蓝紫光照射对烧伤大鼠免疫功能的影响

目的 研究蓝紫光照射对烧伤大鼠免疫功能的影响。方法 将48只大鼠随机分为正常对照组、烧伤对照组及烧伤蓝紫光照射治疗组(治疗组)，在烧伤对照组及烧伤蓝紫光组背部皮肤造成大鼠体表面积(BSA)20％深Ⅱ度烧伤模型，并用蓝紫光对治疗组进行照射。测定烧伤后3d、12d腹腔吞噬细胞吞噬活性、血清免疫球蛋白含量及肿瘤坏死因子细胞毒性的变化。结果 蓝紫光照射可以显著提高烧伤大鼠腹腔吞噬细胞的吞噬能力，并可提高烧伤大鼠血清IgA含量及调节血清中的TNF水平。结论 蓝紫光照射可通过提高大鼠腹腔吞噬细胞的吞噬能力、调节B-细胞功能、TNF水平来提高机体免疫力，从而促进烧伤创面的愈合。     

复方茶多酚软膏对放射性皮炎大鼠伤口愈合和表皮生长因子表达的影响

背景:研究表明复方茶多酚软膏对急性放射性皮炎的伤口有愈合作用,但具体机制尚未阐明.目的:探讨复方茶多酚软青对大鼠放射性皮炎创面愈合及表皮生长因子表达的影响.方法:清洁级雄性成年Wistar大鼠随机分成3组:实验组和对照组大鼠通过60 Co γ射线照射建立大鼠放射性皮炎模型,实验组大鼠采用常规护理后用复方茶多酚软膏外涂辐射伤口区,对照组涂抹凡士林软膏:简单皮肤伤口组大鼠采用1.5 cm2皮肤全切除,仅接受常规护理.通过放射免疫法测定伤后5,10,20和40 d时创面组织的表皮生长因子表达、观测创面愈合率和愈合时间,并与简单伤口组比较.结果与结论:实验组和对照组在V射线照射后5 d创面组织表皮生长因子表达弱于简单皮肤伤口组,提示放射性皮炎与简单皮肤切口损失不同,创面恢复期创面组织表皮生长因子呈弱表达,愈合缓慢:实验组创伤后10和20 d时创面组织表皮生长因子表达显著高于对照组(P＜0.05):实验组在10和20 d时的创面愈合率明显高于对照组(P＜0.05);实验组愈合时间明显短于对照组的愈合时间(P＜0.05),实验组和对照组的愈合时间均明显长于简单皮肤伤口组(P＜0.05).结果表明复方茶多酚软膏外涂对大鼠放射性皮炎的愈合有促进作用,其机制可能与促进创面组织表皮生长因子的表达有关.     

短波紫外线照射后大鼠皮肤羟脯氨酸含量的变化

目的观察大鼠皮肤伤口受不同剂量短波紫外线照射后组织中羟脯氨酸含量的变化 ,探讨紫外线照射对胶原蛋白合成的影响。方法用 3 0只Wistar雄性大鼠建立短波紫外线照射新鲜伤口的动物模型 ,在每只大鼠颈背部做 3个直径 2cm的圆形皮肤全层伤口 ,其中 2个分别接受为 15MED( 15mJ/cm2 )和 60MED( 60mJ/cm2 )短波紫外线照射 ,另 1个作为对照不接受照射 ,然后采用化学法检测伤口肉芽组织中羟脯氨酸含量的变化。结果 15MED照射伤口在照射后 2 1— 2 8d时羟脯氨酸含量高于对照 (P <0 .0 5 ) ;60MED照射伤口在 2 8d时羟脯氨酸含量显著增高 ,与 15MED照射伤口和对照之间的差异具有高度显著性意义 (P <0 .0 1)。结论短波紫外线照射能促进伤口中羟脯氨酸的合成 ,从而增加胶原含量 ,促进伤口愈合 ;60MED短波紫外线照射的作用强于 15MED。     

蓝紫光对大鼠皮肤伤口及烧伤愈合的影响

材料和方法雄性Ｗｉｓｔａｒ大鼠 72只 ,体重 180～ 2 10ｇ ,由军事医学科学院四所提供 ,分笼饲养 ,水及饲料自由摄入。随机分为 8组 (每组 9只 ) ,即正常对照组、烧伤对照组、烧伤治疗组 (进行羟脯氨酸含量测定及病理组织学研究 ) ,创伤对照组、创伤治疗组 (进行愈合伤口抗拉强度测定及病理组织学研究 ) 5组 ,在致伤12ｄ后进行 ;正常对照组、烧伤对照组、烧伤治疗组(进行吞噬率及吞噬指数的测定 ) 3组 ,在致伤 3ｄ后进行 ,为不影响 12ｄ进行的羟脯氨酸含量测定及病理组织学研究 ,该 3组另取动物进行。治疗组均少1只 ,因为开始时用 1%硫喷妥…     

