应用MEBT/MEBO治疗55例烧伤病人的疗效观察

目的：观察MEBT／MEBO对烧伤病人的治疗效果。方法：全程采用MEBT／MEBO治疗55例不同面积和深度的烧伤病人，观察创面愈合时间，感染及创面疼痛程度。结果：55例烧伤病人全部治愈，治愈率100％；创面感染3例，感染率5．5％。各种创面均能在预期内愈合，疼痛减轻和消失。结论：MEBT／MEBO能促进创面愈合，减少创面感染率，对深Ⅱ度烧伤创面治疗愈后不留瘢痕或少留瘢痕，方法简便，效果良好。     

肺结核病人健康教育现状调查与影响因素分析

目的　调查活动性肺结核病人在诊断前接受结核病知识的教育现状 ,分析病人接受结核病知识与社会经济因素的影响。方法　对 2 0 0 0年全国结核病流行病学抽样调查中的 1 2 78名活动性肺结核病人进行社会经济个案调查 ,调查以问卷的形式进行。结果　 1 2 78例肺结核病人在诊断前有 5 1 4例接受过不同形式的健康教育 ,占 40 2 % ,男性接受健康教育比例为 41 8% ,女性为 3 6 9%。各年龄组接受健康教育比例 <1 5岁组最低为2 5 9% ,其次是 65～年龄组为 3 0 9%。随着病人文化程度的增高和家庭人均年收入的增高 ,接受健康教育比例增高。肺结核病人各种职业的分类中 ,无工作者接受健康教育比例最低为 3 5 5 % ,其次为农林牧渔劳动者。按照病人是否有症状、有症状后是否就诊及最后诊断为肺结核病人的 3个过程接受不同形式的健康教育的频率 ,均以广播电视、健康教育和亲友教育为主。结论　在开展健康教育活动中 ,应注意对儿童和老年人群 ,对于文化程度低、家庭经济收入低、无工作者和农林牧渔劳动者等重点人群的教育     

高原康胶囊对大批快速进入高原者血浆醛固酮、血管紧张素II及水负荷的影响及意义

目的 :了解高原康胶囊对快速进入高原者血浆醛固酮 (Aldosterone ,ALD)、血管紧张素II(AngiotensinII ,AII)及水负荷的影响及意义。方法 :将 80名由平原快速进入高原的新兵随机分为实验组 4 0名 ,对照组 4 0名 ,实验组于平原登机前开始给予口服高原康胶囊 ,连服 3日 ,对照组给予安慰剂 ,两组均于进入高原的前 1天及进入高原的第 3天午给予水负荷实验 ,并对饮水前血浆ALD、AII及饮水后 15 0min内各时间段的尿量及两组进入高原后 7天内急性高原病 (Acutehighal titudediseaes ,AHAD)的发病率进行对照比较。结果 :对照组进入高原后与平原相比血浆ALD、AII显著升高 ,水负荷实验 6 1min～ 15 0min各时间段的尿量及相应时间的总尿量与平原时相应各时间段的尿量及相应时间的总尿量相比则显著减少 (P <0 0 5～ 0 0 0 1) ,而实验组则无显著变化 (P >0 0 5 ) ;进入高原后实验组与对照组相比水负荷实验 6 1min～ 90min的尿量及 12 0min、15 0min的尿总量则显著多于对照组 (P <0 0 5 ) ;血浆ALD、AII及AHAD发病率则显著低于对照组 (P <0 0 5～ 0 0 0 1)。结论 :高原康胶囊能显著降低快速进入高原者的血浆ALD、AII ,通过对水负荷调节的影响减少机体的钠水潴留 ,从而防止快速进入高原者AHAD的发生 ,可用于大批快     

PRENATAL DIAGNOSIS Ⅰ. EARLY DIAGNOSIS OF OPEN NEURAL TUBE DEFECTS BY QUALITATIVE ACETYLCHOLINESTERASE ISOENZYME IN AMNIOTIC FLUID

The measurement of amniotic fluid (AF) acetylcholinesterase isoenzyme (AChEI) is a relatively new method for early diagnosis of open neural tube defects (NTDs). As quantitative methods are of unproven reliability at present, the authors used a high resolving power qualitative method-vertical slab polyaerylamide gel electrophoresis. The benefits of this technique are: simplicity of operation, accuracy, unsophisticated equipment, and easily available reagents. Combined results of 9 NTDs studies revealed that samples from early pregnancy gave more accurate results than those from late pregnancy.     

Assessment of sublingual immunotherapy efficacy in children with house dust mite-induced allergic asthma optimally controlled by pharmacologic treatment and mite-avoidance measures

