大黄保护老龄大鼠脑缺血损害及其对细胞因子的影响

目的:从细胞因子探讨大黄保护老龄大鼠脑缺血损伤的作用机制。方法:采用二血管阻断方法制备不完全性脑缺血模型,分离结扎两侧颈总动脉48h。老龄大鼠分为对照组、模型组、尼莫地平组、大黄组,对照组、模型组灌胃生理盐水,尼莫地平组、大黄组灌胃尼莫地平片剂5.92mg/kg、大黄粉0.44g/kg,1次/d。观察脑组织病理变化和脑电图幅度,测定脑组织含水量、钙含量和细胞因子水平。结果:与对照组比较,模型组脑组织损伤明显,脑电图幅值降低,脑组织Ca2 (109.073±27.179)比(142.500±18.949)μg/g和脑含水量(49.583±4.134)%比(60.185±4.240)%及血清白细胞介素1,8和6水平增高;脑组织和血清肿瘤坏死因子水平的增高和转化生长因子,胰岛素样生长因子水平的降低显著。尼莫地平组、大黄组脑电图幅值、病理损伤明显改善,Ca2 含量(98.422±16.622)μg/g和脑含水量(53.344±3.705)%降低较显著,大黄组脑组织和血清肿瘤坏死因子、血清白细胞介素的降低和血清转化生长因子水平增高明显。结论:细胞因子的变化参与老龄大鼠脑缺血损伤,大黄保护脑缺血损伤的机制可能与其调节细胞因子紊乱有关。     

大黄保护老龄大鼠脑缺血损害及其对细胞因子的影响

目的：从细胞因子探讨大黄保护老龄大鼠脑缺血损伤的作用机制。方法：采用二血管阻断方法制备不完全性脑缺血模型，分离结扎两侧颈总动脉48h。老龄大鼠分为对照组、模型组、尼莫地平组、大黄组，对照组、模型组灌胃生理盐水，尼莫地平组、大黄组灌胃尼莫地平片剂5．92mg／kg、大黄粉0．44g／kg，1次／d。观察脑组织病理变化和脑电图幅度，测定脑组织含水量、钙含量和细胞因子水平。结果：与对照组比较，模型组脑组织损伤明显，脑电图幅值降低，脑组织Ca^2+[(109．073&;#177;27．179)比(142．500&;#177;18．949)μg／gl和脑含水量[(49．583&;#177;4．134)％比(60．185&;#177;4．240)％]及血清白细胞介素1，8和6水平增高；脑组织和血清肿瘤坏死因子水平的增高和转化生长因子，胰岛素样生长因子水平的降低显著。尼莫地平组、大黄组脑电图幅值、病理损伤明显改善，Ca^2+含量[(98．422&;#177;16．622)μg／gl和脑含水量[(53．344&;#177;3．705)％]降低较显著，大黄组脑组织和血清肿瘤坏死因子、血清白细胞介素的降低和血清转化生长因子水平增高明显。结论：细胞因子的变化参与老龄大鼠脑缺血损伤，大黄保护脑缺血损伤的机制可能与其调节细胞因子紊乱有关。     

高压氧对脑缺血再灌注大鼠神经功能的影响

【目的】探讨高压氧对脑缺血再灌注大鼠神经功能的影响。【方法】选取60只Wistar大鼠,随机分成3组,假手术组、模型组和实验组,每组20只。假手术组大鼠仅进行手术过程而不造成缺血,模型组大鼠直接行大脑中动脉缺血再灌注,实验组大鼠采用高压氧预处理再行大脑中动脉缺血再灌注,对比三组大鼠再灌注24 h后神经功能缺损评分、脑梗死体积、缺血病灶脑组织神经细胞凋亡指数(AI),脑组织超氧化物歧化酶(SOD)、乳酸脱氢酶(LDH)活力、丙二醛(MDA)、一氧化氮(NO)含量变化。【结果】假手术组的脑组织没有受损,其神经功能缺损评分和脑梗死体积占比均为0。模型组和实验组脑组织均受到损伤,神经功能缺损评分和脑梗死体积及AI这3种指标均升高,但实验组损伤较轻,其数据低于模型组,差异有统计学意义(P<0.05);三组大鼠再灌注24 h后脑组织SOD、LDH活力及MDA、NO含量比较,差异均有统计学意义(P<0.05)。模型组大鼠脑组织SOD、LDH活力均低于假手术组(P<0.05),但实验组大鼠脑组织SOD.LDH活力均高于模型组(P<0.05)。模型组大鼠脑组织MDA、NO均高于假手术组(P<0.05),但实验组大鼠脑组织MDA、NO活力均低于模型组(P<0.05)。【结论】高压氧可通过改善脑组织氧化应激损伤抑制大鼠脑缺血再灌注损伤。     

