急性脊髓创伤后神经肽含量变化的实验研究及临床观察

目的：旨在探讨神经肽在脊髓继发性损伤中的作用。方法：应用放射免疫分析（ＲＩＡ）技术首次系统观察了急性脊髓创伤患者脑脊液中及脊髓损伤大鼠脊髓组织中三种不同内源性阿片肽含量的动态变化。结果：强啡肽（ＤｙｎＡ）随损伤程度的加重进行性升高；β－内啡肽（β－ＥＰ）无明显变化；亮脑啡肽（Ｌ－ＥＫ）伤后含量降低或无明显变化，且与受伤程度无明显相关。临床观察为脊髓损伤越重，脑脊液（ＣＳＦ）中ＤｙｎＡ和β－ＥＰ升高越明显，回复至正常的时间越长，预后也越差。Ｌ－ＥＫ含量在完全性和不完全性截瘫患者伤后均无明显变化。结论：内源性阿片肽参与了脊髓继发性损伤的病理过程，其中ＤｙｎＡ的作用最重要。     

狗颅脑及四肢火器伤后外周血,脑脊液中β—内啡肽的含量变化

为进一步研究β－内啡肽在创伤中的变化规律，笔者制成狗颅脑火器伤和狗后肢火器伤模型，并采用放射免疫法测定动物血浆，脑脊液，下丘脑及垂体中β－内啡肽含量。结果发现颅脑火器伤组后浆，脑脊液中β－内啡肽含量均明显升高，结果提示：在创伤中只要伤情达到一定的严重程度，就可引起β－内啡量含量的变化，不同部位的损伤，其变化的时相亦不同。     

大剂量地塞米松治疗猫急性颅脑损伤后对强啡肽A含量的影响及意义

大剂量地塞米松治疗猫急性颅脑损伤后对强啡肽Ａ含量的影响及意义刘子生，张叔辰，朱诚，张光霁，路长林，王成海２５００３１济南济南军区总医院中图法分类号Ｒ６５１．１５实验证明强啡肽Ａ（Ｄｙｎ－Ａ）参与急性颅脑伤的发病过程，高含量的脑脊液Ｄｙｎ－Ａ可加重继发...     

高压氧对大鼠颅脑创伤后脑损伤和脑水肿的影响

目的：探讨高压氧对大鼠颅脑创伤后脑损伤和脑水肿的影响。方法：将大鼠随机分为对照组、脑创伤组和高压氧（ＨＢＯ）组。采用ＢＩＭ－Ⅲ型撞击机撞击大鼠右侧颅顶，复制闭合性颅脑损伤，于伤后２４小时由心脏取血处死，测定脑组织含水率、伊文斯蓝（ＥＢ）含量及脑组织和血浆脂质过氧化物──丙二醛（ＭＤＡ）含量。结果：（１）脑外伤组大鼠右侧脑组织含水率、脑组织及血浆ＭＤＡ含量均显著高于对照组（Ｐ＜０．０１或Ｐ＜０．０５）；右侧脑组织含水率及ＭＤＡ含量显著高于对侧（Ｐ＜０．０１或Ｐ＜０．０５），右侧脑组织ＥＢ含量较对照组升高，但Ｐ＞０．０５；（２）ＨＢＯ组右侧脑组织含水率及脑组织ＭＤＡ含量显著低于脑外伤组（Ｐ＜０．０１或Ｐ＜０．０５），而与对照组及左侧无明显差别；血浆ＭＤＡ、脑ＥＢ含量与对照组、脑外伤组及左侧均无明显差别。结论：ＨＢＯ能减少脑外伤脑组织氧自由基的生成，减轻脑损伤和脑水肿。     

原发性高血压患者血浆β—EP,Dyn和LEK含量变化及其临床意义

采用放射免疫分析测定对照组和原发性高血压（ＥＨ）组其治疗前后血浆阿片肽含量变化，并观察阿片肽含量变化与血压值变化间的相互关系。结果表明，与对照组相比，ＥＨ组β－内啡肽－（β－ＥＰ）和亮氨酸脑啡肽（ＬＥＫ）含量显著下降（Ｐ＜０．０１），强啡肽（Ｄｙｎ）含量显著上升（Ｐ＜０．０１），ＥＨ组经用硝苯吡啶治疗后，三种阿片肽含量显著上升，其中ＬＥＫ含量变化与平均动脉压（ＭＡＰ）变化之间有显著相关性（ｒ＝－０     

