The results of early resuscitation of 104 adult patients with BSA more than 50%were studied retrospectively. Although the mean amount of fluid replaced during 48h postburn was similar to the amount calculated with our formula, there existed significant individual differences. Therefore it seems not necessary to set up a rigid fluid replacement plan. To ensure adequate tissue perfusion, the fluid replacement formula might be modified as follows: 2 ml/kg/BSA%, with urinary output 30-40 ml/h, in the first 24h; and 1.5ml/kg/BSA%, with urinary output 40-50ml/h, in the second 24h. It should be emphasized that resuscitation should be started as early as possible,and adequate amount of fluid replacement is especially important during the first 2-3h postburn.There was no obvious relationship between the incidence of visceral complications and the total amount of fluid replaced during the resuscitation. Available data indicated that the amount of fluid calculated on the basis of our formula neither increased the incidence of early pulmonary edema nor influenced its development.As far as prevention of pulmonary edema was concerned, it did not seem justifiable to restrict the amount of resuscitation fluids. It was also noted that fluid therapy alone would not prevent entirely the development of postburn renal insufficiency.

Objective To study the clinical significance of Carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CY-FRA21-1) ,neuron specific enolization enzyme (NSE) combined detection in the diagnosis of lung cancer .Methods Using the Chemiluminescence to detect the level of CEA ,NSE and CYFRA21-1 in 61 patient with lung cancer (lung cancer group) and 38 pa-tients with benign diseases(control group) .All datas were analyzed with t test .Optimal cut-off point and diagnostic sensitivity ,spe-cificity were obtained by receiver operating characteristic curve (ROC) .Results The level of serum CEA ,NSE and CYFRA21-1 in Lung cancer group was significantly higher than that in control group (P<0 .05) .The expression level of three tumor markers was no statistically significant difference in the different pathological types of lung cancer (P>0 .05) .The cut-off point of CEA was 3 .50 ng/mL ,sensitivity and speciality were 52 .5% ,94 .7% respectively .The cut-off point of CYFRA21-1 was 5 .21 ng/mL ,the sensitiv-ity and specificity were 67 .2% ,93 .1% .The cut-off of point NSE was 18 .09 ng/mL ,the sensitivity and specificity were 77 .0% , 52 .6% .The three combined detection sensitivity was 96 .7% ,significantly higher than separate one(P<0 .05) .Conclusion The three tumor markers(CEA ,CYFRA21-1 ,NSE) might be valuable in the diagnosis of lung cancer .The combined detection could be used as a better pattern for screening lung cancer .

Objective To investigate the genotype and antifungal susceptibility of AspergiIlus species isolated from clinical settings and environmental sources. Methods Random amplification of polymorphic DNA (RAPD) analysis was performed to profile the genotypes of 48 Aspergillus fumigatus strains, 59 Aspergillus flavus strains and 30 Aspergillus niger strains isolated from clinical settings and environmental sources. NCCLS M38-A protocol was carried out for antifungal susceptibility testing of these Aspergillus isolates. Results As RAPD analysis showed, the 48 Aspergillus fumigatus strains were classified into 8 genotypes, 59 Aspergillus flavus strains into 12 genotypes, and 30 Aspergillus niger strains into 5 genotypes. A significant difference was observed in the susceptibility to terbinafine among the 8 genotypes of Aspergillus fumigatus (χ2 = 33.092, P ＜0.01 ) as well as in that to amphotericin B among the 5 genotypes of Aspergillus niger (χ2 = 15.185, P＜ 0.05).No statistical difference was found in the susceptibility to amphoteriein B, itraconazole, fluconazole or flucytosine among the 8 genotypes of Aspergillus fumigatus or in that to terbinafine, itraconazole, fluconazole or flucytosine among the 5 genotypes of Aspergillus niger. Conclusion There is some difference in the susceptibility to some antifungal agents between different genotypes of Aspergillus fumigatus and Aspergillus niger.

Objective To report the first case of disseminated trichosporonosis in China.Methods A series of clinical,histopatholog ic,and mycologic studies were carried out in a 20year-old-female patien t,who had no definite underlying disease.The causative fungus was identified according to culture,biochemical t est and DNA sequencing.Results Abundant fungal spores,yeasts and h yphae were shown in the specimens tak en from infectious granulomas.The fungal c olonies in the culture of skin lesion s or crusts,liver,oral psedomembra ne,vagina,nasal cavity,urine,and sto ol were the same.The colonies exhibi ted creamy white to yellowish in colo r,rugose on the surface,and hyphae at t he periphery.Under microscopy,there were a lot of rectangular arthrospores,round or oval spores w ith or without buddings,as well as br anched and septate filaments.The isolated fungus was unanimously identified as Trichosporon asahii(No.AS 2.2174)through culture,bio-chemistry and molecular biology tests.The patient's condition was impr oved obviously after the combinatio n treatment of amphotericin B liposom e(Amphotec)and fluconazole.Conclusion The extensive and lasting systemic impairments caused by T.asahii have scarcely been reported at home a nd abroad.Combination therapy with amphotericin B and fluconazole is effective.

