Trauma is still one of the leading causes of death among teenagers and a major cause of morbidity and mortality among the elderly (DeGrauw et al., J Safety Res 56:105–109, 2016). Advances in technology have allowed more affordable and easily accessible imaging modalities. Modern trauma centers rely heavily on imaging for assessment of suspected injuries (Andrawes et al., Trauma Surg Acute Care Open 2(1):e0001012, 2017). In addition to providing information on acute injuries, however, imaging modalities have also been shown to reveal chest pathologies not related to trauma called “incidental findings” which may or may not require further investigation (Salim et al., Arch Surg 141:468–473, 2006; Sampson et al., Clin Radiol 61:365–369, 2006; Seah et al., Injury 47:691–694, 2016). In the acute setting when a patient is too unstable for immediate imaging, there is potential for discovery of incidental findings intraoperatively. Lung nodules or masses can originate from many different etiologies. Very few of these need to be directly addressed in the acute care surgery setting. The acute care surgeon’s role is often to identify the incidental finding and set the patient up for the appropriate work up and specialty follow-up. The diagnosis and correct treatment of these incidental findings could have a major impact on the patient’s future health and survival. The list of potential incidental findings is extensive. In this chapter, we will briefly cover some common incidental findings as well as discuss recommended work-up and potential treatment.

随着居民生活水平的提高、体力活动减少,肥胖逐渐增多.而肥胖,尤其是腹部肥胖是心脑血管疾病、高血压病、糖尿病等慢性非传染性疾病的主要危险因素之一[1].近年来在北京崇文区、西城展览路社区进行的慢性非传染性疾病社区预防模式研究课题中获得的1432名25岁以上城区妇女的体检资料,分析探讨肥胖相关指标(体质指数、腰围、臂围、腰臀比值)与血压、血脂、血糖关系,以了解肥胖对北京妇女健康的影响.

Objectives: To study the apoptosis induced by homocysteine (Hcy) and the protective effects of folic acid, VE and Se. Methods: Inverted microscopy and MTT test were used to observe the protection of these nutrients on the cytotoxic effect of Hcy. DNA agarose gel electrophoresis and flow cytometry were used to observe the inhibition of these nutrients on the apoptosis induced by Hcy. The level of MDA, the activity of SOD and GSH-Px and the generation of active oxygen in cells were also measured to investigate the mechanism of the protective effects. Results: Significant effects of folic acid, VE and Se on the protection of cell damages and the inhibition of apoptosis induced by Hcy were observed. These protective effects may be the results of decreasing MDA in cells provided by folic acid, VE and Se, increasing the activity of SOD by folic acid, increasing the activity of GSH-Px by folic acid and Se, and decreasing the generation of active oxygen by VE. Conclusions: The protective effects of folic acid, VE and Se on the damage of ECV304 cell from Hcy and the inhibitive effect on apoptosis induced by Hcy might be in different mechanisms.

Objective To compare the difference of dietary pattern,body mass index(BMI),waist circumference(WC),blood pressure and serum lipids among diabetes mellitus(DM) patients,people with impaired fast glucose(IFG) and normal people and to find out appropriate approaches on DM prevention.Methods Questionnaires,physical examination,biochemical measurement were carried out in 943 subjects with cross sectional study.Results Out of 943 subjects,there were 168 subjects diagnosed as DM(17 8%) and 150 subjects as IFG(15 9%).The awareness of impaired blood glucose was 75 2% in DM group and 9 8% in IFG group.The average energy intake in DM,IFG and normal group was 2 272 kcal,2 510 kcal and 2 470 kcal respectively.Energy from dietary fat was 34%,33% and 33 2% of total energy in the three groups.The prevalent rates of obesity,blood pressure,serum cholesterol and triglycerides were higher in DM and IFG groups than those in the normal group( P 0 05).The correlation analysis showed that fast blood glucose had close positive relationship with BMI,WC,blood pressure,total cholesterol and triglycerides.Conclusions For DM patients,dietary intervention including total energy intake control and dietary fat intake reduction should be emphasized.IFG patients as the crucial population should enhance their awareness and be provided reasonable intervention for decreasing the occurrence of DM.

目的了解中老年人健康状况及卫生服务需求,明确慢性病社区综合干预的重点.方法对展览路社区35岁以上居民进行问卷、体检及生化检查.结果各种疾病的患病率:高血压40.7%;糖尿病32.6%;脂质代谢紊乱:59.3%;肥胖32.1%.以血压、血脂、血糖和体质指数(BMI)作为慢性病危险因素指标,被调查人群中82.3%的男性和80.3%的女性至少一项指标异常.该人群两周患病率为13.6%(就诊率为66.4%).两周服药率:冠心病78.2%,高血压75.3%,脑卒中53.8%,糖尿病29.6%,脂质代谢紊乱15.3%和肿瘤5.9%.一年住院率6.5%.心脑血管疾病、糖尿病和肿瘤占住院总数的63.9%.平均住院天数22.3天,平均医疗费为13543元.结论老年人群为社会中的弱势群体,各种慢性病的患病率高,是社区医院的主要服务对象.能否报销医疗费和医院的技术设备条件是影响居民选择就诊单位的主要因素.

