高压氧对兔视网膜静脉阻塞后玻璃体氧分压与视网膜血流量的影响

目的 研究实验性视网膜静脉阻塞眼在高压氧(HBO)状态下及HBO暴露后不同时间内玻璃体氧分压与视网膜血流量的变化,以指导HBO治疗的临床应用.方法 应用氩激光制作兔眼视网膜静脉阻塞模型,采用血气分析法和放射微球标记法分别测模型眼在高压氧暴露1 h,出氧舱后1、2、4及20 h时的玻璃体氧分压和视网膜血流量.结果 HBO状态下,模型眼玻璃体氧分压[(175.233±15.016)mmHg]较对照组[(94.500±14.438)mm Hg)]明显升高(P＜0.01);出氧舱1 h氧分压即有下降趋势,但仍高于对照组(P＜0.01);出氧舱2 h的氧分压继续下降,与对照组相比仍有统计学意义(P＜0.01);出氧舱4 h的氧分压与对照组相比已无统计学意义(P＞0.05).HBO状态下,模型眼视网膜血流量[(3.385±1.513)ml·min-1·g-1]较对照组[(0.256±0.083)ml·min-1·g-1]明显升高(P＜0.01);4 h后继续升高,且已高于对照组(P＜0.05);出氧舱后20 h,血流量升至对照组的3倍(P＜0.01).结论 HBO状态下模型眼玻璃体氧分压升高,HBO暴露后视网膜血流量逐步增加,有助于实验性视网膜静脉阻塞眼局部血流量的恢复.     

兔VX2脑瘤血管生成的灌注CT研究

目的观察实验性兔VX2脑瘤的灌注CT改变,并与病理及免疫组织化学(简称免疫组化)结果对照,检验灌注CT反映脑瘤血管生成的效能.方法20只VX2脑瘤荷瘤兔按随机数字表分成3周以下组和3周以上组行灌注CT检查,测量肿瘤、瘤周及对侧正常脑组织的血容量(bloodvolume,BV),血流量(bloodflow,BF)和表面通透性(permeability surface,PS).大体标本观察肿瘤伊文思蓝染色级别.免疫组化观察血管内皮生长因子(vascular endothelial growth factor,VEGF)表达率和微血管密度(microvessel density,MVD).结果肿瘤区BV、BF和PS值[分别为(13.25±4.58)ml·100 g-1、(166.14±69.62)ml·100 g-1·min-1、8.01 ml·min-1·100 g-1]均明显高于瘤周[分别为(2.38±0.80)ml·100 g-1、(62.49±25.83)ml·100 g-1·min-1、0.03ml·min-1·100 g-1]及对侧正常脑组织[分别为(2.24±0.75)ml·100 g-1、(55.72±21.24)ml·100 g-1·min-1、0.04ml·min-1·100 g-1]差异有统计学意义(P值均=0.000).3周以上组肿瘤区BV、BF和MVD[分别为(16.41±4.12)ml·100 g-1、(208.77±63.00)ml·100 g-1·min-1、(61.20±12.93)个/高倍视野]均明显高于3周以下组[(10.09±2.27)ml·100 g-1、(123.51±47.18)ml·100 g-1·min-1、(41.40±7.34)个/高倍视野],差异有统计学意义(P值均＜0.01).肿瘤区MVD与BV(r=0.915,P=0.000)和BF(r=0.901,P=0.000)呈显著正相关,与PS(r=0.459,P=0.042)呈正相关;肿瘤蓝染级别与PS(rs=0.861,P=0.000)呈显著正相关.结论灌注CT可明确区分肿瘤与瘤周和正常组织,准确反映肿瘤的血管生成情况,为脑瘤评价提供重要资料.     

全脑缺血再灌注大鼠血液中血小板激活因子测定研究

目的 :研究血小板激活因子 (PAF)在急性脑缺血过程中的作用。方法 :用高效薄层层析法测定大鼠全脑缺血后再灌注 1、3、6、72h时血液中PAF的含量。结果 :再灌注后 3h血液PAF较对照组明显升高 (1.6 1± 0 .5 6 μg·L-1和 1.0 5± 0 .31μg·L-1,P<0 .0 5 ) ,6h时达高峰 (1.90± 0 .6 1μg·L-1,P <0 .0 1) ,72h时仍高于正常 (1.46± 0 .31μg·L-1,P <0 .0 5 )。结论 :PAF在脑缺血再灌注的病理生理过程中起一定作用。     

