舒他西林、氧氟沙星、氯霉素治疗伤寒128例疗效观察

目的：评价三种抗菌素治疗伤寒的安全性和有效性。方法：将１２８例伤寒患者随机分为三组,分别予舒他西林３ｇ静滴,１次／日;氧氟沙星２００ｍｇ静滴,１次／日;氯霉素１ｇ静滴,１次／日。结果：总有效率舒他西林组为９７８％,氧氟沙星组为９２９％,氯霉素组为８０％。组间比较,舒他西林组与氯霉素组间有显著差异性,Ｐ＜００１。余两组间差异无显著性。副作用发生率：舒他西林组为４３％,氧氟沙星组为１４３％,氯霉素组为７５％。结论：舒他西林治疗伤寒疗效最好而副作用最少,可做为治疗伤寒的首选药物。     

血液透析和导泻疗法治疗肾综合症出血热急性肾功衰竭之比较

目的探讨血液透析（血透）和导泻疗法治疗肾综合症出血热（ＨＦＲＳ）急性肾功衰竭疗效比较。方法血透组５２例,用碳酸透析液、小剂量肝素化,平均透析３８０次。导泻组５６例,用甘露醇、大黄、芒硝口服导泻,一日两次。结果对照两组ＢＵＮ、Ｃｒ、尿常规恢复正常日数,血液组明显少于导泻组。Ｐ＜０．０１。结论对ＨＦＲＳ－ＡＲＦ患者应及早实施血透。     

江苏省肾综合征出血热监测与疫情预测指标研究

目的　探讨直接利用肾综合征出血热（ＨＦＲＳ） 定点监测资料对全省疫情进行定性预测的意义,寻找敏感且易获得的预测指标。方法　兼顾不同地理状况,选点开展鼠密度、鼠带毒率、带毒鼠指数、健康人群抗体水平监测;对江苏省１９８６ 年以来１２ 年的有关监测资料与人间疫情进行相关性分析。结果　春季室内褐家鼠（Ｒｎ） 密度,混合鼠种及Ｒｎ 带毒率、带毒鼠指数与春峰疫情有显著性相关关系;秋季野外混合鼠种及黑线姬鼠（Ａａ） 密度、带毒鼠指数与秋冬峰疫情显著性相关;全年平均鼠密度、鼠带毒率、带毒鼠指数与全年疫情显著性相关;人群隐性感染率与人间疫情无明显相关关系。其中,春季室内混合鼠种及褐家鼠带毒鼠指数与春峰疫情间相关系数分别为０ ．８６３７、０ ．８２９５ （ Ｐ＜ ０．００１） ;秋季野外混合鼠种、黑线姬鼠带毒鼠指数与秋冬峰疫情间相关系数分别为０ ．７０８９ 、０ ．７２５８ （Ｐ＜ ０ ．０１）,与次年春峰疫情间相关系数分别为０．７１１８、０ ．７１１３ （ Ｐ＜ ０．０１） ;全年平均带毒鼠指数与全年疫情间相关系数为０．９２０７ （ Ｐ＜ ０ ．００１）。结论　带毒鼠指数为定性预测出血热疫情的首选指标;在布夹数均衡性较好条件下,鼠密度可作为预测的辅助指     

Serosurvey of wild rodents for Rickettsioses (spotted fever, murine typhus and Q fever) in Java Island, Indonesia

The prevalence of antibodies against spotted fever group rickettsia (SFGR), murine typhus and Q fever were investigated in wild rats captured in Indonesia. Sera of 327 rats were collected from Jakarta and Boyolali on Java Island. The prevalences of antibodies against SFGR and murine typhus were 128 (39.1%) and 48 (14.7%), respectively. Antibodies against Q fever were not detected in these serum samples. Antibodies against SFGR were found in all species of rats (20.8–51.9%). The antibody positive rate against murine typhus in Rattus norvegicus (38.0%) was significantly higher than that in other rat species (0–4.8%, p < 0.01). The antibody positive rates against SFGR and murine typhus in rats captured in Jakarta were significantly higher than those in rats captured in Boyolali (p < 0.01). In this survey, all species of rats had antibodies against SFGR, indicating that the 4 species of tested rats (R. norvegicus, R. rattus, R. exulans, R. tiomanicus) were infected with SFGR and that SFGR may infest the whole of Java Island. Most of the rats that were antibody-positive against murine typhus were captured in Jakarta. Therefore, R. norvegicus and R. rattus are likely to be important hosts of murine typhus in Jakarta. The antibody-positive rates against SFGR and murine typhus in rats captured in the dry season were significantly higher than those in rats captured in the rainy season. This may coincide with the active periods of ticks and fleas in Indonesia.     

