早期肠道营养对严重烧伤大鼠枯否细胞活化状态的影响

目的 了解早期肠道营养对枯否细胞（ＫＣ）的调理作用。方法 ３０％Ⅲ度烧伤大鼠９０只随机分为早期喂养组，延迟喂养组，另设正常对照组１５只。于伤前及伤后１，３，５天观察三否细胞分泌ＴＮＦ，ＰＧＥ２的变化及ＫＣ吞噬胶体颗粒数量的变化。结果 延迟喂养组较早期喂养组ＫＣ分泌ＴＮＦ，ＰＧＥ２及吞噬胶体颗粒量均明显增加。结论 早期肠道营养可下的调理ＫＣ的过度激活，减少其释放活性介质，对严重烧伤后由于炎症反应失控     

烧伤早期肠道喂(营)养的几个问题

提出了早期肠道喂养与营养的含义、共同点及不同点。烧伤早期肠道喂（营养）可维护肠道结构、功能、降低伤后高代谢。早期肠道喂（营养）的机制至少有三；（１）减轻肠道损伤，改善胃肠道血流，减轻缺血再灌注损伤；（２）减少肠道内毒素移位，调理枯否细胞活化；（３）降低体内介质、激素水平。     

严重烧伤病人合并脓毒症时能量消耗的变化

对比研究了５６例烧伤脓毒症和非脓毒症病人能量消耗规律及可能机制。发现２２例烧伤脓毒症病人其烧伤总面积为（６８．７±１６．４）％、Ⅲ度面积为（２９．０±１８．６）％,较３４例烧伤非脓毒症病人其烧伤总面积为（５１．２±１４．８）％、Ⅲ度面积为（２４．５±１３．７）％者,能量消耗大（Ｐ＜０．０５）;脓毒症组病人静息能量消耗（ＲＥＥ）在整个观察期间也明显高于非脓毒症组,并且脓毒症病人在脓毒症期间ＲＥＥ较发生脓毒症前后高２０％～２５％（Ｐ＜０．０５）,脓毒症组病人血浆ＩＬ－６、ＩＬ－８、ＴＮＦ、ＬＰＳ水平明显高于非脓毒症组。表明引起脓毒症的主要影响因素是烧伤总面积和Ⅲ度烧伤面积,脓毒症的发生进一步加重了烧伤后高代谢反应,其原因可能与多种炎症介质的过度释放有关。     

肾综合征出血热患者血清及尿液中TNF与SIL－2R的动态研究

采用双抗体夹心ＥＬＩＳＡ法，对３０例肾综合征出血热（ＨＦＲＳ）患者９６份血清及９６份尿液中肿瘤坏死因子（ＴＮＦ）及可溶性白细胞介素２受体（ＳＩＬ－２Ｒ）水平进行了动态检测。结果显示：ＨＦＲＳ患者各期尿液及血清ＴＮＦ与ＳＩＬ－２Ｒ水平均高于正常对照组（Ｐ＜０．０１），且与临床病程密切相关，尿液与血清变化水平有密切的正相关性（γ＝０．５７５２，Ｐ＜０．００１；γ＝０．５４２７，Ｐ＜０．０１），尿液中含量与尿蛋白含量呈正相关（γ＝０．３４２５，Ｐ＜０．０１；γ＝０．４４８５，Ｐ＜０．０１），血、尿中ＴＮＦ与血、尿中ＳＩＬ－２Ｒ的变化呈正相关（γ＝０．６４２５，Ｐ＜０．０１，γ＝０．６５９６，Ｐ＜０．０１）。提示：ＴＮＦ及ＳＩＬ－２Ｒ是参与ＨＦＲＳ发病机理的重要介质。     

肠源性内毒素在烧伤后诱导肝损伤的作用

目的：探讨烧伤后肠源性内毒素在肝损伤中的作用．方法：大鼠３０％Ⅲ度烧伤，采用免疫组化染色检测肿瘤坏死因子（ＴＮＦ）蛋白在肝组织中的表达及细胞定位，并观察门静脉血浆内毒素、肝组织白细胞介素－８（ＩＬ－８），丙二醛（ＭＤＡ）及腔静脉血清丙氨酸转氨酶（ＡＬＴ）、乳酸脱氢酶（ＬＤＨ）含量变化的关系．结果：烧伤后ＴＮＦ蛋白表达阳性细胞数迅速增加，其动态变化与门静脉血浆内毒素的变化极为相似．烧伤后腔静脉血清中ＡＬＴ、ＬＤＨ及肝组织中ＩＬ－８、ＭＤＡ水平亦显著升高．结论：肠源性内毒素是导致烧伤早期肝损伤的主要致病因素之一；这种损伤效应是由其刺激单核吞噬细胞系统产生的多种细胞因子介导的；中性粒细胞可能也参与了肝损伤过程     

