临近胸膜周围型肺癌的CT表现

目的:探讨临近胸膜周围型肺癌的CT征象,提高对临近胸膜周围型肺癌的诊断符合率。方法:对43例经病理证实的临近胸膜周围型肺癌患者的CT征象进行分析。结果:15例结节型临近胸膜周围型肺癌具有典型的周围型肺癌的CT表现,23例实变型临近胸膜周围型肺癌以临近胸膜实变影、胸膜改变、纤维条索聚集及肺大泡为主要CT征象,5例渗出型临近胸膜周围型肺癌表现为炎症CT征象。结论:全面分析CT征象可提高结节型与实变型临近胸膜周围型肺癌的诊断符合率,渗出型临近胸膜周围型肺癌应进行动态观察提高诊断符合率。     

周围型肺癌SCT增强扫描与血管超微结构和密度的相关性

目的探讨螺旋CT增强扫描与周围型肺癌微血管超微结构和密度相关性。方法对31例手术、病理证实的周围型肺癌,术前进行螺旋CT增强扫描;电镜观察离体肺癌血管超微结构,并对肺癌标本用SP法进行Ⅷ因子免疫组化染色。结果①肺癌微血管内皮细胞间形成缺口,基底膜断裂或缺乏,癌细胞间隙较大。②周围型肺癌螺旋CT扫描增强程度与微血管密度（MVD）呈正相关(r=0.926,P＜0.01)。结论周围型肺癌螺旋CT增强扫描的增强程度,反映了肺癌血管超微结构异常和富血管度。     

球形肺炎的CT表现

目的 :探讨球形肺炎的 CT表现及其鉴别诊断。方法 :选择 2 1例经临床或病理证实的球形肺炎及 2 1例经手术病理证实的周围型肺癌 ,将其 CT资料进行对比分析。结果 :球形肺炎与周围型肺癌 CT表现有明显不同。结论 :CT检查是鉴别球形肺炎与周围型肺癌的有效手段     

陈旧性肺结核合并周围型肺癌的CT诊断

目的探讨陈旧性肺结核合并周围型肺癌的CT影像特征及鉴别诊断。方法对20例肺结核合并周围型肺癌患者的CT影像资料进行回顾性分析。结果20例陈旧性肺结核合并周围型肺癌的患者中,12例具有典型周围型肺癌CT特征容易被诊断,8例由于不具有典型CT征象而被延误诊断。结论陈旧性肺结核合并周围型肺癌较常见,不典型周围型肺癌容易被漏诊。     

周围型小细胞肺癌和非小细胞肺癌CT表现对比分析

目的 探讨周围型小细胞肺癌CT表现特征.方法 应用配比病例对照研究的方法 ,回顾性分析经病理证实的、原发灶≤3 cm的周围型小细胞肺癌和非小细胞肺癌各30例的临床资料和CT表现.结果 30例周围型小细胞肺癌CT表现为分叶征(23/30)、边缘光滑锐利(22/30)、毛刺或棘突征(8/30)、胸膜凹陷征(7/30)、血管连接征(2/30)等.30例周围型非小细胞肺癌CT表现为分叶征(16/30)、边缘光滑锐利(6/30)、毛刺或棘突征(24/30)、胸膜凹陷征(24/30)、血管连接征(8/30)、空泡或空洞或支气管征(13/30)等.经卡方检验发现小细胞肺癌和非小细胞肺癌中的分叶征发生频率差异无统计学意义(χ2=3.5897,P=0.0581),其它征象的差异有统计学意义.30例周围型小细胞肺癌发现肺门和纵隔淋巴结肿大22例(73.3%),30例周围型非小细胞肺癌发现肺门和纵隔淋巴结肿大5例(16.7%),经统计学分析差异有统计学意义(χ2=19.4613,P<0.001).结论 原发灶≤3 cm的周围型小细胞肺癌主要CT表现为边缘光滑锐利的密实结节.原发灶较小时即可伴有明显的肺门、纵隔淋巴结肿大(转移).     

