21天头低位(-6°)卧床前后下体负压和头高位倾斜暴露时的心血管反应

目的探讨２１天头低位（ＨＤＴ）卧床对人体立位应激下心血管反应的影响,以及比较下体负压（ＬＢＮＰ）和头高位倾斜（ＨＵＴ）两种立位应激下心血管反应的差异。方法６名受试者在２１天ＨＤＴ前、后分别进行ＬＢＮＰ（－４．００ｋＰａ／３ｍｉｎ、－６．６７ｋＰａ／３ｍｉｎ及－９．３３ｋＰａ／３ｍｉｎ）和ＨＵＴ试验（３０°／３ｍｉｎ、４５°／３ｍｉｎ、６０°／３ｍｉｎ及７５°／３ｍｉｎ）,以比较两种检测方法的血压（ＢＰ）和心率（ＨＲ）的变化情况。结果与ＬＢＮＰ（或ＨＵＴ）前相比：①ＬＢＮＰ（ＨＵＴ）时ＨＲ显著增加（Ｐ＜０．０１）,ＳＢＰ显著降低（Ｐ＜０．０５）;卧床后相应的变化量增加。②ＬＢＮＰ时ＤＢＰ降低（卧床后达显著,Ｐ＜０．０５）;而ＨＵＴ时ＤＢＰ增加（卧床后达显著,Ｐ＜０．０５）。③ＬＢＮＰ时ＭＡＰ均显著降低（Ｐ＜０．０５）;而ＨＵＴ时在卧床前无变化（Ｐ＞０．０５）,在卧床后显著增加（Ｐ＜０．０５）。结论ＬＢＮＰ和ＨＵＴ引起的ＣＶＳ反应并不相同。笔者认为,ＨＵＴ更能促进心血管系统对立位应激的调节作用。     

预测下体负压耐力方法初探

为探讨预测下体负压耐力的方法，对１１名被试者进行了－４．００ｋＰａ，－５．３３ｋＰａ，－６．６７ｋＰａ各５ｍｉｎ的阶梯式坐位下体负压耐力检查，以晕厥前症状或持续１５ｍｉｎ为终止指征。检查结果将被试者分为耐力良好组（Ａ组，ｎ＝５）和耐力不良组（Ｂ组，ｎ＝６）；组间比较时发现负压作用第１１ｍｉｎ时的ＭＡＰ、△ＳｒＯ２和△ＣＯ（％）判别显著（Ｐ〈０．０５）；用这一时刻的ＭＡＰ和△ＳｒＯ２建立的回归方程对     

下体负压晕厥前症状下事件相关电位变化特征

目的探讨下体负压晕厥前症状（ＰＳＳ）下事件相关电位（ＥＲＰｓ）的Ｐ３潜时（Ｐ３Ｌ）变化特征，为飞行员加速度性晕厥的医学鉴定提供实验方法和依据。方法用下体负压方法（ＬＢＮＰ）诱发ＰＳＳ，观察ＥＲＰｓ的Ｐ３Ｌ变化特征。结果出现ＰＳＳ时，ＥＲＰｓ的Ｐ３Ｌ由３４３．３５±１４．７２ｍｓ延长至５０６．８７±３７．４４ｍｓ（Ｆ（６，４８）＝１４．９６，Ｐ＜０．０５，ＯＺ电极），相关任务反应时（ＲＴ）由５０８．６５±１１．１３ｍｓ延长至６３１．２５±２９．１６ｍｓ（ｔ＝２．９７，Ｐ＜０．０５），靶刺激反应错误率由（４．００±１．６７）％增加至（４３．３８±３．５４）％（ｔ＝３．０６，Ｐ＜０．０５）。ＰＳＳ后第５ｍｉｎ，Ｐ３Ｌ仍明显高于基线值（Ｐ＜０．０５）。而ＲＴ、错误率与基线值已无显著差异（Ｐ＞０．０５）。结论ＥＲＰｓ的Ｐ３Ｌ结合ＲＴ、错误率等指标对飞行员加速度性晕厥的研究有潜在应用价值。     

