电磁辐射对舰船员肺功能的影响

目的：观察舰船电磁辐射对舰船员肺功能的影响。方法：选取健康男性舰船员90例，分为观察Ⅰ组（电磁辐射作业组）、观察Ⅱ组（天线附近部位作业组）和对照组（舰船上电磁辐射场强较低部位作业组）各30例。按照常规方法分别对各组舰船员进行肺功能测试。结果：与对照组比较，观察工组肺功能参数FEV1.0和FEF25%“均下降（P〈0．05）；观察Ⅱ组肺功能参数FVC、FEV1.0、PEFR和FEF25％下降（P〈0．05，P〈20．01）。结论：暴露电磁辐射环境的舰船员呼吸肌力量有所减弱。     

电磁辐射对舰船员健康的影响

目的：观察电磁辐射对舰船员健康的影响。方法：对电磁辐射作业组、天线附近部位作业组和低场强组分别进行自觉症状问卷调查，以及一般健康状况、心电图、血常规检测，并进行组间比较。结果：电磁辐射作业组的主观症状阳性率和心电图异常检出率高于对照组，心率低于对照组；而一般健康状况和血常规无显著差异。结论：长期接触电磁辐射环境，可能对人体神经系统和心血管系统功能产生负面影响，应加强舰船员卫生防护。     

电磁辐射对舰船员生物氧化应激的影响

目的：观察大型水面舰艇电磁辐射对舰船员生物氧化应激的影响。方法：选取健康男性舰船员90例，根据不同位置的磁场强度测量情况，分为观察Ⅰ组、观察Ⅱ组和对照组各30例，分别检测超氧化物歧化酶（SOD）和总抗氧能力（TAC）。结果：观察Ⅰ组和观察Ⅱ组舰船员血浆中SOD和TAC活性与对照组比较均有显著差异。结论：大型水面舰艇舰船员在接受长期电磁辐射后，将导致体内氧化能力应激系统改变。     

船舶电磁辐射对船员脑电图的影响

目的探讨船舶电磁辐射环境对船员脑电图(EEG)的影响。方法通过对船舶电磁辐射作业人员和船舶场强较高部位、较低部位人员的EEG检查,分析不同场强环境对船员EEG的影响。结果与船上场强较低部位船员比较,电磁辐射作业人员和场强较高部位船员EEG中的慢波(包括θ波和δ波)数量显著增加(P<0.01),而其波辐差异无统计学意义(P>0.05);各组EEG中的其他参数的差异均无统计学意义(P>0.05)。结论船舶电磁辐射对船员EEG的影响主要表现为EEG中的慢波数量增加,提示电磁辐射可引起船员大脑抑制过程加强。     

电磁辐射对舰船员血浆促肾上腺皮质激素等含量的影响

目的：观察某大型水面舰艇电磁辐射对人体神经内分泌系统的影响。方法：根据舰船员所处电磁辐射场强部位不同，分为观察Ⅰ组、观察Ⅱ组和对照组各30例，测定各组舰船员血浆促肾上腺皮质激素（ACTH）、皮质醇（CORT）及单胺类物质（5-羟色胺、去甲肾上腺素、多巴胺）含量。结果：观察工组和观察Ⅱ组血浆ACTH含量均显著高于对照组（P〈0．05，P〈0．01）；观察Ⅱ组血浆CORT低于对照组（P〈0.05）；各组之间血浆5-HT、NE、DA含量无显著差异。结论：电磁辐射场强较高部位的舰船员，肾上腺皮质束状带功能下降，可能影响其应激反应能力。     

