数字钼靶X线摄影与彩色多普勒超声对乳腺肿块的诊断价值

目的：评价数字钼靶X线摄影、彩色多普勒超声成像及二者联合应用在乳腺肿块性病变中的定性诊断价值。方法：73例乳腺肿块性病变,其中良性24例,恶性49例。所有病例均行数字钼靶X线摄影和彩色多普勒超声检查,两者单独及联合诊断并与病理结果对照。结果：数字钼靶X线摄影诊断乳腺癌的敏感度、特异度及准确度分别为89．80％、75．00％及84．93％,彩色多普勒超声为85．71％、83．33％及84．93％,二者联合检查为95．92％、91．67％及94．52％。彩色多普勒超声在诊断Ⅰ型及Ⅳ型乳腺病变上较钼靶具有明显的优势（P〈0．05）,钼靶在诊断Ⅱ、Ⅲ型的乳腺病变时准确度（62．50％）高于彩色多普勒超声（45．00％）,但两者差异无统计学意义（P〉0．05）。结论：联合应用乳腺数字钼靶X线摄影检查和彩色多普勒超声成像可提高乳腺肿块性病变的定性诊断符合率。     

彩色多普勒超声联合钼靶X线摄影对乳腺癌的诊断价值

目的:比较彩色多普勒超声、钼靶X线摄影及两者联合应用对乳腺癌的诊断价值。方法:回顾性分析经穿刺活检或手术病理证实的43例(49个病灶)的临床及影像资料,术前均行彩色多普勒超声及钼靶X线摄影,且2种检查间隔3 d。结果:彩色多普勒超声诊断乳腺癌45个,诊断符合率91.84%;钼靶X线摄影诊断乳腺癌42个,诊断符合率85.71%;2种检查单独使用对乳腺癌的诊断符合率,差异无统计学意义(P0.05)。两者联合应用诊断乳腺癌47个,诊断符合率95.92%,与2种方法单独使用比较,差异均无统计学意义(均P0.05)。结论:彩色多普勒超声、钼靶X线摄影及两者联合应用对乳腺癌的诊断符合率无明显差异。彩色多普勒超声在评价结节与肿块方面更具优势,钼靶X线对恶性钙化的显示更具优势,两者联合应用对乳腺癌的诊断具有一定价值。     

超声联合X线钼靶在浆细胞性乳腺炎诊断中的应用

目的 探讨浆细胞性乳腺炎(plasma cell mastitis,PCM)的超声及钼靶X线特征,以及两者联合应用在诊断中的应用价值.资料与方法 回顾性分析经病理证实的29例(31个)PCM的超声及钼靶X线表现,均为非妊娠或非哺乳期妇女,中位年龄35岁(18～64岁).结果 彩色多普勒超声表现可分为4型:单纯导管扩张型(5/31)、囊性型(8/31)、低回声实质型(16/31)、囊实混合型(2/31).16个低回声实质型病灶内血流信号为0～Ⅰ级8个,Ⅱ级4个,Ⅲ级4个,频谱特点为低速低阻型(10/11).钼靶X线表现可分为4型:炎性样型(5/31)、导管扩张型(4/31)、局限浸润型(16/31)、结节肿块型(6/31).单纯应用超声检查的阳性诊断符合率为52%,单纯应用X线钼靶检查的阳性诊断符合率为32%,两者无统计学差异(P>0.05).超声与X线钼靶联合应用的阳性诊断符合率为77%,与单纯行超声和X线钼靶检查比较,两者有统计学差异(P<0.05).结论 超声与X线钼靶的联合应用能明显提高PCM的阳性诊断符合率.     

钼靶X线、彩色多普勒超声对乳腺结节诊断的临床应用价值

目的：评价钼靶X线与彩色多普勒超声（color Doppler ultrasonography，CDUS）对乳腺结节诊断的临床应用价值。方法：对126例经钼靶X线、CDUS检查的乳腺结节资料进行分析比较，并与术后病理结果对照。结果：126例乳腺结节有76例良性病变，钼靶X线诊断正确66例，CDUS诊断正确68例（X2=0．07，P〈0.05），钼靶X线＋CDUS诊断正确71例。有50例恶性病变，钼靶X线诊断正确46例，超声诊断正确36例（X2=3．87，Pd0．05），钼靶X线＋CDUS诊断正确49例。结论：在乳腺结节良性病变诊断中，钼靶X线与CDUS无明显统计学差异，但对乳腺恶性肿块的检出，CR钼靶较CDUS有明显优势，二者联合诊断乳腺疾病的准确率高于两种方法单独使用，在乳腺疾病的检查中可以发挥优势互补的作用。     

钼靶X线摄影和超声联合诊断乳腺癌的价值

目的 :分析X线钼靶、乳腺超声及两者联合应用在乳腺癌诊断中的价值。方法 :回顾性分析经术后组织病理学确诊的27例乳腺癌的钼靶及超声检查资料,比较乳腺超声、钼靶及联合检查的结果。结果:以病理诊断为金标准,钼靶诊断符合率75.00%,乳腺超声诊断符合率75.00%,联合应用诊断符合率90.00%,联合应用与单独钼靶或超声检查比较差异均有统计学意义(均P0.05)。结论:X线钼靶与乳腺超声及其相关技术对乳腺癌诊断均有较大价值,但两者联合应用的诊断率可明显提高。     

