经阴道彩色多普勒超声诊断卵巢良恶性肿瘤的价值

目的:探讨经阴道彩色多普勒超声对卵巢良、恶性肿瘤的诊断价值及其与临床分期的关系。材料和方法:对47例卵巢恶性肿瘤,18例良性肿瘤,5例交界性肿瘤患者术前行经阴道彩色多普勒超声检查。分析瘤内血管分布类型、瘤内动脉血流参数及动脉频谱舒张期切迹等指标与良、恶性肿瘤及临床分期的关系。结果:卵巢恶性肿瘤动脉血流RI值明显低于良性组,且Ⅲ、Ⅳ期RI值明显低于Ⅰ、Ⅱ期。恶性组血管分布多为Ⅲ型,占38/47,良性组血管分布Ⅲ型为1/18,以血管分布Ⅲ型为标准诊断卵巢恶性肿瘤敏感性80.8%,特异性86.9%。恶性组4/47动脉频谱有舒张期切迹,良性组14/18动脉频谱有舒张期切迹,两组比较差异有统计学意义。结论:RI、血管分布类型、脉冲频谱舒张期切迹是鉴别卵巢良、恶性肿瘤的重要指标,对评价预后有一定的参考价值。     

胎儿脑血管彩色多普勒超声检测

目的 :研究正常胎儿颅内动脉的结构和血流动力学参数。方法 :应用彩色多普勒血流显像和脉冲多普勒检测 5 0例正常胎儿大脑前动脉、大脑中动脉、大脑后动脉的血流特征。每次检查时间控制在 10分钟之内 ,胎龄 39- 4 0周。结果 :CDFI总体成功显示率为 94 7%、PW显示率为81% ,以胎头向母体腹侧大脑中动脉显示最好为 10 0 %。胎儿大脑中动脉的PW定量分析显示 :PV5 8 2± 12 1cm/s　mv　 30 3+8 71cm/s　PI　 1 6± 0 3p　RI　 0 6 5± 0 17。结论 :利用彩色多普勒超声检查提供的信息 ,在妊娠期胎儿监测方面将可起到重要作用     

经阴道彩超诊断宫内早早孕73例分析

目的　探讨宫内早早孕阴道彩色多普勒超声特点。方法　分析 73例宫内早早孕的子宫大小、内膜厚度、子宫动脉和内膜血流的阻力指数 (RI)值 ,并与 4 5例育龄非妊娠妇女作对照。结果　子宫动脉平均RI值 0 .82± 0 .0 6 ,与对照组比较无差异 ;子宫增大 2 5例 ,平均值 15 .6 0± 1.70cm ;子宫内膜增厚达 1.1～ 2 .1cm ,≥ 1.2cm者 6 9例 (占94 .5 % ) ;内膜血流显示率 10 0 % ,呈低阻力型 ,平均RI值 0 .4 4± 0 .0 7,三项与对照组比较有差异。结论　子宫大小、内膜厚度及血流特征 ,结合停经史和血HCG阳性 ,对诊断宫内早早孕具有重要的价值     

彩色多普勒超声血流阻力指数结合CA125对卵巢肿瘤的诊断价值

目的探讨彩色多普勒超声血流阻力指数(RI)结合肿瘤标志物CA125判断卵巢肿瘤良恶性的价值.资料与方法107例卵巢肿瘤患者采用Finkler 超声评分系统进行评分,经彩色多普勒超声检查测定 RI,同时测定患者血清 CA125判断卵巢肿瘤良恶性,并与术后病理进行对照.结果恶性卵巢肿瘤患者 Finkler 超声评分明显高于良性卵巢肿瘤患者,RI 值低于良性卵巢肿瘤患者,CA125明显高于良性卵巢肿瘤患者(P <0.01、P <0.05).Finkler超声评分、RI 结合 CA125对卵巢肿瘤良恶性诊断的敏感性及特异性分别为94.59%、89.47%,均高于单一检查方法.结论彩色多普勒超声、RI 及肿瘤标志物 CA125联合应用对提高卵巢肿瘤良恶性的诊断有一定临床价值.     

彩色多普勒能量图检测浅表淋巴结内动脉血流的价值

目的 :探讨彩色多普勒能量图检测浅表淋巴结内动脉血流在鉴别良恶性淋巴结病变的价值。方法 :回顾性分析 12 6例浅表淋巴结病变的彩色多普勒能量图及动脉血流频谱。其中良性淋巴结肿大 33例 ;恶性淋巴瘤 18例 ;淋巴结转移性肿大 75例。均经穿刺活检或手术病理证实。结果 :110个 (87.3% )淋巴结内检出动脉血流频谱 ,血流检出率良性病变为 72 .7% (2 4 / 33) ,恶性肿瘤为 92 .5 % (86 / 93)。良性肿大组、恶性淋巴瘤组和淋巴结转移癌组淋巴结内动脉血流PSV分别为 14 .4± 7.3cm/s、2 0 .1± 7.9cm/s和 18.2± 5 .1cm/s,RI测值分别为 0 .6 2± 0 .0 9、0 .73± 0 .19和 0 .74± 0 .16。t检验结果 ,淋巴结内动脉血流速度 (PSV)和阻力指数 (RI) ,良性疾病与恶性淋巴瘤和淋巴结转移癌组间差异具显著性 ,恶性淋巴瘤组和转移癌组间差异无显著性。结论 :淋巴结内动脉血流RI值可作为鉴别淋巴结良恶性的一个重要指标。但是 ,良恶性病变间PSV、RI值存在一定重叠。     

