新兵训练下肢疲劳性骨折的研究

目的 :研究下肢疲劳性骨折的发病机制 ,探讨新兵基础训练期间疲劳性骨折发生的危险因素 ,制定疲劳性骨折的预防措施 ,指导新兵完成好训练任务。方法 :选择 1978— 2 0 0 1年我院下肢疲劳性骨折 12 6例 (胫骨 12 5例 ,股骨 1例 )分析其X线及CT征象 ,了解及发生的危险因素。对某部 2 0 6名新兵训练期间控制 5km跑作为干预方案 ,对同期训练的某部新兵 2 10名未行干预作为对照组。结果 :干预组疲劳性骨折发生率为 0 97% ,对照组为 3 3 3 % ,两者存在着显著差异 (P <0 0 1)。结论 :控制 5km跑为主的干预方案能降低疲劳性骨折的发生率 ,适合基层部队新兵训练中推广。     

Non‐typhoidal Salmonella infections in children: Review of literature and recommendations for management

Non‐typhoidal Salmonellae are a major cause of infectious diarrhoea worldwide and can cause invasive diseases, including bacteraemia, meningitis and osteomyelitis. Young or immunocompromised children and those with underlying conditions such as sickle cell disease are particularly vulnerable to invasive disease. There has been an increase in the rate of resistant non‐typhoidal Salmonella, which is associated with invasive disease and hospitalisation. The intracellular nature of non‐typhoidal Salmonella protects against extracellular antibiotics and can facilitate disease relapse, particularly meningitis. Effective antimicrobial agents with good intracellular penetration include azithromycin, fluoroquinolones and third‐generation cephalosporins. Antibiotic treatment of non‐typhoidal Salmonella gastroenteritis is only indicated if there are risk factors for invasive disease as it can prolong excretion and does not shorten the duration of gastrointestinal symptoms. Optimal choice and length of therapy for gastroenteritis and invasive disease in children is not clear. Here, we provide a review of the literature and treatment recommendations.     

妊娠晚期胎儿眼外肌Pulley系统发育特征

目的:观察妊娠晚期胎儿眼外肌Pulley形态的异同点,分析人类早期眶内Pulley系统的发育特征,探讨眶内Pulley系统对人类眼球运动及双眼视发育的作用。方法:实验于2006-04/2007-04在天津市眼科研究所完成。孕龄为27周、30周、33周的新鲜胎儿尸头各1例(标本来源合法,并得到科研管理部门的批准)。取完整眼眶,整体固定,常规脱水,石蜡包埋,冠状位连续切片,Masson三染色显示胶原纤维。结果:人类早期眶内Pulley发育中LR-IO间的Pulley连接带首先被观察到有明显的带状发育;孕30周时外直肌Pulley环己较明显,外直肌与上直肌间连接带发育较好;内直肌周围己有胶原纤维环包绕;在孕33周胎儿眶内,内直肌纤维环发育较好,但内直肌与上直肌及内直肌与下直肌间的连接带仍未见明显发育。结论:人类的眼外肌周围结缔组织结构的发育具有时间与空间的顺序性。其发育顺序为颞下侧连接带开始,经外直肌Pulley环、外直肌-上直肌间连接带、上直肌Pulley环,逐渐向鼻侧发育。这提示内侧发达的纤维环及连接带可能是在生后随双眼视功能的发育而发育完善。     

大中小学各学段学生学习适应性的差异及其衔接教育

目的:分析大、中、小各学段在学习适应性上的异同,进而寻找有效的衔接教育对策来促进各学段学生学习适应性的发展。方法:对已有研究资料的整理,结合开放式问卷调查和访谈,探讨不同学段学生学习适应困难的主要表现。结果:大、中、小学生在学习适应上存在阶段发展特点差异,但同时也有着共同之处,从明确目标、找准内容、改革方法3个方面探询衔接教育对策的可行性。结论:注重实证研究,关注过渡期教育,加强差异研究、提高教育的针对性,增加学业情感体验成分将成为研究的重点。     

