隐原性机化性肺炎的CT征象分析

目的：提高对隐原性机化性肺炎（cOP）影像表现的认识。方法：回顾性分析23例经肺活检病理证实为COP患者的影像表现。结果：23例患者中CT表现为多发性斑片状含气实变影15例，主要分布在胸膜下区和双肺下叶。14例伴有磨玻璃影及小支气管扩张，还有条索状影。6例有病灶游走的表现。21例对肾上腺皮质激素治疗有显著疗效。结论：隐原性机化性肺炎的诊断需结合临床表现、影像、病理等检查结果综合分析，对CT表现的认识非常重要。     

对原发性骨质疏松诊断的一些看法

原发性骨质疏松的诊断首先要除外继发性骨质疏松。后者包括的范围很广，内容也很多，需要广博的内科学基础和辨证的逻辑思维才能予以正确鉴别。骨密度检查只能作为一种参考，而不能作为诊断原发性骨质疏松的唯一依据。     

显微外科技术治疗复杂膀胱尿道阴道瘘(附五例报告)

目的 总结显微外科技术修补复杂性膀胱尿道阴道瘘的经验。方法 膀胱尿道瘘患者4例，膀胱阴道多发瘘1例，均在手术放大镜下用细线行瘘修补，膀胱颈缺损多层缝合或利用阴道壁修补尿道缺损。结果 5例均一次修补成功，随访6～12个月，排尿均通畅。1例膀胱颈全尿道缺损者咳嗽时有轻微尿失禁，余4例无尿失禁、无漏尿，性生活满意。结论 多层缝合膀胱颈缺损可恢复膀胱颈括约肌功能，显微外科技术组织对合好、反应小，有利于尿瘘愈合。     

椎管内占位病变的CT评价

本文回顾性分析了２８例椎管内占位病变（包括椎管内肿瘤２４例、蛛网膜囊肿２例、硬膜外脓肿和椎同盘突出各１例）的ＣＴ表现。着重讨论了造影剂增强ＣＴ的特征。大多数增强ＣＴ可显示肿块的轮廓，有助于肿块定位。室管膜瘤和星形细胞瘤的增强ＣＴ表现类似，但雪旺氏瘤、海绵状血管瘤和脓肿具有增强ＣＴ特征；同时还对脂肪瘤、脊膜瘤和蛛网膜囊肿的增强ＣＴ特征进行了探讨。增强ＣＴ定位困难时，ＣＴＭ可有很大的帮助。     

北京市东城区和平里社区居民慢性病防治探讨

为探索慢性病的防治方法，我们于１９８９￣１９９４年社区居民中开展了以高血压为主的循环系统慢性病防治课题，经过５年的干预，观察组与对照组居民及接受管理的高血压病人在减少吸烟，饮酒，控制食盐摄入，掌握慢性病防治知识等方面有显著性差异，取得了满意的结果，从而为今后全面开展慢性病防治积累了经验。     

Fiberglass or silica exposure and increased nephritis or ESRD (end-stage renal disease)

The U.S. multiplant cohort mortality study of workers producing manufactured mineral fibers is finding increasing mortality from nephritis and/or nephrosis. We examine other data sets to see if similar effects can be identified. In a case-referent study among Michigan patients with end-stage renal disease (ESRD), men with exposures to silica have elevated odds ratio for ESRD. In a California occupational mortality study based on 1979–81 data, a number of the construction trades, farmers, and farm laborers show excess mortality for renal disease. The highest mortality ratio is found in the category including insulation workers. This ratio remains significantly elevated when adjusted for estimated exposures to smoking, alcohol, and for socio-economic status. California mortality data from 20 years earlier (1959–61) fail to show much excess renal disease in construction workers, but do for farmers. In Singapore, granite workers with a long-term exposure to silica have excess excretion of albumin and similar compounds compared to less exposed controls, leading to the presumption that silica exposure can lead to silica nephrotoxicity. Balkan nephropathy has been associated with consumption of well water high in silica. In the Negev of Israel, dust storms are a vehicle for increasing respiratory uptake of silica. The Beduin, thought to be a population with maximal exposures, have higher rates of ESRD than do Jews in the age groups over 60 years. Although high blood concentrations of silica are found in persons with renal failure, the close association with elevated creatinine has been interpreted as evidence that the buildup of silica is due to renal failure, rather than vice-versa. The evidence is consistent with, but not yet compelling, that exposure to silica, which can be readily absorbed (or dissolved) from the lung, may increase the long-term risk of renal disease including renal failure. © 1993 Wiley-Liss, Inc.     

The validity of a simple clinical classification of acute ischaemic stroke

The aim of the study reported here was to test the validity of a simple clinical classification of acute ischaemic stroke (Oxfordshire Community Stroke Project, OCSP) in predicting the site and size of cerebral infarction on computed tomography (CT). Consecutive patients admitted to hospital with acute ischaemic stroke were prospectively identified and classified into one of four clinical syndromes according to the OCSP classification, blind to the result of CT. The CT brain scans were classified blind to the clinical features into those demonstrating: small, medium or large cortical infarcts; small or large subcortical infarcts in the anterior circulation territory; and posterior cerebral circulation territory infarcts. A total of 108 patients were included. A recent infarct was seen. on the CT scan in 91 patients (84%), and the clinical classification correctly predicted the site and size of the cerebral infarct in 80 of these (88%; 95% confidence interval 77–92%). The positive predictive value was best for large cortical infarcts (0.94) and worst for small subcortical infarcts (0.63). The OCSP clinical classification is a reasonably valid way of predicting the site and size of cerebral infarction on CT and can, therefore, be used very early after stroke onset before the infarct appears on the scan.     

SPECT对老年人缺血性脑血管病诊断价值的探讨

本文对21例老年人缺血性脑血管病患者进行SPECT检查,并对SPECT对老年人缺血性脑血管病的诊断价值进行探讨。结果发现SPECT诊断老年人缺血性脑血管病的阳性率为95%,明显高于头颅CT。     

Hepatitis B and Delta virus infection among heterosexuals,homosexuals and bisexual men

The hepatitis B virus (HBV) and hepatitis Delta virus (HDV) infection rates were estimated in patients attending a venereal disease outpatient clinic: 759 heterosexuals and 154 homosexual-bisexual men. The anti-HBC prevalence was higher in homo-bisexual men (68.8 per 100) than in heterosexuals (41.8 per 100), whereas HBsAg was roughly the same in the two groups (about 6 per 100). The anti-HBc prevalence rate among heterosexuals was higher than that estimated in hospital personnel from the same geographical area. A positive association between anti-HBc prevalence and present or past sexually transmitted diseases (STD) was found among homo-bisexual men. Anti-HBc was also positively associated with herpes simplex type 2 antibodies in both heterosexuals and homo-bisexual men. These data are consistent with the hypothesis that sexual behavior also plays a role in the spread of infection among heterosexuals. Ten of the 46 HBsAg-positive subjects were anti-HDV positive: 6 of the 36 heterosexuals and 4 of the 10 homosexuals. All HDV-positive subjects had present or past STDs. These findings suggest sexual transmission of HDV infection.