无国界医生在救援中备灾的重要性

无国界医生致力于应对天灾和战祸所引起的人道医疗危机。灾后实时爆发的人道医疗危机包括急性的外科创伤问题和基础医疗系统的破坏导致疫症发生。本文介绍了无国界医生的救援经验以及专业的备灾体系。     

银杏叶提取物对白介素-1β损伤关节软骨细胞一氧化氮体系的影响

目的:观察银杏叶提取物对白介素-1β损伤的关节软骨细胞的作用及对细胞内一氧化氮体系的影响。方法:在无菌环境下消化得到3月龄雌性新西兰白兔膝关节软骨细胞,实验用细胞为第2代软骨细胞。软骨细胞与IL-1β(5μg/L)、IL-1β(5μg/L)+地塞米松(10-7、10-6、10-5mmol/L)、IL-1β(5μg/L)+银杏叶提取物(40mg、80mg、160mg/L)共同孵育,分别在72h后MTT法检测软骨细胞的增殖受到的影响;24h后测定受损伤软骨细胞培养液中的NOi、NOS,逆转录扩增(RT-PCR)检测iNOSmRNA。结果:MTT法显示IL-1β对软骨细胞的增殖有明显的抑制作用;地塞米松同银杏叶提取物均有对抗IL-1β的效应;地塞米松和EGb均能显著减少iNOSmRNAi、NOS、NO的生成(P<0.01);EGb761的这种效应有剂量依赖性。结论:银杏叶提取物通过抑制软骨细胞内的NO生成以保护IL-1β损伤的膝关节软骨细胞。     

左旋布比卡因复合舒芬太尼或芬太尼在分娩硬膜外自控镇痛的应用

目的探讨左旋布比卡因复合舒芬太尼硬膜外自控镇痛（PCEA）用于分娩镇痛的临床效果及安全性。方法随机选择120例美国标准协会（ASA）I-Ⅱ级初产妇，随机分为舒芬太尼组（A组）、芬太尼组（B组）、无镇痛组（C组），每组40例。A组和B组采用PCEA，C组不给予镇痛药物。观察各组不同时段视觉模拟评分（VAS）和不良反应的发生，同时记录3组产程时间、分娩方式、缩宫使用情况、产后出血量、新生儿Apgar评分。结果A、B2组和C组在PCEA20、60min及宫口开全时VAS差异有统计学意义（P〈0.05）；PCEA5min，A、B2组VAS差异有统计学意义（P〈0.05），2组Bromage评分、不良反应差异无统计学意义（P〉0.05）。3组产程时间、分娩方式、产后出血量、新生儿Apgar评分比较差异均无统计学意义（P〉0.05）。结论左旋布比卡因复合舒芬太尼或芬太尼用于分娩镇痛安全有效，对母婴无明显不良影响。     

复方蜥蜴散对慢性萎缩性胃炎模型大鼠血清NO及iNOS水平影响的实验研究

目的:观察复方蜥蜴散对慢性萎缩性胃炎(Chronic atrophic gastritis,CAG)模型大鼠血清NO及iNOS水平的影响,探讨其治疗CAG的作用机制。方法:采取55℃热盐水、2%水杨酸、20mmol/L脱氧胆酸钠三个致萎缩因素配合饥饱失常造成CAG模型。将实验动物分为正常对照组,模型对照组,维酶素组,复方蜥蜴散高、中、低剂量组。检测大鼠血液中NO和iNOS水平及观察胃黏膜组织学方面的改变。结果:模型组大鼠NO和iNOS水平明显高于正常组(P<0.01),病理组织学上也有较大改变,而经复方蜥蜴散治疗1个月后,NO和iNOS水平恢复正常,胃黏膜病理组织学改善明显。结论:复方蜥蜴散可以逆转萎缩胃黏膜的病理改变,发挥保护胃黏膜的作用。     

Critical trust: understanding lay perceptions of health and safety risk regulation

The binary opposition of trusting or not trusting is inadequate to understand the often ambiguous and contradictory ideas people possess about risk regulators, particularly when knowledge and experience of such institutions is limited. The paper reports qualitative and quantitative data from a major study of public perceptions (n?=?30 focus groups) of UK risk regulators. We compare the complex and widely different ‘trust profiles’ of two regulatory organisations which are institutionally related (the Health and Safety Executive and the Railways Inspectorate) but very separate in the minds of our participants. The paper develops the notion of critical trust to interrogate the various ways in which people make sense of such organisations, as well as discussing the modes of reasoning that people deploy. The paper argues that views of participants are the outcome of a reconciliation of diverse perceptions concerning the role of the organisation, structural factors and the nature of the regulated risk.     