The mechanism of homocysteine-induced oxidative injury on ECV304 cell line, a spontaneously transformed immortal human endothelial cell line, was studied. ECV304 cells were incubated with different levels of Hcy (0.05-2.00 mmol/L) for 12 hours. The activity of major anti-oxidative enzymes and the generation of reactive oxidative species (ROS) were measured by chromatometry and fluorochromy. The results showed that Hcy could induce obvious oxidative injury on ECV304 even at low level (0.05-0.10 mmol/L). The level of MDA was increased and the active oxygen was generated in the cells. The activities of anti-oxidative enzymes (SOD and GSH-Px) except the activity of CAT were decreased in the cells. It was concluded that Hcy may induce oxidative injury on EVC304 cell line through increasing the levels of ROS and inhibiting the activities of anti-oxidative enzymes.

UNLABELLEDThis study aimed to analysis the relationship among body mass index (BMI) and waist circumference (WC) with chronic diseases risk factors--serum total cholesterol (TC), triglyceridaemia(TG), high density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP) and the prevalence of chronic diseases. The data was collected from 1995 to 1998 in the study of community base integrated intervention of non-communicable chronic diseases.RESULTSThe prevalence of overweight and obesity in male was 41.7% and 14.6%, in female was 32.0% and 20.4% in this population, respectively. BMI and WC had significant positive relationship with TC, TG, SBP and DBP but negative with HDL-C and HDL-C/TC. WC had significant positive relation with FBG. The prevalence of dyslipidaemia hypertension and diabetes were significantly increased in overweight and obese groups. For early prevention, we have to pay more attention to the population with BMI > 24.0 kg/m2, they had increased risk factors of non-communicable chronic diseases.

我国已进入老龄化社会,我国老年人营养状况及研究存在很多问题,如:老年人群营养不足和不平衡并存,贫血患病率居各年龄组之首,有50%的体重不在正常范围内,老年人群营养基础资料缺乏,某些营养素对老年人健康和慢性疾病预防方面的研究不足等.本文分析了上述问题,并提出了改善我国老年人群膳食结构及营养状态的建议.

目的探讨敬老院健康养老的现状与问题.方法对北京市郊区两所敬老院的管理人员进行专题小组讨论,对入住两所敬老院的老人进行问卷调查.结果两所敬老院的入住率均达100%,但医护人员配置都较少,膳食安排缺乏营养专业人员指导.两所敬老院入住老人的职业、文化程度差异均有显著性意义(P＜0.05),入住老人大多具有1种或以上慢性病,且多有不良膳食习惯.结论敬老院健康养老的社会需求很大,社会各部门应加强对敬老院的支持和管理.敬老院应配备具有综合医疗卫生素质的全科医务人员,尤其是要开展营养宣教活动,加强健康生活方式指导.

To identify the influence of different calcium contents among different calcium agents on absorbing and born density of rats, wistar rats are fed with diet containing different contents of calcium of different calcium agents. 3-day calcium metabolization experiment is carried out in the fourth week and atomic absorption spectrophotometry is applied to measure the calcium content of their dejecta and to estimate apparent absorptivity. Rats are killed in the twelfth week, and their thighbones are peeled. the results show that there is significant difference of the apparent absorptivity with different calcium intake. With the same content of calcium from nine kinds of calcium agents, the absorptivity is not significant different with an exception of those of active calcium, milk powder and oatmeal. Born density from the group of rats, which fed with diet with low level, middle level or high level of calcium, is obviously higher than that of rats fed with basic diet (P < 0.05). Born density of thighbone of the group of rats, which fed with diet with middle or high level of calcium content is not significantly different compared with that of rats fed with diet with calcium carbonate. The absorptivity of calcium is related with calcium content in diet. The effect of absorptivity of calcium agents tested is affirmative, but there is no difference of their effect in comparison with the calcium carbonate.

There was a close relationship between lifestyle, dietary habits and the prevalence of chronic disease.This review involved some diet\|related chronic degenerative diseases.Cataract:a case\|control study showed that appropriate amount of antioxidant nutrients might be expected to prevent or retard the process of lens degenerative changes.Osteoporosis:a cross\|sectional study and calcium supplementation trials showed that calcium supplementation,long\|term intakes of zinc,magnesium,potassium,and high consumption of fruits and vegetables may be important to bone health.Cardiovascular disease:intake of folic acid 400μg/d,vitamin B 6 3mg/d may be useful in the primary prevention of cardiovascular disease.

