1、近年来伤寒的临床演变趋向是什么?答:伤寒是大家所熟悉的常见传染病,但近年来其临床表现多不典型,临床演变趋向轻化。如严重的毒血症已明显减少,消化道症状减轻,典型的热型已不多见,玫瑰疹显著减少,部分患者周围血嗜酸粒细胞不消失等。变异较大的原因,多数学者认为与预防接种,早期应用解热药、抗生素和激素,人民体质的改善,免疫力的增强等有关。是否伤寒杆菌有变异,有待进一步证实。此外,在并发各脏器病变方面,范围较前广泛,如伤寒性肝炎和伤寒性肾炎增多.2、伤寒性肝炎与急性病毒性肝炎如何鉴别?答:鉴别要点:急性病毒性肝炎发热常不太高,一般在3～5天内退热,退热后才出现黄疸;全身中毒症状较少,以乏力、纳差、恶心为主要症状;血清转氨酶上升的幅度较大,恢复较慢;部 1, the clinical evolution of typhoid fever in recent years what is the trend? A: typhoid fever is a common familiar infectious disease, but in recent years its clinical manifestations of atypical, clinical evolution tend to be light. Such as severe toxemia has been significantly reduced, gastrointestinal symptoms reduced, the typical heat type has been rare, significant reduction in rose rhizome, some patients with peripheral blood eosinophilia does not disappear. The reason for the greater variation, most scholars believe that with vaccination, early application of antipyretics, antibiotics and hormones, the improvement of people’s health, increased immunity and so on. Whether there is variation of typhoid bacillus, to be further confirmed. In addition, the complications of various organs, the scope of a wide range of more, such as typhoid fever and typhoid nephritis increased.2, typhoid hepatitis and acute viral hepatitis how to identify? A: The identification of points: often acute viral hepatitis fever Too high, usually 3 to 5 days fever, jaundice after fever; less systemic symptoms of fatigue, anorexia, nausea as the main symptoms; serum aminotransferase increased a larger recovery slower; Department