四肢主要血管散弹伤的救治体会

目的探讨四肢主要血管散弹伤的有效救治方法。方法对我院收治12例四肢主要血管散弹伤的临床资料进行回顺性分析。结果成功修复10（83.3％）,截肢2例（16．7％）。结论平时四肢主要血管散弹损伤救治原则为“生命第一、肢体第二”,自体静脉移植是有效的治疗方法．     

高原地区四肢火器伤骨折早期处理89例报告

四肢长骨火器伤骨折，早期清创时不能使用内固定的治疗原则，世界早已公认．但有研究表明，由于地理环境的特殊性，西藏高原火器伤骨折一期清创时，行内固定术是可行的。我院自1990年以来共Ⅰ期清创内固定四肢枪伤骨折89例，取得了满意效果，伤口Ⅰ期愈合，并就清创和Ⅰ期内固定时限进行探讨，认为拉萨及地理环境类似的地区，伤后24小时内仍不失为清创的最佳时机。火器伤骨折后36小时内在彻底清创的基础上行简单有效的内固定是可行的。高原地区四肢火器伤骨折早期处理89例报告@高峰$西藏军区总医院骨科!850003@鞠明兵$西藏军区总医院骨科!85…     

四肢大血管损伤的修复与临床分析

本文报道47例四肢大血管损伤中41例保住肢体。6例进行截肢,其中火器伤损伤血管4例,软组织碾挫感染截肢1例,因气性坏疽感染截肢1例。强调早诊断、早修复、及时探查。并讨论了诊断、治疗、术后护理等问题。     

四肢火器伤外科初步处理探讨(附36例分析)

和平时期火器伤与战时火器伤有许多不同地方，从１９９０～１９９７年间发生的３６例四肢火器伤患者均采用保守清创术，疗效佳，现报告如下。１　一般资料本组男３５例，女１例；年龄１８～４０岁，平均年龄２８．７岁；均于伤后８小时内就诊。其中低速火器伤３０例，散弹...     

颅脑火器伤40例临床总结

颅脑火器伤是颅脑损伤的特殊类型。战争时期多见,和平时期少见。加强对散发病例的研究,对战时大批伤员的救治有帮助。兹将我院1975～1995年间收治的颅脑火器伤报告如下: 1 临床资料 本组40例颅恼火器伤均为和平时期散发病例。占同时期颅脑损伤的1.28％(40/3120)。男性38例,女性2例。年龄2～60岁,     

四肢大血管损伤的显微修复体会

目的:探讨四肢大血管损伤的治疗体会。方法:总结20例四肢大血管损伤的救治及应用显微外科技术治疗的体会。结果:除1例因发生筋膜室综合征,发生肌肉坏死而行截肢处理外,其余病人在血管修复后恢复血运,肢体功能恢复好。结论:应用显微外科技术,尽早修复肢体血管是取得满意疗效的关键。     

3例腹部火器贯通伤的手术急救护理体会

随着大规模战争的相对减少，平时火器伤受到越来越普遍关注犤１犦。腹部火器贯通伤可造成多个脏器、多部位的损伤。主要危险是内脏出血造成的休克和腹腔脏器破裂造成腹腔感染，如急救不及时可危及生命，因此，尽早进行手术处理是救治的关键。现将近几年我院急诊手术救治火器伤３例的护理体会总结如下。１临床资料本组３例均为男性。年龄分别为２８岁、２５岁、２２岁。例１，被２枚步枪弹丸分别击中右腰和右臀部致右肾粉碎性破裂、肝破裂、右半结肠挫伤、腰L１～２横突骨折。例２，被１枚手枪弹丸自右腰部贯通腹腔致十二指肠破裂、小肠多处…     

吻合血管的皮瓣在小儿手部火器伤中的应用

目的评估吻合血管的游离皮瓣在小儿手部火器伤中的应用效果。方法2006年以来,我院手外科应用吻合血管的游离皮瓣修复6例成功。对其临床资料进行回顾性分析。结果术后所有患者皮瓣全部成活,伤口愈合良好,随访1～3年,伤手外形和功能恢复较满意。结论吻合血管的游离皮瓣是治疗小儿手部火器伤的有效方法之一。     

颅脑火器伤20例临床小结

颅脑火器伤是颅脑损伤的特殊类型,死亡率高,并发症和后遗症严重。平时加强研究对战时救治工作有极大重要性。兹将我院1957～1979年收治的颅脑火器伤20例报告如下:一般资料:本组20例伤员中男性19例,女性1例。年龄2～34岁,其中以20～31岁最多     

四肢骨折合并主要血管神经损伤的诊治体会

目的探讨四肢骨折合并主要血管神经损伤的诊断与治疗。方法回顾分析48例四肢骨折合并主要血管神经损伤病例的临床资料，分析其损伤的特点和诊断与治疗。结果四肢骨折合并主要血管神经损伤48例均无漏诊、漏治。结论骨折合并主要血管神经损伤要早期诊断、正确处理，才可能获得良好的治疗效果。     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Trichinellosis in immigrants in Switzerland

We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia.