NF-κB在高原地区严重烫伤延迟复苏大鼠肺组织中的表达及其意义

目的：探讨高原地区严重烫伤延迟复苏大鼠肺组织中NF-κB的变化规律及其意义。方法：雄性Wistar大鼠240只,分别在1517m和3848m两个海拔高度随机分为延迟复苏组（DFR,n=50）、即时复苏组（IFR,n=60）和对照组（CG,n=10）,建立30%Ⅲ度烫伤模型,分别于伤后1、6、12、24、72和168h取材,观察肺组织病理学改变及NF-κB的表达。结果：随着海拔高度增加,肺组织病理变化越明显,且DFR组较IFR组差异显著。NF-κB阳性表达位于肺泡上皮细胞核或胞浆,高海拔组表达强度高于低海拔组,实验组高于对照组,各海拔高度DFR高于IFR组（P〈0.05）。结论：NF-κB表达强度变化与高原地区严重烫伤延迟复苏大鼠肺组织损伤有关。     

高原地区大鼠烫伤延迟复苏后Peyer氏结中Bax表达及其意义

目的：探讨不同海拔高度大鼠烫伤延迟复苏后回肠Peyer氏结淋巴细胞凋亡和Bax基因表达的意义。方法：Wistar大鼠132只,分别在海拔1517m和3848m随机分为延迟复苏组（DFR）、即时复苏组（IFR）和假伤组（SG）,建立TBSA 30％Ⅲ度烫伤模型,分别于伤后6、12、24、48和72h取材。采用TUNEL、免疫组化与图象分析技术,观察Peyer氏结中淋巴细胞凋亡率及Bax表达。结果：淋巴细胞凋亡率在各海拔高度DFR组和IFR组均高于SG组,随海拔高度上升凋亡率有所上升;DFR组凋亡率高于同海拔IFR组,海拔3848m各实验组分别高于海拔1517m（P〈0．05）;Bax表达强度变化平行于淋巴细胞凋亡率变化,但在伤后6h和72h海拔3848m各实验组分别高于海拔1517m（P〈0．05）。结论：高原地区烫伤延迟复苏后Bax表达增高可能是Peyer氏结T淋巴细胞凋亡增加的重要原因之一。     

不同海拔高度严重烧伤延迟复苏大鼠脑组织损伤的特点

目的：探讨不同海拔高度严重烧伤延迟复苏大鼠脑组织损伤的特点。方法：将240只雄性Wistax大鼠建立高原（海拔3800m）与兰州地区（海拔1517m）严重烧伤动物模型（TBSA30％，Ⅲ度），并随机分为延迟、即时复苏组和正常对照组。采用干湿比重法测定脑组织含水量并应用HE染色与透射电镜技术观察大鼠脑组织结构的变化。结果：高原严重烧伤后早期脑水含量呈显著升高趋势，伤后24h达峰值。大鼠脑组织超微结构变化显示：延迟复苏组脑损伤后24h达高峰，7d尚未恢复。结论：高原严重烧伤延迟复苏脑组织损伤改变明显加重。     

不同海拔高度严重烧伤延迟复苏大鼠脑组织中能量负荷的变化及其意义

目的：探讨不同海拔高度严重烧伤延迟复苏大鼠脑组织能量负荷变化及其意义。方法：以120只雄性Wistar大鼠建立高原（海拔3800m）实验模型（TBSA30％，Ⅲ度），随机分为延迟、即时复苏组和正常对照组，分别于伤后1、6、12、24、72h及7d取材。兰州地区取相等数量动物重复实验。应用高效液相色谱法检测脑组织中AMP、ADP、ATP的含量，并计算能量负荷。结果：能量负荷在高原正常对照组与兰州地区正常对照组差异显著（P〈0．01）。高原烧伤后脑组织能量负荷与对照组相比均降低，即时复苏组伤后早期即出现显著变化（P〈0．01），伤后72h开始恢复，伤后7d差异无显著，延迟复苏组伤后7d仍星显著差异（P〈0．01）。与即时复苏组比较伤后6～24h无显著差异，伤后72h～7d呈显著性差异（P〈0．01）。高原地区各时相点与兰州地区比较，EC值均降低，除即时复苏组6h外，具有统计学意义。结论：不同海拔高度严重烧伤延迟复苏大鼠脑组织能量负荷的改变一定程度上反映了脑损伤的严重程度。     

