医用冰毯用于中枢性高热患者的临床观察

医用冰毯用于２１例中枢性高热患者，应用４ｈ后体温平均降至３７℃，降温幅度最大为４．３℃，最小为０．１℃，平均降温１．５℃。２１例患者治疗前后体温经配对ｔ检验，有显著性差异（Ｐ＜０．００１）。     

海水浸泡对枪弹伤合并失血性休克大鼠血流动力学的影响及机制探讨

目的　研究海水浸泡对枪弹伤合并失血性休克大鼠血流动力学、心肌细胞线粒体功能及一些生化指标的影响 ,探讨海水浸泡对心肌功能的影响及可能的机制。方法　健康Wistar雄性大鼠 2 0只 ,右侧大腿肌肉丰满处应用射钉枪造成贯通伤 ,包扎伤口。右侧颈总动脉插管至左心室 ,接四道生理记录仪 ,记录心肌力学的改变。左侧股动脉快速放血使血压降至 50mmHg(1mmHg =0 .1 33kPa) ,维持低血压 1h后 ,随机分为 2组 :海水浸泡组和陆地对照组 ,测定海水浸泡 5h大鼠平均动脉压 (MAP)、心率 (HR)、左室内压最大变化速率 (±dp·dt- 1 ·max- 1 )、左室收缩压 (LVSP)、心肌细胞线粒体呼吸功能、膜流动性 ,心肌组织Na+ -K+ -ATP酶活性、丙二醛 (MDA)含量及血浆乳酸脱氢酶 (LDH)。结果　海水浸泡 5h ,枪弹伤合并失血性休克大鼠MAP、HR、±dp·dt- 1 ·max- 1 、LVSP显著低于陆地对照组 ,心肌细胞线粒体呼吸控制率 (RCR)显著下降 ,膜脂区微黏度显著升高 ,心肌组织Na+ -K+ -ATP酶活性显著下降 ,心肌MDA含量和血浆LDH活力显著升高。结论　海水浸泡可以严重影响枪弹伤合并失血性休克大鼠血流动力学状态 ,加重其心肌的损伤     

重型颅脑损伤患者早期冰敷的效果观察

目的 探讨早期冰敷对重型颅脑损伤患者的效果观察. 方法 回顾性分析2005-04～2007-03未常规使用冰敷治疗的重型颅脑损伤患者50例和2007-04～2009-03常规使用冰敷治疗的重型颅脑损伤患者50例,对两组患者生命体征、高温持续时间、平均昏迷时间、病死率进行比较. 结果 两组患者在生命体征、高温持续时间、平均昏迷时间、病死率方面有明显差异. 结论 早期冰敷降温治疗重型颅脑损伤患者疗效确切,明显降低病死率,对提高患者生存率及生活质量有重要的意义.     

南海官兵驻岛礁细菌分布及抗菌药物敏感性研究

目的了解我国南海驻岛官兵所生活岛礁的细菌种类、分布情况,以及细菌对抗菌药物的敏感性。方法无菌采集上岛1个月后人体皮肤、生活用品、厨房餐具、驻礁地表面和岛上空气样本,经增菌培养、细菌分离,进行细菌学鉴定和药敏试验。结果 120份样本分离出细菌27种124株;其中弧菌科细菌73株（58.9%）,肠杆菌科细菌27株（21.8%）,非发酵菌11株（8.9%）,革兰阳性球菌6株（4.8%）,厌氧菌2株（1.6%）。药敏结果显示,73株致病性弧菌对亚胺培南/西司他丁、头孢哌酮、阿莫西林/克拉维酸的敏感率为96.2%、88.5%、87.1%,对其它10种抗菌素的敏感率为85.9%～61.5%;27株肠杆菌对亚胺培南/西司他丁、头孢他啶、阿莫西林/克拉维酸的敏感率为92.6%、74.1%、74.1%,对其它10种抗菌素的敏感率为63.0%～40.7%;11株非发酵菌对亚胺培南/西司他丁、阿莫西林/克拉维酸、头孢他啶的敏感率为81.8%、72.7%、63.6%,对其它10种抗菌素的敏感率为54.6%～27.3%;革兰阳性菌对万古霉素、替考拉林、阿米卡星的敏感率为96.8%、93.5%、83.4%,对其它7种抗菌素的敏感率为50.5%～18.7%。结论南海某岛礁细菌分布以孤菌为主,但也进入大量陆地细菌,抗菌素敏感性与近海海水和陆地有所不同,为驻岛礁官兵细菌感染的防治提供了依据。     

叶瓜参多糖活性成分的研究

目的对叶瓜参中的多糖进行分析。方法应用现代提取分离方法和化学及光谱鉴定技术对多糖成分进行分离鉴定。结果从叶瓜参中分离鉴定了CFG-1、CFG-2和CFG-3等3种多糖成分。结论 CFG-1由木糖、3-甲氧基葡萄糖和葡萄糖组成,其摩尔数比=2︰1︰1;CFG-2由木糖、喹纳糖、3-甲氧基葡萄糖和葡萄糖组成,其摩尔数比=2︰1︰1︰1;CFG-3由喹纳糖和葡萄糖组成,其摩尔数比=1︰1。叶瓜参多糖CFG-2的PTP1B酶活性抑制试验显示,对PTP1B酶具有显著的抑制活性。     

Immunolocalization of corticotropin-releasing factor (CRF) and corticotropin-releasing factor receptor 2 (CRF-R2) in the developing gut of the sea bass (Dicentrarchus labrax L.)

