二维超声诊断先天性软骨发育不全1例

1．病历简介 患者,女,25岁。孕2产0。曾有自然流产史。超声检查显示：胎儿双顶径9．2cm,颅骨骨板较薄,颅骨间隙扩大（图1）,上肢肱骨长2．5cm（图2）,股骨长3．1cm（图3）,胫骨长2．4cm（图4）,四肢长骨干骺端粗大呈“哑铃”状,羊水深16．6cm（图5）,胸腔狭窄,心胸比例2：3,腹部较膨隆,未见腹水。超声诊断：①晚期妊娠,单活胎（枕左前位）;②胎儿四肢短小,骨骼发育异常;③羊水量过多。     

彩色多普勒超声诊断胎儿致死性侏儒1例

患者女，26岁，孕26^ 周。妇科查体：宫高脐上一指，腹围81．0cm，胎心博动规律。彩色多普勒超声所见：胎儿双顶径6．8cm，头围23．0cm．腹围18．3cm，脊柱排列规整．胎心146次／分．搏动规律。胎儿肱骨长1．6cm．桡骨长1．3cm．股骨长2．0cm，胫骨长1．5cm，四肢骨均粗短而弯曲(图1，2)，超声诊断：①单胎妊娠(Lop)；②胎儿畸形：致死性侏儒。     

超声诊断胎儿腹裂1例

患者22岁，孕1产0，孕7个月余来院检查。超声显示：胎头位于耻骨联合上方，双顶径8．7cm，股骨长6．3cm，羊水深6．6cm，胎心节律规整，颅内及胸腔结构未见异常，脊柱排列整齐，四肢发育良好，肝胆肾及膀胱未见异常，胎儿脐旁处全腹壁全层缺损，宽2．8cm，大肠及小肠管漂浮于羊水中，外露肠管无腹膜覆盖，脐根部及脐带回声正常。     

超声诊断胎儿多处畸形1例

患者女，26岁。妊娠26周无明显不适，来我院常规检查，孕2产0，以往曾有孕3个月不原因流产史。采用百胜Mylab 90彩超诊断议，凸阵探头3．5MHz，患者仰卧位，探头置腹部检查。超声所见：胎儿颅骨光环完整，颅内结构未见明显异常，双顶径5．4cm，脊柱排列规则，股骨长4．3cm，羊水最大深度6．6cm，颜面部多切面扫查，正常鼻唇结构消失，上唇连续中断0．6cm并向上延续，与鼻分界不清（图1）；     

超声诊断胎儿腹腔寄生胎1例

孕妇21岁。孕39周,孕1产0。产前超声所见：双顶径9．1cm,头围32．5cm,股骨长7．0cm,腹围33．0cm。后壁胎盘,Ⅱ级,羊水指数15．8cm。     

软骨发育不全1例的影像诊断

孕妇27岁。孕8个月，行常规超声检查发现：胎儿臀位，胎头双顶径8．7cm，颅骨光滑完整，脊柱排列整齐，胸部扁平，腹部膨隆．网肢短小；测股骨长约2．1cm，肱骨长约2．0cm，胫骨长约1.6cm，羊水最深处约14cm。其双顶径相当于孕35周，股骨长仅相当于孕17周，二者明显不成比例。超声诊断：宫内单活胎，胎儿四肢发育短小畸形，羊水名．     

胎儿复合畸形的超声表现1例

病例女，32岁，孕36W，外院超声检查提示胎儿脐膨出，来我院复诊。超声所见：胎儿头位，双顶径8．8cm，股骨长6．8cm，胎盘附着于右侧后壁，Ⅱ级，羊水指数16．5cm。于胎儿脐部右侧可见一大小约3．8cm×4．3cm囊实性包块，与缺损腹壁相通，囊壁薄、光滑，包块内实性回声为肝组织样回声及管状无回声。动态观察管状无回声可见蠕动，周边可见液性暗区环绕；同一切面可见小腿长轴与足底平面同时显示；胎儿右侧睾丸鞘膜腔内睾丸三面为液性暗区环绕，液性暗区最大范围约1．6cm×1．4cm。超声提示：（1）晚孕，宫内单活胎，头位；     

产前超声诊断胎儿腹裂2例

胎儿腹裂发生率约为1／5000，是胎儿受某些因素的影响，使得腹壁的关闭过程受到抑制或延缓。我院就2006年12月～2007年3月超声检诊2例，报告如下： 病例 患者1，女，19岁，孕1产0，孕8个月余来我院就诊。超声显示：胎头位于耻骨联合上方，双顶径9．5cm，股骨长6．1cm，羊水深4．2cm，胎心节律规整，颅内及胸腔结构未见异常，脊柱排列整齐，四肢发育良好，肝胆肾及膀胱未见异常，     

超声诊断胎儿泄殖腔外翻1例

孕妇,27岁,孕1产0,既往身体健康,无遗传性疾病。孕31周,因外院超声发现胎儿两股间囊性包块来我院要求进一步超声检查。超声所见子宫内：单胎,头位,双顶径8．1cm,头围29．6cm,腹围28．7cm,股骨长6．2cm,胎儿颅内结构、脊柱排列、胸腔脏器、四肢、胎盘及羊水未见明显异常。胎儿腹部扫查,膀胱未见显示,胎儿下腹壁回声中断约1．8cm,腹壁外探及大小约5．0cm×4．0cm×3．0cm的囊性包块,内见一条状分隔,CDFI示：囊性包块周边见两条静脉血流信号与脐静脉相延续（见图1）。超声诊断：单胎头位晚妊;胎儿泄殖腔外翻畸形。引产一死女婴,可见女婴脐部至外阴腹壁中断,部分肠管及膀胱外翻于体外（见图2）。     

超声诊断胎儿多指畸形1例

孕妇 40岁,孕2产1,既往身体健康,无遗传性疾病。孕29周,产前常规超声检查所见：单胎,头位．双顶径7．5cm,头围27．2cm,腹围26．0cm,股骨长5．2cm,胎儿颅内结构、脊柱排列、朐腹腔脏器、胎盘未见明显异常,     

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.