乳腺浸润性导管癌的X线诊断

目的：分析乳腺浸润性导管癌的高频钼靶X线特征，提高术前X线正确诊断率。方法：回顾性分析经手术病理证实的41例乳腺浸润性导管癌的X线表现。结果：41例乳腺浸润性导管癌中，显示结节或肿块影35例，占85．37％，X线测量肿块大小比临床扪及小有31例，占显示肿块的病例88．57％；显示毛刺状改变23例，占56．1％；有微小钙化17例，占41．46％。结论：乳腺浸润性导管癌在X线上有特征性表现。乳腺高频钼靶X线检查在此病的早期诊断中有重要意义。     

肿块型乳腺浸润性导管癌60例钼靶征象分析

目的：分析肿块型乳腺浸润性导管癌的钼靶表现,进一步提高诊断水平。方法对经手术病理证实,且术前均行全数字化乳腺摄影检查的肿块型浸润性导管癌60例的X线征象进行回顾分析。结果60例X线征象：分叶状肿块6例,边缘规则肿块2例,边缘不规则肿块35例,星芒状肿块10例,边界模糊或呈浸润性改变37例,肿块合并钙化26例,伴有毛刺25例,伴乳头凹陷11例,伴皮肤增厚15例,伴大导管征6例。结论肿块边缘的浸润性改变或边缘的不规则可能是浸润性导管癌最常见的X线表现,其他征象依次为肿块合并钙化、乳头及皮肤改变以及大导管征的出现,亦对定性诊断颇具意义。     

乳腺导管癌的X线表现及其病理基础

目的:分析乳腺导管癌的X线表现及其病理基础,提高对其认识.方法:搜集经手术病理证实的乳腺癌57例,包括浸润性导管癌45例,导管原位癌12例,观察X线表现并与病理结果对照.结果:①X线表现为肿块35例,钙化22例,结构致密或扭曲13例;35例肿块除2例显示边界清晰的良性征象外,其他均为恶性边缘征象的肿块;典型恶性钙化多见(18/22),且钙化除单纯钙化外可同时伴发肿块或结构致密.②45例浸润性导管癌主要表现为肿块34例,结构致密或紊乱10例,以上两者伴钙化10例.③12例原位导管癌中全部表现为典型恶性钙化,且单纯钙化均出现于原位导管癌而未见于浸润性导管癌中.结论:乳腺导管癌的常见X线表现为肿块、钙化和结构致密,单纯钙化首先考虑原位导管癌,其余征象均首先考虑浸润性导管癌.     

乳腺癌的不同病理类型的表现与X线征象分析

目的探讨乳腺癌的X线表现特征,提高诊断水平。方法回顾性分析经手术病理证实的174个乳腺癌的X线表现特征并与病理分型对照。结果乳腺导管内癌X线特征为单纯微钙化、小肿块;浸润性导管癌为肿块影,尤其是毛刺样肿块合并钙化为其特征性表现;浸润性小叶癌表现为不合并簇状微钙化的肿块;粘液癌表现为边界清楚之较大肿块。结论乳腺癌不同病理组织学类型的X线表现特征不同,根据X线表现可推测乳腺癌的病理分型。     

钼靶X线征象与不同类型乳腺癌关系的病理基础研究

目的:探讨不同类型乳腺癌的X线表现与其病理基础之间的关系。方法:经乳腺X线检查,手术、病理证实的乳腺癌36例,共36个病灶,包括浸润性导管癌26个,导管内癌及导管内癌伴微浸润7个,浸润性小叶癌2个,黏液腺癌伴浸润性导管癌1个。观察乳腺癌的X线表现,与病理分型对照。结果:①癌灶的X线表现有肿块者23个(63.9%),有钙化者18个(50%),有结构扭曲者3个(8.3%);②呈肿块表现的以浸润性导管癌为主,占87.9%;有钙化者易出现在导管内癌和浸润性导管癌中,分别占87.5%、42.3%,尤其单纯钙化多出现在导管内癌中(71.4%,5/7);结构扭曲可见于浸润性导管癌和导管内癌中,其它类型未见。结论:肿块、钙化和结构扭曲为乳腺癌的主要X线表现。浸润性导管癌占乳腺癌的大部分,除单纯钙化首先考虑导管内癌,其余征象均首先考虑浸润性导管癌;肿块改变尚要想到髓样癌和黏液腺癌的可能;结构扭曲也可出现在导管内癌中。     