Our previous data indicated an important role for adrenocorticotropic (ACTH)-like molecules co-operating with macrophages to control the modifications in body homeostasis during the first period of the life of sea bass (up to 30 days post-hatching) before the lymphoid cells have reached complete maturation. The aim of the study was to determine the immunolocalization of corticotropin-releasing factor (CRF), which is a very important mediator of stress-related responses. Our data showed that immunostaining for CRF is localized already at 8 days after hatching in nerve fibers of the gastrointestinal tract wall from the pharynx to the anterior gut, when the larvae are still feeding on yolk. This pattern of immunolocalization appeared similar to that in 24-day-old larvae, but at this stage there were also large cells immunopositive to CRF located in the wall of the midgut and hindgut. Lipopolysaccharide (LPS) treatment, which is a known stimulator of stress hormone responses, did not modify the CRF immunostaining pattern, though it did affect the immunolocalization of the peripheral CRF receptor, i.e. CRF-R2. Immunolocalization of CRF-R2 appeared in nerve fibers of the gut wall in larvae fixed 1 h after the end of lipopolysaccharide (LPS) treatment. The present results suggest that CRF plays important autocrine and/or paracrine roles in the early immune responses at the gut level in the larval stages of sea bass (Dicentrarchus labrax L.) as already proposed for ACTH. Moreover, our studies taken together with other research on fish, in comparison with mammals, suggest a phylogenetically old role of CRF in immune-endocrine interactions.     

冰灾时期大批患者入院的护理管理

目的 总结冰灾时期大批患者入院的护理管理经验,为护理管理者今后更好地应对紧急状况提供参考.方法 在2008年1月22日至2月2日停电、停水11 d期间,启动突发事件应急预案,迅速妥善合理安置患者,完善护理风险评估、制订护理风险预案,加强护理工作各环节安全质量管理及监控,加强新组建病区的规范化管理,合理调配护理人力资源等.结果 接诊门诊患者25 254例次,收治入院患者1 212例;新生儿科收治患儿785例;产科接受产妇234例,平安接生婴儿222名;骨科收治485例;手术室做急诊手术196例;ICU抢救危重患者107例."120"出车1 151次,接回患者944例.患者均得到了妥善安置和及时救治,未发生医疗护理差错事故及纠纷;无1例院内跌倒损伤发生.结论 科学、高效、规范、有序的管理是本次有效应对灾害的重要保障.如能启动全国医护人员志愚者项目,将会更有效地缓解紧急状况下医护人员极度缺乏的问题.     

The sea urchin embryo, an invertebrate model for mammalian developmental neurotoxicity, reveals multiple neurotransmitter mechanisms for effects of chlorpyrifos: therapeutic interventions and a comparison with the monoamine depleter, reserpine

Lower organisms show promise for the screening of neurotoxicants that might target mammalian brain development. Sea urchins use neurotransmitters as embryonic growth regulatory signals, so that adverse effects on neural substrates for mammalian brain development can be studied in this simple organism. We compared the effects of the organophosphate insecticide, chlorpyrifos in sea urchin embryos with those of the monoamine depleter, reserpine, so as to investigate multiple neurotransmitter mechanisms involved in developmental toxicity and to evaluate different therapeutic interventions corresponding to each neurotransmitter system. Whereas reserpine interfered with all stages of embryonic development, the effects of chlorpyrifos did not emerge until the mid-blastula stage. After that point, the effects of the two agents were similar. Treatment with membrane permeable analogs of the monoamine neurotransmitters, serotonin and dopamine, prevented the adverse effects of either chlorpyrifos or reserpine, despite the fact that chlorpyrifos works simultaneously through actions on acetylcholine, monoamines and other neurotransmitter pathways. This suggests that different neurotransmitters, converging on the same downstream signaling events, could work together or in parallel to offset the developmental disruption caused by exposure to disparate agents. We tested this hypothesis by evaluating membrane permeable analogs of acetylcholine and cannabinoids, both of which proved effective against chlorpyrifos- or reserpine-induced teratogenesis. Invertebrate test systems can provide both a screening procedure for mammalian neuroteratogenesis and may uncover novel mechanisms underlying developmental vulnerability as well as possible therapeutic approaches to prevent teratogenesis.