通脑精对大鼠局灶脑缺血一氧化氮和自由基的影响

目的 :探讨通脑精对大鼠局灶脑缺血的保护作用及其机制。方法 :采用电凝阻断大脑中动脉造成大鼠局灶脑缺血模型 ,测定血浆中一氧化氮 (NO)、丙二醛 (MDA)含量和超氧化物歧化酶 (SOD)活性 ,及脑组织中一氧化氮(NO)、丙二醛 (MDA)含量和超氧化物歧化酶 (SOD)、一氧化氮合酶 (NOS)活性的变化。结果 :通脑精 (2 g/kg)能显著增加血浆和组织中超氧化物歧化酶 (SOD)活性 ,P <0 .0 1 ,降低血浆中NO、MDA含量和脑组织中NOS活性 ,P <0 .0 1。结论 :通脑精对大鼠局灶脑缺血损伤有保护作用 ,其机理与降低血浆中NO、MDA含量和脑组织中NOS活性及增加脑组织中SOD活性作用有关。     

大肠杆菌肺炎老龄大鼠小肠组织自由基和前列腺素代谢变化

目的 研究老年肺炎的小肠损伤病理生理特点。方法 复制大肠杆菌肺炎模型,分为青年对照组和模型组、老龄对照组和模型组。主要观察肺脏和小肠组织病理改变和含水量,小肠组织6－Keto-PGF1α、TXB2、NO和MDA含量及SOD活性。结果 肺炎鼠的肺、小肠组织损伤明显和含水量增高,老龄大鼠组织损伤较青年大鼠严重。与青年对照组比较,青年 模型组SOD活性和6－Keto-PGF1α含量降低,TXB2、NO、MDA含量较高。老龄对照组NO含量降低和MDA含量增高较青年对照组显著。老龄模型组SOD活性、6－Keto-PGF1α含量的降低和NO、MDA、TXB2含量的增高较老龄对照组显著。与老龄模型组比较,青年模型组MDA、NO含量降低和SOD活性升高。结论 前列腺素及自由基介导的损伤参与肺炎的小肠组织损伤发生发展。由于增龄变化,肺炎老龄大鼠小肠自由基损伤青年大鼠尤为重要。     

肺炎双球菌肺炎老龄大鼠小肠组织自由基和前列腺素代谢变化

目的：研究老年肺炎的小肠损伤病理生理特点。方法：复制肺炎双球菌肺炎大鼠模型，分为青年和老龄对照组及模型组。主要观察肺脏和小肠组织含水量，小肠组织6-酮-前列腺素F1α(6-keto-PGF1α)、血栓素B2(TXB2)、一氧化氮(NO)、丙二醛(MDA)含量及超氧化物歧化酶(SOD)活性。结果：肺炎大鼠的肺组织损伤明显，肺脏和小肠组织含水量增高。青年模型组和老龄模型组小肠组织6-keto-PGF1α含量、SOD活性的降低和TXB2、NO、MDA含量的增高均较青年对照组和老龄对照组显著。与青年对照组比较，老龄对照组SOD活性降低，MDA含量升高。老龄模型组SOD活性的降低和MDA含量的增高较青年模型组显著。结论：前列腺素及自由基介导的损伤参与肺炎小肠组织损伤的发生和发展。由于增龄变化，肺炎老龄大鼠小肠自由基损伤较青年大鼠尤为严重。     

