高原失血性休克发生与救治过程中血浆溶酶体酸性水解酶活性变化

探讨高原失血性休克发病与救治特点以及相应的细胞机制。１４只山羊被随机分为平原组和高原组，分别观察在平原和模拟４０００ｍ高原失血性休克和再灌注后动物血浆溶酶体ＡＰ和β—Ｇ活性（比色法测定），数据经双因素方差分析统计处理。结果：①平原与高原组动物的存活时间分别为２１．４１±３．２５ｈ和９．７４±７．６１ｈ（Ｐ＜０．０１），１２ｈ存活率分别为１００％和１６．７％（Ｐ＜０．０５）；失血及再灌注后高原组均表现为严重的失代偿性酸中毒；③失血后平原组β一Ｇ显著升高（Ｐ＜０．０５），再灌注后ＡＰ与β一Ｇ均无进一步升高；高原组ＡＰ与β一Ｇ在缺血期及再灌注后均比失血前升高非常显著（Ｐ＜０．０１），同时失血后ＡＰ和再灌注后ＡＰ及β一Ｇ比平原组升高非常显著（Ｐ＜０．０１）。结论：高原失血性休克具有死亡率高、存活时间短和难以扩容纠正的特点，而低压缺氧复合组织缺血所致细胞溶酶体膜破裂和水解酶的释放是导致高原失血性休克向不可逆性转化的重要因素。     

模拟4000m高原失血性休克动物血浆血管活性肽的动态变化

目的：观察山羊于缺氧复合失血血休克时血浆中血管活性肽的变化，以探讨其发生机制；方法：山羊预先在低压舱内模拟４０００ｍ高原缺氧２４ｈ后，经股动脉放血使血压维持在５．５ｋＰａｌ小时，然后回输放出的血液，最后输入失血一３倍的等渗输盐水。用放射 免法劝脉血浆中血管活性肽的动态变化；结果：动物失血１ｈ末，内源性洋地黄因子（ＥＤＬＦ）水平降低４４．７％，回输血０．５－４ｈ，ＥＤＬＦ有所回升，但仍显著低于基础值     

三种晶胶液治疗高原创伤失血性休克的比较

高原创伤失血性休克发生快，对液体承受力小、易发生多脏器功能衰竭，死亡率高，救治较为困难．小剂量７．５％高渗盐水／６％右旋糖酐－７０（ＨＳＤ）在平原条件下具有良好的抗休克作用，若用于高原创伤休克的早期救治，可望提高治愈率．本研究模拟海拔４０００ｍ高原条...     

HAPC患者红细胞2,3—二磷酸甘油酸的变化和红细胞ATP酶的活性

目的：了解红细胞２，３－二磷酸甘油酸、红细胞膜ＡＴＰ酶在高原红细胞增多症（ＨＡＰＣ）的变化及二者关系。方法：ＨＡＰＣ患者２４例，正常对照１９例，分别测定红细胞２，３－二磷酸甘油酸，红细胞膜ＡＴＰ酶（Ｎａ＋－Ｋ＋－ＡＴＰ酶，Ｃａ２＋－Ｍｇ２＋－ＡＴＰ酶活性。结果：ＨＡＰＣ组及对照组红细胞２，３－二磷酸甘油分别为：３．２１ｍｍｏｌ／Ｌ±０．１３ｍｍｏｌ／Ｌ，４．８７ｍｍｏｌ／Ｌ±０．０７ｍｍｏｌ／Ｌ，（Ｐ＜０．０５）；Ｎａ＋－Ｋ＋－ＡＴＰ酶活性分别为：４．１±０．０１３λΒ／μｍｏｌ·ｈ－１·ｇ－１，７．４±０．１９λΒ／μｍｏｌ·ｈ－１·ｇ－１（Ｐ＜０．０１）；Ｃａ２＋－Ｍｇ２＋－ＡＴＰ酶活性分别为１５．１±１．７０λΒ／μｍｏｌ·ｈ－１·ｇ－１，２５．３±２．３１λΒμｍｏｌ·ｈ－１·ｇ－１（Ｐ＜０．０１）；相关分析显示：２，３－二磷酸甘油酸与Ｎａ＋－Ｋ＋－ＡＴＰ酶呈正相关（ｒ＋０．４８１７，Ｐ＜０．０１）与Ｃａ２＋－Ｍｇ２＋－ＡＴＰ酶呈正相关（ｒ＝０．４７８３，Ｐ＜０．０１）。结论：ＨＡＰＣ患者红细胞２，３－二磷酸甘油酸的减少，红细胞膜ＡＴＰ酶活力降低，反映机体缺氧状况，体细胞代谢异常     