52例周围型小肺癌的CT图像分析

目的：分析周围型小肺癌的CT表现，加深对周围型小肺癌的的认识。方法：回顾性分析直径≤30mm周围型小肺癌的CT表现。结果：发现周围型小肺癌有独特的CT表现：小结节征、深分叶、棘状突起、胸膜凹陷征、小泡征及支气管充气征和磨玻璃病变共存，对周围小肺癌的诊断有重要价值。     

周围型小肺癌的影像及其病理学基础

目前,对于周围型小肺癌需要解决的问题是如何早期发现及正确诊断.常规胸部X线平片的价值有限.低剂量CT检查可发现周围型小肺癌.薄层高分辨CT是诊断周围型小肺癌的首选影像检查方法.重复CT扫描、CT引导下穿刺活检、PET等可作为补充诊断手段.周围型小肺癌的放射影像征象是其病理学基础的反映,主要表现在瘤体的密度、边缘形态及与周围血管的关系上.     

局灶性磨玻璃征-早期周围型肺癌的重要CT征象

目的:探讨局灶性磨玻璃征(Ground Glass Opacity GGO)对早期周围型肺癌的诊断价值。方法:搜集临床、CT资料完整,经手术病理证实的早期周围型肺癌27例(28个),对其CT表现,作一回顾性分析。结果:28个早期周围型肺癌直径均<2.0cm,呈园形或卵园形22个,其中纯GGO或部分GGO密度的有21个,并见有毛刺14个,血管集束征14个,胸膜凹陷13个,分叶征10个和小泡征8个。结论:局限性GGO为早期周围型肺癌重要CT征象之一,若同时具备下列4项中的一项或多项高度提示早期小肺癌:①结节呈圆或卵圆;②内部见实性结节(即部分GGO);③伴有分叶、毛刺、血管集束征、胸膜凹陷征等其它恶性征象;④短期复查未变化。     

周围型肺癌双源CT灌注成像与肿瘤血管生成的相关性研究

目的 探讨周围型肺癌双源CT灌注成像与肿瘤微血管密度(MVD)、血管内皮生长因子(VEGF)的关系.方法 搜集经胸部X线平片或CT平扫发现肺部肿块并行双源CT容积灌注成像,后经病理证实的周围型肺癌30例.男18例,女12例,年龄40 ～ 77岁,平均58.01岁.将CT图像传至Siemens工作站进行图像处理.计算靶层面感兴趣区(ROI)的时间-密度曲线(TDC).通过最大斜率法获得血流量(BF)、血容量(BV)、对比剂的平均通过时间(MTT)、峰值时间(TFP)和表面通透性(PS)等灌注参数及灌注图像.30例病理标本行常规HE染色病理学检查,采用免疫组织化学检测MVD计数和VEGF的表达情况.分析周围型肺癌双源CT灌注参数与MVD、VEGF表达的关系,比较周围型肺癌有无淋巴转移及与MVD、VEGF表达的关系. 结果 (1)周围型肺癌的MVD、VEGF与CT灌注参数值BF、BV呈正相关;与MTT之间无相关性,与TTP之间呈负相关,MVD与PS无相关性,VEGF与PS呈正相关.与MVD及VEGF具有相关性的CT灌注参数中以BF的相关性最高.(2)有淋巴结转移组肺癌MVD值高于无淋巴结转移组肺癌(P＜0.05);有淋巴结转移组肺癌VEGF高于无淋巴结转移组肺癌(P＜0.05).结论 双源CT灌注成像可评价周围型肺癌的肿瘤微血管生成,有助于在活体评价肿瘤血管生成.MVD、VEGF可作为评价周围型肺癌是否发生淋巴结转移的指标.     

48例周围型肺癌的早期CT诊断

随着CT的临床应用，人们对肺癌的认识水平有了进一步的提高，笔者回顾性分析了经临床病理证实的48例周围型肺癌的CT表现，以探讨CT在周围型肺癌中的诊断价值。     

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.