Three-dimensional X-ray absorptiometry (3D-XA): a method for reconstruction of human bones using a dual X-ray absorptiometry device

Three-dimensional accurate evaluation of the geometry of the proximal femur may be helpful for hip fracture risk evaluation. The purpose of this study was to apply and validate a stereo-radiographic 3D reconstruction method of the proximal femur, using contours identification from biplanar DXA images. Twenty-five excised human proximal femurs were investigated using a standard DXA unit. Three-dimensional personalized models were reconstructed using a dedicated non-stereo corresponding contours (NSCC) algorithm. Three-dimensional CT-scan reconstructions obtained on a clinical CT-scan unit were defined as geometric references for the comparison protocol, in order to assess accuracy and reproducibility of the 3D stereo-radiographic reconstructions. The precision of a set of 3D geometric parameters (femoral-neck axis length, mid-neck cross-section area, neck-shaft angle), obtained from stereo-radiographic models was also evaluated. This study shows that the NSCC method may be applied to obtain 3D reconstruction from biplanar DXA acquisitions. Applied to the proximal femur, this method showed good accuracy as compared with high-resolution personalized CT-scan models (mean error = 0.8 mm). Moreover, precision study for the set of 3D parameters yielded coefficients of variation lower than 5%. This is the first study providing 3D geometric parameters from standard 2D DXA images using the NSCC method. It has good accuracy and reproducibility in the present study on cadaveric femurs. In vivo prospective studies are needed to evaluate its discriminating potential on hip fracture risk prediction.S Kolta and A Le Bras participated equally to this study     

Antisense oligonucleotide eluforsen improves CFTR function in F508del cystic fibrosis

BackgroundCystic fibrosis (CF) is caused by mutations in the CF transmembrane conductance regulator (CFTR) gene. In this study we assessed the effect of antisense oligonucleotide eluforsen on CFTR biological activity measured by Nasal Potential Difference (NPD) in patients with the most common mutation, F508del-CFTR.MethodsThis multi-centre, exploratory, open-label study recruited adults with CF homozygous or compound heterozygous for the F508del-CFTR mutation. Subjects received intranasal eluforsen three times weekly for 4 weeks. The primary endpoint was the within-subject change from baseline in total chloride transport (Cl-free+iso), as assessed by NPD. Secondary endpoints included within-subject change from baseline in sodium transport.ResultsIn the homozygous cohort (n = 7; per-protocol population), mean change (90% confidence interval) in Cl-free+iso was ?3.0 mV (?6.6; 0.6) at day 15, ?4.1 mV (?7.8; ?0.4, p = .04) at day 26 (end of treatment) and ? 3.7 mV (?8.0; 0.6) at day 47. This was supported by improved sodium transport as assessed by an increase in average basal potential difference at day 26 of +9.4 mV (1.1; 17.7, p = .04). The compound heterozygous cohort (n = 7) did not show improved chloride or sodium transport NPD values. Eluforsen was well tolerated with a favourable safety profile.ConclusionsIn F508del-CFTR homozygous subjects, repeated intranasal administration of eluforsen improved CFTR activity as measured by NPD, an encouraging indicator of biological activity.     

龙岩市764例儿童病毒性脑炎流行病学特征分析

目的分析龙岩市儿童病毒性脑炎（EV）流行病学特征,为制定防治策略提供依据。方法对2004—2011年764例患者进行流行病学、临床表现和检查分析。结果病例无聚集现象,以≤7岁为主,男性较多,5~7月为发病高峰。患儿多出现发热（86.1%）、头痛（64.8%）、呕吐（61.5%）、颅内压增高（72.4%）、脑脊液白细胞数增加（58.4%）、脑电图异常（79.0%）;脑积液病毒分离阳性率18.6%,以埃可病毒（ECV）为主（90.1%）。2004和2010年的暴发疫情分别由ECV19和ECV6引起。结论病毒性脑炎多散在发生,临床表现以无菌性脑膜炎为主,实验室检查有利于病例诊断。ECV是主要病原体,ECV30为当地持续流行的毒株。     

