远隔肢体缺血预处理对腹主动脉瘤手术病人肺损伤的影响

目的 评价远隔肢体缺血预处理对腹主动脉瘤手术病人肺损伤的影响.方法 择期行肾下型腹主动脉瘤切除人工血管置换术病人62例,性别不限,年龄54～72岁,体重指数21 ～ 36kg/m2,ASA分级Ⅱ或Ⅲ级.采用随机数字表法,将病人随机分为2组(n=31):对照组(C组)和远隔肢体缺血预处理组(RLIP组).RLIP组在麻醉诱导后手术前将左上肢用袖带加压至200 mm Hg 5 min后袖带放气5 min,重复2次.分别于气管插管后10 min(T0)、主动脉开放后30 min(T1)、术后4 b(T2)、8h(T3)、12 h(T4)、24 h(T5)时采集动脉和静脉的血样,进行动脉血气分析,计算肺泡-动脉血氧分压差(PA-aaO2)和呼吸指数(RI),并测定静脉血血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)浓度、血浆超氧化物歧化酶(SOD)活性和丙二醛(MDA)浓度.分别于上述时点记录气道峰压(Ppeak)、气道平台压(Pplat)和呼气末正压(PEEP),以计算肺动态顺应性(Cs)和肺静态顺应性(Cd).记录术后低氧血症发生情况、拔除气管导管时间和ICU停留时间.结果 与C组比较,RLIP组PA-aO2、RI和血IL-6、TNF-α和MDA的浓度降低,Cs、Cd和血SOD活性升高,术后低氧血症发生率降低,ICU停留时间和拔除气管导管时间缩短(P＜0.05).结论 远隔肢体缺血预处理可减轻腹主动脉瘤手术病人肺损伤,其机制与抑制炎性反应及脂质过氧化反应有关.     

缺血预处理-后处理对大鼠肠缺血再灌注损伤的影响

Objective To evaluate the effects of ischemic preconditioning-postconditioning on the intestinal ischemia-reperfusion (IR) injury in rats. Methods Forty healthy male SD weighing 225-275 g were randomly assigned into 5 groups ( n = 8 each): group I sham operation (group S) ; group II intestinal IR (group IIR); group Ⅲ ischemic preconditioning (group Ipr); group IV ischemic postconditioning (group Ipo); group V Ipr+ Ipo. The rats were anesthetized with intraperitonel 20% urethane 5 ml/kg. Superior mesenteric artery (SMA) was occluded for 60 min followed by 60 min reperfusion. In group S, SMA was isolated but not occluded. In group Ipr, SMA was occluded for 10 min followed by 10 min reperfusion, and the rest procedures were performed using the method described in group IIR. In group Ipo, 60 min ischemia was followed by three 30 s episodes of ischemia at 30 s intervals for reperfusion. In group Ipr+ Ipo, Ipr was performed followed by Ipo and the procedures were performed using the methods described in group Ipr and Ipo. The animals were killed at 60 min of reperfusion. The intestinal tissues were immediately removed for determination of MDA content, SOD and MPO activities and the degree of damage to intestinal mucous membrane was scored according to Chiu score. Arterial blood samples were taken for determination of plasma concentrations of TNF-α and 1L-6. Results Compared with group S, Chiu score, MDA content, MPO activity, and plasma concentrations of TNF-α and IL-6 were significantly increased, whereas SOD activity decreased in the other 4 groups ( P < 0.05). Chiu score, MDA content, MPO activity, and plasma concentrations of TNF-α and IL-6 were significantly decreased, whereas SOD activity increased in group Ipr, Ipo and Ipr + Ipo as compared with group IIR ( P < 0.05). Chiu score and MDA content were significantly lower, whereas SOD activity higher in group Ipr + Ipo than in group Ipr and Ipo ( P < 0.05). No significant differences were detected in the indices between group Ipr and group Ipo ( P > 0.05). Conclusion Ischemic preconditioning-postconditioning can attenuate the intestinal IR injury in rats, and the efficacy is better than that of either Ipr or Ipo alone.     

思密达和金双歧联合治疗小儿腹泻80例疗效观察

目的探讨小儿腹泻应用思密达、金双歧联合治疗的临床疗效.方法对门诊及留察小儿急性腹泻160例随机分成2组,即观察组与对照组.结果思密达、金双歧联合治疗有效率高达96.25%,对照组治疗有效率为80%,两组比较差异有显著性(P＜0.05).结论思密达、金双歧联合治疗对消化道内的病毒、细菌及其毒素等攻击因子具有极强的吸附、固定、抑制作用,随肠蠕动排出体外;还有调节菌群平衡的作用,可抑制有害致病菌的生长,临床应用治疗小儿腹泻疗效好.     

碳基生物材料的医学应用现状和发展前景研究

碳属于“化学惰性”一类元素。这种化学性质特别适合于不对生命体产生伤害的场所。自然界生物的有机成分主要是碳元素。木炭是人们接触最多的碳材料，用作吸附剂、燃料等。碳材料具有优良的抗血栓性质，不与血细胞发生凝血反应。医学研究小组还发现碳纤维具有诱发组织再生的功能。本文研究碳基生物材料的医学应用和发展前景。     

缺血预处理-后处理对大鼠肠缺血再灌注损伤的影响

Objective To evaluate the effects of ischemic preconditioning-postconditioning on the intestinal ischemia-reperfusion (IR) injury in rats. Methods Forty healthy male SD weighing 225-275 g were randomly assigned into 5 groups ( n = 8 each): group I sham operation (group S) ; group II intestinal IR (group IIR); group Ⅲ ischemic preconditioning (group Ipr); group IV ischemic postconditioning (group Ipo); group V Ipr+ Ipo. The rats were anesthetized with intraperitonel 20% urethane 5 ml/kg. Superior mesenteric artery (SMA) was occluded for 60 min followed by 60 min reperfusion. In group S, SMA was isolated but not occluded. In group Ipr, SMA was occluded for 10 min followed by 10 min reperfusion, and the rest procedures were performed using the method described in group IIR. In group Ipo, 60 min ischemia was followed by three 30 s episodes of ischemia at 30 s intervals for reperfusion. In group Ipr+ Ipo, Ipr was performed followed by Ipo and the procedures were performed using the methods described in group Ipr and Ipo. The animals were killed at 60 min of reperfusion. The intestinal tissues were immediately removed for determination of MDA content, SOD and MPO activities and the degree of damage to intestinal mucous membrane was scored according to Chiu score. Arterial blood samples were taken for determination of plasma concentrations of TNF-α and 1L-6. Results Compared with group S, Chiu score, MDA content, MPO activity, and plasma concentrations of TNF-α and IL-6 were significantly increased, whereas SOD activity decreased in the other 4 groups ( P < 0.05). Chiu score, MDA content, MPO activity, and plasma concentrations of TNF-α and IL-6 were significantly decreased, whereas SOD activity increased in group Ipr, Ipo and Ipr + Ipo as compared with group IIR ( P < 0.05). Chiu score and MDA content were significantly lower, whereas SOD activity higher in group Ipr + Ipo than in group Ipr and Ipo ( P < 0.05). No significant differences were detected in the indices between group Ipr and group Ipo ( P > 0.05). Conclusion Ischemic preconditioning-postconditioning can attenuate the intestinal IR injury in rats, and the efficacy is better than that of either Ipr or Ipo alone.     

珊瑚人工骨材料的结构与性能研究

珊瑚(本文指石珊瑚而非软珊瑚)为海洋内腔肠动物珊瑚虫分泌的外骨骼沉积而成,其壳体主要成分为碳酸钙,含量高达95%,它还含有生命不可缺少的许多微量元素,如P、Mn、Zn、Fe、K、Na、Mg、Sr、U等,以及维生素(A、B、C、E、F)及糖类(葡萄糖、果糖、蔗糖、麦芽糖等),其中微量元素的含量     

生物医学工程新动向

生物医学工程是一门运用自然科学和现代工程技术的原理和方法，在多个层次上，研究各种生物体尤其是人体的结构、功能以及其它生命现象的边缘学科。其研究可广泛应用于对人类疾病的预防，诊断、监护、治疗、保健、康复、生殖健康以及有关的生物医学基本问题。其发展与进步。对促进生物医学的进步、人类的健康以及社会经济的发展都有十分重要的作用。本文介绍生物医学工程有关领域的新发展和有关动向。     

精品文化建设研究——以广州医学院第一附属医院为视角

医院的精品文化建设是一个新课题。本文根据广州医学院第一附属医院的精品文化建设实践,较系统论述了医院精品文化的内涵、特征和功能,以及精品文化的建设途径。     

婴儿黄疸的临床回顾性分析研究

目的：了解和分析婴儿黄疸的常见病因,并探讨婴儿黄疸病因构成和发生规律。方法：对我院90例因黄疸住院的婴儿的临床资料采取回顾性分析的方法。结果：本组病例黄疸多为轻至中度,其中以CMV肝炎居首位（27.8%）,先天性胆管闭锁居第2位（26.7%）,母乳性黄疸为第3位（13.3%）,其他病因引起的亦可见。结论：婴儿出现黄疸时,应尽早作临床实验检查,以提高病原菌的检出率,使患儿得到及时有效的治疗,改善预后。     

建设精品文化 创建精品医院的探索与实践

医院文化是实现医院发展战略的价值内核和精神支撑,是现代医院管理的重要内容。结合我院的精品文化建设实践,探讨精品文化如何促进精品医院战略的实施。