上海医学会第八届放射学专科委员会名单

名誉主委冯晓源主任委员陈克敏副主任委员李明华，刘士远，耿道颖秘书宋济昌，许建荣委员(排名不分先后)余强，叶剑定，王建华，滑炎卿，赵泽华，潘自来，王篙，张贵祥，曾蒙苏，李克，李群英，李茂全，李玉华，姚伟武，程红岩，彭卫军，杨军上海医学会第八届放射学专科委员会名单@本刊编辑部~~     

颈静脉孔区神经纤维瘤一例报告

颈静脉孔区神经纤维瘤较为罕见，我院收治1例，现报告如下，女，52岁，病案号：75257，于20年前摔下马昏迷3天，1978年初右耳鸣，听力减退，讲话嘶哑，逐渐出现头痛，头晕，恶心，呕吐，喝水呛咳，咀嚼食物困难，舌右侧半皱缩，转颈受限，右颜面部麻木，步态不稳，因症状加重，于1982年9月25日入院。     

军团菌肺炎1例报告

军团菌病罕见，我科收治三例现报告如下：病例介绍患者男性，69岁，干部。发烧二十多天入院，入院前因受凉后出现咽痛、流涕、体温高达39．0℃，平均体温38℃左右，多在下午和晚上发烧，无盗汗现象，不咳嗽，胸不痛，门诊用青霉素、先锋霉素等治疗，效果均不明显，体温忽高忽低，收入院治疗。入院检查：体温37．6℃，脉搏96次／min，血压15／8kpa，发育正常，营养中等，神志清楚，呼吸平稳，查体合作，言语流利，巩黄（一），表残淋巴结不大；咽部充血，扁桃腺不大，心肺听诊未见明显异常，腹部无压痛，肝脾未及，四肢活动正常，双下肿不肿…     

溢奶窒息、呼吸、心跳停止抢救恢复1例

患儿，男性，4个月，母乳喂养。因喂奶量多，吸吮过急，呛咳后造成误吸，迅速出现窒息。于15min后送急诊室，口腔、鼻腔流出大量乳白色液体。面色发绀，心跳。呼吸停止，瞳孔散大，固定，无任何反射。快速气道内吸引后，口对口人工呼吸，同时心脏按压，建立循环和呼吸功能，配合药物治疗，肾上腺素0．5mg，可拉明0．2，洛贝林1．5mg，静脉推注快速气管插管，手控呼吸，继续心脏按压，静滴5％ GS250ml＋可拉明0．375，洛贝林3mg，阿托品0．5mg，地塞米松5mg，5％碳酸氢钠5ml稀释到20ml，地塞米松7．5mg，去甲肾上腺素1mg，可拉明0．375，洛贝林3mg，阿托品0．5mg，间断分三次静脉推注，用5％GS250ml＋青霉素240万^u，静脉滴注。     

跨颅窝的高密度皮样囊肿一例

患者女，31岁，因恶心，呕吐6个月，头痛伴多饮，多尿，朋经紊乱3个月入院。体检：神志清楚，对答切题，定向力，理解力，记忆力正常；右侧嗅觉丧失；双侧视力，视野正常，双侧瞳孔等大，等圆，直径3mm，双侧眼球活动自如，光反射（＋＋），右侧角膜反射（＋），     

胸腹联合伤1例

我们于1994年7月救治1例重型闭合性胸腹联合伤获得成功，报告如下。1病例报告患者男，22岁，未婚，汉族，战士。1994年7月19日13：00被卡车撞伤胸腹部，当即昏迷，眼球凝视，口吐白沫，约2min后意识清醒，喊叫疼痛，烦躁不安，胸闷，呼吸困难，急诊入院。查体：体温36℃，脉搏110／min，呼吸24／min，血压13．3／8kPa，烦躁不安，神志模糊，双侧瞳孔等大等回，对光反射好，眼睑、面色苍白，查体不合作，左侧肺部呼吸音消失，语音减弱，叩呈浊音，心脏明显向右侧移位，腹平坦，全腹压痛，以左上腹为重。考虑左侧膈疝、脾破裂，急诊行X线胸部…     

胸腺瘤破裂出血一例

患者 男，48岁，因运动中突发左胸疼痛，呈持续性，伴气促，不能平卧7h就诊，既往身体健康，无类似病史。体检，急性痛苦面容，胸廓无畸形，左侧呼吸运动较右侧稍减弱，胸廓无压痛及叩击痛，心界不大，心率90次/min，心音有力，节律齐，未闻及杂音及心包摩擦音，左下肺叩诊浊实音，呼吸音减弱，余肺呼吸音清晰，未闻及干湿性罗音，生命体征正常，实验室检查未见异常。     

飞行员肾综合征性出血热一例

患者，男，35岁，歼-8飞行员，总飞行时间2000h。因发热4d于2003年2月8日入院。患者入院前4d无明显诱因出现发热，体温在39℃以上，最高达40．2℃，不伴有咳嗽、咯血，无流涕、鼻塞，无胸闷、无呼吸困难，伴有头痛，眼眶痛，腰痛，肌肉酸痛，周身乏力，在当地静滴青霉紊2d无效，入院。患者既往身体健康，无肝炎及其他病史，发病前1个月曾做大体检未见异常，飞行合格。本次患病前一直在飞行。入院时查体：体温39．4℃，呼吸19次／min，脉搏96次／min，血压102／62mm Hg，颜面，颈部，前胸潮红，咽红，眼球结膜充血，周身皮肤黏膜未见出血点，心肺腹未见异常，肾区有叩击痛。     

过量外照射和内污染近远期辐射效应研究

过量外照射和内污染近远期辐射效应研究王永孝，纪桂云，徐秀凤，白玉书，周藕良，金璀珍，傅宝华，刘文丽，刘任远，金家美，刘锦文，杨觉雄，李美颖，姚永明，叶青，石瑞，于源龙小剂量外照射和小剂量内污染目前尚无可靠的评价方法与估计标准。因此对小剂量危害的评价，...     

宫外宫角同时妊娠1例

1病历摘要患者34岁，孕1产1，本次月经1994年4月19日，既往月经规律，14。因停经39d，阴道流血伴下腹痛7d，加重4h，于1994年5月18日急诊入院，查体；体温36．5℃、脉搏100／min、呼吸20／min、血压12／8kPa，神清，痛苦面容，贫血貌。查体合作，心、肺正常，腹微膨隆，肝脾未触及，腹肌稍紧，腹下区有明显压痛，反跳痛（＋），移动性浊音（＋）。妇科检查：外明已产型，阴道通畅，有少量暗红色血液，宫颈举痛明显，宫口松，后穹窿饱满，触痛（＋），子宫前位，约40d孕大，压痛（＋），质软，活动，双侧附件触诊不满意，压痛明显，尤以左侧…     

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.