Objective To report Trichosporon asahii first isolation and identification of TH chosporon asahii in chain.Methods A clinical infection fungus strain was isolaled from mouth pseudomembrane vaginal,nasal secretions,urine,faces,and live puncture tissue,injured skin tissue of a female patient,who had no clear underlying disease.Through cultured in medium,biochemical assay,identification of the bacterial race molecular biology test and DNA sequencing.Result We demostrated that the fungus strain was unanimously identified as Trichosporon asahii.Conclution The Trichosporon asahii could induce the disseminated Trichosporonosis.

Objective: To investigate the curative effect of acupuncture on senile benign prostate hyperplasia. Methods: The patients were given acupuncture treatment for 10-30 times;International prostate symptom score (IPSS) and quality of life index (QOL) were used to assess IPSS and QOL scores of the patients before and after treatment. Results: Before treatment IPSS and QOL of the patients were 22.1± 6.7 and 4.5± 0.6 respectively, and after treatment were 9.1 ± 4.3 and 1.9± 1.1 respectively, there were very significant differences in IPSS and QOL between pre-treatment and post treatment(P ＜ 0.01). Conclusion: Acupuncture can relieve the clinical symptoms of prostate hyperplasia and raise the patients' quality of life.

To study the relationship between serum Pre-S1 antigen and HBV DNA, serum Pre-S1 antigen and HBV DNA marker in 229 patients positive for HbsAg were detected by using ELISA method and compared. It was found that both Pre-S1 antigen and HbeAg were correlated with HBV DNA with the coefficient being 0. 9812 and could be used to reflect the existence or reproduction of HBV DNA well. Although there was statistical correlation between them, their clinical implication was not completely the same. Therefore, a conclusion was drawn that combined detection of Pre-S1 antigen, HBV and HBV DNA in the patients with different kinds of HBV infection was helpful to clinical diagnosis, therapeutic effect evaluation and prognosis judgement.

Seventeen cases of postburn multiple organ failure (MOF) were studied prospectively.It was found that MOF mainly occurred in those patients with a burn area over 70% TBSA.Mortality rate of the cases of MOF was directly proportional to the number of organs involved.The incidence of pulmonary failure was the highest and the highest mortality was attributed to renal failure;MOF in the early stage after burns was mainly induced by burn shock and that in the late stage by burn wound infection.Endogenous infection seemed to be one of the important causes to precipitate the outbreak of postburn MOF.The morphological changes of the functionally failed organs were as follows:There were various degrees of cellular degeneration and necrosis.Or- ganelle changes such as swelling and vacuolization of mitochondria,enlargement of endoplasmic reticulum,gap formation of capillary endothelium etc were seen.Extravascular organ water volume of the functionally failed organs was increased.Stasis and/or hyperemia were found in the heart,the lungs,the liver and the GI,tract,but ischemia in the kidneys.The changes of the.enzyme spectrum of the myocardium,PaO2,RI,IB/DB,and DB were parallel to those of pathomorphology and extravascular organ water volume and they could reflect the severity of organ damages firly well.

Tamm-Horsfall protein(THP)was determined with radioimmunoassay in the urine and blood samples of 59 burn patients.It was found that urine and blood THP was significantly decreased postburn and the degree of decresing was correlated with the extent of the burnt body surface and the severity of renal damage.The changes of THP occurred earlier than those of the routine parameters for renal damage such as BUN or Cr.It is suggested that THP determination can be used as an index for the early damage of the Henle's loop and the distal convoluted tubules after burn injury.

Electrolyte imbslance.the changes of serum aldosterone and the ratio of an-giotensin Ⅱ/arterial natriuretic peptide were studied prospectiely in 59 cases of severe burns.Meanwhile,certain parameters of renal functions were detarmined.Hypernatremia devaloped in 6 cases.On the basis of our findings,it is believed that postburn hypernatremia might result from renal dysfunction and the greatly increased mediators,which can enhance the retention of sodium,might also play an important role in the development of postburn hypernatremia.