基础医学研究所举行1980年度学术年会

本院基础医学研究所于一九八○年十二月二十二日至二十三日召开了一九八○年度学术年会。涂通今院长、赵阳政委、何曼秋部长等院部首长参加了会议。所领导同志均参加了会议。周廷冲所长在开幕时致了开幕词、会议结束时又作了总结。年会上宣读了包括神经生物学、细胞生物学、生化药理、生化免疫、遗传工程、生物物理和中医中药等七个方面的二十四篇工作报告。另外还邀请二所有关同志作了协作研究的“视     

超声学进展

电子学、计算机科学、探头材料及阵列设计方面的发展推动了超声学的进展,极大地拓宽了超声在临床和科研工作中的应用范围.概述了探头材料、阵列设计、数字化超声成像和信号处理技术方面的进展,讨论了腔内超声、三维超声及谐波成像,评价了微气泡对比剂的最新临床应用,简述了介入性超声、超声治疗以及超声辅助下的药物和基因传递技术.     

超声学进展

电子学、计算机科学、探头材料及阵列设计方面的发展推动了超声学的进展,极大地拓宽了超声在临床和科研工作中的应用范围。概述了探头材料、阵列设计、数字化超声成像和信号处理技术方面的进展,讨论了腔内超声、三维超声及谐波成像,评价了微气泡对比剂的最新临床应用,简述了介入性超声、超声治疗以及超声辅助下的药物和基因传递技术。     

武警8610部队严密做好世博安保任务部队卫勤保障工作

本刊讯 武警8610部队针对遂行世博安保任务政治责任大、投入兵力多、持续时间长、保障任务重的实际，加强卫勤保障任务研究，对集中居住部队卫生资源采取集中管理、派出保障方式，设立了前方综合救护所．建立了综合门诊、心理门诊、急救室、特检室、药材库、留观病室等十个功能科室，完善了卫生工作规范，落实了分工负责制，狠抓了卫生制度在末端的落实，为部队圆满完成世博安保任务奠定了坚实的基础。     

组织医院卫生技术干部考核的几点做法和体会

为了加强卫生技术干部队伍的建设,根据总政、总后有关通知精神,一九八三年我们对全区医院、疗养院的卫生技术干部进行了全面考核,实考人数占应考人数的93.5％。通过考核摸清了卫生技术干部的数、质量状况,增强了大家学习的自觉性和工作的积极性,加强了团结,促进了业务建设,提高了医疗护理工作质量,基本做到了领导、群众、本人三满意。整个考核分准备、实施和总结三个阶段,其做法和体会是:     

医嘱处理的计算机管理

随着计算机的飞速发展,计算机网络应用技术受到普遍重视。我院将计算机视为医院实现高质量、高效率信息管理的先进工具和手段,一步到位实现了全院临床科、非临床科、机关部门微机联网工作。这一网络的建立达到了信息共享、及时处理、分级管理以及共同监督的目的。其中住院管理系统中医嘱录入部分的运用,改变了护士转抄、查对医嘱的方式,节省了时间,提高了工作效率,较好地把住了医嘱关。     

急性放射病临床研究现状与前瞻

对心血管型、亚急性放射病、皮肤红斑、头部等受大剂量照射后的临床表现作了补充阐述。介绍了白细胞、血小板动态变化对分度的价值;薪抗霉菌、抗病毒药、丙种球蛋白、GM-CSF 的应用。深入探讨了骨髓移植的作用。     

卫生数据交互平台系统应用情况介绍

2007年,我院承担了北京军区“卫生信息数据交互平台”（以下简称“平台”）的试点任务。“平台”的运行,既实现了日报、月报、季报、年报数据的网络直报,又实现了团卫生队、师医院、师卫生科、军卫生处之间的数据信息网络共享,还减少了人为误差,提高了工作效率,确保了数据信息报送的准确性与时效性。现将“平台”应用情况报告如下。     

我院医疗短信服务平台的主要功能

2009年,我院与甘肃号百公司联合研发了医疗短信服务平台,该平台通过移动通信技术和医院HIS、LIS、PACS等系统的结合,实现了将医院预约挂号、候诊排队、检验结果、住院检查、出院随访等信息,在第一时间自动发送或反馈到患者的移动电话上,方便了患者就诊,提高了工作效率和服务质量,产生了良好的社会效益。     

中、重度烧伤的早期治疗及理论依据

本文就中、重度烧伤早期治疗的若干问题进行了综述。对心肺复苏即早期休克的输液成份、电解质的改变以及吸入性损伤气道处理等进行了叙述;二、对代谢与营养,特别是早期进食的优点进行了介绍,并对某些营养物质所摄取的利弊作了较详尽的介绍;三、对创面的处理介绍了应用磺胺嘧啶银、磺胺嘧啶锌作了比较,并认为MEBO效果更好。此节并对烧伤水泡液的害处作了介绍,多数学者主张抽吸而保留水泡膜,作为天然敷料;四、止痛方面,作者认为MEBO有较好效果;五、对预防感染问题进行了讨论。     

