请分析病变性质

患者 男,8岁.左眼红、痛伴视物不见2周.专科检查:左眼无光感,结膜睫状充血,角膜雾状浑浊,瞳孔圆形,约3 mm,光反射消失;玻璃体混浊,眼底欠清晰,视网膜轻度隆起,眼压48 mmHg(1 mmHg=0.133 kPa);眼球无突出,眼球运动正常.右眼未见异常.实验室检查无特殊.     

乙胺丁醇中毒性视神经病变1例

1 临床资料 患者,男性,36岁,因双眼视物模糊2个月入院.8个月前因"左侧附睾炎"开始口服乙胺丁醇、利福平和异烟肼.眼部检查,双眼矫正视力:右眼 0.2,左眼 0.3.双眼前后节检查未见异常.双侧眼压右眼13 mm Hg,左眼15 mm Hg.视野检查显示双眼中心暗点.图形视觉诱发电位(P-VEP)显示P100峰潜时延长,振幅下降(图1).双眼多焦视网膜电图(mERG):双眼中心凹尖峰值、G环反应振幅正常.     

超声诊断眼猪囊尾蚴一例

患者,男性,36岁。自觉左眼视物模糊,视力明显下降,眼前有漂浮物,伴头痛2月,入院诊治。 眼科检查:左眼视力3.5,眼球无突出及震颤,瞳孔约4mm,对光反射灵敏,角膜及晶状体透明,玻璃体轻度混浊,眼压7.5/9=1.75kPa。眼底检查:视     

原始三叉动脉海绵窦瘘栓塞治疗及并发症和处理一例

患者男,22岁.1年前左侧眉弓跌伤,7个月后无明显诱因出现左眼球突出,伴结膜充血、溢汨.体检显示:右眼裸视力0.5,左眼裸视力0.4;非接触(NCT)眼压计测压:右眼16 mm Hg(1 mm Hg=0.133 kPa);左眼20 mm Hg;眼突出度右眼13 mm,左眼21;mm,左侧结膜充血,眶周可闻及收缩期吹风样杂音.辅助检查:头颅MR检查显示左侧颈内动脉海绵窦段增粗迂曲,眼上静脉明显增粗.动态增强扫描显示左侧海绵窦与颈内动脉交通,海绵窦引流静脉增粗,以左眼上静脉为重(图1).脑血管造影见基底动脉与左颈内动脉之间原始三义动脉(primitive trigeminal aftery,PTA)开放显影,PTA海绵窦段破裂形成PTA-海绵窦瘘(图2,3).治疗     

前房注吸术治愈外伤性前房出血继发青光眼1例

患者男，37岁。因左眼被白块击伤后疼痛伴视力下降2d，于2001年6月8日入院。患者伤后即出现左眼剧烈疼痛，视物模糊，伴畏光流泪。次日感左侧偏头痛，呕吐2次。既往曾有黑便史2年。入院后检查：体温36．4℃，脉搏86／min，呼吸20／min。血压14．0／8．5kPa(1kPa=7．5mmHg)，心肺听诊未见异常，上腹部轻度压痛。     

读片窗

患者 男,74岁.2个月前无明显诱因出现右眼视物模糊,自觉眼胀.近1个月来发现右眼球突出,眼红,视物模糊逐渐加重,伴右侧听力下降,无眼球运动障碍,无复视.体检:右眼外侧触及1 cm×1 cm大小肿块,光滑质软,有压痛.右眼瞳孔直接对光放射及间接对光反射均消失,眼球运动可,右眼外斜15·,眼突度:左12 mm＞-105 mm-＜右17mm.左眼未见明显异常.余无特殊.     

飞行员透明隔囊肿1例

1 临床资料患者,男,28岁,某部飞行教员,共飞行950 h。因空中意识丧失1次于1994年11月2日入院。患者飞行中做俯冲跃升时觉头昏、视物模糊,随即意识丧失,20 s后清醒,并觉胸闷、恶心,呕吐一次为胃内容。返回地面后测心率105次/min,血压16/12 kPa。入院后仍有头晕、头痛,查体未见异常。心电图、超声心动图、脑电图、立位耐力试验、次极量运动试验均正常,脑CT示透明隔囊肿(水平直径1.5 cm)。诊断:①空中晕厥;②透明隔囊肿。经服用刺五加、谷维素、维生素等治疗效果欠     

外伤性眶骨骨折误诊为视神经萎缩1例

1 临床资料 患者,男,26岁,高级教练机飞行教员,飞行时间780h。因右眼及颜面部被汽车撞伤,在当地驻军医院清创缝合。视力右眼0.3,左1.0。头颅CT检查示右侧筛窦内少量积血。对症处理一周,右眼视物模糊、复视及眼前暗影均无明显改善,遂转体系医院。眼科检查:视力右眼0.6,上睑轻度下垂。右眼球轻度内陷,外展上转运动均受限。屈光间质及眼底均正常。再次行     

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病例99病例资料患者,女,70岁,左眼眶内肿物9个月,伴睁眼困难1个月,无视物模糊、眼胀及眼痛,偶有眼红。检查示左眼视力0.8,眼球上转受限,眼眶外上方触一扁平肿物,质韧,活动差,无触痛、头晕、恶心及结膜充血等;体温正常。右眼检查无异常。尿常规RBC(+),血淋巴细胞降低,血沉7mm/h,尿素升高,碱性磷酸酶和血管紧张素转化酶正常。结核菌素试验阴性。胸片未见异常。     

西藏高原首诊眼科颅内血管病变2例

病例1 女,43岁,已婚,藏族,居住地海拔4100 m.主诉：左眼红肿痛伴视物下降1个月余.患者产后1个月余发现左眼红肿疼痛,视物模糊,伴头痛,曾用消炎药（具体不详）,无明显好转,并且左眼肿胀明显加重,故来院就诊.局部检查：视力右眼1.0,左眼0.15,不能矫正.左眼球固定,眼球各方向活动受限,眼球正前方突出,眼球突出度右眼12 mm,左眼18 mm.左上下眼睑红肿,眶压较高,上睑肿胀遮挡角膜,球结膜充血水肿,球结膜水肿脱出于睑裂外部,角膜清,前房正常深浅,房水清,瞳孔约4.0 mm大小,对光反应迟钝.     

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.