静脉曲张型食管癌1例

患者　男 ,4 7岁。胸骨后疼痛 ,并间断性吞咽困难 3月。3月前患者出现胸骨后疼痛不适 ,伴有咽部异物感 ,经抗炎治疗后症状减轻。 2月前再次出现胸骨后疼痛 ,食欲减退 ,吞咽轻度阻挡感 ,并呕血 1次 ,因既往有多年慢性乙肝病史 ,考虑为食管静脉曲张 ,后经食管钡餐检查诊断为食管静脉曲张 ,经止血补液及保肝治疗缓解。 2周后因吞咽困难逐渐加重 ,在外院再次行食管钡餐检查 ,诊断为重度食管静脉曲张。因治疗效果不佳 ,来我院进一步检查 ,再次钡餐检查为静脉曲张型食管癌 ,后经胃镜病理证实。　　钡餐检查 :食管中下段及部分上段可见多发不规则小…     

食管Crohn 病一例

患者，41岁，主诉进食吞咽困难伴胸骨后疼痛2个多月而来诊。2个月前，患者无明显诱因出现吞咽面食胸骨后不适，症状持续1个多月，就诊于本地某医院，诊断为食管静脉曲张。口服药物治疗效果不佳，症状进行性加重，出现胸骨后疼痛加剧，并向脊柱放射。2个月来患者进食减少，以软流食为主，无呕叶，无黑便，但有消瘦及乏力感。来我院行上消化道钡餐造影：示食管钡剂通过不畅，食管中下段黏膜粗乱，食管呈节段性病变，病变黏膜皱襞粗乱，有铺路石样充盈缺损，食管腔轮廓不规则，边缘呈小锯齿状。管腔狭窄，     

读片窗

患者　女 ,5 2岁。自述 1 990年以来胸骨后间断性疼痛 ,9个月前因受凉发热后疼痛转为持续性 ,进食时明显。无返酸及吞咽困难 ,无恶心、呕吐。当地医院以返流性食管炎、慢性胃炎治疗 ,效果不佳 ,于1 995年 5月 5日来我院就诊。查体 :发育正常 ,营养中等 ,慢性病容 ;口腔右侧颊部见 1 .0ｃｍ× 0 .5ｃｍ溃疡 ;心肺 (- ) ,腹软 ,肝脾未及肿大 ;会阴部大小阴唇见多发溃疡面 ,局部触痛明显。实验室检查 :血常规、肝功能正常 ,大、小便 (- )。咽及食管拭物霉菌培养 (- )。Ｘ线钡餐造影 :显示食管中下段不规则扩张 ,右侧壁呈假憩室样突出 ,粘膜表面…     

食管非何杰金淋巴瘤浸润1例报告

非何杰金淋巴瘤 (ＮＨＬ)在消化道以侵及空肠和胃多见 ,侵及食管者国内文献报告较少 ,我们遇到 1例报告如下。患者　男 ,5 0岁 ,因吞咽不畅伴胸骨后疼痛 2月余收入院。两个多月前无明显诱出现吞咽梗阻感 ,伴胸骨后隐痛 ,间断发热、盗汗 ;曾在当地医院钡餐透视拟诊“食管癌”。经治疗 (用药不详 )发热、盗汗症状消失 ,但仍有吞咽不畅及胸骨后隐痛。入院后食欲正常 ,半小时内可食下 3碗米饭。查体 :Ｔ 3 6.4℃ ,营养中等 ,双侧腹股沟可触及 12粒 0 .8ｃｍ× 1.6ｃｍ的淋巴结 ,胸骨后明显压痛 ,肝右肋缘下 1ｃｍ触及 ,无压痛。实验室检查 :血常…     

食管异物致食管穿孔主动脉破裂一例

病例资料患者,男,46岁,于2003年12月28日因误吞食鱼骨头致胸骨后疼痛,当时无咳嗽、呕血等,未及时就诊。2004年1月4日患者因饮酒后感胸骨后疼痛加重,并出现呕血,量约100ml,鲜红色,后多次少量呕血,当地就诊,口服药物治疗;1周后出现无明显诱因大量呕血,约450ml,当地县医院诊断为食     

食道异物并食管胸膜瘘1例

患者女,26岁。吞咽异物(鱼刺)后致食管胸膜瘘2月。患者曾因吞食鱼刺颈胸部不适3天后,去当地医院行吞钡絮检查未发现异物,1周后出现颈部与胸背部疼痛,呼吸困难,伴发热。于当地间断非正规"消炎治疗"近2月无明显好转,来院申请胸背部核磁共振检查。临床拟诊:①食管胸膜瘘;②脓胸。磁共振扫描仪意见:食管及右侧胸腔、胸壁、右肺异常信号影,考虑食管胸膜瘘,并右肺及侧胸壁感染(图1～10)。     

食管内支架重置术一例

患者女,56岁.左肺癌术后1年,吞咽困难1个月余,于2008年8月12日入院.患者2007年6月因左肺癌行左肺切除术.术后1年余出现吞咽困难.CT示纵隔淋巴结肿大,食管中下段受累,管壁增厚.钡透示食管中下段重度狭窄.遂于2008年8月15口置入18～140 mm覆膜支架(南京微创)1枚,术后造影复查见支架通畅,贴壁良好.2009年3月12 日因复发吞咽困难并胸骨后疼痛1个月,加重3 d入院.     

原发性食管小细胞神经内分泌癌18F-FDG PET/CT显像1例

<正>1资料患者,男性,66岁,无明显诱因下出现声音嘶哑、吞咽异物感,偶有饮水呛咳伴有胸骨后疼痛,进食时疼痛明显,于2020年5月19日至外院行计算机体层成像（computed tomography,C T）检查发现食管中上段肿物,考虑为食管癌。2020年5月25日,患者转诊于广西医科大学附属肿瘤医院,入院后检查肿瘤标志物：     

食管原发性恶性黑色素瘤18F－FDG PET/CT显像1例

患者女, 70岁, 因"吞咽困难2个月"入院。患者2个月前无明显诱因出现吞咽困难, 进食干硬食物时加重, 吞咽时伴梗阻感及轻度胸痛, 无胸闷憋气, 无腹痛、腹胀, 无反酸嗳气, 无恶心呕吐。近日吞咽困难加重, 伴轻度后背部疼痛。上消化道钡餐示:食管下段见长径约6.8 cm类椭圆形充盈缺损, 相应管腔呈偏心性狭窄, 对比剂通过较慢, 其上段食管扩张。胸部CT示:食管下段见不规则团块影, 最大截面约3.8 cm×3.7 cm, 其上段食管扩张;胃贲门壁增厚;肝-胃间隙见最大截面约4.0 cm×2.8 cm肿大淋巴结。入院肿瘤标志物检查均未见异常。     

胸段食管嵌顿性巨大异物1例

1病例介绍 患者男性,41岁。因吞服长条形汤匙7天入院。入院时患者一般情况差,体质消瘦,痛苦面容。自述胸骨后疼痛,吞咽困难,呼吸费力。查体：神志清楚,口角流涎,轻度呼吸困难,咽部粘膜光滑,元明显充血,颈部压痛明显。胸部正侧位片提示胸段食管内见一长条形不规则金属异物影,入院诊断：     

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.