Firearm suicides in Sweden

In a setting with restrictive firearm laws, prevention of firearm deaths is challenging. Around 100 firearm suicides occur annually in Sweden, representing the most common manner of death from firearm use. In order to explore a possible correlation between firearm suicides and firearm availability, legality of firearm possession, and demographic and geographical factors, all firearm suicides in Sweden among adults during the years 2016–2017 were studied. Data were collected from the National Board of Forensic Medicine and the Swedish Police. In total, 221 firearm suicides were found. Most victims were male (99%) and half (49%) were ≥65 years old. Firearm suicide rates were positively correlated with firearm ownership rates in Swedish counties. Legal firearms (80%) and long-barreled firearms (76%) predominated in the overall material, but illegal firearms were common among young suicide victims (18–29 years) and in urban areas. Prevention work needs to emphasize strategies to reach firearm owners at risk of suicide. Local health and healthcare-related factors, as well as geographic and demographic factors, should be considered in tailoring such strategies.     

抗菌抗炎药物缓释体在海水浸泡肢体软组织火器伤救治中的应用

目的探讨抗菌、抗炎药物缓释体对海水浸泡肢体软组织火器伤的治疗作用.方法磷酸三钙药物载体盛装环丙沙星、替硝唑和吲哚美辛,采用紫外分光光度法测定药物缓释体在生理盐水中释放的药物浓度,采用高效液相测定缓释体放置兔浸泡肢体软组织火器伤伤口时,组织和血液药物浓度,观察用药后损伤组织的病理变化和细菌计数.结果缓释体体外药物释放稳定,组织内药物浓度高,伤后36小时放置缓释体的火器伤组织继发损伤轻,无明显感染.结论抗菌、抗炎药物缓释体适宜在海水浸泡火器伤救治中应用.     

平时颅脑火器伤的诊断和治疗

目的研究非战争时期医院收治的颅脑火器伤在临床诊断和治疗中的特点．方法对86例平时收治的各类颅脑火器伤者进行回顾性分析，探讨其诊断和治疗等方面的特点，寻找最佳的诊治方案。结果除2例（2％）在手术后24h内死于大血管损伤和严重脑损伤外，其余患者均经手术治愈（80例，93％）或症状改善（4例，5％）。结论颅脑火器伤是引起人群死亡和致残的最为严重的原因，彻底清除异物，特别是彻底清除碎骨片和失活组织，把开放性损伤变为闭合性损伤极为重要。X线头颅摄片金属异物定位、立体定向技术、异物细菌培养和药敏试验、以及抗癫痫药的应用是降低平时颅脑火器伤死亡率和并发症的关键。     

Firearm fatalities in Delhi, India

Studies on firearm fatalities in various countries have been published. However, pattern and incidence of fatal firearm injuries in Delhi has largely gone unreported. This study was taken up with the objective of reporting the pattern and incidence of fatal firearm injuries in Delhi and comparing it with the pattern seen in other countries. One hundred and seven firearm fatalities autopsied during the last 6 years were studied. 46.7% victims were aged between 20 and 30 years and 90.7% were males; similar findings were seen in other countries. 92.6% were victims of homicidal attacks, 6.5% suicidal and 0.9% accidental. This is in sharp contrast to the pattern in other countries where suicides were the predominant group and homicides accounted for a small number of cases. A high presence of illegal country made guns was an explanation for this trend. Single firings were the norm. Chest (39%) and head (29.6%) were the two most common entry sites for the bullets, a pattern somewhat similar to that of other countries. Survival time, cause of death and recovery of projectiles was also studied. Elimination of illegal country made guns is of the utmost importance in order to curb the high homicidal firearm fatality rate in this region.     

四肢血管战创伤的显微外科治疗

目的 对四肢战伤伤所致血管伤的显微外科治疗效果进行了分析比较。方法1979年3月－2001年6月收治血管火器伤和一般血管创伤670例，应用显微外科治疗。结果 经积极救治后，痊愈613例，功能障碍25例，截21例，死亡11例。结论 大部分四肢战创伤所致血管伤的显微外科治疗效果良好。     

Multiple variations of firearm injuries - a case report

Variation from common findings in death due to firearm injury is not commonly encountered. When there is an atypical finding, the forensic pathologist may feel it difficult for differentiating firearm entry wound from firearm exit wound, tracing the wound track, estimating approximate range of firing and differentiating suicidal injury from homicidal injury. Failure to differentiate entry wound from exit wound can cause error in calculating number of projectiles entered into the body, lodged inside the body or exited through the body, besides posing problem in ascertaining direction of firing and direction of wound track etc. Failure to differentiate contact or close range firearm injury from distant range firearm injury can lead to wrong interpretation about the manner of death. The authors have reported a fatal case of rifled firearm injury showing multiple variations from common findings.     