茶氨酸对脑缺血损伤大鼠自由基代谢的影响

目的:从对自由基代谢影响方面探讨茶氨酸对脑缺血损伤的保护作用机制。方法:选用30只SD雄性大鼠,线栓阻塞大鼠大脑中动脉制备局灶性脑缺血模型,观察脑缺血损伤大鼠神经症状改变,测定脑组织含水量、脑组织病理及钙离子含量;观察其血清和脑组织超氧化物歧化酶(SOD)活性、丙二醛(MDA)含量变化以及茶氨酸对上述变化的影响。结果:脑缺血组大鼠的神经症状评分、脑组织含水量及钙离子含量均显著增高,病理损伤明显,正常神经元细胞数目减少;茶氨酸可显著降低神经症状评分、脑组织含水量及钙离子含量,增加正常神经元细胞数目。脑缺血组大鼠的血清、脑组织SOD活性显著降低,茶氨酸组大鼠血清、脑组织SOD活性较脑缺血组显著增高;脑缺血组大鼠的血清、脑组织MDA含量显著增高,茶氨酸组脑组织MDA含量较脑缺血组下降明显。结论:茶氨酸对大鼠脑缺血损伤具有显著的保护作用,可能与调节脑缺血损伤引起的自由基代谢失调有关。     

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。     

大鼠全脑缺血/再灌注后银杏叶提取物减轻脑水肿机制的探讨

目的 探讨大鼠全脑缺血/再灌注损伤后银杏叶提取物(EGb761)减轻脑水肿的机制.方法 四血管法制作全脑缺血/再灌注模型的40只雄性SD大鼠,随机分为假手术组、缺血/再灌注组、小剂量EGb761治疗组、中剂量EGb761治疗组和大剂量EGb761治疗组,每组8只;观察脑组织含水量、血清S100B、丙二醛(MDA)和超氧化物歧化酶(SOD)含量.结果 与缺血/再灌注组相比,EGb761治疗能降低脑组织含水量、血清S100B蛋白和MDA含量,提升血清SOD含量.结论 EGb761可减轻全脑缺血/再灌注损伤后大鼠的脑水肿,其机制可能与血清S100B蛋白含量下降和抗自由基损伤有关,并且呈剂量依赖性.     

丹参注射液对脑缺血再灌注损伤大鼠的保护作用

目的观察丹参注射液对线栓法所致大脑中动脉缺血损伤再灌注大鼠的影响。方法采用大鼠大脑中动脉线栓法制备脑缺血再灌注损伤模型,将建模的SD大鼠随机分为模型组、尼膜同组及丹参注射液高、中、低剂量组等5组,每组10只,假手术大鼠10只设为对照组。观察丹参注射液对缺血再灌注损伤大鼠的行为学、脑梗死率、脑含水量、脑指数及血清丙二醛(MDA)、超氧化物歧化酶(SOD)含量的影响。结果丹参注射液高、中剂量组可以升高缺血再灌注大鼠的行为学评分,降低脑梗死率及脑含水量,降低血清MDA含量,升高SOD含量,与模型组比较差异均有统计学意义(P<0.05或P<0.01)。且高剂量的丹参注射液对脑缺血再灌注大鼠的各种效应与尼膜同组相似。结论丹参注射液对脑缺血再灌注大鼠具有一定的保护作用。     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

糖尿病视网膜病变筛查与防治中存在的问题及对策

目的探讨糖尿病视网膜病变(diabetic retinopathy,DR)患者筛查和防治中存在的问题及对策。方法以76例糖尿病DR患者为对象,调查未能早期接受眼科诊治的原因。结果存在问题主要是患者对DR防治知识不了解、血糖控制不理想、内科医生未建议进行专科检查等。结论眼科医护人员应密切与糖尿病专科的联系,尽早对DM患者进行DR健康教育,并开展社区DR防治工作。     

