氯沙坦和卡托普利对大白兔心肌缺血再灌注损伤影响的比较

 目的比较氯沙坦和卡托普利对心肌缺血再灌注损伤的影响.方法健康大白兔随机分为2组,每组各10只:(1)对照组:每日灌服卡托普利40 mg/kg;(2)治疗组:每日灌服氯沙坦40 mg/kg,给药7 d.所有大白兔制作心肌缺血再灌注动物模型,观察心律失常的发生率、心率的变化.复灌后120 min采血,测定血清肌酸磷酸激酶(CPK)、乳酸脱氢酶(LDH)、一氧化氮(NO)、一氧化氮合酶(eNOS)、血管紧张素Ⅱ(AngⅡ)、丙二醛(MDA)及超氧化物歧化酶(SOD)的含量.实验完毕,分别用双重染色确定心肌梗死的面积.结果氯沙坦治疗组CPK、LDH和MDA较对照组明显降低(P＜0.05),而NO、eNOS和SOD则明显增高,降低了心肌缺血再灌注诱发室性心律失常的发生率,具有明显的负性频率作用.治疗组梗死心肌占危险区心肌重量百分比(30.21±5.10)%,较对照组(37.67±6.46)%显著降低.结论氯沙坦能明显减轻心肌缺血再灌注损伤.     

DSA彩色编码技术在评估兔骨骼肌缺血再灌注损伤中的应用

目的：利用DSA彩色编码成像技术（syngo iFlow）观察兔后肢急性缺血再灌注后肌肉组织的iFlow参数变化,探讨其在评价骨骼肌缺血再灌注损伤中的应用价值。 方法：新西兰大白兔30只平均随机分成缺血再灌注（ischemia reperfusion,IR）0 h、6 h、12 h、24 h组与假手术对照组。IR各组分别在右下肢缺血3 h后再灌注0 h、6 h、12 h、24 h行双下肢动脉造影,利用syngo iFlow软件分析造影图像并得到iFlow参数（rPeak）。同时检测各组血清中CK、LDH、MDA、SOD的含量,比较各组的血清生化指标及rPeak的差异,并分析rPeak与生化指标的相关性。 结果：与对照组比较,IR各组的血清CK、LDH及MDA值升高,SOD值降低（P均<0.05）;且随着再灌注时间的延长,血清LDH及CK含量逐渐升高。而再灌注各组间的MDA、SOD含量差异无统计学意义。IR各组的rPeak值均低于对照组,且随着IR时间的延长逐渐下降（P<0.05）。rPeak与LDH、CK、MDA呈负相关（r分别为-0.885、-0.908、-0.541,P均<0.05）,与SOD呈正相关（r=0.832,P<0.05）。 结论：iFlow参数rPeak与实验室指标有较好的相关性,能够在一定程度上实时量化地评估骨骼肌再灌注损伤的严重程度。     

1,6-二磷酸果糖对缺血再灌注损伤心肌的保护作用与抗脂质过氧化的关系

目的　探讨 1,6 二磷酸果糖 (FDP)的抗再灌注心律失常作用与脂质过氧化的关系。方法　应用硫代巴比妥酸法和肌酸固定法 ,分别测定丙二醛 (MDA)及血清肌酸激酶 (CK)在家兔心肌缺血和再灌注条件下的含量变化。结果　心肌缺血组SD大鼠CK含量升高 (与对照组比较 ,P <0 .0 5 ) ;缺血再灌注组血清CK含量和MDA含量均急剧上升 (与心肌缺血组比较 ,P <0 .0 1) ;FDP组CK含量和MDA含量均显著降低 (与缺血再灌注组比较 ,P <0 .0 1)。结论　再灌后心肌损伤加重 ;FDP对再灌注心肌损伤有明显的保护作用。     

海拔4300m世居藏族和移居汉族心肌酶及肌红蛋白活性对比观察

目的　探讨高原世居藏族和移居汉族青年心肌酶及肌红蛋白活性变化。方法　对世居西藏阿里地区 (海拔 430 0m)的 2 0名藏族士兵和移居该地区的 2 0名汉族士兵检测血清天冬氨酸氨基转移酶 (AST)、乳酸脱氢酶 (LDH)、α 羟丁酸脱氢酶 (α HBDH)、肌酸激酶 (CK)及其MB型同功酶 (CK MB)、血乳酸 (BLA)、肌红蛋白 (Mb)。结果　高原移居汉族较世居藏族AST、LDH ,α HBDH ,CK MB ,BLA及Mb增高非常显著 (P <0 .0 1) ,CK增高显著 (P <0 .0 5 )。结论　高原世居藏族心肌酶活性 ,乳酸性氧债及非乳酸性氧债均低于移居汉族 ,这可能与他们取得了对高原低氧环境适应有关。     

脉络宁对兔肢体缺血再灌注损伤的防护作用

目的　探讨脉络宁对肢体缺血再灌注损伤的防护作用。　方法　将 2 0只家兔随机分为对照组和脉络宁组 ,制备肢体缺血再灌注损伤模型。在即将恢复血流灌注时 ,两组分别自耳缘静脉注射等渗盐水和脉络宁注射液。在再灌注前、后不同时间点上分别测定血清有关生化指标并取胫前肌行光、电镜观察。　结果　对照组再灌注后血清天冬氨酸氨基转移酶 (AST)、乳酸脱氢酶 (LDH)、肌酸激酶 (CK)、丙二醛 (MDA)明显升高 (P <0 .0 1) ,超氧化物歧化酶 (SOD)活力明显下降 (P <0 .0 1)。脉络宁组再灌注后各指标变化不明显 ,而与对照组同期相比 ,差异有非常显著性意义 (P <0 .0 1)。光、电镜观察可见再灌注后对照组组织损伤严重 ,而脉络宁组较轻。　结论脉络宁对肢体缺血再灌注损伤具有明显的防护作用。     