烧伤大鼠血清在内毒素诱导肝细胞损伤中的作用

目的 探讨烧伤务血清中是否存在内毒素致敏物质及其在内毒素诱导肝细胞损伤中的作用。方法 以Ｗｉｓｔａｒ大鼠为对象,采用二步灌注法分离肝细胞及枯否细胞,分别与内毒素和烧伤血清培养后,观察培养上清中乳酸脱氢酶（ＬＤＨ）及肿瘤坏死因子（ＴＮＦ）的变化。     

延迟复苏对烫伤大鼠心肝肾氧自由基生成的影响及维生素E和维生素C治疗效果评价

采用３６只肠内含５种细菌悉生的大鼠，分成伤前对照组（Ⅰ组）、早期复苏组（Ⅱ组）、延迟复苏组（Ⅲ组）和治疗组（Ⅳ组），观察了伤后８ｈ和１ｄ心、肝、肾氧自由基（ＯＦＲ）相对量（ＥＳＲ技术）及丙二醛（ＭＤＡ）含量变化。结果发现，Ⅱ、Ⅲ组大鼠心、肝、肾ＯＦＲ相对含量均增高，Ⅲ组升高更明显，各时间点较Ⅱ组均有显著差异（Ｐ＜０．０１），尤以肾脏升高最明显。Ⅳ组各脏器ＯＦＲ相对含量低于Ⅲ组（Ｐ＜０．０１）。各脏器ＭＤＡ含量与ＯＦＲ相对含量变化规律基本一致。该结果表明，延迟复苏增加烧伤后早期脏器ＯＦＲ生成，导致脂质过氧化反应加重，ＯＦＲ对肾脏的影响可能重于其它脏器。维生素Ｅ、维生素Ｃ联合治疗可有效清除脏器中ＯＦＲ，可用于延迟复苏后脏器功能保护。     

内毒素对培养人脐静脉内皮细胞的损伤作用

目的研究内毒素对内皮细胞的直接损伤作用，以便对烧伤早期入血的内毒素对血管内皮细胞的影响作出初步评价。方法以培养的原代人脐静脉内皮细胞（ＨＵＶＥＣ）为模型，加入不同浓度内毒素，观察在不同时相点培养液中乳酸脱氢酶（ＬＤＨ）活性变化，前列腺环素（ＰＧＩ２）代谢产物６－酮－前列环素Ｆ１ａ（６－酮－ＰＧＦ１ａ）含量和内皮细胞中的Ｆ－肌动蛋白丝（Ｆ－ａｃｔｉｎ）含量与细胞形态学变化。结果ＬＤＨ活性在内毒素达到０．４μｇ／ｍｌ并作用１２小时后才有显著升高（Ｐ＜０．０５），而６－酮－ＰＧＦ１ａ含量在各组内毒素损伤中变化均不显著。内皮细胞中Ｆ－ａｃｔｉｎ含量在各组中均有明显下降（Ｐ＜０．０１），但程度略有不同，细胞形态也有相应变化。结论内毒素直接损伤血管内皮细胞（ＶＥＣ）须较大浓度（＞０．４μｇ／ｍｌ），但在较低浓度下（０．１μｇ／ｍｌ）可直接引起内皮细胞的一些形态学变化和Ｆ－ａｃｔｉｎ含量的变化，初步推测血管内皮细胞可能存在着与通常认识的内毒素—内毒素结合蛋白—ＣＤ１４途径激活细胞不同的分子机制     

早期肠道喂养对烧伤对肝功能的保护及其作用机制

为研究早期肠道喂养（ＥＥＦ）对恶性烧伤大鼠肝功能的保护及其作用机制，采用Ｗ ｉｓｔａｒ大鼠３０％体表烫伤模型，动态观察了ＥＥＦ对伤后胃粘膜内ｐＨ（ｐＨｉ），门脉静内毒素水平，肝组织含水量，血浆肿瘤坏死因子（ＴＮＦ－α）、丙氨酸转氨酶（ＡＴＬ）、天冬氨酸转氨酶（ＡＳＴ）活性，总胆红素（ＴＢ）、直接胆红素（ＤＢ）含量，汉及血浆总蛋白、白蛋白浓度变化的影响。结果显示，与烧伤对照组相比，ＥＥＦ对严重烧伤大     

MEBO对家兔内毒素血症血液粘度和TNF—α的影响

目的：检测ＭＥＢＯ对家兔内毒素血症血液粘度和ＴＮＦ－α的影响。方法：利用ＬＢＹ－Ｎ６型血液粘度计测定在１１５ｓ＾－１和１０ｓ＾－１切变率下的血液粘度。采用ＥＬＩＳＡ双抗体夹心法检测ＴＮＦ－α水平。结果：试验组注射内毒素前后血液粘度相比Ｐ〉０．０５。对照组注射内毒素前后血液粘度相比Ｐ〈０．０１。内毒素血症ＴＮＦ－α水平试验组与对照组相比Ｐ〈０．０５。结论：ＭＥＢＯ可改善内毒素血症血液粘度,可降低内毒素血症ＴＮＦ－α水平。     

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.