白芨对大鼠创面愈合几个要素的影响

目的:研究白芨对大鼠创面愈合几个要素的影响,探讨其促进伤口愈合的机制。方法:大鼠麻醉后,在背部脊柱两侧1.5cm处切除两个直径约1.6cm的圆形,以随机数字表法选择其中一个创面局部涂抹白芨胶溶液;或在背部脊柱两侧1.5cm处各切开一约8cm长的全皮层切口,埋入聚乙烯醇(Polyvinylalcohol,PVA)海绵,随机数字表法选择一侧注入白芨胶溶液。结果:伤后3(或5),7,10,14,21d白芨治疗组创面残留面积百分率显著低于对照组,创面平均愈合时间提前2.5d,创面组织蛋白含量和羟脯氨酸含量也显著高于对照。伤后3,5,7d白芨组伤口巨噬细胞数量也显著提高。结论:白芨提高创面愈合的速度和愈合的质量,增加伤口巨噬细胞数量可能是其促愈合的重要机制之一。     

蓝玉簪颗粒治疗大鼠放射性肺纤维化的CT影像研究

目的探讨蓝玉簪颗粒治疗放射性肺纤维化的影像学研究。方法将30只雄性SD大鼠采用随机数字法分为正常对照组、30Gy照射对照组和30Gy+蓝玉簪颗粒治疗组。照射后10、20、30d时,使用20%乌拉坦腹腔麻醉动物,CT扫描及重建,观察影像学变化;并进行病理组织学及肺部羟脯氨酸含量检测。结果受照大鼠肺CT影像在各时间点均见反应改变,30d后纤维化影像学变化显著,30Gy+蓝玉簪颗粒治疗组肺纤维化影像学变化与30Gy照射对照组比较,差异有统计学意义(P0.05);病理组织学检测表明,30Gy+蓝玉簪颗粒治疗组大鼠肺组织改变与30Gy照射对照组比较,差异有统计学意义(P0.05)。大鼠肺部组织进行羟脯氨酸含量检测显示,30Gy照射对照组在照射后8、10d比30Gy+蓝玉簪颗粒治疗组及正常对照组均显著升高,差异有统计学意义(P0.01),其他时间点也明显升高,差异有统计学意义(P0.05)。结论蓝玉簪颗粒对照射引起的肺纤维化有潜在的治疗作用。     

基因枪转人碱性成纤维细胞生长因子基因促进深Ⅱ度烧伤创面的愈合

背景:大量的体内和体外实验已证实,碱性成纤维细胞生长因子对不同组织和细胞具有广泛作用,可加快创面愈合进程.目的:观察基因枪转人碱性成纤维细胞生长因子基因促进深Ⅱ度烧伤创面愈合的效果和可行性.设计、时间及地点:完全随机设计,观察实验,于2007-12/2008-10在解放军第二军医大学长海医院全军烧伤中心实验室完成.材料:SD清洁级大鼠,体质量200-250 g,雌雄不拘.方法:将天然人碱性成纤维细胞生长因子基因重组优化,以pCI-neo为载体构建重组人碱性成纤维细胞生长因子基因高效真核表达载体pCI-neo-bFGF,并转染人胚肾细胞293T细胞,转染后以dot blot和western blot检测碱性成纤维细胞生长因子的表达.利用基因枪技术对SD大鼠深Ⅱ度烧伤创面模型进行转基因,以转染pCI-neo-bFGF为实验组,以转染空载体pCI-neo为对照组.主要观察指标:记录创面愈合时间,在转基因后24 h,48 h,96 h,7d,10d和14d测定创面组织羟脯氨酸和胶原酶Ⅰ水平,评价创面愈合情况.结果:重组构建的pCI-neo-bFGF经转染人胚肾细胞293T细胞,dot blot和western blot 检测结果显示,构建的pCI-neo-bFGF表达载体可表达人碱性成纤维细胞生长因子,荧光显微镜下合成基因的表达水平明显高于天然基因表达;基因枪转基因实验结果显示,实验组创面愈合时间为(13.00±1.31)d,对照组为(14.75±1.28)d,两组相比较差异有显著性意义(P＜0.05):两组羟脯氨酸及胶原酶Ⅰ水平均于基因枪转染后48h即伤后第5天达到高峰,随后逐渐下降至一定水平后维持,实验组各时间点羟脯氨酸水平均高于对照组(P＜0.05,P＜0.01);实验组转基因后48 h和96 h胶原酶Ⅰ水平明显高于对照组(P＜0.01).结论:基因枪转人碱性成纤维细胞生长因子基因可以缩短创面愈合时间.增加创面愈合期间组织羟脯氪酸和胶原酶Ⅰ水平,加快深Ⅱ度烧伤创面愈合进程.     

