双侧迷走神经切除对大鼠肺缺血再灌注损伤炎症反应的影响

目的 观察双侧迷走神经切除对大鼠肺缺血再灌注损伤(LIRI)导致的炎症反应的影响.方法 SD大鼠24只,随机分为假手术组(S组)、缺血再灌注组(IR组)和双侧迷走神经切断合并缺血再灌注组(NIR组),每组8只.于缺血前、再灌注0.5h及再灌注4h抽取动脉血进行血气分析,观察动脉血氧分压(PaO2)及肺泡动脉氧分压差(A-aDO2)的变化.实验结束时取左肺测量肺组织的湿/干重比(W/D),于光学显微镜下观察缺血再灌注后肺的病理学改变,采用ELISA检测肺组织匀浆中肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)含量及髓过氧化物酶(MPO)活性等炎性指标的水平.结果 与S组比较,IR组PaO2明显降低,A-aDO2明显升高,W/D及肺组织匀浆中TNF-α、IL-10含量和MPO活性明显增加,肺组织炎性细胞浸润、肺泡腔红细胞增多、肺泡破坏及组织水肿明显(P<0.05).与IR组相比,NIR组PaO2进一步降低,肺组织炎性反应及病理学损伤更加严重(P<0.05),但A-aDO2无明显变化.结论 切断双侧迷走神经可加重大鼠肺缺血再灌注损伤,提示迷走神经完整性在LIRI的炎性反应调节中具有重要作用.     

肢体缺血预处理对肺缺血再灌注兔细胞因子和肺细胞凋亡的影响

研究肢体缺血预处理对肺缺血再灌注兔细胞因子和肺细胞凋亡的影响。方法：18只日本大耳白兔随机分为假手术组（S组）、肺缺血再灌注组（I／R组）、肢体缺血预处理组（L组）,每组6只。分别测定肺缺血前后各时间段兔血清及实验结束时兔左肺组织中TNF-a、IL-6、IL-10的含量和细胞凋亡指数（AI）,观察肺组织病理学变化和肺损伤定量评价（IQA）。结果：与I／R组比较,L组肺缺血再灌注后各时间段血清和肺组织TNF-仅、IL-6浓度明显降低（P〈0．05或P〈0．01）,IL-10浓度明显升高（P〈0．01）。L组光镜下肺组织病理学改变较I／R组明显减轻,且IQA及AI明显低于I／R组（P〈0．01）。结论：肢体缺血预处理能有效的减少肺缺血再灌注后血清和肺组织中促炎细胞因子浓度,增加抗炎细胞因子浓度,从而减少肺组织细胞凋亡的发生。     

氢气预处理及后处理对大鼠肠缺血/再灌注认知功能的影响

目的 观察氢气(H2)预处理及后处理对肠缺血/再灌注(I/R)大鼠认知功能的影响,并探讨相关机制.方法 将SD大鼠64只随机分为4组(n=16):假手术(Sham)组、肠缺血/再灌注(I/R)组、H2预处理(Pre)组和H2后处理(Post)组.夹闭肠系膜上动脉(SMA) 90 min再灌注方法制备大鼠肠I/R模型.Pre组及Post组分别于造模前或再灌注后吸入2％氢气3h.用Morris水迷宫评定大鼠认知功能;检测海马白细胞介素(IL)-1β IL-6、肿瘤坏死因子(TNF)-α、活性氧(ROS)、丙二醛(MDA)含量及超氧化物歧化酶(SOD)活性.结果 与Sham组比较,I/R组、Pre组和Post组大鼠潜伏期延长,穿越平台次数及平台象限停留时间减少;IL-1β、IL-6、TNF-α、ROS、MDA含量增加,SOD活性降低(P＜ 0.05或P＜0.01).与I/R组比较,Pre组和Post组潜伏期缩短,穿越平台次数及平台象限停留时间增加;IL-1β、IL-6、TNF-α、ROS、MDA含量降低,SOD活性增加(P＜0.01),但Pre组和Post组之间差异未见统计学意义.结论 氢气预处理及后处理能同等地改善肠缺血/再灌注(I/R)大鼠认知功能的变化,机制可能与抑制神经炎症反应,减轻氧化应激损伤有关.     

