Bloodletting Puncture at Hand Twelve Jing-Well Points Relieves Brain Edema after Severe Traumatic Brain Injury in Rats via Inhibiting MAPK Signaling Pathway

Objective:To investigate whether blood-brain barrier(BBB)served a key role in the edema-relief effect of bloodletting puncture at hand twelve Jing-well points(HTWP)in traumatic brain injury(TBI)and the potential molecular signaling pathways.Methods:Adult male Sprague-Dawley rats were assigned to the shamoperated(sham),TBI,and bloodletting puncture(bloodletting)groups(n=24 per group)using a randomized number table.The TBI model rats were induced by cortical contusion and then bloodletting puncture were performed at HTWP twice a day for 2 days.The neurological function and cerebral edema were evaluated by modified neurological severity score(mNSS),cerebral water content,magnetic resonance imaging and hematoxylin and eosin staining.Cerebral blood flow was measured by laser speckles.The protein levels of aquaporin 4(AQP4),matrix metalloproteinases 9(MMP9)and mitogen-activated protein kinase pathway(MAPK)signaling were detected by immunofluorescence staining and Western blot.Results:Compared with TBI group,bloodletting puncture improved neurological function at 24 and 48 h,alleviated cerebral edema at 48 h,and reduced the permeability of BBB induced by TBI(all P<0.05).The AQP4 and MMP9 which would disrupt the integrity of BBB were downregulated by bloodletting puncture(P<0.05 or P<0.01).In addition,the extracellular signal-regulated kinase(ERK)and p38 signaling pathways were inhibited by bloodletting puncture(P<0.05).Conclusions:Bloodletting puncture at HTWP might play a significant role in protecting BBB through regulating the expressions of MMP9 and AQP4 as well as corresponding regulatory upstream ERK and p38 signaling pathways.Therefore,bloodletting puncture at HTWP may be a promising therapeutic strategy for TBI-induced cerebral edema.     

如何学好药理学

药理学是研究药物与机体相互作用、作用机制及规律的科学,是连接基础医学与临床医学、医学与药学的一门重要课程.许多学生在初次学习药理学时,认为药理学不好学,内容复杂、抽象,药物种类较多,抓不住重点,难以记忆,不知道怎样学习药理学,现就这些问题谈谈学习药理学的方法.     

昆虫抗冻蛋白及其在医学领域中的应用

抗冻蛋白(antifreeze protein,AFP)是一类结构多样的蛋白质,具有热滞效应(thermal hysteresis,TH,降低冰点而不改变熔点)和重结晶抑制效应(recrystalization inhabition,RI).通过非共价吸附抑制机制吸附到冰核表面,限制冰晶生长和抑制冰晶重结晶,从而保护有机体免受结冰引起的伤害.由于抗冻蛋白具有阻止冰晶生长而不破坏细胞的特点,因而利用抗冻蛋白在低温中长期保存各种细胞、组织和器官,特别在器官移植中可能具有很好的应用前景.     

Sternal Reconstruction of Deep Sternal Wound Infections Following Median Sternotomy by Single-stage Muscle Flaps Transposition

Objective To assess clinical effectiveness of using bilateral pectoralis major or plus rectus abdominis muscle flaps in treating deep sternal wound infection （DSWI） following median sternotomy. Methods Between January 2009 and December 2013, 19 patients with DSWI after median sternotomy for cardiac surgery were admitted to our hospital, including 14 males （73.7%） and 5 females （26.3%）, aged 55±13 （18-78） years. According to the Pairolero classification of infected median sternotomies, 3 （15.8%） patients were type II, and the other 16 （84.2%） were type III. Surgical procedure consisted of adequate debridement of infected sternum, costal cartilage, granulation, steel wires, suture residues and other foreign substances. Sternal reconstruction used the bilateral pectoralis major or plus rectus abdominis muscle flaps to obliterate dead space. The drainage tubes were placed and connected to a negative pressure generator for adequate drainage. Results There were no intraoperative deaths. In 15 patients （78.9%）, bilateral pectoral muscle flaps were mobilized sufficiently to cover and stabilize the defect created by wound debridement. 4 patients （21.0%） needed bilateral pectoral muscle flaps plus rectus abdominis muscle flaps because their pectoralis major muscle flaps could not reach the lowest portion of the wound. 2 patients （10.5%） presented with subcutaneous infection, and 3 patients （15.8%） had hematoma. They recovered following local debridement and medication. 17 patients （89.5%） were examined at follow-up 12 months later, all healed and having stable sternum. No patients showed infection recurrence during the follow-up period over 12 months. Conclusion DSWI following median sternotomy may be effectively managed with adequate debridement of infected tissues and reconstruction with bilateral pectoralis major muscle or plus rectus abdominis muscle flap transposition.     