高住低训对大鼠心肌线粒体呼吸链酶复合物活性的影响

目的:探讨高住低训(HiLo)习服过程中大鼠心肌线粒体呼吸链酶复合物活性的动态变化。方法:40只SD大鼠分为5组:常氧对照组以及HiLo1、2、3、4周组,每组8只。HiLo组大鼠每天在模拟海拔2500m(氧含量约为15.4%)的环境生活,在模拟海拔1300m(氧含量约为19.4%)环境游泳1h,每周6天。通过光谱分析法,观察在1~4周时间内,在HiLo作用下大鼠心肌线粒体呼吸链酶复合物Ⅰ(NADH-CoQ还原酶)、复合物Ⅱ(琥珀酸-CoQ还原酶)、复合物Ⅲ(CoQ-细胞色素C还原酶)和复合物Ⅳ(细胞色素氧化酶)活性的变化。常氧对照组不进行运动,测试指标与运动组相同。结果:HiLo1周组大鼠心肌线粒体酶复合物Ⅰ、Ⅱ、Ⅲ、Ⅳ活性与对照组相比均显著下降(P<0.05,P<0.01)。HiLo2周组除酶复合物Ⅲ外,其他三种酶复合物活性均显著低于对照组(P<0.05,P<0.01)。HiLo3周组心肌线粒体酶复合物Ⅰ、Ⅱ、Ⅲ、Ⅳ活性与对照组相比差异无统计学意义;但线粒体蛋白含量显著升高(P<0.05)。HiLo4周组心肌线粒体酶复合物Ⅰ、Ⅱ、Ⅳ活性显著升高(P<0.05,P<0.01);线粒体蛋白含量显著升高(P<0.05)。结论:大鼠心肌线粒体呼吸链酶复合物Ⅰ、Ⅱ、Ⅲ、Ⅳ活性在HiLo的习服过程中需要3周时间。     

术中富集骨髓细胞构建组织工程骨成骨能力的研究

目的 观察术中富集骨髓干细胞构建的组织工程骨在山羊脊柱横突间融合的成骨效果,为组织工程骨探索一种新型的构建方法.方法 将多聚左旋赖氨酸(poly-L-lysine,PLL)修饰于山羊脱钙骨基质(demineralized bone matrix,DBM)制备成基质材料(PLL-DBM);以山羊横突间隙为植骨模型,观察PIL-DBM富集骨髓细胞构建的组织工程骨(Ⅰ A组)的成骨能力;对照组为自体髂骨组(Ⅰ B组)、DBM富集骨髓组(Ⅱ C组)、空白DBM组(Ⅱ D组).于术后第16周取融合段标本行X线片、三维CT及CT值检测和生物力学检测,对比分析、评价其成骨能力.结果 X线表现:ⅠA组、Ⅰ B组融合范围基本相同,明显较ⅡC组宽,Ⅱ D组基本无融合.三维CT:Ⅰ A组的CT值为(696.76±102.75)HU,ⅠB组的CT值为(766.03±69.24)HU,二者差异无统计学意义(P>0.05),均明显较ⅡC组高(P<0.05),Ⅱ C组CT值较ⅡD组高(P<0.01).生物力学性能:Ⅱ A、Ⅰ B两组最大载荷、抗弯强度比较差异均无统计学意义(P>0.05),ⅠA组较Ⅱ C组高(P<0.01,0.05),Ⅰ B组较ⅡC组高(P<0.01),ⅡC组较ⅡD组高(P<0.01). 结论 PLL-DBM术中富集骨髓干细胞快速构建的组织工程骨是一种理想的组织工程骨,其成骨能力与自体髂骨相当.     

兔肢体爆炸伤合并海水浸泡后在不同复温速率及维持浅低体温下机体炎症反应的特征

目的 观察不同复温速率及浅低温对兔肢体爆炸伤合并海水浸泡后机体炎症反应的特点.方法 复制肢体爆炸伤合并海水浸泡致低体温[(31.0±0.5℃)]模型.成年家兔24只,随机分为4组,每组6只.Ⅰ组复温至(38.0±0.5)℃,复温速率(8.94±0.93)℃/h;Ⅱ组复温至(38.0±0.5)℃,复温速率(3.88±0.22)℃/h;Ⅲ组复温至(38.0±0.5)℃,复温速率(2.18±0.12)℃/h;H组复温至(34～35)℃并维持至实验结束,复温速率(4.49±0.66)℃/h.以调节环境温度及加温输液的方法将体温恢复到目标体温后维持该体温观察6 h.于致伤前(T0)、浸泡降温后(T1)、复温即刻(T2)、复温后3 h(T3)、复温后6 h(T4)共5个时相点检测血清肿瘤坏死因子(TNF-α)、白介素-1β(IL-1β)、白介素-6(IL-6).实验结束后取动物心、肝、肠、肺、肾组织.测定组织匀浆髓过氧化物酶(MPO)活性.结果 复温后,Ⅰ组、H组IL-1β、IL-6、TNF-α值较Ⅱ组、Ⅲ组明显升高(P<0.01或P<0.05),其中Ⅰ组升高更为显著.Ⅰ组、H组心、肝、肠、肺、肾组织匀浆中,MPO活性较Ⅱ组、Ⅲ组明显增高(P<0.01或P<0.05),Ⅱ组、Ⅲ组比较差异无统计学意义.结论 肢体爆炸伤合并海水浸泡致低体温后,快速复温及维持机体低体温均可导致机体内IL-1β、IL-6、TNF-α水平明显升高,组织中MPO活性明显增高;缓慢复温则可以明显抑制这3种炎症因子的水平及组织中MPO活性.     

