兔肢体爆炸伤合并海水浸泡后在不同复温速率及维持浅低体温下机体炎症反应的特征

Objective To investigate effects of different rewarming rates and maintenance of light hypothermia on inflammatory response in rabbits after limb blast injury, coupled with seawater immersion. Methods First, the model of limb blast injury coupled with seawater immersion was reproduced [the animals were immersed to low body temperature of (31.0±0.5℃)]. Then, 24 adult rabbits were randomly divided into group Ⅰ [the rapid rewarming group, n=6, rewarmed to (38±0.5)℃ at a rate of (8.94±0.93)℃/h], group Ⅱ [the slow rewarming group, n=6, rewarmed to (38±0.5)℃ at a rate of (3.88±0.22)℃/h], group Ⅲ [another slow rewarming group, n=6, rewarmed to (38±0.5)℃ at a rate of (2.18±0.12)℃/h], and the H group [the hypothermia group, n =6, rewarmed to (34 - 35)℃ at a rate of (4.49±0.66)℃/h and kept at that temperature till termination of the experiment]. Regulation of ambient temperature and warm transfusion were used to restore body temperature to target levels and maintained there for 6 hours. Blood samples were taken at 5 different times, I.e. Pre-injury time(T0), post-immersion time (T1), the time when rewarming started (T2), 3 h after rewarming (T3), and 6 h after rewarming (T4). Tissue samples from heart, liver, intestinum, lung and kidney were also collected. Levels of TNF-α (tumor necrosis factor-α), IL-1β (interleukin-1β) and IL-6 (interleukin-6) in plasma and MPO (myeloperoxidase) in homogenate were detected. Results Following rewarming, TNF-α, IL-1β, IL-6 concentrations in the plasma of the animals in group Ⅰ and group H were significantly higher when compared with those of the animals in group Ⅱ and group Ⅲ (P<0.05, P<0.01), and MPO activity in homogenate was significantly higher when compared with that of the animals in group Ⅱ and group Ⅲ(P<0.01, P<0.05), and no statistical difference could be seen between group Ⅱ and Ⅲ (P>0.05). Conclusions Rapid rewarming and maintenance of light hypothermia could obviously elevate TNF-α, IL-1β, IL-6 concentrations in plasma and MPO activity in homogenate, following limb blast injury coupled with hypothermia induced by seawater immersion, while slow rewarming (with a rewarming rate of 2-4℃/h) could significantly inhibit TNF-α, IL-1β, IL-6 levels and PMN activity.     

骨科研究存在的问题与对策

骨科研究涵盖的范围相当广泛，只要是跟骨骼肌肉系统相关的研究都与骨科临床有直接关系。若以研究类型和使用工具来区分，骨科研究基本上包括人体或体内实验、体外实验、计算器模拟工具及临床随访资料等研究类型（图1），各类型又分为各个主题及方法。[第一段]     

HPLC法测定滑膜炎颗粒中原儿茶醛的含量

目的建立滑膜炎颗粒剂中原儿茶醛的含量测定方法质量。方法采用高效液相色谱法对方中原儿茶醛进行含量测定。结果高效液相色谱法测定结果表明原儿茶醛在0．1005～1．005μg范围内呈线性关系，平均加样回收率为99．22％；RSD为0．72％。结论本法简便，重现性好、结果可靠，可作为控制滑膜炎颗粒剂的质量方法。     

海拔3417m世居及移居者无氧代谢阈与左心功能关系的探讨

在海拔３４１７ｍ对１８名健康世居藏族和１６名移居汉族用Ｊｅａｇｅｒ气体代谢自动分析系统和心阴抗图测定了无氧阈和最大摄氧量时的ＳＶ、ＣＯ、ＰＥＰ／ＬＶＥＴ和ＳａＯ２。结果显示：在海拔３４１７ｍ测得ＡＴ值明显低于海平面；世居藏族ＡＴ出现较晚，并且ＡＴ时的功率、ＶＯ２、ＭＶ、ＨＲ、ＣＯ、ＳＶ均高于移居汉族，而ＰＥＴ／ＬＶＥＴ比值小于移居组；两组的ＳＶ峰值出现时间不同，蕊居组在ＡＴ或ＡＴ以后出现的占７２％     

