震动伤犬血清CG、ALT含量测定

目的 观察震动伤犬血清甘胆酸(CG)和丙氨酸氨基转移酶(ALT)含量变化特点,对震动伤的伤情分类、临床诊断和治疗方案的确定提供依据.方法 在地下模拟爆炸炸现场获取震动伤动物模型.方法是分别在距爆炸心地平面0m、100m、200m、300m处设四个点,选择当地家犬34只,采用自由位和右卧位布放在上述四上个点.对爆炸炸前、后动物血清中的CG和ALT含量进行配对分析.结果 检查发现,爆炸后10小时开始,血清CG和ALT含量即明显升高(1116.8±1181.2nmol/L和66.8±49.5U/L,P＜0.01.),至爆炸后17d血清CG尚未完全恢复(773.2± 408.1nmol/L,P＜0.01.).结论 实验动物受震动伤时,血清CG和ALT水平异常升高.提示在临床诊断、治疗震动伤伤员时,除常规检测血清ALT外,血清CG含量测定是反应肝脏损伤和修复程度的敏感指标.特别是在治疗后期,血清ALT已经恢复正常时,CG含量测定可为临床治疗效果的评价提供可靠依据.     

血清皮质醇水平及其动态监测与急性颅脑损伤严重程度及预后关系分析

目的 分析不同程度急性颅脑损伤患者血清皮质醇(COR)水平的动态监测特征及与预后关系.方法 80例急性颅脑损伤患者按入院时格拉斯哥昏迷(GCS)量表评分和颅脑CT表现判定颅脑损伤程度,并将其分为三组:轻型(n=28)、中型(n=30)、重型(n=22).于伤后1、2、3、7d及14d采集三组血清标本测定COR水平,并进行预后评估,以Pearson相关系数来评价血清COR水平与预后的关系.结果 轻型、中型、重型急性颅脑损伤患者伤后各时点血清COR水平依次明显升高,组间比较有显著性差异(P<0.05);且重型急性颅脑损伤患者伤后1、2、3、7d及14d血清COR水平波动幅度显著高于轻型、中型患者(P<0.05),三组伤后7、14d血清COR水平均呈正常趋势.轻型、中型、重型急性颅脑损伤患者ICU住院时间、机械通气时间及总住院时间依次明显延长,格拉斯哥预后评价量表(GOS)评分依次显著降低,组间比较有显著性差异(P<0.05);且三组预后情况分布差异有统计学意义(P<0.05),以重型急性颅脑损伤患者预后最差.急性颅脑损伤患者伤后14d血清COR水平与GOS评分呈负相关(P<0.05).结论 急性颅脑损伤患者血清COR水平明显升高,且损伤程度越严重COR水平升高越明显,动态监测变化幅度越大,且治疗期间COR水平变化与预后密切相关.     

爆炸冲击震动致犬神经内分泌改变及应激损害的研究

目的：观察爆炸强烈冲击震对犬神经内分泌的影响并搪塞有效预防措施。方法：分别应用清醒、麻醉、阻断肾上腺素能神经和抑制促肾上腺皮质激素（ＡＣＴＨ）犬布放于爆心周围。检测爆炸震动前后犬平均动脉压、血浆ＡＧＴＨ、去甲肾上腺素（ＮＥ）和皮质醇水平 及重要脏器的病理变化。结果：清醒犬受到强烈震动后,血浆上一种激素水平明显上升高,血压较震前升高、脑、心、肺、肾等有不同程度损伤;而麻醉、阻断肾上腺素能神经和抑制Ａ     

