妊娠兔骨折愈合的影像学研究

目的探讨妊娠对兔骨折愈合的影响。方法日本大耳白雌兔随机分成对照组、妊娠组,对照组不做处理,妊娠组交配受孕,妊娠组孕后9d分组造模成左小腿中段闭合骨折模型,按造模前、造模后即时、造模后1、2、3周各时点抽取耳缘静脉血或心穿血,提取血清后-80℃冻存。按时点计算机数字化X线成像(Computed radiography,CR)、骨密度检查,其数据行统计学检验。结果妊娠组造模后1、2、3周骨痂骨密度值[(0.456±0.019)、(0.469±0.016)、0.461±0.022)g/cm2]、骨痂骨矿质含量值[(0.773±0.103)、(0.968±0.140)、(1.127±0.213)g]均高于对照组[(0.347±0.039)、(0.372±0.039)、(0.409±0.021)g/cm2]、;(0.617±0.083)、(0.783±0.062)、(0.998±0.087)g](P﹤0.05);CR定量测得的骨痂平均光密度值,妊娠组造模后1、2、3周均高于对照组(P﹤0.05)。结论兔早中期妊娠可能对骨折愈合有促进作用。     

壮筋续骨汤对骨折大鼠血清GH和PTH水平的影响

目的研究壮筋续骨汤对股骨骨折大鼠血清生长激素(GH)和甲状旁腺素(PTH)水平的影响。方法成年健康雄性Wistar大鼠72只,用低速牙科钻在股骨中段切断股骨制备骨折模型,随机分为对照组、模型组和治疗组各24只。治疗组应用壮筋续骨汤灌胃治疗,每日1次,连续28天。利用影像学和病理解剖学方法观察骨折局部愈合情况,酶联免疫吸附法检测血清中GH和PTH水平。结果大鼠骨折后第7天,在骨折断端出现肉芽组织,第14天形成纤维性骨痂,21天可见骨吸收、骨痂重塑,模型组与治疗组未见显著差异,28天治疗组骨痂质量明显优于模型组。大鼠血清GH和PTH水平在骨折术后7天、14天、21天、28天模型组和治疗组明显高于对照组(P<0.05),而模型组与治疗组在7天、14天、21天无显著差异,在28天治疗组明显高于模型组(P<0.05)。结论在骨折愈合后期,壮筋续骨汤可能通过维持血清GH和PTH含量而发挥促进骨折愈合作用。     

脊髓损伤对股骨骨折骨痂中VIP和NGF表达的影响

目的观察大鼠脊髓损伤对股骨骨折骨痂中血管活性肠肽(VIP)和神经生长因子(NGF)表达的影响。方法将健康雌性Wistar大鼠32只随机分为单纯股骨骨折组和股骨骨折并脊髓损伤组,每组16只,每组再分为骨折后1、4、7、14d亚组,每个亚组4只。应用物体自由坠落打击法建立脊髓损伤大鼠模型,免疫组织化学技术检测骨痂中VIP和NGF的表达水平。结果单纯骨折组表现为典型的骨折愈合过程,骨痂内纤维母细胞及成骨细胞内VIP和NGF阳性表达相对较弱。骨折并脊髓损伤组早期形成大量纤维骨痂和软骨骨痂,VIP和NGF强阳性表达,VIP和NGF表达达高峰。结论合并脊髓损伤的股骨骨折部位愈合较快,VIP和NGF表达明显增强,提示VIP和NGF具有促进骨折愈合的作用。     

大鼠脑损伤对股骨骨折骨痂中CGRP和PDGF表达的影响

目的研究大鼠脑损伤股骨骨折骨痂中降钙素基因相关肽(CGRP)和血小板衍生生长因子(PDGF)的表达规律。方法成年健康雄性Wistar大鼠90只,随机分为脑外伤合并骨折组、单纯骨折组和假手术组各30只。HE染色观察骨痂的结构变化,免疫组化染色检测骨痂中CGRP和PDGF表达。结果脑外伤合并骨折组骨折愈合速度较单纯骨折组快,骨痂中CGRP阳性表达出现早,7d达高峰,维持时间长,21d才开始下降;PDGF于14d达高峰,维持21d下降。结论颅脑损伤后,骨折骨痂中CGRP和PDGF表达出现时间早,表达强度高,维持时间长,可加快骨折愈合过程。     

接骨胶囊治疗骨折的药效学研究

目的研究接骨胶囊对实验动物骨折愈合的药理作用。方法将家兔造成双侧桡骨中下段不完全性骨折,随机分成对照组、接骨胶囊2治疗组及伤科接骨片阳性对照组。2治疗组给予接骨胶囊0.45g/kg体重和0.90g/kg体重口服治疗30天。观察体重变化,双桡骨X光摄片,骨折部位进行抗折力试验,测定血清碱性磷酸酶以及骨痂钙、磷和胶原蛋白含量,并做骨痂组织学检查。结果接骨胶囊治疗组血清碱性磷酸酶含量增高,桡骨抗折力增加,钙/磷比值趋于合理,胶原含量减少,X片检查结果表明,给药组愈合程度优于对照组。结论接骨胶囊具有一定的促进骨折愈合作用。     

