G_z重复暴露对大鼠脑组织能量代谢的影响

目的观察＋Gz重复暴露后大鼠脑组织能量代谢的动态变化特点，探讨其在＋Gz致脑损害中的可能作用及新的有效防护措施。方法应用高效液相色谱法，观察＋10Gz持续3min重复暴露三次后32只大鼠脑组织乳酸、乳酸脱氨酶、腺苷酸及嘌呤代谢的动态变化过程。结果＋Gz重复暴露三次后即刻，脑皮层三磷酸腺苷（ATP）含量、能量负荷（EC）及乳酸脱氨酶（LDH）活性较对照组分别降低37．2％（P＜0．05）、265％（P＜0．01）及70．7％（P＜0．01），而二磷酸腺苷（ADP）、一磷酸腺苷（AMP）及乳酸含量则分别升高105．0％（P＜0．05）、30．6％（P＜0．05）及43．6％（P＜0．01）；暴露后1h，脑皮层ATP、ADP、AMP含量及EC则基本恢复至对照组水平，而乳酸含量及LDH活性则仍未恢复正常，与对照组间仍有非常显著性差异（P＜0.01）；暴露后6h，上述指标则均基本恢复正常。结论＋10Gz持续3min重复暴露三次可引起脑组织能量代谢一过性降低。脑能量代谢降低可能是＋Gz重复暴露后发生脑离子平衡紊乱及脑损害的主要因素。     

亚低温对完全性脑缺血再灌注后丙二醛含量和超氧化物歧化酶活性的影响

目的：观察完全性脑缺血再灌注后全脑亚低温对脑组织丙二醛（ＭＤＡ）含量和超氧化物歧化酶（ＳＯＤ）活性的影响．方法：将１７只犬随机分为三组：非缺血对照组、缺血对照组和亚低温治疗组，采用谭秀娟等建立的心脏停跳复苏动物模型，于心肺复苏后４小时取脑组织测定ＭＤＡ含量和ＳＯＤ活性．结果：全脑缺血１０分钟后再灌流４小时，脑组织ＭＤＡ含量明显上升（Ｐ＜０．０１），ＳＯＤ活性下降（Ｐ＜０．０１）；而３４℃亚低温治疗组与缺血对照组比较，ＭＤＡ含量明显下降（Ｐ＜０．０１），ＳＯＤ活性上升（Ｐ＜０．０１）．结论：完全性脑缺血再灌注后全脑亚低温可抑制脑内脂质过氧化反应，保护脑组织自身抗氧化能力，有利于脑复苏．     

改良猪深低温模型脑保护机制研究

目的 研究猪改良深低温动物模型深低温不停循环(DHNCA)90min期间脑保护作用机制。方法 实验分二组：假手术组6只，37℃不予特殊处理；实验组8只，18～25℃深低温不停循环90min，复温后观察生理指标变化、脑组织形态学和超微结构变化，用逆转录聚合酶链反应(RT～PCR)方法检测即早基因c～fos和c～jun mRNA的表达。结果 实验组光镜下可以观察到少量神经元形态学改变；电镜下线粒体形态基本正常，突触前膜有大量囊泡聚集；c-fos和c-jun mRNA表达上调。结论 猪改良动物模型在深低温脑保护研究中有效简便。深低温不停循环90min对神经组织无明显损害，可作为下一步深低温脑保护液辅助灌注实验的基础。     

高压氧对沙鼠脑缺血海马神经细胞Ca2+-ATP酶活力的影响

目的探讨高压氧（HBO）作用后对脑缺血海马神经细胞Ca^2＋-ATP酶活力的影响。方法用蒙古种沙土鼠，采用双侧颈总动脉结扎制作前脑缺血模型，动物随机分为正常对照组、缺血再灌注组（夹闭双侧颈总动脉30min制作全脑缺血模型，随后放开动脉夹使再灌流80min）、0．1MPa纯氧组、0．25MPa高压氧组、0．25MPa常氧高氮组共5个组。采用定磷法测定海马神经细胞Ca^2＋-ATP酶活力。结果急性脑缺血再灌注后，Ca^2＋-ATP酶活力显著下降（P〈0．01），经0．1MPa纯氧和0．25MPa高压氧作用后，Ca^2＋-ATP酶活力均明显恢复，与急性脑缺血再灌注组相比，差异有统计学意义（P〈0．01），而且以0．25MPa高压氧组作用更为显著，0．25MPa常氧高氮组Ca^2＋．ATP酶活力无明显改变，结论高压氧可通过恢复Ca^2＋-ATP酶活力以恢复细胞内游离Ca^2＋浓度。     

左旋精氨酸对复苏犬缺血缺氧性脑损害的影响

目的 利用犬停循环(CA)复苏模型,研究深低温及NO前体-左旋精氨酸(L-arg)对复苏犬脑氧代谢及超微结构的影响.方法 健康成年杂种犬10只,随机分为L-arg预处理组和对照组,每组5只.按临床方法建立体外循环转流降温至鼻咽温18℃停循环,90min后恢复体外循环复苏.分别于CA前30min、CA 0min、CA 45min、CA 90min、复苏后60min抽取颈静脉、颈动脉血测算颈静脉血氧饱和度(SjvO2).取脑皮质透射电镜观察脑超微结构改变.处死后测脑皮质含水量.结果 停循环后SjvO2逐步降低,至CA 90min达最低值,复苏后回升.停循环期L-arg预处理组SjvO2高于对照组(P＜0.001).复苏后L-arg预处理组脑皮质超微结构改变轻于对照组,脑组织含水量亦低于对照组(P＜0.05).结论 深低温可改善停循环后脑氧供需平衡,对缺血缺氧性脑损害有保护作用,L-arg预处理有利于停循环后脑复苏治疗.     

