Toxic streptococcal syndrome

The reappearance of more virulent strains of exotoxin-producing streptococci over the past decade has led to the re-emergence of invasive Group A streptococcal infections and the recognition of a new syndrome resembling staphylococcal toxic shock syndrome. Toxic streptococcal syndrome is characterized by fever, shock, multiorgan system failure and a desquamating scarlatiniform rash. It usually occurs in otherwise healthy young adults, often in association with a severe soft tissue infection and has a 30% mortality rate. The case of a 37-year-old obese man, who rapidly developed features of this syndrome after an antecedent pharyngitis and cellulitis, is presented. There was serological evidence of a recent Group A streptococcal infection. Intensive organ supportive measures and intravenous antibiotic therapy led to his gradual recovery.     

高速分散液相色谱法测定毒饵中的溴敌隆

本文介绍了高效液相色谱法测定毒饵中的溴敌隆，样品经高速分散器萃取后直接进行分析，紫外检测器波长设定２８０ｎｍ，色谱柱为ＹＷＧ－Ｃ１８Ｈ３７，分析结果的相对标准偏差为１．８％，回收率为９２．４％，可简便、快速测定含量在０．００５％左右的溴敌隆毒饵，亦可有效地分离鉴定杀鼠迷和杀鼠灵等香豆素类杀鼠剂。     

三种食用油对小鼠脂质过氧化的影响及其意义

选用４月～６月龄的小鼠，分别饲以多不饱和脂肪酸含量下同的猪油，花生油及豆油，观察其对机体脂质过氧化的影响，结果发现，血浆及肝中脂质过氧化产物丙二醛仿猪油低于花生油组及豆油组，肝中超氧化物歧化酶含量前者高于后二者，有显著性关系，花生油组与豆油可增强机体脂质过氧化，而猪油则相反，故而多种食用油合理塔配应用有利于健康。     

心包积液的诊断──磁共振成像与超声心动图的对照研究

作者叙述了２４例心包积液（ＰＥ）的ＭＲＩ所见，并同超声心动图（ＵＳ）检查结果进行了对比分析，研究结果表明：ＭＲＩ与ＵＳ均为诊断ＰＥ的有效手段，可用于ＰＥ的半定量分析。ＭＲＩ发现少量ＰＥ较ＵＳ敏感，能从多体位更准确地显示ＰＥ的部位、分布等，同时对积液性质的判断也有一定的帮助。     

Current considerations in the etiology and diagnosis of tympanosclerosis

Current concepts of formation of tympanosclerosis in the middle ear are reviewed, as are various clinical considerations. Ultrastructural changes are discussed. A differential diagnosis includes disorders affecting middle ear sound conduction, with the most prevalent involving otosclerosis and cholesteatoma.     

腹腔镜治疗急性胆囊炎145例分析

目的 评价腹腔镜胆囊切除术(LC)治疗急性胆囊炎的安全性及可行性。方法回顾分析1994年～2000年LC治疗急性胆囊炎145例。结果本组急诊行LC，手术时间：30min～130min，平均68min。术后并发症5例，2例为胆囊动脉出血，均再次腹腔镜下止血成功；1例胆漏，1例大网膜损伤出血，再次开腹手术完成；1例肝下脓肿，经抗炎治疗痊愈。一次手术成功率96．6％(140／145)。结论急性胆囊炎发作1天～3天内，B超提示胆囊壁厚≤5mm，急诊胆囊切除术能在腹腔镜下完成。     

准分子激光光学角膜切削术治疗近视眼

对１０３例经准分子激光光学角膜切削术治疗的低于—６Ｄ近视患者随访６个月。患者按近视程度分组，通过对术前术后裸眼视力、最佳矫正视力、屈光情况及角膜曲率等结果的比较，证明该手术对低于—６Ｄ近视是一种安全、效果稳定、预测性高的角膜屈光性手术。在术后６个月时８８．３５％的患者裸眼视力≥１．０，９４．１７％的患者实际矫正度数与预测矫正度数差≤±１．００Ｄ。仅少数病例出现上皮下雾状混浊和短暂的激素性眼压升高。     

氯胺酮复合曲马多病人自控静脉镇痛用于肝功能不全患者术后镇痛

目的　研究小剂量氯胺酮复合曲马多应用于肝功能不全患者术后病人自控静脉镇痛(PCIA)的可行性和安全性。方法 4 0例肝炎后肝硬化合并脾功能亢进需行脾切除术的患者 ,ASAⅡ～Ⅲ级 ,随机等分为T组 (曲马多 15 0 0mg、恩丹西酮 8mg加生理盐水至 15 0ml)、TK组 (曲马多12 0 0mg、氯胺酮 30 0mg、恩丹西酮 8mg加生理盐水至 15 0ml)。两组持续输注速度 0 0 3ml·kg 1·h 1,首剂为 0 1ml/kg ,单次PCA给药剂量 2ml,锁定时间 15min。记录术后第 2、4、8、16、2 4、36、4 8、72h的VAS评分、PCIA用药量、PCA总按压次数 /有效按压次数 (D/D)、呼吸和循环的状况以及不良反应的发生情况。结果　两组患者一般情况相同 ,术后第 3天的肝功能与术前相比无显著差异 (P >0 0 5 )。两组患者呼吸通畅 ,SpO2 均在 96 %以上。在术后 36h内TK组的VAS评分、用药量、D/D明显低于T组 (P <0 0 1) ,36h以后无显著差异 (P >0 0 5 ) ;两组患者的并发症发生率无显著差异 (P >0 0 5 )。结论　小剂量氯胺酮复合曲马多可以改善镇痛效果 ,明显减少曲马多的用量 ,可以安全有效地应用于肝功能不全的患者术后静脉镇痛     

Clinical observation on treatment of hyperthyoidism with integrated chinese medicine

Clinical and laboratory criteria were observed in 82 patients of hyperthyroidism treated with integrated Chinese medicine. Results showed that patients were recovered more rapid than the control group which were treated with Western medicine only. The serum free triiodothyronine, free tyroxin, total thyroxin, total triiodothyronine and reverse antitriiodothyronine of patients all went up beyond the normal range before treatment. After treatment, the number of patients with these abnormal criteria normalized in integrated therapy group was much greater than that in the control group.