植皮区域局限性皮肤松弛症1例

病人,女,81岁.40年前在工作时双上肢不慎被火烧伤,当年在大连化工厂医院烧伤科给予取自体腹部皮肤行前臂植皮术,术后植皮区域皮肤成活修复良好.4年前无明显诱因双侧前臂植皮区域肤色逐渐变深,无意中发现皮肤明显松弛,无不适感.近3个月自觉植皮区域疼痛不适,局部无红肿等,轻微牵拉皮肤时疼痛明显.自发病起4年皮损未见扩大.患者既往体健,否认家族有类似病患者.     

对症喝汤好处多

夏季多喝汤不仅能调节口味,补充体液,增强食欲,而且能防病抗病,对健康有益. 日常人们常喝的汤有荤、素两大类.荤汤有鸡汤、肉汤、骨头汤、鱼汤、蛋花汤等,素汤有海带汤、豆腐汤、紫菜汤、番茄汤、冬瓜汤和米汤等.无论是荤汤还是素汤,都应根据各人的喜好与口味来选料烹制,加之"对症喝汤",就可达到抗衰治病、清热解毒的"汤疗"效果.     

第16届欧洲呼吸学会年会会议纪要

第16届欧洲呼吸学会年会(The European Respiratory Society 16th Annual Congress)于2006年9月1日～6日在德国慕尼黑市国际会议中心(ICM)召开,来自100多个国家和地区的16 888名代表参加了会议,大会共收到论文5277篇,接收论文4221篇,其中来自中国(包括香港、澳门和台湾)84篇(图1).现将会议内容扼要介绍如下.     

POCT的信息管理

POCT是在医疗条件下,由非实验室的卫生保健人员,在实验室的质控指导下,于病人身边进行的检验。它广泛适用于医院(如外科,儿科)、监护病房、急救单位、保险公司、社区医疗、家庭保健网络等领域。当今,POCT在全球方兴未艾,据调查,现今已有10%的诊断实验是在POCT仪器上完成的,究其原因,无非是POCT兼具医学上的有效性及经济两个方面的优势。当然,随着POCT设备的投放不断增加,使用范围不断拓展,POCT的管理问题也日益凸现,本文将对POCT实施中的信息管理的若干问题进行初步探讨。     

维生素B1和维生素B12肌注致过敏性休克1例报告

1 临床资料 患者,男,23岁,因左下肢疼痛20 d来医院就诊.询问病史:患者2 d前在上级医院诊断为坐骨神经痛.既往健康,无药物过敏史.门诊当日给予维生素B1 100 mg,维生素B12 250靏肌注,用药约5 min时患者感到头晕、胸闷、呼吸困难、寒战,面色苍白,脉搏105次·min-1,血压80/50 mmHg,考虑为药物所致过敏性休克,立即给予平卧,氧气吸入,肾上腺素1 mg肌注,地塞米松10 mg静注,5 min后患者恢复正常.     

氟碳保存角膜的实验研究

目的　探讨氟碳在角膜中期保存中的应用价值。方法　将 6 0只新西兰兔角膜随机分为 3组 :( 1)空白对照组 ;( 2 )通氧组 ;( 3)实验组。每组角膜各 4 0片。空白对照组以Dexsol中期保存液常规保存 ;通氧组在常规保存同时持续通氧保存 ;实验组在通氧组基础上加入等量氟碳液保存。 3     

大肠多发原发性癌:危险因素、诊治和预防(附8例报告)

综述分析1954～84年国内外文献,探讨了大肠多发原发性癌的诊断标准、发病情况、临床表现、发病危险因素、外科处理以及预防和诊断检测技术等问题,强调了大肠腺瘤,遗传基础、免疫缺陷、慢性溃疡性结肠炎等在发病上的作用,及高危险组患者应按方案进行常规检测监护之重要性。述介了大肠多发原发性癌系一种原发性大肠癌多中心发生的形式,在诊治上前者与后者有一致性,亦各有其独特性。报告宁夏医学院附属医院肿瘤科1977～84年收治的8例住院大肠多发原发性癌病例的临床资料,对诊治经过进行了初步总结。     

