模拟氦氧饱和潜水实验中监测潜水员尿量及尿电解质的作用

目的 探讨模拟2.6 MPa氦氧饱和潜水暴露时潜水员尿量及尿电解质变化对潜水员健康干预的监护作用.方法 7名健康男性潜水员参加模拟250 m氦氧饱和潜水,在暴露前、中、后每日取晨尿和24h尿检测尿常规、尿量、尿电解质、肌酐及N-乙酰-β-D-氨基葡萄糖苷酶(NAG)排泄量.结果参试潜水员尿常规在高压暴露过程中没有明显变化;尿量在暴露于2.0 MPa以上压力时略有增高,但无统计学意义(P＞0.05):尿Na+、K+、Cl-、Ca2+、Mg2+、NAG酶在高压下排泄减少(P＜0.05),尤以钙减少明显且持续时间长,但在减压后1周基本恢复至正常水平.结论 模拟2.6 MPa氦氧饱和潜水暴露过程中潜水员尿量和尿电解质排泄存在波动,检测尿量和尿电解质排泄量可为舱内潜水员的健康干预提供参考依据.     

不同剂量右美托咪定对全麻患者尿量和电解质的影响

目的比较不同剂量的右美托咪定(dexmedetomidine,DEX)对全麻病人尿量和体内主要电解质的影响。方法择期颌面外科整形患者60例(ASAⅠ级),随机分为5组(n=12):生理盐水对照组(C组),DEX 0.2、0.5、0.8、1.1μg/kg 4组(D1～4组)。术中监测尿量和血浆中Na+、K+、Ca2+浓度,比较各时段数据差异。结果与C组相比,D1组尿量无明显变化(P>0.05),D2～4组明显增多(P<0.05),而D3与D4组相比无明显差异(P>0.05),且各组中上述离子浓度无明显变化(P>0.05)。结论 DEX具有利尿作用,并呈剂量相关性,大剂量(0.8μg/kg)具有封顶效应,且对Na+、K+、Ca2+浓度无明显影响。     

腹水超滤浓缩腹腔回输治疗肝硬化顽固性腹水临床观察

目的探讨腹水超滤浓缩腹腔回输治疗肝硬化顽固性腹水的疗效。方法使用腹水超滤浓缩回输系统对68例顽固性腹水患者进行超滤浓缩腹腔回输,同时加上保肝、利尿、维持水电解质平衡、限钠限水等措施进行治疗,观察腹水消退情况。结果 治疗后患者临床症状明显减轻,尿量增加,血中白蛋白及总蛋白浓度明显增加,同时BUN、K+、Na+、Cl-无明显变化,而腹水中电解质浓度变化不明显。结论 腹水超滤浓缩腹腔回输治疗肝硬化顽固性腹水方法简单易行,安全可靠,经济实用,适合临床广泛应用。     

东莨菪碱防治家兔急性肾功能衰竭的实验研究

本组使用60只家兔,实验观察东莨菪碱对甘油致家兔ARF的防治作用。在实验中做四项检查:(1)肾血流量,(2)血浆A_Ⅱ含量;(3)FE-(Na)、RFI;(4)病理检查。其结果表明,当甘油致家兔ARF在严重缺血时期,东莨菪碱却有解除血管痉挛,改善微循环,增加肾血流量的作用。同时预防组血浆A_Ⅱ含量明显比对照组减少,故认为该药可能抑制A_Ⅱ的产生。通过FE_(Na)、RFI的测定显示该药对肾小管钠重吸收有保护作用。从病理形态上亦可证实用药后肾浊肿明显减轻。     

模拟高强度军事训练对大鼠肾组织Na+,K+-ATP酶活性的影响

目的:探讨模拟高强度军事训练对大鼠肾组织Na+,K+-ATP酶活性的影响.方法:①一次性力竭运动:大鼠随机分对照组(A组)、一次性力竭运动组(B组).B组模拟军事训练行一次性力竭跑台运动,检测运动结束即刻(B1组)及24h后(B2组)尿液指标及肾组织Na+,K+-ATP酶活性.②递增负荷跑台运动:大鼠随机分对照组(C组)、递增负荷跑台运动组(D组).D组模拟军事训练行递增负荷跑台运动,检测4周末(C1组、D1组)和8周末(C2组、D2组)尿液指标及肾组织Na+,K+-ATP酶活性.结果:①一次性力竭运动结束即刻,B1组尿蛋白、尿N-乙酰-β-D-葡萄糖苷酶(NAG酶)较A组显著升高(P＜0.05),肾组织Na+,K+-ATP酶活性显著降低(P＜0.05),24h后有所恢复但仍低于A组(P＜0.05).②递增负荷跑台运动4周末D1组尿蛋白、尿NAG酶、肾组织Na+,K+-ATP酶活性均较C1组显著升高(P＜0.05);8周末D2组尿蛋白、尿NAG酶较C2组显著升高,肾组织Na+,K+-ATP酶活性显著降低(P＜0.05),且与尿NAG酶排泄呈负相关.结论:模拟高强度军事训练可引起大鼠肾组织Na+,K+-ATP酶活性的不同改变.     

