湿性医疗技术治疗成批烧伤临床体会

目的：观察湿性医疗技术（MEBT/MEBO）对成批不同面积和不同深度烧伤病人的治疗效果。方法：14例烧伤病人全程采用MEBO治疗，烧伤面积10％-55％TBSA，浅Ⅱ度烧伤3例，浅Ⅱ-深Ⅱ度烧伤7例，伴有Ⅲ度烧伤者4例，深度烧伤辅以耕耘疗法或薄化坏死层技术治疗。结果：14例病人全部治愈，深Ⅱ度以下创面无瘢痕，浅Ⅲ度有软性瘢痕，但无功能障碍，小面积深Ⅲ度创面未予植皮。结论：MEBT／MEBO结合耕耘疗法用于成批伤员救治，对于各种面积和深度烧伤，均有很好的治疗效果。     

应用MEBO治疗一批28例烧伤患者的体会

近几年来，由于各种原因引起的成批烧伤病员不断增加。我院于１９９６年１２月１５日下午三点钟，收治一批炮药起火烧伤病人，当场烧伤２８名工人，其中１３例严重烧伤，于伤后一小时入院。２８名均为女性，年龄最大６８岁，最小１５岁。烧伤面积在５０％以上为１３例，３０至４９％者为８例，１０至２９％者为７例，其中有１５例合并吸入性损伤；有２例Ⅲ度烧伤，使用ＭＥＢＯ治疗，并采取了早期复苏、抗感染等各种措施，使２８例病     

极重度放烧复合伤大鼠异体骨髓和皮肤移植后的病理学…

大鼠３Ｇｙ全身照射复合１５％Ⅲ度烧伤，伤后６小时内进行异体骨髓和同一供体皮肤移植，治疗组大鼠５０天动物存活５０％，其异体皮全部存活，至伤后１００和４８０天时，存活动物的异体皮仍然生长良发，组织结构正常，骨髓移植后５天，受体骨髓现出现再生，第１０天再生明显增多，淋巴结和脾脏皮质区淋巴细胞第１５天出现生。致伤对照大鼠于伤后７天内全部死亡，骨髓无明显再生，结果表明，在极重度放烧复合伤情况下，早期进行异体     

烧伤皮肤再生修复的临床治疗观察

目的：总结各种深度烧伤创面再生修复的临床演变过程。方法：对我院1987年至2002年救治的12500例入院与出院病人登记资料统计，结合以往所进行的阶段性资料总结，阐述病人的基本情况与湿润烧伤膏（MEBO）治病下的创面愈合过程．结果：全国最大烧伤面积99.8％TRSA，最大患病年龄88岁，最小初生两天；深Ⅱ度浅型创面伤后2周愈合，无瘢痕增生；深Ⅱ度深型3周内愈合，瘢痕发生率15％；浅Ⅲ度创面应辅以皮肤耕耘减张处理，瘢痕发生率为25％；深Ⅲ度烧伤需借助外科技术封闭创面，所有创面的主体治疗药物为MEBO。结论：深度烧伤在MEBO治疗前提下，辅以耘耘疗法或借助外科技术可促进创面再生修复，降低瘢痕发生率。     

MEBO治疗15例大面积烧伤病人的临床体会

我院自1993－1996年共收治15例大面积烧伤病人，最少烧伤面积50％，最大烧伤面积95％，均为深Ⅱ度和Ⅲ度烧伤创面，其中伴中度或重度吸入性损伤10例。全部采用MEBT／MEBO治疗，由于及时实施了气管切开、吸氧、雾化吸入等抢救措施处理，除1例因多脏器功能衰竭（MOF）死亡外，余14例均治愈出院。     

