严重烧伤病人静脉导管引发脓毒症的因素分析

严重烧伤病人静脉导管引发脓毒症的因素分析柴家科郭振荣盛志勇吴力明刘习章导管脓毒症是严重烧伤病人死亡的重要原因之一。我们回顾性地调查了我科近７年２７８例次静脉内置管的严重烧伤病人，其中７例次发生导管脓毒症。１９８６年５月～１９９３年１２月我科共收治烧伤...     

湿润烧伤膏致小儿中小面积烧伤多系统并发症21例

文中报告了我科自１９９０年１月至１９９２年１２月收治的１２岁以下小儿烧伤，经院外湿润烧伤膏治疗后发生侵袭性全身感染，多脏器并发症及严重电解质紊乱而转入我科的２１例危重病例。年龄１～５岁，烧伤总面积５％～３０％（平均１６．０％±５．８％），均发生二个系统以上并发症和电解质紊乱。２１例中，死亡４例。我们认为使用湿润烧伤膏后造成的创面严重感染是导致多脏器损害的主要原因。因此，建议慎重使用湿润烧伤膏。     

烧伤病人血流变学动态改变与体液复苏的关系

目的 探讨烧伤病人血流变学的变化特点及其与体液复苏的关系以及严重烧伤后贫血的防治措施。方法 将２３８例烧伤住院患者按轻重程度及体液复苏方案不同，分为四组观测。结果 烧伤后２４￣４８ｈ内及时补充新鲜血并结合中药治疗，可明显改善血流变学的异常指标，对有效减少烧伤后输血量是十分有益的。结论 血液流变学的动态观测是监测烧伤休克和指导体液复苏的最佳指标之一，严重烧伤后早期补充新鲜血并给予中药治疗是改善血流变     

烧伤病人血流变学动态改变与体液复苏的关系

目的探讨烧伤病人血流变学的变化特点及其与体液复苏的关系以及严重烧伤后贫血的防治措施。方法将２３８例烧伤住院患者按轻重程度及体液复苏方案不同，分为四组观测。结果烧伤后２４～４８ｈ内及时补充新鲜血并结合中药治疗，可明显改善血流变学的异常指标，对有效减少烧伤后输血量是十分有益的。结论血液流变学的动态观测是监测烧伤休克和指导体液复苏的最佳指标之一，严重烧伤后早期补充新鲜血并给予中药治疗是改善血流变学的异常指标，防治贫血的有效措施。     

肢体热压伤的治疗

热压伤在烧伤中时常可见，其致伤特点不同于一般的热烧伤，致伤因素中既有热力因素，又有一定的压力因素，加重了局部组织的损害，程度较单纯的热烧伤重，且在治疗和预后方面也不同于一般的热烧伤。现将我科近5年来收治的51例较严重的肢体热压伤介绍如下。     

小儿严重烧伤合并脑水肿三例

小儿严重烧伤合并脑水肿三例仇佩庆脑水肿是小儿严重烧伤并发症之一，我科１９９５年曾治愈３例严重烧伤合并脑水肿的患儿。例１女，１８个月，１２ｋｇ，面部以下烫伤，面积８３．５％，深Ⅱ度～Ⅲ度６４％，浅Ⅱ度１９．５％。伤后６小时内输入１０％葡萄糖液１５００ｍ...     

处理烧伤早期病人的体会

在我多年治疗烧伤病人的实践中,多次见到由于远途转送失去早期防治休克机会而造成预后不良的严重烧伤病人,实为憾事。于是,我总希望在我们国内急救中心尚不能胜任大范围抢救任务的当前,不具烧伤专科的单位,所有医生都应掌握一些对烧伤病人的早期处理知识。接收烧伤病人后,认真计算烧伤面积和划分深度很重要,因为它是制订治疗方案的确切依据。常用的有手掌法和新九分法,切不可粗略估计,但也不可无限制地拖延时间。对严重烧伤病人能在伤后48小时以     

湿润烧伤膏致小儿中小面积烧伤多系统并发症21例

文中报告了我科自1990年1月至1992年12月收治的12岁以下小儿烧伤,经院外湿润烧伤膏治疗后发生侵袭性全身感染,多脏器并发症及严重电解质紊乱而转入我科的21例危重病例。年龄1～5岁,烧伤总面积5％～30％(平均16.0％±5.8％),均发生二个系统以上并发症和电解质紊乱。21例中,死亡4例。我们认为使用湿润烧伤膏后造成的创面严重感染是导致多脏器损害的主要原因。因此,建议慎重使用湿润烧伤膏。     

烧伤后早期肠道营养

烧伤后早期肠道营养余静波，汪仕良，黎鳌烧伤后早期肠道营养是近年来日益受到重视的课题。我们拟就其主要进展、存在的问题及研究趋势作一简要综述。一、概述分解代谢增强是烧伤后体重急剧下降、抵抗力严重削弱，以致严重感染及器官功能障碍等诸多并发症的重要原因之一，...     

