实验性松质骨骨折愈合的生物力学研究

目的：为临床治疗关节松质骨骨折提供生物力学依据。方法：选用成年新西兰兔５２只，４只作为对照，另４８只随机分为４组。在兔股骨髁上截骨后分别采用松质骨（Ａ组）和皮质骨螺钉内固定（Ｂ组）、石膏外固定（Ｃ组）以及未固定（Ｄ组）等方法处理。术后３、６、８和１２周，对骨折界面剪切强度进行生物力学性能测定。结果：每组虽然在不同阶段的剪切强度都呈上升趋势，但以Ａ组最高，Ｂ组次之，Ｃ组再次之，Ｄ组最低（Ｐ＜０．０１）。除Ａ组和Ｂ组在１２周以外，其余各组不同阶段的剪切强度均存在明显差异（Ｐ＜０．０１），同时统计表明，各组在术后１２周时的剪切强度与正常对照组仍存在着显著性差异（Ｐ＜０．０１），但Ａ组和Ｂ组的剪切强度已分别达到正常对照值的８０％和７８％左右。结论：对关节松质骨骨折的治疗应尽可能做到解剖复位和坚强固定，以利于松质骨的生物力学性能的恢复。     

活动平板运动试验多项指标分析在冠心病诊断中的意义

目的：通过对活动平板运动试验（ＴＥＴ）多项指标进行分析，旨在评价ＴＥＴ在冠心病诊断中的价值。方法：对２４５例患者按Ｂｒｕｃｅ方案进行了ＴＥＴ检查，把阳性患者分为疼痛组（Ａ组）和无症状组（Ｂ组），两者进行比较，并与试验阴性组（Ｃ组）比较。结果：运动时间，最大心率Ａ组＜Ｂ组＜Ｃ组（Ｐ＜０．０５～０．０１）。运动血压Ｃ组＞Ａ组（Ｐ＜０．０１）。Ａ组与Ｂ组、Ｂ组与Ｃ组比较无差异（Ｐ＞０．０５）。ＳＴ段下移级别Ｂ组＞Ａ组（Ｐ＜０．０１），下移深度Ａ组＞Ｂ组（Ｐ＜０．０１）。结论：ＴＥＴ多项指标判断冠心病的准确性明显提高。     

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。     

女子田径运动员免疫机能对模拟比赛的应答及恢复特征观察

观察了９名女子田径运动员免疫机能对模拟比赛的应答及恢复特征。结果显示，模拟比赛后即刻ＷＢＣ计数及其亚类ＬＹＭＰＨ、ＭＩＤ、ＧＲＡＮ较比赛前显著升高（Ｐ＜０．０１）；３小时后ＬＹＭＰＨ、ＭＩＤ已基本恢复，而ＷＢＣ仍高于赛前（Ｐ＜０．０１），ＧＲＡＮ继续升高，达比赛前２．２倍（Ｐ＜０．０１＝。比赛后即刻和２４小时后ＩｇＡ均高于运动前（Ｐ＜０． ０５）。Ｃ３、Ｃ４比赛前后均无显著变化。     

高压氧与一氧化氮对高原脱适应青年血流动力学的影响

目的：研究高压氧（ＨＢＯ）与一氧化氮（ＮＯ）对高原脱适应青年血流动力学的影响。方法：将海拔５０００ｍ以上居住１年返回海拔１４００ｍ的３６名青年随机分为：对照组;ＨＢＯ治疗组;ＮＯ治疗组。治疗前后分别用ＸＧⅢ型血液循环功能自动测试仪检测血流动力学。结果：对照组前后差别不显著（Ｐ＞０．０５）;ＨＢＯ组ＢＶ增加显著（Ｐ＜０．０５）,Ｐ、ＳＶ增加非常显著（Ｐ＜０．０１）,η降低非常显著（Ｐ＜０．０１）;ＮＯ组Ｐ、ＢＶ、ＳＶ、ｍＡＰ增加非常显著（Ｐ＜０．０１）,ＡＬＴ、ＰＡＷＰ降低显著（Ｐ＜０．０５）,ＴＰＲ、η降低非常显著（Ｐ＜０．０１）。结论：ＨＢＯ与ＮＯ对久居特高海拔返回后脱适应青年低排高阻性血流动力学有明显的增排降阻作用,吸入ＮＯ较ＨＢＯ效果更好     

高压氧对大鼠颅脑创伤后脑损伤和脑水肿的影响

目的：探讨高压氧对大鼠颅脑创伤后脑损伤和脑水肿的影响。方法：将大鼠随机分为对照组、脑创伤组和高压氧（ＨＢＯ）组。采用ＢＩＭ－Ⅲ型撞击机撞击大鼠右侧颅顶，复制闭合性颅脑损伤，于伤后２４小时由心脏取血处死，测定脑组织含水率、伊文斯蓝（ＥＢ）含量及脑组织和血浆脂质过氧化物──丙二醛（ＭＤＡ）含量。结果：（１）脑外伤组大鼠右侧脑组织含水率、脑组织及血浆ＭＤＡ含量均显著高于对照组（Ｐ＜０．０１或Ｐ＜０．０５）；右侧脑组织含水率及ＭＤＡ含量显著高于对侧（Ｐ＜０．０１或Ｐ＜０．０５），右侧脑组织ＥＢ含量较对照组升高，但Ｐ＞０．０５；（２）ＨＢＯ组右侧脑组织含水率及脑组织ＭＤＡ含量显著低于脑外伤组（Ｐ＜０．０１或Ｐ＜０．０５），而与对照组及左侧无明显差别；血浆ＭＤＡ、脑ＥＢ含量与对照组、脑外伤组及左侧均无明显差别。结论：ＨＢＯ能减少脑外伤脑组织氧自由基的生成，减轻脑损伤和脑水肿。     

