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。     

己酮可可碱对重度失血性休克大鼠肝脏缺血再灌注后氧自由基的影响

目的探讨已酮可可碱(PTX)对重度失血性休克大鼠肝脏缺血再灌注后氧自由基的影响。方法 48只SD大鼠随机分为4组(n=12):对照组(C组)、单纯休克组(NR组)、乳酸林格液复苏组(LR组)及乳酸林格液联合PTX(25mg/kg)复苏组(LRPTX组)。采用改良Wiggers法制备失血性休克动物模型,分别于休克前(Ts)、处死前(Td)取静脉血检测谷丙转氨酶(ALT)及谷草转氨酶(AST)含量。NR组在休克后即刻、其余组在复苏后4h处死大鼠取肝组织测定过氧化物歧化酶(SOD)活性,丙二醛(MDA)含量,诱导型一氧化氮合酶(iNOS)及NF-κB蛋白表达情况。电镜及光镜下观察各组大鼠肝组织病理变化。结果与C组比较,NR组、LR组和LRPTX组Td时间点静脉血中AST及ALT水平均明显升高(P<0.05);肝组织MDAi、NOS含量明显升高,NF-κB蛋白表达增加,SOD活性降低(P<0.05)。肝组织病理学损伤明显。与LR组比较,LRPTX组静脉血中AST、ALT、MDAi、NOS含量均明显下降,NF-κB蛋白表达减少,SOD活性升高(P<0.05),肝组织病理学损伤减轻。结论 PTX可减少肝脏iNOS生成,抑制NF-κB活化,减少肝脏氧自由基生成,提高SOD活性,降低肝缺血再灌注损伤。     

1,6-二磷酸果糖对大鼠肝脏创伤救治的影响及其作用机制

目的 观察1,6-二磷酸果糖(FDP)在大鼠肝脏创伤救治中的作用并探讨其可能的机制.方法 选取健康SD大鼠49只,建立肝脏撞击破裂伤模型.先取42只建模后大鼠,随机分为对照组、葡萄糖组、FDP组(n=14),分别于致伤10min后静脉注射0.9%氯化钠、5%葡萄糖及15%FDP注射液2ml(均在10min内静注完),各组再按处死取材时相点随机均分为缺血前和再灌注4h两个亚组(n=7).剩余7只建模后大鼠为再灌注4h假手术组.测定各组动物外周血谷草转氨酶(AST)、谷丙转氨酶(ALT)水平,肝组织丙二醛(MDA)、糖原含量及超氧化物歧化酶(SOD)活性.结果 在缺血前时相点,肝糖原含量对照组<葡萄糖组葡萄糖组>FDP组>假手术组(P<0.01或P<0.05),AST水平对照组>葡萄糖组/FDP组>假手术组(P<0.01或P<0.05),FDP组与葡萄糖组比较无显著差异;肝组织SOD活性对照组<葡萄糖组葡萄糖组>FDP组>假手术组(P<0.01或P<0.05).结论 与葡萄糖比较,FDP对大鼠肝脏撞击破裂伤有更好的保护作用,其机制可能为在应激条件下肝脏能更有效地以FDP为底物合成糖原,增加肝脏缺血前糖原贮备,从而减轻肝脏创伤救治中的热缺血再灌注损伤.     

丹参保护胰腺缺血再灌注损伤作用的机制探讨

目的探讨丹参(SM)对大鼠胰腺缺血—再灌注(IR)损伤的作用及其机制。方法夹闭大鼠腹腔动脉、肠系膜上动脉40 m in,再灌注6 h制备胰腺IR损伤模型,取SD大鼠36只,随机分为3组(n=12):假手术组(Sham组)、缺血—再灌注组(IR组)、缺血—再灌注丹参保护组(SM组)。光、电镜观察胰腺腺泡细胞结构改变;测定血淀粉酶、脂肪酶含量,测定大鼠胰腺组织SOD活性、MDA含量。结果SM组淀粉酶、脂肪酶含量较IR组显著降低(P<0.01);SM组SOD活性较IR组显著升高,丙二醛含量较IR组显著降低(P<0.01)。结论丹参可能通过提高SOD活性、降低MDA含量对胰腺缺血再灌注损伤起保护作用。     

