血友病性骨关节病：附30例临床X线分析

本文报告30例血友病性骨关节病,其中1例为女性(血友病丙),X线片上可有以下10种改变:(1)关节囊、软组织肿胀;(2)关节间隙增宽或变窄;(3)骨性关节凹凸不整;(4)股骨髁间凹或鹰咀窝加深;(5)骨骺或骨端过度发育增大变方;(6)方形膑骨;(7)骨骺线或骨骺不规则;(8)关节骨性僵直;(9)骨内囊肿样变;(10)软组织内钙化。文中对上述表现进行了评价并对病理改变与X 线表现的关系进行了讨论。     

儿童先天性假关节(附11例报告)

目的:提高对先天性假关节病理、X线表现及诊断的认识.材料与方法:总结11例先天性假关节的X线表现.发生于胫骨10例,其中8例合并同侧腓骨假关节;发生在尺桡骨1例.结果: 先天性假关节的X线特点为假关节近端稍张开呈浅杯口状或变细变尖,远端变细变尖呈锥状,局部无骨痂.患骨有骨质增生硬化,可伴有囊性病变.结论:根据其X线特点,结合临床作出本病诊断并不困难,对于有骨质硬化或囊性变的胫骨前外方弯曲应定期X线检查,警惕有假关节形成的可能.     

Fahr病影像学诊断及病理学分析

目的 进一步提高对Fahr病影像学、组织学表现及遗传特点的认识，分析囊变的发生机制。方法 3例中女2例，男1例。2例经临床、实验室及手术病理证实；临床及实验室检查诊断1例。结合文献，分析Fahr病组织学表现、并发症（囊变、出血）的发生机制和遗传特点。结果影像学表现为双基底节区、大脑灰白质交界区广泛且较对称的钙化；小脑齿状核单侧、双侧性钙化各1例。2例分别于右额叶、左顶叶发生囊变。病理学检查见病变区有陈旧性出血所致含铁血黄素细胞形成。血管壁大部分呈玻璃样变性，管壁及邻近脑实质内见有钙盐沉积形成的沙砾体和不规则钙化。部分血管出现纤维素坏死，腔内血栓形成，并可见小动脉炎改变。囊变灶壁见有明显的含铁血黄素细胞沉积。实验室检查患者的血磷、钙指标均正常。结论 根据影像学表现，结合临床实验室检查，大多数病例可做出正确诊断。脑内出血、囊变均应视为本病的并发症。CT由于具有高的密度分辨率，因而在本病诊断中应作为首选检查方法。     

血友病性骨关节病的X线诊断（附15例报告）

本文报告１５例血友病性骨关节病，其中１０例为血友病甲，２例为血友病乙，１例为血友病丙，余２例未分型。均为男性。其Ｘ线表现为关节囊软组织肿胀、密度增高（１５例），骨端或骨骺增大变方（６例），关节间隙变窄、关节面硬化和囊性变（１２例），关节骨端破坏（６例），骨性关节强直（１例），股骨髁间凹和尺骨鹰咀窝增宽变深（１０例），骨膜新生骨（３例）和血友病性假肿瘤（２例）。文中分析本病的Ｘ线表现并讨论其病理基础。     

Charcot关节的影像学表现分析

目的 分析Charcot关节的X线、CT及MRI影像学特征.方法 搜集Charcot关节24例,男11例,女13例.24例均行X线检查,9例行CT检查,5例行MR检查,3种检查都进行者2例.结果 24例Charcot关节分为增生型(12例)和吸收型(12例).X线及CT表现:增生型受累关节骨质增生硬化,伴有骨赘形成,关节周围软组织肿胀;吸收型受累关节骨端吸收、消失,关节周围软组织肿胀,可见游离碎骨片影,可有关节半脱位或脱位.MRI也反映了相同的影像学表现,在MRI增强扫描,肥厚关节囊及其周围软组织均明显强化,其内缘边界清楚.结论 Charcot关节的影像学表现具有特征性.     