反复下体负压致脑缺血对大鼠脑组织离子含量、ATP酶活性及神经元形态的影响

为阐明多次发生＋Ｇｚ致意识丧失对脑的影响及其机制，观察了反复下体负压（ＬＢＮＰ）致脑缺血对大鼠脑组织离子含量、ＡＴＰ酶活性及神经元形态的影响。雄性ＳＤ大鼠３０只，随机分为３组。将动物麻醉后置于－４．０ｋＰａ的下体负压舱内（下降速率为０．６７ｋＰａ／ｓ），至脑电波消失２ｍｉｎ后恢复常压。分别于一次和三次ＬＢＮＰ作用后１ｈ测定脑组织Ｎａ＋－Ｋ＋－ＡＴＰ酶活性、Ｋ＋、Ｎａ＋及水含量等。结果表明，一次ＬＢＮＰ作用后１ｈ，大鼠脑组织Ｎａ＋－Ｋ＋－ＡＴＰ酶活性较对照组显著降低（Ｐ＜０．０５），Ｋ＋、Ｎａ＋及水含量有升高趋势，但均未达到显著水平，顶叶皮层和海马区神经元与对照组基本相似。三次ＬＢＮＰ作用后１ｈ，脑组织Ｎａ＋－Ｋ＋－ＡＴＰ酶活性显著降低（Ｐ＜０．０１），Ｋ＋、Ｎａ＋及水含量均显著升高（Ｐ＜０．０５），顶叶皮层和海马区多数神经元表现为缺血性改变。结果提示，反复三次ＬＢＮＰ致脑缺血可引起大鼠脑组织离子平衡紊乱及神经元损害     

21d头低位卧床中几种体液调节激素的变化

目的观察卧床模拟失重所致血浆肾素活性（ＰＲＡ）、醛固酮（Ａｌｄ）及前列腺素（ＰＧＩ２）的变化和ＬＢＮＰ对抗措施对上述激素的影响。方法１２名健康男性志愿者进行了２１ｄＨＤＴ－６°卧床实验。被试者年龄２３．７±５．０岁,随机等分为对照组（ＣＯＮ）和下体负压（ＬＢＮＰ）组。ＬＢＮＰ组在卧床最后一周进行下体负压锻炼（－３０ｍｍＨｇ,１ｈ／ｄ）。卧床前、卧床第２、４、１１天及卧床结束日清晨分别抽取肘静脉血。结果与卧床前相比,Ａｌｄ在第２天显著下降（ＣＯＮ－３０％,Ｐ＜０．０５;ＬＢＮＰ－３８％,Ｐ＜０．０１）,在第１１天显著上升（ＣＯＮ＋３０％,Ｐ＜０．０５;ＬＢＮＰ＋４８％,Ｐ＜０．０１）。ＰＲＡ在第４天达到峰值（Ｐ＜０．０５）,第２２天回落到低于对照水平。ＰＧＩ２在ＨＤＴ过程中均高于对照水平。对照组在第２２天增加＋２６０％（Ｐ＜０．０１）,ＬＢＮＰ组在第１１天,第２２天分别升高１４９％,１０２％（Ｐ＜０．０５）。采用ＬＢＮＰ对抗措施后,ＰＲＡ,Ａｌｄ在两组间无明显差别,ＰＧＩ２在ＬＢＮＰ组未进一步升高。结论２１ｄ头低位卧床导致ＰＲＡ、Ａｌｄ的一过性升高及ＰＧＩ２持续性升高。     

缺氧对肺动脉内皮细胞和平滑肌细胞分泌血管活性肽的影响

用放射免疫测定和免疫组化法缺氧对培养的小牛肺动脉内皮细胞（ＰＡＥＣ）和肺动脉平滑肌细胞（ＰＡＳＭ）自分泌心钠素（ＡＮＰ）、血管紧张素Ⅱ（ＡＴⅡ）和内源性洋地黄因子（ＥＤＬＦ）的影响。无氧培养２４ｈ末，ＰＡＥＣ分泌ＡＮＰ减少４３．５％（Ｐ〈０．００１），ＡＴⅡ和ＥＤＬＦ呈明显负相关（ｒ为－０．８８和－０．７８６，Ｐ〈０．０１），细胞内ＡＮＰ阳性颗粒也显著减少（Ｐ〈０．００１）；ＰＡＳＭ分泌ＡＮＰ无显     

白细胞介素-4和γ-干扰素在哮喘发病机制中的研究

对发作期哮喘和慢性阻塞性肺疾病（ＣＯＰＤ）病人及正常人各２０例，检测外周血淋巴细胞（ＰＢＬＣｓ）培养上清液中白细胞介素－４（ＩＬ－４）含量、γ－干扰素（ＩＦＮ－γ）活性及其血清ＩｇＥ总浓度。结果表明，发作期哮喘组ＩＬ－４和ＩｇＥ均明显高于ＣＯＰＤ组及正常对照组（Ｐ＜０．００１）。ＩＬ－４和ＩＦＮ－γ及ＩＦＮ－γ与ＩｇＥ均呈负相关（ｒ＝－０．４８，－０．７５；Ｐ＜０．０５，０．００１）。而ＣＯＰＤ组与正常对照组之间的ＩＬ－４和ＩｇＥ无显著差异（Ｐ＞０．０５）。３组之间ＩＦＮ－γ活性亦无差异（Ｐ＞０．０５）。提示ＩＬ－４和ＩＦＮ－γ之间的相互平衡是哮喘发病过程中血清ＩｇＥ浓度调节的一种重要因素。     