腺苷对心肌缺血再灌注心律失常的保护作用

目的观察腺苷对在体大鼠心肌缺血／再灌注（I／R）心律失常的影响，探讨其可能的作用机制。方法健康Wister大鼠36只，随机分成3组假手术组、对照组、腺苷组，每组12只。开胸结扎左冠状动脉前降支30分钟，再灌注45分钟．制作大鼠心肌缺血／再灌注损伤模型。假手术组只穿线不结扎冠状动脉。腺苷组于结扎前1分钟给予腺W（0．4ml／kg）左心室内注入，对照组给予等量生理盐水左心室内注入。观察再灌注室性心动过速（VT）、室颤（VF）发生率和死亡率；检测左心室心肌组织超氧化物歧化酶（SOD）及丙二醛（MDA）含量。结果①腺苷组大鼠再灌注VT及VF发生率及死亡率均较对照组明显降低（P〈0.01）；②与对照组比较，腺苷组大鼠SOD活力提高（P〈0．05），而MDA生成量明显减少（P〈0．01）。结论心肌缺血再灌注可导致缺血心肌进一步损伤，腺苷具有抗大鼠I／R心律失常作用，可能与抑制缺血再灌注氧自由基的产生有关。     

海拔5 380m富氧室对士兵力竭运动后心肌酶活性的影响

(崔建华 ,等 .西北国防医学杂志 ,2 0 0 4 ,2 5 (1) :2 0～ 31)　　研究富氧室对高原人体运动血中心肌酶活性的影响 ,在海拔 5 380m将室内氧浓度提高到 2 7% ,检测 10名青年安静时、进入富氧室前后力竭运动后的天冬氨酸基转移酶 (AST)、乳酸脱氢酶 (LDH)、α—羟丁酸脱氢酶 (α—HBDH)、肌酸肌酶 (CK)及其同工酶 (CK—MB)的含量或活性。力竭运动后较安静时AST、LDH、α—HBDH、CK及CK—MB活性均升高 (P <0 .0 1或P <0 .0 5 )。证明富氧能减少高原运动时心肌酶的释放 ,增强氧合功能 ,对提高战斗力 ,恢复因极度缺氧造成的机体代…     

海拔3700m富氧室对士兵力竭运动后肌红蛋白及心肌酶的影响

目的 :研究富氧室对高原部队青年血中肌红蛋白 (Mb)和心肌酶的影响。方法 :在海拔 370 0m将室内氧浓度提高到 2 4% ,检测 10名青年未富氧静息状态、未富氧力竭运动后和富氧及力竭运动后的Mb、AST、LDH、α HBDH、CK和CK MB的含量或活性。结果 :未富氧力竭运动后较未富氧静息状态Mb、TST、α BHDH、CK MB增高 ,P <0 0 1,LDH和CK增高 ,P <0 0 5。富氧及力竭运动后较未富氧静息状态Mb和AST增高 ,P <0 0 1;α HBDH增高 ,P <0 0 5 ;较未富氧力竭运动后AST降低 ,P <0 0 1;Mb和CK MB降低 ,P <0 0 5。结论 :高原富氧室能改善缺氧 ,降低力竭运动后血中的Mb含量和心肌酶活性。     

参麦注射液对大鼠心肌缺血/再灌注心律失常的影响

目的探讨参麦注射液对大鼠缺血/再灌注心律失常的影响及其作用机制。方法复制大鼠缺血/再灌注模型,采用缺血10min和缺血60min两种模型观察缺血性心律失常,观察发生率最高的缺血10min后再灌注心律失常,对照组和参麦注射液组分别给予生理盐水和参麦注射液1.5ml/kg,动态Ⅱ导心电图监测室性早搏（PVB）、室性心动过速（VT）及心室颤动与扑动（VF）的发生率。结果参麦注射液可明显减少缺血10min和60min心律失常PVB、VT、VF的发生率（P〈0.01）,亦可明显减少再灌注10min心律失常VT（P〈0.05）及VF（P〈0.01）的发生率。结论参麦注射液可明显减少大鼠缺血/再灌注心律失常的发生率。     

丙泊酚对兔肝脏缺血后再灌注损伤的保护作用

目的探讨丙泊酚对兔肝脏缺血后再灌注损伤的影响。方法将实验兔随机分为拟手术组(S组),肝脏缺血后再灌注组(IR组),及微量泵连续静脉输注丙泊酚[10mg/(kg.h)]组(PRO组),IR组和PRO组将入肝血流阻断25min后再灌注120min,然后观察不同时相丙氨酸氨基转氨酶(ALT)、天冬氨酸氨基转氨酶(AST)、乳酸脱氢酶(LDH)的变化,检测肝组织超氧化物歧化酶(SOD)活性及丙二醛(MDA)含量。结果IR组、PRO组再灌注120min后肝功能均有损害,而IR组的ALT,AST,LDH均高于PRO组;PRO组肝脏组织MDA浓度低于IR组(P<0.05),PRO组的SOD浓度高于IR组(P<0.05)。结论肝脏缺血后再灌注可使大量氧自由基释放,它在肝损伤中发挥重要作用,丙泊酚可抑制再灌注后的过度氧化反应,减轻肝组织损伤。     

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.     

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).     

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.     

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.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.