缺血预处理对兔心肌细胞凋亡的影响

 目的 探讨缺血预处理及缺血再灌注对兔缺血再灌注心肌细胞凋亡的影响.方法 制备兔缺血预处理(ischemic preconditioning,IP)、缺血再灌注损伤(I/R)模型,采用末端脱氧核苷酶转换酶介导的生物素平移缺口末端标记技术(transferase-mediated dUTP nick end labeling,TUNEL)检测心肌细胞凋亡情况.结果 RI组细胞凋亡率(43.37±4.82)%,IP组虽然也有一定的心肌细胞凋亡率(24.53±2.95)%,但较I/R组明显降低(P<0.01).IP组心肌梗死范围较I/R组明显减小.结论 心肌缺血再灌注损伤可诱发或加重心肌细胞凋亡,IP能明显减少缺血再灌注诱导的心肌细胞凋亡的发生率,能明显减少心肌梗死范围,减轻缺血再灌注损伤;IP能减少心肌梗死范围、减轻缺血再灌注损伤的机制可能与其能明显减少心肌细胞凋亡有关.     

高压氧对大鼠小肠缺血/再灌注损伤保护作用的研究

目的 在大鼠小肠缺血/再灌注(I/R)的不同时期应用高压氧(HBO)干预治疗,观察其对大鼠肠黏膜的保护作用.方法 采用肠系膜上动脉夹闭/松夹闭方式建立小肠I/R损伤模型.50只大鼠随机分为5组(每组10只):对照组(sham组)、I/R组、HBO预处理组(HBO-P组)、缺血期RBO组(HBO-I组)和再灌注期HBO组(HBO-R组).采用酶联免疫吸附试验法(ELISA)检测肠道组织肿瘤坏死因子-α(TNF-α);应用翻转囊袋法测定胰岛素(相对分子质量5000)黏膜-浆膜通过量以检测黏膜通透性;应用光镜和电镜观察肠道组织学改变并进行损伤评分.结果 肠黏膜通透性依次为:Sham组最低,其次HBO-I组,再次HBO-P组(每2组比较P<0.05),均明显低于HBO-R组和I/B组(P<0.05);HBO-R组略低于I/R组,但2组比较差异无统计学意义(P>0.05).肠道组织TNF-α含量依次是:Sham组最低,其次HBO-I组,再次HBO-P组(每2组比较P<0.05),均明显低于HBO-R组和I/B组(P<0.05);HBO-R组略低于I/R组,但2组比较差异无统计学意义(P>0.05).组织学损伤评分依次是:Sham组最低,其次为HBO-I组,HBO-P组次之(每2组比较P<0.05),均明显轻于HBO-R组和I/R组(P<0.05);HBO-R组略轻于I/R组,但2组比较差异无统计学意义(P>0.05).结论 HBO预处理和缺血期应用HBO对大鼠肠黏膜I/R损伤有明显的保护作用,可以降低肠黏膜通透性和减少炎症反应;再灌注期应用HBO虽然对肠黏膜有一定的保护作用,但效果不明显.     

高渗盐液对肾缺血再灌注损伤的预防作用

目的:探讨高渗盐液对肾脏缺血再灌注损伤的预防作用.方法:将56只清洁健康雄性SD大鼠随机分为假手术组(S组,n=8)、单纯缺血再灌注组(IR组,n=24)和高渗盐液预处理组(H组,n=24),IR组和H组又分别再分为3个亚组,每个时相点各8只,观察肾脏缺血45 min再灌注4、6、12 h后血清尿素氮(BUN)、肌酐(Cr)、肿瘤坏死因子-α(TNF-α)、白介素10(IL-10)水平及肾小管损伤评分(Paller's scoring)的改变.结果:H组各时相点血清BUN、Cr、TNF-α和Paller评分显著低于IR组,而血清IL-10水平明显高于IR组(P＜0.05).结论:高渗盐水通过抑制TNF-α的表达,并增加IL-10的产生,对肾脏缺血再灌注损伤产生预防作用.     