康肤霜对大鼠放射性皮肤损伤创面愈合的影响

背景:放疗中引起的放射性皮肤损伤,常使用重组人表皮生长因子和聚维酮碘治疗,但两者均有一定缺陷.而康肤霜能促进细胞分裂增殖,具有一定的抗菌消炎作用,可能对放射性皮肤损伤有很好的疗效.目的:观察康肤霜对大鼠放射性皮肤损伤创面愈合的影响.方法:高能X射线照射Wistar大鼠臀部皮肤建立深II度皮肤烧伤创面模型.照射后12d创面出现后,将损伤动物随机分为康肤霜组,重组人表皮生长因子组和聚维酮碘组.各组每日将药物均匀涂抹在创面,直至创面取材或创面愈合.观察创面愈合率及愈合时间.各组动物分别于创面治疗后7,14,21d取创面组织,观察病理组织学变化、创面组织增殖细胞核抗原的表达,以标记指数法测定增殖细胞核抗原阳性细胞数,评估组织创面的修复情况.结果与结论:康肤霜组与重组人表皮生长因子组创面愈合时间、愈合率均优于聚维酮碘组(P<0.01),但两组间无显著差异(P>0.05)且两组创面组织标本中增殖细胞核抗原表达量也明显高于聚维酮碘组(P<0.01),但其两组间比较差异无显著性意义(P>0.05).说明康肤霜能减轻创面早期的炎症反应,促进创面的再上皮化和表皮各层的分化,加速大鼠放射性皮肤损伤创面的愈合.     

短波紫外线照射四肢火器伤后组织中羟晡氨酸含量的变化

目的观察四肢火器伤受不同剂量短波紫外线照射后,组织中羟脯氨酸含量的变化,以期分析紫外线照射对胶原蛋白合成的影响.方法实验于2003-09/2004-09在解放军总医院理疗科实验室和解放军军事医学科学院放射医学研究所完成.选用新西兰大白兔90只,随机数字法分为3组30 mJ/cm2照射组、60 mJ/cm2照射组和对照组,每组30只.麻醉动物后,以"五四"式手枪击兔右股部肌肉丰满处,造成贯通伤模型.常规清创后采用紫外线治疗仪分别对3组实验动物伤道进行30 s(30 mJ/cm2)照射,60 s(60 mJ/cm2)照射和无照射干预.在致伤后第2和3天继续在伤道内进行照射,日增加前次照射剂量的30%.采用化学法在伤后7,14,21,28,42,56和70 d测量肉芽组织中羟脯氨酸含量的变化.结果实验动物82只进入结果分析.①致伤后7 d,各组大白兔组织中羟脯氨酸的含量无差别.②伤后14 d,60 mJ/cm2照射组羟脯氨酸的含量高于30 mJ/cm2照射组和对照组[(11.91±0.49)mg/g,(10.88±0.61)mg/g,(10.35±0.85)mg/g,P＜0.05];伤后21～56 d,60mJ/cm2照射组伤口中的羟脯氨酸含量均高于30mJ/cm2照射组伤口和未照射组(P＜0.01).③伤后70 d时,各组羟脯氨酸的含量下降接近正常组织水平,60 mJ/cm2照射组仍稍高于30 mJ/cm2照射组和未照射组[(10.02±0.65)mg/g,(9.85±0.54)mg/g,(9.27±0.43)mg/g,P＜0.05].④在伤后21～56 d 30 mJ/cm2照射组伤口中羟脯氨酸的含量高于对照组(P＜0.05).结论短波紫外线照射能促进伤口中羟脯氨酸的合成,增加胶原含量,60 mJ/cm2照射的作用强于30 mJ/cm2.     

