低氧性肺动脉高压大鼠肺血管结构及血浆一氧化氮的变化

为了探讨一氧化氮（ＮＯ）在低氧性肺动脉高压形成中的作用,作者将Ｗｉｓｔａｒ大鼠１２只（６个对子）随机分配到低氧组和对照组,低氧舱内氧浓度为１０．０％±０．５％（体积分数）,用右心导管法测定肺动脉压力,分光光度法间接测定血浆ＮＯ含量,同时观察大鼠肺组织的显微结构和超微结构,结果低氧组肺动脉平均压（Ｐｕｌｍｏｎａｒｙａｒｔｅｒｙｍｅａｎｐｒｅｓｓｕｒｅ,ＰＡＭＰ）２．７５ｋＰａ±０．３０ｋＰａ,其血浆含量低氧组（３．５±１．２）μｍｏｌ／Ｌ,明显低于对照组（４．８±０．４）μｍｏｌ／Ｌ。光镜下低氧组…     

移居高原健康青年几种尿液酶的变化

目的：探讨高原低氧移居者尿液酶Ｎ－乙酰－β－Ｄ－氨基葡萄糖甘酶（ＮＡＧ），γ－谷氨酰转移酶（γ－ＧＴ），乳酸脱氢酶－Ｌ（ＬＤＨ－Ｌ），碱性磷酸酶（ＡＬＰ）的排泄变化。方法；对从平原进驻海拔３７００ｍ和５３８０ｍ高原第７天和半年的某部官兵进行尿液检测，且与平原健康青年作对照，结果：高原低氧环境下尿液酶ＮＡＧ，γ－ＧＴ，ＬＤＨ－Ｌ和ＡＬＰ活性均明显高于平原（Ｐ〈０．０５或Ｐ〈０．０１）；初入高原第７天     

糖皮质激素在成人呼吸窘迫综合征救治中的合理应用

采用放射配体结合法测定２８例成人呼吸窘迫综合征（ＡＲＤＳ）病人外周血白细胞糖皮质激素受体（ＧＣＲ），结果（１０１８．３±８２５．２）位点／细胞，显著低于正常人（４６３４．１±４３６．５）位点／细胞（Ｐ＜０．０１）。而其血浆皮质醇浓度为（２８９±１５１）ｕｇ／Ｌ，高于正常人（１２４±４７）ｕｇ／Ｌ（Ｐ＜０．０５）。结合病人ＡＰＡＣＨＥⅡ评分，并根据ＧＣＲ指导地塞米松的用法，使ＡＲＤＳ的病死率由８８．３％下降至３６。４％。     

高原失血性休克发生与救治过程中血浆溶酶体酸性水解酶活性变化

探讨高原失血性休克发病与救治特点以及相应的细胞机制。１４只山羊被随机分为平原组和高原组，分别观察在平原和模拟４０００ｍ高原失血性休克和再灌注后动物血浆溶酶体ＡＰ和β—Ｇ活性（比色法测定），数据经双因素方差分析统计处理。结果：①平原与高原组动物的存活时间分别为２１．４１±３．２５ｈ和９．７４±７．６１ｈ（Ｐ＜０．０１），１２ｈ存活率分别为１００％和１６．７％（Ｐ＜０．０５）；失血及再灌注后高原组均表现为严重的失代偿性酸中毒；③失血后平原组β一Ｇ显著升高（Ｐ＜０．０５），再灌注后ＡＰ与β一Ｇ均无进一步升高；高原组ＡＰ与β一Ｇ在缺血期及再灌注后均比失血前升高非常显著（Ｐ＜０．０１），同时失血后ＡＰ和再灌注后ＡＰ及β一Ｇ比平原组升高非常显著（Ｐ＜０．０１）。结论：高原失血性休克具有死亡率高、存活时间短和难以扩容纠正的特点，而低压缺氧复合组织缺血所致细胞溶酶体膜破裂和水解酶的释放是导致高原失血性休克向不可逆性转化的重要因素。     

血管内皮细胞受损后急性低氧性肺血管收缩反应减弱

为了探明血管内皮细胞在急性低无性肺动脉高压中的作用进行了本研究。雄性ＳＤ大鼠经２０％乌拉坦麻醉，气管插管，呼吸机通气。动物分为两组：单纯低氧组（ｎ＝１０只）吸１０．５％低氧混合气体５分钟；另一组为肺损伤低无组（ｎ＝７只），ＡＮＴＵｌｍｇ／ｋｇ缓慢注入肺动脉内，再吸入１０．５％低氧混合气体。实验结果表明：大鼠吸入低氧混合气体后肺动脉平均压ＰＰａ）增加２０．４±６．５％，而肺损伤后再吸入低氧气体，ＰＰａ仅增加８．７±３．８％，显著低于单纯低氧组（Ｐ＜０．０１）．结果提示：血管内皮细胞受损后急性低氧性肺血管收缩反应明显减弱。     

慢性低氧对大鼠肺内血管内皮生长因子表达的影响

本文作者将体重为２００ｇ～２２０ｇ的雄性大鼠２０只随机分为低氧组１３只，对照组７只，采用常压低氧（Ｆ１Ｏ２＝１０％±０．５％）处理低氧组３周，对照组置于同一实验室内，不进行特殊处理，３周后经大鼠右侧颈外静脉插入微导管至肺动脉测定肺动脉平均压（ｍＰＡＰ...     