注射用血凝酶对髋关节置换术患者围术期出凝血功能影响的研究

目的观察注射用血凝酶(巴曲亭)预防和治疗髋关节置换术患者围术期出血的效果,并探讨其对机体凝血功能的影响,为临床合理使用注射用血凝酶提供一定的客观依据。方法80例美国麻醉医师协会(ASA)评分Ⅰ～Ⅱ级择期髋关节置换术患者随机分为两组,每组40例,Ⅰ组(对照组)于术前10min静脉注射等渗盐水4ml,肌肉注射等渗盐水2ml;Ⅱ组(注射血凝酶组)于术前10min静脉注射注射用血凝酶2kU,肌肉注射注射用血凝酶1kU,分别测定术中及术后出血量,并于术中、术毕、术后第1,5天检测相关凝血功能指标。结果(1)Ⅱ组患者术中及术后出血量均明显少于Ⅰ组患者(术中P<0.01,术后P<0.05);(2)活化部分凝血活酶时间(APTT)值术毕及术后1dⅡ组患者较Ⅰ组患者明显缩短(P<0.01);活化部分凝血酶原活动度[APTT(A)]值术毕Ⅱ组患者较Ⅰ组患者明显增高(P<0.01);纤维蛋白原(Fbg)值术后1dⅡ组患者较Ⅰ组明显降低(P<0.01);其余指标各时间点两组患者间差异均无显著性意义。结论术前预防性使用注射用血凝酶能明显减少术中及术后出血。使用注射用血凝酶后可在术中一过性地改善部分凝血功能,术后恢复正常,提示术前预防性使用注射用血凝酶不会增加术后血栓形成的风险。     

纤支镜下较大容量肺叶灌洗治疗煤工尘肺临床体会

目的：观察纤支镜下较大容量肺叶灌洗治疗煤工尘肺的临床疗效。方法选择已确诊为Ⅰ、Ⅱ尘肺而且进行了肺叶灌洗的90例患者作为观察组,同时抽取90例已确诊为Ⅰ、Ⅱ尘肺但未进行过肺叶灌洗的病例为对照组,观察临床症状、满意度、动脉血气、肺功能及胸部CT检查。结果观察组患者经治疗后临床症状、动脉血气、肺功能部分指标都有所改善。对肺灌洗比较满意。结论对于煤工尘肺肺患者,及时通过纤支镜下较大容量肺叶灌洗,可有较明显的治疗效果,可以在临床推广。     

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.     

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).     

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.     

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）     

Die rechtsmedizinische Identifizierung — Bedeutung und Beweiswert —

Zusammenfassung Bei der rechtsmedizinischen Identifizierung kann die Identität im strengen Sinn allenfalls bei lebenden Personen festgestellt werden; sonst läßt sich nur von Teilen auf das Ganze (vom Untersuchungsobjekt auf die Person) schließen, wobei die verschiedenen Merkmale des Untersuchungsobjektes entsprechend der Hdufigkeit ihres Vorkommens eine unterschiedliche Beweiskraft haben. Bei der Schädelidentifizierung mit Hilfe moderner photographischer oder elektronischer Superprojektionsverfahren ergeben sich unter Berücksichtigung der Weichteildicken so viele (fiktive) Vergleichspunkte, daß bei geeignetem Vergleichsmaterial (Photographien) Identität wegen der Vielzahl übereinstimmender Bezugspunkte in den meisten Fällen evident ist.     

Imaging of abdominal nodal spread in malignant disease

This is a review of the role of imaging procedures for the assessment of abdominal and pelvic lymph nodes. The diagnosis of malignant lymphatic spread is rarely the sole purpose of imaging, because it is usually part of a general abdominal examination, most frequently with CT or US, or increasingly with MRI. These studies are often requested in order to obtain information about the situation to be encountered during surgery, or to alert the surgeon to irresectability or to unexpected metastases outside the initially planned area of exploration. In most surgically treated tumours the role of imaging for preoperative staging is limited, due either to its insufficient sensitivity or because the initial treatment is independent of the lymph node stage. Imaging is commonly used to verify treatment response to chemo- or radiotherapy and for follow-up.Correspondence to: S. Delorme