糖皮质激素对大叶性肺炎患儿血清TNF-alpha、IL-6、IL-8水平的影响

目的：探究糖皮质激素对大叶性肺炎患儿血清TNF-alpha、IL-6、IL-8 水平的影响。方法：选取2014 年3 月至2014 年8月我院收治的大叶性肺炎患儿60 例,并将其随机分为对照组和实验组。对照组30 例,给抗炎、退热、镇咳、平喘等临床常规治疗;实验组30例,在与对照组相同治疗的基础上加用糖皮质激素联合治疗。治疗结束后,比较两组患儿治疗前后血清TNF-alpha、IL-6、IL-8 水平的变化。结果：治疗前,两组患儿的血清TNF-alpha、IL-6、IL-8 水平比较均无统计学差异(P 均>0.05);治疗后,两组患儿的血清TNF- alpha、IL-6、IL-8 水平均较治疗前显著降低(P 均<0.05),且实验组患儿的血清TNF-alpha、IL-6、IL-8 水平均显著低于对照组,差异均有统计学意义(P 均<0.05)。结论：糖皮质激素辅助治疗可降低大叶性肺炎患儿血清TNF-alpha、IL-6、IL-8 的水平,这可能是其治疗儿童大叶性肺炎的药理学作用之一。     

复合型抗菌药联合阿奇霉素对大叶性肺炎炎性指标的影响

目的:头孢哌酮钠舒巴坦钠与阿奇霉素联合应用对大叶性肺炎病人体内TNF-α、IL-6及HMGB1的变化影响及其临床疗效研究。方法:收集2012年11月至2015年3月期间到笔者所在医院就诊并诊断患有大叶性肺炎的病人随机平分成两组,其中A组与B组成员分别使用头孢哌酮钠舒巴坦钠+阿奇霉素和仅使用阿奇霉素进行大叶性肺炎对症治疗。通过炎性指标变化情况及对肺功能、不良反应的观察,分析两种药物联合应用对大叶性肺炎病人体内TNF-α、IL-6及HMGB1的变化影响和临床应用价值。结果:A组经联合用药治疗后相关炎症指标改善情况普遍优于B组;A组大叶性肺炎病人咳嗽、啰音及相关体征表现恢复速度快于B组,且A组病人在联合药物治疗后FEF和FEF50指标上的改善情况更为突出;而A组病人不良反应发生种类及例数、比率与B组却相差不大(P0.05)。结论:头孢哌酮钠舒巴坦钠与阿奇霉素的联合应用可有效降低病人体内TNF-α、IL-6及HMGB1浓度水平,且其治疗效果较为突出,具有一定的应用价值。     

炎症因子在大叶性肺炎患儿支气管肺泡灌洗液及血清中的表达及临床意义

目的:探讨炎症因子在大叶性肺炎患儿支气管肺泡灌洗液及血清中的表达水平及其临床意义。方法:收集2014年6月至2016年6月我院儿科收治的79例大叶性肺炎患儿为病例组,按照临床肺部感染评分(CPIS)分为重度组(n=46)和轻度组(n=33),于同期随机选取30例健康儿童为对照组,采用双抗体夹心酶联免疫吸附法(ELISA)检测各组支气管肺泡灌洗液及血清炎症因子如白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-17(IL-17)、肿瘤坏死因子(TNF-α)以及高迁移率族蛋白B1(HMGB1)表达水平。结果:重度组、轻度组血清IL-6、IL-8、IL-17、TNF-α及HMGB1水平高于对照组,重度组血清IL-6、IL-8、IL-17、TNF-α及HMGB1水平高于轻度组,差异有统计学意义(P0.05)。病例组患儿支气管肺泡灌洗液IL-6、IL-8、IL-17、TNF-α及HMGB1水平高于血清,差异有统计学意义(P0.05)。重度组、轻度组支气管肺泡灌洗液IL-6、IL-8、IL-17、TNF-α及HMGB1水平高于血清,差异有统计学意义(P0.05),重度组支气管肺泡灌洗液、血清IL-6、IL-8、IL-17、TNF-α及HMGB1水平分别高于轻度组,差异有统计学意义(P0.05)。经Spearman积矩相关分析,支气管肺泡灌洗液与血清中IL-6、IL-8、IL-17、TNF-α及HMGB1水平分别呈正相关关系(r=0.711、0.695、0.752、0.793、0.728,P0.05)。结论:炎症因子在大叶性肺炎患儿支气管肺泡灌洗液及血清中呈高表达,并与大叶性肺炎病情严重程度密切相关,联合检测有助于早期评估病情。     