儿童汉语阅读障碍的脑血流与阅读技能研究

目的　探讨儿童汉语阅读障碍 (RD)的脑血流改变与阅读技能诊断测试 (CRSDT)评分的关系。方法　用非采血法SPECT显像测定 2 5例RD患儿和 2 0例正常对照者全脑血流量 (CBF)、左右脑血流量及局部脑血流量 (rCBF)。CRSDT测得阅读技能总粗分 (TRS) ,并分析TRS与CBF间的关系。结果　患儿组CBF为 (38.87± 3.77)mL·10 0g- 1 ·min- 1 ,明显低于对照组 [(4 3.6 5± 2 6 4)mL·10 0g- 1 ·min- 1 ,P <0 .0 1],患儿rCBF显著降低区域分布频率为额叶、枕叶 >顶枕交界区 >颞叶 >顶叶 >丘脑>其他 (小脑、脑干、基底节 ) ,RD组TRS与CBF呈明显正相关 (r为 0 .6 5 1,P <0 0 5 )。结论　RD儿童存在脑血流代谢降低 ,SPECT脑血流显像及定量测定能够客观评价其病变的严重程度。     

高压氧综合治疗视网膜震荡28例

视网膜震荡临床上比较常见 ,而且严重影响视功能 ,目前临床上无特效疗法。自 1990年 6月～ 1999年 10月 ,我院采用高压氧 (HBO)结合中西药治疗此症 2 8例 (2 9眼 ) ,其中部分合并脉络膜破裂伤 ,取得较好疗效 ,报告如下。一、临床资料1.一般资料 :患者均经我院眼科确诊。 HBO结合中西药物治疗组 (HBO组 ) 2 8例 (2 9眼 ) ,均为男性 ,年龄 9～ 5 0岁。对照组单纯用中西药物治疗 ,共 2 0例 (2 0眼 ) ,男性 19例 ,女性 1例 ,年龄 8～ 5 0岁。HBO组均经检查无 HBO治疗禁忌证 ,就诊时间为伤后 2 h～ 4 0 d。2 .治疗方法 :(1) HBO组 :采用 …     

OCT对玻璃体腔内注射曲安耐德治疗弥漫型糖尿病黄斑水肿的疗效评价

目的　探讨光学相干断层扫描 (OCT)在玻璃体腔内注射曲安耐德 (TA)治疗弥漫型糖尿病黄斑水肿 (DME)疗效评价中的作用。方法　对激光治疗无效的弥漫型DME 2 4例患者的 (2 5只眼 )进行玻璃体腔内注射TA 0 1ml(4mg)治疗 ,治疗前后检查项目包括视力、眼底血管荧光造影 (FFA)和OCT对黄斑区视网膜厚度的测量。随访期 3～ 6个月 ,平均 4 5个月。结果　最佳矫正视力治疗前为0 12± 0 0 7,治疗后为 0 3± 0 16 (P<0 0 1) ,2 2只眼的视力得到提高。黄斑中心凹视网膜神经上皮层厚度治疗前为 4 71 76± 191 30 μm ,治疗后为 193 88± 5 3 2 2 μm ,治疗前后比较差异有统计学意义 (P <0 0 1) ;距黄斑中心凹 10 0 0 μm鼻侧、颞侧、上方、下方视网膜神经上皮层平均厚度治疗前为 4 6 2 72±12 3 76 μm ,治疗后为 2 78 36± 5 7 6 1μm(P <0 0 1)。结论　对激光治疗无效的弥漫型DME ,玻璃体腔内注射TA治疗后黄斑部视网膜水肿消退明显 ,患者视力得到提高 ;OCT能从黄斑部视网膜形态的改变上客观、精确、有效地评判这一方法的疗效。     

冲击波对兔眼后节组织的早期损伤

目的　探讨冲击波对家兔眼后节组织的损伤特点和致伤机制。　方法　采用BST -Ⅲ型生物激波管复制可进行量效关系研究和较接近临床实际的眼冲击伤模型 ,建立以压力峰值为( 42 9± 38.80 )kPa和 ( 834± 6 .47)kPa的轻、重伤两组伤型。在伤前对照、伤后 0 .5 ,3,6和 2 4h 5个时相点 ,观察眼部伤情 ,测定脉络膜血流量、视网膜电图 ,荧光眼底血管造影 ,观察其病理及超微结构 ,重点动态观察了伤后早期眼后节组织损伤的变化过程。　结果　在眼冲击伤早期 ,眼底组织、脉络膜微循环和视觉功能的损害均严重。　结论　冲击波造成视网膜、脉络膜、视神经的直接损伤和脉络膜血流量减少是导致视觉功能障碍的主要因素     