联合使用B超与钼靶射线用于诊断乳腺疾病中的应用

目的：探讨使用B超与钼靶X线诊断乳腺良性病变和恶性病变的效果对比。方法分析2014年1月－2016年1月收治的135例乳腺肿瘤患者,分别使用钼靶X线、B超及钼靶X线和B超联合诊断,其结果与术后病理检查结果进行对照,比较三种诊断手段的敏感性、特异性和准确度。结果 B超和钼靶X线诊断乳腺良恶性病变敏感性、特异性及准确度无统计学差意（ P＞0.05）;联合B超和钼靶X线的敏感性、特异性、准确度明显高于单独使用B超和乳腺钼靶X线诊断（ P＜0.05）。结论 B超诊断和乳腺钼靶X线诊断乳腺良恶性病变各有特点,联合使用可提高诊断的准确率,发挥多科协作的优势。     

数字钼靶X线摄影、彩色多普勒超声成像及查体对乳腺肿块性病变的诊断价值

目的 探讨联合数字钼靶X线摄影、彩色多普勒超声成像及查体对乳腺肿块性病变的诊断价值.方法 回顾性分析92例经手术、病理证实的乳腺肿块性病变患者的临床、数字钼靶X线摄影及彩色多普勒超声成像资料,患者均为女性,年龄18～80岁,平均49.8岁,良性43例,恶性49例.数字钼靶X线主要观察病变的部位、形状、边缘、有无钙化及患侧腋窝淋巴结,彩色多普勒超声观察并记录肿块的二维声像图特征、肿块内部及周边血流.查体主要观察乳腺的皮肤、乳头及通过触诊了解病变的边缘、质地及活动度等.结果 数字钼靶X线摄影诊断乳腺恶性病变的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为85.71%、79.07%、82.35%、82.93%及82.61%;彩色多普勒超声为79.59%、83.72%、84.78%、78.26%及81.52%;查体为71.42%、76%、74%、77.78%、70.21%及73.91%;三者联合诊断为91.84%、93.02%、93.75%、93.3%及90.91%.三者联合诊断的准确性明显高于单独诊断(P＜0.05),但三者单独诊断两两比较差别无统计学意义(P＞0.05).结论数字钼靶X线摄影、彩色多普勒超声检查,结合查体后联合诊断,可以提高乳腺肿块性病变的诊断准确性.     

钼靶X线、超声及MRI在乳腺癌早期诊断中的应用

目的:通过分析钼靶X线、超声及MRI对乳腺癌早期的诊断要点,探讨3种影像学检查方法在乳腺癌早期诊断中的意义。方法:收集经手术病理证实的31例乳腺癌患者资料,以病理结果为诊断标准,对比分析钼靶X线、超声及MRI对早期乳腺癌诊断准确性的差异。结果:31例乳腺癌中钼靶X线诊断符合率为83.87%(26/31),超声为87.10%(27/31),两者联合诊断为93.55%(29/31)。行MRl检查的17例中,诊断符合率为94.12(16/17),而三者联合应用的诊断符合率达96.77%(30/31)。经统计学分析,超声与钼靶X线的诊断准确率差异无统计学意义,二者联合检查与单独应用超声或钼靶X线摄影相比差异有统计学意义。结论:早期乳腺癌在钼靶X线、超声及MRI检查中均可出现不典型表现,钼靶X线、超声及MRI是目前乳腺检查的主要手段,但各有不足,合理、联合应用,能明显提高乳腺癌的早期诊断准确率。     

乳腺叶状肿瘤的钼靶X线、超声表现与病理对照分析

目的：探讨乳腺叶状肿瘤的临床特点、钼靶X线及超声表现,以提高诊断水平。材料和方法：应用钼靶X线及彩色多普勒超声检查12例经手术病理证实的乳腺叶状肿瘤患者,观察其X线及超声表现并与病理对照分析。结果：12例乳腺叶状肿瘤中,6例为良性,3例为交界性,3例为恶性。X线诊断为乳腺叶状肿瘤3例,乳腺癌3例,乳腺纤维腺瘤6例。超声诊断为叶状肿瘤2例,乳腺占位病变8例,纤维腺瘤2例。结论：乳腺叶状肿瘤的钼靶X线和超声表现缺乏特异性,但具有比较典型的影像特征,二者联合并结合临床资料有利于早期发现本病,但其良恶性与影像学表现无显著关系,确诊主要依靠病理检查。     

乳腺病变的彩色多普勒超声、超声弹性成像与X线钼靶的诊断价值

目的:分析彩色多普勒超声、超声弹性成像与X线钼靶对乳腺病变的影像学表现,探讨彩色多普勒超声、超声弹性成像与X线钼靶在乳腺成像及诊断方面的价值。方法:回顾性分析经病理证实的479例患者共502个手术病灶,分别分析彩色多普勒超声、超声弹性成像与X线钼靶的诊断符合率以及三者结合的诊断符合率。结果:彩色多普勒超声、超声弹性成像与X线钼靶的诊断符合率分别为81.90%、83.50%、79.91%,三者相结合诊断符合率为95.62%。结论:①彩色多普勒超声、超声弹性成像对乳腺病变的诊断价值优于X线钼靶;②X线钼靶对钙化诊断价值高;③超声弹性成像对液化诊断价值较高;④三者结合可明显提高诊断符合率。     

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.