白细胞过滤对单采血小板保存中趋化性细胞因子含量的影响

目的：研究保存前白细胞过滤对单采血小板保存过程中趋化性细胞因子含量的影响.方法：应用细胞分离机单采血小板,然后经白细胞过滤,并于标准条件下保存5 d,同时设自身对照.间隔取样用ELISA法检测MCP-1,MCP-3,MIP-1α及RANTES含量.结果：对照组在保存1 d后,所有趋化性细胞因子含量明显升高,并与保存前比较有显著差异（P〈0.05）,过滤组中趋化性细胞因子含量分别在不同保存时间与保存前比较有显著增高,但其含量要显著低于对照组（P〈0.05）.结论：保存前白细胞过滤能有效减少单采血小板保存过程中趋化性细胞因子含量,因此能有效地预防单采血小板输注后的副反应.     

静脉血白细胞过滤法对脓毒症犬白细胞CD11/18、CD14的影响

 目的 了解静脉血白细胞过滤法对脓毒症犬白细胞CD11/18、CD14的影响。方法 大肠埃希杆菌(O111∶B4)经静脉注入健康犬体内建立大肠埃希杆菌型脓毒症犬模型。将脓毒症犬随机分为对照组（n=9）和白细胞过滤组（过滤组, n=9）。过滤组犬行静脉血白细胞过滤。以开始注入大肠埃希氏杆菌点为T_0′, 开始静脉血白细胞过滤时间点为T₀。检测两组犬T_0′、T₀、T₁、T₅各时间点的平均动脉压（MAP）、心率（HR）、体温、红细胞浓度(RBC)、血小板浓度(PLT)、白细胞浓度(WBC)、血浆TNF-α浓度、IL-6浓度、中性粒细胞CD11/18与单核细胞CD14表达。结果 与对照组比较, 过滤组心率、RBC浓度、PLT浓度、血清TNF-α浓度、IL-6浓度差异无统计学意义, T₁时MAP升高, 体温降低, WBC浓度下降 (P<0.05); T₅时中性粒细胞CD11/18表达下降(P<0.05);T_{1, 5}时单核细胞CD14表达下降（P<0.05）。结论 静脉血白细胞过滤方法可以有效改善大肠埃希杆菌型脓毒症犬的血流动力学, 降低白细胞浓度, 降低中性粒细胞CD11/18和单核细胞CD14的表达, 对血浆中炎症因子无明显影响。     

血小板保存专用塑料血袋的储存性能评价

目的：以美国Gambro BCT公司生产的Trima set血小板保存袋为对照,评价山东威高集团医用高分子制品股份有限公司生产的血小板保存袋对单采血小板的储存性能。方法将1U单采血小板平分成两份,分别加入实验血袋和对照血袋中,于血小板恒温振荡保存箱中保存。分别于保存0、3、5、7d取样,比较分析两组的血小板含量和血小板平均体积、pH值、体外聚集活性、氧分压和二氧化碳分压、葡萄糖、乳酸和乳酸脱氢酶浓度、低渗休克反应、血小板活化和凋亡、血小板形态结构及细菌培养试验。结果两种保存袋保存的血小板在保存期内,相同保存时间实验组与对照组之间各项检测结果差异无统计学意义（P＞0．05）;无菌试验均为阴性。结论国产血小板专用塑料血袋与美国Trima set血小板保存袋对该实验使用的15份单采血小板具有相似的储存性能。     

冰冻血小板战时运输和储存的允许温度

为了探索战时冰冻血小板运输和储存的允许温度范围，取ll袋血小板，各袋加入终浓度为5％DMSO后等分为8份，随机分为配对的A、B、C、D、E、F、G、H组，置于-80℃冰箱保存l天后。取B、C、D、E、F、G、H组分别于-60℃、-50℃、-40℃、-30℃、-20℃、-l0℃、0℃冰箱保存4h，然后将各组复温。测定各组血小板磷脂酰丝氨酸(PS)阳性率、CD62p再表达、SPAT、aPCT变化。连续测定A组复温后4h(PS)阳性率、CD62p再表达、SPAT、aPCT变化。结果显示：①与对照组比较B、C、D、E组PS阳性率、CD62p再表达率、SPAT差异无显著性意义(P＞0．05)；F、G、H组发生显著变化。各组aPCT均无显著变化。②A组复温后4h内PS阳性率、CD62p再表达、SPAT、aPCT均无显著变化。结果提示：5％DMSO冰冻血小板保存的可行性温度为-40℃以下，而-30℃～0℃温度段为冰冻血小板致死温度；复温成为液体状态后可以在22℃振荡保存4h。     

多种损伤因子与重型颅脑损伤凝血功能障碍的相关性研究

目的 探讨内毒素（LPS）、白细胞介素-6（IL-6）、磷脂酶A2（PLA2）、血小板活化因子（PAF）与重型颅脑损伤凝血功能障碍的相关性.方法 收集我院急诊科符合重型颅脑损伤诊断标准的患者65例作为观察组,急诊抢救的同时检测其血小板计数（PLT）、部分活化凝血酶原时间（APTT）、凝血酶原时间（PT）、血浆D-二聚体（D-D）、LPS、IL-6、PLA2、PAF;以同期健康体检者43例作为对照组,对两组检测结果进行统计学分析.结果 两组比较,观察组PLT减少（t=3.892,P＜0.01）,APTT、PT、D-D、LPS、IL-6、PLA2、PAF均升高（t=3.971、3.904、6.532、4.028、4.115、4.274、5.037,P＜0.01）;观察组PLT与LPS、IL-6、PLA2、PAF之间相关系数（r）均≤-0.9319,呈显著负相关;APTT、PT、D-D与LPS、IL-6、PLA2、PAF之间r值均≥0.9091,呈显著正相关.结论 LPS、IL-6、PLA2、PAF参与了重型颅脑损伤凝血功能障碍的发生过程,对LPS、IL-6、PLA2、PAF进行早期干预,可减轻患者凝血功能障碍.     