早期乳腺癌X线征象421例分析

目的提高对早期乳腺癌X线征象的认识。方法回顾性分析421例经病理证实的早期乳腺癌的X线特征。结果421例病例中,非浸润性癌87例(20.6%),早期浸润性癌97例(23.0%),早期浸润性特殊型癌52例(12.4%),浸润性非特殊型癌(肿块直径≤1 cm)185例(44.0%)。乳腺X线检查显示89%的非浸润性癌和70%的早期浸润性癌灶可见钙化,而肿块在2组的发现率仅分别为18.0%和43.0%。结论乳腺X线片中微小钙化灶对早期乳腺癌的诊断具有重要价值。如果患者有乳头溢液,建议进一步进行乳腺导管造影检查。     

乳腺癌61例X线表现及病理对照分析

目的探讨和分析乳腺癌的钼靶X线影像特点及其病理基础,提高乳腺癌的X线诊断水平。方法回顾性分析研究61例经乳腺钼靶X线摄影检查、手术及病理证实的乳腺癌患者的X线表现。结果①61例患者中,单纯肿块41例,肿块伴钙化13例,单纯钙化8例,结构扭曲5例,结构扭曲伴钙化4例,局灶性致密影5例,磨玻璃样改变1例,阴性1例。②有钙化者多见于浸润性导管癌和导管原位癌,有肿块者多见于浸润性导管癌、粘液腺癌和髓样癌,结构扭曲者和局部致密性影多见于浸润性导管癌。结论①乳腺癌常见的X线表现为单纯肿块、钙化伴肿块、单纯钙化和结构扭曲。②浸润性导管癌占乳腺癌的大部分,乳腺癌的病理基础不同,导致了不同类型的X线表现。③X线摄影对乳腺癌有很高的诊断价值,尤其对临床检查阴性的患者,但对致密性乳腺还是有一定的局限性。     

乳腺浸润性导管癌的钼靶X线表现与病理对照研究

目的：分析乳腺浸润性导管癌的钼靶X线表现的病理基础。方法：回顾性分析86例浸润性导菅癌并与病理分型对照。结果：浸润性导管癌最常见的钼靶X线表现为不规则高密度肿块影、边缘毛刺状72例、伴钙化（28例）；局部腺体密度增高影5例；单纯泥沙样钙化堆9例。结论：不规则高密度肿块影及肿块边缘毛刺、微小钙化，在判断浸润性导管癌的病理分型及伴有纤维增生，具有显著意义。在一定程度上可为临床治疗方法的选择提供参考。     

微小钙化在早期乳腺癌X线诊断中的应用价值

目的探讨乳腺钙化在全数字化乳腺X线摄影中的表现特征及其对早期乳腺癌的诊断价值。方法回顾性分析160例乳腺X线钼靶片中表现为微小钙化的病例,观察钙化的数目、形态、大小、分布、密度等,并与手术病理结果做对照。结果乳腺良、恶性疾病均可出现钙化。本组病例乳腺恶性病变112例,其中导管原位癌24例,浸润性导管癌88例,良性病变48例。钙化呈簇状分布、沿导管方向走行或呈蠕虫型、混合型形态的钙化多见于乳腺癌,弥漫性分布及粗颗粒型或融合型形态的钙化多见于乳腺良性病变。结论分析乳腺X线片中微小钙化形态学表现、密度、数目、走向分布及钙化与肿块的关系,能显著提高乳腺良恶性病变的诊断正确率,对早期乳腺癌的诊断具有极其重要价值。     

乳腺浸润性导管癌的临床与X线表现

目的:分析乳腺浸润性导管癌的临床与X线表现。方法:总结经病理证实的102例浸润性导管癌的临床、X线表现。结果:各年龄组间发病率差异有统计学意义(P<0.05)。左、右侧发病差异有统计学意义(P<0.05)。触诊肿块91例(89.2%),肿块伴疼痛9例(8.8%);疼痛5例(4.9%);溢液溢血10例(9.8%)。X线表现为单纯肿块26例(25.5%),肿块伴钙化55例(53.9%),簇状沙砾样钙化15例(14.7%),结构扭曲伴钙化6例(5.9%);肿块边缘呈分叶征46例(45.1%),边缘不清65例(63.7%),毛刺征53例(52.0%);血管增粗26例(25.5%);同侧腋下淋巴结肿大34例(33.3%)。其他征象:乳头凹陷11例,皮肤增厚11例,大导管增粗3例。结论:乳腺浸润性导管癌的临床好发年龄41～60岁,临床表现以肿块为主,左侧发病高于右侧。X线表现常见为肿块及钙化,具有较高诊断价值;其他征象:结构紊乱、乳头凹陷、皮肤增厚、大导管增粗对定性诊断有意义。     

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.