经腹联合经阴道彩色多普勒超声对子宫肌瘤的诊断价值

目的 探讨经腹联合经阴道彩色多普勒超声对子宫肌瘤的诊断与鉴别诊断价值.方法 回顾性分析自2008年1月～2014年3月间,经我院术前超声诊断的210例子宫肌瘤患者,经手术与病理证实.结果 经手术病理符合193例,符合率91.9％,误诊17例,误诊率8.09％;其中,误诊为子宫腺肌瘤7例,卵巢肿瘤10例.210例中,我们选取均行经腹与经阴道检查的135例进行对照,结果显示单纯经阴道检查符合率为96.29％（5/135）,单纯经腹检查符合率91.11％（12/135）.两者联合应用可明显提高其诊断符合率.结论 超声是子宫肌瘤首选的检查方法,彩色多普勒经腹联合经阴道超声检查可明显提高诊断准确率.     

经阴道彩色多普勒超声对子宫肌瘤的诊断分析

目的:探讨经阴道彩色多普勒超声子宫肌瘤的声像图特征.方法:对过去3年来经阴道彩色多普勒超声诊断为子宫肌瘤已手术证实的277例作回顾性分析.结果:251例为肌间及浆膜下肌瘤,子宫黏膜下肌瘤14例,经阴道超声诊断不符12例.结论:子宫肌瘤的部位、时期与其临床表现及声像图特征相对应.经阴道彩色多普勒超声对子宫肌瘤诊断水平明显提高.     

超声引导下射频消融治疗子宫肌瘤疗效分析

目的：采用超声引导下射频消融治疗子宫肌瘤。探讨微创技术治疗子宫肌瘤的临床效果。方法：对自愿接受射频消融自凝刀治疗的60例子宫肌瘤患者，其中粘膜下肌瘤9例，壁间肌瘤51例，在超声引导下将自凝刀经阴道置入肌瘤进行射频消融治疗。结果：治疗后随访3、6个月，瘤体缩小率100％。9例粘膜下肌瘤患者术后月经恢复正常；26例擘间肌瘤经节增多者中．术后3、6个月经节恢复正常者达83．3％、95．4％。结论：射频消融自凝刀治疗子宫肌瘤是一种微创并保留子宫的好方法，方法简单、安全、易推广。     

三种影像学检查对子宫肌瘤的诊断价值分析

目的探讨3种影像检查对子宫肌瘤的诊断价值。方法对经彩超、CT、MRI检查的影像资料与临床证实的156例子宫肌瘤进行系统分析，并对其影像检查方法作比较。结果（1）12例小至5mm的子宫肌瘤B超及CT均未发现，只有MRI才发现并作出诊断，其余病例B超、CT、及MRI诊断均符合临床。（2）156例子宫肌瘤患者中只有MRI提示：粘膜下肌瘤86例（占55．1％其中多发14例），壁内肌瘤42例（占26．9％，其中多发34例），浆膜下肌瘤28例（占18％其中多发12例），彩超及CT均未能作定位诊断。结论（1）超声检查能发现大多数子宫肌瘤，但不能进行准确定住，也难识别小肌瘤，作为子宫肌瘤的筛查方法，应为首选检查方法。（2）CT检查除钙化外，缺乏特征性表现。一般不用于子宫肌瘤的检查。（3）MRI能检出小至5mm的子宫肌瘤，易于分辨粘膜下、肌层内、浆膜下的子宫肌瘤。是发现和诊断子宫肌瘤的最敏感方法。     

经阴道腔内超声结合腹部超声对异位妊娠诊断的诊断价值

目的：探讨经阴道腔内超声结合腹部超声对异位妊娠的诊断价值。方法：回顾分析本院自2005～2011年经手术治疗并经病理证实的57例异位妊娠患者的术前经阴道超声结合腹部超声诊断资料及临床相关资料。结果：经阴道超声结合腹部超声对异位妊娠的诊断准确率为93％,显著高于腹部超声诊断。结论：经阴道超声能够准确诊断宫外孕,为临床发现病变,选择治疗方案提供重要依据。     

