外伤性小脑幕裂孔下疝的CT表现

目的认识外伤性小脑幕裂孔下疝的CT征象,并探讨其对判定第四脑室继发性缩窄的意义。方法临床上出现双侧瞳孔散大的103例重型颅脑损伤病例均经CT扫描,对所有病例的CT表现进行了回顾性分析。结果103例均有第四脑室改变。第四脑室变化按缩窄程度分为闭塞、重度狭窄、轻度狭窄3组,其中,第四脑室闭塞型62例,重度狭窄型28例,轻度狭窄型13例。第四脑室伴有变形移位共36例,68例中脑和脑桥有明显变形、移位或伴有旋转,脑干界面消失35例。脑桥小脑角池双侧闭塞87例、一侧扩大16例。结论第四脑室闭塞或狭窄是CT诊断小脑幕裂孔下疝的可靠征象。     

小脑幕切迹下疝的CT诊断

目的 确定小脑幕切迹下疝的CT表现。方法 回顾性分析经临床证实的68例小脑幕切迹下疝的CT表现。结果 CT显示因脑组织移位及中脑本身受压移位导致单侧或双侧鞍上池改变60例、脚间池改变56例、环池改变52例、四叠体池改变50例。多数为前疝和半环疝。均有脑干的移位、旋转及变形改变，可伴有四脑室的变窄、闭塞及幕上占位病变的一系列改变。结论 参考原发病变的占位程度，脑干与脑干周围脑池两CT改变均存在并结合起来分析，可作出正确诊断。     

小脑幕硬膜下血肿并小脑幕切迹下疝的CT分析

目的：分析小脑幕硬膜下血肿并小脑幕切迹下疝CT表现，探讨其形成机制，提高对该病的早期CT诊断水平。材料和方法：收集资料完整的小脑幕硬膜下血肿并小脑幕切迹下疝27例，并分析CT表现。结果：小脑幕硬膜下血肿主要CT表现为小脑幕区的条片状高密度影边界清楚或模糊；小脑幕切迹下疝主要CT表现为幕上脑组织疝出、脑池变窄或闭塞、脑干受压移位及中线移位。结论：采用适当的CT扫描方法，可准确诊断小脑幕硬膜下血肿并小脑幕切迹下疝。     

小脑幕切迹下疝的螺旋CT诊断价值

目的:探讨小脑幕切迹下疝的螺旋CT扫描行MPR(多平面重建)像观察的诊断价值。方法:分析37例小脑幕切迹下疝患者的螺旋CT扫描临床资料。结果:与斜坡垂直的冠状MPR图像可直观显示上下关系改变,显示幕上脑组织挤入幕下2~4 mm 7例,4~6 mm 18例,>6 mm 12例;病变位于脑干侧前方3例,侧方25例,侧后方9例。脑干不同程度受压变形、移位。部分可见同侧邻近及以下环池的扩大(22例)。结论:根据螺旋CT扫描横断位提示,结合MPR图像对直接病理改变征象的观察分析,在小脑幕切迹下疝的诊断中具有重要的意义和价值,应作为诊断依据。     

Dandy－Walker综合征的CT诊断（附七例报告）

笔者报告７例Ｄａｎｄｙ－Ｗａｌｋｅｒ综合征，均经ＣＴ检查后确诊，其中６例手术证实，２例有手术后ＣＴ复查。Ｄａｎｄｙ－Ｗａｌｋｅｒ综合征主要病理基础是第四脑室顶盖部的发育异常。此征的ＣＴ表现有惊人的相似性，它们是：（１）小脑蚓部缺失；（２）第四脑室从缺失的蚓部向后上方扩张，可呈羹袋状、扇形、三角形、（３）小脑半球向前外方分离退缩，两侧可不对称；（４）天幕上抬，窦汇及债窦升高，后颅凹扩大；（５）幕上脑室系统一般呈对称性扩张。笔者还报告了第四脑室从后囱门疝出和脑室内出血极为罕见的ＣＴ表现。     

早期颞叶型小脑幕孔疝的CT检查

早期颞叶型小脑幕孔疝的ＣＴ检查巩若箴周存升柳澄王涛材料和方法１．研究对象：自１９９３年１月至１９９５年６月间，应用ＣＴ对１０２例无瞳孔改变的单侧颅内压明显增高病人进行多种扫描方式检查。年龄１９～８７岁；男５７例，女４５例；发现颞叶组织疝至幕下４８例（...     