臂丛神经阻滞复合右旋美托咪啶对上肢创伤患者应激反应的影响

目的探讨应用臂丛神经阻滞复合右旋美托咪啶对上肢外科创伤患者应激反应的影响,为临床的应用提供参考。方法将2009年1月~2014年1月我院收治的260例上肢创伤需行手术治疗患者的病例收集进行回顾性的整理,分析,随机分成臂丛神经阻滞复合右旋美托咪啶组(实验组)和单纯臂丛神经阻滞组(对照组)各130例,分别于麻醉前1h(T1)麻醉后2h(T2)、术后8h(T3)、术后24h(T4)四个时间点分别监测两组患者血流动力学和其他创伤应激反应相关指标,收集和处理数据,分析上述两种麻醉方法影响创伤应激反应形式和程度。结果①两组患者血流动力学相关指标对比情况院实验组T2、T3和T4时心率、收缩压均显著低于对照组,但组间MAP比较无明显差异。舒张压、经皮指脉氧饱和度、呼气末二氧化碳分压在各组内及两组间比较均无统计学差异。②两组患者创伤应激反应其他相关指标组间和组内对比：麻醉后2h、术后8h、术后24h对照组和实验组WBC、CRP于各组内对比均较麻醉前明显增加。T1时两组间GAS、COR、WBC差异均不显著,T2、T3及T4时实验组COR、CRP、GAS明显低于对照组。对照组COR于T2时最低,T3时略有回升,T4时又略微下降,GAS则进一步下降;实验组COR、GAS于T2时迅速降低,T3时略有回升,T4时又稍下降;两组T2时ANP均略有增高,T3、T4时均下降,各组内不同时间点间均具显著性差异,但两组间相同时间点ANP的差异无统计学意义。结论臂丛神经阻滞复合右旋美托咪啶可减轻上肢外科创伤后应激反应程度同时改善所致血流动力学紊乱,临床应用效果优于传统的单一臂丛神经阻滞。     

创伤性脑损伤后大鼠外周血CD8的变化

目的:探讨外周血CD8在创伤性脑损伤后的变化特点。方法:改良Feeney's自由落体打击法制备创伤性脑损伤模型;ELISA检测大鼠血清中神经元特异性烯醇化酶(NSE)和CD8的含量,双变量分析两者的相关性;Western blot法检测大鼠血液淋巴细胞FasL蛋白的表达。结果:颅脑外伤后大鼠血清CD8升高滞后于NSE。大鼠伤后1 d血清NSE水平即显著升高,伤后3 d达到峰值,随后逐渐下降;大鼠血清CD8在伤后3 d开始升高,峰值出现在伤后7 d,随后逐渐下降。统计分析显示伤后1 d、3 d、7 d的血清的NSE与伤后3 d、7 d、14 d的血清CD8含量变化呈现正相关。但伤后不同时间大鼠血液淋巴细胞FasL蛋白表达的差异均无统计学显著性。结论:创伤性脑损伤后释放入血的NSE刺激机体免疫应答,引起外周血CD8增多,推测其可能与创伤性脑损伤后继发性损伤的免疫应答有关。     

电磁脉冲辐射对猕猴凝血机制影响研究

目的:探讨电磁脉冲对猕猴凝血机制影响。方法:经高场强电磁脉冲源以6×104V/m全身辐照5只猕猴,于照前及照后1、3、7、14、28及90d下肢前静脉采血,采用AYW-8001型血凝仪检测电磁脉冲对动物血浆中TT、PT、APTT及FIB的影响。结果:动物血浆中TT于伤后1d及14～28d延长,APTT于伤后1d延长,FIB含量于伤后14d减少,PT在照射前后无明显变化。结论:电磁脉冲照射可对实验猕猴凝血机制产生影响,可通过TT、APTT延长和FIB含量减少而使机体凝血机制发生障碍。     

小鼠腹部照射后肾上腺皮质醇分泌含量变化及生物学效应

目的：探讨小鼠腹部照射后肾上腺皮质醇分泌含量和生物学效应的变化,为累及至肾上腺的腹部放射治疗的安全性提供参考依据。方法：将小鼠分为4组,每组小鼠各给一个剂量点照射,分别为0Gy,6Gy,9Gy和12Gy。运用放射免疫分析和组织化学法观察照射后第3d、7d、14d、30d小鼠血清皮质醇含量和肾上腺形态的变化。结果：小鼠腹部照射后血清皮质醇含量和肾上腺形态均发生变化,其表现为：照射后第3d皮质醇分泌增多,肾上腺髓质内毛细血管扩张充血;第7d皮质醇分泌较前下降,肾上腺皮质体积不同程度缩小;第14d出现皮质醇分泌下降到基础水平,肾上腺皮质球状带细胞的代偿性增生;第30d出现皮质醇分泌上升和肾上腺形态的恢复。结论：不同剂量腹部照射后皮质醇分泌量和肾上腺形态发生阶段性的适应性改变,这种改变可能为临床治疗肿瘤并同时保护肾上腺及其功能提供帮助。     