Suicide among discharged psychiatric inpatients in the Department of Veterans Affairs

OBJECTIVE: The objective of this study was to explore correlates of the use of firearms to commit suicide. METHODS: A national sample of psychiatric patients discharged from Department of Veterans Affairs medical centers was followed from the time of discharge until December 1999. The study explores state-level measures as correlates of overall suicide and suicide by firearm, controlling for individual sociodemographic characteristics and psychiatric diagnosis. The outcomes of interest were completed suicide and suicide by firearm. RESULTS: Patients who were male, Caucasian, and who had a diagnosis of substance abuse or post-traumatic stress disorder were significantly more likely to use a firearm than another means to commit suicide. Multivariable models indicated that veterans living in states with lower rates of gun ownership, more restrictive gun laws, and higher social capital were less likely to commit suicide with a firearm. CONCLUSIONS: Gun ownership rates, legislation, and levels of community cohesiveness are significantly associated with the likelihood of psychiatric patients committing suicide with a gun.     

Firearms accidents in Northern India (1980-2000)

This paper investigates firearms accidents from the last two decades (1980-2000), with information received from the three North Indian states, Chandigarh, Delhi and Himachal Pradesh and from the military and paramilitary organisations working in the region. In this study 139 cases were analysed for evaluation of various parameters such as type of accident, type of firearm used, age, sex, occupation and caste of victim, day of the week and the season in which the accident occurred, place of incident and location of wound. Information was extracted from the case histories and First Information Reports (FIR), and also from autopsy and injury reports. The accidents were self-inflicted in nine cases while another person fired the weapon in 130 cases. Most accidents occurred during hunting or from mishandling the firearm. Gun cleaning accidents rarely occurred and few cases were due to technical defects of the firearm. Shotguns and rifles caused most of the accidents. Shotgun accidents occurred mostly in rural areas whereas the cases involving rifles and handguns were from urban areas. Victims were predominantly male with a mean age of 26 and 30 years for males and females respectively. Victims' occupations were principally agricultural followed by service class and housewives. The most aggressive community was the Kshatriya caste. Most of the accidents occurred during the winter season and on days between Sunday and Tuesday. Accident locations were most commonly the forest, the fields or the home. The chest and head were the most common anatomical sites of injury. All accidental cases were the result of only one firing. It is important to mention that, based on these findings, firearm accidents could be reduced significantly if firearm holders were better trained regarding the handling and safety aspects of their guns, particularly farmers to whom firearm licences are granted specifically for the protection of crops.     

Homicidal firearm injuries: a study from Sri Lanka

Stabbing, mechanical asphyxia, blunt head injury and shooting are the most common methods of homicides, with firearm homicides on the increase throughout the world. This study was a retrospective study carried out by the Department of Forensic Medicine, University of Kelaniya, Sri Lanka over a 1 year period on firearm homicides examined at two principal forensic institutions in the western province (Office of the Judicial Medical Officer Colombo and Ragama) of Sri Lanka. During the period of the study (June 2005 to July 2006) 3100 medicolegal autopsies were carried out at these two institutions with 265 representing alleged homicides. Eighty-three cases (31%) were identified as homicides due to fatal firearm injuries. The majority of the victims (N = 76) were young adult males (aged 18–40 years). Almost half of the firearm homicides (47%; N = 39) were associated with previous enmity, while 33% (N = 27) were due to ethnic rebel killings in the North and East. Daylight hours (6.00 a.m. to 6.00 p.m.) were preferred by rebels, while there was no relation to the time of day in the other firearm deaths. The weapon of choice was a rifled firearm (98%). While 70% of war-related deaths had one or two fatal shots, either to the head or chest, homicides motivated by personal enmity had multiple wounds, with an average of 5.7 fatal shots per victim. This study demonstrates that firearm homicides in Sri Lanka mainly involve young men, and that when related to armed conflict the fatal injury usually consists of a single shot to the head or chest.     

低温环境放火器复合伤细菌感染的实验研究

目的：探讨低温放火器复合伤感染的发生特点。方法：将健康兔随机分为低温放火器复合伤（HFR）组和低温火器伤（HF）组，于致伤后0、4、8、16、24h进行体温、伤道和血液细菌学的检测。结果：HFR组伤后体温持续明显升高，伤道细菌数明显上升，在对应时间点较HF组升高显著（P〈0．05，P〈0．01），2组分别于8和24h出现肠道菌群且细菌入血，细菌数达感染临界值。结论：低温放火器复合伤后细菌生长繁殖快，感染时限缩短且严重，应早期彻底清创，合理使用广谱抗生素。