下体负压作用下人心率,血压变异性谱的变化及其与心血管反应…

观察了－６。６７ｋＰａ下体负压（ＬＢＮＰ）持续作用期间人心率变异性（ＨＲＶ）、血压变异性（ＳＢＰＶ）谱的变化，并探讨了谱特征与心血管反应之间的关系。结果表明：耐力良好者ＨＲＶ谱的调频峰功率（ＨＦＨＲＶ）显著降低，归一化高频参数（ＨＦＨＲＶ，ｎ）与低频参数（ＬＦＨＲＶ，ｎ）分别呈明确的降低或升高变化；ＳＢＰＶ谱的低频峰功率（ＬＦＳＢＰＶ）ＬＢＮＰ作用时降低，后又回升，至实验终止时已超出对照水平。ＬＢ     

六个月有氧锻炼对立位耐力及循环反应的影响

目的为了阐明有氧锻炼是否与立位耐力之间有一定联系，以及引起相应的循环反应变化。方法用－６．６７ｋＰａ／３０ｍｉｎ卧位下体负压（ＬＢＮＰ）试验及以－１．３３ｋＰａ／３ｍｉｎ为一个梯级的递进式坐位ＬＢＮＰ试验，检查大学生有氧锻炼６个月前、后立位耐力与循环反应的变化，并与一组中、长跑运动员进行横向比较。此外，还比较了Ｖａｌｓａｌｖａ动作各期心率、血压反应的差别。结果６个月有氧锻炼（每周累计跑２０ｋｍ～２５ｋｍ）可引起大学生卧位ＬＢＮＰ作用初期出现一过性低血压及坐位ＬＢＮＰ耐力显著降低（Ｐ＜０．０５）；Ｖａｌｓａｌｖａ动作时，Ⅱ期舒张压恢复幅度显著减小、Ⅲ期收缩压下降幅度显著增大（Ｐ＜０．０５）。与中、长跑运动员的横向比较亦支持上述结果。结论研究结果表明，有氧锻炼可影响立位负荷下维持血压稳定的机制。笔者提出，下肢肌肉动脉系统收缩反应性减弱可能是主要原因之一。     

重离子辐射对体外支气管上皮细胞的失活效应

目的观察Ｌｉ、Ｃ、Ｆ三种重离子辐射诱发的细胞失活效应。方法用中国原子能科学院核物理研究所的ＨＩ１３串列加速器产生的Ｌｉ（Ｚ＝３,ＬＥＴ＝１００ｋｅＶ／μｍ）、Ｃ（Ｚ＝６,ＬＥＴ＝３００ｋｅＶ／μｍ）、Ｆ（Ｚ＝９,ＬＥＴ＝１０００ｋｅＶ／μｍ）三种离子束以０．５～６．０Ｇｙ剂量设计值照射人支气管上皮细胞系（ＢＥＡＳ－２Ｂ）,以１０００个细胞／瓶接种,计算存活分数。结果三种重离子照射细胞后的细胞存活分数与照射剂量呈指数负相关关系,存活分数（ＳＦ,无量纲）与剂量（Ｄ,Ｇｙ）关系的拟合方程分别为Ｓ＝ＥＸＰ（－Ｄ／１．２８）（Ｌｉ）,Ｓ＝ＥＸＰ（－Ｄ／１．１８）（Ｃ）,Ｓ＝ＥＸＰ（－Ｄ／２．０９）（Ｆ）;辐射敏感参数Ｄ０为１．２８、１．１８、２．０９Ｇｙ,呈单击单靶模型。以６０Ｃｏγ射线的Ｄ０为参比,Ｌｉ、Ｃ及Ｆ离子的相对生物效应值相继是２．５４、２．６７和１．５５。失活截面（σｉ）分别为１２．５、４０．６、７６．５μｍ２。结论Ｌｉ、Ｃ、Ｆ对体外细胞的失活效应大于６０Ｃｏγ射线,细胞失活至少需要一次以上的离子打击。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.