山西省计划免疫冷链设备现状调查

为了解山西省计划免疫冷链设备现状,于2001年5月对全省各级卫生防疫站进行了调查.结果显示截止调查时全省装备的6种主要冷链设备共4419台(件,下同),其中前10年(1986～1995年)装备2489台,占56.3%;后6年(1996～2001年)装备1930台,占43.7%.在4419台中,当前正常运转的1930台(43.7%),尚可使用的1057台(23.9%),损坏报废的1432台(32.4%).为满足当前需要,全省尚需增补1888台,其中县、乡两级需增补普通冰箱1011台,低温冰箱805台,疫苗运输车35辆;省、市两级需增补普通冷库4台,低温冷库10台,冷藏车9辆,疫苗运输车14辆.说明需增补的重点在基层.     

地塞米松对冷藏离体肺表面活性物质和顺应性的影响

目的:观察地塞米松对冷藏离体肺表面活性物质和顺应性的影响.方法:32只家兔肺随机均分为对照组、地塞米松冷藏(4℃)保存24h、72h、120h3个组.对照组:测定室温条件下的肺表面活性物质及顺应性.冷藏组:肺离体后立即置于含有地塞米松台式液中冷藏,在相应时间取出肺,室温条件下复温后,置入生理盐水中,测定肺表面活性物质,并测定注气(生理盐水)和抽气(生理盐水)过程中,肺容积在10ml、20ml、30ml时的肺顺应性.结果:冷藏24h组注水、抽水;72h组肺容积在10ml、20ml抽气、冷藏120h组在肺容积为10ml、20ml抽气的肺顺应性同对照组比较,差异无显著性(P>0.05).其余各组、项与对照组比较差异具有显著性(P<0.05),伴有表面活性物质的减少.结论:地塞米松冷藏离体肺顺应性增大,其影响程度随冷藏时间的延长而增加,同时伴有肺表面活性物质的减少.     

实验冻伤大鼠神经纤维的超微结构改变

为探讨冷冻损伤发生、发展及转归的规律，采用健康Ｗｉｓｔａｒ大鼠，分为冻伤组（２０只）和对照组（５只）。电镜下观察大鼠后肢冷冻至－２０℃后即刻、４小时、２４小时及７２小时时周围神经的超微结构改变。冻后即刻，神经髓鞘即出现轻度变性；冻后１～２４小时，有髓神经雪旺细胞及轴突严重变性，而无髓神经变性较轻；冻后７２小时，神经溃变及修复并存，无髓神经较有髓神经易于修复。     

The cold pressor test: Vascular and myocardial response patterns and their stability

The purposes of the present study were to compare the cardiovascular response patterns evoked by three versions of the cold pressor test (either forehead stimulation or hand or foot immersion) and to determine the reproducibility of the responses over a 2-week interval. Blood pressure, heart rate, stroke volume, cardiac output, total peripheral resistance, and systolic time intervals were obtained during rest and during the cold pressor test in 42 young men. Across conditions, the pressor response was supported by peripheral resistance increases with concomitant stroke volume decreases. Although the response panerns were generally similar across sites, exceptions were apparent for heart rate. Forehead stimulation was characterized by no significant change in heart rate, whereas limb (hand or foot) immersion was associated with significant heart rate acceleration. The responses elicited by the three cold pressor test conditions were reliable and showed little evidence of attenuation over the test-retest interval.     

自身免疫性溶血性贫血20例临床分析

本文报道温抗体型自身免疫性溶血性贫血20例,其中包括特殊类型“兼有冷抗体和温抗体的自身免疫性溶血性贫血”3例,伴有血小板减少性紫瘢的Fisher—Evans综合征4例。并对本病致病因素、发病年龄、临床表现及特殊类型产生机理进行了讨论。     

Thermal responses of men and women during cold-water immersion: influence of exercise intensity

