招飞复检中K值引导法对激光角膜屈光手术眼的筛查

目的 在招飞体检中提高对激光角膜屈光手术眼的筛查效率.方法 对参加招飞复检的3400名学生在裂隙灯检查前,行常规角膜曲率检查,对低K值（角膜曲率值）者重点进行角膜裂隙灯检查,并酌情进行角膜厚度和角膜地形图检查;最后结合病史综合鉴定.结果 参加招飞复检的高中生和大学生中,低K值者68例135眼.重点进行裂隙灯检查68例136眼,其中13例25眼角膜表面具有不同程度异常.行角膜地形图检查65例130眼,其中异常者11例21眼.行角膜厚度检查60例120眼,其中角膜厚度异常11例21眼.14例27眼结合相关检查确诊或高度疑似激光角膜屈光矫治眼,筛查阳性率为0.40%.结论 K值引导筛查法针对性强,可明显提高对激光角膜屈光手术眼的筛查效率,值得在招飞体检工作中推广使用.     

招飞体检中发现角膜塑形术后一例

一、临床资料患者 ,男 ,18岁 ,应届高中毕业生。1999年 1月 2 7日参加招飞体检 ,否认眼科病史。双眼视力均为 1.2 ,散瞳后裂隙灯和检眼镜检查 ,角膜、前房、晶体、玻璃体和视网膜均未见异常。 7月入校前复查得知该生有用角膜接触镜史后 ,对其作了详细检查 ;一般检查结果同前 ,角膜莹光素染色未见异常。检眼镜彻照法检查 ,当光线从眼颞侧与视轴约成 45°射向角膜时于右眼角膜中央有一边缘模糊密度较淡的暗区 ,散瞳后光线于正面射向角膜时见右眼角膜中央区较透亮 ,周围有明暗相间的同心圆环 ;左眼则仅在散瞳后光线于正面射向角膜时 ,角膜中央…     

飞行人员胆囊切除术后胆总管结石一例

一、临床资料 患者男性,35岁,轰-6通射员,飞行时间1100h.以间断性上腹部疼痛4月余,加重1d之主诉于2010年2月24日入院.查体:一般情况好,皮肤、巩膜无黄染,心、肺检查正常,腹部检查除右上腹压痛外未发现阳性体征.辅助检查:血、尿、便常规,肝、肾功能,电解质、血糖等均正常.     

歼击机飞行员准分子激光角膜屈光手术后放飞一例并文献复习

目的 探讨飞行员角膜屈光手术治疗的飞行适应性及航空医学的鉴定原则.方法 分析1例歼轰-7飞行员双眼近视的临床诊断、治疗过程及医学鉴定情况,复习相关文献.结果 本例飞行员诊断为近视性屈光不正2年,保守治疗无效.本人要求手术治疗.眼科检查未见手术禁忌证,经过准分子激光上皮下角膜磨削术治疗,术后常规局部抗炎、促进角膜伤口愈合等药物治疗约1个半月,3个月后复查视功能（包括视力、立体视觉、对比敏感度）恢复正常;双眼角膜伤口愈合良好,电脑验光屈光度稳定;角膜地形图示切削区居中.经低压舱模拟航空低压缺氧环境检查,视功能稳定,给予特许飞行合格.术后正常参加双座机飞行40 h. 结论 军事飞行员近视角膜屈光手术治疗后,角膜伤口愈合良好,视功能恢复正常者可以考虑放飞.飞行适应性评价除常规定期视功能、屈光度、角膜等检查外,应进行对比敏感度、眩光等与飞行环境相关的特殊视功能检测.准分子激光角膜屈光手术是解决军事飞行员近视的有效方法.     