不同海拔高度大鼠严重烫伤延迟复苏心肌组织ET-1和HSP70的变化

目的：探讨高原地区不同海拔高度（3840m，1517m）大鼠严重烫伤后延迟复苏心肌组织内皮素-1（ET-1）与热休克蛋白70（HSP70）的变化规律。方法：雄性Wistar大鼠240只随机分为延迟复苏组（DFR，n=100）、即时复苏组（IFR，n=120）和对照组（CG，n=20），建立总体表面积30％的Ⅲ度烫伤模型，分别于伤后1、6、12、24、72和168h取材。应用免疫组化方法检测心肌组织ET-1和HSP70的含量。结果：ET-1在心肌细胞浆及血管内皮组织表达高于对照组，随海拔梯度上升ET-1表达增高，海拔高组高于海拔低组，DFR组高于IFR组（P〈0．01）；HSP70表达在海拔低者差异早于海拔高者（P〈0．01）。结论：高原地区大鼠严重烫伤后随海拔升高，心肌保护物质消耗增多，ET-1／HSP70调节变化更加显著。     

高海拔地区大鼠严重烧伤延迟复苏后肝脏HSP70的表达及其意义

目的：探讨高海拔地区大鼠严重烧伤延迟复苏后肝脏HSP70表达的意义及与肝损伤的关系。方法：雄性Wistar大鼠240只,分别在海拔1 517 m和3 848 m分为即时复苏组（IFR,n=60）、延迟复苏组（DFR,n=50）和假伤组（SG,n=10）,建立30%体表面积Ⅲ度烫伤模型,分别于伤后1、6、12、24、72和168 h取材。采用组织病理学、组织芯片技术、原位末端标记（TUNEL）法、免疫组织化学染色与图像分析技术,观察肝组织病理学改变与细胞凋亡及HSP70蛋白的表达。结果：两个海拔高度HSP70表达强度,实验组均高于假伤组,高海拔组表达强度均高于低海拔组的强度,各海拔高度DFR组高于IFR组（P〈0.05）;肝细胞凋亡率DFR组高于IFR组,且高海拔组高于低海拔组（P〈0.05）。结论：HSP70可能参与肝缺血缺氧等应激损伤过程,HSP70在一定程度上反映机体应激水平和损伤程度,其表达可能与肝细胞自我保护机制启动有关。     

不同海拔高度大鼠严重烫伤延迟复苏心肌组织ET-1和HSP70的变化

本研究以Wistar大鼠为对象,建立严重烫伤即时与延迟复苏模型,检测烧伤延迟复苏后心肌组织内皮素-1(ET-1)、热休克蛋白70(HSP70)的变化,探讨高海拔地区严重烧伤延迟复苏后心脏病生特点,为制订符合高原临床特点的防治措施提供实验依据。作者选取雄性Wistar大鼠240只,将其随机分为延迟复苏组(DFR,n=100),即时复苏组(IFR,n=120)和对照组(CG,n=20),建立总体表面积30%的度烫伤模型,分别于伤后1h、6h、12h、24h、72h和168h取材。应用免疫组化方法检测心肌组织ET-1和HSP70的含量。结果ET-1在心肌细胞浆及血管内皮组织表达高于对照组,随海拔…     