麻醉学实践教学中临床技能培训与考核标准的架构与思考

本文探讨如何在麻醉学实践教学中构建规范化的临床技能培训模式与考核标准,以达到改进和完善麻醉学实践教学质量,充实专业内涵建设的目的。以麻醉学临床实践教学为切人点,引入标准化病人并充分利用模拟教学等措施,构建科学、适用、规范的麻醉学临床技能培训与考核内容。经过郧阳医学院附属太和医院规范化技能培训与考核的学生,在毕业后实际工作中的技能水平较其他医院实习学生具有一定的优势。实践证明,规范化培训与考核是加强麻醉学实践教学的有效手段。     

颅骨嗜酸性肉芽肿影像学诊断

目的分析颅骨嗜酸性肉芽肿的影像学表现,提高其诊断水平。方法回顾性分析经手术病理证实的16例颅骨嗜酸性肉芽肿的影像资料。观察指标：病灶数目、部位、形态、大小、边缘、密度或信号及强化程度。结果单发15例,其中额骨6例,顶骨5例,枕骨3例,眼眶1例;多发1例共3个病灶,分别位于额骨、枕骨及斜坡。额骨、顶骨及枕骨病灶为圆形或类圆形,边缘清晰;眼眶及斜坡病灶形态不规则,边缘清晰伴有硬化缘。X线表现为溶骨性破坏,边界清楚,多边缘无硬化,仅眼眶及斜坡处病灶局部有硬化缘。CT主要表现为颅骨内外板类圆形骨质破坏,眼眶及斜坡病灶呈不规则侵蚀性骨质破坏,边界清楚,无骨膜反应;其中6例单发病灶及1例多发病灶均见骨质破坏内残留小点及细条骨片;软组织肿块部分呈均匀等密度,增强后软组织部分轻度强化。MRI均见骨质破坏区向颅骨内外形成软组织肿块,其中11例11个病灶T1WI呈低信号,4例6个病灶呈中等信号,1例1个病灶T1WI见斑点状高信号;T2WI及脂肪抑制序列均呈高信号,信号均匀;病灶软组织肿块均呈显著性强化。结论 X线结合MRI有助于诊断颅骨嗜酸性肉芽肿,具有较高的临床价值。     

临床医学五年制学生实习出科考核方法研究

对进入实习阶段的临床医学五年制学生的出科考核方法进行研究和实践,及时进行分析、反馈、改进,形成了完整、系统的考核内容、考核细则、评分标准,注重了学生综合素质评价,促进了医院师资队伍培养和教研室建设,可评估教学效果,提高教学质量。     

应重视肺功能检查在呼吸系统疾病诊治中的地位

目的：了解肺功能检查在呼吸系统疾病诊治中的应用情况．方法：收集整理我院呼吸内科2003年收治的呼吸系统疾病患者1073例的临床资料，统计他们接受肺功能测定的情况并与全国的情况进行对比．结果：呼吸系统疾病患者进行肺功能测定的检查率仅为23．48％，而确诊为慢性阻塞性肺疾病（COPD）患者的检查率也仅为23．7％，明显低于三级医院的肺功能检查率；与国内部分省市诊断COPD过程应用肺功能情况相比也处于较低水平．结论：广大呼吸内科医生应重视肺功能检查在临床的应用，使诊断水平和疗效的判断建立在更为可靠的科学基础上；应作为常规的体检项目。以便较早防治呼吸系统疾病．     

周口市某化工厂职业病危害因素现状调查

[目的]了解某化工厂职业病危害因素状况,对超标岗位或工种提出控制措施。[方法]2010年9月对某化工厂生产岗位或工种存在的职业病危害因素进行现场调查和检测。[结果]制糖车间谷物制粉岗位、乳酸钙粉碎车间粉碎岗位、精制车间乳酸钙粉碎岗位、钙粉房加钙位作业工人接触粉尘总尘浓度不符合国家职业卫生限值标准要求;对30个岗位或工种进行噪声检测,最大声强101.0 dB(A),最小声强78.0 dB(A),平均87.2 dB(A),其中21个岗位或工种不合格,合格率为30.0%。[结论]某化工厂作业岗位或工种接触粉尘和噪声危害因素合格率较低,应该改善作业环境,加强个人防护,保护劳动者健康。