川芎嗪和参麦注射液对脑缺血—再灌注肺损伤老龄大鼠ATP酶的自由基代谢的影响

目的：从ATP酶活性变化和自由基损伤方面探讨川芎嗪和参麦注射液及其配伍而成的川芎参麦注射液对老龄大鼠脑缺血-再灌注肺损伤防护作用的机制。方法：老龄（20月龄以上）大鼠分为模型组、对照组、尼莫通组、川芎嗪组、参麦注射液组（参麦组）、川芎参麦组（川参组）,观察各组大鼠全脑缺血30分钟=再灌注60分钟后肺组织病理和肺组织超氧化物歧化酶（SOD）、ATP酶活性及丙二醛（MDA）含量的变化。结果：老龄模型组肺组织出现明显的病理损伤,川芎嗪组、参麦组及川参组肺损伤均显著改善,老龄模型组肺组织Ca^2 -ATP酶活性低于老龄对照组,川芎嗪组高于老龄模型组,川芎嗪组、川参组及参科组肺组织MDA/SOD比值均低于老龄模型组。结论：脑缺血-再灌注可导致老龄大鼠肺损伤,川芎嗪和参麦注射液及其配伍改善肺损伤可能与其拮抗自由基有关,其中以参麦注射液作用较佳,川芎嗪提高组织Ca^2 -ATP酶活性可能是其作用机制之一。     

川芎嗪和参麦注射液对脑缺血一再灌注肺损伤老龄大鼠ATP酶和自由基代谢的影响

目的 :从 ATP酶活性变化和自由基损伤方面探讨川芎嗪和参麦注射液及其配伍而成的川芎参麦注射液对老龄大鼠脑缺血再灌注肺损伤防护作用的机制。方法 :老龄 (2 0月龄以上 )大鼠分为模型组、对照组、尼莫通组、川芎嗪组、参麦注射液组 (参麦组 )、川芎参麦组 (川参组 ) ,观察各组大鼠全脑缺血 30分钟、再灌注 6 0分钟后肺组织病理和肺组织超氧化物歧化酶 (SOD)、ATP酶活性及丙二醛 (MDA )含量的变化。结果 :老龄模型组肺组织出现明显的病理损伤 ,川芎嗪组、参麦组及川参组肺损伤均显著改善。老龄模型组肺组织Ca2 ATP酶活性低于老龄对照组 ,川芎嗪组高于老龄模型组。川芎嗪组、川参组及参麦组肺组织 MDA /SOD比值均低于老龄模型组。结论 :脑缺血再灌注可导致老龄大鼠肺损伤 ,川芎嗪和参麦注射液及其配伍改善肺损伤可能与其拮抗自由基有关 ,其中以参麦注射液作用较佳 ,川芎嗪提高组织 Ca2 ATP酶活性可能是其作用机制之一。     

川芎嗪和参麦注射液对老龄大鼠脑缺血再灌注心肌损伤的保护作用

目的：从多巴胺（DA）、去甲肾上腺素（NE）、肾上腺素（E）和神经肽Y（NPY）的变化研究川芎嗪和参麦注射液及其配伍对老龄大鼠脑缺血再灌注心肌损伤防护作用的机制。方法：老龄大鼠分为模型组和对照组、尼莫通组、川芎嗪组、参麦注射液组（参麦组）、川芎参麦组（川参组）,观察大鼠全脑缺血再灌注后心肌组织形态和乳酸脱氢酶（LDH）、肌酸磷激酶（CPK）活性及NE、DA、E、NPY含量的变化。结果：与老龄对照组比较,老龄模型组心肌组织出现明显的病理改变和单胺类神经递质紊乱,血清中CPK和LDH活性及脑组织NPY含量增高,参麦组和川参组心肌病理改变和脑组织NPY含量明显改善,川参组、川芎嗪组血清CPK水平和参麦组、川芎嗪组血清中LDH水平显著降低,川参组、参麦组、川芎嗪组单胺类神经递质紊乱改善明显。结论：老龄大鼠脑缺血再灌注心肌损伤与交感－肾上腺系统兴奋增强有关。川芎嗪和参麦注射液及其配伍调节单胺类神经递质紊乱作用和降低NPY含量可能是防治脑缺血再灌注心肌损伤的机制之一。     

老龄大鼠脑缺血再灌注肺损伤机制研究

目的：从ATP酶活性变化和自由基损伤方面研究老龄大鼠脑缺血再灌注肺脏损伤机制。方法：青年（5月龄）和老龄（20月龄以上）大鼠均分为模型组和对照组,观察大鼠全脑缺血30min再灌60min后肺脏组织形态和丙二醛（MDA）含量及超氧化物岐化酶（SOD）、ATP酶活性的变化。结果：青年和老龄模型组大鼠肺脏组织均出现明显的病理改变,老龄模型组较青年模型组严重。老龄对照组肺组织MDA/SOD比值高于青年对照组。青年模型组肺Ca^2 -ATP酶活性低于青年对照组和老龄模型组。结论：脑缺血再灌注肺损伤老龄大鼠较青年大鼠严重,Ca^2 -ATP酶活性的降低和自由基损伤可能是肺损伤发生的机制之一。     