经阴道子宫肌瘤剔除术的临床研究

目的 探讨经阴道子宫肌瘤剔除的可行性及优越性。方法 对58例要求保留子宫的子宫肌瘤患者在全麻或硬膜外麻醉下实施经阴道子宫肌瘤剔除术。观察手术适应证、术中并发症、手术时间、术中出血量、术后病率、并发症及住院时间等。结果 57例(98．3％)手术成功,无中转开腹。平均手术时间：48．16min;平均出血量：70．58ml;术后病率：3．4％(2例)。术后并发症：1．7％(1例),系子宫切口感染。平均体温正常时间：1．8天。平均排气时间：1．3天。平均住院时间：4．9天。术后随诊：4例肌瘤复发,复发率为7．0％。结论 经阴道子宫肌瘤剔除术对腹腔骚扰小,术后恢复较快,腹壁不留疤痕。     

经腹部及经阴道超声在子宫黏膜下肌瘤诊断中的应用分析

目的探讨经腹部超声及经阴道超声在子宫黏膜下肌瘤中的诊断价值。方法对76例子宫黏膜下肌瘤(3cm)患者中,分别接受经腹部超声检查和经阴道超声检查,回顾性分析全部患者临床检查结果。结果经腹部超声检出肌瘤直径0.8~3.0cm共54例,诊断符合率为71.05%,误诊率为9.21%,漏诊率为19.74%,经阴道超声检出肌瘤直径0.5~3.0cm共69例,诊断符合率为90.79%,误诊率为3.95%,漏诊率为5.26%,两种诊断方式检出符合率差异具有统计学意义;对子宫黏膜下肌瘤直径0~1cm、1~2cm、2~3cm进行检查,经阴道超声和经腹部超声检查结果无明显差异(P0.05)。结论经腹部超声及经阴道超声两者结合起来,可提高诊断准确率,减少误诊漏诊。     

低场MRI与超声对诊断子宫腺肌症的比较

目的探讨低场（0．23T）MRI与超声对子宫腺肌症的诊断价值。方法由手术和病理证实的子宫腺肌症45例和对照组子宫肌瘤36例术前均行超声（经腹、经阴道途径）、MRI检查。比较各种方法的诊断敏感性、特异性、准确性、阳性预测值及阴性预测值。结果MRI柃查对子宫腺肌症的诊断敏感性为95．56％,特异性为100％,准确性97．53％,阳性预测值为100．00％,阴性预测值为97．74;经阴道超声分别为80．0％、88．89％、83．95％、90．00％、78．05％;经腹部超声分别为68．89％、83．33％、75.31％、83．78％、68．18％。结论对于子宫腺肌症的诊断,低场MRI为最有价值的检查手段,而经阴道超声又优于经腹部超声。     

超声造影对子宫肌瘤与腺肌瘤的鉴别诊断价值分析

目的：探讨超声造影在子宫肌瘤和腺肌瘤鉴别诊断中的价值。方法：采用新型超声造影剂结合超声造影技术,观察子宫局灶性病变73例的血流灌注特点,对子宫肌瘤和腺肌瘤进行鉴别诊断,并与常规超声及术后病理结果进行对照验证。结果：采用超声造影检查方法对子宫内病灶检出数目较常规超声显著增多,并且提高了病变诊断的准确性。结论：超声造影能显示子宫肌瘤与腺肌瘤各自不同的血流灌注方式,是术前较理想的鉴别诊断手段。     

经阴道彩色多普勒超声宫腔造影诊断宫内病变56例分析

目的探讨经阴道彩色多普勒超声宫腔造影技术诊断宫内病变的价值。方法r对宫腔镜治疗或手术前经阴道彩色多普勒超声宫腔造影诊断的宫内病变患者56例的声像学特点进行分析,并与宫腔镜治疗、手术后的病理结果进行对比。结果宫腔造影诊断子宫粘膜下肌瘤25例、子宫内膜息肉12例、子宫内膜增生过长7例、宫腔粘连9例,诊断符合病例53例,准确率为94．6％。各种不同宫内病变均具有特征性的声像学特点。结论经阴道彩色多普勒超声宫腔造影对宫内病变具有较高的诊断准确性,对大多数病例均可于宫腔镜治疗或手术前做出定性、定位诊断及鉴别诊断,可为临床制定最佳治疗方案提供有价值的诊断信息。     

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.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

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.     

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.     

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.     

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.