Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

海马头部浅沟消失对海马硬化诊断价值的探讨

目的　探讨海马头部浅沟消失对海马硬化的诊断价值。方法　对 18例经组织学检查证实的海马硬化患者的MRI检查资料和 18例年龄相匹配的对照组进行回顾性分析 ,观察海马头部浅沟的显示情况、海马头部大小和信号改变。结果　 18例海马硬化患者中 ,16例硬化侧海马头部浅沟消失 ,1例硬化侧海马头部浅沟明显变浅 ,几乎消失 ,1例硬化侧海马头部浅沟存在。硬化侧海马头部均有萎缩 ,并在T2 WI和液体衰减恢复 (FLAIR)成像呈高信号。海马头部浅沟消失对海马硬化诊断的敏感性为 88.9% ,特异性为 10 0 %。结论　海马头部浅沟消失是诊断海马硬化的一个可靠征象 ,结合患侧海马有萎缩性改变和T2 加权成像信号增高 ,可肯定诊断海马硬化。     

X线照片均方根值粒状度的测试探讨

作者介绍了Ｘ线照片均方根值（ＲＭＳ）粒状度的测试原理及方法。对ＣａＷＯ４／Ｆｕｊｉ和ＢａＦＣｌ：Ｅｕ／Ｆｕｊｉ两种屏胶系统在不同条件下的ＲＭＳ值进行了测试。     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Study of age of fusion of hyoid bone

The present study was conducted to determine the age of fusion of greater cornua with the body of hyoid bone. Age of fusion of hyoid bone can help in determining the age of an individual, especially of unknown dead bodies where only skeletal remains are available. A victim of compression of neck will more likely have fracture of hyoid bone if his hyoid bone is fused. Indian authors have reported that the fusion of hyoid bone occurs after 40 years of age. Studies done by foreign workers observed that hyoid bone fused at an earlier age (30-40 years). A total of 170 excised hyoid bones from dead bodies belonging to the age group of 20-65 years were studied. Fusion occurred earlier in females as compared to males by about 5 years. The mean age of unilateral and bilateral fusion in males was 38.25 and 53.16 years, respectively. The mean age of unilateral and bilateral fusion in females was 38.00 and 48.50 years, respectively. All the hyoid bones were fused after the age of 60 years. No significant differences were found between the fusion on right and left side.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

湿润烧伤膏治疗婴儿湿疹的临床疗效观察

目的观察、探讨湿润烧伤膏(MEBO)治疗婴儿湿疹的临床疗效。方法将84例婴儿湿疹患儿随机分为治疗组(44例)和对照组(40例),治疗组外涂湿润烧伤膏治疗,对照组外涂湿疹膏治疗,连续治疗1周后,观察两组疗效。结果治疗组有效率为97.73%,对照组有效率为82.50%;两组疗效经秩和检验,差异具有统计学意义(P0.05);随访1个月,治疗组未见复发,对照组有2例患儿复发。结论湿润烧伤膏治疗婴儿湿疹疗效好,无毒副作用,安全可靠。     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.     

The value of information of duration of pregnancy in establishment of paternity

Summary In order to get an idea of the value of the information on the duration of pregnancy in establishment of paternity, 511 records from 17 lower courts in Sweden were studied.It was found that when a blood group investigation has been performed, only a small number of cases remain where the paternity claim should be rejected by a court of law for the reason that the period of pregnancy has been extremely long or short.It was shown that only very extreme probability values (percentages) should give reason for rejection of paternity claims if a larger risk of error is to be avoided. The risk is somewhat smaller with long pregnancies than with short ones.The results of this study emphasize the difficulties involved in probability assessment in paternity suits.This report was presented at the Seventh International Medical-Legal Seminar, Stockholm 1971.     