窒息新生兔中枢及外周血脑啡肽含量的变化

目的　探讨脑啡肽与新生兔窒息的关系。方法　采用放射免疫测定法测定 2 4只正常新生兔 (对照组 )及 2 6只窒息新生兔 (窒息A组 )中枢及外周血中脑啡肽的含量。将 2 0只孕 3 0d母兔窒息后立即剖宫取出仔兔 ,随机分为 4组 :新生兔窒息未治疗组 (窒息B组 ) ,新生兔窒息ICI17486 4 治疗组 (ICI组 ) ,新生兔窒息脑啡肽抗血清治疗组 (抗血清组 ) ,新生兔窒息兔血清治疗组 (血清组 )。后2组仔兔在分娩后分别脑内注入脑啡肽抗血清 (滴度 1∶60 0 0 )或等量不含抗体的兔血清 ,ICI组按体重静脉注入ICI17486 4 80ng kg。仔兔均于剖宫产后 1、5、10、15及 3 0min进行Apgar评分。结果　①窒息A组新生兔下丘脑、垂体及外周血脑啡肽的含量分别为 (63 5.2± 57.6)、(452 .7± 3 7.5)及 (2 97.6± 2 8.4)ng L ,对照组分别为 (185.7± 2 9.6)、(150 .9± 2 1.4)及 (12 1.5± 19.9)ng L。与对照组相比 ,窒息A组中枢及外周脑啡肽含量均明显升高 (P <0 .0 1及 <0 .0 5)。②抗血清组及ICI组兔Apgar评分明显高于窒息B组及血清组 (P <0 .0 1及 <0 .0 5) ,后两组间差异无显著性 (P >0 .0 5)。结论　脑啡肽与新生兔窒息的发生发展密切相关 ,其不利作用为通过δ受体介导     

氯雷他定胶囊和片剂的药动学及相对生物利用度

目的　研究氯雷他定胶囊与片剂的人体药动学和生物等效性。方法　选择 2 0名健康男性志愿者 ,随机交叉口服单剂量 (4 0mg)氯雷他定胶囊或片剂两种制剂 ,采用HPLC法测定血清中氯雷他定的浓度。结果　口服氯雷他定胶囊及片剂的Cmax分别为 (34.5± 1 5 .1 )ng·ml-1 和 (33.7± 1 5 .6 )ng·ml-1 ;Tmax　分别为 (1 .2± 0 .4 )h和 (1 .3± 0 .4 )h ;T1 / 2 β　分别为 (4 .3± 1 .2 )h和 (4 .5± 1 .4 )h ;AUC0 -2 4分别为 (99.1± 4 0 .2 )ng·h·ml-1 和 (99.6± 4 3.9)ng·h·ml-1 ;AUC0 -∞ 分别为 (1 0 4 .0± 39.2 )ng·h·ml-1 和 (1 0 5 .1± 4 3.4 )ng·h·ml-1 ;氯雷他定胶囊对片剂的相对生物利度为 (98.9± 31 .7) %。结论　氯雷他定胶囊和片剂具有生物等效性     

纳米级雄黄粉体药代动力学研究

目的　制备纳米级雄黄粉体 ,比较传统雄黄与纳米级雄黄的药代动力学行为。方法　两组家兔分别单剂量口服5 0mg ,比较纳米级雄黄粉体和传统雄黄在兔体内的药代动力学参数。结果　传统雄黄组家兔的药动学参数为 :A =0 .0 96 2±0 .0 0 93mg·L-1,Ke =0 .0 70 2± 0 .0 0 74l/h ,Ka =0 .4 72 3± 0 .0 712l/h ,Lagtime=0 .0 30 0± 0 .0 0 0 0H ,T1/ 2　 (Ka) =0 .15 1± 0 .2 38H ,T1/ 2　 (Ke) =10 .0 5 6± 0 .895H ,T(peak)　　 =4 .80 6± 0 .4 0 1H ,C(max)　 =0 .0 6 0± 0 .0 0 0mg·L-1,AUC =1.16 8± 0 .0 84 (mg·L-1)h ,CL/F(s) =4 3.0 78± 3.4 95L/h ,V/F(c) =6 2 0 .6 96± 2 9.6 4 9L ;纳米雄黄组家兔的药动学参数为 :A =0 .2 4 4 3± 0 .0 0 5 2mg·L-1,Ke =0 .0 2 2 7±0 .0 0 5 2l/h ,Ka =0 .92 2 5± 0 .0 5 93l/h ,Lagtime =0 .0 30 0± 0 .0 0 0 0H ,T1/ 2　 (Ka) =0 .75 4± 0 .0 4 9H ,T1/ 2　 (Ke) =2 8.74 6± 1.0 0 7H ,T(peak)　 =4 .0 6 6± 0 .174H ,C(max)　 =0 .2 16± 0 .0 0 5mg·L-1,AUC =9.82 2± 0 .394 (mg·L-1)h ,CL/F(s) =5 .10 8± 0 .2 0 8L/h ,V/F(c) =2 11.5 6 6± 3.2 97L。结论　纳米级雄黄粉体与传统雄黄比较 ,其药代动力学发生显著变化 ,吸收相增大而消     

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.