生姜水提物对脑缺血再灌注损伤的保护作用

目的研究生姜水提物对脑缺血再灌注损伤的保护作用。方法采用结扎小鼠双侧颈总动脉反复缺血再灌注模型,化学比色法测定脑组织Na -K -ATP酶、Ca2 -ATP酶、超氧化物歧化酶(SOD)活性和丙二醛(MDA)含量。结果与假手术组比较,模型对照组小鼠脑组织Na -K -ATP酶Ca2 -ATP酶活性降低,SOD活性与MDA含量无明显变化。生姜水提物能显著升高全脑缺血再灌注模型小鼠脑组织Na -K -ATP酶、Ca2 -ATP酶和SOD活性,显著降低MDA含量。结论生姜水提物对缺血再灌注脑组织损伤的保护作用机制与增强ATP酶活性和抗氧化有关。     

养阴益气活血冲剂对脑缺血再灌注损伤保护作用的实验研究

目的：探讨养阴益气活血冲剂对脑缺血－再灌注损伤保护作用。方法：制作SD大鼠脑缺血与再灌注损伤模型,随机分为假手术对照组,脑缺血－再灌注损伤组、脑缺血组、养阴益气活血冲不剂量治疗组及维脑路通对照治疗组,观察各组脑组织前列环素（PGI2）和血栓素A2（TXA2）含量;脑组织超氧化物歧化酶（SOD）活性和丙二醛（MDA）含量;血浆组织型纤溶酶原激活性（t-PA)及其抑制物（PAI）活性等指标的变化。结果：养阴益气活血冲剂可显著提高脑组织PGI2含量,降低TXA2含量;调节血浆t-PA和PAI的活性;显著降低脑组织MDA含量,提高脑组织SOD活性。结论：养阴益气活血冲剂具有抗凝、提高纤溶活性,提高细胞抗氧化等多种作用,对脑缺血－再灌注损伤具有显著保护作用。     

高压氧对脑缺血再灌注小鼠抗氧化酶类及血脑屏障通透性的影响

目的　探讨高压氧 (HBO)在脑缺血再灌注损伤中对自由基的产生及血脑屏障 (BBB)通透性的影响。方法　昆明种小鼠 3 2 0只 ,随机分为假手术组、HBO组、脑缺血再灌注组和HBO 脑缺血再灌注组 ,每组各 80只。复制清醒脑缺血再灌注模型 ,并于术后经 0 .2 5MPaHBO治疗 5次 ,采用比色法检测各组小鼠海马组织SOD、CAT、GSH PX活性和MDA及EB的含量。取小鼠海马组织常规制片 ,透射电镜下观察并进行比较。结果　脑缺血再灌注组与假手术组比较 ,SOD、CAT及GSH PX活性明显下降 (P <0 .0 1) ,MDA含量明显升高 (P <0 .0 1) ,与脑部EB含量增高相一致。HBO 脑缺血再灌注组与脑缺血再灌注组相比 ,SOD、CAT、GSH PX活性明显升高 (P <0 .0 5 ) ,MDA含量明显下降 (P <0 .0 1) ,并与脑部EB含量减少相一致。HBO组与假手术组相比 ,GSH PX酶活性明显增高 (P <0 .0 5 )。电镜下示脑缺血再灌注组神经元坏死明显 ,星形胶质细胞胞体水肿 ,微管、微丝明显减少 ;HBO 脑缺血再灌注组神经元坏死不明显。结论　高压氧可增强脑缺血再灌小鼠脑组织抗氧化酶类活性 ,恢复星形胶质细胞功能 ,降低BBB通透性。     

二苯乙烯苷对脑缺血小鼠脑组织含水量及自由基代谢的影响

目的 探讨2，3，5，4′—四羟基二苯乙烯—2—O—β—D—葡萄糖苷(简称二苯乙烯苷)对缺血再灌注小鼠脑保护作用的机理。方法夹闭小鼠双侧颈总动脉，撤去动脉夹再灌注后迅速断头取脑。采用干—湿重法测定脑组织含水量；应用硫代巴比妥酸法测定脑组织中丙二醛(MDA)的含量，采用亚硝酸盐法测定过氧化物歧化酶(SOD)活性。结果 模型组脑组织含水量明显高于假手术组。二苯乙烯苷灌胃给药各剂量组可降低模型小鼠的脑组织含水量；模型组脑组织SOD活性比假手术组降低，MDA的含量升高；与模型组相比，二苯乙烯苷治疗组SOD活性升高，MDA含量降低。结论 二苯乙烯苷可以减轻脑组织水肿，增加脑组织抗氧化能力，可能具有脑保护作用。     

