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静脉内超声造影对无法进行胸廓超声心动图诊断的重症监护病房(ICU)患者的补救

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世界核心医学期刊文摘（心脏病学分册） 2005年第1期1卷 14-14页

作者： Nash P.J. Kassimatis K.C. Borowski A.G. J.d. Thomas 郭宁 dept. of Card iovascular Medicine Section of Cardiovascular Imaging Cleveland Clinic Foundat ion Cleveland OH United StatesDr.

Transthoracic echocardiography (TTE) is often technically difficult on patient s in intensive care units. Contrast echocardiography can improve left ventricula r wall visualization and the assessment of regional and global left ventricular wall motion. Our study undertook to determine what proportion of nondiagnostic T TE studies on patients in intensive care units could be salvaged (i.e., converte d to diagnostic studies) with contrast. Ninety-two patients with nondiagnostic TTEs had a repeat study after contrast. Using predefined criteria, 51%of studie s were salvaged with contrast. Female gender emerged as the only factor associat ed with less likelihood of salvaging a study.

关键词：超声心动图诊断 ICU 超声造影重症监护重复检查左心室壁诊断分析左室壁整体运动

通过初级医疗提供哮喘治疗指导以减少贫困的未成年城市儿童住院治疗及急症就医率

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世界核心医学期刊文摘（儿科学分册） 2005年第10期1卷 53-53页

作者： Cloutier M.M. Hall C.B. Wakefield d.B. Bailit H. 虎小毅李丹 Asthma Center Connecticut Children's Med. Center 282 Washington Street Hartford CT 0 6106 United States Dr.

Objectives: To determine whether an organized, citywide asthma management prog ram delivered by primary care providers (PCPs) increases adherence to the Nation al Asthma education and Prevention Program (NAEPP) Asthma Guidelines and whether adherence to the guidelines by PCPs decreases medical services utilization in l ow-income, minority children. Study design: Analysis of the utilization of medi cal services for a cohort of 3748 children with asthma who presented for care at one of six primary care urban clinics in Hartford, Connecticut, and whowere enr olled in a disease management program (Easy BreathingTM) between June 1, 1998 an d August 31, 2002. Results: Of the 3748 children with physician confirmed asthma , 48%had persistent disease. Paid claims for inhaled corticosteroids increased 25%(P der adherence to the NAE PP guidelines for anti-inflammatory therapy increased from 38%to 96%. Easy Br eathing children with asthma experienced a 35%decrease in overall hospitalizati on rates (P decrease in asthma emergency department (ed) visits (P d a 19%decrease in outpatient visits (P ed, disease management program increased adherence to the NAEPP guidelines for anti-inflammatory use by PCPs in urban clinics. Adherence to this element of t he guidelines by PCPs reduced hospitalizations, ed visits, and outpatient visits for children with asthma.

关键词：哮喘治疗城市儿童哮喘儿童住院治疗哮喘管理依从性急诊就医疾病管理持续症状医疗诊所

光学相干断层扫描仪对正常儿童及青光眼患儿黄斑和视网膜神经纤维层的分析

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世界核心医学期刊文摘（眼科学分册） 2005年第8期1卷 27-27页

作者： Hess d.B. Asrani S.G. Bhide M.G. S.F. Freedman 张鹏 duke UniversityEye Center Box 3802 DUMCErwin Road Durham NC 27710 United States Dr.

.PURPOSE: To evaluate macular and nerve fiber layer (NFL)thickness in normal a nd glaucomatous eyes of children 3 to 17 years old using optical coherence tomog raphy (OCT-3).dESIGN: Observational cross-sectional study. .METHOdS: One hundr ed fifty-six eyes of 79 patients were enrolled in this institutional study. Fif ty-two eyes (33.3%) met criteria for glaucoma and 104 (66.7%) were normal. Th ere were 44 female (55.6%) and 35 male (44.3%) subjects whose ages ranged from 3 to 17 years old (mean 9.5 years, standard deviation 3.5 years, median 9 years ). The OCT-3 (Carl Zeiss Meditec, dublin, California) was used to obtain a fast macular thickness map as well as a fast retinal NFL map of each eye. data from specific locations around the macula, as well as total macular volume, was analy zed. Similarly, the retinal NFL scan reports average NFL thickness from specific locations around the optic nerve. data from the superior temporal and inferior temporal sections was analyzed. RESULTS: There was a statistically significant d ifference in macular thickness and NFL thickness when normal eyes were compared against those with glaucoma, in all quadrants studied (all P values ≤.001). Mea n macular volume was 7.01±0.42 mm3 vs 6.57 ±0.85 mm3 for normal vs glaucomatou s eyes, respectively (Pdiagnosis of glaucoma. We have found a difference between normal and glaucomato us eyes in children, similar to that reported in adult studies. Further investig ation of OCT testing in children should be considered.

