加减瓜篓薤白半夏汤对实验性心肌缺血大鼠抗心律失常及血流动力学的影响

目的：观察加减瓜蒌薤白半夏汤对大鼠急性心肌缺血模型血流动力学的影响.方法：结扎SD大鼠左冠状动脉前降支造成实验性心肌缺血模型,应用多导电生理监测仪监测血压（BP）、左室舒张末压力（LVEDP）、左室等容收缩期最大上升速率（＋dp/dtmax）、左室等容舒张期最大下降速率（dp/dtmax）.结果：大剂量中药可抑制心肌缺血所致LVEDP升高和BP、＋dp/dtmax、-dp/dtmax的降低（P＜0.01）.结论：加减瓜蒌薤白半夏汤可显著改善缺血心肌的血流动力学指标.     

大豆肽对大鼠离体工作心脏血流动力学的影响

目的:观察大豆肽对正常和经异丙肾上腺素预处理的大鼠离体工作心脏的作用。方法:采用改良的Langendorff心脏灌流装置,通过主动脉压力(AP),心室内压(LVSP),舒末压(LVEDP),左室内压最大上升或下降速率(±dp/dtmax),主动脉流量(AF),冠脉流量(CF),心率(HR)等血流动力学指标的变化来考察大豆肽0.03、0.10和0.30 mmol/L对正常大鼠离体工作心脏和0.1 mmol/L大豆肽对经异丙肾上腺素预处理的大鼠离体工作心脏的影响。结果:大豆肽0.03、0.10和0.30 mmol/L皆能降低正常大鼠AP,LVSP,LVEDP,±dp/dtmax,AF,并且增加CF,而对HR没有明显的影响;大豆肽0.1 mmol/L能降低经异丙肾上腺素处理的大鼠离体工作心脏AP,LVSP,LVEDP,±dp/dtmax和HR。结论:大豆肽具有负性肌力作用,且能拮抗异丙肾上腺素对大鼠离体工作心脏的正性肌力作用。     

银杏叶茶对大鼠在体心肌缺血-再灌注后左心室功能及抗氧化酶的影响

[目的]探讨银杏叶茶对大鼠在体心肌缺血再灌注损伤后左心功能及抗氧化酶的影响.[方法]将20只健康大鼠随机分为2组:生理盐水对照组和银杏叶茶处理组,分别用生理盐水和银杏叶茶灌胃4周后,造成缺血-再灌注模型,观察再灌注15 min、25 min后左心室内压力峰值(LVSP)、左心室舒张末期压(LVEDP)和左心室内压最大变化速率(+dp/dtmax);血中超氧化物歧化酶(SOD)活性、活性氧(ROS)及丙二醛(MDA)含量的变化.[结果]再灌注15 min时,银杏叶茶处理组动物LVSP、±dp/dt max明显升高(P＜0.01),LVEDP明显降低(P＜0.05);再灌注25 min后,银杏叶茶处理组动物LVSP、±dp/dtmax明显升高(P＜0.01、P＜0.05)、LVEDP变化不显著;银杏叶茶能明显提高再灌注15min时血中SOD活性(P＜0.01),降低MDA和ROS的含量(P＜0.01).[结论]银杏叶茶能明显提高缺血-再灌注损伤后的左心功能,可提高血中SOD活性,降低MDA和ROS的含量.     

糖尿病大鼠心功能及结构改变

目的观察不同病程糖尿病(DM)模型大鼠心脏功能、心脏指数、心肌形态的变化并探讨其相关性。方法将SD大鼠随机分为4组,对照组8周组和12周组,DM模型大鼠8周组和12周组,每组10只。对照组正常饲料喂养,采用链脲佐菌素50mg/kg诱发DM大鼠模型。测定各组大鼠左心室收缩压(LVSP)、左心室舒张末期压(LVEDP)、室内压最大上升速率(+dp/dtmax)、室内压最大下降速率(-dp/dtmax)、室内压上升达最大速率所需时间(t-dp/dt)和心脏指数,采用光学显微镜及电子显微镜观察心肌结构改变。结果与对照组比较,8周时DM组大鼠LVEDP明显升高,-dp/dtmax明显降低,差异均有统计学意义(均P<0.05);12周时LVEDP进一步升高,-dp/dtmax进一步降低,LVSP、+dp/dtmax显著降低,t-dp/dt显著延长,差异均有统计学意义(均P<0.01)。8周时DM组大鼠体重、心脏重量和左心室重量均明显低于对照组大鼠,但心脏指数和左心室指数则明显高于对照组大鼠,差异均有统计学意义(P<0.05)。12周时DM组体重几乎无增长,心脏重量和左心室重量显著低于对照组大鼠,心脏指数和左心室指数显著高于对照组大鼠,差异均有统计学意义(均P<0.01)。8、12周时,DM大鼠均有明显的心肌结构的改变,以12周改变更为明显。结论糖尿病大鼠出现心肌超微结构的改变,导致左室肥厚及心脏功能受损,且随病程的延长而进一步加重。     