肱骨远端全骺分离

肱骨远端全骺分离在5岁以下儿童中是较常见的肘部损伤,且极易误诊为肱骨髁上骨折或肘关节脱位。本组25例肱骨远端全骺分离均为向内侧移位,年龄11个月至14岁,平均5.6岁,属Salter-HarrisⅠ型或Ⅱ型。对本症骨骺损伤的解剖学和组织学,诸骨(和骨化中心)之间的对应关系以及骨骺损伤的诊治进行了简短的讨论。     

抗菌静脉导管的初步研究

目的 :制作抗菌导管 ,预防静脉导管感染。方法 :用洗必尽和医用聚氨酯为主要成份涂覆硅胶胶管制成抗菌导管。抗菌试验包括 :(1)涂覆液MIC测定 ;(2 )体外抗菌作用观察 ;(3)体外抗菌作用持续时间观察 ;(4 )导管加温对抗菌作用的影响 ;(5 )动物试验检测抗菌效果。结果 :涂覆液对金     

食指背侧皮瓣的临床应用

通过对右手虎口挛缩以及左拇指皮肤剥脱损伤各一例应用直指背侧皮瓣修复的成功经验,提出该手术的适应症和优点,并重点介绍其应用解剖学和手术方法。     

婴幼儿毛细支气管炎血中TXB2、6－Keto－PGF1α变化的研究

应用放射免疫分析法对２０例正常儿、２７例毛细支气管炎、７例肺炎和６例上感进行血浆血栓素Ｂ＿２（ＴＸＢ＿２）,６－酮－前列素Ｆ＿（１α）（６－Ｋｅｔｏ－ＰＧＦ＿（１α））测定,动态观察其变化。结果显示：（１）毛细支气管炎急性期ＴＸＢ＿２、ＴＸＢ＿２／６－Ｋ     

“椎骨错缝”大鼠模型的影像学研究

目的利用腰椎X线摄片技术观察大鼠腰椎部分节段固定对椎间隙前、后径和棘突间距的影响。方法120只体质量为350~450g的SPF级雄性SD大鼠随机分为单纯固定组、旋转固定组和假手术组。单纯固定组大鼠腰椎L ₄-L ₆节段植入椎体外部连接固定装置；旋转固定组大鼠则在此基础上于连接钢板和棘突钢板之间放置金属垫片，使L ₅棘突向右侧旋转，造成L ₅棘突与L ₄和L ₆棘突不共线；假手术组则只切开皮肤后缝合。造模1周、4周、8周和12周时大鼠腰椎X线摄片，测量各组固定节段椎间隙前、后径和棘突间距的距离。 结果造模4周后，单纯固定组固定节段L ₃-L ₄、L ₄-L ₅、L ₅-L ₆和L ₆-S ₁椎间隙前径分别为28.11±3.94、25.73±4.70、29.51±6.34和34.97±4.65像素；椎间隙后径分别为7.39±1.63、6.65±1.76、7.02±1.52和9.62±2.50像素；棘突间距分别为39.33±11.74、14.11±5.75、21.32±6.84和77.43±13.69像素，均小于假手术组( P < 0.05)。造模8周及12周后，单纯固定组固定节段L ₃-L ₄、L ₄-L ₅、L ₅-L ₆和L ₆-S ₁椎间隙前、后径和棘突间距与假手术组相比继续减小( P < 0.05)。旋转固定组与单纯固定组的测量结果一致，在造模4周、8周和12周后，其固定节段L ₃-L ₄、L ₄-L ₅、L ₅-L ₆和L ₆-S ₁椎间隙前、后径和棘突间距也均小于假手术组( P < 0.05)。造模8周后，单纯固定组和旋转固定组腰椎固定节段出现了较明显的骨赘。 结论腰椎部分节段固定可造成椎间隙减小并导致骨赘形成。     

Translating Mendelian and complex inheritance of Alzheimer's disease genes for predicting unique personal genome variants

Objective

Although trait-associated genes identified as complex versus single-gene inheritance differ substantially in odds ratio, the authors nonetheless posit that their mechanistic concordance can reveal fundamental properties of the genetic architecture, allowing the automated interpretation of unique polymorphisms within a personal genome.