囊性脑膜瘤的CT及MRI诊断

目的:总结囊性脑膜瘤的CT及MRI表现,提高对囊性脑膜瘤的影像学认识.方法:搜集经病理证实的囊性脑膜瘤23例,12例行CT检查,其中行增强扫描6例;17例行MRI检查,其中行增强扫描7例;6例同时行CT和MRI检查.观察、分析囊性脑膜瘤不同类型的CT和MRI表现.结果:囊性脑膜瘤除具有典型脑膜瘤CT、MRI表现外,由于有囊腔的存在,多数表现为实质性肿块伴大小不等的囊性区,实质部分强化明显,囊腔无强化,囊壁可有或无强化.本组23例中,Nauta Ⅰ型5例,Nauta Ⅱ型6例,Nauta Ⅲ型3例,Nauta Ⅳ型2例,7例为2种或2种以上的混合型.结论:囊性脑膜瘤有一定的影像学特征,CT和MRI对明确诊断具有重要意义,MRI优于CT.     

血友病性假瘤的MDCT表现

目的提高对血友病性假瘤多层螺旋CT(MDCT)表现特点的认识。方法回顾性分析16例经临床证实的血友病性假瘤患者的CT影像学特点。16例均行MDCT检查,并行冠状位及矢状位重组,着重分析假肿瘤的部位、大小、形态、密度、强化方式及骨质改变。结果 16例经实验室检查确诊为血友病A型12例,血友病B型4例。16例中12例有外伤史。主要影像学改变为溶骨性破坏14例,软组织肿胀、肿块13例。结论血友病性假瘤影像学特征取决于病变的首发部位和出血程度。CT对血友病性假瘤的诊断具有一定的临床实用价值,对临床治疗具有重要的指导意义。     

腺性膀胱炎的影像诊断(附8例报告)

目的 探讨腺性膀胱炎的的影像学表现及鉴别诊断要点.方法 对8例经病理证实的腺性膀胱炎患者的影像学表现和临床资料结合文献进行回顾性分析.结果 8例中结节状肿块4例,弥漫型2例,混合型2例,1例伴有囊变,2例经治疗后复查病灶明显减小,增强扫描后病变较平扫值平均增加约15.8 HU.病变范围广泛者2例,比较局限者6例.结论 腺性膀胱炎在影像学上具有一定特征性表现,但确诊需依靠膀胱镜病理活检.     

胸锁关节结核临床及影像学表现

目的 分析胸锁关节结核的X线和CT表现特征,旨在提高对本病的认识.方法 回顾性分析经病理及临床随访证实的14例胸锁关节结核患者的X线和CT影像学表现.结果 7例行X线检查,发现锁骨骨质破坏3例.14例CT检查,发现病变累及左侧5例、右侧6例、双侧3例,主要表现局部软组织肿胀10例,脓肿4例,其中包膜钙化1例,关节面骨质破坏、硬化伴关节间隙假性增宽9例,累及邻近的胸肋关节5例.肺部发现结核病灶6例.结论 CT检查在胸锁关节结核的诊断上较X线平片更具有价值.     

人感染H7N9禽流感胸部影像学表现:2例报告并文献复习

目的 分析人感染H7N9禽流感患者的胸部影像学特点,为临床合理诊断和评价病情提供依据.方法 回顾性分析人感染H7N9禽流感确诊2例患者的胸部影像学资料及特点.结果 病例1为极危重患者,首次CR胸片,表现为侵及右肺上中下3叶的节段性、局灶性随机分布的磨玻璃样渗出性病变和肺实变,此后的2h、9h余追踪CT复查,病灶迅速进展扩散,累及的肺叶增多,面积扩大,病灶融合,短时间内进展为ARDS,呈典型的“白肺”征;病例2为临床轻症患者,初次胸部CT表现为累及双下肺叶及右肺上叶的多发斑片状、片状磨玻璃样渗出性病变.出院前复查胸部DR及CT片,2例患者均显示肺间质及小叶间隔增厚.结论 人感染H7N9禽流感患者的胸部影像学表现颇具特征性,结合症状、体征及实验室检查,对临床诊断有较好的提示作用.     

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.