武警某院急诊科抗菌药物处方分析

 目的 了解武警某院急诊科抗菌药物的使用情况。方法 提取急诊科2015年下半年的处方,遴选出使用抗菌药物(除去眼膏、外用膏药及中成药)的处方。对抗菌药物处方进行分类统计及分析, 包括使用抗菌药物的种类及比例、使用居前6位的抗菌药物、抗菌药物的联合使用情况等。结果 在2015年下半年急诊处方中有抗菌药物处方3872张,占处方总数的22.3%。使用抗菌药物构成比中,喹诺酮类药物使用频率最高,占42.9%。使用居第一位的药物是左氧氟沙星,占39.8%。单联处方77.86%,二联处方22.14%,无三联处方。结论 2015年下半年我院急诊科抗菌药物使用符合卫生部抗菌药物使用规定,但有些方面还需要进一步改进。     

抑郁意象特征因子结构探索

 目的 探索抑郁意象特征问卷的因子结构及有效性,为抑郁情绪判定和测量提供依据。方法 通过文献分析、专家小组讨论确定抑郁意象特征因子56项并编制初测问卷施测于109名被试,对初测数据进行项目分析和探索性因素分析,确定22个抑郁意象特征的正式施测问卷,并施测于另一组109名被试,对数据进行因子选取及主成分分析,而后进行方差最大正交旋转法进行因子旋转,获得主成分数目特征值>1的为因子数目,进行KMO和Bartlett球形度检验分析。结果 在探索性因素分析中,抽取12个项目中特征值>1的因子4个:情绪低落、乐感降低、精力减退和能力下降,共解释总方差的55.18％。验证性因子分析结果为:近似误差均方根(RMSEA)为0.057、χ²值与自由度之比(χ²/df) 为2.134、拟合优度指数(GFI)为0.935、比较拟合指数(CFI)为0.912、不规范拟合指数(NNFI)为0.896。结论 由12个抑郁意象特征问卷构建的四因子结构,数据对模型拟合较好,验证抑郁意象特征四因子模型是合理的,可以作为抑郁情绪判定和测量的依据     

Efficacy of noninvasive modalities of diagnosis of thrombophlebitis

In a blind prospective study of 158 limbs, Doppler ultrasound, pneumoplethysmography, and radionuclide venography (RNV) using 99mTc-MAA were compared to phlebography as methods of detecting thrombophlebitis. All three noninvasive modalities were very insensitive to isolated thrombus below the knee. In patients with extension of thrombus above the knee and isolated thrombus in the deep veins of the upper limb, Doppler ultrasound had a sensitivity of 81% and RNV had a sensitivity of 77%. All of the noninvasive modalities were found to be dependent on venous occlusion. Overall, pneumoplethysmography had a sensitivity of 28% and specificity of 96%, compared with 56% and 91%, respectively, for Doppler ultrasound and 51% and 84% for RNV. Based on these findings, phlebography would still seem to be the modality of choice in the diagnosis of thrombophlebitis.     

多发性肋骨骨折两种处置方式的比较

目的 探讨多发性肋骨骨折治疗的有效方法.方法 按纳入及排除标准筛选34例常规外固定病例（常规组）及31例行肋骨内固定术病例（内固定组）,比较两组的住院时间、疼痛持续时间、呼吸情况,以及肺部感染发生率.结果 两组患者一般资料及合并肺挫伤和胸水情况比较差异无统计学意义;内固定组住院时间、疼痛持续时间、呼吸频率恢复时间、SaO2恢复时间和肺部感染与常规组比较差异有统计学意义（P＜0.05）.常规组肺部感染发生率为26.5％（9/34）,内固定组肺部感染发生率为3.2％ （1/31）,两组比较差异有统计学意义（P＜0.05）.结论 肋骨内固定术优于常规外固定法.     