头孢曲松+小剂量糖皮质激素联合肺泡灌洗术治疗儿童大叶性肺炎疗效分析

摘要 目的：探讨头孢曲松+小剂量糖皮质激素联合肺泡灌洗术对儿童大叶性肺炎的治疗效果。方法：选取我院2019年10月到2022年10月收治的270例大叶性肺炎儿童作为研究对象,依据治疗方法将患儿分为A、B、C三组,每组90例。所有患儿均采取常规维持水电解质、酸碱平衡、吸痰、清热、平喘、止咳等治疗,A组患儿在常规治疗基础上应用头孢曲松治疗,B组应用头孢曲松+小剂量糖皮质激素治疗,C组应用头孢曲松+小剂量糖皮质激素联合肺泡灌洗术治疗,对比三组患儿体征消失时间、影像学恢复时间,治疗前后白细胞计数（WBC）、中性粒细胞百分比（GRA）、降钙素原（PCT）、C反应蛋白（CRP）、血沉（ESR）表达水平,临床疗效以及不良反应发生率。结果：三组患儿肺啰音/哮鸣音消失时间、咳嗽消失时间、发热总天数、影像学恢复时间对比差异显著,且C组明显低于B组和A组（P＜0.05）;三组患儿治疗前WBC、GRA、PCT、CRP、ESR表达水平对比无明显差异（P＞0.05）,治疗后三组患儿WBC、GRA、PCT、CRP、ESR表达水平均降低,且C组明显低于B组和A组（P＜0.05）;三组患儿治疗效果对比差异显著,C组明显高于B组和A组（P<0.05）;三组患儿不良反应发生率对比无明显差异（P＞0.05）。结论：采用头孢曲松+小剂量糖皮质激素联合肺泡灌洗术治疗儿童大叶性肺炎能够快速减轻患儿临床症状,降低炎症因子反应,提升治疗效果,且安全性较高,能够让患儿早日康复出院。     

乙酰半胱氨酸雾化联合肺泡灌洗术对大叶性肺炎患儿炎症吸收时间及血清CRP、LDH、D-D水平的影响

摘要 目的：观察乙酰半胱氨酸雾化联合肺泡灌洗术对大叶性肺炎患儿炎症吸收时间及血清C反应蛋白（CRP）、乳酸脱氢酶（LDH）、D-二聚体（D-D）水平的影响。方法：选取2021年1月~2022年12月我院收治的大叶性肺炎患儿80例,以随机数字表法将患儿分成对照组（n=40）与联合组（n=40）。给予对照组患儿肺泡灌洗术治疗,联合组则在对照组基础上予以乙酰半胱氨酸雾化治疗。比较两组患儿临床疗效、临床症状改善情况,治疗前后的肺功能[1秒用力呼气容积（FEV₁）、用力肺活量（FVC）、呼气峰值流速（PEF）]及血清学指标水平。结果：经过治疗后联合组临床疗效的总有效率为92.50%,显著高于对照组的75.00%（P<0.05）,且联合组患儿肺部炎症吸收时间、咳嗽缓解时间及退热时间均显著少于对照组（P<0.05）。此外,治疗后两组患儿的FEV₁、FVC及PEF均较治疗前升高,且联合组高于对照组（P＜0.05）;CRP、LDH及D-D水平均较治疗前降低,且联合组低于对照组（P<0.05）。结论：乙酰半胱氨酸雾化联合肺泡灌洗术治疗大叶性肺炎患儿疗效确切,可显著缓解临床症状,缩短炎症吸收时间,同时能显著改善患儿肺功能,降低血清炎性因子水平。     

The “proletarian disease” on stage. Theatrical anti-tuberculosis propaganda in the early Soviet Union