内毒素血症心功能不全的脂肪酸代谢紊乱机制的初步研究

目的明确内毒素血症中心脏功能改变和可能涉及的脂肪酸代谢途径变化的机制,探讨AMPK(单磷酸腺苷活化蛋白激酶AMP-activated protein kinase)及下游靶点在心肌组织能量贮存与消耗调节中的作用。方法 SD大鼠尾静脉注射LPS(5mg/kg)建立内毒素血症模型,12h后麻醉,经颈总动脉置管监测心功能:左心室内压(LVSP)、左心室舒张末压(LVEDP)、左心室压力上升/下降最大速率(±dp/dtmax),进行心肌和血清游离脂肪酸检测,应用western blot方法测定AMPKα,p-AMPKα,肌型-肉毒碱脂酰转移酶1(muscle carnitine pamitoyltransferase1,m-CPT1),乙酰辅酶A羧化酶(acety1 coenzyme A carboxylase,ACCase),p-ACCase蛋白变化。结果内毒素血症组(LPS组)大鼠在注射LPS 12h后,+dp/dtmax,-dp/dtmax,和LVSP与正常对照组相比明显降低,而LVEDP则明显上升。内毒素血症组血清及心肌游离脂肪酸均高于正常组。两组之间AMPKα和ACCase蛋白表达无显著差异,而p-AMPKα和p-ACCase表达在内毒素血症大鼠组中明显增高,同时m-CPT1蛋白表达明显下降。结论内毒素血症心肌损伤与脂肪酸代谢紊乱有关,涉及到m-CPT1,p-ACCase和p-AMPKα蛋白表达的变化。     

短毛五加总甙对血流动力学影响的实验研究

本文探讨短毛五加总甙（AGVPS）以及普萘洛尔（Pro）对麻醉狗血压（Bp）、心率（HR）、左室内压变化速率（dp／dtmax）、左室内压（LVP）的影响，并将AGVPS与Pro作对照。还观察了AGVPS对麻醉大鼠血压与心率的影响及其降压机理的初步研究。结果表明，AGVPS与Pro对麻醉狗血流动力学的影响，能显著地降低血压、减慢心率、抑制dp／dtmax及减少LVP的作用。AGVPS也明显地降低大鼠血压和减慢大鼠心率、其降压作用不被M受体阻断剂阿托品所阻断，屯不能对抗肾上腺素的升压作用。     

战(创)伤失血复合氰化物中毒对大鼠心功能的影响

目的观察战(创)伤失血复合氰化物中毒对大鼠心功能的影响。方法将成年SD大鼠随机分为假手术组、失血性休克组、氰化钾中毒组和失血性休克复合氰化钾中毒组,观察各组大鼠心肌线粒体超氧化物歧化酶(SOD)、丙二醛(MDA)和谷胱甘肽过氧化物酶(GSH-Px)活力的变化,采用生理信号采集系统记录大鼠心率(HR)、左心室收缩压峰值(mLVSP)和左心室压力上升最大速率(+dp/dtmax),采用生化分析法检测大鼠心肌酶谱天冬氨酸转氨酶、乳酸脱氢酶、肌酸激酶、肌酸激酶同工酶(AST、LDH、CK和CKMB)的活力变化。结果与氰化钾中毒组比较,失血复合氰化钾中毒组大鼠心肌中线粒体SOD、GSH-Px活力明显降低,MDA含量升高;大鼠心脏HR、mLVSP、+dp/dtmax和心肌酶谱活力变化明显异常。结论战(创)伤失血条件下氰化物对大鼠心脏功能的影响更为严重,需要进一步探索相应的防治措施。     