犬腹部5.56mm弹致伤后早期肝脏的变化及其机理

本研究观察了犬腹部高速投射物伤后早期肝功能的变化及内皮素、压力波在其中的作用。结果发现：伤后肝组织ＭＤＡ含量明显增高（Ｐ〈０．０１），ＡＴＰ水平显著下降；而肝血流量于伤后一直低于伤前；血清内皮素含量在伤后明显升高，其变化与肝血流量下降间有显著负相关关系。肝脏损伤的发生与肝血流减少及压力波的直接作用有关，而肝血流减少的原因则可能与失血性应激所致的血流再分配及内皮素的作用有关。     

高速投射物伤伤后血液流变性的变化特点及意义

探讨压力波对血液流变性的影响。方法：将实验犬２４只随机分为二组：一组以５．５６ｍｍ军用弹致伤犬的双后肢;另一组伤前暂时结扎犬双后肢股动静脉,以阻断致伤时压力波传播,伤后立即去除结扎。二组伤前、伤后０．５、２、６和１０ｈ分别采静脉血,用锥板粘度法测全血粘度并计算红细胞压积、红细胞变形指数和红细胞聚集指数。结果：伤后二组动物全血低切粘度（３．８４Ｓ－１）、红细胞压积、红细胞聚集指数较伤前明显升高;伤后６ｈ内红细胞变形指数较伤前明显下降。结扎组变化程度明显小手致伤组。结论：高速投射物伤时,血液流变性发生了明显变化,可能与致伤时压力波沿血管传播有关。     

兔胸腹部爆炸伤后的血液浓缩及其可能机制

目的 :探讨爆炸性冲击伤后血液浓缩的特点及其可能的机制。方法 :采用雷管所致兔爆炸性冲击损伤模型 ,以1 2 5I 白蛋白标记的方法 ,观察爆炸性冲击伤前后红细胞压积与血浆外渗情况。结果 :距爆源 2 0cm处的爆炸冲击波作用时 ,红细胞压积增加 14 .9% ,血浆丢失为对照的 5 .12倍 ,白蛋白漏出率为伤前的 1.3倍 ,左肺组织中残留放射性较对照组增加约 18% ,该点平均压力峰值为 174 .4kPa。结论 :爆炸冲击伤后的红细胞压积增加、血浆丢失是伤后微循环功能障碍的重要原因     

Influence of hypergastrinemia secondary to long-term proton pump inhibitor treatment on ECL cell tumorigenesis in human gastric mucosa

Proton pump inhibitor (PPI) therapy causes hypergastrinemia, which could promote the development and progression of neuroendocrine tumors (NETs). Concerns have been raised about the safety of long-term PPI use due to a possible increased risk of NETs. This study aimed to investigate the association between hypergastrinemia and the risk of NETs. Twenty outpatients presenting with serum gastrin levels greater than 400 pg/mL after long-term PPI treatment were registered in this study. Immunohistochemical analyses for chromogranin A (CgA), Ki67, gastrin and CCK/B gastrin receptor (CCKBR) were performed, and positive cell numbers were counted. There were no NET or gastric epithelial neoplasia cases observed among any of the 20 patients examined throughout the PPI treatment period. Histologically, ECL cell hyperplasia were shown in all patients. However, no relationship was found between serum gastrin levels and the number of CgA positive ECL cells. There was also no relationship between serum gastrin levels and the proportion of Ki67 positive cells or the density of CCKBR positive cells. The data indicate no relationship may exist between NETs and hypergastrinemia secondary to PPI treatment in patients having no, or mild, atrophic gastritis.     

