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。     

成纤维细胞生长因子21抗动脉粥样硬化的研究进展

成纤维细胞生长因子21(fibroblast growth factor 21,FGF21)是一种多效应的内分泌因子,主要在肝脏和脂肪组织中分泌,具有降脂、抗炎、抗氧化和抗动脉粥样硬化作用。近年来发现,FGF21在心血管疾病中能够诱导保护作用,心血管疾病患者血浆中FGF21水平升高,可作为亚临床动脉粥样硬化的生物标志物,可作为动脉粥样硬化性心血管疾病的治疗靶点。故本文将对FGF21抗动脉粥样硬化作用的最新进展进行综述。     

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.     

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.     

综合医院急诊科应对群体性伤害紧急医疗救援

综合医院急诊科开展群体性伤害的紧急医疗救援，建立一支训练有素的队伍应从建立突发事件应急救援指导小组、培养急诊医护人员基本技能、制定应对群发伤预隶、掌握4个阶段重点等方面进行，循序渐进规范急诊质量体系。     

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.     

三氧化钙无机聚合物或氢氧化钙直接盖髓对因龋露髓恒牙活髓保存疗效的Meta分析

目的采用Meta分析比较因龋露髓恒牙使用三氧化钙无机聚合物(mineral trioxide aggregate,MTA)或氢氧化钙(calcium hydroxide,CH)进行直接盖髓以保存活髓的临床疗效。方法计算机检索Pubmed、Embase、中文生物医学文献数据库、中国期刊全文数据库、维普数据库、万方数据库,筛选国内外有关采用MTA或CH进行直接盖髓的龋坏恒牙活髓保存的临床研究,检索范围为建库至2015年7月15日。在严格筛选资料和质量评价的基础上,采用Rev Man5.3软件对纳入的研究结果进行Meta分析。结果共纳入9篇临床对照试验研究。Meta分析结果显示:使用MTA或CH直接盖髓治疗因龋露髓恒牙的疗效数据具有同质性,采用固定效应模型分析。MTA优于CH,差异有统计学意义(OR合并=3.65,95%CI=2.54~5.26,P<0.000 01)。结论使用MTA直接盖髓治疗因龋露髓恒牙的活髓保存效果良好,与CH比较,更适合作为直接盖髓材料。但由于本研究中部分文献的质量不高,纳入文献相对较少,上述结论还需要更多高质量,大样本的临床对照试验进一步验证。