车祸致颅脑损伤患者家属心理健康状况与社会支持相关性研究

目的 了解车祸致颅脑损伤患者家属的心理健康状况和社会支持状况,探讨其相关性。方法 采用自编一般资料调查表、症状自评量表（SCL - 90）和社会支持量表（SSRS）,对225名到精神专科医院就诊的车祸致颅脑损伤患者家属进行问卷调查。结果 车祸致颅脑损伤患家属的SCL - 90总分为（178.45±82.56）分, SCL - 90总分、阳性项目数和9个因子分均显著高于肿瘤患者家属和全国常模(P＜0.05)。社会支持总分为（38.52±8.23）分,社会支持水平与家属的心理健康状况呈显著的负相关（r = - 0.416, P＜0.05）。多元线性回归分析显示,社会支持总分可以负向预测家属的心理健康状况（β = - 0.399,P＜0.05）。结论 车祸致颅脑损伤患者家属的心理问题发生率较高,应从个人、家庭和社会层面为家属提供社会支持资源。     

观察脊柱脊髓损伤不同时间段手术的术后神经功能恢复情况

目的对脊髓损伤患者不同时间段尽早急诊手术的术后神经功能康复情况进行观察。方法选取35例脊柱脊髓损伤并进行创伤外科急诊手术治疗患者的临床资料,进行统计并分析比较其不同时间段进行手术,术后的神经功能康复情况。结果 35例患者术后神经功能恢复均较术前明显好转,8小时手术的患者神经功能康复较8小时的患者好,越早进行手术的患者神经功能康复越好,所有患者术后的脊髓功能ASIA评分(针刺觉评分、轻触觉评分、运动评分)均较术前提高,且时间越早手术的术后ASIA评分提高值就越高,与术前、不同时间段之间比较P0.05,差异具有统计学意义。结论对于脊髓损伤的患者需加快其院外及院内的抢救,以最大限度降低患者的损伤,提高其术后神经功能康复力。     

颅脑外伤后局部脑组织中P物质和生长抑素的表达及意义

本文旨在分子水平探讨人脑外伤后神经肽的变化,为脑外伤后病理生理变化机制提供理论依据。采用免疫组织化学技术和多功能真彩色病理图像分析系统(CMIAS)对31例脑外伤患者局部脑损伤区和12例无脑损伤猝死患者相同脑区神经细胞中P物质(SP),生长抑素(SS)的表达进行了检测。结果得出脑伤患者局部伤区及周围神经细胞中SP、SS表达较尸检对照组明显减少并具时程特点。但与伤情及预后无显著关系。本实验表明SP、SS在颅脑损伤的病理生理过程中起了重要作用。     

脊髓全横断损伤后凋亡因子Fas和FasL的表达变化

本研究通过制备SD大鼠脊髓全横断性损伤模型,应用免疫组织化学ABC法和灰度值测定揭示促凋亡因子Fas和FasL在脊髓完全性损伤后,不同时间点之间的相互变化趋势,以探讨Fas和FasL在脊髓损伤中的作用。结果显示:正常和脊髓全横断损伤后的不同时间组SD大鼠脊髓灰质的前角神经元中均可观察到Fas和FasL的免疫阳性产物。与正常组比较,Fas、FasL阳性神经元细胞数在术后1、3、7、14d组均升高(P<0.05),21d组则降低(P<0.05)。前角Fas、FasL阳性神经元的灰度值在术后1、3、7d组较正常组降低(P<0.05),14、21d组无显著性差异(P>0.05)。结果提示大鼠脊髓全横断损伤后,在损伤节段尾侧脊髓前角神经元Fas与FasL的表达经历了由增高到降低的过程,Fas和FasL表达增加有诱导神经细胞凋亡的趋势,可能参与诱导了脊髓继发性损伤。     

提高脊柱骨折水平复位力量对Harrington分离棒应力分布的影响——二维光弹性实验研究

使用Edwards套棒可提高Harrington装置对脊柱骨折的解剖复位率,但同时使Harrington棒各点应力值呈线性增加,尤以套棒所在点受影响最大,然而总体应力分布趋势不变,棒体——齿棘区交界处应力集中为棒的危险断面,棒前侧应力值高于后侧;齿棘部高于棒体部。实验结果提示,临床应用Ebwards套捧时应注意将其安置在尽量远离危险断面处,并使危险断面尽量靠近上钩,以减少在交变应力作用下应力集中造成的Harrington棒疲劳断裂。     

Edwards装置中套棒位置对Harrington分离棒应力分布影响的研究

Edwards套棒装置可显著提高胸腰椎骨折复位率,但套棒的不同位置对Harrington棒的应力分布有明显影响。利用光弹性实验技术在实验载荷下可直观地观测到Harrington棒模型各部的应力情况。当套棒位于Harrington棒的齿棘区,光滑区交界处时,齿棘区应力集中最为严重,平均应力值分别高于套棒在Harrington棒工作长度内中点及远端1/4点时的23.9％,32.9％(棒前侧点)及31.3％、43.6％(棒后侧点)(P<0.01)。无论套棒位置如何。Harrington棒前侧点的应力值均高于棒后侧相应点(P<0.01)。实验结果提示使用Edwards装置时应尽量使套棒远离齿棘区,或选用齿棘区短的Harrington棒以减少应力集中造成的Harrington棒疲劳断裂。     

