兔肢体爆炸伤合并海水浸泡后在不同复温速率及维持浅低体温下机体炎症反应的特征

Objective To investigate effects of different rewarming rates and maintenance of light hypothermia on inflammatory response in rabbits after limb blast injury, coupled with seawater immersion. Methods First, the model of limb blast injury coupled with seawater immersion was reproduced [the animals were immersed to low body temperature of (31.0±0.5℃)]. Then, 24 adult rabbits were randomly divided into group Ⅰ [the rapid rewarming group, n=6, rewarmed to (38±0.5)℃ at a rate of (8.94±0.93)℃/h], group Ⅱ [the slow rewarming group, n=6, rewarmed to (38±0.5)℃ at a rate of (3.88±0.22)℃/h], group Ⅲ [another slow rewarming group, n=6, rewarmed to (38±0.5)℃ at a rate of (2.18±0.12)℃/h], and the H group [the hypothermia group, n =6, rewarmed to (34 - 35)℃ at a rate of (4.49±0.66)℃/h and kept at that temperature till termination of the experiment]. Regulation of ambient temperature and warm transfusion were used to restore body temperature to target levels and maintained there for 6 hours. Blood samples were taken at 5 different times, I.e. Pre-injury time(T0), post-immersion time (T1), the time when rewarming started (T2), 3 h after rewarming (T3), and 6 h after rewarming (T4). Tissue samples from heart, liver, intestinum, lung and kidney were also collected. Levels of TNF-α (tumor necrosis factor-α), IL-1β (interleukin-1β) and IL-6 (interleukin-6) in plasma and MPO (myeloperoxidase) in homogenate were detected. Results Following rewarming, TNF-α, IL-1β, IL-6 concentrations in the plasma of the animals in group Ⅰ and group H were significantly higher when compared with those of the animals in group Ⅱ and group Ⅲ (P<0.05, P<0.01), and MPO activity in homogenate was significantly higher when compared with that of the animals in group Ⅱ and group Ⅲ(P<0.01, P<0.05), and no statistical difference could be seen between group Ⅱ and Ⅲ (P>0.05). Conclusions Rapid rewarming and maintenance of light hypothermia could obviously elevate TNF-α, IL-1β, IL-6 concentrations in plasma and MPO activity in homogenate, following limb blast injury coupled with hypothermia induced by seawater immersion, while slow rewarming (with a rewarming rate of 2-4℃/h) could significantly inhibit TNF-α, IL-1β, IL-6 levels and PMN activity.     

宫颈妊娠1例报告

宫颈妊娠是罕见的异位妊娠,现报告1例如下。患者,27岁,停经14周,因下腹阵发性隐痛,并触及包块,不觉胎动来院就诊。经B超探查提示为中期妊娠,活胎、宫颈口内见胎盘。因要求引产,于1986年1月15日住院。1984年曾作人工流产一次,1985年2月曾孕足月剖宫产,现存一女婴。查宫底达耻骨上4横指,胎位不清,胎心140次/分。入院后曾     