The present contribution analyses sanitary theatrical performances as a means of anti-tuberculosis propaganda in the early Soviet Union. Starting in the 1920s, sanitary theatrical performances were demonstrated in open-air theatres and clubhouses for workers and farmers. Since 1925, the newly founded Moscow Theatre for Sanitary Culture centrally managed the theatrical hygiene propaganda. It became a role model for other theatres of hygienic enlightenment and numerous sanitary amateur stages. Their anti-tuberculosis repertoire ranged from the so-called “mock trials” where a person or even Koch's bacillus must stand trial for the spreading of tuberculosis, to “living newspapers” which used entertainment elements such as music or acrobatics to provide a mass audience with the hygiene knowledge. The contribution describes in which images, figures and actions knowledge about tuberculosis was presented on stage, which genre traditions and communicative instruments were used and which changing political implications those performances were based on. To achieve this goal, the archive sources, selected texts of theatrical performances, reports and reviews in daily press have been evaluated.     

Une médecine du fonds des âges : trépanations,amputations et tatouages thérapeutiques au Néolithique

The first shepherds and peasants of the European Neolithic period, between VIth century and IIth millennium BC, had acquired serious medical knowledge. The cranial trepanations and the amputation of members accomplished successfully testify perfectly controlled surgical techniques, which indicate a transmissible knowledge. Tattoos towards a therapeutic end reveal however that the medicine of this time still remained under the influence of rituals and magic.     

Health in exchange: teachers,doctors, and the strength of informal practices in Russia

This article explores teachers' and doctors' informal medical exchange practices in the context of the transforming health care system in post-Soviet Russia. Despite the advent of a medical marketplace, most Russians have low incomes and cannot buy the goods and services the market offers. Instead, they bypass the formal market mechanisms (such as obtaining cheaper medicine through personal connections) and official procedures (such as obtaining free or cheaper health care services despite the emergence of paid services) by using their social networks. This paper uses a network perspective to investigate how doctors' and teachers' mutual relations are formed and what resources form the basis of these informal exchange practices. Drawing on structured diary data and qualitative interviews with 20 teachers, in addition to interviews with eight doctors in St. Petersburg, the study goes beyond mere statistics on health care and attempts to depict from below the implications health and illness have for survival in contemporary Russia.     

美国实验动物医学发展简史——对中国实验动物医学发展的思考

美国实验动物医学的发展起始于上世纪50年代,目前可能代表着世界上该领域的最高水平.本文对其发展史作了简的地回顾,包括生物医学领域对实验动物兽医的需求,实验动物科学领域早期的兽医实践,实验动物医学会的诞生,实验动物医学领域的培训、教育和考核等的沿革,以及相关法律法规对实验动物医学发展的影响等.笔者依据自身的工作实践和中国国情对中国实验动物医学领域的发展进行了一些思考,期盼实验动物相关法律法规能更加完善、在兽医教育中适度增加实验动物医学相关内容、加强实验动物医学领军人才的培养、加强实验动物医学界多渠道的交流、增加相关领域科研投入和支持等.中国要站在西方发达国家的肩膀上,借鉴其成功的经验,发展有中国特色的实验动物医学事业.     

The genius of E. E. metchnikoff— Discoveries over the centuries

On the 15 of May we celebrated the 150th anniversary of the outstanding Russian biologist Elias E. Metchnikoff (1845–1916)—Nobel Prize winner (1908), full and honorary member of many scientific academies of the world. His main works were applied to the zoology of invertebtates, evolution, embryology, immunology, microbiology, infectious pathology, gerontology, etc. Elias Metchnikoff published essays on anthropology, theory of orthobiosis, role of social and social-hygienic factors in solving the problems of old age and life elongation. On 30 May-2 June 1995 an International Symposium dedicated to Metchnikoff's 150th anniversary was held in Moscow. This is a text of the lecture given by us at the opening ceremony.     

East-Side story: the standardisation of psychotropic drugs at the Charité Psychiatric Clinic, 1955-1970

The present article illustrates the history of psychotropic drugs introduced in the German Democratic Republic (GDR) from 1945 onwards. We begin by examining the introduction of an anti-depressant and a tranquilizer at the university psychiatric clinic, Charité, in East Berlin. On the basis of patient files, we consider the monitoring routines, altered by the use of psychotropic drugs, and the difficulties that arose when these routines were translated into existing research programs. In the 1960s, attempts to evaluate the psychiatric practice were based on psychopathology whereas at the end of the 1960s there was a shift to “target symptoms”.