Summary The influence of exercise intensity on thermoregulation was studied in 8 men and 8 women volunteers during three levels of arm-leg exercise (level I: 700 ml oxygen (O₂) · min^–1; level II: 1250 ml O₂ · min^–1; level III: 1700 ml O₂ · min^–1 for 1 h in water at 20 and 28°C (T _w). For the men inT _w 28°C the rectal temperature (T _re) fell 0.79°C (P<0.05) during immersion in both rest and level-I exercise. With level-II exercise a drop inT _re of 0.54° C (P < 0.05) was noted, while at level-III exerciseT _re did not change from the pre-immersion value. AtT _w of 20°C,T _re fell throughout immersion with no significant difference in finalT _re observed between rest and any exercise level. For the women at rest atT _w 28°C,T _re fell 0.80°C (P<0.05) below the pre-immersion value. With the two more intense levels of exercise,T _re did not decrease during immersion. InT _w 20°C, the women maintained higherT _re (P<0.05) during level-II and level-III exercise compared to rest and exercise at level I. The_{T re} responses were related to changes in tissue insulation (I _t) between rest and exercise with the largest reductions inI _t noted between rest and level-I exercise acrossT _w and gender. For men and women of similar percentage body fat, decreases inT _re were greater for the women at rest and level-I exercise inT _w 20°C (P< 0.05). With more intense exercise, the women maintained a higherT _re than the men, especially in the colder water. These findings indicate that exercise is not always effective in offsetting the decrease inI _t and facilitated heat loss in cool or cold water compared to rest. The factors of exercise intensity,T _W, body fat, and gender influence the thermoregulatory responses.     

Physiological responses and manual performance in humans following repeated exposure to severe cold at night

We evaluated human physiological responses and the performance of manual tasks during exposure to severe cold (–25°C) at night (0300–0500 hours) and in the afternoon (1500–1700 hours). Thirteen male students wearing standard cold protective clothing occupied a severely cold room (–25°C) for 20 min, and were then transferred to a cool room (10°C) for 20 min. This pattern of exposure was repeated three times, for a total time of exposure to extreme cold of 60 min. The experiments were started either at 1500 hours or 0300 hours and measurements of rectal temperature, skin temperature, blood pressure, performance in a counting task, hand tremor, and subjective responses were made in each condition. At the end of the experiment at night the mean decrease in rectal temperature [0.68 (SEM 0.04)°C] was significantly greater than that at the end of the experiment in the afternoon [0.55 (SEM 0.08)°C, P<0.01]. After the second cold exposure at night the mean increase in diastolic blood pressure [90 (SEM 2.0) mmHg] was significantly greater than that at the end of the second cold exposure in the afternoon [82 (SEM 2.8) mmHg, P<0.01]. At the end of the second cold exposure at night, mean finger skin temperature [11.8 (SEM 0.8)°C] was significantly higher than that at the comparable time in the afternoon [9.0 (SEM 0.7)°C, P<0.01]. Similarly for the toe, mean skin temperature at the start of the second cold exposure at night [25.6 (SEM 1.5)°C] was significantly higher than in the afternoon [20.1 (SEM 0.8)°C, P<0.01]. The increased skin temperatures in the periphery resulted in increased heat loss. Since peripheral skin temperatures were highest at night, the subjects noted diminished sensations of thermal cold and pain at that time. Manual dexterity at the end of the first cold exposure at night [mean 83.7 (SEM 3.6) times·min^–1] had decreased significantly more than at the end of the first cold exposure in the afternoon [mean 89.4 (SEM 3.5) times·min^–1, P<0.01]. These findings of a lowered rectal temperature and diminished manual dexterity suggest that there is an increased risk of both hypothermia and accidents for those who work at night. Electronic Publication     