山莨菪碱对急性完全性脑缺血再灌流后脑组织Ca2+、MDA含量、SOD活性及超微结构的影响

40只家兔随机分为假手术组（A组）、缺血组（B组）、缺血再灌流组（C组）、治疗组（D组）。采用闭塞双侧颈总动脉和椎动脉及体循环低血压法建立急性完全性脑缺血再灌流损伤模型，缺血时限20min，再灌流2h，观察了脑组织Ca2＋、脂质过氧化产物一丙二醛（MDA）含量、超氧歧化酶（SOD）活性及脑组织超微结构改变。结果发现：治疗组于再灌流前1min注射山莨菪碱10mg／kg体重，并以5mg／h维持2h，脑组织Ca2＋、MDA含量较缺血组及缺血再灌流组明显降低，（P＜0．05，P＜0．01），SOD活性较缺血再灌流组明显增加（P＜0．05）同时脑组织超微结构损伤明显减轻。结果表明；再灌流早期给予山莨菪碱治疗对完全性脑缺血再灌注损伤具有明显保护作用。膜稳定作用、Ca2＋拮抗作用、抗脂质过氧化是其重要的作用环节。     

芍药苷对脑缺氧和缺血再灌注损伤的的改善作用研究

目的：探讨芍药苷对脑缺氧和缺血再灌注损伤的改善作用。方法：复制小鼠脑缺氧与大鼠脑缺血再灌注损伤动物模型，观察芍药苷对中枢神经系统缺氧的影响和对脑缺血再灌注自由基损伤的保护作用。结果：芍药苷可显著提高亚硝酸钠中毒小鼠的生存时间，提高脑组织中SOD的含量，GSH—PX的活性，降低MDA的含量。结论：芍药苷能增加脑的抗耐缺氧能力、保护大鼠脑自由基损伤。     

雌激素对脑缺血再灌注时SOD和MDA的影响

目的：通过观察雌激素对脑缺血再灌注时超氧化物歧化酶(SOD)、丙二醛(MDA)的影响．探讨雌激素在脑缺血再灌注中的神经保护作用。方法：取沙土鼠48只．随机分为假手术组(A组)、单纯脑缺血再灌注组(B组)、卵巢切除的脑缺血再灌注组(C组)、卵巢切除后给予苯甲酸雌二醇治疗的脑缺血再灌注组(D组)．采用双侧颈总动脉夹闭法复制沙土鼠脑缺血再灌注模型．于术后12h处死动物取材，测定SOD活性和MDA含量。结果：B组和D组SOD活性高于C组；MDA含量低于C组。结论：雌激素可以减少脑缺血再灌注时自由基的产生．从而提供神经保护作用。     

参附注射液对小鼠大脑缺血再灌注损伤保护作用研究

目的 :观察参附注射液对小鼠大脑缺血再灌注损伤保护作用。方法 :在造成小鼠高脂血症的基础上,进行颈总动脉缺血再灌注造成脑细胞损伤,建立动物模型。术后分别使用参附注射液5mg/kg.d、10mg/kg.d进行干预治疗。10天后,跳台试验测试小鼠的学习和记忆能力。然后将小鼠断头取脑,制备脑匀浆。以比色法测定谷胱甘肽-S-转移酶(GST)、超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-PX)活性及丙二醛(MDA)含量。结果 :参附注射液能提高小鼠大脑缺血再灌注损伤的神经功能水平,升高大脑SOD、CAT、GSH-PX活性和降低MDA水平。结论 :参附注射液对小鼠大脑缺血再灌注损伤具有保护作用,机理与降低氧化应激的作用有关,此作用有助于大脑缺血再灌注损伤的治疗。     

左卡尼汀对脑缺血再灌注损伤的抗氧化作用及其机制研究

目的：观察左卡尼汀对脑缺血再灌注损伤的保护作用,探讨其作用机制。方法：健康雄性Wistar大鼠40只,随机分成4组：假手术组、生理盐水对照组、左卡尼汀100mg／kg治疗组及左卡尼汀200mg／kg治疗组,每组10只。采用线栓法制备大脑中动脉缺血再灌注模型,缺血2h,再灌注24h,观察左卡尼汀对脑组织丙二醛（MDA）、超氧化物歧化酶（SOD）含量的影响,HE染色观察大鼠脑组织的病理改变。结果：左卡尼汀可明显减少MDA的含量,升高SOD活性,同生理盐水对照组相比,P〈0．01。结论：左卡尼汀对脑缺血再灌注损伤有保护作用,与提高脑组织中抗氧化酶活性、抑制氧自由基产生及脂质过氧化反应有关。     

郁金对低张性缺氧小鼠脑功能的影响

目的观察郁金对低张性缺氧小鼠脑功能的影响。方法利用常压密闭耐缺氧实验和断头实验复制小鼠急性缺氧模型，用郁金低、中、高剂量（10g／kg、20g／kg、40g／kg）连续灌胃6d。采用低张性缺氧模型观察各组小鼠存活时间；通过断头实验观察各组小鼠张口次数和喘吸时间；检测脑组织超氧化物岐化酶（SOD）活性和丙二醛（MDA）含量；镜下观察脑组织形态变化。结果郁金高、中剂量组小鼠急性缺氧条件下的存活时间显著延长（P〈0．001），各郁金剂量组小鼠断头喘息时间、断头后张口次数均增加（P〈0．05～0．001），脑组织SOD活性显著提高（P〈0．001），MDA含量明显下降（P〈0．01～0．001）；镜下可见模型组小鼠脑组织有明显的嗜神经现象、血管周围炎性水肿和脑膜下出血，而郁金治疗组小鼠脑组织除偶见脑膜血管扩张外未见其他异常。结论郁金对低张性缺氧小鼠脑组织有一定的保护作用。     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

Prevalence and severity of nausea and vomiting of pregnancy and effect of vitamin supplementation.

