动态增强MRI(DCE-MRI)对儿童和青年克罗恩病的定量评估

正目的探讨动态增强MRI(DCE-MRI)在儿童和青年克罗恩病中的临床应用价值。方法自2017年8月—2018年10月,共收集克罗恩病病人30例[其中男21例,女9例,     

克罗恩病18例临床和诊断分析

克罗恩病又称节段性肠炎或局限性肠炎，病变可发生在从口腔到肛门之间消化道的任何部位，不同的病变部位出现不同的临床表现，使克罗恩病的临床表现复杂多样，诊断困难，容易误诊和漏诊.近年随着对本病认识及检查手段的提高。被诊断的克罗恩病病例逐渐增多。本文收集大理学院附属医院1990～2008年9月18年间收治的诊断明确的18例克罗恩氏病的临床资料、手术所见、肠镜检查、X线表现和病理检查的资料进行分析．以提高诊断克罗恩病的水平。     

小肠CT成像对末端回肠克罗恩病活动性炎症期的诊断准确性:FBP全剂量及半剂量重建与SAFIRE半剂量重建对比研究

摘要目的比较小肠CT成像滤过反投影法(FBP)和正弦迭代(SAFIRE)半剂量重建与FBP全剂量重建对于末端或近末端回肠克罗恩病活动性炎症期诊断的准确性和成像质量。方法本回顾性研究符合HIPAA并得到伦理委员会批准,无需病人知情同意书。90个病例行双源CT小肠成像检查(活动性末端回肠克罗恩病45例,无克罗恩病45例)。活动     

9例军团菌病的护理与管理

我院在1998—06～1999-12先后收治军团菌病9例,这9例病人均为滇南首次发现。现将护理与管理工作报告如下:     

评价定量PET/MR影像标志物鉴别克罗恩病炎性狭窄和纤维性狭窄

正摘要目的回顾性评价PET/MR在克罗恩病病人中鉴别炎性狭窄和纤维性狭窄的应用价值。方法该回顾性研究已通过伦理审查委员会的批准,并取得病人的知情同意。19例克罗恩病病人进行了PET/MRI肠道成像检查,这些病人都经过术后病理已证实存在肠道狭窄。2名放射学医师和1名核医学医师共同评估肠壁的PET/MR影像标志物,包括以     

根据手术标本病理结果评价常规、动态增强及扩散加权MRI对克罗恩病的定量评估价值

正摘要目的前瞻性对照克罗恩病的常规MR序列、动态增强(DEC)MRI和扩散加权成像(DWI)与手术标本的组织病理学表现。方法对安排4周内手术的连续克罗恩病病人     

病态肥胖病人Roux—en—Y胃旁路术后继发性内疝：小肠X线检查表现分析

目的前瞻性比较CT和MR小肠成像及小肠灌肠造影3种检查方法发现克罗恩病病人活动性小肠炎症和肠外并发症的准确性。方法机构伦理审查委员会批准本研究计划,并所有参与者知情同意。对连续31例克罗恩病或疑有克罗恩病的病人行CT和MR小肠成像、小肠灌肠造影和回肠结肠镜检查。2位独立的阅片者回顾CT和MR小肠成像及小肠灌肠造影影像以确定活动性末端回肠炎和肠道外并发症的存在。以回结肠镜检查结果作为参考标准,利用受试者工作特性曲线方法来评估CT和MR小肠成像及小肠灌肠造影确定活动性末端回肠炎的准确度。     

克罗恩病并发急性小肠穿孔一例

克罗恩病(Crohn病)，是一种胃肠道的慢性非特异性炎症性疾病。起病常较缓慢，病程多较长，发病率约为6／10万至7／10万，以消化道穿孔为首发症状的病例较少见。我科近日收治了一例克罗恩病并急性小肠穿孔的患，报告如下：     

克罗恩病和肠结核的CT小肠造影鉴别指标筛选北大核心CSCD

目的:筛选鉴别诊断克罗恩病和肠结核的CT小肠造影指标。方法:回顾性分析2008年5月1日—2018年9月1日所收治的243例克罗恩病患者和106例肠结核患者的CT小肠造影表现,筛选出能区分克罗恩病和肠结核的CT小肠造影单因素指标,而后进行多因素二元logistic回归分析,建立回归方程(数学模型),采用ROC曲线分析回归方程的诊断效能。结果:鉴别诊断克罗恩病和肠结核CT小肠造影指标的数学模型为P=1/[1+e-(-1.630+7.923X16+3.451X37+4.546X33-2.874X25-5.378X18-4.279X19-5.126X30)],其中X16、X37、X33、X25、X18、X19、X30分别代表肠管非对称性受累、脓肿、梳状征、淋巴结分布在回结肠动脉引流区、回盲瓣挛缩变形、回盲瓣固定开口和淋巴结中央坏死。其诊断的灵敏度为97.8%,特异度为94.2%,准确度为96.3%,阳性预测值为98.2%,阴性预测值为89.9%,诊断预测值为0.783,AUC值为0.989。结论:筛选出的CT小肠造影指标对克罗恩病和肠结核的鉴别诊断具有较高的准确度。在鉴别肠结核和克罗恩病的流程中,CT小肠造影应作为首选的检查方法。     

瓦斯爆炸烧伤病人的救治体会

目的:总结我院近5年来采用烧伤湿性医疗技术(MEBT/MEBO)治疗95例瓦斯爆炸烧伤病人的心得体会。方法:对2001年1月-2005年8月所收治的14批95例瓦斯爆炸烧伤病人的创面均采用MEBT/ MEBO治疗。结果:除1例死于并发症外,其余94例瓦斯爆炸烧伤病人全部治愈出院。结论:采用MEBT/ME- BO处理创面效果良好。     

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.