进驻高原不同海拔高度不同时间健康青年血脂与载脂蛋白的变化

目的：探讨不同海拔高度不同居住高原时间健康人脂质代谢状况；方法：对从平原进驻海拔３７００ｍ和５３８０ｍ高原第７天和半年的某部官兵血清胆固醇（Ｃｈ），甘汪三酯（ＴＧ），高密度脂蛋白（ＨＤＬ－Ｃ），低密度脂蛋白（ＬＤＬ－Ｃ）及载脂蛋白Ａ－１（ＡｐｏＡ－１），载脂蛋白Ｂ（ＡｐｏＢ）进行检测，并与海拔１４００ｍ健康青年作对照。结果：初入高原Ｃｈ、ＴＧ明显高于平原（Ｐ〈０．０５或Ｐ〈０．０１），且随海拔高度     

神经节苷酯对低氧大鼠脑钙,钙调素及蛋白激酶Ⅱ的影响

观察了神经节苷酯对急性低氧组大鼠（Ａ组：模拟海拔７００ｍ，５ｈ；Ｂ组：给神经节苷酯）和常氧对照组大鼠（Ｃ组：常氧；Ｄ组：给神经节苷酯）脑组织Ｃａ￣（２＋）、钙调素（ＣａＭ）及ＣａＭ依赖性蛋白激酶Ⅱ（ＣａＭＰＫⅡ）活性的影响。用Ｆｕｒａ－２测得Ｃａ￣（２＋）水平分别为７２２．１±８１．２．６４０．６±７４．４、２５８。７±３９．２和２６３．８±４１．３ｎｍｏｌ／Ｌ，Ａ组明显高于常氧对照组（Ｐ＜０．０１）；Ｂ组明显低于Ａ组（Ｐ＜＜０．０５）。用流式细胞仪（ＦＡＣＳ）所测ＣａＭ平均荧光强度分别为４０．２±４．７、４４．３±４．８．４６．１±５．１和４５．９±５．０道；Ａ组明显低于常氧对照组。用同位素（ｒ￣（３２）－ＡＴＰ）液闪计数法所测ＣａＭＰＫⅡ活性分别为１８２．９±７．９、１９２．３±８．２、１９７．９±９．２和１９８．２±９．３ｐｍｏｌｐｉ．ｍｉｎ￣（－１）ｍｇ￣（－１）ｐｒｏｔｅｉｎ，Ａ组明显低于其它三组，急性低氧Ｂ组与常氧对照组比无明显差别。表明，低氧时神经节苷酯可以减少胞内Ｃａ￣（２＋）蓄积和稳定ＣａＭ和ＣａＭＫｉｎａｓｅⅡ的变化．     

高原失血性休克及再灌注后狗的死亡原因分析

本文用放射免疫法检测了海拔３６５８ｍ（大气压６５．１７ｋＰａ，氧分压１３．５８ｋＰａ）１６条高原失血性休克狗血浆心钠素（ＡＮＰ）、内源性洋地黄因子（ＥＤＦ）、肾素活性（ＰＲＡ）、血管紧张素Ⅱ（ＡⅡ）的含量，结果：实验中死亡的６条狗其休克期血浆ＡＮＰ、ＥＤＦ浓度较１０条存活狗显著降低（Ｐ＜０．０５、Ｐ＜０．０１），而血浆ＰＲＡ，ＡⅡ水平明显升高（Ｐ均＜０．０１）。揭示上述激素的异常改变是导致狗死亡的重要原因。     