老龄大鼠脑缺血再灌注肺损伤机制研究

目的从ATP酶活性变化和自由基损伤方面研究老龄大鼠脑缺血再灌注肺脏损伤机制。方法青年(5月龄)和老龄(20月龄以上)大鼠均分为模型组和对照组,观察大鼠全脑缺血30min再灌注60min后肺脏组织形态和丙二醛(MDA)含量及超氧化物岐化酶(SOD)、ATP酶活性的变化。结果青年和老龄模型组大鼠肺脏组织均出现明显的病理改变,老龄模型组较青年模型组严重。老龄对照组肺组织MDA/SOD比值高于青年对照组组。青年模型组肺Ca2+-ATP酶活性低于青年对照组和老龄模型组。结论脑缺血再灌注肺损伤老龄大鼠较青年大鼠严重,Ca2＋-ATP酶活性的降低和自由基损伤可能是肺损伤发生的机制之一。     

补阳还五汤对沙土缺脑缺血损伤能量代谢的影响

目的：研究补阳还五汤对脑缺血损伤后脑组织能量代谢的影响。方法：采用沙土鼠侧颈总动脉夹闭脑缺血－再灌注模型,于再灌注后48小时取前脑皮测定Na^ -K -ATP酶,Ca^2 -ATP酶,Mg^2 -ATP酶和乳酸。结果：缺血－再灌注后48小时脑组织Na^ -K -ATP酶,Ca^2 -ATP及Mg^2 -ATP酶活性均降低,而乳酸含量无明显变化。腹腔注射补阳还五汤可防止缺血－再灌注48小时后脑组织Na^ -K^ -ATP酶活性的降低,而对Ca^2 -ATP酶及Mg^2 -ATP酶活性无明显影响。结论：脑缺血后的神经细胞损伤与脑内能理代谢障碍有一定的关系,补阳还五汤可能通过调节脑组织能量代谢而发挥抗抗脑缺血的作用。     

不同治则方药对大鼠局部脑缺血-再灌注模型脑组织能量代谢的影响

目的：了解熄风开窍、通腑化痰、清热熄风通络、活血化瘀等不同治则方药对脑缺血-再灌注大鼠脑组织能量代谢的影响。方法：用大脑中动脉闭塞(MCAO)法复制大鼠局部脑缺血-再灌注模型，分别灌服熄风开窍合剂、通腑合剂、羚蝎胶囊、中风回春丸，检测脑组织ATP酶的变化。结果：与模型组相比，羚蝎胶囊组、中风回春丸组Na^ -K^ -ATP酶、Ca^2 -ATP酶和Mg^2 -ATP酶活性均显著升高，熄风开窍合剂组Ca^2 -ATP酶、Mg^2 -ATP酶活性均显著升高，而通腑合剂组各ATP酶升高不显著。结论：以清热熄风通络、活血化瘀和熄风开窍治则为主立方的方药具有提高大鼠局部脑缺血-再灌注模型脑组织ATP酶活性的作用。     

滋补脾阴方药保护兔脊髓继发性损伤的实验研究

目的：探讨滋补脾阴方药对脊髓继发性损伤的保护作用。方法：采用Allen法致伤造成家兔脊髓损伤模型，随机分为假手术组，2h、12h、24h、60h滋补脾阴方药组及各中药组生理盐水对照组，观察脊髓细胞线粒体Na^ ，K^ -ATP酶，Ca^2 ，Mg^2 -ATP酶活性及超氧化物歧化酶(SOD)和丙二醛(MDA)含量变化。结果：脊髓损伤后脊髓细胞线粒体Na^ ，K^ -ATP酶、Ca^2 Mg^2 -ATP酶活性、SOD含量明显降低，MDA含量明显升高。使用滋补脾阴方药后，增高Na^ ，K^ -ATP酶、Ca^2 ，Mg^ -ATP酶活性，使SOD含量升高，使MDA含量降低。结论：滋补脾阴方药可以改善脊髓细胞线粒体ATP酶活性，缓解脂质过氧化反应，从而发挥脊髓保护作用。     

