飞行学员视网膜静脉周围炎一例

一、临床资料 男性飞行学员,22岁,飞行时间约110 h.因右眼视物不清4 d于2002年10月31日入院.患者于2002年10月28日无诱因自觉右眼视物模糊不清,眼前有暗影及絮状物飘动,视物变暗,无眼红、眼痛及视物变形.曾在学院医院用"眼药水"点治疗,效果欠佳.入院查体:一般情况良好.视力:右眼0.2、近视力0.3;左眼1.5、近视力1.0.双外眼及前节无异常.扩瞳后见:双眼视盘边界清,色正常.     

飞行员白塞病一例

一、临床资料患者,男性,32岁,已婚,初教-6飞行员,飞行时间2500 h,因左眼反复疼痛,视力连续下降5年,疼痛再次发作1周后于2010年2月8日入院.该飞行员于5年前无明显诱因反复出现左眼疼痛,视力下降,多次住我院,诊断为"左眼虹膜睫状体炎",治愈后飞行合格,耐力尚可.1周前再次出现上述症状入我科.     

眼底镜-8D窥清眼底视力屈光正常放飞一例

一、临床资料飞行学员,男性,年龄20岁。1996年8月入校。9月初空军体检组来校复查。常规眼底检查发现,用眼底镜常规屈光度窥不清,调至-8D时方能窥清。当时有4个医生会诊结果相同,断定有屈光不正。根据眼底镜屈光度初步判定大约有300度左右的近视度,属于招飞超标范围。查视力右眼1.0 2,左眼1.0 3。查原始体检档案,屈光度右-1.2,左 0.25,作者单位:071051　保定市,中国人民解放军86004部队卫生处都在正常标准内。复查结论:观察待定。1997年8月年度体检,双眼视力都在1.0以上。仍用眼底镜-8D才能窥清眼底。1998年3月转院体检,右眼视力1.0 3,左眼1…     

飞行员准分子激光原位角膜磨削术后对比敏感度降低一例

一、临床资料 患者，男性，35岁，外籍飞行员，飞行时间5100h。准分子激光原位角膜磨削术（laser in situ keratomileusis，I。ASIK）后1年，至我中心行年度体检。主诉偶有阴天视物不清。眼部检查：远视力1.0／1．0，近视力1．0／1．0，角膜清，周边见环形手术切痕，前房清深，晶体透明，后段（一）。     

丝裂霉素C致低眼压性黄斑病变1例

患者 :男 ,19岁 ,1998年 3月因双眼慢性开角性青光眼在我院行双眼小梁切除加丝裂霉素C探试术。术后两周 ,双眼视力均为 1 0 ,眼压 ,右眼5mmHg,左眼 4mmHg,术后一个月双眼视力逐渐下降 ,99年 1月再次入院。眼部检查 :视力 :右眼 0 .3、左眼 0 .3、双眼结膜滤过泡弥漫隆起 ,色苍白。眼前段未见异常 ,眼底见黄斑区视网膜脉络膜皱褶 ,中心凹光反射消失 ,眼压 :右眼 3mmHg,左眼 3mmHg,印象 :①双眼丝裂霉素C反应性低眼压。②黄斑皱褶。治疗 :双眼分别行手术治疗。手术方法 :①术眼球周及表面麻醉。②结膜滤过泡上缘切口做结膜瓣 ,用 1/ 4层厚…     

飞行人员二尖瓣脱垂伴关闭不全术后放飞一例

一、临床资料 患者,男性,39岁,运7领航员,飞行总时间3000 h. 2007年12月因感冒后心悸、胸闷就诊于体系医院,行心脏超声检查发现"二尖瓣脱垂伴关闭不全,二尖瓣中量反流",经治疗后症状消失,结论飞行合格.此后正常参加飞行,每年大体检心脏超声均提示"二尖瓣脱垂伴关闭不全及少、中量反流".2010年12月在体系医院行心脏超声检查提示"二尖瓣脱垂伴关闭不全,可疑后瓣腱索断裂,大量反流",结论:暂时飞行不合格,转我院进一步治疗.查体:听诊闻及心尖部全收缩期吹风样杂音(3/6).超声结果提示"二尖瓣脱垂伴关闭不全,二尖瓣大量反流".于2012年2月22日转解放军总医院行全机器人二尖瓣成形术,手术过程顺利.术后转回我院康复治疗,1周后出院,结论:暂时飞行不合格.     