高原老年人右心室舒张功能的脉冲多普勒超声研究

海拔２２６０ｍ老年１３例（Ａ组），海拔３５００～４２００ｍ老年１２例（Ｂ组），年龄６０～７４岁。ＥＣＧ、ＵＣＧ、心三位片和肺功能无右室肥大和器质性心脏病及慢阻肺。脉冲多普勤测定三尖瓣口Ｅ＿ｖ、Ａ＿ｖ、Ｅ＿Ｉ、Ａ＿Ｉ、Ａ＿ｖ／Ｅ＿Ｉ、ＥＤＴ、ＡＴ。结果发现Ｂ组的Ａ＿ｖ／Ｅ＿ｖ增大（Ｐ＜０．００１）；ＥＤＴ及ＡＴ缩短（分别Ｐ＜０．００１）；ＡＴ与ＥＤＴ呈高度正相关（ｒ＝０．９３５、Ｐ＜０．０１）；ＡＴ与Ａ＿ｖ／Ｅ＿ｖ呈高度负相关（ｒ＝－０．９１６、Ｐ＜０．０１）；且ＥＤＴ与Ａ＿ｖ／Ｅ＿ｖ亦呈高度负相关（ｒ＝－０．９０７、Ｐ＜０．０１）；表明尚无高原心脏病的海拔３５００ｍ以上高原老年人，右室舒张功能减低，右室后负荷已有一定程度增加，两者间呈高度正相关关系。     

危重病患者死亡风险预测:胃粘膜pH与新型简化急性生理评分的比较

观察了８７ 例患者入ＩＣＵ 后第１ 个２４ｈ 内的胃粘膜内ｐＨ（ｐＨｉ）和新型简化急性生理评分（ＳＡＰＳⅡ）。１１ 例（１２．６％ ）患者在ＩＣＵ治疗期间死亡。死亡组患者的ｐＨｉ为７．０３±０．２７,存活组ｐＨｉ为７．４２±１３,两组相比,死亡组ｐＨｉ显著低于成活组（Ｐ＜ ０．０１）。死亡组的ＳＡＰＳⅡ（４５±１１．７７）则显著高于存活组（１９．５８±１０．３２）,两组差异有非常显著性意义（Ｐ＜ ０．０１）。从ＳＡＰＳⅡ值计算的病死率,１１ 例死亡患者中６ 例（５４．４％ ）＞５０％ ,而所有１１ 例死亡患者中,９例（８１．８％ ）ｐＨｉ＜ ７．３２。作者推论,在估计危重病患者个体死亡时,ｐＨｉ较ＳＡＰＳⅡ更有价值。     

茶多酚对飞行人员球结膜微循环的作用

目的观察茶多酚（ｔｅａｐｏｌｙｐｈｅｎｏｌｓ，ＴＰ）对飞行人员球结膜微循环（ｂｕｌｂａｒｃｏｎｊｕｎｃｔｉｖａｍｉｃｒｏｃｉｒｃｕｌａｔｉｏｎ，ＢＣＭ）的影响，为飞行员选择合适的天然药品，以提高其健康水平。方法４０名健康疗养飞行人员随机分为两组，试验组服ＴＰ６００ｍｇ／ｄ×２０ｄ，对照组服安慰剂，于２０ｄ后检查ＢＣＭ。结果与对照组相比，试验组微血管数明显增加（Ｐ＜０．０１）；微血流速度明显加快（Ｐ＜０．０５）；红细胞聚集明显减轻（Ｐ＜０．０５）；缺血区明显减少（Ｐ＜０．０１）；Ａ／Ｖ比值明显变小（Ｐ＜０．０１）。结论ＴＰ可明显改善飞行人员的微循环功能状态。     

绞股蓝总皂甙对肝脏四氯化碳损伤保护作用的实验研究

给慢性四氯化碳（ＣＣ１＿４）肝损害小鼠灌喂绞股蓝总皂甙（ＧＰｓ），剂量为每次７５ｍｇ／ｋｇ或１５０ｍｇ／ｋｇ（每周５次，共３周），均能明显减轻肝组织损害，与未治疗组比较差异有显著意义（Ｐ＜０．０５和Ｐ＜０．０１）。用ＧＰｓ治疗的两组小鼠血清丙氨酸转氨酶（ＡＬＴ）活性均较未治疗组降低，血清白蛋白含量和Ａ／Ｇ比值较未治疗组升高。在原代培养大鼠肝细胞损伤模型上，预先用浓度为１０ｍｇ／Ｌ和４０ｍｇ／Ｌ的ＧＰｓ处理大鼠肝细胞，肝细胞ＤＮＡ合成速率分别从ＣＣ１＿４损伤组的３１．９％升高到６７．６％（Ｐ＜０．０５）和８２．４％（Ｐ＜０．０１）；肝细胞培养液中ＡＬＴ活性均明显低于损伤组（Ｐ＜０．０１）。表明ＧＰｓ能减轻ＣＣ１＿４诱导的小鼠慢性肝损害和离体大鼠肝细胞损伤，改善肝脏合成白蛋白的功能，保护肝细胞ＤＮＡ合成。     

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.