黄芩苷对急性呼吸窘迫综合征大鼠心功能的影响

[目的]探讨黄芩苷对急性呼吸窘迫综合征（ARDS）大鼠心功能的影响。[方法]将120只健康成年雄性SD大鼠随机分为对照组、ARDS模型组和黄芩苷干预组,经股静脉注射油酸（0．12mL／kg）复制ARDS模型,干预组同时腹腔注射黄芩苷溶液（300mg／kg）;在不同时间分别插管至颈动脉、右心室、左心室,记录血压、右心室收缩末期压力（RVSP）、左心室收缩末期压力（LVSP）、收缩末期左心室压力最大上升速率（＋dp／dtmax）及舒张末期左心室压力最大下降速率（-dp／dtmax）;之后采集动脉血测血氧分压。[结果]模型组大鼠动脉氧分压在注射油酸后10min时与对照组比较有明显下降（P〈0．01）,氧合指数2h时为（189．45±43．03）mmHg（7．5mmHg=1kPa）,达到了ARDS的诊断标准（〈200mmHg）;干预组氧分压和氧合指数在各时间点均低于对照组（P〈0．01）,在30min及1、2、6、12、24h均高于模型组（P〈0．05或0．01）。模型组平均动脉压、RVSP、＋dp／dtmax、LVSP等指标与对照组比较明显下降;干预组上述指标均较模型组明显改善。[结论]ARDS时心脏功能受到明显影响,尤以右心为著;黄芩苷可改善ARDS时的缺氧状态,也有助于改善心脏功能。     

丹参总酚酸对兔急性呼吸窘迫综合征时心功能的影响

目的探讨丹参总酚酸对兔急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)时心功能的影响及其可能机制。方法新西兰兔24只,分为对照组、ALI/ARDS组和丹参总酚酸干预组;经颈静脉注射油酸(OA,0.15mg/kg)复制兔ALI/ARDS模型,颈动脉插管至左心室,随时记录左室收缩末期压力(LVSP)、收缩末期左心室压力最大上升速率(+dp/dtmax)、舒张末期左心室压力最大下降速率(-dp/dtmax),开胸分离胸主动脉根部,套以内径适宜的电磁流量计探头,备测心输出量(CO),肺动脉根部插管备测平均肺动脉压(mPAP)。丹参总酚酸组于注OA前30min静脉注射丹参总酚酸(10mg/kg);各组于注OA后10、30、60、120min采血测定血浆丙二醛(MDA)含量,2h后取肺做病理检查。结果ALI/ARDS组兔在注射OA后10、30、60、120min各时间点,血浆MDA水平均显著高于对照组(P<0.01或P<0.05);注射OA后10min,CO开始降低,mPAP即见升高;至60min、120min时,+dp/dtmax和-dp/dtmax方明显低于对照组(P<0.01)。丹参总酚酸干预组与ALI/ARDS组比较,各时间点血浆MDA水平均见降低,而左心室功能于注射OA后60min、120min时则显著高于ALI/ARDS组(P<0.05),且与对照组比较差异无显著性(P>0.05)。结论ALI/ARDS兔存在心功能障碍,mPAP升高可能为其始动环节,可依次导致右心或左心功能降低;丹参总酚酸有助于改善心脏功能,其机制可能与其抗氧化功能有关。     

葡萄糖酸镁对离体大鼠心肌缺血再灌注细胞凋亡的影响

目的观察葡萄糖酸镁对离体大鼠心肌缺血／再灌注（I／R）细胞凋亡的保护作用及可能机制。方法选用48只雄性SD大鼠随机等分为3组：对照组,I／R组,葡萄糖酸镁组。实验1：每组取8只大鼠,对照组用改良的K—H液持续灌注110min;I／R组用改良的K—H液灌流20min后,停灌30min,再灌注60min;葡萄糖酸镁组改良的K—H液中加入葡萄糖酸镁2．4mmol／L,余同I／R组。检测心肌灌流液中肌酸激酶（CK）,乳酸脱氢酶（LDH）含量,心肌组织中Ca^2＋和一氧化氮（NO）含量。实验2：每组其余8只大鼠,实验过程类似实验1,不同点再灌时间120min。实验结束检测心肌细胞凋亡指数。观察实验l、2再灌注20min内心律失常发生情况。结果与I／R组比较,葡萄糖酸镁组心律失常发生率显著下降（P〈0．01）;再灌流出液中CK、LDH含量明显降低（P〈0．01）;心肌组织Ca^2＋和NO含量及细胞凋亡指数明显降低（P〈0．01）。结论葡萄糖酸镁可通过增加NO含量减轻钙超载从而减少凋亡。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.