犬失血性休克早期血浆3种酶活性值的变化

用１０只犬复制失血性休克模型,观察休克前、休克３０ｍｉｎ及回输血后３０ｍｉｎ时,血浆中心肌相关酶—肌酸激酶（ＣＫ）、谷草转氨酶（ＧＯＴ）、α－羟丁酸脱氢酶（ＨＢＤ）活性值的变化。结果发现：失血性休克３０ｍｉｎ时,ＣＫ、ＧＯＴ较休克前显著下降（Ｐ＜０．０５,Ｐ＜０．０１）;ＨＢＤ值也下降,但无统计学意义（Ｐ＞０．０５）。输血后３０ｍｉｎ时,ＣＫ、ＧＯＴ、ＨＢＤ值回升,与休克３０ｍｉｎ时比显著升高（Ｐ＜０．０５）,与休克前比无显著性差别（Ｐ＞０．０５）。提示：失血性休克早期心肌细胞可能存在有一种保护性反应,心肌细胞没有发生明显损伤。     

儿童接种肾综合征出血热Ⅰ型灭活疫苗的成本效益和效果分析

采用建德市肾综合征出血热Ⅰ型灭活疫苗效果考核现场资料,计算５～９岁和１０～１４岁各年龄组的效益费用比（ＢＣＲ）和效果费用比（ＣＥＲ）。结果各年龄组ＢＣＲ和ＣＥＲ均小于１或大于０;５～９岁年龄组儿童接种疫苗后的ＣＥＲ和预防一个病人的费用是１０～１４岁年龄组的一倍左右。结论：可在高发区１０～１４岁儿童中开展ＨＦＲＳ疫苗预防接种。     

Two outbreaks of typhoid fever related to the war in Bosnia and Herzegovina

Two outbreaks of typhoid fever caused by Salmonella typhi of the same phagotype (A, biotype II) and antibiotic susceptibility are reported. Both occurred during the war in Bosnia and Herzegovina. The first outbreak appeared among the refugees from the town of Jajce. The second outbreak appeared among the inhabitants in the village of Vidosi near Livno. This report describes main clinical, epidemioloigcal and laboratory findings for 22 patients treated in Split University Hospital, Croatia, in the period November 1992–January 1993. Possible epidemiological connections between those two outbreaks are discussed.     

Hepatic levels of prostaglandins F2α and I2 (prostacyclin) and of thromboxane A2 in dogs developing hemorrhagic shock

Professorial Department of Surgery, L'vov Medical Institute. L'vov Branch, Kiev Research Institute of Hematology and Blood Transfusion. (Presented by Academician of the Academy of Medical Sciences of the USSR V. S. Savel'ev.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 113, No. 2, pp. 134–135, February, 1992.     

Clinical characteristics of haemorrhagic fever with renal syndrome in children

From January 1988 to September 1989, seven patients (4 girls and 3 boys, aged 3–12 years) with haemorrhagic fever with renal syndrome (HFRS) were hospitalised at the University Children's Hospital in Belgrade. In four patients the disease appeared as a family outbreak, the others were sporadic cases. In six patients the clinical presentation was suggestive of HFRS, as they had fever with headache, myalgia, sore throat and gastrointestinal illness followed by renal abnormalities. However, severe haemorrhagic syndrome with petechia, haematoma, haematemesis and melaena was present in one patient only. Renal disease presented as nephritic syndrome and/or acute renal failure. Five patients recovered after 2–3 weeks without sequellae, one patient had decreased renal function 17 months after the start of the disease and the remaining patient died. In six patients the diagnosis of HFRS was confirmed serologically by a significant rise in antibody titres against hantaviruses, while in the patient with the fatal and fulminant course of the disease, the diagnosis was established on the basis of epidemiological and autopsy findings. We suggest that children living in endemic areas who develop an ill-defined, febrile and gastrointestinal disease with renal dysfunction should be evaluated for HFRS.     

Chronic hematuria and localized bladder damage following combined cyclophosphamide and local radiotherapy.

A 13-year-old white male had Ewing sarcoma of the right pubic and ischial bones. Initial therapy consisted of 5,400 rads in seven weeks to the right side of the pelvis and 14 intravenous injections of cyclophosphamide (Cytoxan, CTX) at 500 mg/m2; BCNU and Adriamycin maintenance therapy continued for a total of two years. He has now been disease-free for five years. Three months following the completion of the right pelvic radiotherapy (RT), while on intravenous CTX, severe hematuria appeared, which subsided, but at present he has continuous microscopic hematuria, as well as periodic episodes of gross hematuria. Serial cystocopies initially revealed thickening and hemorrhagic and edematous changes on the right (irradiated) side of the bladder, and recent multiple telangiectatic patches have been demonstrated as a late "healing" phase. This case demonstrates the additive toxicity to the bladder of CTX and RT, illustrating that the hemorrhagic cystitis can be extremely protracted lasting five years.