白芨对大鼠创面愈合几个要素的影响

研究白芨对大鼠创面愈合几个要素的影响，探讨其促进伤口愈合的机制，方法：大鼠麻醉后，在背部脊柱两侧1.5cm处切除两个直径约1.6cm，的圆形,以随机数字表法选择其中一个创面局部涂抹白芨胶溶液：或在背部脊拄两侧1.5cn，处各切开一约8cm长的全皮层切口，埋入聚乙烯醇(Polyvinyl alcohol,PVA)海绵，随机数字表法选择一侧注入白芨胶溶液结果：伤后3(或5)，7，10，14，21d白芨治疗组创面残留面积百分率显低于对照组，创面平均愈合时间提前25d．创面组织蛋白含量和羟脯氨酸含量也显高于对照。伤后3．5．7d白芨组伤口巨噬细胞数量也显提高。     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

我院文职护士管理和培训的实践与体会

目的构建文职护士培训、使用及管理的科学方法。方法通过规范管理、科学施训、作为骨干大胆任用等多种管理方式,使文职护士得到充分的发展。结果文职护士群体成长为医院优秀骨干,首批满3年的文职护士顺利通过续聘考核。结论科学的管理培训是文职护士成长的重要基石,对医院护理管理有着重要作用。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.

     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

通用设计原则与产品研发策略

本文介绍了通用设计的概念和设计原则,并阐述了根据此原则实施通用设计的产品研发策略。通用设计惠及的不仅是残疾人,也惠及了包括普通公众在内的广泛人群,以及企业。应将通用设计的原理应融入政府相关政策和未来发展的规划中,为残疾人以及更多人群提供合理便利的通用设计产品。     

Prevalence and severity of nausea and vomiting of pregnancy and effect of vitamin supplementation.

OBJECTIVE: Although nausea and vomiting of pregnancy is the most common medical condition during pregnancy, there are many unanswered questions regarding its cause, epidemiologic features and optimal management. The objectives of this study were to ascertain the prevalence of nausea and vomiting in a sample of Canadian women, to characterize the distribution of their severity and to investigate the role of vitamin B6 deficiency in their etiology. DESIGN: Prospective study. SETTING: Antenatal counselling service for pregnant women. PATIENTS: Three cohorts of women: a prospective, population-based cohort of 193 women, to estimate the rate and severity of nausea and vomiting (cohort A); a cohort of 555 women who sought advice for nausea with or without vomiting, to study the correlation between the maximal daily number of episodes of vomiting and maximal weight loss (cohort B); and a prospective cohort of 301 women who reported vomiting, to correlate vitamin supplementation with vomiting (cohort C). INTERVENTIONS: All 3 cohorts were interviewed during the counselling session, and cohort B was followed up prospectively. OUTCOME MEASURES: Frequency of nausea and vomiting, weight loss, maximal number of daily episodes of vomiting, rate of multivitamin supplementation. RESULTS: Overall, 67% of the women in cohort A reported experiencing nausea or vomiting, or both; 22% reported vomiting, and 9% experienced weight loss. In cohort B there was a significant correlation between the maximal number of daily episodes of vomiting and maximal weight loss, although there was wide variation (r2 = 0.25, p < 0.001). There was a highly significant correlation between the number of daily vomiting episodes and mean weight loss (r2 = 0.99). In cohort C, vomiting was significantly associated with lack of supplementation with multivitamins before 6 weeks' gestation (p = 0.002). CONCLUSIONS: The relation between number of daily vomiting episodes and mean weight loss may serve as a clinical tool to assess the severity of nausea and vomiting in pregnancy and the success of anti-emetics and rehydration regimens. Further study is needed to elucidate the biologic basis of the observed association between vomiting and lack of multivitamin supplementation in early pregnancy.     

胃癌DNA含量与E-cad、EGFR表达的关系及其意义

目的　探讨胃癌组织DNA含量与E cad、EGFR表达的关系 ,评价其在浸润、转移潜能及预后判断中的作用。方法　应用图像分析仪及SP免疫组化法检测 30例正常胃黏膜上皮、30例不典型增生和 5 0例胃癌组织DNA含量与E cad、EGFR蛋白表达情况。结果　①正常胃黏膜上皮、Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌组的DI、PI、S %、>5c %逐渐增高 ,与胃癌分期、淋巴结转移显著相关 (P <0 0 1)。②E cad在正常胃黏膜上皮阳性表达率 10 0 % ,EGFR呈阴性表达 ;Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌E cad阳性表达率逐渐降低 ,EGFR的阳性表达率逐渐升高 ,且差异显著 (P <0 0 5 ) ;E cad表达减弱、EGFR表达升高与胃癌分化差、淋巴结转移显著相关 (P <0 0 1)。③E cad表达阴性的胃癌DNA指数及EGFR表达水平显著高于E cad阳性 (P <0 0 1)。结论　检测DNA含量及E cad、EGFR蛋白表达有助于胃癌的早期诊断及转移潜能和预后的判断。