含二氦嗪停搏液对缺血再灌注心肌能量代谢保护作用研究

目的 观察线粒体内膜三磷酸腺苷敏感钾离子通道开放剂二氮嗪加入停搏液内对缺血再灌注大鼠心肌能量代谢的保护作用。方法 50只大鼠随机分为五组，每组lO只，取离体心脏；A组取正常心肌，其余制备离体工作心脏灌注模型；B组停灌30min，复灌60min；其余三组分别灌注不同的停搏液，C组灌注停搏液，D组灌注含二氮嗪的停搏液，E组灌注含二氮嗪停搏液之前10min给予格列苯脲，各组复灌30min后进行工作模式心脏灌注，监测心率、左室收缩峰压和舒张末压。实验终了取心肌，提取线粒体，测定细胞色素氧化酶活性、线粒体H^＋-三磷酸腺苷酶活性；高效液相法测定心肌含量。结果 缺血再灌注心肌线粒体细胞色素氧化酶活性和线粒体H^＋-三磷酸腺苷酶活性降低（P〈0．05）；而二氮嗪处理组相应指标显著改善（P〈0．01）。结论 含二氮嗪停搏液能够改善缺血再灌注心肌功能，能量代谢恢复。     

经右腋动脉选择性脑灌注在主动脉夹层手术中的应用

目的总结右腋动脉插管体外循环(ECC)、选择性顺行脑灌注在主动脉夹层手术中应用的初步经验。方法回顾性分析我院2005年1月—2008年7月采用深低温停循环(DHCA)加右腋动脉插管选择性顺行脑灌注(ASCP)手术治疗I型主动脉夹层10例。男8例,女2例。年龄24~63岁,平均(41.7±12.0)岁。升主动脉+全弓置换+降主动脉术中支架置入术5例,升主动脉+全弓置换2例,升主动脉+右半弓置换3例。结果本组主动脉阻断时间83~258min,平均(132.3±52.8)min。深低温停循环时间8~53min,平均(29.10±18.30)min,选择性脑灌注时间8~58min,平均(33.4±18.5)min。手术死亡2例,1例因术中出血、体外循环时间长不能脱机,1例因术后低心排和多脏器功能衰竭。术后暂时性脑损害2例,均治愈出院,无永久性脑损害发生。结论右腋动脉插管灌注和顺行脑灌注在主动脉夹层手术中可提供有效的脑保护,其操作简便、安全。     

亚低温对实验犬复苏后血清及脑脊液中血小板活化因子含量的影响

目的 探讨亚低温治疗的脑保护作用机制。方法 采用犬室颤致心跳骤停动物模型,观察复苏过程中亚低温治疗对血清及脑脊液中血小板活化因子（ＰＡＦ）含量的影响。结果 ①复苏后血清及脑脊液中ＰＡＦ含量较心跳骤停前明显升高（Ｐ〈０．０１）;②亚低温治疗组脑脊液中ＰＡＦ含量明显低于常温对照组（Ｐ〈０．０１）,而血清中ＰＡＦ含量两组间无明显差异。结论 ＰＡＦ在缺血及再灌注脑损害中起重要作用,亚低温抑制复苏后脑组织中     

Gz重复暴露对大鼠脑组织离子含量及ATP酶活性的影响

为探讨持续性高十Gz对脑的影响及新的有效防护措施，观察了十10Gz／3min重复暴露3次对大鼠脑皮层K 、Na 、Ca2 和水含量以及ATP酶活性的影响。结果表明，＋10Gz／3min重复暴露3次后即刻及1h，大鼠脑皮层K 含量较对照组显著升高（P＜0．05），Na －K －ATP酶活性均显著降低（P＜0．01），暴露后6hK 含量及Na －K －ATP酶活性已基本恢复，与对照组相差均不显著；在十Gz暴露后即刻，Na 含量有升高趋势，但未达到显著水平，水含量则无明显变化，暴露后1h及6hNa 及水含量均显著升高（P＜0．05）；＋Gz暴露后各时间组的Ca2 含量及Ca2 －ATP酶活性较对照组则均无显著性差异。提示十10Gz／3min重复暴露3次可引起大鼠脑皮层离子平衡的紊乱。后者可能在十Gz致脑水肿的发生过程中起重要作用。     

参麦注射液联合极化液对大鼠复苏后脑组织的影响

目的探讨参麦注射液联合极化液对心肺复苏后脑保护的作用。方法建立成年雄性SD大鼠心脏骤停-心肺复苏模型,随机分为对照组（A组）、复苏组（B组）、极化液组（C组）、参麦组（D组）和联合用药组（E组）,每组8只。复苏后24 h进行神经功能评分,并观察脑组织细胞结构,测定脑组织含水量、丙二醛（MDA）含量、超氧化物歧化酶（SOD）及Na＋-Ka＋-ATP酶活力的变化。结果 B组脑组织含水量、MDA含量较各治疗组显著增高,SOD及Na＋-Ka＋-ATP酶活力减低（P〈0.05）,E组各项指标检测较C组、D组好（P〈0.05）、脑组织超微结构改变轻微。结论参麦注射液联合极化液对心肺复苏后脑组织有一定程度的保护作用。     

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.     

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.     

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).     

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.