丹参对缺血再灌注诱导的大鼠肝脂质过氧化和血清ALT活性变化的影响

目的:研究丹参对缺血再灌注(IR)肝损伤的防治作用;方法:阻断肝血流,建立IR模型,检测再灌注后不同时相点肝血清谷丙转氨酶活性和脂质过氧化物丙二醛水平;结果:在再灌注后6h各指标达最高峰,丹参组与IR组比较,丹参可降低血清谷丙转氨酶(ALT)(148.2±13.1)U/L与(241.6±29.8)U/L及脂质过氧化物(MDA)(33.8±7.3)mmol/L与(53.2±10.5)mmol/L)水平(P<0.05),而使超氧化歧化酶(SOD)保持在较高水平(91.3±9.1)mU/L与(72.5±5.5)mu/L,(P<0.05);结论:丹参能抑制IR引起的大鼠肝血清ALT和MDA水平的升高,具有防治IR肝损伤的作用。     

右美托咪啶对大鼠肝缺血再灌注损伤的保护作用

目的探讨右美托咪啶对大鼠急性肝缺血再灌注损伤（ischemiareperfusioninjury,IRI）的保护作用。方法sD大鼠32只,随机分为对照组（S组）、缺血-再灌注组（IR组）、右美托咪啶组（Dex组）、右美托咪啶＋育亨宾组（Dex＋Yoh组）,每组8只。IR组制备大鼠肝缺血再灌注模型。Dex组通过尾静脉以5μg／（kg·h）的速度持续泵注右美托咪啶1h,余同IR组。Dex＋Yoh组静脉输注右美托咪啶前10min,静脉注射育亨宾1mg／kg,其余同Dex组。分别测定血清AST、ALT活性,肿瘤坏死因子-α（TNF-α、自细胞介素-6（IL-6）浓度,肝组织超氧化物歧化酶（SOD）活性、丙二醛（MDA）含量,光镜观察肝组织的病理学变化。结果与S组比较,IR组血AST、ALT、TN-α、IL-6,肝组织MDA水平显著增加,SOD水平下降（P〈0．05）;与IR组比较,Dex组血AST、ALT、TNF-α、IL-6下降（P〈0．05）,肝组织SOD水平升高,MDA水平下降（P〈0．05）,Dex＋Yoh组无显著变化（P〉0．05）;形态学上,病理损伤程度与生化指标相符合。结论右美托咪啶能减轻肝缺血再灌注损伤,其机制可能是激活d,肾上腺素受体,抑制氧自由基反应和炎性因子的释放。     

人参皂甙Rb1对急性运动小鼠肝损伤保护作用的研究

目的探讨人参皂甙Rb1对急性运动小鼠肝损伤的保护作用及其机制。方法实验小鼠随机分为4组:安静+生理盐水组(A组,n=7),安静+人参皂甙Rb1组(B组,n=7),力竭运动+生理盐水组(C组,n=7),力竭运动+人参皂甙Rb1组(D组,n=7)。测定血中AST、ALT的含量;检测肝脏组织超氧化物歧化酶(SOD)、还原型谷胱甘肽(GSH)及丙二醛(MDA)的活性。结果 C组小鼠血中转氨酶水平及肝脏中MDA活性比D组显著升高,差异有统计学意义(P<0.05),而肝脏组织中SOD及GSH的活性显著低于D组,差异有统计学意义(P<0.05);A、B、D三组之间的血中转氨酶及肝脏SOD、GSH及MDA活性比较,差异无统计学意义(P>0.05)。结论人参皂甙Rb1能够通过增强肝脏清除自由基能力的机制从而起到保护急性运动肝损伤的作用。     