关键词：神经纤维层特定部位横断面研究观察性有显著性差异诊断标准快速扫描扫描图早期诊断

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怀孕期进行ERCP的安全性和有效性

世界核心医学期刊文摘（胃肠病学分册） 2005年第2期1卷 34-34页

作者： Kahaleh M. Hartwell G.d. Arseneau K.O. P. Yeaton 赵丽娜 digestive Health Center Radiation Oncology Physics Dept. Anesth. Univ. Virginia H. Charlottesv illeVA United StatesDr.

Background Choledocholithiasis during pregnancy increases the risk of morbidit y and mortality for both fetus and mother because of cholangitis and pancreatiti s. ERCP has been advocated as safe and effective in pregnant women, but fetal ra diation exposure is not routinely monitored. The aim of this study was to record fetal exposure to ionizing radiation during ERCP and to assess outcome. Methods Seventeen ERCPs were performed in pregnant women between January 1995 and Augus t 2003. Techniques to minimize fluoroscopy were used, and fluoroscopy times were recorded. Thermoluminescent dosimeters affixed to the skin of the mother were u sed to estimate fetal radiation exposure. Observations Mean gestational age was 18.6 (8.9) weeks (range 5-33 weeks). Mean fluoroscopy time was 14 (13) seconds (range 1-48 seconds). Estimated fetal radiation exposure was 40 (46) mrad (rang e 1-180 mrad).There was a correlation between fluoroscopy time and radiation ex posure, but there was a wide range of radiation exposure for individual fluorosc opy times. Complications included postsphincterotomy bleeding in one patient (co ntrolled by hemoclip placement) and post-ERCP pancreatitis in one patient that necessitated 3 days of hospitalization. Two women developed third-trimester pre eclampsia, and labor was induced in *** of the 15 patients who deliver ed were contacted and they confirmed that their child was in good health. Conclu sions ERCP with modified techniques is safe during *** should be routinely recorded.

关键词：电离辐射母婴死亡率妊娠时间胆总管结石热释光括约肌切开术透视检查止血夹先兆子痫量仪

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1例罕见的儿童损伤:外伤性幽门前横断

世界核心医学期刊文摘（儿科学分册） 2006年第8期2卷 46-46页

作者： Whyte L.H. Soundappan S.V.S. Harvey J. Cass d.T. 朱新菊 department of Academic Surgery and Trauma Children's Hospital at WestmeadSydneyNSW 2145Australia

The diagnosis and management of a 14-year-old girl with isolated traumatic t ransection of the prepylorus after amotor vehicle accident are *** nal computed tomography was useful in the diagnosis of pneumoperitoneum associat ed with hollow viscous *** diagnosis and surgical repair of this unusu al injury resulted in an uncomplicated recovery.

关键词：外伤性横断幽门损伤罕见儿童腹部CT扫描快速诊断治疗经过交通事故

睾酮替代治疗性功能减退合并心绞痛患者可以改善缺血和提高生活质量

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世界核心医学期刊文摘（心脏病学分册） 2005年第1期1卷 20-20页

作者： Malkin C.J. Pugh P.J. Morris P.d. K.S. Channer 张明娟 M131 Cardiology Royal Hallamshire Hospital Glossop Road Sheffield S102JF United KingdomDr.

Background: Low serum testosterone is associated with several cardiovas cular r isk factors including dyslipidaemia, adverse clotting profiles, obesity, and ins ulin resistance. Testosterone has been reported to improve symptoms of angina an d delay time to ischaemic threshold in unselected men with coronary disease. Obj ective: This randomised single blind placebo controlled crossover study compar ed testosterone replacement therapy (Sustanon 100) with placebo in 10 men with isc haemic heart disease and hypogonadism. Results: Baseline total testosterone and bioavailable testosterone were respectively 4.2 (0.5) nmol/l and 1.7 (0.4) nmol/ l. After a month of testosterone, delta value analysis between testosterone and placebo phase showed that mean (Sd) trough testosterone concentrations increased significantly by 4.8 (6.6) nmol/l (total testosterone) (p=0.05) and 3.8 (4.5) n mol/l (bioavailable testosterone) (p=0.025), time to 1 mm ST segment depression assessed by Bruce protocol exercise treadmill testing increased by 74 (54) secon ds (p=0.002), and mood scores assessed with validated questionnaires all improve d. Compared with placebo, testosterone therapy was also associated with a signif icant reduction of total cholesterol and serum tumour necrosis factor αwith del ta values of -0.41 (0.54) mmol/l (p=0.04) and -1.8 (2.4) pg/ml (p=0.05) respec tively. Conclusion: Testosterone replacement therapy in hypogonadal men delays t ime to ischaemia, improves mood, and is associated with potentially beneficial r eductions of total cholesterol and serum tumour necrosis factor α.

