动态静脉尿路造影术在上尿路疾病诊断中的价值

目的：比较动态静脉尿路造影术(DIVU)与静脉尿路造影(IVU)在上尿路疾病检查中的应用,探讨DIVU对各种上尿路疾病的诊断价值。方法：158例可疑上尿路病变患行DIVU检查,120例疑上尿路病变患行IVU检查作为对照。对上尿路各部位的显影清晰度进行评分,比较2种检查方法对上尿路各段的显示能力。按病种分类,评价DIVU对各种上尿路疾病的诊断价值,并与IVU比较。结果：正常组DIVU和IVU在显示肾盏、肾孟和上、中段输尿管方面,差异无显性意义。对下段输尿管的显示方面DIVU优于IVU,差异有显性意义(P=0．000)。异常组DIVu对肾盏显示优于IVU,差异有显性意义(P=0．001);对上、中、下输尿管的显示优于IVU,差异有显性意义(P=0．000);对于肾孟的显影,DIVU评分高于IVU,但二差异无显性意义。DIVU对重复肾输尿管畸形、上尿路积水的诊断符合率均为100％,高于IVU。结论：DIVU可提高上尿路疾病的诊断率。如疑有上尿路畸形、积水等疾病,可首选DIVU检查。     

动态静脉尿路造影及MSCT尿路成像联合应用对泌尿系先天性畸形的诊断价值

目的:探讨动态静脉尿路造影(DIVU)及MSCT尿路成像(MSCTU)对泌尿系先天性畸形的诊断价值。方法:46例患者行DIVU检查,对尿路显影不良或需进一步明确诊断的12例再行MSCTU。结果:DIVU及DIVU后MSCTU联合诊断泌尿系先天性畸形46例,其中肾盂输尿管交界处狭窄12例,肾盂与输尿管重复畸形15例,输尿管囊肿7例,腔静脉后输尿管3例,肾融合畸形3例,肾发育不全2例,单侧肾缺如1例,异位肾1例,巨输尿管1例,膀胱憩室1例。结论:DIVU及MSCTU联合应用可明显提高先天性泌尿系畸形的显示率、诊断率。     

螺旋CT尿路成像在小儿上尿路疾病诊断中的价值

目的 比较螺旋CTN水路成像（CTU）与静脉尿路造影（IVU），磁共振尿路成像（RU）在小儿上尿路疾病检查中的应用，探讨CTU对各种上尿路外科疾病的诊断价值。方法 62例疑上尿路病变儿童均做了CTU检查，31例同时行IVU检查，13例同时行MRU检查作为对照。对上尿路各部位的显影清晰度进行了评分，比较3种检查方法对上尿路各段的显示能力。按病种分类，评价CTU对儿童各种上尿路外科疾病的诊断价值，并与IVU，MRU比较。结果 在尿路形态正常组，CTU和IVU对上尿路各段的显影统计学上差异无显著性意义，且均好于MRU（P＜0．01）。在异常组，CTU对肾盏，肾盂的显示优于IVU和MRU（P＜0．01）；上段输尿管的显影，三者间统计学上差异无显著性意义；中，下段输尿管的显示，CTU，MRU均高于IVU，且统计学上差异有显著性意义（P＜0．01）。CTU对重复肾输尿管畸形，肾发育不良的诊断符合率均为100％。高于IVU和RU;峄上尿路积水的诊断符合率，CTU，MRU均为100％，高于IVU（62．5％）。结论 CTU为诊断小儿上尿路外科疾病提供了确切依据，解决了诊断中的难题，提高了诊断率。如疑有肾发育不良，重复肾输尿管畸，肾输尿管重度损伤等上尿路外科疾病，可首选CTU检查。     

螺旋CT尿路造影和静脉尿路造影诊断泌尿系梗阻性的临床分析

目的探讨螺旋CT尿路造影(MSCTU)和静脉尿路造影(IVP)技术在泌尿系梗阻性疾病诊断中的效果。方法对40例泌尿系梗阻性疾病患者,均接受螺旋CT尿路造影和静脉尿路造影技术检查。结果 40例患者顺利完成检查,与病理结果比较,螺旋CT尿路造影检出25例泌尿系结石、5例肿瘤、6例尿路狭窄、4例输尿管畸形,诊断符合率为100.00%,静脉尿路造影检出19例泌尿系结石,1例肿瘤,1例尿路狭窄,4例输尿管畸形,诊断符合率为62.50%;螺旋CT尿路造影对梗阻性积水显示准确率100.00%,较对照组的80.00%显著提高,差异存在统计学意义(P0.05)。结论螺旋CT尿路造影诊断效果优于静脉尿路造影技术,从定位、定性不同角度观察病变部位及周边情况。     