川芎预防急性肾功能衰竭的实验研究及临床应用

通过甘油致急性肾功能衰竭的家兔模型,对川芎及其成份川芎嗪、阿魏酸及挥发油预防急性肾衰的作用研究表明,川芎能增加肾血流量、具有肾髓质扩血管性前列腺素样作用;其有效成份存在于挥发油中。临床上7例严重创伤用药结果:尿量正常的5例肾功维持良好、恢复顺利。少尿的2例,其中1例尿量未增加,死于多器官功能衰竭;另1例尿量增加,肾功恢复,后死于肺部感染。     

植入微囊化hANP cDNA转染细胞治疗大鼠高血压的观察

目的 研究植入微囊化的人类心房肽(hANP)cDNA转染细胞对高血压大鼠的治疗效果,为临床应用基因工程细胞治疗高血压提供新方法。方法 将转染有hANP cDNA的CHO细胞包被在具有免疫隔离作用的聚己内酯(PCL)管内形成微囊化基因转染细胞,其后移植至二肾一夹(2KlC)高血压大鼠腹腔内,检测微囊植入对高血压大鼠的血压及多项生理生化指标的影响,并用放射免疫分析法(RlA)检测血浆hANP水平,用免疫组化结合图像分析法半定量检测肾脏心房肽A型受体(NPR-A)的表达。结果 微囊化的hANP cDNA转染细胞移植10d后,血浆hANP水平显著升高;移植30d后高血压大鼠的血压明显降低,而尿量、尿钠排出量(USO)和尿cGMP明显增加;移植45d后肾小球滤过率(GFR)和肾血流量(RBF)明显增加,同时高血压大鼠肾脏NPR-A的表达下调被抑制。结论 植入的微囊化hANP cDNA转染细胞能产生和向囊外排出hANP,引起明显的利尿利钠和降血压效应;本研究结果为高血压的心房肽基因治疗提供了新途径。     

体外反搏治疗冠心病前后血浆心钠素水平临床分析

血浆心钠素为心脏分泌的一种多肽激素,以右心耳含量最高。其利尿机制为:(1)增加肾小球滤过率;(2)增加肾血流量,影响逆流倍增机制;(3)使乳头部集合管钠重吸收降低;(4)抑制血管加压素的释放。体外反搏提高肾动脉灌注压,增加回心血量。提高右心房压力,使心房牵张力上升,中心静脉压增高,均可刺激心房肌细胞分泌和释放心钠素。本组病人体外反搏前血浆心钠素水平平均为2.8ng/ml,反搏后为3.4ng/ml,有显著统计学差异(t<2.703 P<0.05)。病人在体外反搏治疗后表现尿量增多,心功能明显改善。     

高张盐在严重烧伤延迟复苏中的应用研究

 目的 通过回顾性研究探讨高张盐在烧伤延迟复苏中的作用. 方法 选取31例病例,分为平衡盐复苏组及高张盐复苏组;观察第1个24 h及第2个24 h的补液量、尿量、Na+、K+和Cl+的变化; 结果第1个24 h高张盐组的补液量和尿量,分别为1.52±0.15 ml/(kg·1% TBSA)和0.94±0.12 ml/(kg·1% TBSA),平衡盐组的补液量和尿量分别为1.74±0.26 ml/(kg·1% TBSA)和1.24±0.30 ml/(kg·1% TBSA),差异有统计学意义(P<0.05);第2个24 h高张盐组的的补液量和尿量分别为1.21±0.14 ml/(kg·1% TBSA)和1.18±0.15 ml/(kg·1% TBSA),平衡盐组的补液量和尿量分别为1.47±0.21 ml/(kg·1% TBSA)和1.40±0.30 ml/(kg·1% TBSA),差异有统计学意义(P<0.05);K+、Na+、Cl+在治疗前、伤后24 h及48 h的变化,在两组间的差异无统计学意义(P>0.05).结论 高张盐复苏可以在补液量相对少的情况下,取得和平衡盐复苏相似的效果,具有明显临床应用价值.     

异搏停防治急性肾功能衰竭的实验研究

实验观察了在家兔甘油性急性肾功能衰竭时异搏停对肾脏功能及血流的影响。结果表明,异搏停能增加尿量和肌酐清除率,降低血尿素氮,具有防治急性肾功能衰竭的作用。其机理与增加肾血流量、改善肾皮质缺血区域的血液循环等因素有关。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.