水痘是由水痘-带状疱疹病毒(VZV)原发感染引起急性呼吸道传染病,潜伏期一般为12 ~21 d,平均14 d,是集体单位常见的传染病之一[1] .近年来,武警部队十分重视传染病防疫工作,但仍偶有部队传染病发病报道,不同程度地影响了部队的战斗力,严重危及官兵身体健康[2] .

随着新一轮改革的推进,武警部队遂行任务越来越多样化,这也对基层部队的卫勤保障工作提出了更高的要求. 特别是武警部队着眼新疆任务实际,在南疆地区组建了一支山地反恐特战部队,从任务实际看,疆区部队驻地执勤点多、线长、面广,基层卫勤保障人员相对紧缺,现有编制内的军医力量远不能满足部队需要,为适应部队改革与发展,卫勤工作必须向实战化靠拢. 卫生员队伍作为卫勤保障的重要力量,处于一个更加突出的重要位置. 因此,提高卫生员的救治能力对降低伤员病死率和伤残率、增强卫勤保障能力、服务广大基层官兵,都具有重要的意义[1].

目的 本研究旨在将ST抬高心肌梗死(STEMI)患者治疗指南用于院外紧急医疗服务,通过评估首次调度判断不恰当的比例,确定其对STEMI患者再灌注治疗延迟的影响.方法 本辖区具有STEMI患者前瞻性注册登记资格医疗机构数据库详细的登记报告和首次结果,作为分析的原始数据.以本辖区内的EMS呼叫中心病人第一次呼叫计算的245例患者,研究他们再灌注治疗的主要记录日期和时间.结果 首次EMS调度决策是合适(重症监护救护车)171(70％)例患者和74(30％)患者不适合.不适当的决定包括给予了医疗服务(N=9)、得到医生朋友的指导(N=59)、并派遣救护车(N=6).不恰当的首次决策导致中位数时间增加有38例接受溶栓再灌注(95 vs 53 min;P ＜0.001),28例患者接受直接PCI(170 vs 107 min;P＜0.001).两组间住院死亡率没有统计学差异(6.8％ vs 9.9％;P=0.42).结论 首次调度判断有30％STEMI患者不适当,其结果是再灌注治疗时间推迟,电话分流的精度将改善急性冠脉综合征先兆症状患者的EMS响应.

Objective To investigate the incidence and the drug-sensitivity results of mycoplasma infection in genital tract from the gynecological outpatients,in order to provide a laboratory evidence for clinical rational use of drug.Methods The drug sensitiv-ity kit was used for isolation and culture of mycoplasma,reproductive tract secretions samples of 1 067 cases of gynecological pa-tients were collected to do mycoplasma identification and drug sensitivity test.Results In 1 067 samples,the positive rate of myco-plasma were 659 samples,including ureaplasma urealyticum(Uu)positive rate was 72.99%(481/659),mycoplasma hominis (Mh) positive rate was 3.79%(25/659),Uu and Mh positive rate accounted for 23.22%(1 53/659).The drug sensitivity results of 12 kinds of antimicrobial agents showed that single infection Uu was more sensitive to josamycin,doxycycline,minocycline,tetracy-cline,clarithromycin,azithromycin and roxithromycin.Single infection Mh was more sensitive to doxycycline,josamycin,minocycline and tetracycline.Mixed infection of Uu and Mh was more sensitive to josamycin,minocycline and doxycycline.Conclusion The main pathogen isolated from patients infected with plasma in our hospital is Uu,whether single Uu or Uu,Mh mixed infection,there are differences in the sensitivity of antimicrobial,clinicians should use drug rationally according to the conditions of patients and drug sensitivity results to reduce drug resistance rate.

鼻出血是耳鼻喉科最常见的多发病之一,新疆地处边远,气候干燥、寒冷,气压变化较大,鼻出血患病率较高。且部队基层医疗单位条件及设备有限,治疗方法以往主要以鼻腔填塞为主,但有些病例经多次鼻腔填塞后亦不能控制出血,称之为难治性鼻出血。过度填塞还会引起耳部、鼻窦等诸多并发症,官兵思想压力较大,从而影响正常的训练生活。随着鼻内窥镜技术应用的成熟以及微波治疗技术的不断发展,难治性鼻出血的治疗有了明显的改进。

<正>随着检验医学的迅速发展,临床对检验的依存度逐渐提高,对检验质量要求更加严苛。分析后的质量控制是检验质量控制程序中最后也是最关键的一步[1]。其中非技术因素对分析后质量控制的影响不容忽视,检验结果是临床实验室日常工作的最

本世纪自然灾害、事故灾害、突发公共安全事件、及社会安全事件频繁发生,尽管灾害型式和程度各有不同,但都涉及到人员伤亡这一主题.大规模伤亡事件(mass casualtyincidents,MCIs)是造成大规模人员伤亡的灾害事故,主要有自然灾害和人为灾害两类.大规模伤亡事件又称群体伤亡事件,特指人员伤亡的规模超出当地现场急救、转运或医院的处理能力(医疗需求＞医疗资源),安是灾害(或事件)发生后,出现大量伤亡病例(包括:疾病、外伤、失踪、死亡),救治伤亡的医疗需求超过了现有的医疗资源[1,2].