肢体火器伤神经体液髓鞘碱性蛋白释放表达实验研究

目的：探讨肢体火器伤中枢神经系统（ＣＮＳ）应变内环境紊乱的病理生理基础．方法：借助犬双后肢低、高速投射物伤模型，采用ＲＮＡ斑点杂交、ＥＬＩＳＡ法，动态观察、定量分析脑组织、脑脊液（ＣＳＦ）、血清髓鞘碱性蛋白（ＭＢＰ）表达与释放．结果：伤后８小时血清、ＣＳＦ、脑组织ＭＢＰ含量增高（Ｐ＜０．０１），高速组尤甚；低速组下丘脑，高速组下丘脑、海马区ＭＢＰ－ｍＲＮＡ表达增强（Ｐ＜０．０５）．结论：肢体火器伤虽未直接伤及大脑，但提示下丘脑、海马区受损，可能为ＣＮＳ应变反应的重要病理生理基础之一．     

6周不同负荷训练后大鼠下丘脑、垂体和血浆β-内啡肽、强啡肽A1-13、精氨酸加压素以及缩宫素的变化

应用放射免疫测定法分别测定了６周不同负荷训练后大鼠下丘脑、垂体和血浆β内啡肽（β＿ＥＰ）、强啡肽Ａ１—１３（ＤｙｎＡ１＿１３）、精氨酸加压素（ＡＶＰ）以及缩宫素（ＯＴ）含量的变化。结果发现,与对照组比较,大鼠６周过度负荷训练后,下丘脑和外周血中βＥＰ含量明显升高,ＤｙｎＡ１＿１３含量在下丘脑和垂体水平明显升高,ＯＴ和ＡＶＰ含量在下丘脑和外周血中均明显升高,但垂体水平ＡＶＰ含量明显低于对照组。６周一般负荷训练引起下丘脑、垂体和外周血中βＥＰ、ＤｙｎＡ１＿１３、ＡＶＰ和ＯＴ含量一定程度的变化,但与对照组比较无统计学意义。结果表明：６周过量负荷训练造成大鼠下丘脑、垂体和血浆内βＥＰ、ＤｙｎＡ１＿１３、ＡＶＰ和ＯＴ含量异常改变     

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     

急性颅脑伤对大鼠脑区、垂体及血浆中β－内啡肽含量的影响

急性颅脑伤对大鼠脑区、垂体及血浆中β－内啡肽含量的影响刘志敏王成海路长林赵小林林葆城为了探讨β－内啡肽免疫活性物质（ｉｒ－β－ＥＰ）与急性颅脑伤的关系，笔者应用放射免疫分析法（ＲＩＡ）系统地检测了颅脑伤后不同时程大鼠多个重要脑区、垂体和血浆中ｉｒ－β...     

轴突细胞骨架对非中断性轴索损伤的反应及在亚低温治疗后的早期改变

目的 观察轴索损伤早期轴突细胞骨架超微结构的改变和早期亚低温处理后细胞骨架的改变。为亚低温治疗弥漫性轴索损伤（ＤＡＩ）寻找实验依据。方法 实验组豚鼠右侧视神经受牵拉致伤。伤后常温实验组动物体温维持在３６．０￣３７．５℃，低温实验组动物体温降至３２．０￣３２．５℃，两组于伤后２ｈ和４ｈ各处死一半动物。电镜下观察轴突细胞骨架的变化，并用电脑图像分析系统进行定量分析。结果 常温实验组伤后２ｈ，大、中、小     

Glutamine supplementation in vitro and in vivo,in exercise and in immunodepression