桃红四物汤干预骨痂微血管新生及VEGF表达的实验研究

目的 研究桃红四物汤对骨折断端骨痂组织内微血管新生重建及VEGF表达的影响。方法 利用日本大耳白兔65只随机分成四组：三组作右前肢桡骨中段手术骨折造模并分别给予桃红四物汤、炎迪宁片、蒸馏水灌胃，另一组为正常对照组，在骨折后7、15、21、35d。采用免疫组化方法检测骨痂组织中VEGF表达，组织学染色检测骨痂组织内微血管变化，并作计数对比分析。结果 桃红四物汤干预组VEGF表达量高于其它各组，并在第15d表达峰值后下降不显著，同时，各时相点骨痂微血管增殖和塑形优于其他各组。结论 桃红四物汤通过提高骨折后骨痂内VEGF的表达，加速断端微血管新生重建，促进骨折愈合。     

刺老苞根皮黄酮对大鼠骨折愈合骨质代谢影响

目的研究刺老苞根皮黄酮对大鼠胫骨骨折模型骨质变化影响。方法 6周龄SD(雌雄各半)大鼠随机分5组,每组10只;刺老苞根皮黄酮高、中、低剂量组(30、20、10 mg/kg)和对照组、模型组,连续灌胃28 d,分别于灌胃第4、7、14、21、28 d进行骨代谢相关参数(碱性磷酸转移酶、骨钙素、羟脯氨酸以及总胶原蛋白)测定。结果与对照组比较,模型组骨碱性磷酸转移酶(245.7±20.9)U/L、骨钙素(3.12±1.10)U/L、羟脯氨酸(8.69±1.81)μg/mL含量均降低(P<0.01);与模型组比较,高剂量刺老苞根皮黄酮组骨折28d骨碱性磷酸转移酶活性(292.3±23.2)U/L、骨钙素(3.88±1.15)U/L、羟脯氨酸(14.01±3.01)μg/mL含量均升高(P<0.01)。结论刺老苞根皮黄酮可以改善大鼠胫骨骨折骨代谢状况,有利骨折愈合修复。     

壮筋续骨汤促进骨折愈合的实验研究

目的 研究壮筋续骨汤促进大鼠股骨骨折愈合的作用.方法 成年健康雄性Wistar大鼠50只,用线锯在股骨中段切断股骨制备骨折模型,应用壮筋续骨汤水煎液灌胃治疗.X线观察骨折愈合情况,苏木精-伊红染色观察骨折愈合的病理变化.结果 治疗后7天,大鼠局部肿胀消失;X线片示纤维性骨痂开始形成,骨折线模糊;HE染色示骨折端断成纤维细胞和成骨细胞增多.治疗后14天,大鼠患肢活动逐渐恢复;X现示骨折处显示纤维性骨痂和钙盐沉积,骨折线消失;HE染色示骨折端有大量纤维性骨痂,软骨性骨痂和骨性骨痂,趋于愈合.结论 壮筋续骨汤能促进实验性大鼠骨折愈合.     

海洋胶原肽对剖宫产大鼠伤口愈合促进作用

目的观察海洋胶原肽对大鼠剖宫产术后恢复的促进作用。方法将96只SD孕鼠在孕19 d时进行剖宫产手术,随机分为4组,3个剂量组术后每天给予0.13,0.38,1.15 g/(kg.bw)剂量的海洋胶原肽灌胃,空白对照组等体积生理盐水灌胃;在术后7,14,21 d每组分别处死8只大鼠,观察切口愈合情况,测定皮肤切口和子宫切口的抗张力强度、羟脯氨酸含量。结果给予海洋胶原肽1.15 g/(kg.bw)组大鼠皮肤伤口中羟脯氨酸含量在3个时间点上均高于对照组,差异有统计学意义(P0.05);在7,21 d时,给予海洋胶原肽1.15 g/(kg.bw)组大鼠皮肤张力为(354.45±200.45),(978.23±20.40)g/mm2,子宫压力为(874.63±293.51),(818.20±227.52)mmHg,均大于空白对照组的(165.44±29.82),(379.21±171.46)g/mm2和(684.52±220.16),(511.92±86.48)mmHg,差异有统计学意义(P0.05);21 d时,给予海洋胶原肽0.38g/(kg.bw)组大鼠的皮肤张力为(936.59±56.27)g/mm2,大于空白对照组,差异有统计学意义(P0.05)。结论海洋胶原肽能够促进伤口胶原蛋白合成,促进大鼠剖宫产术后伤口的愈合。     

半枝莲多糖对兔下颌骨骨折愈合的影响

目的:观察半枝莲多糖对家兔下颌骨骨折愈合过程中SGF、CDF变化和骨折愈合的影响并初步探讨其机制。方法:30只兔于左侧下颌骨体部位制造骨折模型后,随机分为模型对照组、半枝莲多糖组、骨肽治疗组,每组10只;在造模3天后,半枝莲多糖组每天腹腔注射药物剂量为150 mg/(kg·d),骨肽治疗组注射剂量为25 mg/(kg·d),在第1、3、5 w检测兔血液中SGF、CDF含量变化及骨密度和免疫组织化学法测骨形态发生蛋白-2(BMP-2)含量,并测定血清骨钙素水平。结果:经过检测半枝莲多糖组的兔静脉血中SGF、CDF含量、骨密度值、BMP-2、骨钙素水平均高于模型对照组(P0.01),差异有显著性。结论:半枝莲多糖在促进兔下颌骨骨折的愈合过程中,可能通过调节SGF、CDF使BMP-2、骨钙素升高从而达到治疗效果。     

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.