Although several studies have demonstrated the efficacy of subcutaneous immunotherapy in allergic asthma, few have shown the same benefit using sublingual immunotherapy (SLIT) in asthmatic patients. This study was conducted to assess the efficacy of house dust mite (HDM) SLIT in addition to allergen avoidance and standard pharmacologic treatment. A double-blind, placebo-controlled trial was performed in 111 children (aged 5-15 yr) with HDM-induced mild-to-moderate asthma. After a 4-week baseline phase, patients were randomly assigned to receive SLIT with tablets of HDM extract (n = 55) or placebo (n = 56) for 18 months. Pharmacologic treatment was adjusted every 3 months following a step-down approach. Asthma symptom scores, reduction in use of inhaled corticosteroids and inhaled beta(2)-agonists, rhinitis symptoms, lung function tests, skin sensitivity to HDM, dust mite-specific immunoglobulin (Ig) E and IgG(4), and quality of life (QoL) were assessed during the study. After 18 months of treatment, diurnal and nocturnal asthma symptoms scores did not show significant differences between SLIT and placebo groups. Inhaled corticosteroids and inhaled beta(2)-agonists use was reduced in both groups without significant differences between groups. There were no significant differences in lung function (forced expiratory volume in 1 s and peak flow rate variations) between groups. Rhinitis symptom score decreased in both groups, with no difference between the two groups. The severity dimension of QoL was significantly improved in the SLIT group (age 6-12 yr). SLIT induced a significant reduction of skin sensitivity to HDM (p < 0.01) and a significant increase in HDM-specific IgE and IgG(4) antibodies (p < 0.001) in the SLIT group compared with the placebo group. SLIT was well tolerated with mild/moderate local adverse events. No severe systemic reactions were reported. This study indicates that, when mild-moderate asthmatic children are optimally controlled by pharmacologic treatment and HDM avoidance, SLIT does not provide additional benefit, despite a significant reduction in allergic response to HDM. Under such conditions, only a complete, but ethically unfeasible, discontinuation of inhaled corticosteroid would have demonstrated a possible benefit of SLIT.     

糖尿病脑内胰岛移植临床初步研究(附三例报告)

本文报告胰岛细胞脑内移植治疗I型糖尿病共3例,分别经过3个月、4个月、6个月的临床观察,其临床症状明显改善或消失,空腹血糖由移植前平均12.38mmol/L下降至7.77mmol/L;3例患者普通胰岛素用量平均每日62.3~u,移植后第21～30天均完全停用胰岛素,其中1例已持续撤离胰岛素治疗达5个月。观察结果提示:胰岛移植物在患者的脑内成活,并具有良好的内分泌功能。     

Safety of levocetirizine treatment in young atopic children: An 18-month study

There are more than 40 H(1)-antihistamines available worldwide. Most of these medications have never been optimally studied in prospective, randomized, double-masked, placebo-controlled trials in children. The aim was to perform a long-term study of levocetirizine safety in young atopic children. In the randomized, double-masked Early Prevention of Asthma in Atopic Children Study, 510 atopic children who were age 12-24 months at entry received either levocetirizine 0.125 mg/kg or placebo twice daily for 18 months. Safety was assessed by: reporting of adverse events, numbers of children discontinuing the study because of adverse events, height and body mass measurements, assessment of developmental milestones, and hematology and biochemistry tests. The population evaluated for safety consisted of 255 children given levocetirizine and 255 children given placebo. The treatment groups were similar demographically, and with regard to number of children with: one or more adverse events (levocetirizine, 96.9%; placebo, 95.7%); serious adverse events (levocetirizine, 12.2%; placebo, 14.5%); medication-attributed adverse events (levocetirizine, 5.1%; placebo, 6.3%); and adverse events that led to permanent discontinuation of study medication (levocetirizine, 2.0%; placebo, 1.2%). The most frequent adverse events related to: upper respiratory tract infections, transient gastroenteritis symptoms, or exacerbations of allergic diseases. There were no significant differences between the treatment groups in height, mass, attainment of developmental milestones, and hematology and biochemistry tests. The long-term safety of levocetirizine has been confirmed in young atopic children.     

耳源性脑疝25例临床分析

耳源性脑疝25例,抢救成功者19例。采用单纯脑脓肿穿刺抽脓抢救脑疝6例,仅1例成功;开颅减压术抢救脑疝20例,18例抢救成功。本组临床实践和文献报道都说明耳源性脑疝一旦发生应即刻行开颅减压术,能卓有成效地抢救生命     

Multicenter Randomized Comparison of Xenon and Isoflurane on Left Ventricular Function in Patients Undergoing Elective Surgery

Background: Volatile anesthetics are commonly used for general anesthesia. However, these can induce profound cardiovascular alterations. Xenon is a noble gas with potent anesthetic and analgesic properties. However, it is uncertain whether xenon alters myocardial function. The aim of this study was therefore to investigate left ventricular function during anesthesia with xenon compared with isoflurane.

Methods: The authors performed a randomized multicenter trial to compare xenon with isoflurane with respect to cardiovascular stability and adverse effects in patients without cardiac diseases scheduled for elective surgery. Two hundred fifty-nine patients were enrolled in this trial, of which 252 completed the study according to the protocol. Patients were anesthetized with xenon or isoflurane, respectively. Before administration of the study drugs and at four time points, the effects of both anesthetics on left ventricular function were investigated using transesophageal echocardiography.

Results: Global hemodynamic parameters were significantly altered using isoflurane (P < 0.05 vs. baseline), whereas xenon only decreased heart rate (P < 0.05 vs. baseline). In contrast to xenon, left ventricular end-systolic wall stress decreased significantly in the isoflurane group (P < 0.05 vs. baseline). Velocity of circumferential fiber shortening was decreased significantly in the xenon group but showed a more pronounced reduction during isoflurane administration (P < 0.05 vs. baseline). The contractile index (difference between expected and actually measured velocity of circumferential fiber shortening) as an independent parameter for left ventricular function was significantly decreased after isoflurane (P < 0.0001) but unchanged using xenon.