特技飞行对血清胰岛素、皮质醇、血管紧张素Ⅱ和胃泌素的影响

为观察特技飞行对胰岛素、皮质醇、血管紧张素Ⅱ和胃泌素等激素的影响。２０名健康男性飞行员（年龄２４～３０岁），复杂特技飞行时最大加速度为＋６．０Ｇｚ，分别在飞行前２ｈ，飞行后即刻、６ｈ及飞行后２４ｈ采血。用放射免疫法测定上述激素。结果发现，飞行后即刻血清胰岛素含量（２６．４±３．６８μＩＵ／ｍｌ）较飞行前（１３．１±０．４８μＩＵ／ｍｌ）有明显升高（Ｐ＜０．０１），飞行后２４ｈ胰岛素含量（１７．２±１．３７μＩＵ／ｍｌ）明显下降，与飞行后即刻比较有显著性差异（Ｐ＜０．０５），但与飞行前比较，无显著性差异（Ｐ＞０．０５）。飞行后即刻６ｈ血清胃泌素明显升高（９６．４±２２．０，１１０．７±２８。７ｐｇ／ｍｌ）与飞行前（３５．３±１５，０ｐｇ／ｍｌ比较，有显著差异（Ｐ＜０．０５）。飞行后２４ｈ血清胃泌素明显下降，与飞行后即刻比较有显著差异（Ｐ＜０．０５）。飞行前后血清皮质醇和血管紧张素Ⅱ均无显著性变化（Ｐ＞０．０５）。飞行后即刻胰岛素及胃泌素含量均明显高于飞行后２４ｈ，二者同为上午１０时抽取的标本，说明其升高不是正常日节律所致，与饮食亦无明显关系。有研究发现，特技飞行后即刻血液中胃动素含量明显升高，胃动素能促进胰岛     

移居高原健康青年几种尿液酶的变化

目的：探讨高原低氧移居者尿液酶Ｎ－乙酰－β－Ｄ－氨基葡萄糖甘酶（ＮＡＧ），γ－谷氨酰转移酶（γ－ＧＴ），乳酸脱氢酶－Ｌ（ＬＤＨ－Ｌ），碱性磷酸酶（ＡＬＰ）的排泄变化。方法；对从平原进驻海拔３７００ｍ和５３８０ｍ高原第７天和半年的某部官兵进行尿液检测，且与平原健康青年作对照，结果：高原低氧环境下尿液酶ＮＡＧ，γ－ＧＴ，ＬＤＨ－Ｌ和ＡＬＰ活性均明显高于平原（Ｐ〈０．０５或Ｐ〈０．０１）；初入高原第７天     

7.5%高渗氯化钠溶液治疗高原地区创伤性休克48例体会

西宁地区海拔２２６０ｍ,大气压８１．２ｋＰａ,氧分压１６．７ｋＰａ。为探讨高原海拔地区创伤性休克的治疗,现将我院近两年来应用７．５％高渗氯化钠溶液治疗创伤性休克４８例,疗效满意,报告如下。临　床　资　料１　一般资料　本组４８例,男３６例,女１２例,年龄４岁～６２岁,平均３４．２岁。伤因：车祸伤２２例,坠落伤１０例,挤压伤６例,刀刺伤８例,塌方伤２例。受伤至就诊时间：最早３０ｍｉｎ,最迟７２ｈ。伤情：一器官伤２４例,二器官伤１１例,三器官伤８例,四器官以上伤５例,伤情评分Ｉｓｓ＞１６。就诊时血压：…     

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.     

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.     

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).     

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.