In situations of stress, such as clinical trauma, starvation or prolonged, strenuous exercise, the concentration of glutamine in the blood is decreased, often substantially. In endurance athletes this decrease occurs concomitantly with relatively transient immunodepression. Glutamine is used as a fuel by some cells of the immune system. Provision of glutamine or a glutamine precursor, such as branched chain amino acids, has been seen to have a beneficial effect on gut function, on morbidity and mortality, and on some aspects of immune cell function in clinical studies. It has also been seen to decrease the self-reported incidence of illness in endurance athletes. So far, there is no firm evidence as to precisely which aspect of the immune system is affected by glutamine feeding during the transient immunodepression that occurs after prolonged, strenuous exercise. However, there is increasing evidence that neutrophils may be implicated. Other aspects of glutamine and glutamine supplementation are also addressed.     

Temporal changes in the oxidation state in in vitro blood

The rates at which the paramagnetic compounds deoxyhemoglobin (Hb) and methemoglobin (MHb) form in vivo within an area of hemorrhage are unknown. The present experiment establishes the baseline concentrations and rates of change in paramagnetic hemoglobin concentrations, as well as the pH in normal heparinized and clotted human blood maintained in vitro at 37 degrees C under anaerobic conditions over 30 hours. There was a moderate increase in Hb concentration in normal heparinized blood (average increase was 15.5%, rate = 0.50%/hour) and a slight increase in MHb concentration in the heparinized blood and clots (average increase was 1.4%, rate = 0.044%/hour). A second experiment was done to verify the activity of the RBC systems responsible for maintaining the hemoglobin molecule in the reduced state. Conversion of MHb to Hb in these samples proceeded at a rate of 5.6%/hour. In a third experiment, blood from 11 normal subjects maintained at 4 degrees C 25 degrees C was analyzed for MHb concentration over the course of 28 days. The level of MHb formation remained in the range of normal for at least 11 days in all subjects. The authors conclude that at basal conditions created in vitro, the blood levels of both Hb and MHb remain at relatively low levels. Therefore, if the accumulation of Hb and/or MHb occurs in acute in vivo hematomas it must be driven by intrinsic tissue factors.     

Carcinoma in situ in cryptorchid testes in post-pubertal patients]

The pathohistologic analysis of testis sections of 37 postpuberty patients with different types of cryptorchism is performed. The tissue samples were taken during orchiopehy, fixed in Bouin's solution and treated by the standard histologic techniques. The morphologic criteria are presented for identification of the presence of the so called carcinoma in situ cells found in two cases. Besides, in 13 patients rare, mainly single, atypical germinative cells were found in a smaller number of the seminiferous tubules. It has been concluded that the presence of carcinoma in situ cells in undescended testes of some patients and considering the simple way of sampling, lack of complications and high reliability of the diagnostic procedure, it is absolutely justified to take routine biopsy of testes during orchiopexy in each postpuberty and perhaps prepuberty patient.     

我国医用辐射防护研究概况

医学放射学技术的迅速发展及介入放射学在临床广泛应用，使更多的人受到电离辐射的照射，同时也促进了医疗照射防护工作的发展。文中重点综述了我国医用辐射防护工作者近年来在Ｘ射线ＣＴ的医疗照射防护、对介入放射学工作者的剂量监测以及应用医疗照射防护体系，降低医疗照射剂量等方面所作出的成绩和研究进展     

新时期军医学院人才培养的思考

在新的历史条件下 ,军医学院迎接未来高技术局部战争的挑战 ,适应部队武器装备的不断更新以及医学科技、社会发展对人才素质提出的新要求 ,必须在更为广阔的时空背景下找准人才培养的着眼点 ,科学确立人才培养方向 ,提高人才培养质量。现就人才培养思考如下 :1　改变教育观念 ,     

成批煤气爆燃烧伤的救治体会

报道治疗因煤气泄漏爆炸烧伤病员7例，经应用MEBT技术积极救治，其中6例于伤后17天痊愈出院，另一例特重伤员也于伤后30天康复出院。作者认为：应严格按照MEBT／MEBO要求进行规范治疗，正确处理生命体征、休克、感染、脏器功能和创面的辨证关系。同时，不能忽视外科营养在过程中的重要作用，它是创面修复的物质保证。