Reversal of cold induced haemoconcentration

Summary Classically, cold induced plasma volume reduction is explained by an increased diuresis which is generated by an inhibition of antidiuretic hormone release. However, most of the haemoconcentration appears to be reversible during rewarming. This observation weakens the former statement. The aim of this study was to clarify the mechanisms involved in the reversal of the cold induced haemoconcentration. Six young males, resting in a dorsal reclining position, were exposed successively to a thermoneutral environment (30 min), a cold environment (1° C; cold) or thermoneutrality (control) for 120 min, and during a 60-min recovery period in thermoneutral conditions. During cold stress, a reduction of 15% (i.e. 510 ml) of the plasma volume was observed, and osmolality was unchanged. After the 60-min recovery under thermoneutral conditions, plasma volume variation between the Cold and the Control experiments was reduced and reached 3% (i.e. 100 ml). This volume equalled the increased amount of urine production observed during the cold stress experiment. Haemoconcentration cannot be explained by increased urinary water loss (± 100 ml) alone. Therefore a transient shift of plasma water from vascular to interstitial spaces, due to an increase of blood pressure, could be involved in the reduction of plasma volume.     

Hand and finger skin temperatures in convective and contact cold exposure

The present study aimed at investigating the spatial variability of skin temperature (T _sk) measured at various points on the hand during convective and cold contact exposure. A group of 8 subjects participated in a study of convective cooling of the hand (60 min) and 20 subjects to contact cooling of the finger pad (5 min). Experiments were carried out in a small climatic chamber into which the hand was inserted. For convective cold exposure,T _sk was measured at seven points on the palmar surface of the fingers of the left hand, one on the palmar surface and one on the dorsal surface of the hand. The air temperature inside the mini-chamber was 0, 4, 10 and 16°C. With the contact cold exposure, the subjects touched at constant pressures an aluminium cube cooled to temperatures of –7, 0 and 7°C in the same mini-chamber. ContactT _sk was measured on the finger pad of the index finger of the left hand. TheT _sk of the proximal phalanx of the index finger (on both palm and back sides), and of the middle phalanx of the little finger was also measured. The variation ofT _sk between the proximal and the distal phalanx of the index finger was between 1.5 to 10°C during the convective cold exposure to an air temperature of 0°C. Considerable gradients persisted between the hand and fingers (from 2 to 17°C at 0°C air temperature) and between the phalanges of the finger (from 0.5 to 11.4°C at 0°C air temperature). The onset of cold induced vasodilatation (CIVD) on different fingers varied from about 5 to 15 min and it did not always appear in every finger. For contact cold exposure, whenT _sk on the contact skin cooled down to nearly 0°C, the temperature at the area close to the contact skin could still be 30°C. Some cases of CIVD were observed in the contact skin area, but not on other measuring points of the same finger. These results indicated that local thermal stimuli were the main determinents of CIVD. Representative hand skin temperature may require five or more measuring points. Our results strongly emphasised a need to consider the large spatial and individual variations in the prediction and modelling of extremity cooling.     

Change in sympathetic activity,cardiovascular functions and plasma hormone concentrations due to cold water immersion in men

The purpose of this study was to determine whether or not repeated short-term cold water immersions can induce a change in the activity of the sympathetic nervous system and, consequently, in cardiovascular functions in healthy young athletes. Changes in some plasma hormone concentrations were also followed. A single cold water immersion (head-out, at 14°C, for 1 h) increased sympathetic nervous system activity, as evidenced by a four-fold increase (P < 0.05) in plasma noradrenaline concentration. Plasma adrenaline and dopamine concentrations were not increased significantly. Plasma renin-angiotensin activity was reduced by half (P < 0.05) during immersion but plasma aldosterone concentration was unchanged. Stimulation of the sympathetic nervous system during immersion did not induce significant changes in heart rate, but induced peripheral vasoconstriction (as judged from a decrease in skin temperature) and a small increase (by 10%) in systolic and diastolic blood pressures. No clear change in reactivity of the sympathetic nervous system was observed due to repeated cold water immersions (three times a week, for 6 weeks). Neither the plasma renin-angiotensin activity, aldosterone concentration nor cardiovascular parameters were significantly influenced by repeated cold water immersions. A lowered diastolic pressure and an increase in peripheral vasoconstriction were observed after cold acclimation, however. Evidently, the repeated cold stimuli were not sufficient to induce significant adaptational changes in sympathetic activity and hormone production.