歼击机飞行员准分子激光角膜屈光手术后放飞一例并文献复习

目的 探讨飞行员角膜屈光手术治疗的飞行适应性及航空医学的鉴定原则.方法 分析1例歼轰-7飞行员双眼近视的临床诊断、治疗过程及医学鉴定情况,复习相关文献.结果 本例飞行员诊断为近视性屈光不正2年,保守治疗无效.本人要求手术治疗.眼科检查未见手术禁忌证,经过准分子激光上皮下角膜磨削术治疗,术后常规局部抗炎、促进角膜伤口愈合等药物治疗约1个半月,3个月后复查视功能（包括视力、立体视觉、对比敏感度）恢复正常;双眼角膜伤口愈合良好,电脑验光屈光度稳定;角膜地形图示切削区居中.经低压舱模拟航空低压缺氧环境检查,视功能稳定,给予特许飞行合格.术后正常参加双座机飞行40 h. 结论 军事飞行员近视角膜屈光手术治疗后,角膜伤口愈合良好,视功能恢复正常者可以考虑放飞.飞行适应性评价除常规定期视功能、屈光度、角膜等检查外,应进行对比敏感度、眩光等与飞行环境相关的特殊视功能检测.准分子激光角膜屈光手术是解决军事飞行员近视的有效方法.     

飞行员胰头导管内乳头状黏液性肿瘤一例

一、临床资料 患者,男性,38岁,轰6飞行员,飞行时间3000 h.患者于2011年4月中旬饱餐后出现腹部饱胀不适,无发热,无明显腹痛、恶心、呕吐,无黑便及体重下降.2011年4月20日来医院就诊,入院查体:一般情况良好,上腹部轻度压痛,余无阳性体征.心电图、腹部超声均正常,腹部核磁未见异常.化验:胰淀粉酶升高,10 000 U/L.逆行胰胆管造影提示胰腺占位性病变.于4月26日行手术切除,肿物大小0.5 cm×0.7cm,病理示低度恶性胰头导管内乳头状黏液性肿瘤.术后未行放疗及化疗,结论:暂时飞行不合格.术后每3个月复查1次,未见异常,仍在随访中.     

飞行员多形性胶质母细胞瘤1例

1 病例报告 患者为男性,35岁,歼击机飞行员,飞行时间1250h。于1998年7月24日无明显诱因出现双眼视力模糊,先后被送当地县医院、空军医院做眼科检查,无异常发现,双眼视力左眼:1.2,右眼:1.2。于1998年8月1日出现头晕,航医遂怀疑脑部病变,报上级卫勤领导,建议做头部CT检查。8月3日脑CT结果示:神经胶质瘤。术后病理标本组织学分类为多形性胶质母细胞瘤。     

直升机飞行员慢性鼻窦炎伴鼻息肉鼻内镜手术治疗二例

一、临床资料 例1,患者,男性,39岁,直-9飞行员,总飞行时间3200 h.双侧鼻塞10年,加重伴头痛1年.自诉嗅觉减退,飞行耐力不良.曾于2009年入院治疗,予以全身应用抗生素,鼻腔应用鼻内激素及鼻腔冲洗等治疗.症状缓解后出院.近1年患者症状加重,伴头痛头晕等.2012年5月再次入院,鼻腔检查见双侧鼻腔中鼻道有半透明白色肿物.鼻窦CT检查提示:双侧筛窦、双侧上颌窦及额窦密度增高,额窦黏膜浑浊肿胀(图1,封二).全麻行鼻内镜下双侧鼻息肉切除,双侧筛窦开放、双侧上颌窦开放,Draf Ⅰ型(额隐窝切除)额窦开放术.术中平均动脉压控制在60～70 mm Hg(1 mmHg=0.133 kPa);应用电动吸切钻切除息肉及鼻窦内病变.     

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.