外伤性急性硬膜下血肿CT征象与临床预后关系

目的：研究急性硬膜下血肿ＣＴ表现与临床预后关系。方法：对１３１例急性硬膜下血肿ＣＴ表现中线移位、基底池压闭及脑肿胀分别评分，结合临床病情，研究预后关系，结果：中线移位和基底池压闭明显，其脑损伤程度严重，中红移位≥１０ｍｍ，死亡率达８２．５％，基底池消失评分≥１分，死亡率８８．７％，伴有弥漫性脑肿胀，死亡率８０．８％，结论：急性硬膜下血肿，中线移位和脑池受压的和蔼及有否弥漫性脑肿胀，对判断损伤程度及预后有重大意义。     

经股浅动脉入路药盒植入术并发症及处理

目的：介绍经股浅动脉入路药盒植入术并发症相应处理方法。材料与方法：６０便,男５３例,女７例,平均年龄４９岁。无栓塞适应症的原发性肝癌３６例,转移性肝癌１４例,其他晚期肿瘤１０便。经经股浅动脉植入药盒。结果：随时间最长１８月,药盒导管移位５例（８．３％）,靶血管闭塞２例（３．３％）,药盒导管闭塞３例（５．５％）。伤口延迟愈合１例（１．６％）。导管移位镁采用介入技术调整导管至腹主词汇经盒导管闭塞溶栓再     

儿童脑性偏瘫的CT诊断研究

目的：研究儿童脑性偏瘫的ＣＴ形态学改变。材料和方法：对７２例临床诊断为脑性偏瘫的患儿进行ＣＴ检查，并对其ＣＴ表现进行回顾性分析。结果：７２例中，ＣＴ异常６３例，ＣＴ阳性率为８７．５％。ＣＴ表现可分成五种不同的类型：（１）脑发育畸形（１１．１％），反映出生前大脑的发育障碍；（２）脑室周萎缩（３８．９％），与早产儿缺血缺氧性脑损害有关；（３）皮质或皮质下软化（２２．２％）；（４）混合型（１５．３％）；（５）正常（１２．５％）。结论：ＣＴ表现及分类反映了不同脑发育阶段脑损害的病理特点，ＣＴ形态学研究对脑性偏瘫的病因学诊断及预后判断有重要价值。     

外伤性急性硬膜下血肿CT征象变化及其临床意义(附32例报告)

目的：研究急性硬膜下血肿ＣＴ表现与临床预后关系。方法：对３２例急性硬膜下血肿ＣＴ表现中线移位、基底池压闭及脑肿胀分别评分，结合临床病情（ＧＣＳ），研究预后相关性关系。结果：中线移位和基底池压闭明显者，其脑损伤程度严重。中线移位和基底池压闭与脑损伤积度均呈显著负相关（分别ｒ＝－０．７４４７，ｒ＝－０．６９２４，Ｐ＜０．０１），伴有急性弥漫性脑肿胀者，ＧＣＳ均在８分以下，属重型脑损伤。中线移位≥９ｍｍ者，死亡率７０．６％，基底池消失评分≥１２分，死亡率７３．３％，伴有弥漫性脑肿胀，死亡率７３．６％。结论：急性硬膜下血肿中线移位和脑池受压的程度及有否弥漫性脑肿胀对判断脑损伤程度及预后有意义     

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,     

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.     

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.     

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.