消妇炎胶囊辅料的合理性实验研究

目的确定消妇炎胶囊的辅料及用量。方法以浸膏粉的吸湿率和流动性为考察指标,对加入淀粉、糊精及微晶纤维素3种不同辅料后制得的颗粒进行考察,优选出最佳辅料后,再对最佳辅料的不同用量进行考察。结果加入辅料后,颗粒的抗吸湿能力和流动性都明显改善,其中加入淀粉后,分别在6、12、24、48、60 h测得的吸湿率为2.01%、4.03%、5.98%、6.66%、7.31%,休止角为34.61°,均小于糊精与微晶纤维素,表明加入淀粉颗粒质量最好;每80 g浸膏粉中分别加入30、45、60 g淀粉,综合判定45 g较好。结论每80 g浸膏粉加入淀粉45 g为辅料用量参数,制得颗粒的抗吸湿能力和流动性均好,可节约成本。     

Variant of quantitative evaluation of the mechanisms of orthostatic response of central hemodynamics

This paper describes an approach that can help clarify mechanisms of central circulation of orthostatic men using a mathematical model and noninvasive methods of examinations. Circulation parameters such as peripheral resistance (PR), arterial compliance (Ca), and ratio of vein compliance (Cv) to the pump coefficient of the heart (beta) were determined by the "partial identification" method of the two-component circulation model with the aid of cardiac output and arterial blood pressure measured by tetrapolar thoracic rheography and tachooscillography. The paper also contains physiological interpretation of the above parameters as related to the upright posture of man. Peripheral resistance in the head-up position characterizes both the degree of arterial vasoconstriction and the state of the so-called muscle pump. Blood displacement to the lower body results in an increase of the ratio Cv . beta. The orthostatic reaction of circulation of 28 healthy male subjects was investigated. Blood pooling in the lower body, with venous and cardiac reactions being manifest, led to the fall of arterial pressure and cardiac output to 67% when compared with the pretest level. The change in the properties of resistance vessels (Ca and PR) accelerated the recovery of the arterial pressure value.     

过夜佩戴角膜塑形镜中心偏离的原因分析

目的探讨实验法验配角膜塑形镜过夜佩戴后发生光学区中心偏离的原因,为提高验配成功率提供依据。方法应用Tomy-4角膜地形图仪定量分析52例（104只眼）近视眼佩戴角膜塑形镜后1个月、3个月、6个月时偏中心的距离,分析偏中心距离与佩戴前近视屈光度（SPH）、角膜平坦曲率（fiatK）、角膜表面非对称指数（SAI）、角膜表面规则指数（SRI）等参数的关系。结果戴镜1个月、3个月、6月时,偏中心距离分别为（0．465±0．260）mm、（0．452±0．296）mm、（0．471±0．338）mm。戴镜后1个月、3个月、6月时偏中心距离0．5～1．0mm者比例分别为27．88％、26．92％、24．04％．偏中心距离≥1．0ram者比例分别为2．88％、4．81％、4．81％。戴镜1个月、3个月、6个月时左、右眼镜片中心均向颞侧偏斜。光学区偏中心距离与戴镜前屈光度、SAI、SRI、fiatK的相关系数,戴镜1个月时分别为rSPH=0．017,tsar=0．008,rSRI=0．050,rK=0．012;戴镜3个月时分别为确=0．030,rsa,=0．030,rSRI=0．097,rx=0．006;戴镜6个月时分别为r蜊：O．005,rSd产0．095,rSRI=0．069,rx=0．007（P均大于0．05）。结论戴镜后不同时期镜片中心均向颢侧偏斜,镜片偏中心距离与佩戴时间、矫正前近视屈光度、角膜平坦K、SRI、SAI等均无明显相关性．镜片偏中心可能与角膜自然生理形态有关。加强佩戴后的随访．是提高验配成功率的关键．     

Maintenance of certification: current attitudes of members of the American Society of Neuroradiology