飞行员准分子激光原位角膜磨削术后对比敏感度降低一例

一、临床资料 患者，男性，35岁，外籍飞行员，飞行时间5100h。准分子激光原位角膜磨削术（laser in situ keratomileusis，I。ASIK）后1年，至我中心行年度体检。主诉偶有阴天视物不清。眼部检查：远视力1.0／1．0，近视力1．0／1．0，角膜清，周边见环形手术切痕，前房清深，晶体透明，后段（一）。     

飞行人员肾结核一例

一、临床资料 患者,男性,33岁,直-9空中机械师,飞行时间1800 h.2008年6月体检B超检查时发现右肾异常回声区,经体系医院静脉肾盂造影及CT检查考虑为右肾结石、右肾小盏积水.因患者为直升机机械师给予飞行合格.2009年5月因泌尿系刺激症状就诊于地方医院,超声检查右侧输尿管中段扩张,尿中白细胞增多,按输尿管结石伴尿路感染进行抗感染及体外冲击波碎石治疗,复查仍提示输尿管结石.再次住体系医院,经膀胱镜检查为泌尿系结石.2009年11月出现发热,夜间出汗增多,再次住体系医院,经超声、MRI及静脉肾盂造影检查疑诊肾结核,右肾功能差,于2009年12月转送空军总医院.阳性检查结果如下:血沉44 mm/第1h;尿常规检查白细胞满视野;结核杆菌抗体试验阳性;腹部B超示右肾多发钙化影,右肾中、重度积水,右侧输尿管上段轻度扩张;肺CT示右肺上叶尖段、后段、下叶后基底段,及左肺上叶尖后段、舌段多发小片状及结节状密度增高影.     

新兵跳伞动作地面训练致股骨下段应力性骨折一例

一、临床资料 患者男性,18岁.入伍第1年战士,因左大腿肿痛、畸形伴活动受限2 h入院.患者在两周前新兵跳伞地面动作训练时将左大腿"拉伤",休息后疼痛缓解.就诊前30 min参加离机动作和着陆动作训练时,突感左大腿骨疼痛,活动受限.初步检查:左侧股骨纵向扣击痛阳性,假关节形成,可扪及骨擦感.右下肢检查未见异常.X线片示左股骨下段骨折,断端向后外侧成角.遂送附近驻军医院.入院查CT示左股骨下段斜形重叠骨折,有层状骨膜反应.初步诊断:左股骨下段病理性骨折.     

招飞体检中正常视力眼角膜屈光力的研究

目的 通过在招飞体检中进行角膜屈光力的测定,了解角膜屈光力与眼的屈光状态之间的关系,为是否在招飞体检中进行角膜屈光力的测定提供理论依据.方法 测定分析招飞体检中856只视力正常眼的屈光状态分布及角膜屈光力,对其进行均数比较和相关分析.结果 856只视力正常眼中远视占74.53%,近视、正视及远视3组问的角膜屈光力无显著性差异.结论 视力正常眼角膜屈光力与眼的屈光状态无明显相关性,角膜屈光力的变化不是导致近视的主要原因,在招飞体检中不必要进行角膜屈光力检查.     

招飞体检中正常视力眼角膜屈光力的研究

目的 通过在招飞体检中进行角膜屈光力的测定,了解角膜屈光力与眼的屈光状态之间的关系,为是否在招飞体检中进行角膜屈光力的测定提供理论依据.方法 测定分析招飞体检中856只视力正常眼的屈光状态分布及角膜屈光力,对其进行均数比较和相关分析.结果 856只视力正常眼中远视占74.53%,近视、正视及远视3组问的角膜屈光力无显著性差异.结论 视力正常眼角膜屈光力与眼的屈光状态无明显相关性,角膜屈光力的变化不是导致近视的主要原因,在招飞体检中不必要进行角膜屈光力检查.     

招飞体检中正常视力眼角膜屈光力的研究

目的 通过在招飞体检中进行角膜屈光力的测定,了解角膜屈光力与眼的屈光状态之间的关系,为是否在招飞体检中进行角膜屈光力的测定提供理论依据.方法 测定分析招飞体检中856只视力正常眼的屈光状态分布及角膜屈光力,对其进行均数比较和相关分析.结果 856只视力正常眼中远视占74.53%,近视、正视及远视3组问的角膜屈光力无显著性差异.结论 视力正常眼角膜屈光力与眼的屈光状态无明显相关性,角膜屈光力的变化不是导致近视的主要原因,在招飞体检中不必要进行角膜屈光力检查.     

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,     

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.     

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.     

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.