护士礼仪课的教学与实践

为适应医学模式的转变和市场需求，福建中医学院护理学系开设护士礼仪选修课，并对此课程进行教学设计，包括师资培养设计、教学对象设计、教学内容设计、教学方法设计。在授课结束对学生问卷调查、访谈和考试，并对结果进行统计学处理．认为教学实践效果较好。另在教学实践基础上讨论开设护士礼仪课程的意义，提出护士礼仪课程建设若干思考。     

体外培养诱导外周血淋巴细胞促进大鼠面神经再生的实验研究

目的:通过在神经缺损处局部回输体外分离培养纯化的淋巴细胞,了解此种方法促进面神经损伤修复的效果。方法:将20只Wistar大鼠的面神经颊支剪断并立即缝合(其余3支反折缝合)制成面神经损伤模型大鼠,将其分成淋巴细胞组和对照组,每组10只,每组再分成2周组和8周组。淋巴细胞组局部回输体外分离培养的外周血淋巴细胞,对照组作对照。于2周和8周测定面神经颊支-触须肌复合动作电位传导速度,辣根过氧化物酶(HRP)神经逆行示踪测定面神经核团的神经元阳性数目。结果:淋巴细胞组面神经颊支-触须肌复合动作电位传导速度8周时为0.64±0.07,与对照组(0.56±0.07)相比,差异有统计学意义(P<0.05)。HRP神经逆行示踪测定面神经核团神经元阳性数目,淋巴细胞组2周及8周与对照组同时间段相比差异均无统计学意义(均P>0.05)。结论:体外分离培养纯化的淋巴细胞在局部应用于神经损伤处对面神经再生修复可起一定的促进作用。     

实验性腹主动脉瘤瘤体外径与iNOS相关性分析及分期研究

Objective To construct new model of experimental abdominal aortic aneurysm (AAA) and detect the AAA outer diameter and the change of induce nitric oxide synthase(iNOS) in the abdominal aor-tic aneurysm in different period,and analysis the correlation between experimental AAA and iNOS.Methods During the operation of the experiment group,the vascular prosthesis of PTFE was implanted to the rabbit abdominal aorta to form an aneurysm,while sham operation was done in the control group.The tissue of ab-dominal aortic aneurysm was harvested in 1 d,7d,14d,and 28d after operation,respectively.The tissue bo-mogenate concentration of iNOS in the abdominal aortic aneurysm were detected by enzyme linked immu-nosorbent assay (ELISA).Results In experimental group,mean concentration of the tissue bomogenate concentration of iNOS in the abdominal aortic aneurysm in 1 d,7 d,14 d,28 d were (22.129 ±2.518)μ/mL,(27.337±5.321) μ/mL,(36.047±4.584)μ/mL,(44.756±1.799)μ/mL,respectively;In control group,that was (12.499±1.807)μ/mL.The concentration of iNOS in experimental group was significantly higher than that of control group (P < 0.01).The difference during the experimental group all had statisti-cal significance (P < 0.05).Conclusion It is possible that iNOS has some biological function during the formation and progression of the abdominal aortic aneurysm.     

