地塞米松对脑损伤大鼠核转录因子-κB水平的影响

Objective To explore the effects of dexamethasone on nuclear factor-kB (NF-κB) expression in brain tissue after traumatic brain injury (TBI). Methods Forty rats were randomly divided into two groups: dexamethasone treatment and no treatment, and severe brain injury was produced by gas percussion in both groups. At 0, 6, 24, 72 and 120 hours after injury, 5 rats of each group were executed and the histopathological changes in brain tissue in rats were observed by hematoxylin-eosin (HE) stain. The expression of NF-κB in brain tissue of rats was detected by immunohistochemical method. Results NF-κB expression was significantly up-regulated at 6 hours in brain tissue of rats after TBI (P<0.05), reaching the highest level at 24 hours (P<0. 01). It showed a tendency to lower, but was still high at 120 hours after TBI (P<0. 05 or P<0. 01). After treatment with dexamethasone, NF-κB level was lowered at 6, 24 and 72 hours (all P<0. 01). Conclusion NF-κB expression is up-regulated in brain tissue in early period after TBI, and keeps on a high level, thus inducing inflammatory response to produce secondary injury to brain tissue. Dexamethasone shows protective effects by regulating the levels of NF-κB and prevents secondary injury which is caused by the inflammatory cytokines in rat brain tissue after TBI.     

急性百草枯中毒严重程度的早期评估及预后

急性百草枯中毒(APP)死亡率高,可引起多器官功能障碍甚至衰竭,临床治疗方案常采用多项措施联合的集束化治疗。故在患者就诊早期即对APP严重程度进行评估,能够为临床治疗方法的选择提供指导,对启动不同级别的治疗措施和预后改善都具有重要的临床价值。本文就早期评估APP严重程度及预后的研究进展做一述评。     

糖尿病大鼠模型的下肢肌肉血流灌注特点研究

目的研究糖尿病大鼠模型下肢肌肉组织的血流灌注特点。方法将70只雄性SD大鼠分为两组。采用链脲菌素腹腔注射法制备大鼠糖尿病动物模型,建模成功后饲养4周。使用PHILIPS Brilliance64 CT扫描机,利用JOG技术对两组进行全身灌注扫描。结果实验组45只,其中39只建模成功,33只成功获得灌注数据,血流量（BF）：（6.08±1.87）ml/100g/min;血容量（BV）：（4.67±1.50）ml/100 g;对照组25只,其中22只成功获得灌注数据,血流量：（4.00±0.95）ml/100g/min;血容量：（4.71±1.06）ml/100g。结论糖尿病大鼠模型的下肢肌肉血流量大于对照组,两组血容量未发现差异。     

反向结膜瓣缝合术在后节玻璃体切割术中的应用

经巩膜睫状体平坦部的封闭式玻璃体切割术已经广泛地应用于眼科临床,对于治疗某些眼科疾病有不可替代的作用[1].     

中国脓毒症/脓毒性休克急诊治疗指南(2018)

正脓毒症和脓毒性休克是急危重症医学面临的重要临床问题,全球每年脓毒症患病人数超过1 900万,其中有600万患者死亡,病死率超过1/4,存活的患者中约有300万人存在认知功能障碍[1-3]。早期识别与恰当处理可改善脓毒症患者的预后。近年来,国内外对脓毒症领域的研究不断深入,临床实践及证据不断增加,2016年美国重症医学会(SCCM)与欧洲重症医学会(ESICM)联合发布脓毒症3.0定义及诊断标准,新定义的出现及临床证据的积累都会对临床决策产生重要影响。为了更好地指导     

危重地震伤员院前转运要点

自2008年以来中国已经发生了三次严重的地震伤亡事件,每次大批量的地震伤员被分拣以后,短期内就需转运到当地医院进行救治。但常因危重伤员较多和当地医疗资源的匮乏,大量的危重伤员需要立刻从地震现场转运到后方医院治疗。由于其生理功能的紊乱及途中医疗条件的限制,会造成转途中存在着较大的风险。虽然目前国际上有较多关于危重病人转运的研究和指南,但主要是针对一般危重病人的院际及院间转运。