创伤后多器官功能不全综合征抗炎症反应和免疫抑制

目的：研究创伤后多器官功能不全综合征的抗炎症反应和免疫功能状况。方法 用ELISA法测定了33例创伤患者血浆IL－40、10、12、13水平。结果（1）所有患者不论是否出现SIRS、器官衰竭、血浆中均未测出IL－4。（2）血浆IL－10水平随器官衰竭数目的增加而升高（P＜0．05）;SIRS组、死亡组IL－10水平较非SIRS组、存活组明显升高（P＜0．01）。（3）SIRS组血浆IL－12水平较正常且和无SIRS组高（P＜0．05）。存活组血浆IL－12水平较死亡组高,提示血浆IL－12水平升高的创伤患者预后较好。（4）SIRS组、死亡组血浆IL－13水平与非SIRS组、存活组比较无明显差异,但较正常组升高（P＜0．05）。结论 创伤后多器官功能不全综合征抗炎症反应占主导,免疫抑制的患者预后多不良。     

补充谷氨酰胺对急性运动大鼠血浆白细胞介素的影响

采用ＳＤ大鼠进行一次急性负重游泳运动，观察补充谷氨酰胺（Ｇｌｎ）对大鼠血浆白细胞介素的影响。结果：急性运动使大鼠血浆白细胞介素－１和白细胞介素－６较安静对照组明显增加（Ｐ＜０．０５），白细胞介素－２下降，但无显著性差异。补充Ｇｌｎ可使急性运动大鼠血浆白细胞介素－１进一步升高（Ｐ＜０．０１＝，白细胞介素－６明显增加（Ｐ＜０．０５＝，而较单纯运动组有下降趋势，但无显著性差异（Ｐ＞０．０５）。     

糖尿病脑血管病血浆GMP-140变化的研究

为探讨糖尿病脑血管病血浆GMP－140的变化及其意义，采用放免法和常规计数法分别测定13例糖尿病合并脑梗死患者血浆颗粒膜蛋白（GMP－140）和血小板数量，并以单纯糖尿病、单纯脑梗死及正常人作对照，结果显示，糖尿病合并脑梗死患者与各对照组间的血小板主数差异无显著性意义（P＞0.05）；GMP－140水平则显著高于糖尿病组及正常人（P＜0.010，与单纯脑梗死组比较差异无显著性意义，提示血浆GMP－140可作为反映体内血小板活化程度的一项指标。     

内毒素致兔早期急性肺损伤机制的探讨

目的采用氯喹干预的方法,研究大肠杆菌内毒素（日）致兔早期急性肺损伤的机制。方法大耳白兔随机分为对照组、ET致伤组、ET致伤＋氯喹治疗组。静脉注射ET（500μg／kg）引起兔早期肺损伤,测定动脉血气分析、外周血白细胞及血小板计数变化、血清及肺组织中磷脂酶A2（PLA2）活性、肺组织脂质过氧化物（LPO）、超氧化物歧化酶（SOD）变化,取肺组织进行光镜及电镜病理检查,观察ET的致伤作用及PLA2抑制剂氯喹对早期肺损伤病理生理过程的影响。结果静注ET后兔出现动脉血氧分压（PaO2）下降、外周血白细胞及血小板减少、肺内白细胞扣押等早期肺损伤病理改变。ET组血清及肺组织中PLA2活性增高,肺组织LPO增高（P〈0．05）,SOD明显降低（P〈0．05）。ET组病理检查见肺水肿,部分肺组织片状出血,炎细胞浸润,透明膜形成,伴局灶性肺不张和肺气肿。超微病理改变表现为Ⅰ型、Ⅱ型肺泡上皮细胞损伤,血管内皮细胞肿胀,肺泡隔明显增厚。氯喹治疗组PaO2未见下降,血清及肺组织PLA2活性低于ET组（P〈0．05,P〈0．05）,LPO降低（P〈0．01）,SOD增高（P〈0．01）,病理检查见轻度肺水肿,炎细胞浸润较ET组少,肺组织超微病理检查显示损伤轻于ET组。结论静脉注射ET可复制兔早期肺损伤动物模型,氯喹具有抑制PLA2激活、减轻肺组织内氧化损伤的作用,实验结果证实PLA2激活及氧化应激在ET致兔早期急性肺损伤的发病机制中具有重要作用。     

冰冻血小板战时运输和储存的允许许温度

为了探索战时冰冻血小板运输和储存的允许温度范围,取11袋血小板,各袋加入终浓度为5%DMSO后等分为8份,随机分为配对的A、B、C、D、E、F、G、H组,置于-80℃冰箱保存1天后.取B、C、D、E、F、G、H组分别于-60℃、-50℃、-40℃、-30℃、-20℃、-10℃、O℃冰箱保存4h,然后将各组复温.测定各组血小板磷脂酰丝氨酸(PS)阳性率、CD62p再表达、SPAT、aPCT变化.连续测定A组复温后4h(PS)阳性率、CD62p再表达、SPAT、aPCT变化.结果显示①与对照组比较B、C、D、E组PS阳性率、CD62p再表达率、SPAT差异无显著性意义(P＞O.05);F、G、H组发生显著变化.各组aPCT均无显著变化.②A组复温后4h内PS阳性率、CD62p再表达、SPAT、aPCT均无显著变化.结果提示5%DNMSO冰冻血小板保存的可行性温度为-40℃以下,而-30℃～O℃温度段为冰冻血小板致死温度;复温成为液体状态后可以在22℃振荡保存4h.     

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.     

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.     

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）