实验性狗溃疡病手术后G细胞密度及功能的变化研究

目的 研究实验性狗溃疡病手术后G细胞密度和功能的变化。方法 给成年杂种狗分别施行胃大部切除、胃空肠吻合术(DPG-BⅡ)或保留幽门括约肌胃段切除术(PPSG)或高选择性迷走神经切断术(HSV)。以中和滴定法测定胃酸;以放射免疫法测定血清胃泌素;用免疫组化方法检测G细胞数量和功能。结果 三种手术均能有效抑制胃酸分泌。DPG-BⅡ和PPSG术后血清胃泌素降低,而HSV术后血清胃泌素升高。三种手术后胃窦或残留胃窦、十二指肠和空肠的G细胞数密度增加、功能增强。结论 溃疡病术后G细胞呈代偿性增生和功能增强,胃泌素水平不随胃酸降低而相应降低。     

Circadian rhythms of serum aldosterone, cortisol and plasma renin activity in burn injuries

Circadian rhythm of serum aldosterone and cortisol concentrations and of plasma renin activity (PRA) were measured by radioimmunoassay in 10 adults with thermal injuries. The determinations were begun 6 to 48 hours after the injury and continued for five consecutive days four times a day. In all patients, the normal pattern of the circadian rhythm for all three hormones disappeared and values remained quite high at any time of the day or the night. Four patients developed an hypertensive crisis with quite elevated levels of aldosterone, cortisol and plasma renin activity. The same hormones were also found very elevated in two hypotensive patients with 80 percent or more of injured body surface who were in agonal conditions and succumbed to the injury.     

A longitudinal evaluation of urinary cortisol in kennelled dogs, Canis familiaris

Urinary cortisol levels (based on cortisol : creatinine ratios) were evaluated in a randomly selected sample of shelter dogs kennelled over a 31-day period. Urine was collected on days 2, 5, 10, 17, 24 and 31 (with day 1 referring to the day of admittance to the shelter). Cortisol levels peaked on day 17 and steadily declined thereafter, although a high degree of individual variation was found, with cortisol levels peaking sooner in some dogs. Cortisol levels in kennelled dogs were significantly higher on all days except d 31 than the baseline measures taken from 20 dogs in their home environments. There were no differences between cortisol levels in male and female dogs on each day of sampling and there was no significant linear correlation between age and cortisol levels. The results are discussed in relation to stress management and the welfare of kennelled dogs.     

Regulation of antral gastrin content

Five groups of rats were fasted for 3 days and injected with either NaCl or 5, 10, 20, or 40 micrograms/kg bombesin every 8 h. The animals were killed, and their serum and antral gastrin levels were compared with those of normally fed rats. Fasting reduced serum gastrin to 14% of control; antral gastrin was reduced to 21% of control. All doses of bombesin significantly increased serum gastrin in fasted rats, and 20 and 40 micrograms/kg significantly increased antral gastrin. A group of normally fed rats was also compared with one fed a liquid diet for 7 days. Half of each of these was injected with 20 micrograms/kg bombesin (3 times/day) and the other half with NaCl. Bombesin significantly increased serum and antral gastrin in the rats fed solid food. The liquid diet lowered serum and antral gastrin to 17 and 59% of control values, respectively. Bombesin injection totally prevented these decreases. These data indicate that food in the gastrointestinal tract is not required for either gastrin release or synthesis. Furthermore, the data suggest that gastrin synthesis is regulated primarily by gastrin release or by direct stimulation by bombesin rather than by specific food products.     

