糖尿病并发无痛性心肌梗死3例报告

本院内科近1年收治糖尿病并发无痛性心肌梗死患者3例，1例死亡，2例治愈，现报告如下。     

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.     

氟中毒状态下大鼠晶体的形态学改变

为了解氟中毒状态下实验动物的晶体形态学改变，以75或100mg／L的氟化钠溶液造成Wistar鼠的氟中毒，并以正常饮水的大鼠作为对照组。在供毒后1、2、4、6个月以裂隙灯显微镜进行晶体的形态学观察。结果：80．1%(23／28)的氟中毒大鼠晶体出现了程度不同的前囊下、皮质、核的混浊，而对照组仅有10.5%(2／19)的晶体出现了皮质及核的混浊，但无前囊下混浊，且程度较轻。两组差异具有非常显意义(P<0．01)。结论：实验性氟中毒可造成晶体形态学改变。     

面向21世纪的我军野战外科

未来在２１世纪发生的战争可能是在核、化学、生物武器威摄下，使用高技术常规武器的局部战争，我军野战外科如何适应由打赢一场一般技术在常规战争转向高技术局部战争，这一课题已严峻地摆在我们军事医学工作者面前。本文试图分析高技术常规武器的特点，并在回顾越南，中东十月、海湾等战争的伤情特点的基础上，讨论面向２１世纪的我军野战外科的新课题。     

医用粘合剂用于眼内异物定位

眼内异物的X线定位法已有近一个世纪的历史,因其定位较为准确可靠,而且不受眼的屈光介质浑浊的影响,所以一直在临床上广泛应用,并在实践中不断发展.现在临床上仍多采用Norman于1915年所设计的角膜缘环形标记定位法,最简便的方法是角膜缘缝线的方法,将一金属环固定于角膜缘作为标记来进行定位.为了增加应用的便利、减少病人的痛苦,我们试用了医用粘合剂粘合固定定位环的方法来诊断眼内异物,获得了理想的效果,现介绍如下:     

浅谈创伤弹道学的理论及应用

创伤弹道学是研究投射物(弹丸、破片)击中机体的致伤效应和致伤原理的科学,熟悉创伤弹道学的基础知识,有助于外科医生在处理火器伤时,正确判定投射物的种类,损伤类型和范围,确定切实可行的治疗方案。本文介绍创伤弹道学的基础知识,并结合肌组织投射物伤的典型伤例进行讨论。     

海马内部血管构筑—硷性磷酸酶显示法

本文用硷性磷酸酶示内皮法，对１５例ＳＤ系大鼠海马内部的微血管构筑在光镜下进行了观察，结果显示大鼠海马内部各区各层的血管分布与其神经组织构筑有明显的对应关系，即从血管的排列可辨认海马内部各层，ＣＡ１区锥体层血管密度最低，而其腔隙分子层血管密度最高，辐状层血管相互平行排列且与海马裂垂直。在ＣＡ２及ＣＡ３区交界处有恒定的小动脉及其分支出现，ＣＡ１与ＣＡ２区移行处锥体层硷性磷酸酶反应可明显差异，此外还观察     

早产儿的喂养方法及护理

由于早产儿的发育不完善，其生命力低下，是新生儿期死亡的主要原因之一。本组就如何进行早产儿的喂养及护理进而减少早产儿的死亡率浅析如下：