湿润烧伤膏致严重皮肤过敏反应四例

湿润烧伤膏致严重皮肤过敏反应四例方振玉，张彩霞１９９３年我科短期内先后接诊４例在基层医院外用湿润烧伤膏发生严重过敏反应的烧伤病人。烧伤及涂药面积最大５５％，最小４％，均为浅Ⅱ度。过敏发生时间，最长为用药后１５天，最短为用药后第２天。４例病人烧伤后均应...     

Hazards and complications of endoscopic transurethral ureterolithotripsy and lithoextraction and means of prevention

Complications related to ureterolithotomy and ultrasonic ureterolithotripsy performed under the control of visual endoscope were analyzed in 86 ureterolithiasis patients, methods of their prevention discussed. All the aforementioned complications were distributed into three groups: inapplicability of surgery due to anatomic and functional defects of lower and upper urinary tracts, intraoperative, and postoperative complications. The commonest ones were ureteral abruption and perforation, acute pyelonephritis, temporary vesicoureteral reflux. Their control measures were considered as relative methods of treatment: immediate surgical intervention in case of ureteral abruption, renal catheterization in patients with insignificant ureteral perforation or acute pyelonephritis. Adequate ureteroscopy, careful consideration of pro- and contraindications, catheterization of renal pelvis and urinary bladder performed within 2-3 days after the surgery and adequate antibacterial therapy are the most decisive steps in the control of aforementioned complications.     

牙体牙弓颌骨阻力中心及其临床意义

牙体、牙弓及颌骨的阻力中心在正畸矫治力系统中具有重要的意义,也是正畸学领域争论较多的一个问题。Dermaut等研究表明,当力作用于物体阻力中心时,物体将发生平动,否则将发生平动和转动的复合运动。目前,国内外多数学者认为牙体、牙弓及颌骨存在阻力中心,但其位置存在争议。本文就牙体、牙弓及颌骨的阻力中心及其临床意义作一综述。     

Characterisation and differentiation of chondroblastomas and chondromyxoidfibromas - presence and expression of collagen types I and II

AIM: Chondroblastomas and chondromyxoidfiibromas are rare benign skeletal neoplasms with reported overlapping histology. Aim of this study was to analyse the biochemical composition of the matrix of these tumour entities in order to further characterise the cellular phenotypes of these neoplasms using typical cell biological marker genes. METHODS: The matrix compositions of chondroblastomas and chondromyxoidfibromas were analyzed by HE-histology, histochemistry, and immunolocalization techniques. Cellular gene expression patterns were detected by mRNA in situ hybridization. RESULTS: Chondroblastomas are rich in collagen type I and show foci of an osteoid-like matrix, whereas collagen type II as a typical marker of chondrocytic differentiation was not detected in any of the specimens. Chondromyxoidfiibromas had foci of chondroid appearance with chondroblastic cellular differentiation characterised by collagen type II expression. CONCLUSION: These results characterise chondroblastomas and chondromyxoidfiibromas as skeletal neoplasms that have a different biology and which can be distinguished by matrix protein expression products: collagen type II, the typical marker of chondroblast differentiation, could only be detected in chondromyxoidfibromas, but not in chondroblastomas. Thus, both neoplasms are clearly different on the cell biological level.     