Objective Determining various indices like total IgE and specific IgE to further investigate the role of ADCC activity triggered by mast cells as part of the immune response to muscle larvae in rats with trichinosis.Methods Male Wistar rats served as an animal model of Trichinella spiralis infection.Ninety rats were divided into 10 groups at random,with 9 rats in each group.Total IgE and specific IgE were detected using double-antibody sandwich enzyme-linked immunosorbent assay(ELISA) and indirect ELISA,and then mast cells with the highest level of IgE were selected and cultured in vitro in a CO2 atmosphere.Killing of muscle larvae by these cells in immune serum was observed.Results In immune serum,mast cells of infected rats and normal rats both killed muscle larvae.The number of muscle larvae killed was 31.5 and 17.5(χ2=13.146,P0.01);(χ2=28.543,P0.01),respectively.Conclusion IgE antibodies enhanced the action of mast cells as part of ADCC that killed muscle larvae in rats with trichinosis.

部队官兵因公、因病发生器官缺损、功能障碍、能理障碍等,根据民发[2004]195号文件可申请伤病残评定.伤病残评定是一项政策性、专业性很强的工作,直接关系到广大官兵的切身利益.我院承担驻疆武警部队官兵的伤病残评定工作,结合做好部队伤残评定工作谈几点体会.

<正>循证医学,顾名思义就是遵循证据的医学,不同于传统的以经验为主的医学模式,是现代医学领域的一场划时代的革命。循证医学的哲学思想起源于19世纪中叶,强调任何医疗决策的制定应遵循和应用科学证据,强调在疾病的诊断和治疗过程中,将个人的专业知识与现有的最好研究证据、患者的选择结合起来,为每个患者做出最佳的医疗决策。循证医学对立于传统的经验性医学模式,医学在其发展历程中,一直被看作是一门经验性科学。在医疗实践中,医生根据临床经验、临床资料和对疾病的理解来诊治患者,由于缺乏证据的指导,临床实践中不乏很多错误的观点和经验

Objective To investigate the cytotoxic effect of platelets on the muscular stage larvae of Trichinella spiralis in vitro.Methods Male Wistar rats served as an animal model of infection with T.spiralis.Ninety rats were randomly divided into 7 groups.Immune serum(stock serum: complement inactivated at 56 ℃ for 30 min;inactivated complement and IgE serum: complement inactivated at 56 ℃ for 4 h) was observed.Results The level of total IgE in sera of the normal control group was 132.53±12.45 mg/L.The level of total IgE(202.70±11.60 mg/L,F test,P0.05) in sera of infected rats started to increase one week after infection with T.spiralis,peaked(275.93±14.44mg/L,P0.01) after three weeks,and began to gradually decrease(193.87±9.98 mg/L,F test,P0.05) after four weeks.The specific IgE in serum peaked after two or three weeks(at both times,sera were positive at a rate of 88.9%),and the level of specific IgE in serum differed markedly from that in the control group(P0.01).The control group was positive for specific IgE at a rate of 11.11% and the experimental group was positive at a rate of 57.41%;the levels of positivity differed significantly(P=0.027).When serum was immune,muscular larvae of T.spiralis was readily killed by platelets in both infected rats and normal rats.After 48 hours,there were marked differences in the parasite-killing ability of platelets in infected rats and rats administered inactivated complement alone.Conclusion Immune serum is required for platelet-mediated ADCC to kill muscular larvae in rats with trichinosis.

目的探讨酶法测定血清钾、钠的量值溯源性及准确度。方法分别用全自动生化分析仪和原子吸收分光光度计测定同一份血清的钾、钠值,并进行比对。结果酶法测定血清钾、钠的精密度,CV值分别为1.116%和0.939%;回收率为99.2%和101.5%;酶法与原子吸收法相关系数,钾r=0.989 1(回归方程Y=0.961 6X+0.312 6),钠r=0.986 1(回归方程Y=1.019 5X+0.682 3)。结论酶法测定血清钾、钠与原子吸收法有较好的一致性,结果准确可靠。

1 病例报告 例1:男,30岁.被马蜂蛰伤下颌部,自己取出毒刺,步行5 min来我院就诊.诉头晕、心慌,测BP 60/40 mm Hg,HR 115次/min,突然晕倒,立即予0.1%肾上腺素0.5 ml肌肉注射,地塞米松10 mg肌肉注射,吸氧,约5 min后苏醒,诉头晕、心慌、乏力、恶心,呕吐胃内容物,周身瘙痒,震颤发冷,诉曾于1 a前被马蜂蛰伤未出现不适.后患者颜面水肿,周身风团样荨麻疹.