MEBT/MEBO联合紫外线照射治疗耳廓深度烧伤临床总结

目的：观察烧伤湿性医疗技术（MEBT／MEBO）紫外线照射治疗耳廓深Ⅱ度与Ⅲ度烧伤的疗效。方法：20例病人40只烧伤耳廓全程采用MEBT／MEBO治疗，同时对深Ⅱ度深型与Ⅲ度烧伤耳廓行早期耕耘疗法；于伤后3天－5天加用紫外线照射治疗。结果：37只烧伤耳廓达到良好愈合，Ⅰ期愈合率为92．5％；3只耳廓发生耳软骨炎（7．5％），最终为不同程度瘢痕愈合。结论：MEBT／MEBO可促进深度烧伤耳廓愈合，降低阼软骨炎发生率。     

深Ⅱ度烧伤的疗效分析

目的：深Ⅱ度烧伤由于转归比较复杂,治疗方法一直存在争议。本文旨在探索深Ⅱ度烧伤的最佳疗法,总结烧伤湿润暴露法／湿润烧伤膏（MEBT／MEBO）对烧伤深Ⅱ度创面的疗效。方法：自1987年12月至1997年12月采用多中心、随机大样本的前瞻性研究,对目前三种最常用的疗法即MEBT／MEBO（M组）、SD-Ag(S组）干燥暴露及早期切痴植皮（E组）进行比较。结果：M组356例,平均年龄24．6±18．7岁,平均烧伤面积26．6％±16．8％;S组232例,平均年龄22．1±15．4岁,平均烧伤面积24．9％±18．3％;E组269例,平均年龄23．6±16．4岁,平均烧伤面积26．3％±18．6％。各组之间年龄、烧伤面积、烧伤部位、烧伤原因及是否合并吸入性损伤无显著差别（P＞0．05）,说明各组具有可比性。M组平均愈合时间22．6±7．2天,疤痕增生率11.5％,功能残废率2．1％,病死率为1．8％。均显著低于S组及E组。此外M组还能显著减少植皮次数和抗生素使用时间,降低SIRS、MODS及脓毒症发生率。结论：MEBT／MEBO对深Ⅱ度烧伤的治疗优于传统的SD－Ag干燥暴露及早期切痴植皮疗法。     

5‰淡碘酒在烧伤创面处理中的应用

５‰淡碘酒在烧伤创面处理中的应用黄洛平烧伤创面的处理，在烧伤科治疗中有着极重要的意义，尤其在刀“（包括深对”、浅显勺烧伤；创面处理的好坏，直接关系到烧伤创面的修复，能否平安渡过休克期和感染期。当烧伤面积大（即Ｂ”、皿“烧伤面积成人在１５％，小儿在５％...     

1294例小儿烧伤创面特点的临床分析

目的：探讨影响小儿烧伤创面大小和深度的因素。方法：通过对1294例14岁以下小儿烧伤住院患者病史资料的分析,探讨不同性别、年龄、烧伤原因和不同年代或人口组成对小儿烧伤创面的影响。结果：患儿平均烧伤面积为11．83±9．89%TBSA,Ⅲ度烧伤面积为3．89±1．24%TBSA,性别间无统计学差异(P＞0．05)。烧伤创面主要分布在头面颈、躯干前侧；热液是主要烧伤原因,非热液的Ⅲ度烧伤面积显著较大；居家是发生烧伤主要场所,而公共场所Ⅲ度烧伤面积显著较大(P＜0．01)；4～6岁组患儿平均烧伤面积显著较大(P＜0．01),7～14岁组Ⅲ度烧伤面积最大(P＜0．01)；本市和外来患儿烧伤总面积和Ⅲ度烧伤面积无统计学差异(P＞0．05)。结论：患者年龄、烧伤原因、烧伤场所是影响烧伤面积大小的重要因素。     

MEBT治疗烧伤19例临床体会

作者自１９８４年７月至１９９４年１２月共收治了烧烫伤病人１６８例，其中应用ＭＥＢＯ治疗烧伤１９例，烧伤面积最大８０％，浅Ⅱ度，深Ⅱ度、Ⅲ度不同，并体会到深Ⅲ度病例除用ＭＥＢＯ配合少许邮票植皮治疗大面积创面，恢复以后就是存在上皮化瘢痕，其瘢痕柔软，不影响功能，比干性疗法痊愈后遗瘢痕，造成畸形，影响功能等方面明显具有优越性。     

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.