缺血预处理对大鼠移植胰缺血再灌注损伤的保护作用和机制

目的：探讨缺血预处理（IPC）对大鼠移植胰缺血再灌注（I／R）损伤的影响，并分析其中可能的机制。方法：糖尿病大鼠随机分为缺血再灌注组（I／R组，／n=6）和缺血预处理组（IPC组，n=18），IPC组又根据不同方法分为3个亚组：IPC3、IPC2和IPC3（n均=6）组，检测各组再灌注前及再灌注后血糖；再灌注后2h血清中TNF-α和NO的含量、胰腺组织中SOD、MPO和MDA含量。结果：①再灌注后IPC组相对于I／R组血糖低；②再灌注后IPC组较I／R组血清中TNF-α含量高、NO含量低；③再灌注后IPC组较I／R组胰腺组织中SOD含量高，MDA和MPO含量低。结论：①IPC对大鼠移植胰的VR损伤具有保护作用，机制可能是提高SOD的活性、增加内源性NO的合成、减少TNF-α的生成和减轻PMNs的粘附与聚集；②缺血5min再灌注5min2次是最佳的移植胰IPC诱导办法。     

兔缺血再灌注肺损伤中蛋白酶变化及蛋白酶抑制剂的保护作用

目的观察兔缺血再灌注肺损伤中蛋白酶及细胞因子的表达变化,并探讨蛋白酶抑制剂乌司他丁对缺血再灌注肺损伤的保护作用。方法30只新西兰白兔随机均分为对照组、创伤失血性休克组(休克组)和创伤失血性休克乌司他丁治疗组(治疗组),观察休克前、休克末及复苏后2、4h血清中细胞因子TNF-α、IL-8的动态变化,并于复苏后4h测定肺组织髓过氧化物酶(MPO)及肺泡灌洗液中中性粒细胞弹性蛋白酶(BALF-NE)的活性。结果休克组和治疗组休克末及复苏后2、4h血清TNF-α水平及复苏后4hIL-8水平均明显高于休克前,但治疗组均明显低于休克组(P<0.05)。复苏后4h休克组和治疗组肺组织MPO活性及BALF-NE活性均明显高于对照组,但治疗组明显低于休克组(P<0.05)。结论乌司他丁可降低血清TNF-α、IL-8水平及肺组织MPO、BALF-NE活性,对兔缺血再灌注肺损伤具有一定的保护作用。     

谷胱甘肽对肝缺血再灌注损伤细胞因子的影响

 目的观察炎性细胞因子在家兔肝缺血再灌注(Ischemia-reperfusion,I/R)损伤中的变化及谷胱甘肽的保护机制.方法将30只健康家兔随机分为对照组、I/R组和谷胱甘肽保护组,制备肝缺血再灌注损伤模型,测定3组血清或血浆和肝组织中ALT、MDA、TNF-α、IL-1β、IL-6、IL-8含量,观察肝脏病理变化和肝组织中PMN浸润数.结果肝I/R组损伤后,ALT、MDA、TNT-α、IL-1β、IL-6、IL-8含量相继明显升高,肝组织中中性粒细胞(PMN)浸润明显增多(P＜0.05),肝脏出现明显的病理变化;使用谷胱甘肽后,上述指标的异常变化均明显减轻,差异有显著性意义(P＜0.05).结论炎性细胞因子参与了肝I/R损伤,甘胱甘肽通过清除氧自由基,减少炎性细胞因子的生成,减轻PMN在病变部位聚集,对肝I/R损伤有积极的保护作用.     

谷氨酰胺预处理对肝缺血-再灌注后肺损伤的干预效果及机制

目的观察谷氨酰胺预处理对肝缺血-再灌注后急性肺损伤的干预效果。方法成年SD雄性大鼠36只,按随机数字表法将其平均分为三组:假手术组(Sham,S组);缺血-再灌注组(I-R组);谷氨酰胺组(Gln,G组)。其中I-R组为完全阻断肝动脉、门静脉及胆总管(参照Pringle's法)持续缺血30 min后再灌注1 h;而G组以0.75 mg/kg谷氨酰胺于全肝血流阻断前60 min经尾静脉注射行预处理。测定肺组织肿瘤坏死因子-α(TNF-α)、核因子-κb(NF-κb)、髓过氧化物酶(MPO)活性;肺湿/干重比(W/D);HE染色观察肺组织形态学变化以及谷氨酰胺预处理对大鼠肝缺血-再灌注后肺组织热休克蛋白-70(HSP-70)表达的影响。结果与I-R组比较,G组大鼠肺组织W/D比、TNF-α、NF-κb水平明显下降,MPO活性显著降低,HSP-70蛋白表达水平明显增加(P<0.05),光镜下肺组织损伤明显改善。结论谷氨酰胺预处理可通过增加肺组织HSP-70表达,抑制NF-κb等炎症因子的释放,对肝脏缺血-再灌注后的急性肺损伤起到一定的保护作用。     

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.