关于护理院校日语教学的探讨

在护理专业院校教学中以护理专业知识为重点，如何遵循教学宗旨，培养个性化人才，使日话教学从普通的公共学科中脱颖而出，是护理院校日语教师教学工作的重中之重。     

CT scan and threshold vibrometry in the diagnosis of spinocerebellar degenerations

45 patients with spinocerebellar degeneration (SCD) underwent through quantitative investigation of the ventricular and cisternal systems by CT scanning and threshold vibrometry in the limbs to find out whether these parameters could be used for distinguishing mainly spinal from cerebellar forms or from olivopontoce-rebellar atrophy. The increase in the vibration sense threshold and the mild atrophy in the posterior cranial fossa proved typical of spinal forms and the reverse for cerebellar forms. In olivopontocerebellar atrophy enlargement of the cisterns and dilatation of the ventricles always exceeded 85% of normal values.

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Sommario 45 pazienti affetti da degenerazione spinocerebellare (SCD) sono stati sottoposti ad uno studio approfondito di esplorazione quantitativa del sistema ventricolare e cisternale alla TAC e della soglia di percezione vibratoria agli arti per valutare la possibilità di distinguere con questi parametri le forme prevalentemente spinali da quelle cerebellari o delle atrofie olivopontocerebellari. L'aumento della soglia vibratoria e la modesta atrofia in fossa posteriore è risultata tipica delle forme spinali, mentre l'inverso si verifica per le forme cerebellari. Nelle atrofie olivopontocerebellari l'allargamento delle cisterne e la dilatazione dei ventricoli supera quasi sempre l'85% rispetto ai casi normali.

     

血液与非血液灌流行缺血预处理鼠心的电生理实验研究

本实验研究血液与非血液灌流条件下缺血预处理（ＩＰ）对心肌的保护作用。应用离体大鼠Ｌａｎｇｅｎｄｏｒｆ灌流模型，分血液灌流ＩＰ组、非血液（ＫｒｅｂｓＨｅｎｓｅｌｅｉｔ液，ＫＨ液）灌流ＩＰ组及相应的对照组。测量心肌电生理特性等指标。结果与ＫＨ液灌流心脏相似，用血液灌流的大鼠心脏经ＩＰ后，在随后的停灌和复灌期间，心室颤动阈升高，心律失常发生率明显降低。实验结论为在用血液灌流离体大鼠心脏模型上，ＩＰ对心肌的保护作用与用生理溶液灌流的模型基本相同。     

5-羟色胺对大鼠脊髓P物质痛觉调制的影响(英文)

比较SP,5-HT与For诱发的脊髓内c-fos表达的异同,以及它们之间的相互关系,从而进一步了解SP在脊髓痛觉调制中的主要作用.方法:用免疫组织化学法和痛阈测定法.结果:发现大鼠it P物质(sP)10μg和sc5％甲醛(For)150μL诱发的脊髓c-fos表达主要在背角Ⅰ,Ⅱ,Ⅴ及Ⅵ层,同时SP使痛阈降低,For使痛级均数(PIR)升高.5-HT it 20μg引起的c-fos表达较多地分布于背角Ⅲ—Ⅳ层,并可使痛阈升高.5-HT和Fen可分别减弱和增加SP及For诱发的脊髓c-fos表达及痛反应.结论:SP在脊髓内可能主要起致痛作用,5-HT可抑制SP引起的脊髓c-fos表达,从而参与SP的痛觉调制作用.     

Carbon dioxide recruitment threshold as a predictor of successful weaning in chronic obstructive pulmonary disease patients: A pilot study

Abstract Several methods have been used to predict successful weaning and extubation among chronic obstructive pulmonary disease (COPD) patients. The objective of this study is to determine whether carbon dioxide recruitment threshold (PCO₂RT) can be used as adjunct to conventional weaning parameters to predict early weaning and successful extubation. Twelve COPD patients who were ready to be extubated based on conventional weaning parameters were divided into group A ( n = 7) and group B ( n = 5). Group A were those patients with better weaning parameters and hence a higher probability of successful extubation as compared to group B. Carbon dioxide apnoeic threshold (PCO₂AT) was obtained by hyperventilating the patient using an increment of two breaths per min until apnoea occurs. At this point, the PCO₂AT or the PaCO₂ during said apnoeic period was recorded. A dead space of 150 cc is then added to the circuit until the patient starts to breathe as evidenced by the sensitivity trigger indicator. The PCO₂ obtained at this period is termed PCO₂RT. After weaning for 30 min on a T-tube, another arterial blood gas is determined and this is called the PCO₂SB or the CO₂ level after 30 min on spontaneous breathing. If the PCO₂SB-PCO₂RT difference is high with a sensitivity of 85.71% and specificity of 100% vs sensitivity of 57.14% and specificity of 60% using the conventional weaning parameters. Thus an increase in PCO₂SB at 30 min T-tube is indicative of impending respiratory pump failure and that other causes of failure to wean must be investigated.