Histochemical and contractile properties of striated muscles of urethra and levator ani of dogs and sheep

AIMS: To understand their possible importance in long- and short-term control of continence, some properties of the striated muscles of the urethra and pelvic floor (levator ani) of dogs and sheep were investigated, especially fiber types and contractile characteristics. MATERIALS AND METHODS: Striated muscles of urethra and levator ani of 29 male and 6 female dogs and 11 male and 6 female sheep were removed and cut into strips. Some strips were frozen and stained for ATPase at pH 9.4 and 4.3 for fiber typing; others were set up in an organ bath to study contractile responses to nerve stimulation. RESULTS: All muscles contained both type I (slow) and type II fibers, ranging from 97% type II in female greyhound urethra to 60% in female sheep levator ani. For each muscle, there were fewer type II muscles in sheep than in dog. The diameters of the urethral fibers were about 60% of the levator ani in dogs and 34% in sheep. Contraction of the urethral muscle was faster than for levator ani and declined to about 80% of the peak, 500 msec after the beginning of stimulation at 20 Hz. The levator ani contraction rose to a steady level as long as stimulation continued. CONCLUSIONS: Both the levator ani and urethral striated muscles contain slow and fast fiber types. The levator ani muscles are capable of sustained contraction with rapid onset which will produce long-term closure of the urethra. The circular urethral muscle contraction was faster but less well maintained.     

Incorporation and release of85Sr and14C-proline-hydroxyproline in mineral and collagen of bone and incisor teeth of growing rats

The extent to which exchange and reutilization processes of mineral tracers affect skeletal mineral accretion and resorption measurements was evaluated by comparing the rates of appearance and disappearance of⁸⁵Sr and¹⁴C-proline-hydroxyproline in bones and teeth in growing rats for 12 days following simultaneous parenteral injection of these tracers. Expressions for the relative rates of collagen synthesis and breakdown, which unlike mineral metabolism are considered not to be complicated by exchange phenomena, were based on¹⁴C-proline conversion to¹⁴C-hydroxyproline; the specific activity of the latter was determined. Both the mineral and the collagen specific activities reflected the rates and patterns of growth of the samples assayed; rapid growth and a short interval of time between formation and resorption of tissue in themetaphyseal bone which contains the cartilagineous growth plate, slow growth and an interval of time between formation and resorption of tissue indiaphyseal bone and incisor teeth which is longer than the 12 days of the experiment. However, in metaphyseal bone the specific activity collagen/mineral ratio dropped by one half during the 4–12 day interval in contrast to diaphyseal bone and incisor teeth in which no change in this ratio was observed during this period of time. The data indicate that collagen in the metaphyseal growth zone is removed by resorption before it has become fully mineralized, and that exchange is a relatively unimportant factor in the long term kinetics of bone mineral.

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Zusammenfassung Das Ausmaß, bis zu welchem Austausch- und Wiederverwendungsprozesse der mineralen Tracer die Messungen des mineralen Skelett-Auf- und Abbaues beeinflussen können, wurde ausgewertet; zu diesem Zweck wurde die Geschwindigkeit des Auftretens und Verschwindens von⁸⁵Sr und von¹⁴C-Prolin-Hydroxyprolin in Knochen und Zähnen von wachsenden Ratten während der 12 auf die simultane parenterale Injektion dieser Tracer folgenden Tage verglichen.Der Ausdruck für die relative Geschwindigkeit des Kollagen-Auf- und Abbaues, bei welchem im Gegensatz zum Mineralmetabolismus kein Mitwirken des Austauschphänomens vermutet wird, basiert auf der Umwandlung von¹⁴C-Prolin zu¹⁴C-Hydroxyprolin; die spezifische Aktivität des letzteren wurde bestimmt.Aus der spezifischen Aktivität des Minerals sowie jener des Kollagens konnten die Geschwindigkeit und die Art des Wachstums der untersuchten Proben ersehen werden, d.h.schnelles Wachstum und ein kurzes Zeitintervall zwischen Bildung und Resorption des Gewebes imKnochen der Metaphyse, die auch die knorpelige Wachstumsplatte enthält, und andererseitslangsames Wachstum und längeres Zeitintervall (länger als die 12 Tage des Experimentes) zwischen Bildung und Resorption des Gewebes imKnochen der Diaphyse und in den Schneidezähnen. Immerhin fiel die spezifische Aktivität des Kollagen/Mineral-Anteils im Knochen der Metaphyse während dem 4–12tägigen Zeitintervall auf die Hälfte, im Gegensatz zum Knochen der Diaphyse und der Schneidezähne, bei welchen während dieser Zeitspanne kein Unterschied in diesem Verhältnis beobachtet wurde.Diese Ergebnisse zeigen, daß Kollagen in der Wachstumszone der Metaphyse durch Resorption verschwindet, bevor es ganz mineralisiert ist, und daß der Austausch ein relativ unwichtiger Faktor in der Kinetik auf lange Sicht des Knochenminerals ist.