高原失血性休克与代谢性酸中毒的研究

山羊１２只，随机分为平原失血性休克组（Ｌ）和高原失血性休克组（Ｈ）．Ｈ组山羊于模拟４０００ｍ高原低压舱内连续减压２４小时，两组动物分别于平原（３００ｍ）和模拟高原（４０００ｍ）复制失血性休克。结果显示：高原失血性休克组与平原组比有如下特点：①致休克失血量明显减少，仅为平原组的６８．７％（Ｐ＜０．０５）；②血浆ＰＨ和ＢＥ显著降低，回输血后２ｈ分别为７．２２６±０．１７３（平原组７．４８１±０．０５２）和一１６．５０±４．７０ｍＭ／Ｌ（平原组一１．７０±２．７７ｍＭ／Ｌ），与平原组相比，Ｐ值均小于０．０１；③存活时间缩短、死亡率增加，平均存活时间为６．２±４．２ｈ，１２ｈ存活率为１６．７％，而平原组动物在２４ｈ观察期内无一例死亡。表明模拟４０００ｍ高原２４ｈ，山羊对失血的耐受性明显降低，在休克过程中发生严重代谢性酸中毒，存活时间缩短、在活率降低。     

重度肺动脉高压心脏直视术后急性肺损伤的防治研究

目的：探讨先心病合并重度肺动脉高压围手术期应用中药红景天合剂开展早期防治术后急性肺损伤的可能性。方法：根据均衡配比和肺动脉高压分级标准将拟行手术的病例随机分为防治组（ Ｅ Ｇ） 与常规处理对照组（ Ｃ Ｇ） 。 Ｅ Ｇ 在常规术前准备同时开始应用红景天合剂 Ｒ Ｃ Ｏ（ 术前７ ～１０ ｄ ,术后５ ～７ ｄ） 。 Ｃ Ｇ 于住院后只按常规方法进行处理,两组按对应时间点进行各项预设指标检查。结果： Ｅ Ｇ 多项指标优于 Ｃ Ｇ, Ｐ＜ ０ ．０５ 或 Ｐ＜ ０ ．０１ 。 Ａ Ｒ Ｄ Ｓ发生率和死亡率 Ｅ Ｇ 依次为１／２２（４ ．５ ％ ） ,０／１ ; Ｃ Ｇ为５／２０（２５ ％ ） ,２／５（４０ ％ ） 。结论：藏药红景天合剂可能对创伤性大手术并发 Ａ Ｒ Ｄ Ｓ有一定的预防作用和研究价值。     

激光心肌血管重建术治疗心肌缺血后左室形态和功能表现

作者采用钕钇铝石榴石（Ｎｄ：ＹＡＧ）激光直接心肌血管重建术观察对左室形态学和功能学的远期影响。１２只犬完全随机分力实验组（ＥＧ）和对照组（ＣＧ）。左室造影显示：ＥＧ的左室整体和局部射血分数（ＴＥＦ，ＡＥＦ）和左室短轴径缩短率（△Ｄ）均高于ＣＧ（Ｐ＜０．０５）：ＥＧ有２只犬显示左室前壁运动减弱，ＣＧ全部大显示左室前壁室壁瘤形成：左室舒张终末压（ＬＶＥＤＰ）在ＥＧ为－０．０６±０．８６ｋＰａ（１ｋＰａ＝７．５ｍｍＨｇ）．在ＣＧ为０．３６±０．７３ｋＰａ（Ｐ＞０．０５）。ＳＰＥＣＴ显示：ＣＧ全部犬发生透壁性心肌梗塞，ＥＧ仅１只犬发生心内膜下心肌埂塞（Ｐ＜０．０１）。结论：左室造影和ＳＰＥＣＴ可用于检测心肌血管重建术后的效果；Ｎｄ：ＹＡＧ激光用于直接心肌血管重建术是一种有效可行的方法。     

神经节苷酯对低氧大鼠脑钙,钙调素及蛋白激酶Ⅱ的影响

观察了神经节苷酯对急性低氧组大鼠（Ａ组：模拟海拔７００ｍ，５ｈ；Ｂ组：给神经节苷酯）和常氧对照组大鼠（Ｃ组：常氧；Ｄ组：给神经节苷酯）脑组织Ｃａ￣（２＋）、钙调素（ＣａＭ）及ＣａＭ依赖性蛋白激酶Ⅱ（ＣａＭＰＫⅡ）活性的影响。用Ｆｕｒａ－２测得Ｃａ￣（２＋）水平分别为７２２．１±８１．２．６４０．６±７４．４、２５８。７±３９．２和２６３．８±４１．３ｎｍｏｌ／Ｌ，Ａ组明显高于常氧对照组（Ｐ＜０．０１）；Ｂ组明显低于Ａ组（Ｐ＜＜０．０５）。用流式细胞仪（ＦＡＣＳ）所测ＣａＭ平均荧光强度分别为４０．２±４．７、４４．３±４．８．４６．１±５．１和４５．９±５．０道；Ａ组明显低于常氧对照组。用同位素（ｒ￣（３２）－ＡＴＰ）液闪计数法所测ＣａＭＰＫⅡ活性分别为１８２．９±７．９、１９２．３±８．２、１９７．９±９．２和１９８．２±９．３ｐｍｏｌｐｉ．ｍｉｎ￣（－１）ｍｇ￣（－１）ｐｒｏｔｅｉｎ，Ａ组明显低于其它三组，急性低氧Ｂ组与常氧对照组比无明显差别。表明，低氧时神经节苷酯可以减少胞内Ｃａ￣（２＋）蓄积和稳定ＣａＭ和ＣａＭＫｉｎａｓｅⅡ的变化．     

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.