BACKGROUND AND PURPOSE: The maintenance of certification (MOC) process has begun in radiology, and many physicians will be affected by it. We sought to assess the compliance with and knowledge of the MOC steps by American Society of Neuroradiology (ASNR) members.MATERIALS AND METHODS: An on-line survey was distributed via e-mail to the members of the ASNR for whom e-mail addresses were available. The survey addressed 3 components of the MOC currently implemented: 1) MOC cognitive examinations, 2) self-assessment modules (SAMs), and 3) continuing medical education (CME) credits.RESULTS: The response rate was 1020/2662 (38.3%). Of those responding, 11% stated that they either do not support the MOC examination (8%) or were unaware of it (3%), 21.4% of respondents have completed an SAM module, but >30% were unaware that they had to complete SAMs or did not know where they were offered. Many members will receive most of their 25 required CME hours for 2007 from sources besides the ASNR annual meeting. Of the small proportion of respondents who made comments (247/1020, 24.2%), those about the MOC process were favorable in 6.1% (15/247), unfavorable in 46.6% (115/247), and neutral in 47.4% (117/247).CONCLUSION: The MOC process remains poorly understood, with limited compliance. The radiology societies should spend additional effort publicizing the requirements and offering support and products aimed at allowing their members to achieve compliance in a reasonable cost-effective fashion.

The goal of certifying the subspecialty of neuroradiology largely began to be implemented in 1995 with the development of the Certificate of Added Qualification (CAQ) in neuroradiology. Initially, there was a period of grandfathering, whereby individuals whose practice was predominantly neuroradiology but who had never been fellowship-trained were allowed to sit for the neuroradiology CAQ. From a political standpoint, this certification was thought to be an opportunity to establish credentials independent of senior membership in the American Society of Neuroradiology (ASNR) and also to bolster the preeminence of the subspecialists in neuroradiology.The success of the CAQ process remains debatable. However, other forces entered this subspecialty certification initiative largely as a result of the report on errors in medicine of the Institute of Medicine, which led to a critical look at physicians’ maintenance of competence.^1,2 The American Board of Medical Specialties (ABMS) subsequently began to demand that certification be time-limited and that maintenance of certification (MOC) include other requirements besides simply passing a cognitive test.³ The processes of self-assessment, continuing medical education (CME), and practice improvement measures were introduced along with the cognitive test as a means of addressing the core competencies in physician quality. The ABMS, therefore, proposed a program consisting of 4 components: 1) professional standing, 2) lifelong learning and self-assessment, 3) cognitive expertise, and 4) practice performance improvement.⁴ Incorporated into these paradigms were the previously invoked 6 core competencies (medical knowledge, patient care, interpersonal skill, professionalism, practice-based learning and self-improvement, and systems-based practice), which were determined to be key elements to continuous quality improvement. These 6 competencies were previously implemented in trainee evaluations and are now being applied to practicing physicians.⁴ The American Board of Radiology (ABR) reflected the ABMS guidelines by requiring recertification testing at 10-year intervals, promoting the development of self-assessment modules (SAMs), developing requirements of 25 CME hours on average per year for 10 years, and initiating practice quality–improvement initiatives.³Anecdotal ASNR member responses to the directives of the ABR that were reported to the ASNR executive committee ranged from anger at the imposition to confusion with the implementation of the MOC process. Because the 1995 and 1996 CAQ (now renamed “Subspecialty Certification”) classes came due in 2005 and 2006, 10 years later, there has been a scramble to understand the process of maintaining one’s certification. The ASNR, in an effort to better understand the attitudes about and compliance with the MOC requirements, developed a survey that was distributed to its membership regarding the process. These data will be used to develop programs to serve its members’ needs. The purpose of this article is to present the results of that survey, to extend the education process about the MOC to its members, and to propose steps to be taken by the society to enhance the adherence to the MOC process by the rank and file.     

Results of sociological interview of physicians of military-medical committees

Was effectuated an interview of 95 physicians of regional military-medical committees of Kirovskaya area. For the question, whether military-medical expertise (MME) was given in IHE, affirmative answer gave 10.9% of respondents. A rather low (16.4%) was percent of physicians, got education in MME during postgraduate courses. Analyze has shown that nowdays the education of physicians on the topic of MME is effectuated predominantly in the course of work, conversance of judicial consequences of expertise is insufficient. It is found that physicians underestimate value of MME and don't perceive it as a self direction.