烧伤早期脏器损害发病机制的探讨

烧伤后脏器损害是当前烧伤主要的死亡原因，其发病机制的尚未完全阐明。本研究认为其本质是缺血缺氧性损害；血液灌流不足与肠源性感染是其主要发病因素；失控性炎症反应是其基本病理生理变化；血管内皮细胞起关键作用。改善早期复苏方案，应用延迟性速补液可改善脏器血液灌流，应用早期肠道营养能减轻肠道损害，有助于防止肠源性感染；伤后尽快一次切除大部分焦痂能减轻失控炎症反应，降低内脏并发症的发生率。     

院内念珠菌感染的流行病学研究进展

念珠菌病是由白色念珠菌或其它念珠菌感染引起的疾病,可引起皮肤、粘膜的局部感染亦可引起播散性全身感染。深部念珠菌感染多为院内感染,且多为重症病人,一旦发生全身感染,病死宰相当高,真菌感染常难以诊断,即使诊断已确定,对全身性感染的治疗亦非常困难。因此,了解真菌感染的流行病学知识,采取有效的预防和控制措施,就显得尤为重要。现就念珠菌感染的感染源、感染菌种分类、发病率、病死率以及感染常见危险因素等作一综述。     

IgY防治SPF小鼠白色念珠菌感染的研究

目的：观察自制的抗白色念珠菌鸡蛋黄抗体IgY体内生物学效应。方法：建立服小鼠烧伤后口服白色念珠菌(白念菌)感染模型，应用活菌计数方法检测其回肠膜粘附白念菌量、盲肠内容物白念菌量，应用ELISA检测血浆肿瘤坏死因子(INFα)和二胺氧化酶(DAO)含量。结果：烧伤SPF小鼠喂服IgY后，能明显抑制肠道内白念菌生长和白念菌粘附肠上皮细胞；明显降低小鼠血浆中DAO和TNFα含量。结论：特异性鸡蛋黄抗体IgY具有良好的体内生物学效应。     

严重烧伤后局部肠黏膜免疫组织细胞功能的变化

目的 对烧伤后肠黏膜免疫组织淋巴细胞增殖、分化进行观察。方法 无特殊病原菌（ＳＰＦ）小鼠分为正常对照组、给菌对照组及给菌后烧伤组，后两组动物经口给入白色念珠菌。给菌对照组于给菌后１４ｄ处死取材，给菌后烧伤组于１４ｄ致２０％ＴＢＳＡⅢ度烧伤，伤后１，２，３处死取材。观察项目：（１）淋巴细胞体内增殖情况；（２）肠固有层ＩｇＡ型浆细胞数量变化；（３）肠黏液中特异抗白色念珠菌ＩｇＡ水平变化；（４）白色念珠     

高海拔地区26例艾滋病机会性感染临床分析

目的：了解高海拔地区艾滋病（AIDS）机会性感染的发生发展规律。方法：对我院收治的26例AIDS病人机会感染发生情况进行分析。结果：机会性感染呈多系统受累达84．69／6,为呼吸系统、消化系统、血液系统、皮肤黏膜、神经系统、心血管系统。机会性感染依次为细菌性肺炎、肺结核、口腔白色念珠菌感染、单纯疱疹、各种感染性腹泻。结论：高海拔AIDS机会性感染病原体与省外、国外报告相差较大,应结合实际有针对性地预防和及时治疗。     

血液病免疫抑制治疗后播散性白色念珠菌感染的CT表现

目的探讨血液病免疫抑制治疗后的播散性白色念珠菌感染的CT表现。方法分析5例经临床和病理活检证实的免疫抑制治疗后播散性白色念珠菌感染的患者并进行文献复习。结果 5例均发现肝多发结节病灶,其中2例伴肺部多发结节病灶,1例伴有脾脏及双肾、后腹膜区多发结节病灶。肝脏CT平扫均表现为多发类圆形等或略低密度结节影。增强动脉期表现为结节中心低密度无强化区、周边为高密度强化环,即呈"牛眼征"2例;结节均匀强化2例;结节中心小结节样强化、周边低密度环、外周环状强化1例。所有活动期病灶周围肝实质动脉期均伴有一过性高密度灌注区。门脉期及延迟期病灶边缘仍可见环形强化,强化范围较动脉期缩小2例、呈花环样强化2例、外周强化环消退1例。脾脏和肾脏病灶表现与肝脏类似;肺部结节表现为实性结节或伴空洞。结论血液病免疫抑制治疗后播散性白色念珠菌感染的CT表现有一定特征性,该特征性有助于早期诊断和疗效监测。     

头孢噻甲羧肟对烧伤创面脓毒症的防治作用

头孢噻甲羧肟（ＣＡＺ）是治疗烧伤感染的主要抗生素之一，它在严重烧伤病人体内的药代动力学过程发生了明显改变，但用药剂量无需调整［１］．动物实验证明，早期全身性使用ＣＡＺ能预防烧伤后肠源性感染的发生［２］．笔者旨在探讨ＣＡＺ对烧伤创面组织的穿透性及对烧伤...     

严重烧伤后肾功能与损伤机制的研究进展

严重烧伤后可造成全身许多脏器的损伤,其中肾脏组织损伤是较早出现的并发症。有些属可逆性损伤,有些为不可逆损伤。烧伤后大量体液自创面外渗造成低血容量性休克,由此引发的缺血、缺氧性损害及失控性炎症反应是严重烧伤后多脏器损害的主要因素。作为全身性损伤的一部分。肾组织损伤的发生与多种细胞因子、嘌呤池耗竭、自由基的生成增多和清除能力减弱、能量代谢障碍、钙离子稳态失衡、微血管损伤和白细胞学说、细胞内酸中毒、细胞凋亡和坏死等多种因素的作用有关。本文通过文献回顾,综述近几年来其相关研究进展。     

1286例维吾尔族妇女阴道分泌物染色检查分析

目的:探讨新疆喀什地区维吾尔族妇女阴道炎症感染特征。方法:对1286例维吾尔族患者的阴道滴虫、加特纳菌、淋病双球菌、纤毛菌、霉菌检测结果进行分析。结果阳性检出率:加特纳菌24.26％、白色念珠菌14.15％、阴道滴虫4.91％、纤毛菌0.62％、加特纳菌感染占首位。结论:新疆喀什地区阴道炎感染情况基本符合我国内陆城市的特征。淋病感染有上升趋势应引起重视。白色念珠菌维族感染占总数14.15％。汉族感染占总数25.86％,是个值得注意的问题。     

侵袭性白念珠菌小鼠感染模型的建立与评估

目的：建立侵袭性白念珠菌小鼠感染模型。方法体外通过菌丝生长实验评价白念珠菌的毒力大小,通过尾静脉注射白念珠菌菌悬液感染小鼠后,观察小鼠生存时间,评价白念珠菌体内毒力大小;以感染后7 d 内小鼠100％死亡为标准,建立了侵袭性白念珠菌小鼠感染模型,对感染小鼠进行氟康唑治疗效果评价。结果白念珠菌体外毒力与体内毒力一致,4种培养基中菌丝均生长良好的菌株,体内感染小鼠后,小鼠生存率也最低;感染模型中,氟康唑对敏感白念珠菌的治疗效果强于对氟康唑耐药白念珠菌（P ﹤0.05）。结论建立的侵袭性白念珠菌感染模型可用于药物体内抗白念珠菌活性的筛选。     

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.