吃药您喝足水了吗

张大爷患有多种慢性病，经常需要服用药物进行治疗，有时，他图省事，将药片放在口中后，不喝水或仅喝一口水，用力一咽，算是服完了药。其实，这种服药方式是不可取的。     

多发性骨髓瘤患者化疗后医院感染病原菌分布及危险因素分析

目的 探讨多发性骨髓瘤(MM)患者化疗后医院感染病原菌种类及其危险因素,以降低感染率。方法 回顾性分析2010年3月-2013年3月80例多发性骨髓瘤患者临床资料,分析感染部位、感染病原菌种类以及化疗后感染影响因素。结果 80例患者中有21例化疗后发生感染,感染率为26.25%;其中感染部位主要是消化系统占42.85%,其次呼吸道、泌尿系统,分别占23.81%、19.05%;共分离出病原菌23株,其中革兰阳性菌5株占21.73%,革兰阴性菌16株占69.57%,革兰阳性菌中以金黄色葡萄球菌为主占13.03%,革兰阴性菌中以大肠埃希菌为主占26.09%;多因素分析显示,BMI高(β=3.085,OR=21.854)、Dukes分期高(β=3.189,OR=24.247)、合并有糖尿病(β=2.671,OR=25.221)是MM患者化疗后感染的影响因素。结论 多发性骨髓瘤患者化疗后容易导致各种病原菌感染,临床上需要加强患者的风险评估,对于合并有糖尿病、临床症状严重以及肥胖的患者应采取有效的预防和控制感染手段。     

维甲酸联合三氧化二砷治疗初发APL的临床疗效观察

目的:探讨全反式维甲酸(ATRA)和三氧化二砷(As2O3)治疗初发急性早幼粒细胞白血病(APL)的疗效和不良反应。方法:对16例初治病人给予ATRA联合As2O3以诱导缓解,完全缓解(CR)后用DA(D:柔红霉素,A:阿糖胞苷)、HA(H:高三尖杉酯碱,A:阿糖胞苷)和中剂量Ara-C(阿糖胞苷)方案巩固化疗,维持治疗方案用ATRA、MTX(甲氨蝶呤)和As2O3依次序贯治疗。结果:16例患者均获CR,其中15例目前仍保持CR状态,持续CR的时间8～46个月,l例因为皮肤浸润复发而死亡。结论:ATRA联合As2O3诱导缓解治疗APL以及维持治疗阶段以ATRA、As2O3、MTX序贯治疗,不良反应无显著增加,不仅能提高CR率,缩短达到CR的时间,并可降低复发率,有助于延长APL患者的持续缓解时间及无病生存时间。     

2-乙氧基乙醇对小鼠睾丸毒性作用的病理学研究

2-乙氧基乙醇（2－Ethoxyethanol，EE）属亚乙基二醇烷化酯类，工业上用于合成感光液、生产SP版等。高星等曾对SP版生产线男工进行调查，发现接触EE越多，其精子数量下降越多，并且精子存活率下降、平均精子畸形率上升。本实验观察染毒小鼠睾丸的病理形态学变化，探讨其形态与功能影响的关系。1材料和方法使用北京化工厂生产的EE。取健康昆明种雄性小白鼠40只，体重18～22g。实验动物分为高（485mg·kg-1）、中（243mg·kg-1）、低（12mg·kg-1）3个不同浓度的染毒组及生理盐水阴性对照组。每天腹腔注射1次，连续5天。30天后将小鼠处死…     

猝死50例临床病理分析

心源性猝死38例占本组76.0％,冠心病为其半数。非心源性猝死以急性出血性坏死性胰腺炎居多共8例,其中1例合并左室前壁急性心肌梗塞、1例合并左侧脑室扩张出血。尸检证明冠状动脉多支受累,粥样硬化明显,无论是否伴有严重管腔狭窄均可突发室颤而猝死。冠心病猝死不等于有心肌梗塞,20例冠心病死者中有5例尸检未证实有心梗。     

活体枢椎齿突三维重建模型与干骨标本解剖学研究

目的 探讨活体枢椎齿突三维重建模型与干骨标本解剖学差异. 方法 利用活体头颈部CT连续扫描数据,建立枢椎齿突三维重建模型,将其参数测量结果与干骨标本对应参数测量结果进行统计学分析.结果 枢椎齿突三维重建模型与干骨标本的枢椎总高度、齿突高度、齿突基底部的左右径、齿突基底部的前后径的统计学分析均无差异. 结论 活体枢椎齿突三维重建模型可以替代干骨标本进行解剖学研究.     

寰枢椎固定技术的研究进展

早在1910年,Mister和Osgund就尝试外科固定器从背部途径固定C1和C2,当时是用粗金属线将C1和C2的棘突固定在一起[1].