军队医院参与法医门诊的几点体会

1993年4月,我院受成都市检察院委托设立了第四法医门诊部。7年来,共进行法医伤残评定104例,其中工伤评定44例,民事纠纷30例,交通事故30例。在法医伤残评定中,受公检法委托23例。厂矿50例,乡政府24例,交警7例。进行法医验伤149例,其中工伤15例,民事纠纷85例,交通事故49例,无1例被投诉或复评、复验。同时,还进行法医咨询1000余人次。 通过7年来的实践证明,军队参与法医门诊评     

军队医院参与法医门诊的几点体会

1993-04,受成都市检察院委托,我院设立了第四法医门诊部。7年来,我院累计共进行法医伤残鉴定104例,验伤149例,接收法医咨询近1000人次,体会是多方面的。     

重庆市高速公路部分交通事故死亡案例的特点分析

目的 对重庆市2006年～2010年高速公路部分致死性交通事故的资料进行收集和分析,探讨其事故特征.方法 对重庆法医验伤所2006年1月～2010年6月高速公路部分致死性事故死亡人员尸检报告及重庆市交通行政执法总队高速公路支队所提供的事故情况报告进行分类、归纳、整理与统计.结果 (1)共693起致死性交通事故,死亡人数...     

201例交通事故导致膝关节损伤的法医学分析

目的 探讨交通事故导致膝关节损伤的特点,为其法医学鉴定提供客观依据. 方法 对2006 -2008年间经重庆法医验伤所鉴定的201例交通事故导致的膝关节损伤案例进行回顾性研究. 结果 根据膝关节的损伤类型,将本组案例分为骨损伤组、软组织损伤组及骨合并软组织损伤组.通过对各组膝关节功能情况的分析发现:对于负重情况,其正常率以及不能负重率,骨损伤组以及骨合并软组织损伤组均与软组织损伤组差异有统计学意义(P＜0.05). 结论 将患者的负重情况、行走功能以及步态情况纳入鉴定过程,会使交通事故导致膝关节损伤的法医学鉴定更为合理.     

高分辨率64层螺旋CT在鼻骨骨折法医鉴定中的应用价值

目的评价高分辨率64层螺旋CT(HR-MSCT)扫描在鼻骨骨折法医鉴定中的应用价值。方法收集自我院200例(包括外伤性180例和非外伤性20例)鼻骨骨折患者均经颅面部HR-MSCT扫描。其中,180例外伤性鼻骨骨折患者依据其CT表现分为3种类型:Ⅰ型为单侧或双侧鼻骨骨折,断端无明显错位或成角,Ⅱ型为单侧或双侧鼻骨骨折,伴有明显的断端错位(大于1/2)或明显的成角(大于等于45°),Ⅲ型为粉碎性骨折。结果在200例患者中,外伤性与非外伤性鼻骨骨折患者分别见于180例和20例。研究证实,在180例外伤性鼻骨骨折患者中有Ⅰ型41例,Ⅱ型35例以及Ⅲ型104例。结论 HR-MSCT扫描可清晰显示鼻骨骨折的部位、范围、积液,并能对外伤性骨折准确分型,为司法鉴定及临床诊治提供可靠依据。     

数字X线摄影在胃肠道藏毒筛查中的应用价值

目的：探讨数字X线摄影在胃肠道藏毒筛查中的应用价值。方法筛选进行胃肠道藏毒检查者50例,作为研究对象。对所有被检者进行DR检查,根据X线影像做出诊断,并与法医检验结果进行比较,总结数字X线摄影在胃肠道藏毒检查中的影像征象。结果 DR检出胃肠道藏毒患者47例,检出率为94．00％,检出腹腔异常形状疑似物62处,与法医检验结果比较无显著差异（ P＜0．05）,藏毒定位中DR检出胃内藏毒23例,小肠内藏毒8例,结肠内藏毒患者16例。结论应用数字X线摄影筛查胃肠道藏毒可提高藏毒检出率,并且针对藏毒数量、藏毒部位定位较为准确,检查方式较为方便且速度较快,具有临床应用及推广价值。     

肝肾综合征43例临床分析

肝肾综合征是指肝硬化及严重肝病（重症肝炎等）患者发生无其它已知原因的功能性肾衰竭，发病机制尚未完全清楚，病死率高，如治疗不及时或不合理，病人常在短期内死亡。本研究对我院1998—2004年收治的43例肝肾综合征病人的临床特点进行回顾性分析，现报道如下。     

肋骨骨折X线平片漏诊原因分析与对策

肋骨骨折在胸部创伤中最常见,X线平片是检查的首选方法,除发现肋骨骨折外,尚可发现锁骨、肩胛骨等部位的骨折,是否合并胸腔积液、气胸、液气胸、肺挫裂伤、支气管阻塞、肺实变、皮下纵隔积气等异常改变。但有些肋骨骨折,外伤时骨折端无错位或骨折端有嵌入,胸部X线平片很难发现,另有些患者病情危重,甚至是在抢救过程中床边摄片,胶片质量较差,伪影较多,造成误诊或漏诊,延误诊断,给病人造成痛苦或危及生命,有些给法医鉴定带来困难或引起医疗纠纷。我院2002-01以来,胸部创伤有肋骨骨折的患者138例,28例X线平片误诊或漏诊,现分析报告如下。坠落…     

颅脑外伤的CT同一性检验探讨

资料方法 本组资料125例分布在各年龄段，其中男性7l例，女性54例，均为1997年至今在我院及兄弟医院CT室直接检查出或由法医要求协助检查情况下证实的。机型：西门子AR、GE Hispeed Advantage、GE Synergy扫描方法：常规平扫或增强扫描，基线OM，层厚10mm、层距10mm。辅以目标扫描与薄扫以及重建技术。     

3008例肺癌纤支镜检查结果分析

1979～1994年,我们对疑诊肺癌及其它肺部疾病万余例患者进行了纤维支气管镜检查(简称纤支镜),经病理和/或细胞学检查确诊肺癌3317例,其中鳞癌1608例,腺癌532例,未分化小细胞癌868例,其它类型和未定型者309例。本文对常见病理类型鳞癌、腺癌和未分化小细胞癌共3008例进行临床对比分析。重点讨论其临床特征和早期发现与诊     

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.