arcaine 对大鼠局灶性脑缺血损伤的神经保护作用

目的 观察N-甲基-D-天冬氨酸(NMDA)受体/通道复合物多胺位点拮抗剂arcaine对脑缺血损伤的神经保护作用.方法 将45只Wistar大鼠随机分为对照组、缺血模型组、术前24h组、术前1h组及术后1h组.后4组大鼠均采用线栓法阻断大脑中动脉制作急性脑梗死模型.缺血模型组在造模成功后1h给予生理盐水(0.4ml/kg),术前24h组、术前1h组和术后1h组分别在术前24、1h和术后1h给予3mg/kg areaine.检测大鼠神经功能行为、脑梗死体积,并观察光镜及电镜下脑组织损伤情况.结果 神经功能评分显示,术前24h组、术前1h组和术后1h组大鼠神经功能行为评分(1.25±0.46、1.33±0.50、1.40±0.58分)与缺血模型组(2.63±0.52分)相比有显著差异(P<0.05),且术后给药对神经运动功能障碍的改善效果较术前给药效果差(P<0.05).术前24h、术前1h组和术后1h组大鼠脑梗死体积百分比(分别为5.72%±2.91%、26.36%±5.30%、36.35%±6.66%)较缺血模型组(51.10%±3.86%)明显减少(P<0.05);术后1h组大鼠脑梗死体积百分比较术前24、1h组增加(P<0.05).除对照组外,各组光镜下病理分级结果 差异无统计学意义.电镜下观察各组大鼠皮层及海马神经元均有不同程度的变性坏死,其中缺血模型组病理损害最为严重.结论 arcaine能够显著减少脑梗死的体积、减轻梗死所致的神经功能损伤,且预防给药效果更佳,但是arcaine对缺血所致神经元超微结构的损伤无明显逆转作用.     

MRI对线栓法制作大鼠脑缺血再灌注模型分组的价值

目的观察线栓法制作单侧大脑中动脉供血区脑缺血再灌注后的MRI表现,确定不同病变模式神经功能评分,评价MRI在模型制作中的价值。材料与方法清洁级健康雄性SD大鼠(200～250g)18只,随机分成两组:脑缺血1.5h再灌注组(MCAo/R)14只,假手术对照组4只。再灌注后24h行神经功能评分,并行MR扫描观察脑缺血范围,计算病变体积。结果4只假手术对照组大鼠MRI上皮质、皮质下结构等脑组织各部均未出现异常信号,神经功能无缺陷,评分为5分。1只MCAo/R组大鼠因出血而被排除。13只MCAo/R组大鼠MRT2WI有两种形态学改变模式:8只表现为病变范围累及皮质下区(尾状核壳核)和皮质,称为cp 组;5只病变范围限于尾状核壳核,称为cp组。测量计算校正后病变脑半球体积比(%HLV),cp组为(14.5±3.9)%,cp 组为(34.7±6.3)%。神经功能评分cp组为4.0±0.7,cp 组为2.4±0.5。两组间病变体积和神经功能评分差异有统计学意义。结论线栓法制作大鼠MCAo再灌注模型MRI显示两种病变模式,且神经功能损害程度存在差异。MRI和神经功能评分的联合使用有助于统一模型的纳入原则和亚型分组。     

急性血栓性大脑中动脉栓塞脑缺血模型的建立

目的评价急性血栓性大鼠大脑中动脉栓塞(MCAO)脑缺血造模的可行性,旨在提高模型的可重复性和可控制性。方法健康雄性成年SD大鼠60只,体重300～450g,随机分为3组:大栓子组(栓子长1.2～1.5mm,15只)、中等栓子组(0.8～1.0mm,30只)和小栓子组(0.5～0.6mm,15只)。取同系大鼠的股动脉血0.6ml与0.15ml凝血酶溶液混匀后,注入微导管内制备成线样血栓。将切好的栓子经大鼠左侧颈内动脉注入,建立MCAO模型。使用GESigna1.5T超导成像仪,3英寸环形表面线圈行大鼠脑MRI检查,并将检查结果与病理结果对照。结果小栓子组15只,9只发现脑梗死灶(60%),中等栓子组和大栓子组所有大鼠均出现脑梗死灶,小栓子组与另2组比较差异有统计学意义(P<0.05)。中等栓子组脑梗死灶均位于同侧大脑半球,局限于左侧顶叶皮质、皮层下及基底节的占93.3%(28/30)。小栓子组9只,在24h或死亡时的平均脑梗死体积占同侧大脑半球的(14.41±8.72)%,中等栓子组30只占(48.29±18.57)%,大栓子组15只占(73.68±18.29)%。3组之间脑梗死体积比较差异有统计学意义(F=33.171,P<0.01)。小栓子组9只,平均生存时间(301.1±23.02)h;中等栓子组30只,平均生存时间(277.43±20.27)h;大栓子组15只,平均生存时间(59.93±25.03)h。大栓子组与另2组之间生存时间比较差异有统计学意义(F=24.676,P<0.01),而中等栓子组的生存时间与小栓子组比较差异无统计学意义(P>0.05)。中等栓子组脑梗死区相对脑血流容量(rCBV)在3～18h内比较差异无统计学意义(F=1.578,P>0.05)。结论经过改良后,中等栓子建立的大鼠MCAO模型脑梗死体积适中、存活率高、脑梗死部位恒定而rCBV持续降低,具有良好的可重复性和可控性。     