脑创伤对大鼠学习记忆功能的影响

目的：观察ＴＢＩ后大鼠主动性条件回避反应（ＡＣＡＲ———穿梭箱实验，ｓｈｕｔｌｅｂｏｘｔｅｓｔ）及被动性条件回避反应（ＰＣＡＲ———步入与步下实验，ｓｔｅｐｔｈｒｏｕｇｈａｎｄｓｔｅｐｄｏｗｎｔｅｓｔ）的变化。方法：用２０ｇ重物从不同高度垂直坠落至大鼠一侧暴露的硬脑膜复制脑创伤（ＴＢＩ）模型。结果：重度ＴＢＩ后大鼠ＡＣＡＲ的习得率和保持率均出现下降，ＰＣＡＲ的步入和步下潜伏期缩短；轻度ＴＢＩ后仅表现出ＡＣＡＲ的习得率降低。结论：ＴＢＩ易导致脑高级功能障碍，其受损程度与原发伤情有关。     

Mannose prevents lipopolysaccharide-induced acute lung injury in rats

Objective: To investigate the effect of mannose on lipopolysaccharide (LPS) induced acute lung injury (ALI) in rats. Methods: Ten groups of Sprague–Dawley rats were used: 1) the control group received an intratracheal instillation of saline, 2) the LPS group received an intratracheal instillation of LPS (3 mg/kg), 3–6) the mannose groups were injected i.v. with 15, 45, 135, and 405 mg/kg mannose, 7–9) the glucose, galactose, and fructose groups were injected with different hexoses (135 mg/kg), and 10) the dexamethasone (DXM) group was injected with DXM (2 mg/kg). In groups 2–8, LPS was administered after injection of drugs. Lung wet/dry weight ratio, permeability index (PPI), total leukocytes and polymorphonuclear neutrophils (PMNs) counts in bronchoalveolar lavage fluid (BALF), myeloperoxidase (MPO) and superoxide dismutase (SOD) activity, tumor necrosis factor (TNF)-α and interleukin (IL)-10 in lung and BALF were determined. Results: Pre-treatment with mannose attenuated pulmonary edema and protein exudation in a dose-dependent manner, the maximal effect was similar to or greater than that of DXM. Mannose also prevented the inflammatory cell accumulation, although the maximal effect was weaker than that of DXM. Mannose was more effective than DXM in inhibiting MPO activity and restoring SOD activity. Moreover, it inhibited production of TNF-α and IL-10. Histological changes of the lungs were also ameliorated by mannose. There were no significant improvements observed in rats pre-treated with glucose, galactose or fructose. Conclusions: Mannose is effective in reducing LPS-induced ALI. Project supported by the National Natural Science Foundation of China, No. 30670930 and the Science and Technology Department of Zhejiang Province (No.2004C23011) Received 4 March 2007; returned for revision 13 May 2007; returned for final revision 17 July 2007; accepted by M. Katori 12 September 2007     

牛磺酸对大鼠心脏模拟缺血再灌注损伤的保护作用

在离体大鼠心脏模拟缺血再灌注(I/R)损伤的模型上观察了牛磺酸的心肌保护作用。实验结果发现预先给大鼠牛磺酸灌胃(300mg/kg)三日或再灌注同时给药(20mmol/L),对心肌均有保护作用,明显减少心肌细胞内的Mb、LDH的漏出,降低心肌MDA的生成,减轻细胞内钙的聚集,促进心肌ATP含量的恢复。在本实验条件下预防应用牛磺酸较再灌注的同时应用更为有效,表现为更大程度地减少LDH漏出,抑制心肌MDA生成和钙聚集。结果证明牛磺酸具有心肌保护作用,对于防治心肌I/R损伤可能具有临床应用价值。     

Design Characteristics for the Tissue Engineering of Cartilaginous Tissues

Tissues like the temporomandibular joint (TMJ) disc and the knee meniscus are often mistakenly viewed as a tantamount to hyaline cartilage, largely due to the absence of a comprehensive understanding of the distinguishing properties of cartilaginous tissues. Because of this confusion, fibrocartilaginous tissue engineering attempts may not be based on suitable experimental designs. Fibrocartilaginous tissues are markedly different than hyaline cartilage; however, the dearth of knowledge related to their cellular and biochemical composition, as well as their biomechanical characteristics, is stunning. Hyaline articular cartilage is exclusively composed of chondrocytes that produce primarily type II collagen, whereas the TMJ disc and the knee meniscus have a mixed cell population of fibroblasts and cells similar to chondrocytes, which predominantly secrete type I collagen. Additionally, fibrocartilaginous tissues have a low glycosaminoglycan content, a low compressive modulus, and a high tensile modulus when compared to hyaline cartilage. Therefore, it is crucial for fibrocartilaginous tissue engineering attempts to be tissue-specific, utilizing the knowledge of the distinct and unique properties of these tissues. At the same time, advances and insights related to the science and engineering aspect of hyaline cartilage regeneration must be carefully considered for the in vitro engineering of fibrocartilaginous tissues.