经阴道彩色多普勒血流显像诊断卵巢恶性肿瘤

本文在经阴道超声二维灰阶图像的基础上添加彩色多普勒血流显像技术 ,对卵巢恶性肿瘤在早期诊断方面进行了研究和探讨 ,目的在于为临床提供一种能早期诊断卵巢恶性肿瘤的有效方法。材料与方法所有病例均来自 1997年 11月至 1999年 7月期间到我院住院患者 ,术前均行阴道彩色多普勒血流显像检查 ,术中标本送病理 ,彩色多普勒提示为恶性的术中均行快速病理检验 ,最后的诊断由组织病理学检查结果确定。卵巢肿瘤患者 95例 ,其中良性肿瘤 5 5例 ,平均年龄为(37.9± 1.3)岁 ;恶性肿瘤 40例 ,平均年龄为 (4 6 .9± 11.5 )岁。方法　仪器使用美国ＡＴ…     

肿瘤血管阻力指数和内径在乳腺良、恶性肿瘤鉴别中的应用

目的:探讨肿瘤血管阻力指数和内径对乳腺良、恶性肿瘤的鉴别诊断价值.材料和方法:应用彩色多普勒和频谱多普勒超声检测30例正常乳腺和120例乳腺肿瘤(良性66例,恶性54例),观察其血流分布,计测阻力指数(RI)和血管直径(D).结果:120例乳腺肿瘤中112例(良性60例,恶性52例)能检出血流信号,良性组与正常组相比,血管RI及D差异不显著(P＞0.05);恶性肿瘤组与正常组及良性肿瘤组比较,RI增高和D增宽(P<0.01);乳腺肿瘤动脉RI≥0.82和D≥0.28提示恶性肿瘤敏感性、特异性分别为79%、91%.结论:肿瘤血管阻力指数增高和内径增宽是乳腺良、恶性肿瘤鉴别诊断的重要指标,能提高乳腺恶性肿瘤的诊断准确性.     

彩色多普勒对视网膜脱离血液动力学研究

目的 :利用彩色多普勒技术评价视网膜脱离 (RD)患者球后血流动力学变化。方法 :视网膜脱离患者 3 5例 ,55只眼。对照组 2 6例 ,51只眼。彩色多普勒超声指导下 ,采用脉冲多普勒超声检测眼动脉 (OA)、视网膜中央动脉 (CRA)、睫状后动脉(PCA)收缩期 (PSV)、舒张期 (ESV)、平均血流速度 (AV)及阻力指数 (RI)、搏动指数 (PI)。结果 :RD与对照组的OA血流速度无明显差异 (P >0 .0 5) ;CRA、PCA的PSV、EDV、AV血流速度均减低 (P <0 .0 5) ;PI、RI值无显著性差异 (P >0 .0 5)。结论 :视网膜脱离的血流动力学的变化直接影响到视网膜的微循环状态。彩色多普勒超声可正确评估球后血流灌注情况与病变的关系 ,较传统的荧光血管造影法更为直接和敏感 ,为视网膜脱离的基础研究及药物辅助治疗提供了重要的依据     

血清一氧化氮、一氧化氮合酶与彩色多普勒超声在卵巢癌诊断中的价值

目的 :探讨血清一氧化氮 (NO)、一氧化氮合酶 (NOS)及经阴道、经腹彩色多普勒超声联合应用对早期诊断卵巢癌的价值。方法 :对 97例卵巢肿瘤患者术前抽取空腹静脉血测定血清NO、NOS含量 ,经阴经腹彩色多普勒超声检查肿瘤特性 ,并与术后病理结果对比分析。结果 :恶性肿瘤患者血中NO、NOS含量高于良性肿瘤 (P <0 .0 1) ;彩色多普勒超声检查评分高于良性肿瘤 (≥ 3) ,差异显著 (P <0 .0 1) ;恶性肿瘤内部易显示血流信号 ,RI≤ 0 .5 ,与良性肿瘤差异显著 (P<0 0 1)。结论 :血清一氧化氮、一氧化氮合酶及彩色多普勒超声检查联合应用可大大提高卵巢良恶性肿瘤的诊断符合率 ,有助于早期卵巢癌的发现。     

妊娠期肝内胆汁淤积症的脐动脉超声多普勒变化

目的:评价彩色多普勒血流成像检测妊娠期肝内胆汁淤积症(ICP)胎儿血流动力学变化在预测围产儿预后中的价值.方法:应用彩超检测119例孕36~40周ICP孕妇及544例同孕周正常孕妇的胎儿脐动脉超声多普勒变化,测出脐动脉血流收缩期峰值(S)与舒张期末流速(D)的比值(S/D)、搏动指数(PI)和阻力指数(RI)值,两者进行比较.结果:单纯ICP组与正常妊娠组比较,S/D、PI和RI无统计学差异,而ICP并发胎儿宫内窘迫时与正常组比较,S/D有差异,PI和RI无统计学差异;ICP脐动脉多普勒检查阻力升高者出现胎儿窘迫的敏感性为42.9%,特异性为89.4%,阴性预测值52.6%,阳性预测值47.4%.结论:彩色多普勒超声监测ICP胎儿脐动脉多普勒测定为临床早期诊断胎儿窘迫提供可靠依据.     

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.