复方降脂胶囊对高脂血症合并脑缺血损伤大鼠神经的保护作用

目的建立高脂血症合并脑缺血损伤模型,观察复方降脂胶囊对高血脂症合并脑缺血损伤的防治作用。方法本实验采用三氯化铁法制备大鼠脑缺血损伤模型,观察复方降脂胶囊对模型大鼠的神经症状、脑梗死范围及对大鼠脑组织中NF-κB、iNOS表达的影响。结果复方降脂胶囊高剂量组与高脂血症合并脑缺血损伤模型组比较,神经功能学评分显著降低;复方降脂胶囊中剂量、大剂量组和步长脑心通组大鼠的脑梗死体积显著低于高脂血症合并脑缺血症模型组;复方降脂胶囊对脑组织NF-κB及iNOS的表达具有抑制作用。结论复方降脂胶囊可改善大鼠的神经功能缺失症状,缩小脑梗死体积,对脑缺血损伤具有保护作用。     

参芪脑保颗粒对光化学诱导的大鼠局灶性脑梗死治疗作用的实验研究

目的 研究中药参芪脑保颗粒对大鼠局灶脑梗死的疗效。方法 采用光化学法制成大鼠局灶脑缺血模型，随机分为对照组、参芪脑保颗粒大、中、小剂量组、溶栓胶囊治疗组、金纳多片治疗组，分别于光照后3h、1、2、3、4d给予灌胃治疗，并观察各组大鼠的体重及神经功能评分变化。第5d处死，用TTC及HE染色观察梗死灶体积及病理改变。结果 参芪脑保颗粒治疗组的体重恢复较对照组及金纳多组快，大、中剂量组的梗死灶体积明显小于对照组(P＜0．001)及金纳多治疗组(P＜0．05)，大剂量组的梗死灶体积小于小剂量组(P＜0．05)，与溶栓胶囊治疗组相比差别不显(P＞0．05)。参芪脑保颗粒治疗组神经元缺血性损伤较对照组及金纳多组轻。结论 参芪脑保颗粒对大鼠局灶脑梗死有治疗作用。     

罗布麻提取物对大鼠局灶性脑缺血再灌注损伤的保护作用

目的 观察罗布麻提取物（Aplocyilum venetum L Extract,AVE）对大鼠局灶性脑缺血再灌注损伤的保护作用。方法 将雄性Wistar大鼠随机分为假手术组、模型组、AVE（高、低剂量）组和阳性对照组（银杏叶胶囊）,口服给药5d后,采用改良的Ionga法,建立大鼠局灶性脑缺血再灌注损伤模型。再灌注2,4h后对大鼠神经功能障碍进行评分,测量其脑梗死面积、脑含水量。结果 与模型组相比,AVE两个剂量组可以减轻神经症状,缩小缺血面积,并且可以减轻脑水肿。与阳性对照组对比,各指标无显著性差异。结论 AVE对局灶性脑缺血再灌注模型大鼠具有保护作用。     

蜕皮甾酮对大鼠局灶性脑梗死的保护作用及机制初讨

目的：观察蜕皮甾酮（EDS）对大鼠局灶性脑梗死是否有保护作用,并探讨其可能的机制。方法：应用大脑中动脉线栓法（MCAO）建立大鼠局灶性脑梗死模型,大鼠随机分为正常对照组、缺血组、于预组。干预组于MCAO术后2h,腹腔直接注射EDS20mg&#183;kg^-1&#183;d^-1。连续给药2d后,统计大鼠死亡率,采用5级评分法评定神经功能缺损程度,采用TTC染色测定脑梗死体积,同时测定脑组织含水量及动脉血清MDA含量、SOD活性。结果：MCAO术后48h,干预组的死亡率较缺血组明显降低,神经功能缺损评分降低,脑梗死体积减小,脑组织含水量降低,血清MDA含量降低,SOD活性升高,两组之间的差异均有硅著性。结论：EDS对大鼠局灶性脑梗死后神经损伤具有一定的保护作用,其保护作用可能与拮抗脑缺血后自由基损害、减轻脑水肿有关。     