高原不同海拔地区大鼠严重烫伤延迟复苏后肾组织细胞凋亡及Bcl-2蛋白的表达

目的 探讨高原不同海拔地区大鼠严重烫伤延迟复苏后肾脏组织Bcl-2蛋白的表达及其与肾组织细胞凋亡的关系.方法 雄性Wistar大鼠240只,分别在1 517m和3 848m两个海拔高度建立30%TBSAⅢ度高原烫伤模型,随机分为即时复苏组(IFR组,伤后即刻腹腔注射等渗盐水4ml/kg,n=60)、延迟复苏组(DFR组,伤后6h开始按4ml/kg补液,n=50)和假烫对照组(NC组,n=10),分别于伤后1、6、12、24、72和168h取材.采用组织芯片技术和原位末端标记法(TUNEL)检测肾组织细胞的凋亡,免疫组织化学染色与图像分析技术检测肾组织Bcl-2蛋白的表达.结果 随着海拔梯度上升,肾小管上皮细胞发生水肿、颗粒变性、坏死及崩解;肾小球毛细血管出现不同程度扩张、充血,内皮细胞变性及坏死,肾间质充血、水肿及炎性细胞浸润.病变程度DFR组较IFR组加重,高海拔地区较低海拔地区加重.肾组织细胞凋亡率和Bcl-2蛋白表达水平DFR组高于IFR组,高海拔地区高于低海拔地区(P＜0.001),且二者呈明显正相关(r=0.516,P＜0.001).结论 高原严重烧伤导致的肾损伤与肾小管细胞凋亡有关,而凋亡抑制因子Bcl-2的高表达反映了损伤过程中细胞自我保护机制的增强.     

高原大鼠严重烧伤后氧化应激反应对小肠凋亡相关基因Bax,Bcl-2表达的影响

高原地区严重烧伤具有不同于平原地区的病理生理特点,在缺氧性损害的基础上加上再灌注损伤可造成机体各器官组织损伤加重。作者以海拔3840m（甘肃马晗山）和1517m（兰州）为背景,以大鼠为研究对象,建立大鼠严重烧伤后即时复苏与延迟复苏模型,检测不同海拔高度肠黏膜组织匀浆液中丙二醛（MDA）和总巯基（TSH）含量的变化,并采用免疫组化法观察肠黏膜上皮细胞Bax,Bcl-2基因表达情况,旨在探讨高海拔地区严重烧伤延迟复苏后氧化应激反应对肠黏膜Bax基因表达的影响,探讨有关高原地区严重烧伤延迟复苏后肠黏膜屏障损伤的防治对策。选取Wistar大鼠132只,雌雄各半,体质量（200±20）g。将其分为兰州组（1517m）和高原组（3840m）,兰州组包括兰州即时复苏组（LIFR,n=30）、兰州延迟复苏组（LDFR,n=30）、假伤组（LCG,n=6）,高原组包括高原即时复苏组（HIFR,n=30）、高原延迟复苏组（HDFR,n=30）、假伤组（HCG,n=30）。大鼠背部30%TBSA（总体表面积）Ⅲ度烫伤后,立即或伤后6h液体复苏,观察伤后肠黏膜中MDA和TSH变化及凋亡相关基因Bax,Bcl-2表达变化。     

不同海拔高度严重烧伤延迟复苏大鼠脑组织中神经肽-Y的变化

目的:探讨不同海拔高度严重烧伤延迟复苏大鼠脑组织神经肽-Y(Neuropeptide-Y,NPY)变化及意义。方法:将240只雄性Wistar大鼠建立高原与兰州地区严重烧伤模型(TBSA30%,Ⅲ度),随机分为延迟复苏组和即时复苏组及正常对照组,应用免疫组织化学SABC法检测大鼠脑组织中NPY的表达。结果:NPY阳性表达主要分布在神经元细胞的胞浆中。高原地区各组间在伤后1~72 h差异显著(P<0.01)。高原地区各组与兰州地区相比较,NPY表达均减少。结论:NPY表达减少与高原严重烧伤延迟复苏脑损伤的发生有关。     

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.     

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）     

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.