Smoothing the mosaic subclinical melanoderma by calcipotriol

BACKGROUND: The observation of photo-exposed skin under ultraviolet light reveals a mosaic pattern of varying intensity in epidermal melanization. Several patterns of mosaic subclinical melanoderma (MSM) have been described using a specially designed CCD camera and the ultraviolet light-enhanced visualization (ULEV) method. Vitamin D(3) and its analogues influence the biology of keratinocytes and melanocytes. OBJECTIVE: To assess the effect of calcipotriol on MSM. METHODS: This randomized split-face study was conducted in 27 men to compare the effect of once daily applications of 5% calcipotriol cream or a moisturizing cream on the heterogeneity of facial MSM. Computerized image analysis of video images was used at 1-month intervals before and during a 2-month treatment, as well as during a 3-month follow-up. RESULTS: At both sites, the average melanin content of the epidermis showed no significant change over time. However, the mottled appearance was smoothened at the calcipotriol site, whereas it was increased at the site receiving the moisturizer. CONCLUSION: The decreased heterogeneity in MSM after calcipotriol applications suggests a control of the epidermal melanocyte unit by the vitamin D(3) derivative.     

红景天对高原去势大鼠骨质疏松症的血清IL-6、TNF-α和尿DPD影响

目的:探讨高原高寒地区低氧环境去势大鼠骨质疏松症与血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和尿脱氧吡啶酚(DPD)的关系及红景天预防骨质疏松的作用。方法:选用Wistar雌性大白鼠75只,分别摘除卵巢或假性去卵巢。分为A组(假手术组),B组(切除卵巢组),C组(切除卵巢 尼尔雌醇组),D组(切除卵巢 红景天混合饲料组),E组(切除卵巢 红景天浸液组)。每组15只,术后在海拔3100m青海海北州地区饲养,术后3个月处死,应用放免方法测定血清IL-6、TNF-α和化学发光法测定尿中DPD含量。结果:B组血清IL-6、TNF-α和尿DPD含量显著高于A、C、D、E组。C、D、E组血清IL-6、TNF-α和尿DPD含量与A组比较差异无显著性统计学意义。结论:红景天的抗高原骨质疏松症的作用可能与降低血清IL-6、TNF-α含量和尿中DPD浓度有关。     

Comparative study of renal sodium transport between ouabain-hypertensive rats and ouabain-nonhypertensive rats

Objective: To compare renal sodium transport, using fractional excretions of lithium(FELi) as a marker of proximal tubule sodium reabsorption, between hypertensive and non-hypertensive ouabain-treated rats and further to elucidate the role of ouabain in pathogenesis of hypertension. Methods: Thirty male Sprague-Dawley rats weighting 180-200 g were randomly divided into normal control group and ouabain treated group. Rats were infused with 1 ml/kg·d normal saline or 27. 8μg/kg·d ouabain in-traperitoneally once a day respectively. Systolic blood pressure (SBP), heart rate and body weight were recorded weekly. Rats were sacrificed 6 weeks after treatment. Blood and 24-hour urine sample were collected to measure the serum and urinary concentration of sodium, trace lithium and creatinine. Endogenous creatinine clearance rate(Ccr), fractional excretions of sodium (FENa), fractional excretions of lithium (FELi) and fractional reabsorption of sodium in the postproximal tubules (FDRNa) were calculated. Ouabain levels of plasma and renal tissue, plasma renin activity, angiotensin I and aldosterone concentration were determined. Results: 65% of the ouabain-treated rats achieved significantly higher SBP after 4 weeks, compared with that of the saline control groups or self baseline (P<0. 01). But in the other 35% of the ouabain-treated rats, their SBP was similar with control group during the experiment (P>0. 05). The body weight, heart rate and food intake between the 3 groups were no significant differences (P> 0. 05). FELi and FDRNa were significantly lower in ouabain-hypertensive group compared with ouabain-non-hypertensive group and control group(P<0. 01 and P<0. 05). The FEu and FDRn, of ouabain-nonhyper-tensive groups were similar with control group(P>0. 05). Ccr and FENa were comparable between the 3 groups (P>0. 05). Plasma and renal tissue ouabain levels, plasma renin activity, angiotensin I and aldosterone contents in ouabain-hypertensive rats were comparable with ouabain-nonhypertensive rats. Conclusion: Increase of proximal tubule sodium reabsorption play an important role in the pathogenesis of ouabain-hypertensive rats. The change of renal sodium transport may result from regulation to renal Na+ , K + -ATPase by ouabain.