果显示(1）短跑组、足球组、篮球组、武术组、中长跑组和体育人口组具有比对照组较高的骨密度值（BMD）,尤其是短跑组、武术组与对照组有高度显著性差异（P＜0.01）;(2）运动强度、运动史与骨密度值（BMD）呈正相关,而运动频率大于3次/周具有较佳的健骨效果;(3）肌力指标、肌力/身高指标与骨密度值（BMD）有显著正相关(r=0.661,r=0.623),而其它体质指标则不具有显著相关性。提示提高青年时期骨峰值、预防骨质疏松症的运动处方应为持之以恒地进行频率大于3次/周、每次运动时间不少于半小时的适宜于自身条件的高强度运动。     

应用苯妥英钠后急性低压缺氧条件下大鼠脑单胺递质的变化

目的探讨苯妥英钠（Ｄｉｐｈｅｎｙｌｈｙｄａｎｔｏｉｎ，ＤＰＨ）在急性缺氧条件下的脑保护作用。方法给大鼠应用ＤＰＨ，用荧光分光法检测其在低压舱模拟升空７．５ｋｍ后１ｈ、２ｈ的脑匀浆单胺递质含量，同时观察脑细胞形态学改变。结果ＤＰＨ实验组在缺氧１ｈ及２ｈ时脑多巴胺和５－羟色胺含量升高（Ｐ＜０．０５），而脑去甲肾上腺素在缺氧１ｈ时降低（Ｐ＜０．０５），缺氧２ｈ恢复正常。电镜形态学观察，低压缺氧条件下对照组大鼠脑细胞水肿，线粒体嵴严重缺失，细胞核明显变形；应用ＤＰＨ的实验组细胞形态基本正常。结论给大鼠应用苯妥英钠后，在急性缺氧条件下，动物脑单胺递质含量的变化可能与缺氧适应或耐受的形成有关。