某装甲步兵进攻性演习常见疾病发生规律分析

目的　研究装甲部队进攻性演习疾病发生规律。方法　采用随队军医对病人进行就诊登记的方法。并给予相应的治疗。结果　在整个演习过程中 ,消化系统疾病发生最多 ,其次是呼吸系统和五官疾病。消化系统疾病主要集中在急性肠炎和胃炎 ,呼吸系统主要是上呼吸道感染 ,五官主要是口腔溃疡。结论　装甲部队演习过程中的主要疾病是急性肠炎和急性胃炎 .其次是上呼吸道感染和口腔溃疡     

慢阻肺无创呼吸机护理中人性化护理疗效

目的：对于人性化护理在慢阻肺无创呼吸机护理过程中的应用效果展开分析和研究。方法：对90例在本院进行无创呼吸机治疗的慢阻肺患者进行随机分组,对照组是常规护理,观察组是人性化护理,对比其疗效。结果：观察组在护理效果上是优于对照组的,在并发症方面是小于对照组的,对比存在差异,P<0.05;观察组在生活质量评分上是高于对照组的,在焦虑和抑郁评分上是低于对照组的,相比是有较大差异的,P<0.05。结论：人性化护理在进行无创呼吸机治疗的慢阻肺患者护理中的应用疗效显著。     

对正确处理医德医风与利益导向关系的思考

在市场经济条件下,经济效益是医院生存的根本,利益导向日渐强化,如何处理好军队医院医德医风与利益导向的关系,是值得我们探索和研究的一个问题。１我军医德医风的产生发展及其在市场经济条件下的现状我军的医德医风是在长期革命斗争实践中产生和发展起来的。在过去的...     

间歇缺氧对动脉粥样硬化的影响

动脉粥样硬化（atherosderosis,AS）是进展性动脉疾病,是缺血性心脏病、脑血管病和周围血管病的主要促进因子。在西方,AS是引起死亡的主要原因之一。尽管有了血管造影检查和降脂治疗,在北美仍有38％的死亡归因于心血管疾病,说明没有完全控制AS的进展。     

RSNA2013乳腺影像学

乳腺影像学是2013年RsNA大会非常重要的组成部分,乳腺论文方面在论文数量方面较往年明显增加,且有更多新的技术和进展在乳腺检查中得到应用。和往年相比,内容有如下方面的特点和热点：①MRI的研究内容中非常重要的一方面是MRI新技术在乳腺方面的应用,主要是DwI和MRS,高超强7TMR的应用也是一个重要的方面;②乳豫超声方面弹性成像仍旧是研究的重点,这方面论文数量在超声乳腺研究中占主导地位;③乳腺断层摄影（DBT）是今年研究的一个热点,论文数目较往年明显增多;④计算机辅助诊断（CAD）主要集中于乳腺MRI诊断方面,在x线的辅助诊断方面也有较多进展;⑤核医学和放疗方面的文章也出现于2013年RsNA大会中,但是数目并不算多。     

99mTc-葡糖二酸显像剂的研究进展

葡糖二酸(GLA)是一种六碳二元羧酸盐的葡萄糖类似物,是葡萄糖在生物体内代谢的产物之一,存在于组织和体液中,可被99mTc标记。本文论述了GLA的制备、99mTc-GLA药盒的制备以及99mTc-GLA在心肌梗死显像和肿瘤显像中的研究进展。现有的研究结果表明,99mTc-GLA在诊断心肌梗死和某些肿瘤(如乳腺癌)表现了良好的性质,因此是一种很有应用前景和研究价值的显像剂。     

情境意识的定义、测量和训练

已经采取种种办法来帮助飞行员在飞行中保持空间定向能力。情境意识是飞行员除对气象、飞行阶段和其它飞行器的了解之外,保持自身和飞机定向的能力,是飞行员做出最佳决策的关键。在单座和多座飞机中,其基础是建立在对情境意识的一致理解上。主要研究者将介绍一些现在用来测量飞行员在诸飞行阶段中操作能力的技术,这些技术可能会对情境意识产生负性     

将培养“如何学习”作为每门课程的核心

个人的学习不再是专指在学校学习,因为在校学习仅仅是终身性继续教育的一部分。过去学校教育注重教学的具体内容,学校努力的焦点都是在决定学生:“应该学些什么”和“应该想些什么”,往往忽视了学生创造能力和“如何学习”的培养。1　培养“如何学习”的意义学习是指人和动物获得关于外界信息(知识)的神经生物学过程。而学习又不仅仅是吸收新信息,我们还要思考这些信息,把它储存在大脑的深层记忆中去。记忆是将所获得的信息(知识)贮存和读出的神经活动过程。贮存信息也仅是学习过程中的一部分,信息(知识)还要被激话、被使用,产生创造力,这才…     

人在视频外科中的效能问题

如今,“侵害最小的手术”是病人的高要求。在外科手术视频时代开始时,留有大量重要的问题。最初的兴趣是在外科医生和病人之间增加一个照相—电视中介。有关信息的观察是一个主动的过程,通过此过程我们要获得探查所需的视觉的和感知到的信息。外科探查病人病情的传统的方法是通过眼看和手摸。视频外科或内窥镜技术剥夺了外科大夫直接的观察和触觉检     

