鼻内镜在鼻咽部疾病诊断中的作用探讨

鼻内镜检查为鼻咽部疾病的诊断提供了一个可靠的方法,在鼻内镜下行鼻咽部活检,具有操作简单,取材准确,不易漏诊的优点。现将我科218例在鼻内镜下行鼻咽部活检的情况报告如下：     

男性前列腺特异性抗原升高的简略双参数前列腺MRI特征

正摘要目的在前列腺特异性抗原(PSA)升高且活检结果为阴性的男性病人中,明确简略双参数MRI诊断临床显著性前列腺癌的准确性,并与多参数MRI进行比较。确定双参     

超声内镜诊断特发性急性胰腺炎的临床价值

目的探讨超声内镜(EUS)诊断特发性急性胰腺炎(IAP)的临床价值。方法收集我院33例特发性急性胰腺炎患者,先行磁共振胰胆管成像(MRCP),再行超声内镜检查确定其病因,并将两者检出病因的构成比作比较,以及评价两种诊断方法。结果特发性急性胰腺炎的病因包含胆管微小结石、胆囊淤泥、慢性胰腺炎、胰腺癌、十二指肠乳头病变、胰腺导管内乳头状黏液瘤以及胰腺分裂。其中1例胰腺癌通过超声内镜引导下细针穿刺活检术,得到病理确诊。EUS对胆囊淤泥、慢性胰腺炎检出病因构成比要明显高于MRCP(P 0. 05);另外EUS和MRCP两种不同诊断方法结果不一致,(Kappa值=0. 085,P 0. 05); EUS阳性诊断率75. 76%明显高于MRCP的12. 12%(P 0. 05)。结论超声内镜对特发性急性胰腺炎的病因诊断率明显高于MRCP;并可通过超声内镜引导下细针穿刺活检术得到病理诊断。超声内镜可以作为诊断特发性急性胰腺炎的一种有效检查手段。     

螺旋CT仿真内镜对胃癌诊断的研究近况

胃部病变的诊断一直以钡餐和纤维内镜及镜下活检为主要手段。CT仿真内镜成像(CT virtual endoscopy,CTVE)自1994年Vining等[1]最先报道以来,几乎涉及人体所有空腔器官的临床应用,具有无创性,快速适时的成像特点,患者耐受性好,临床适应证广等优点而倍受医学影像学和临床医生的关     

介绍一种简易内镜注射器的制备与应用

目前进口及国产的内镜注射器价格都比较昂贵,损坏后多不能修配,有些为一次性使用。我院自制的内镜注射器,经临床上多次应用,初步认为安全可靠,性能良好,介绍如下: 材料与制作 1.材料:①能够从内镜活检孔插入的硅胶管一根(长度长于镜身50cm);②4号小儿头皮针一个③0.3mm不锈钢丝20mm;④带孔小螺丝帽一个(直径等于硅胶管内径)。     

窄带成像内镜在喉癌术后诊断中应用价值

目的探讨窄带成像(NBI)内镜在喉癌术后诊断中的应用价值。方法选取自2010年1月至2018年6月于中国科学技术大学附属第一医院行喉部手术且术后病理证实为鳞状细胞癌的60例患者为研究对象。术后行NBI内镜检查,对疑似复发患者行病理活检,比较白光内镜及NBI内镜诊断的差异及与活检病理的相关性。结果喉癌术后患者病理活检中,鳞癌10例,炎症及肉芽肿5例,不典型增生6例。白光内镜诊断的准确性为73. 3%、灵敏度为40. 0%、特异度为80. 0%,NBI内镜诊断的准确性为95. 0%、灵敏度为90. 0%、特异度为96. 0%。NBI内镜诊断的准确性、灵敏度及特异度均高于白光内镜,差异均有统计学意义(P <0. 05)。喉癌病变的NBI分型与病理结果呈明显正相关(r=0. 714,P <0. 05)。结论 NBI内镜能明显提高喉癌患者术后早期复发的检出率,较好地预测病变性质。     

结肠血吸虫病4例内镜诊断及病理特征分析

结肠血吸虫病是血吸虫虫卵在结肠、直肠壁沉着所引起的急、慢性特异性炎性反应。目前,由于我国长期开展预防工作,急性血吸虫感染多为散发病例,而结肠血吸虫病在临床已较少见,大多数医师对此病较为陌生,并且其临床及内镜下表现缺乏特异性,易导致漏诊和误诊。我院内镜室于2004—10至2010—10,通过结肠镜检查并组织活检病理学检查确诊为结肠血吸虫病4例,现将其内镜下表现及组织病理学特征回顾性分析报告如下,旨在引起对结肠血吸虫病的重视。     

MRI低张充气造影与内镜对胃肠道间质瘤筛查对照分析

目的 探讨低张充气造影MRI扫描与内镜对胃肠道间质瘤(GIST)筛查中的价值并进行对照分析。方法 选取我院行低张充气造影MRI及内镜检查并经手术病理证实的GIST患者32例为观察对象，低张充气造影MRI检查嘱患者扫描前30 min饮水500 ml,扫描前10～15 min,肌注654-2 10 mg,开始扫描前1 min,温水口服发泡剂10 mg。结果 低张充气造影MRI扫描对发现GIST的病变优于内镜。内镜对起源于小肠和消化道外的GIST均是盲区；高危组ADC值明显低于中危和低危组，差异有统计学意义(P<0.05)。结论 低张充气造影MRI在筛查及诊断GIST中是一种无创无辐射的实用筛查方法，患者无插管痛苦，容易接受，且信号特点有助于对GIST侵袭危险度的评估。     

内镜下复方黄芪胶和胃二号胶治疗消化性溃疡128例

1 临床资料1.1 一般资料 本组病例均为住院病人,经内镜或活检病理确诊为消化性溃疡或伴出血者为治疗对象。采用随机分组,有复查结论     

共聚焦内镜对早期胃癌内镜黏膜下剥离术治疗界限确定的价值

目的探讨共聚焦内镜对早期胃癌内镜黏膜下剥离术（endoscopicsubmucosaldissection,ESD）治疗范围确定的可行性及准确度。方法选择经普通胃镜检查加组织活检确诊为胃癌,并经超声胃镜检查病变局限于黏膜层的患者25例。用共聚焦内镜对病灶黏膜进行多部位扫描,找到正常黏膜与癌变黏膜的分界线,并对分界线用氩离子血浆凝固术（APC）进行标记,沿APC标记界限行ESD治疗,将剥离黏膜送病理科,对病灶组织由浅至深逐层切片,对所有组织切片进行逐层观察,并检查病灶切除的完整性。结果经共聚焦内镜标记的早期胃癌黏膜切除完整,癌灶边缘有一圈少许正常黏膜组织,深层癌灶剥离完全。结论共聚焦内镜能清晰地区分癌变胃黏膜和正常黏膜结构,为早期胃癌的ESD提供有效的治疗界限,为早期胃癌的完整切除提供安全保障,避免了单纯在普通胃镜下靠经验估计的盲目性。     

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.