环孢霉素A对弥漫性轴索损伤后大鼠神经功能保护的研究

目的　探讨大鼠弥漫性轴索损伤后应用环孢霉素A治疗能否促进大鼠神经功能的恢复。方法　将 2 4只SD大鼠随机均分为正常对照组、损伤对照组和环孢霉素A治疗组 ,制作大鼠弥漫性轴索损伤模型 ,用Morris水迷宫和木梁平衡实验评价大鼠学习记忆能力和综合平衡能力。结果　环孢霉素A治疗后 ,大鼠在木梁上的时间长于损伤对照组 (F =2 75 4 4 ,P <0 0 1 ) ,在连测的 5天内 ,治疗组和损伤对照组行为评分呈下降趋势 ,治疗组平衡能力好于对照组 (F =36 97,P <0 0 1 )。在水迷宫实验中 ,尽管治疗组找到平台的时间和正常对照组相比有所延长 (F=6 9 2 7,P <0 0 1 ) ,但明显少于损伤对照组 (F =1 72 1 0 ,P <0 0 1 )。结论　环孢霉素A能改善大鼠的学习记忆能力和综合平衡能力 ,促进大鼠神经功能的恢复     

法舒地尔预处理对大鼠脑缺血再灌注损伤细胞色素C和caspase-3表达的影响

目的研究法舒地尔对大鼠局灶性脑缺血再灌注损伤细胞色素C（CytC）和caspase-3蛋白表达的影响,探讨其脑保护机制。方法线栓法制作大鼠中动脉缺血再灌注损伤模型。成年雄性SD大鼠120只随机分成3组：假手术组（Sham组）、脑缺血再灌注模型组（Mod组）、法舒地尔干预组（Fas组）,再分为再灌注3h、12h、24h和48h,以及TTC染色组5个亚组,每组8只大鼠。缺血再灌注后进行神经功能缺损评分（NDS）,免疫组织化学方法检测脑组织中CytC蛋白、cas-pase-3的表达,TTC染色测量鼠脑梗死体积并计算百分比。结果①Sham组大鼠无神经功能缺损,NDS评分为0,TTC染色亦未见脑组织梗死;Mod组和Fas组大鼠均有明显的神经功能缺损,TTC染色亦可见明显的脑组织梗死;但与Mod组相比,Fas组神经功能缺损少、NDS评分低（P〈0.01）,脑梗死体积减小（P〈0.05）。②与Sham组相比,脑缺血再灌注后,Mod组和Fas组大鼠脑组织CytC和caspase-3的表达显著升高（P〈0.01）,其中CytC表达高峰出现在12h,caspase-3表达高峰出现在24h;Fas组和Mod组间比较显示Fas组CytC和caspase-3的表达又显著低于Mod组（P〈0.01）。结论①法舒地尔能减轻大鼠脑局灶性缺血再灌注引起的神经功能缺损,减小脑梗死体积。②部分抑制脑缺血再灌注引起的CytC和caspase-3表达增加可能是法舒地尔的脑保护机制之一。     

丁苯酞对大鼠局灶性脑缺血再灌注损伤的保护作用

目的 观察丁苯酞对大鼠局灶性脑缺血再灌注损伤后血管内皮生长因子(VEGF)表达的影响及其对缺血再灌注损伤治疗时间窗的影响.方法 SD大鼠72只,随机分为假手术组24只,缺血再灌注组24只,丁苯酞治疗组24只.每组再分为缺血2、3和4 h 后再灌注3个亚组,每亚组8只.采用改良线栓法制作大鼠局灶性脑缺血再灌注模型,观察各组神经功能和脑梗死范围,免疫组化法检测脑组织中VEGF表达.结果 随着缺血时间延长,再灌注后,神经功能评分和脑梗死范围也随之增高,缺血再灌注组在缺血2、3和4 h的神经功能评分分别为(2.6 ± 0.6)分、(3.7 ± 1.0)分和(4.2 ± 1.0)分,脑梗死容积比率分别为(27.6 ± 5.4)%、(33.1 ± 6.1)%和(42.3 ± 7.3)%;而在丁苯酞治疗组则分别为(1.2 ± 0.5)分、(1.6 ± 0.7)分、(2.3 ± 0.9)分和(9.8 ± 1.6)%、(16.7 ± 2.3)%和(20.7 ± 3.9)%,与缺血再灌注组比较丁苯酞治疗组明显较低,差异有统计学意义(P值均＜ 0.05).并发现丁苯酞治疗组的缺血4 h的症状评分和脑梗死容积比率与缺血再灌注组缺血2 h比较,差异无统计学意义(P ＞ 0.05).随着缺血时间的延长,丁苯酞治疗组和缺血再灌注组的VEGF表达均逐渐减弱.与假手术组比较,缺血再灌注组脑组织中VEGF表达明显减弱(P ＜ 0.01).与其他两组比较,丁苯酞治疗组的VEGF表达明显较强,差异有统计学意义(P ＜ 0.01).结论 丁苯酞对大鼠局灶性脑缺血再灌注损伤具有保护作用,其作用机制可能与VEGF表达相关,并能延长缺血再灌注治疗时间窗.     

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.     

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）     

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.