加强医德建设提高医疗质量

医德是医务人员对本职工作在伦理上达到的思想境界所持的基本态度。是医务工作者在履行本职工作中应遵循的行为规范的总和。医德建设是深化医院工作的重要手段,是纠正行业不正之风的治本之策,是完善监督制约机制的有效措施,是实现医院管理以人为本的重要保证。我院在临床工作中注重医德建设。把医德医风工作纳入规范化轨道,医德伦理水平得到了明显的提高。医务人员发扬奉献精神,树立正确的价值观,促进了优质服务,提高了医疗质量,医院的吸引力和竞争力显著提高,收到了较好的社会效益和经济效益。     

空心加压螺钉内固定术治疗股骨颈骨折的疗效

目的：探讨研究空心加压螺钉内固定术治疗股骨颈骨折的疗效及安全性。方法选取2013年1月～2015年2月骨科收治的70例股骨颈骨折患者,采用随机数字法分为治疗组和常规组,对照组采用DHS进行固定,观察组采用空心加压螺钉内固定治疗,并对两组患者康复情况满意度、两组患者术后发生的愈合率、两组患者股骨头坏死情况进行比较。结果观察组的患者康复情况满意度、两组患者术后发生的愈合率、两组患者股骨头未坏死情况均高于对照组,差异具有统计学意义（ P＜0．05）。结论空心加压螺钉内固定术手术的创伤面积小,无需进行术后的特殊护理,是一种较可靠、安全、理想的内固定法,值得临床的广泛推广和应用。     

免疫正常儿童肺隐球菌病的CT表现

目的 研究免疫正常儿童肺隐球菌病的CT表现.方法 回顾分析经临床确诊的21例无基础疾病及免疫缺陷肺隐球菌病患儿的临床资料和CT表现.结果 免疫正常儿童肺隐球菌病肺内CT表现为左肺舌叶胸膜下直径约1 mm的孤立结节1例;肺内大小不均匀多发结节20例,胸膜下及肺外带分布12例,肺内弥漫分布8例;结节直径＜10.0 mm 18例,其中3.0 mm以下14例,＞10 mm2例;结节为类圆形且边界光滑15例.淋巴结肿大17例,CT增强后3例轻度强化、2例环形强化.14例合并肝、脾、肾和中枢神经系统感染等肺外病变.随访1例患儿死亡,20例痊愈.结论 免疫正常儿童肺隐球菌病以肺内多发小结节伴多组淋巴结肿大为主要的CT特征,并易合并肺外器官播散.     

Selective renal venography in patients with primary renal disease and the nephrotic syndrome

Fifteen patients with primary renal disease and renal vein thrombosis who presented with the nephrotic syndrome were investigated venographically. In 46% of the patients the cavogram was normal. Selective renal venography is necessary in such patients because the course of patients with renal vein thrombosis and membranous glomerulonephritis is identical to that of patients with membranous glomerolonephritis alone. Eighty per cent of our patients had membranous glomerulonephritis; renal vein thrombosis is now thought to be secondary to this disease.     

Postmenopausal bleeding: value of imaging

Endovaginal sonography in combination with HSG is an effective screening tool in evaluating patients with postmenopausal bleeding. Endovaginal sonography is highly sensitive for detecting endometrial carcinoma and can identify patients at low risk for endometrial disease obviating the need for endometrial sampling in this subgroup of patients. In patients with abnormal findings at sonography, a detailed morphologic analysis can be used to determine which patients can undergo blind endometrial sampling successfully versus those who would benefit from hysteroscopic guidance. In patients in whom endovaginal sonography and HSG are inadequate, MRI may provide additional information on the appearance of the endometrium, particularly in patients in whom endometrial sampling is difficult (eg, patients with cervical stenosis).     

肝小静脉闭塞症与布-加综合征的CT鉴别诊断

目的探讨肝小静脉闭塞症(HVOD)与布-加综合征(BCS)的CT鉴别诊断要点。资料与方法收集20例经病理或临床诊断的HVOD及20例经介入或手术确诊的BCS患者,回顾性分析两组患者的临床资料及CT表现,总结具有特征性的临床及CT表现。结果HVOD患者侧支循环数显著少于BCS患者,差异有统计学意义(P<0.05);两组患者均可出现肝静脉狭窄,但BCS患者更易出现闭塞及远端下腔静脉扩张(P<0.05)。BCS患者更易出现下肢水肿(P<0.05)。16例HVOD患者有服用“土三七”等中药史。HVOD患者中,17例出现3支肝静脉周围正常肝实质强化(即“三叶草”样强化);BCS患者中无此征象出现。HVOD及BCS患者均可出现“地图样”强化,差异无统计学意义(P>0.05)。结论HVOD患者肝静脉可狭窄,但多保持通畅,下腔静脉无扩张,侧支循环少,较少出现下肢水肿,且多有服用“土三七”等中药史。“三叶草”样强化是HVOD的重要强化特点。     

Usefulness of 201Tl myocardial scintigraphy after dipyridamole infusion in patients with atherosclerotic vascular disease]