关键词：睾酮替代治疗性功能减退生活质量男性冠心病平板运动试验血浆睾酮血浆总胆固醇 Bruce 异常脂蛋白血症缺血性心脏病

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妊娠并发抗C型同种免疫的治疗

世界核心医学期刊文摘（妇产科学分册） 2005年第2期1卷 59-59页

作者： Hackney d.N. Knudtson E.J. Rossi K.Q. R.W.O'Shaug hnessy 郭慧芳 561Means Hall 1654Up -ham DriveColumbusOH 43210-1282United States Dr.3

OBJECTIVE:To review cases of anti -c isoimmunization and determine the most appropriate management ***:We performed a review of 102pregnancies managed at The Ohio State University from 1967to 2001for anti -c *** these,55had complete data and are included in this *** collected included serum titers,△Od 450 values,Liley zones,fetal and neonatal hemoglobin levels and a ntigen typing,neonatal direct antiglobulin test,and neonatal *** appropriateness of traditional management was then ***:Of the 55pregnan cies,46had fe-tuses with positive direct antiglob ulin test,and nine preg-nancies had unaffected *** t he affected neonates,12(26%)had serious hemolytic disease of the *** these 12,8required fetal transfu sion,and the remain-ing 4newborns had hemoglobin levels of less than 10g /dL at the time of delivery.A titer of 1:32or greater or the presence of hydrops fetalis identified all such *** were 58amniocenteses perform ed for△Od 450 .When plotted on modified Liley graph s,△Od 450 values corresponded to disease severity.T here were no perinatal deaths attributable to anti -c hemolytic disease of the ***:Anti -c isoimm unization might cause significant fetal and newborn hemolytic disease.A titer of 1:32or greater or evidence o f hydrops fetalis i-dentified all the serious hemolytic disease at our *** significance of antibody t iters and△Od 450 values was similar to Rh -d sensitize d pregnancies,and management by the same modalities is appropriate.

关键词：同种免疫血红蛋白水平溶血性疾病抗体滴度疾病患儿围生期俄亥俄州立大学致敏

急性胸痛病人调查研究:心脏CT血管成像联合肌钙蛋白检测的应用价值

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国际医学放射学杂志 2011年第5期 483-483页

作者： A.Nasis I.T.Meredith N.Nerlekar J.d.Cameron P.R.Antonis P.M.Mottram 付娇慧 Monash Cardiovascular Research Centre Monash-HEART246 Clayton RoadClaytonVIC 3168Australia and Southern Health and Monash University Department of MedicineMelbourneAustralia

目的评价心脏CT血管成像(CTA)对急诊室(ed)内具有低至中度缺血风险且伴胸痛病人的等待时间和常见心血管不良事件发生率的影响。材料与方法该研究获得机

关键词：血管成像 CTA 肌钙蛋白肌肉蛋白 CT 病人心脏

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水力增压及高效破岩实验研究

石油钻探技术 2004年第2期32卷 21-24页

作者：王希勇熊继有龙刚刘海容西南石油学院石油工程学院四川成都610500 中国石化西南分公司井下作业处四川成都610500 中国石油西南销售贵州分公司贵州贵阳600000

充分有效地利用井底的水力能量,既要能够提高水力能量的利用率,同时又要易于井下实现。为此,设计了一种新型的井下水力增压装置,该装置依靠脉冲射流的卷吸、自激振荡反馈负压区的形成,以及井壁环空液柱压力的它激作用实现井下增压,所用... 详细信息

充分有效地利用井底的水力能量,既要能够提高水力能量的利用率,同时又要易于井下实现。为此,设计了一种新型的井下水力增压装置,该装置依靠脉冲射流的卷吸、自激振荡反馈负压区的形成,以及井壁环空液柱压力的它激作用实现井下增压,所用增压介质仅为井下环空流体。井下水力增压装置是一种既能产生脉冲射流,又以环空液柱为它激射流源的新型增压装置。利用该装置分别进行了自增流量实验和射流瞬时动压力实验,并由此得出了实现最佳自增流量的开孔方案。实验结果表明:射流瞬时冲击力可以达到无孔时的2倍以上。

关键词：钻井速度水力射流增压装置岩石破碎液柱压力射流瞬时冲击力射流破岩技术