尿毒症患者的性激素变化及其临床意义探讨

目的 :探讨女性尿毒症患者卵巢功能障碍的发病情况及其临床意义。方法 :应用酶免疫法 (EIA)测定了2 3例更年期前女性尿毒症非透析患者、15例透析患者及 2 9例健康献血者中促卵泡素 (FSH)、泌乳素 (PRL)、促黄体素 (LH)、雌二醇 (E2 )及孕酮 (P)的水平。结果 :尿毒症女患者PRL、FSH及LH均较健康对照组升高 ,而孕酮值显著降低 ,对此均有显著差异 ;且尿毒症女患者PRL升高、孕酮值降低与肾小球滤过率 (GFR)呈明显相关。透析患者较非透析患者PRL升高更为明显 ,孕酮值亦较非透析患者有所升高 ,但无显著意义。结论 :尿毒症女患者的排卵障碍及月经紊乱等都与尿毒症的严重程度相平行。透析并不能改善尿毒症女患者的卵巢功能障碍 ,只有纠正与改善肾功能 ,才能使尿毒症女患者的卵巢功能得以改善     

跳水运动员颈椎损伤的生物力学研究

作者通过在新鲜成人颈椎标本上做了椎体静力性负荷和动力性负荷实验,表明颈椎在后伸位应力为前屈位的50%,最大应力位于颈椎4-6,是跳水运动员头颈部入水时引起颈椎致伤的生物力学因素。     

开胸术后排痰的方法分析及护理

开胸手术是治疗许多疾病的重要手段,但由于手术时间长、创伤大,术后肺功能损害明显,黏液分泌紊乱和清除障碍[1],加上气管插管侵入性操作及麻醉和术后过程中误吸口腔和胃肠道内容物,如不及时清除容易使分泌物、误吸物积聚堵塞气管,诱发肺部感染和肺不张,严重者甚至发生低氧血症,     

心脏跳动下修补小儿室间隔缺损的临床研究

目的　探讨在浅低温体外循环心脏跳动下完成小儿室间隔缺损修补术的可行性。方法　 18例小儿室间隔缺损随机分为观察组和对照组 ,观察组在浅低温体外循环心跳下修补室间隔缺损 ,对照组为常规心脏停跳下修补室间缺损。测定心肌同功酶释放和三磷酸腺苷 ,观察左室压力 ,评价术野显露及气栓预防效果等。结果　观察组心肌同功酶释放明显低于对照组 ,三磷酸腺苷含量明显高于对照组 ,心肌超微结构基本正常 ,术中左室压力低于主动脉压力 ,术后无气栓发生。结论　浅低温体外循环心脏跳动下行小儿室间隔缺损修补术能更好地保护心肌。术野显露技术和防气栓的方法简便可行。     

麻醉药品的严格管理方法

文章编号:1009-6493(2006)12C-3352-02麻醉药品的管理是医院管理工作的一项重要任务,如果管理有方,使用得当,可以治病;如果失之管理,使用不当,危害生命健康及社会治安。2005年8月3日,国务院颁布了《麻醉药品和精神药品管理条例》以来我院采取了各种有效的相关措施,保证了麻醉药品的合理使用,取得了良好的社会效益。现将我院严格管理麻醉药品的方法介绍如下。1严格建卡要管理好麻醉药品,首先要严格建卡,建卡时要手续齐全。1.1户口本病人的户口要在建卡医院管辖区内,如超出所管辖区,应有三级甲等医院的证明或肿瘤专病医院的证明及病历。1.2病…     

Is magnesium neuroprotective following global and focal cerebral ischaemia? A review of published studies.

Neuroprotective activity with magnesium associated with animal models of cerebral ischaemia, seizure, perinatal hypoxia/ischaemia, subarachnoid haemorrhage and traumatic brain injury has provided the justification for clinical stroke trials. However, the recent IMAGES stroke clinical trial found magnesium to be largely ineffective. Hence, due to the negative stroke trial outcome, current FAST-MAG trial and our own experience with magnesium in cerebral ischaemia animal models, we thought it prudent to review these preclinical and clinical studies. We reviewed nine studies describing the use of magnesium following global cerebral ischaemia and fourteen following focal cerebral ischaemia. Four global ischaemia and six focal ischaemia studies did not show a significant neuroprotective effect with magnesium. In the majority of positive magnesium studies animal body temperature was not monitored post-ischaemia. Thus the effects of post-ischaemic hypothermia cannot be ruled out as a confounding factor in positive magnesium cerebral ischaemia studies. Moreover, data from our own laboratory indicates that magnesium is only neuroprotective when combined with post-ischaemic hypothermia. These data provide a possible explanation of why the IMAGES trial was largely unsuccessful, as current stroke patient management does not involve hypothermia induction. Future preclinical and clinical cerebral ischaemia trials with magnesium should consider combining treatment with mild hypothermia.     

大网膜包裹人工神经移植体再血管化及神经再生的研究

目的 探讨大网膜包裹人工神经移植体的早期再血管化，以及增强移植体血供对神经再生的影响。方法 75只大耳白兔制作成左前肢正中神经2．0cm缺损，随机分成3组：A组，带蒂大网膜包裹人工神经移植体移植；B组，人工神经移植体桥接神经缺损；C组，自体神经桥接神经缺损，作为对照组。术后3、7和14d应用伊凡思蓝（evans blue bound to albumin，EBA）毛细血管造影，检测各组移植体的再血管化；术后12周通过电生理、光镜、透射电镜等检测评估神经再生的效果。结果 A、C组术后3d移植神经出现再血管化，7d和14d再血管化程度逐渐增强；B组7d出现再血管化，与A、C组比较，再血管化延迟。术后12周，A组和C组运动神经传导速度、有髓神经纤维密度、神经内纤维组织面积及面积比、髓鞘厚度、髓鞘直径等差异无统计学意义（P〉0．05），但均优于B组，差异有统计学意义（P〈0．05）。结论 大网膜包裹人工神经移植体可促进移植体早期再血管化，增强移植体血供，促进神经再生。     

A comparative study of using comet assay and gammaH2AX foci formation in the detection of N-methyl-N'-nitro-N-nitrosoguanidine-induced DNA damage.

Comet assay is a useful technique in the detection of DNA damages, particularly DNA strand breaks; and it has been utilized to show that a potent carcinogen N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), can induce such damages. Recently, gammaH2AX foci formation has been suggested as another sensitive way to detect DNA double strand breaks (DSBs). However, there is no systematic comparison being conducted to evaluate the consistency of these two methods. Using MNNG as a model chemical, the sensitivity of neutral comet assay and gammaH2AX foci formation in detecting MNNG-induced damage was studied. It was found that at concentrations of 0.1 and 1 microg/ml, both methods can detect MNNG-induced damage in human amnion FL cells. However, at 0.1 microg/ml, comet assay revealed more percentage of cells with DNA damage than gammaH2AX fluorescence revealed. On the other hand, while gammaH2AX foci were readily formed at very early times by 10 microg/ml MNNG treatment, neutral comet assay did not detect any significant DNA damage at the same time points. In addition, 10 microg/ml MNNG induced a distinct whole nuclei staining pattern of gammaH2AX, a type of DNA damage which was not detected by neutral comet assay but could be detected by alkaline comet assay. Therefore, gammaH2AX may be used as a sensitive indicator for DNA damage.