Materials and methods

An analytical method, SPADE-gen, spanning three biological scales was developed to demonstrate the mechanistic concordance between Mendelian and complex inheritance of Alzheimer''s disease (AD) genes: biological functions (BP), protein interaction modeling, and protein domain implicated in the disease-associated polymorphism.

Results

Among Gene Ontology (GO) biological processes (BP) enriched at a false detection rate <5% in 15 AD genes of Mendelian inheritance (Online Mendelian Inheritance in Man) and independently in those of complex inheritance (25 host genes of intragenic AD single-nucleotide polymorphisms confirmed in genome-wide association studies), 16 overlapped (empirical p=0.007) and 45 were similar (empirical p<0.009; information theory). SPAN network modeling extended the canonical pathway of AD (KEGG) with 26 new protein interactions (empirical p<0.0001).

Discussion

The study prioritized new AD-associated biological mechanisms and focused the analysis on previously unreported interactions associated with the biological processes of polymorphisms that affect specific protein domains within characterized AD genes and their direct interactors using (1) concordant GO-BP and (2) domain interactions within STRING protein–protein interactions corresponding to the genomic location of the AD polymorphism (eg, EPHA1, APOE, and CD2AP).

Conclusion

These results are in line with unique-event polymorphism theory, indicating how disease-associated polymorphisms of Mendelian or complex inheritance relate genetically to those observed as ‘unique personal variants’. They also provide insight for identifying novel targets, for repositioning drugs, and for personal therapeutics.     

吉林省长春地区儿童龋病患病现状及相关影响因素调查分析

目的：了解吉林省长春地区儿童龋病的患病状况,并探讨其发病的相关影响因素,为长
春地区儿童龋病的防治提供流行病学依据。方法：采用多阶段抽样方法进行调查,首先采用整
群抽样的方法,随机抽取长春市3个区（朝阳区、南关区和宽城区）和3个县城（农安县、榆
树市和德惠市）为研究区域。采取分层抽样的方法从研究区域选取6所小学（小学五、六年
级）和6所初中（初中一、二年级）991名学生为研究对象。检测计算患龋率并分析患龋率相
关影响因素（如牙齿排列、牙龈炎患病情况、牙菌斑、牙齿检查、餐后漱口、刷牙频次、营
养状况、服用钙剂情况、睡眠时长、个人饮食习惯和家庭相关因素）。结果：所有受检查儿
童总患龋率为51.77%,其中小学五、六年级,初中一、二年级患龋率分别为57.91%、52.48%、
48.16%和48.98%。随着年级的增长,患龋率呈下降趋势,但差异无统计学意义（P>0.05）。城市儿童患龋率高于县城儿童（P<0.05）。患龋与非患龋儿童菌斑性牙龈炎发病率比较差异有统计学意义（P<0.05）。服过钙剂、睡眠时间短、每餐后不漱口、牙齿排
列不整齐、偏食、营养不良、喜食零食或甜食、饮用酸奶的频率高、独生子女、父母双方患龋齿、家长对
口腔健康重视程度低和家庭收入低等是儿童龋病发病的重要诱导因素。性别、喂养方式、刷
牙次数和父母职业对儿童龋病发病无明显影响。Logistic回归分析结果,患有牙龈炎、不
进行定期口腔科检查、有牙菌斑、喝牛奶加糖、睡眠时间不足、偏食和营养不良是儿童龋病
发生的主要影响因素。结论：根治牙龈炎、定期口腔科检查、去除牙菌斑、喝牛奶不加糖、保证睡眠时间、纠正偏食和营养不良可以预防儿童龋病的发生,应加强县城儿童龋病的防治。     

动脉粥样硬化大鼠弓状核L-脑啡肽免疫反应阳性细胞的变化

使用免疫细胞化学过氧化物酶抗过氧化物酶复合体（ＰＡＰ）法和计算机图象分析技术,对动脉粥样硬化大鼠下丘脑弓状核Ｌ－脑啡肽免疫反应（Ｌ－ＥＮＫ－ｉｒ）阳性细胞的变化进行了半定量研究。结果发现：动脉粥样硬化大鼠下丘脑弓状核Ｌ－ＥＮＫ－ｉｒ阳性细胞数目增加,在单