To determine the utility for detecting ischemic heart disease (IHD), Dipyridamole thallium myocardial images (DIP-Tl) have been performed in the 103 patients with atherosclerotic vascular disease who can't exercise fully. Of 103 patients, there were 36 patients with arteriosclerosis obliterans (ASO), 31 patients with aneurysm of the abdominal aorta (AAA), 24 patients with aneurysm of the thoracic aorta (TAA) and 12 patients with dissecting aortic aneurysm (DAA). Clinical evidence of IHD was found in 20 patients with ASO, 10 with AAA, 7 with TAA and 4 with DAA respectively. Positive evidence of DIP-Tl was identified in 66% of 41 patients who had clinical evidence of IHD, and particularly in the patients with AAA (80%) and ASO (65%). On the other hand, in the patients without clinical evidence of IHD, positive evidence of DIP-Tl was identified in 19% of 62 patients and particularly in the patients with AAA (39%). In all patients, the percentage of the positive DIP-Tl ratio was 38%. And, when the 38% patients of the positive DIP-Tl were added to the patients of the negative DIP-Tl who had clinical evidence of IHD, almost half patients (51%) were considered to be complicated with IHD. This study suggests that the atherosclerotic vascular disease is highly complicated with IHD and DIP-Tl is useful to detect IHD.     

苯中毒重型再障免疫细胞及免疫因子变化

目的通过对苯中毒急性再生障碍性食血(AAA)患者的免疫细胞及相关因子动态检测,探索苯中毒AAA发病机制及治疗特点。方法对32例苯中毒AAA患者在治疗前及治疗后4个月作血清白介素-2(sIL-2),及外周血T细胞亚群分类,NK细胞检测,并与同期原发性AAA患者作比较。结果苯中毒AAA患者sIL-2增高,T细胞亚群及NK细胞异常,通过非免疫相关治疗4月后都恢复正常。结论苯中毒AAA患者存在异常免疫,免疫功能在经过非免疫相关治疗可恢复,免疫异常不是苯中毒AAA发病的主要因素,免疫治疗非苯中毒AAA治疗首选。     

Untreated osteochondritis dissecans of the femoral condyles: prediction of patient outcome using radiographic and MR findings

 Objective. We investigated the usefulness of plain film and MR findings in predicting the outcome of conservatively treated patients with femoral osteochondritis dissecans. Design. Without knowledge of the clinical outcome, we retrospectively reviewed the initial plain films and MR examinations. Each MR examination was evaluated for the four MR findings of instability. Patients. Fourteen patients were studied in whom osteochondritis dissecans of a femoral condyle had been treated conservatively for periods ranging from 1.2 to 8.5 years. Results and conclusion. Three of five patients with an open femoral growth plate and one of nine patients with a closed growth plate had a good clinical outcome. Both patients with lesions smaller than 160 mm² in area had a good outcome and ten of 12 patients with larger lesions had a poor outcome. Both patients with stable lesions by MR imaging had a good outcome while ten of 12 patients with a lesion unstable by MR imaging had poor outcomes. All six patients with a cartilage fracture or articular defect had poor outcomes. The results of this study should be considered preliminary since only 14 patients were followed. However, it appears that a good clinical outcome is likely when the femoral growth plate is open, when the osteochondritis dissecans is small, and when the lesion is stable by MR imaging. When a cartilage fracture or articular defect is found on MR imaging, the patient is likely to have a poor outcome.     

Computed tomography of bowel infarction

Bowel infarction is a potentially lethal disorder that is notoriously difficult to diagnose clinically and radiographically. Computed tomography is often used in the early radiographic evaluation of patients with severe abdominal pain of unknown etiology. This study defines the CT findings in patients with bowel infarction. The findings in 22 patients with mesenteric infarction were reviewed. Seven were due to mesenteric arterial occlusion, six due to mesenteric venous occlusion, and nine were nonocclusive. The CT abnormalities were diffuse or focal bowel wall thickening (19 patients), bowel dilatation without mural thickening (three patients), intramural low attenuation zones of edema (eight patients), intramural gas (11 patients), mesenteric gas (five patients), portal or mesenteric venous gas (one patient), mesenteric vascular occlusion (eight patients), and peritoneal gas or fluid (12 patients). The diagnosis of bowel infarction must be considered when performing CT in patients with abdominal pain of unknown etiology.     

Selenomethionine liver scanning in the diagnosis of hepatoma

Liver subtraction scans using 99Tcm sulphur coloid and 75Se-selenomethionine were carried out in 58 patients with suspected hepatoma. Of the 18 patients with hepatoma proven by histology, 16 showed selective concentration of selenomethionine in the tumour, giving a true positive rate of 89%. Of the 40 patients who did not have hepatoma, 32 scans showed no evidence of selective concentration of selenomethionine, giving a true negative rate of 80%. The false positive rate was 8% in non-cirrhotic patients with focal disease, but 55% in patients with cirrhosis. It is concluded that combined scanning with this technique is useful in non-cirrhotic patients in distinguishing hepatoma from other causes of focal disease, but that the technique is not useful and frequently misleading in patients with cirrhosis.