静脉尿路造影输尿管显影不良延迟螺旋CT诊断价值

腹部平片并静脉尿路造影(IVU)是评价输尿管病变的基本方法，对肾功能良好者效果较好，但多数患者由于输尿管不完全或完全梗阻而致肾排泄功能不良，输尿管不能显影，对其病变的诊断带来困难。笔者搜集我院2001年12月至2004年10月有完整资料的输尿管病变12例，静脉尿路造影后不显影输尿管延迟螺旋CT扫描提供了很大的临床价值。     

静脉尿路造影联合CT平扫对上尿路病变的诊断价值

目的评价静脉尿路造影(IVU)后的螺旋CT平扫(IVU+CT)对上尿路疾病的诊断价值。资料与方法195例患者因临床怀疑上尿路疾病、超声(US)未能确诊而行IVU检查,从中实时选出IVU不能作明确诊断的患者作为研究对象,共71例。其中65例行立即或延迟腹部CT平扫,将原始资料传递至影像工作站做后处理,获得多平面重组(MPR)、最大密度投影(MIP)、曲面重组(CPR)和容积再现(VR)图像。比较IVU+CT与单纯IVU对上尿路病变的诊断能力。结果IVU+CT诊断正确62例,诊断符合率达95.4%。同期IVU检查的195例中确诊者124例(63.6%),两者有统计学意义(χ2=29.4,P<0.05)。IVU+CT对上尿路结石的敏感性、特异性分别为97.6%、91.3%,对上尿路病变定性诊断的敏感性、特异性分别为95.2%、100%;与此相对应,IVU的结果分别为59.0%、89.7%、70.8%和43.1%。结论IVU+CT对上尿路病变的定位、定性诊断能提供更多的诊断信息,且相对省时省力,是对IVU的重要补充。     

延时CT尿路造影对儿童IVU不显影病变的诊断价值

目的:探讨延时尿路CT平扫对儿童IVU不显影病变的诊断价值。方法:2012年6月-2013年5月因泌尿系统病变行IVU检查的单侧或双侧肾脏不显影的31例患儿,行延时120min尿路CT平扫检查,检查结果与手术结果对照。结果:发现肾脏不显影的患儿31例(36侧),肾实质病变16.7%,肾盂病变19.4%,输尿管病变30.6%,反流病变33.3%,IVU/CT结果均与手术病理相符合。延时尿路CT平扫显示肾实质厚度无明显变化2.8%,肾实质变薄66.7%,肾实质菲薄30.6%;肾实质可见较明显强化16.7%,可见强化58.3%,未见明显强化25.0%。结论:延时尿路CT平扫对儿童IVU不显影病变临床诊断及肾功能评估提供依据。     

经皮肾盂穿刺造影加逆行尿路造影诊断输尿管梗阻

目的探讨超声引导下经皮肾盂穿刺造影加上逆行尿路造影诊断输尿管梗阻的临床诊断价值。资料与方法 56例患者均经超声诊断为肾积水、输尿管积水,行静脉肾盂造影患侧肾、输尿管不显影,行逆行尿路插管造影剂不能充盈梗阻近端输尿管,后均行经皮肾盂穿刺造影加逆行尿路造影。结果 56例均经手术证实,其中13例肾盂输尿管交界处梗阻,11例输尿管上段梗阻,23例输尿管中段梗阻,9例输尿管下段梗阻。经皮肾盂穿刺造影加逆行尿路造影的诊断符合率100%。结论经皮肾盂穿刺造影加逆行尿路造影可清楚的显示肾盂和全段输尿管梗阻部位,弥补了静脉肾盂造影和逆行尿路造影的局限性。     

影像学检查(尿路造影、CT、MRI)对上尿路梗阻性疾病的诊断价值

目的分析评价影像学检查(尿路造影、CT、MRI)对上尿路梗阻性疾病的诊断价值。方法搜集116例经尿路造影诊断并经手术、病理或膀胱镜、输尿管镜检证实为上尿路梗阻疾病的病例,进行了相关研究。结果尿路造影对上尿路梗阻疾病的梗阻存在、定位诊断的灵敏度为100%(127/127)、97.7%(126/129),对良恶性梗阻鉴别诊断的灵敏度、准确性均为95.3%(121/127),定性诊断的灵敏度、准确性分别为85%(108/127)、83.7%(108/129),对梗阻与扩张程度判断的灵敏度为97.6%(124/127),均优于螺旋CT和MRI(Ρ<0.025和P<0.05);但对腔壁和尿路外的病变方面,SCT、MRI则具有明显优势。结论尿路造影是上尿路梗阻性疾病诊断的主导手段,CT、MRI作为一种必要的补充。     

静脉尿路造影检查技术创新

目的通过适当改变体位缩短尿路检查时间,提高静脉尿路造影质量,完善显影。方法对156例静脉尿路造影进行改变体位后,透视下观察点片。结果通过采用改变体位并透视下观察点片,在156例中有67位输尿管显示,效果显著。结论在静脉尿路造影中,通过改变体位适时点片观察,可以补充传统造影检查技术的一些不足,缩短患者检查时间,完善显影,提高诊断质量。     

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.