肝门阻断对肠黏膜屏障的影响

目的 探讨肝门阻断对肠黏膜屏障的影响及其意义.方法 采用雄性Wistar大鼠,随机分为2组: 假手术组(Ⅰ组)和实验组(Ⅱ组).采用Pringle's法进行肝门阻断,持续35分钟.分别于肝门阻断前及再灌注后2、4、24小时每组各选取10只大鼠,分别测定肠组织谷胱甘肽(GSH)、超氧化物歧化酶(SOD)、丙二醛(MDA)的含量,检测门静脉血浆内毒素水平.光镜观察组织形态学变化,测定肠粘膜厚度,肠绒毛高度.结果 与Ⅰ组相比,再灌注后Ⅱ组肠组织中MDA含量增高(P＜0.05),而GSH及SOD水平下降(P＜0.05),门静脉内毒素水平明显增高(P＜0.05).再灌注后,Ⅱ组肠粘膜厚度、肠绒毛高度明显低于Ⅰ组(P＜0.05).结论 肝门阻断可造成肠道过氧化损伤,导致肠粘膜屏障的破坏,促进内毒素移位.     

甲烷生理盐水对肝缺血再灌注小鼠肝线粒体的影响

 目的 在肝缺血再灌注小鼠模型中研究甲烷对肝线粒体的影响。方法 将C57小鼠18只随机分为空白对照组(SHAM组)、缺血再灌注组(IR组)和甲烷盐水治疗组(IR+CH4组),每组6只,采用70%肝缺血再灌注模型,IR+CH4组再灌注开始前予甲烷生理盐水10 ml/kg腹腔内注射,留取标本检测氧化、抗氧化、线粒体相关指标。结果 与IR组相比,IR+CH4降低了ROS水平(t=3.154,P=0.0083)及MDA(t=3.738, P=0.028)水平,提高了GSH(t=2.687, P=0.0177)及SOD(t=3.480, P=0.0037)水平;采用Westen blot 检测蛋白的表达,与对照组相比,IR组线粒体融合蛋白Mfn1(q=7.57,P＜0.05)和OPA1(q=6.41,P＜0.05)表达减少,分裂蛋白DLP1(q=3.718,P＜0.05)表达增加;与IR组相比,IR+CH4组融合蛋白Mfn1(q=5.277, P＜0.05)增加,分裂蛋白DLP1(q=6.700,P＜0.05)表达下降;IR组PINK1(q=4.606, P＜0.05)表达上调,IR+CH4组PINK1(q=3.922, P＜0.05)表达下降。结论 甲烷生理盐水可降低氧化应激,提高机体抗氧化能力,促进线粒体融合,减少分裂,促进线粒体功能的恢复。     

腺苷后适应对大鼠心肌缺血再灌注损伤的影响

目的初步探讨腺苷后适应对大鼠缺血再灌注损伤心肌的保护作用及机制。方法48只健康雄性SD大鼠随机分为4组:假手术组(Sham组)、缺血再灌注组(IR组)、缺血后处理组(IPTC组)及腺苷后适应组(ADOP组),每组12只,建立大鼠在体心肌缺血再灌注损伤模型。实验终点测定心肌梗死面积(TTC染色),心肌核因子-κB(NF-κB)mRNA的表达水平(RT-PCR),同时观察心肌组织中白细胞介素-6(IL-6)、丙二醛(MDA)及超氧化物歧化酶(SOD)的含量变化,并行心肌组织病理学检查。结果Sham组心肌组织形态改变不明显,IR组心肌损伤较重,IPTC组及ADOP组中心肌组织病理学损伤较IR组明显减轻。与IR组比较,ADOP组的心肌梗死面积、NF-κBmRNA的表达水平及IL-6、MDA含量明显降低(P<0.01),而SOD含量则显著升高(P<0.01);而ADOP组与IPTC组相比,除NF-κBmRNA的表达及IL-6的分泌稍许降低(P<0.05)外,其他均无统计学差异(P>0.05)。结论腺苷后适应可通过抑制再灌注后氧自由基的过量生成及NF-κB活化所诱导的早期炎症反应,增强心肌抗氧化能力,从而发挥保护效应。     

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.     

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.     

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）