OBJECTIVE: Although nausea and vomiting of pregnancy is the most common medical condition during pregnancy, there are many unanswered questions regarding its cause, epidemiologic features and optimal management. The objectives of this study were to ascertain the prevalence of nausea and vomiting in a sample of Canadian women, to characterize the distribution of their severity and to investigate the role of vitamin B6 deficiency in their etiology. DESIGN: Prospective study. SETTING: Antenatal counselling service for pregnant women. PATIENTS: Three cohorts of women: a prospective, population-based cohort of 193 women, to estimate the rate and severity of nausea and vomiting (cohort A); a cohort of 555 women who sought advice for nausea with or without vomiting, to study the correlation between the maximal daily number of episodes of vomiting and maximal weight loss (cohort B); and a prospective cohort of 301 women who reported vomiting, to correlate vitamin supplementation with vomiting (cohort C). INTERVENTIONS: All 3 cohorts were interviewed during the counselling session, and cohort B was followed up prospectively. OUTCOME MEASURES: Frequency of nausea and vomiting, weight loss, maximal number of daily episodes of vomiting, rate of multivitamin supplementation. RESULTS: Overall, 67% of the women in cohort A reported experiencing nausea or vomiting, or both; 22% reported vomiting, and 9% experienced weight loss. In cohort B there was a significant correlation between the maximal number of daily episodes of vomiting and maximal weight loss, although there was wide variation (r2 = 0.25, p < 0.001). There was a highly significant correlation between the number of daily vomiting episodes and mean weight loss (r2 = 0.99). In cohort C, vomiting was significantly associated with lack of supplementation with multivitamins before 6 weeks' gestation (p = 0.002). CONCLUSIONS: The relation between number of daily vomiting episodes and mean weight loss may serve as a clinical tool to assess the severity of nausea and vomiting in pregnancy and the success of anti-emetics and rehydration regimens. Further study is needed to elucidate the biologic basis of the observed association between vomiting and lack of multivitamin supplementation in early pregnancy.     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.

     

我院文职护士管理和培训的实践与体会

目的构建文职护士培训、使用及管理的科学方法。方法通过规范管理、科学施训、作为骨干大胆任用等多种管理方式,使文职护士得到充分的发展。结果文职护士群体成长为医院优秀骨干,首批满3年的文职护士顺利通过续聘考核。结论科学的管理培训是文职护士成长的重要基石,对医院护理管理有着重要作用。     

通用设计原则与产品研发策略

本文介绍了通用设计的概念和设计原则,并阐述了根据此原则实施通用设计的产品研发策略。通用设计惠及的不仅是残疾人,也惠及了包括普通公众在内的广泛人群,以及企业。应将通用设计的原理应融入政府相关政策和未来发展的规划中,为残疾人以及更多人群提供合理便利的通用设计产品。     

骨脂肪瘤及血管脂肪瘤的CT及MRI表现:9例报告并文献复习

目的探讨骨脂肪瘤及血管脂肪瘤的CT及MRI表现。方法收集手术病理证实的9例骨脂肪瘤及血管脂肪瘤的临床及影像学资料,9例术前8例接受CT扫描,3例接受MRI检查。结果9例中骨脂肪瘤6例,骨血管脂肪瘤3例。6例骨脂肪瘤发生于骨内4例,骨旁2例。骨内脂肪瘤跟骨1例,距骨1例,眶骨1例,肱骨1例。骨旁脂肪瘤颅骨1例,股骨1例。骨血管脂肪瘤发生于肋骨1例,颅骨1例,椎骨1例。骨内脂肪瘤CT显示病变骨质呈轻度膨胀性改变,边缘见轻度硬化环,病灶内见脂肪密度及条弧形、结节状钙化,MRI显示病灶T1WI呈高信号,PDWI及T2WI抑脂序列呈低信号。骨旁脂肪瘤CT呈不均匀高密度团块,MRI显示病灶T1WI呈高信号,T1WI及T2WI抑脂序列呈低信号。3例骨血管脂肪瘤CT显示病变骨质呈显著膨胀性改变,骨破坏边缘及内部见多发骨嵴及粗大骨小梁,高密度骨针呈放射状、簇状或不规则排列。结论骨内脂肪瘤及血管脂肪瘤CT及MRI表现均以脂肪成分为主要特征,骨旁脂肪瘤CT以骨化性团块为特征,骨血管脂肪瘤骨质膨胀性改变较骨内脂肪瘤显著,病灶边缘及中心以多发骨嵴及粗大骨小梁为特征。