核素直接法膀胱显像对膀胱输尿管反流的分级

为了使核素直接法膀胱显像（ＤＲＣ）用于膀胱输尿管返流（ＶＵＲ）分级，使ＤＲＣ更有效地指导ＶＵＲ的治疗，以ＶＵＲ国际分极标准为依据，结合核素显橡的特点提出ＤＲＣ的返流分级标准。对２８例ＶＵＲ患儿，同期分别做ＤＲＣ和Ｘ线排尿性膀胱尿道造影（ＭＣＵ）检查，胺ＤＲＣ分级标准将返流分级与ＭＣＵ分级进行对比。结果：ＤＲＣ分级与ＭＣＵ分极完全相同的３５侧（８３．３３％），比ＭＣＵ低１级４侧（９．２５％），比ＭＣ     

膀胱输尿管返流X线排尿性膀胱尿道造影观察

目的：认识膀胱输尿管返流（ＶＵＲ）出现在膀胱充盈期和排尿期的意义。方法：２０例ＶＵＲ患儿做排尿性膀胱尿道造影（ＭＣＵ）复查时,电视间断监视膀胱充盈期,发现返流拍片。另外,常规于排尿期拍片。结果：２０例患儿,２例返流消失,１８例仍有返流。其中８例双侧输尿管返流,１０例单侧返流,共２６侧返流。２６侧返流中,１２侧返流只出现于排尿期;余１４侧返流在膀胱充盈期就已出现,并且其返流程度在排尿期加重。结论：排尿期出现返流,是因膀胱输尿管抗返流结构有缺陷不能抵抗排尿压,使尿液在排尿期返流入输尿管。当抗返流结构的缺陷进一步加重,不能抵抗膀胱充盈期压,尿液就在较低的充盈压作用下返流入输尿管。充盈期出现返流,提示抗返流结构存在严重的缺陷。     

尿道前列腺返流显像及其在慢性前列腺炎的应用

目的探讨尿道前列腺返流显像在前列腺内尿液返流（ＩＰＵＲ）诊断中的价值及ＩＰＵＲ在慢性前列腺炎（ＣＰ）发病中的作用。方法在ＣＰ患者中进行插管法与静脉注射法放射性核素尿道前列腺返流显像（ＵＰＲＩ）,计算尿道前列腺返流比率（ＵＰＲＲ）,评价ＵＰＲＲ与ＣＰ症状评分的关系。结果３２例ＣＰ患者中８７５％（２８例）存在ＩＰＵＲ,其ＵＰＲＲ值为７６±３９,正常对照组为１８±１２,两者间差异有显著性（ｔ＝３２５,Ｐ＜００１）;插管法与静脉注射法ＵＰＲＲ在ＩＰＵＲ诊断中无明显差异（ＵＰＲＲ值分别为５４±２３和５８±２６）。ＣＰ患者ＵＰＲＲ与症状评分及ＩＰＳＳ、Ｑｍａｘ和ＭＵＣＰ有好的相关性,ｒ分别为０８９、－０８７和０９１,Ｐ均＜００１。结论ＩＰＵＲ与ＣＰ发病有关,静脉注射法显像能较好地评价ＩＰＵＲ,并具有无创、简便的优点。     

MR泪道造影的初步研究

目的 探讨ＭＲ泪道造影（ＭＲＤ）技术和应用价值。方法 ２０例正常人和８例慢性泪囊炎（ＣＤ）患者共５３侧泪接受了ＭＲＤ检查,扫描序列为三维稳态构成干扰序列（３Ｄ ＣＩＳＳ）和快速自旋回波（ＴＳＥ）。统计ＭＲＤ的显影结果,并对ＭＲＤ图像进行分析。结果 ３Ｄ ＣＩＳＳ序列ＭＲＤ,４０侧正常泪道显像２２侧,１３侧ＣＤ泪道显像１１例。３Ｄ ＣＩＳＳ序列较好地显示了正常人和ＣＤ患者泪道形态。ＴＳＥ序列ＭＲＤ对     

99mTc-MIBI延迟心肌断层显像评估存活心肌的初步临床研究

目的评价４小时９９ｍＴｃ甲氧基异丁基异腈（ＭＩＢＩ）延迟显像在评估心肌活力方面的价值。方法对３０例冠心病（ＣＡＤ）病人（１８例经冠状动脉造影证实）进行常规静息和４小时延迟９９ｍＴｃＭＩＢＩ心肌断层显像。对其中１０例经冠状动脉血运重建术治疗的病人术后３５６±１９２天进行心肌断层显像随访。将左室心肌划分为９个节段。采用四点计分法对各节段核素分布进行半定量评价（摄取正常＝３，重度降低或缺损＝０）。结果３０例ＣＡＤ病人常规静息显像示１２６个（４６７％）节段核素分布异常，延迟显像示１０５个（３８９％）节段核素分布异常。常规静息显像心肌计分≤１（“无活力”）的节段有９３个；延迟显像时３６４％的０分节段和５３１％的１分节段计分改善≥１。延迟显像与冠状动脉血运重建术后显像对比，判断存活心肌的阳性预测值为８４２％，阴性预测值为９００％，预测准确率为８７２％，两者有良好的一致性（χ２＝２１５９，Ｐ＜００１）。结论９９ｍＴｃＭＩＢＩ延迟心肌显像，通过一次给药可较有效地克服静息心肌显像低估心肌活力的不足，对判定缺血心肌活力状态方面具有临床实用价值     

应用核素显像评价小儿肾瘢痕形成与膀胱输尿管返流

目的：探讨膀胱输尿管返流（VUR）与急性肾盂肾炎（APN）后肾瘢痕形成的关系及评价小儿泌尿道感染（UTI）核素显像方法。方法：研究对象为临床首次诊断为上尿路感染的患儿48例，均经^99Tc^m-二巯基丁二酸（DMSA）肾皮质显像确诊为APN。肾显像后10d内行直接法放射性核素膀胱显像（DRC）以评价VUR。结果：（1）肾皮质显像示29．2％（14／48例）患儿APN伴瘢痕形成。DRC示47．9％（23／48例）患儿、44．8％（30／67个）病变肾存在VUR。（2）伴瘢痕形成APN患儿，其VUR发生率为85．7％，明显高于无瘢痕者（32．4％，P＜0．01）；伴瘢痕肾VUR发生率为88．2％，明显高于无瘢痕肾（30．0％，P＜0．01）。（3）有VUR的30个肾中，重度VUR侧肾瘢痕发生率为73．3％，明显高于无VUR及轻、中度VUR侧肾（11．5％，P＜0．01）。结论：证实VUR是诱发APN后肾瘢痕形成的危险因素之一。DRC为一辐射低、灵敏度高的评价VUR的方法，尤其适用于小儿。     

十二指肠胃返流对心肌灌注显像的影响

十二指肠胃返流对心肌灌注显像的影响［英］／ＭｉｄｄｌｅｔｏｎＧＷ…∥ＮｕｃｌＭｅｄＣｏｍｍｕｎ．－１９９６，１７（２）．－１１４～１１８用９９ｍＴｃ－ＭＩＢＩ进行心肌灌注显像时，十二指肠胃返流（ＤＧＲ）可影响心肌显像，严重者，因无法进行图像重建而需重...     

模拟二尖瓣返流彩色多普勒血流三维重建的实验研究

目的：采用三维（３Ｄ）超声重建技术定量评价模拟二尖瓣返流（ＭＲ）的大小。材料和方法：血流模型由有机玻璃构成,使用ＡＴＬＡｐｏｇｅｅ彩色多普勒超声仪,探头附着在一种机械臂上,在ＴｏｍＴｅｃ计算机控制下进行０～１８０°旋转扫描获得３Ｄ重建的数据。结果：３Ｄ重建后的返流容积与实际测量的返流容积（ｍｌ／ｂｅａｔ）和最大流量（Ｌ／ｍｉｎ）相关良好（ｒ＝０．９２和ｒ＝０．８８）。彩色多普勒血流（ＣＤＦＩ）的最大返流面积与实际返流容积和最大返流量相关较好（ｒ＝０．８４和ｒ＝０．８８）。结论：３Ｄ重建可观察ＣＤＦＩ返流束的空间分布,并可改进二维测量的准确性。３Ｄ重建是定量ＭＲ较准确、可行的方法。     

扩张型心肌病和缺血性心肌病心肌灌注,代谢及功能的综合评价

目的 探讨核素显像在扩张性心肌病（ＤＣＭ）的缺血性心肌病（ＣＡＤ－ＤＭ）诊断及鉴别诊断中的作用。方法 对２８例ＤＣＭ和５５例ＣＡＤ－ＣＭ均行＾９９Ｔｃ＾ｍ－甲氧基异丁基异腈（ＭＩＢＩ）静息心肌灌注ＳＰＥＣＴ及＾１８Ｆ－脱氧葡萄糖（ＦＤＧ）心肌代谢ＰＥＴ显像，其中７３例行核素心室显像，６８例做冠状动脉造影。结果 心肌灌注显像２３例（８２％）ＤＣＭ为不呈节段分布的、散在的稀疏，４例（１４％）有灌注缺损     

99mTc-MDP乳腺显像诊断乳腺肿块的价值

目的评价９９ｍＴｃ羟基亚甲基二膦酸（ＭＤＰ）乳腺显像对乳腺癌的诊断价值。方法对６５例乳腺肿块患者进行乳腺和骨显像，取前位、左侧位、右侧位。病人均经手术和病理检查证实。结果９９ｍＴｃＭＤＰ诊断乳腺癌的灵敏度为９３３％，特异性８２９％，诊断正确率８７７％，假阴性率６７％，假阳性率１７１％，乳腺肿块与健侧相应部位ＲＯＩ的放射性比值，乳腺癌组为２５１±０３３，良性病变组为１９１±０２０，Ｐ＜０００１。３０例乳腺癌骨显像中７例发现有转移灶。结论９９ｍＴｃＭＤＰ显像对乳腺癌的诊断、良恶性乳腺肿块的鉴别及有无早期骨转移灶的判断很有价值。     

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.