罕见和未知基因型珠蛋白生成障碍性贫血的分析与鉴定

目的对珠蛋白生成障碍性贫血(简称地贫)血液学表型阳性但未检出常见地贫基因型的疑似个体做进一步分子水平检测,以明确诊断。方法收集2015年5月至2018年8月在清远市妇幼保健院就诊的地贫血液学表型阳性但常见地贫基因型检测为阴性的标本96例(包括疑似α-地贫88例和β-地贫8例),分别采用单管多重PCR、DNA测序法、荧光定量PCR和芯片捕获测序法检测罕见和未知缺失型地贫基因。结果从上述疑似α-地贫标本中共检出罕见α-地贫基因型17例,其中泰国缺失型(--^THAI/αα)5例,菲律宾缺失型(--^FIL/αα)2例,α^ΔCD303例,α珠蛋白基因拷贝数增加(ααα^anti3.7或ααα^anti4.2)5例,并且发现2例新的α-地贫突变,即α^ΔCD272-279delAGCTTCGG和CD167-169insT。在8例β-地贫特征个体中检出罕见β-地贫基因型Poly A(A>G)2例,-90(C>T)3例,CD37(TGG>TAG)1例,IVS-I-2(T>A)1例,另外还鉴定出1例新的缺失型β-地贫基因(缺失位置为ch11:5,246,000-5,250,500,缺失长度为4kb左右)。结论对未检出常见地贫突变但血液学表型阳性个体进行深度分析,既可提高地贫基因的检出率,有利于遗传咨询和产前诊断,又可能发现新的地贫突变,丰富了中国人群的地贫基因突变谱。     

Prevalence and severity of nausea and vomiting of pregnancy and effect of vitamin supplementation.

OBJECTIVE: Although nausea and vomiting of pregnancy is the most common medical condition during pregnancy, there are many unanswered questions regarding its cause, epidemiologic features and optimal management. The objectives of this study were to ascertain the prevalence of nausea and vomiting in a sample of Canadian women, to characterize the distribution of their severity and to investigate the role of vitamin B6 deficiency in their etiology. DESIGN: Prospective study. SETTING: Antenatal counselling service for pregnant women. PATIENTS: Three cohorts of women: a prospective, population-based cohort of 193 women, to estimate the rate and severity of nausea and vomiting (cohort A); a cohort of 555 women who sought advice for nausea with or without vomiting, to study the correlation between the maximal daily number of episodes of vomiting and maximal weight loss (cohort B); and a prospective cohort of 301 women who reported vomiting, to correlate vitamin supplementation with vomiting (cohort C). INTERVENTIONS: All 3 cohorts were interviewed during the counselling session, and cohort B was followed up prospectively. OUTCOME MEASURES: Frequency of nausea and vomiting, weight loss, maximal number of daily episodes of vomiting, rate of multivitamin supplementation. RESULTS: Overall, 67% of the women in cohort A reported experiencing nausea or vomiting, or both; 22% reported vomiting, and 9% experienced weight loss. In cohort B there was a significant correlation between the maximal number of daily episodes of vomiting and maximal weight loss, although there was wide variation (r2 = 0.25, p < 0.001). There was a highly significant correlation between the number of daily vomiting episodes and mean weight loss (r2 = 0.99). In cohort C, vomiting was significantly associated with lack of supplementation with multivitamins before 6 weeks' gestation (p = 0.002). CONCLUSIONS: The relation between number of daily vomiting episodes and mean weight loss may serve as a clinical tool to assess the severity of nausea and vomiting in pregnancy and the success of anti-emetics and rehydration regimens. Further study is needed to elucidate the biologic basis of the observed association between vomiting and lack of multivitamin supplementation in early pregnancy.     

头面部血管肉瘤3例报告并文献复习

目的:总结我们对头面部血管肉瘤手术联合放射治疗方法的经验认识。方法:报道3例头面部血管肉瘤病例,并复习相关文献。结果和结论:头面部血管肉瘤是一种少见的、多中心的血管肿瘤,预后差。头面部血管肉瘤的手术治疗常常需要切除较广的范围。放射治疗对头面部血管肉瘤是一种合理治疗,既能使受侵犯的真皮组织和周围皮肤得到进一步治疗,又能保护其下的正常组织。     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.