41例传染性非典型肺炎的影像表现

目的：探讨传染性非典型肺炎的X线表现的发展变化规律。方法：回顾性分析已确诊的41例传染性非典型肺炎患者，对一系列胸片和CT片影像进行统计学分析。结果：患者均以高热为早期症状，大部分患者在起病一周内肺部出现斑片状模糊影，并且发展迅速，2周内病变发展达高峰，有75．0％患者两肺受累，4例呈“白肺”改变。40例患者经治疗后在1个月左右肺部病灶逐渐消散，18．0％的患者出现肺间质纤维化的改变，其中1例死亡。结论：传染性非典型肺炎早期却可出现肺部渗出性改变，且发展迅速，大部分患者两肺受累，易致肺间质纤维化。     

降低高原地区低出生体重儿病死率措施探讨(附344例临床分析)

目的:探讨降低高原地区低出生体重儿(LBW)的病死率及提高其治愈率的措施。方法:对在我院2003年—2005年新生儿科收住的344例LBW儿(甲组)的治疗措施与1998年-2000年208例LBW儿(乙组)资料作对照,比较两组治愈率与病死率。结果:甲乙两组危重程度各为94.8%和96.1%,P>0.05,差别无显著性。两组治愈率由45.7%上升至62.2%,P<0.01,病死率由25%下降至7.6%,P<0.01,显著有差别。结论:经过医疗水平提高,设备完善,总结经验,改进措施,使LBW儿病死率明显下降。     

传染性非典型肺炎首次阳性胸片分析

目的：探讨传染性非典型肺炎初始发病时的胸部X线表现，提高该病的诊断符合率。方法：回顾性分析260例传染性非典型肺炎患者首次阳性胸片的X线表现。结果：260例传染性非典型肺炎首次阳性胸片的胸部X线表现为斑片状影176例(67．7％)，大片状影56例(21．5％)，间质改变72例(27．7％)，44例(16．9％)斑片状影伴间质改变；单肺受累117例(45．0％)，双肺受累143例(55．0％)；163例(62．7％)片状影内可见支气管气像。结论：斑片状影、大片状影、间质改变是传染性非典型肺炎首次阳性胸片的主要X线表现，胸片检查应作为传染性非典型肺炎常规检查方法。最后诊断应结合临床和实验室检查。     

重症毒鼠强中毒两种血液净化治疗疗效比较

 目的 探讨序贯性血液灌流(Hemoperfusion,HP)与连续性静脉-静脉血液滤过(Continuous venovenous hemofiltration,CVVH)治疗重症毒鼠强中毒患者的临床疗效和对预后的影响.方法 44例重症毒鼠强中毒的患者入院后随机分为两组.在常规治疗的基础上,接受序贯性HP+CVVH治疗的22例为治疗组,接受单纯HP治疗的22例为对照组,观察两组昏迷至清醒时间、抽搐完全停止时间、治愈率及病死率.结果 治疗组恢复清醒时间、抽搐完全停止时间与对照组比较明显减少(P<0.05),治愈率提高(P<0.05),病死率降低(P<0.05).较早治疗患者痊愈率显著高于晚期治疗患者(91.7% vs 60%,P<0.05).结论 序贯性HP+CVVH治疗重症毒鼠强中毒优于单用HP治疗,能有效缓解临床症状,提高抢救成功率,降低病死率,可明显改善毒鼠强中毒患者的预后,但血液净化治疗须尽早进行.     

序贯性血液净化治疗重度中毒48例疗效分析

 目的 探讨序贯性血液灌流(HP)与连续性静-静脉血液滤过(CVVH)对重度中毒患者的疗效.方法 在常规治疗的基础上,治疗组48例重度中毒患者行序贯性HP+CVVH治疗,对照组43例仅行HP治疗,观察两组昏迷至清醒时间、机械通气时间、平均住院天数、治愈率及病死率.结果 治疗组昏迷至清醒时间、机械通气时间与对照组比较明显减少(P＜0.05),平均住院天数缩短(P＜0.05),治愈率提高(P＜0.05),病死率降低(P＜0.05).结论 序贯性HP+CVVH治疗重度中毒优于单用HP治疗,能改善临床症状,有效提高抢救成功率,为临床救治各种重度中毒提供了新的方法.     

多层螺旋CT对肝脓肿的诊断价值探讨

肝脓肿病因众多，早期诊断、及时治疗可减少并发症，降低病死率。我院影像科于2003年5月-2005年6月对28例肝脓肿患者采用动态增强CT扫描，以显示不同增强时期肝脓肿的CT征象，旨在提高对肝脓肿直、间接征象的认识，从而提高诊断准确率。     

42例侧脑室外引流术后观察与护理

目的：为了进一步做好侧脑室外引流,降低病死率,提高患者的生命质量.方法：回顾性分析我院神经内科2008-08～2009-08收治的脑室出血患者42例经侧脑室引流术后的护理措施.结果：除1例因术后再次继发脑室内出血死亡,另外41例顺利康复出院.结论：加强临床观察,积极做好各项护理工作,是预防并发症,促进患者康复的关键.     

早产儿综合护理干预的临床体会

目的：观察早产儿临床治疗效果及综合护理干预中的护理体会。方法：对我科2003年1月-2005年1月住院的120例早产儿进行综合治疗，包括氧疗、保暖、抗感染、对症退黄、营养支持治疗等。在护理中给予加强呼吸道管理、早哺乳、非营养性吸吮、抚触、深暖等综合护理。结果：120例早产儿中痊愈110例，治愈率91．7％，死亡10例，病死率8．3％。结论：早产儿综合护理干预十分重要。 早     

脑弥漫性轴索损伤68例临床分析

目的探讨脑弥漫性轴索损伤的临床表现、诊断与治疗,以提高治愈率,减少致残、致死率。方法回顾总结68例脑弥漫性轴索损伤的损伤原因、诊断方法、救治措施及预后情况。结果68例脑弥漫性轴索损伤患者多为车祸伤及坠落伤,治愈16例,中残23例,重残14例,植物生存状态2例,死亡13例。结论脑弥漫性轴索损伤患者应以生命支持、防治脑水肿、防止或减少继发性脑损害、预防并发症、必要时手术治疗等综合性治疗措施为主,早期诊断及综合治疗可降低病死率,提高生存质量。     

193例严重急性呼吸综合征临床综合分析

传染性非典型肺炎(Infection atypical pneumonia)为一种新发现的由冠状病毒亚型引起传染性强的呼吸系统疾病，世界卫生组织(WHO)将其命名为严重急性呼吸综合征(svereacute respiratory syndrome SAILS)。该病传染性强，病死率高。我们对北京小汤山医院部分病区193例SAILS病人进行综合临床分析，旨在提高我们对SAILS这种新型传染病的认识。     

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.