关于sepsis中文译名的商榷

自sepsis更新为感染加全身炎症反应综合征（SIRS）的新概念以来,一直存在多种中文译名,最近则多应用“脓毒症”一词。我认为“脓毒症”只是表达了化脓性感染。它不能反应sepsis这一复杂过程中多种微生物感染伴有全身炎症反应这一综合征的本质。且易误导抗生素过度应用。事实上,“脓毒症”命名也不易为患儿家长和普通人群所理解,这对医患沟通和医学知识普及均不利。     

婴儿尿路感染致脓毒症八例临床分析

目的 探讨婴儿尿路感染的临床特点及与脓毒症的关系.方法 回顾性分析温州医学院附属育英儿童医院2006年1月至2009年1月收治的8例婴儿尿路感染病例的临床特点.结果 8例患儿中有7例年龄小于6个月,均以发热为主要表现,8例中有3例中段尿培养阳性,分别为大肠埃希菌2例及肺炎克雷白菌1例,血培养7例阳性,分别为大肠埃希菌5例,肺炎克雷白菌1例,金黄色葡萄球菌1例.结论 婴儿尿路感染临床表现不典型,易误诊或漏诊,且有导致脓毒症的危险性,应及时、积极干预,合理选择敏感抗生素,以降低脓毒症的发生率及肾脏损害.     

Acromicric dysplasia and geleophysic dysplasia: Similarities and differences

Abstract We report on a girl with severe growth retardation, characteristic facies, short stubby hands and feet, progressive joint stiffness, mild aortic and mitral valve insufficiency, and normal intelligence. These features are compatible with the diagnosis acromicric dysplasia. The differential diagnosis with Moore-Federman syndrome and geleophysic dysplasia is discussed; major points to consider in differentiating these entities are the facial appearance, the aspect of the proximal femora, and the presence or absence of storage phenomena. The differences in pattern of inheritance are important in adequate patient care, especially in genetic counselling.Conclusion Acromicric dysplasia, geleophysic dysplasia, and Moore-Federmann syndrome may be allelic forms of the same disorder or different disturbances of the same metabolic pathwayIn memory of our late colleague Hanna Oorthuys, who died in June 1992     

脓毒症急性肾损伤发病机制的研究进展

脓毒症急性肾损伤是脓毒症多器官功能障碍的表现之一.当出现急性肾损伤时,往往提示病情危重.脓毒症急性肾损伤主要与肾脏血流动力学改变、缺血再灌注损伤、直接的炎症损伤、凝血和血管内皮细胞功能紊乱及细胞凋亡等有关.     

先天性白色念珠菌败血症2例报告

例1：女，30min，双胎之小。因“胎龄32周，生后30min，复苏后伴阵发性发绀30min”入院。患儿第1胎第2产，母亲前10d有流产史，经保胎后再次阴道流血而在本院妇产科剖宫产娩出。患儿出生体重1．5kg，全身皮肤发绀，伴呻吟，1分钟Apgar评分6分，予心肺复苏后，5分钟评分9分，10分钟评分10分，羊水正常，脐带中段狭窄畸形呈麻花状，胎盘无异常。生后出现阵发性发绀转入我科。入院体检：体温不升，P80次／min，R22次／min，体重1．5kg。     

Transient low level of IgG3 induced by sepsis

Staphylococcus aureus sepsis developed in a 14 year old girl. Immunological evaluation revealed low level of IgG3, although total IgG level was normal. The level of IgG3 increased gradually along with the recovery from sepsis. Immunoglobulin replacement therapy might have been useful in this patient, even though the total immunoglobulin level was within normal limits.     

Similarities of Kawasaki disease and Yersinia pseudotuberculosis infection epidemiology

Although an infectious etiology is strongly suspected in Kawasaki disease (KD), an etiologic agent has not yet been identified. By reviewing epidemiologic data published in past decades, this work highlights a higher incidence of KD when populations were exposed to the risk of Yersinia pseudotuberculosis infection. This hitherto unnoticed element reinforces the hypothesis whereby this bacterium might contribute to the development of KD in some cases.     

SIRS/sepsis与复杂性感染

全身炎症反应综合征/全身感染炎症综合征(SIRS/sepsis)的核心理念是:假设感染、全身性炎症/免疫反应系急危重症疾病的一种重要发病机制.SIRS/sepsis视不同的刺激/感染可以产生相同或相似的临床表现为,并认为不同感染合并全身炎症反应可发生相同或相似的序贯过程~([1-2]).这种简约化、综合性思维(包括宏观与微观的思维)对临床急重症和疑难病的诊断治疗具有明显优越性.     

早产儿医院感染败血症的危险因素及病原学分析

目的：探讨早产儿医院感染败血症的主要危险因素和病原菌分布。方法：对2003年1月至2010年12月收治的3418例早产儿进行回顾性分析,对发生医院感染败血症的危险因素进行病例对照研究。结果：早产儿医院感染败血症感染率为3.10%（106/3418）,发生感染日龄的中位数为19(4～48) d。感染病原菌中革兰阳性菌占45.2%,以凝固酶阴性葡萄球菌的比例较高（24.3%）;革兰阴性菌占41.7%,以肺炎克雷伯杆菌为主（25.2%）;真菌13.0%。Logistic回归分析提示出生体重、中心静脉置管和肠外营养时间是早产儿院内感染败血症的主要危险因素（OR值分别为3.765、3.051、2.998, 均P<0.05）。结论：早产儿医院感染败血症的主要危险因素是出生体重、中心静脉置管和肠外营养时间;肺炎克雷伯杆菌是早产儿医院感染败血症的主要病原菌。