成人环形胰腺伴胆总管下端狭窄1例

患者女,55岁,反复剑下疼痛伴呕吐20余年,再发1月.查体:皮肤、巩膜无黄染,腹平坦,全腹无压痛、反跳痛,未及包块,Murphy征(-),肝、脾肋下未触及,肝区叩痛(+),移动性浊音(-),双下肢无水肿,余无殊.     

布-加综合征合并原发性肝癌一例

患者男,43岁.因肝区隐痛不适伴腹胀1个月人院.既往体健,无药物过敏史及烟酒史,无血吸虫病及慢性肝炎病史.体检:心肺(-);腹壁静脉显露,血流自下向上;腹平、软,肝脾肋下未触及,肝浊音界缩小,肝区叩击痛(+).肠鸣音正常,移动性浊音(-),双下肢不肿.     

原发性肾上腺平滑肌肉瘤1例

正患者女,40岁。1月前无明显诱因出现腹部间断性隐痛不适,进行性加重,以左侧为著。既往史无特殊及遗传病史。查体:BP 120/80mmH g。左侧腹部轻压痛、无反跳痛,于左侧中上腹可扪及一包块,质韧,活动尚可,大小及边界扪不清,移动性浊音(-),余无特殊发现。实验室检查:血、尿常规、肝功能、肿瘤标记物正常,HIV(-),EB(-),血清儿茶酚胺和肾上腺皮质激素水平均在正常范围内。CT检查:左侧肾     

CT诊断空肠闭孔疝1例

1病历简介 患者,女,69岁.主因阵发性腹痛伴恶心、呕吐1周,收入我院.体检:体温36.8℃,血压13.36/8.2kPa(100/60mmHg),神清,腹平坦、软,中腹部有压痛,无反跳痛及肌紧张,Murphy's征(-),叩诊呈鼓音,移动性浊音(±),肠鸣音弱.     

急性坏疽性胆囊炎穿孔并出血误诊一例

病例资料男,46岁,汉族。发现胆囊结石8年,因间断性腹痛8年伴加重3天入院。查体:皮肤、巩膜无黄染,腹平软,无压痛、反跳痛及肌紧张,无恶心、呕吐及发热,移动性浊音(-),肠鸣音正常。实验室检查:白细胞计数(WBC)3.68×109/l,红细胞计数(RBC)3.22×1012/l,血红蛋白(HG)91g/l,甲胎蛋     

高脂血症性急性胰腺炎伴脾脏密度一过性减低1例

<正>患者男,24岁。入院前2天突发腹痛、恶心、纳差,来院就诊,既往有胰腺炎和糖尿病病史。查体:上腹部及脐周局部压痛,无反跳痛和肌紧张;皮肤及黏膜无黄染;移动性浊音(一);心肺未见明显异常。实验室检查:空腹血糖10.2mmol/L,甘油三酯59.82mmol/L,尿淀粉酶正常(370U/L),血淀粉酶1100U/L。临床诊断:急性胰腺炎、糖     

酷似慢性炎性肉芽肿的肝内胆管细胞腺癌1例

患者 女,52岁,因月经紊乱,体检发现左肝占位性病变15 d入院.查体:皮肤巩膜无黄染、无皮肤瘙痒,无明显肝掌及蜘蛛痣,腹部对称、无膨隆,腹壁静脉无怒张,无陶土色大便;浅表淋巴结未触及肿大;腹部柔软并且无压痛及反跳痛,未触及包块;无移动性浊音,轻度鼓音,肝浊音界存在,肝上界在右侧锁骨中线第5肋间,肝区无叩痛.辅助检查:血常规、生化、大便常规基本正常范围.     

上皮性卵巢癌多西他赛化疗致高血压1例

病人,女,53岁.体检发现盆腔包块3个月.患者孕3产2,既往无高血压、糖尿病病史.入院查体:血压100/70mmHg(1 mmHg=0.133 kPa),脉搏70次/min,心肺无异常,腹平软,无压痛、反跳痛,移动性浊音阴性,双下肢无水肿.     

Caroli病1例

患者男,14岁.因腹痛5小时,发现肝囊肿3月而入院.病例资料患者3月前无诱因出现上腹部疼痛,呈持续性,于当地医院就诊,超声提示"肝左叶囊肿",化验肝功正常,5小时后疼痛自行缓解,后于多家医院就诊,证实为"肝左叶囊肿".查体:神清,精神可,皮肤巩膜无黄染,肝掌(-),心肺听诊未见异常,腹平软,无压痛和反跳痛,墨菲氏征阴性,肝脾肋下未及,移动性浊音(-),双下肢无水肿,神经系统未见异常.     

空肠异位胰腺组织致肠系膜动脉栓塞1例

病人,女,36岁。入院前10d无明显诱因出现持续性中上腹疼痛,阵发性加剧,疼痛向腰背部放射,屈曲位疼痛稍减轻,无发热、黄疸、恶心、呕吐,曾排黏液稀便2次,无血便。查体:体温:37.0℃;脉搏:95次/min;血压:120/70mmHg(1mmHg=0.1333kPa)。皮肤、巩膜无黄染。腹平坦,中上腹部压痛、反跳痛( ),腹肌稍紧张,未触及包块,肝区双肾区无叩击痛,移动性浊音阴性,肠鸣音稍亢进。腹部平片未见异常。血常规示:WBC:7.34×109/L;GR0.83。血、尿淀粉酶正常。初步诊断:(1)腹痛待查:消化道穿孔?急性胰腺炎?(2)急性腹膜炎。予胃肠减压、制酸、抗感染等治疗后腹痛…     

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.