5 and 10nmol/L O~(.)_(2) could induce NIH3T3 apoptosis and Se (1.15mumol/L) and VE (2.3mumol/L) inhibited apoptosis in NIH3T3 cells induced by O~(.)_(2).

Biochemical evidence on lens culture suggests that antioxidant nutrients can protect lens against peroxidation caused by radiation. A case-control study was carried out on 262 middle aged (45-54) and aged (55-64) subjects. The relationship between biochemical markers of antioxidant status and senile lens changes (including cataract) was examined in 131 subjects with senile lens changes and 131 control subjects with clear lens. Antioxidant status was measured using plasma and erythrocyte glutathione peroxidase, erythrocyte superoxide dismutase and catalase activity and plasma levels of vitamin E and vitamin A. Subjects were grouped by age and sex. The results were as follows: (1) The subjects with lens changes tended to have lower plasma levels of vitamin E and vitamin A, lower activity of several antioxidant enzymes and higher level of MDA. (2) The subjects with senile lens changes had significantly lower erythrocyte glutathione peroxidase level. (3) In the middle-aged group, subjects with senile lens changes were observed to have lower erythrocyte and plasma glutathione peroxidase level than those without senile lens changes. The results suggest that appropriate amount of antioxidant nutrients might be expected to prevent or retard the process of lens changes.

The activities of glutathione peroxidase (GSH-Px), glutathione reductase (GSSG-R), superoxide dismutase (SOD) and the contents of malondialdehyde (MDA) and free radicals were measured, and the morphological changes were observed in the lens of control rats, selenium-deficient (SeD) and/or vitamin E deficient (VED) rats. The activities of GSH-Px in the lens of SeD rats decreased significantly. The GSH-Px activities of lens were positively related to erythrocytes selenium level. There was a free radical at g = 2.0015 in the rat lens of all groups, but the content of free radicals in the lens of SeD group was significantly higher than that of the control group. The free radical content of lens was negatively related to erythrocytes selenium level, as well as the GSH-Px activities in the lens. In vitro, ultraviolet radiation caused the generation of another kind of free radical (g = 2.0097) in the lens of all groups, but the amount of the free radical in the lens of the SeD group was also significantly higher than that of the control group. The activities of SOD and GSSG-R in VED rat lens were significantly decreased. The amount of MDA in the lens of SeD and/or VED rats were significantly increased. The results showed that the decrease of antioxidative capability in the lenses of SeD and/or VED rats accelerated the lipid peroxidation and generation of free radicals. Although only early morphological changes in SeD and/or VED rat lens were observed, it is considered that selenium and vitamin E deficiency may be involved in the occurrence of cataract.

The effect of selenium deficiency on the chronic toxicity of adriamycin was examined in rats fed diets adequate in vitamin E. Selenium-deficient and selenium-supplemented diets were fed to rats for 10 wk, after which groups of 10 rats fed each diet were given weekly intravenous injections of adriamycin in saline at doses of 0, 0.5 or 1.0 mg/kg body weight for 12 wk. All rats were killed at 24 wk. Even though the cardiac glutathione peroxidase activity in the selenium-deficient group was less than 1% of that of the selenium-supplemented group, the severity of the adriamycin-induced cardiomyopathy was similar in both groups. However, the selenium-deficient rats were more sensitive to the growth-inhibiting effect of the higher dose of adriamycin than the selenium-supplemented rats. Moreover, the lower dose of adriamycin caused a mild nephropathy in 70% of the deficient rats but affected only 10% of the supplemented rats. Selenium status may have to be considered when adriamycin is used as a chemotherapeutic agent.

本文首次报道ECHO 13型病毒性心肌炎。3例病毒学分属于Lerner病原学意义的高、中、低度关联。一例为ECHO 13型病毒性心肌炎,死后病理证明有急性心肌炎;心肌分离到ECHO 13型病毒。两例有ECHO 13型病毒感染同时临床有心肌炎症状,其中一例粪便分离到ECHO 13型病毒,双份血清ECHO 13型阳性;另一例有ECHO 13型双份血清抗体四倍升高。据此考虑ECHO 13型病毒能引起心肌炎。

Keshan disease, an endemic cardiomyopathy in China, was prevalent in rural areas located in a long belt region where the selenium content was low in foods. Intervention studies with well controled subjects revealed a prophylactic effect of sodium selenite. Multifocal necrosis and fibrous replacement of the myocardium characterized the histopathological features and myocytolysis was present in most cases. Ultrastructural observations on twelve postmortem cases revealed remarkable changes in many organelles of which mitochondria appeared to be most important in the development of myocardial lesions. Three kinds of specific granules, which have not been found in other reports on cardiomyopathies, were represented and other factors which might also contribute to the aetiology are discussed.