内洋地黄素拮抗剂减轻心肌缺血再灌注损伤的实验研究

目的 观察心肌缺血再灌注(myocardial isehemia reperfusion，MIR)时心肌组织内洋地黄素水平的变化和内洋地黄索特异性拮抗剂地高辛抗血清对MIR的影响，证明内洋地黄素是介导MIR损伤的重要介质之一。方法 采用左冠状动脉前降支结扎30min，复灌45min建立在体大鼠MIR、模型。SD大鼠随机分成7组：假手术组，模型组，生理盐水组，维拉帕米组，小剂量、中剂量、大剂量地高辛抗血清组。连续记录Ⅱ导联心电图，于再灌注45min后立即取左室心尖部缺血区心肌，检测心肌匀浆中内洋地黄素含量、心肌细胞膜Na^ -K^ -ATP酶和线粒体内Ca^2 含量。结果MiR损伤时，心肌组织内洋地黄素水平明显升高。心肌细胞膜Na^ -K^ -ATP酶活性显著下降，线粒体内Ca^2 含量升高；心电图ST段显著抬高，再灌注时发生明显的室性心律失常。地高辛抗血清组可显著降低心肌组织内洋地黄素水平，恢复细胞膜Na^ -K^ -ATP酶活性，降低线粒体内Ca^2 含量；显著改善MIR所致ST段抬高和再灌注心律失常的发生率。结论 MIR时，心肌组织内洋地黄素水平显著升高，是介导MIR损伤的重要物质之一。地高辛抗血清通过拮抗内洋地黄素的生物学作用，减轻MIR损伤。     

茶多酚对运动小鼠心肌钙离子、ATP酶及自由基代谢的影响

目的：探讨茶多酚对运动小鼠心肌组织损伤的保护作用。方法：以小鼠力竭运动为模型，观察茶多酚对心肌组织钙离子（Ca^2＋）含量、钠泵（Na^＋-K^＋-ATPase）和钙泵（Ca^2＋-ATPase）活性、丙二醛（MDA）含量、超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH—Px）和总抗氧化能力（TAC）的影响。结果：力竭运动可引起小鼠心肌组织Ca^2＋和MDA含量显著升高，心肌组织Ca^2＋-ATPase、Na^＋-K^＋-ATPase、SOD、GSH—Px和T—AOC的显著下降，而茶多酚可抑制小鼠力竭运动后心肌Ca^2＋和MDA含量显著升高，抑制小鼠心肌Ca^2＋-ATPase、Na^＋-K^＋-ATPase、SOD、GSH—Px和TAC的显著下降。结论：茶多酚可减少力竭运动后自由基对心肌组织的攻击，具有保护力竭运动后心肌的功能和防止心肌损伤的作用。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Clinical Trial Updates and Hotline Sessions presented at the European Society of Cardiology Congress 2007

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions at the European Society of Cardiology Congress 2007 in Vienna. The key presentations were performed by leading experts in the field with relevant positions in the trials or registries. It is important to note that unpublished reports should be considered as preliminary data, as the analysis may change in the final publications. The comprehensive summaries have been generated from the oral presentation and the webcasts of the European Society of Cardiology and should provide the readers with the most comprehensive information of relevant publications.     

Balance and Boundaries in Grief Counseling: An Intervention Framework for Volunteer Training

Volunteers or paraprofessional counselors are commonly used to provide supportive care to the bereaved. These counselors generally are trained in basic listening skills, providing a generic, nonspecific approach to intervention that remains to be proven effective. The present paper outlines a framework that provides paraprofessionals with a broader model for intervention with the bereaved. Attention to boundaries as a helper and balance in the grief recovery are central to the model. Interventions are described that provide the paraprofessional counselor with more options for tailoring their counseling strategy to the individual. These include techniques that are presumed to be more specific to the enhancement of grief recovery.     

A new method for the simultaneous analysis of unmodified and modified urinary nucleosides and nucleobases by high performance liquid chromatography

Details are given of a new, rapid and simple pre-fractionation method and an isocratic high performance liquid chromatography system suitable for parallel analysis of nucleosides and nucleobases from urine and other biological fluids. The quantitative recovery and excellent reproducibility of the method is demonstrated by analysis of representative standard RNA catabolites. The advantage of this new method for application to biological samples is discussed.     

Adsorption of Charged Non-albumin Bound Drugs by Amorphous Silica

We investigated the in vitro drug adsorption of PQ 10150 sodium silicate gel (AIS, Santa Clara, CA) with particle size of 230 um and surface area of 400 nr/g. We observed 99% to 88% adsorption of gentamicin; a mean 91 % of disopyramide; a mean 89% of quinidine at low concentration, falling to 75% at higher concentration. Insulin was 88% adsorbed at low concentrations but less so (65%) at higher concentrations. We observed a mean 83 % adsorption of procainamide, a mean 84% of N-acetyl procainamide, 74% oflidocaine, 73% of amitriptyline; and 44% of desipramine. We found an average 14% reduction of total digoxin concentration when serum containing digoxin (2 to 33 ng/mL) was exposed to sodium silicate, while the reduction in free digoxin concentration was 16%. Five percent ethosuximide was also removed. The adsorption of theophylline, phenobarbital, acetaminophen, phenytoin, ethylene glycol, methotrexate, salicylate, thiocyanate and diazepam was minimal and not significant. We conclude that significant amounts of charged, non-albumin bound drugs can be removed by PQ 10150 sodium silicate gel.