消化性溃疡患者血清胃蛋白酶元、胃泌素和TGF-α水平的变化及临床评估

目的：探讨了消化性溃疡患者治疗前后血清胃蛋白酶元（PG）、胃泌素（GS）和转化生长因子-α（TGF-α）水平的变化及临床意义。方法：采用放射免疫分析对33例消化性溃疡患者进行了治疗前后血清PG、GS和TGF-α水平进行了检测,并与35名正常健康人作比较。结果：消化性溃疡患者在治疗前血清PG、GS水平显著地高于正常人组（P〈0.01）,而TGF-α水平又非常显著地低于正常人组（P〈0.01）。经治疗1个月后与正常人组比较无显著性差异（P〉0.05）。血清TGF-α、PG与GS水平呈显著负相关（r=-0.4684、-0.4512、-0.5012,P〈0.01）。结论：检测消化性溃疡患者血清PG、GS和TGF-α的水平变化对溃疡的诊断、治疗和预后观察均有一定的实用价值。     

消化性溃疡患者血清IL-2、IL-18和Gas检测的临床意义

目的：评估消化性溃疡患者治疗前后血清IL-2、IL-18和胃泌素水平的变化及临床意义。方法：应用放射免疫分析对38例消化性溃疡患者进行了治疗前后血清IL-2、IL-18和胃泌素水平测定,并与35名正常健康人作比较。结果：消化性溃疡患者在治疗前血清IL-2水平非常显著地低于正常人组（P〈0.01）,而血清IL-18、胃泌素水平又非常显著地高于正常人组（P〈0.01）,经治疗3个月后则与正常人组比较无显著性差异（P〉0.05）。结论：检测消化性溃疡患者血清IL-2、IL-18和胃泌素水平的变化与疾病的进程密切相关,可确认具有提示预后的价值。     

Serum free and phospholipid-bound choline decrease after surgery and methylprednisolone administration in dogs

We designed this study to determine whether serum free and phospholipid-bound choline concentrations change after surgery or methylprednisolone treatment in dogs and rats. In dogs, serum free and phospholipid-bound choline concentrations were decreased by 29% and 17% immediately after abdominal-pelvic surgery under xylasine+ketamine anesthesia, respectively, and both remained low for 24 h. Serum cortisol was elevated after surgery. The elevation in serum cortisol was inversely correlated with the decreases in free (r=-0.737; P<0.001) and phospholipid-bound (r=-0.771; P<0.001) choline concentrations. After methyprednisolone administration (5-20 mg/kg) free and phospholipid-bound choline concentrations decreased in a dose- and time-dependent manner. In rats, either surgery or methylprednisolone failed to alter serum free choline concentrations while phospholipid-bound choline decreased after surgery. These data show that the decrease in serum choline after surgery results from the increase in circulating glucocorticoids.     

慢性湿疹患者治疗前后血清IL-2、IL-6和Gas检测的临床意义

目的：探讨慢性湿疹患者治疗前后血清IL-2、IL-6和胃泌素（Gas）水平的变化及意义。方法：应用放射免疫分析对38例慢性湿疹患者进行治疗前后血清IL-2、IL-6和Gas检测,并与35名正常健康人作比较。结果：在治疗前血清IL-2水平非常显著地低于正常人组（P〈0.01）,而IL-6和Gas则显著地高于正常人组（P〈0.01）,经治疗1个月后,除IL-6、Gas水平与正常人组比较无显著性差异外（P〉0.05）,IL-2与正常人组比较仍有显著性差异（P〈0.05）。结论：检测慢性湿疹患者血清IL-2、IL-6和Gas水平的变化对了解病情、指导临床实践有重要的临床价值。     

Effects of antral distension on pancreatic exocrine secretion in dogs: evidence for a short reflex

In chloralose anesthetized dogs and decerebrated dogs whose pyloric sphincter was submucosally ligated, the pancreatic exocrine secretory response to antral distension was studied. Distensions of the antral pouch with Tyrode's solution and 0.1 N HCl caused graded rises in pancreatic flow and protein and bicarbonate outputs. The serum gastrin concentration gradually rose after the distention with Tyrode's solution, while no rise in serum gastrin was elicited by acid distension. After cervical vagotomy, a reduced pancreatic response persisted but no rise in the serum gastrin was seen. After splanchnicectomy following vagotomy, the pancreatic response became greater than before splanchnicectomy. This pancreatic response was observed even after caeliac and superior mesenteric ganglionectomies, but was completely abolished by an external tight ligature around the pyloric sphincter, or by administration of hexamethonium or atropine sulfate. The results suggest the existence of an antropancreatic short reflex in addition to a long route vago-vagal reflex.