研究证实,冠心病的发生不仅与血脂紊乱、高血压等因素有关,还与免疫损伤密切相关.近年来,急性心肌梗死(A-cute myocardial infarction,AMI)免疫功能研究不断深入,随着对白细胞(White blood cell,WBC)在AMI病理过程的发生、发展中所起作用的不断研究,发现WBC对AMI急性期病情的发展起到十分重要的作用,本文通过观察WBC数不同于其它因素如肌酸激酶同工酶(Creatine kinase-MB,CK-MB)、血脂等与病死率的关系,探讨WBC计数升高对AMI预后的临床意义.

Objective To explore the effect of air temperature on nitric monoxide (NO) and nitric monoxide synthase (NOS) in armed policemen from different air temperature zones.Methods 755 healthy armed policemen,randomly chosen from different air temperature zones(Harbin,Beijing,Nanjing,Guangzhou and Chengdu),were divided into five groups according to air temperature and were matched with sex,age and service time.Contents of NO and activities of NOS in plasma were detected with corresponding reagent kits after the questionnaire.Results The contents of NO and activities of NOS in plasma of armed policemen from Harbin,Beijing,Nanjing,Chengdu and Guangzhou were(62.31±49.51), (76.63±48.32), (76.71±53.25), (79.35±28.65), (81.37±40.96) μmol/L and (36.96±2.81),(37.43±3.53),(37.92±3.04),(37.98±3.63), (38.14±1.85) U/ml respectively.They tended to increase as the air temperature did.There were significant differences among five groups (P0.05).Conclusions Air temperature could result in increase of the content of NO and activity of NOS.The content of NO and activity of NOS might be considered as an index to evaluate heat tolerance of armed policemen fron different air temperature zones.

胃食管反流病(GERD)是消化专科常见病、多发病,在西方国家发病率非常高,人群患病率达51%,在我国北京、上海两地的流行病学调查结果提示,症状发病率为8.97%,CERD发病率为5.77%,反流性食管炎为1.92%[1].其病因和发病机制目前尚未完全明了,且无统一治疗方案.我们从2001年起用奥美拉唑(洛赛克)、多潘立酮(吗丁啉)联合治疗门诊GERD 30例,主要观察其联合治疗GERD的疗效.

目的探讨气候因素对不同地区的武警战士脂质氧化抗氧化系统的影响和可能的生物学意义.方法从6个不同气候地区随机抽取健康男性武警战士共1 000人,采用试剂盒测定各项指标.结果 6个不同地区武警战士的超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)活力及谷胱甘肽(GSH)浓度比较,差异有显著性(P＜0.05).SOD和GSH-Px在不同气候地区间呈相似的变化趋势,GSH渐升后突降,而丙二醛(MDA)浓度各地区间比较,差异均无显著性(P＞0.05).结论气候因素对武警战士的脂质抗氧化酶活力有影响,寒冷和炎热地区武警战士血浆中SOD、GSH-Px活力较低,但气候因素对脂质过氧化物MDA的含量无明显影响.

Objective To prepare total alkaloids granules of Peganum harmala L.Method The effective ingredients were separated and extracted with ethyl alcohol according to orthogonal design.The content of harmine was used as study index.The influential factors for the extraction of effective ingredients that included the time of decocting medicinal herb,concentration of ethyl alcohol,and the extraction time studied.Results The best technique of preparing the total Peganum harmala L alkaloid granules has been selected.Conclusions This preparation technique is simple,and the quality of total peganum harmala L.alkalaloid granules is stable.

目的测定血浆中游离血红蛋白.方法用2,4,6-三溴-三羟基苯甲酸(HBHBA)做色原剂和4-AAP(4-氨基氨替吡啉)形成红色醌类物质,用比色法测定其浓度.结果该法线性范围0～0.8 g/L.重复性试验,低值血清批内CV＝2.8%,批间CV＝5%;高值批内CV＝1.7%,批间CV＝3.7%.平均回收率98.6%(96%～102%).对照实验r＝0.986 0(Y＝0.99x+0.2).正常参考值0.013～0.073 g/L.结论所用试剂无毒性,不致癌,显色稳定,灵敏度高,重复性好,结果准确可靠,是一种理想的测定方法.

ALCYON 160或300型全自动生化分析仪,具有智能化程度高,结构紧凑,精密性好等优点,但在使用中也经常出现了一些故障,为使各医院能更好的使用该机,提高工作效率,现将有关常见故障的排除介绍如下.