重点中学中学生6 307人的抑郁障碍现况调查

目的了解中学生抑郁障碍的患病情况.方法在北京、辽宁、安徽3省市各随机取1所重点中学,在同1个月内分别对该校全体非毕业班的在校中学生6 307人采用抑郁自评量表进行抑郁障碍的筛查.对筛查结果异常及由班主任提供的筛查结果虽正常但怀疑有情绪问题的学生进行精神科检查,根据ICD-10中F32抑郁发作、抑郁复发和F34.1恶劣心境的诊断标准筛选出抑郁障碍的学生.其中北京市某校参加学生(北京组)3 727人;辽宁省某校学生(辽宁组)1 637人;安徽省某校高一年级学生943人(安徽组).结果发放问卷6 307份,收回合格问卷6 307份,有效率100%.①在6 307人,抑郁自评量表筛查的阳性率为23.50%;诊断为抑郁障碍的学生184例,患病率2.92%(184/6 307).其中北京组89例,辽宁组45例,安徽组50例.男女学生抑郁障碍的发病情况接近,差异无显著性意义(85/3 016,99/3 291,x2=0.392,P=0.531).三所中学高一学生的总检出率以安徽最高(50/943),辽宁次之(32/870),北京最低(25/668),差异无显著性意义(x2=5.423,P=0.066).北京组高中学生抑郁障碍患病率与辽宁组接近,差异无显著性意义[3.11%(42/1349),2.75%(45/1647),x2=0.344,P=0.558].②北京组中学学生抑郁障碍的总患病率为2.39%.初一学生的总患病率明显低于初二、高一、高二学生,且差异有显著性意义(P=0.001,0.011,0.037).但各年级中学生抑郁障碍男女性别之间差异均无显著性.③辽宁组中学学生抑郁障碍总检出率为2.75%.高一学生抑郁障碍患病率明显高于高二学生(3.68%,1.84%,x2=6.016,P=0.0146);各年级男女学生抑郁障碍患病率差异无显著性.④安徽组高一学生抑郁障碍总患病率为5.31%(50/943),男女学生差异无显著性意义(5.20%,5.44%,x2=0.027,P=0.870).结论所调查的重点中学学生中抑郁障碍比较常见,从初二年级开始出现有较明显的增加趋势,男女学生抑郁障碍的患病情况无明显差别.     

一侧兔膝关节注射外源性尿激酶型纤溶酶原激活物引起双侧膝关节软骨降解的实验

目的:观察关节腔内注射外源性尿激酶型纤溶酶原激活物对关节软骨的影响。方法:实验于2005-01/2006-06在新疆石河子大学动物实验中心完成。将48只大白兔按体质量、性别随机分为实验组(n=24)、空白对照4周组(n=6)、盐水对照组(n=18)。实验组每只兔子在右膝关节内注射外源性尿激酶型纤溶酶原激活物0.2mL(0.4μg);空白对照4周组,未行任何处理;盐水对照组在右膝关节内注射生理盐水0.2mL。造模后4,8,12周分批麻醉处死后取兔双膝关节软骨进行组织学观察及电镜检查。结果:纳入大白兔48只,均进入结果分析,实验过程中无1例膝关节感染发生。①实验组兔双膝关节软骨表面不规则、缺损及结构破坏,软骨细胞数目明显减少、纤维增生,并出现潮线的完整性破坏。②Mankin’s评分结果显示,盐水对照组与空白对照4周组之间比较,软骨没有任何变化(0.83±0.75,0.80±0.74,P>0.05),而与实验组之间比较,不论4,8,12周,差异均有显著性意义(0.83±0.75,5.38±0.92;1.00±0.63,8.25±1.39;0.83±0.75,11.75±0.89;P<0.01),同时实验组各时间点之间比较,差异也有显著性意义(5.38±0.92,5.35±0.90;8.25±1.39,8.51±0.94;11.75±0.89,12.03±0.91;P<0.05)。结论:①实验结果显示,兔双膝关节均出现关节软骨损伤的病理现象。②尿激酶型纤溶酶原激活物可能是关节软骨降解的始动因子,对软骨的降解起着重要的病理作用,促使软骨降解病变的逐步加重。     

Vagal hyperactivity in stress induced gastric ulceration in rats

Indirect evidence suggests that stress ulceration is provoked by vagal hyperactivity. However, direct evidence of hypervagal activity during stress conditions is lacking. Experiments were designed to directly measure vagal activity under different stress conditions in rats. Starvation stress for 48 h did not change the mean amplitude of action potentials, but their frequency was significantly decreased. Restraint stress at 22°C increased vagal activity, both amplitude and frequency, in the first 60 min; these responses were markedly enhanced by cold (4°C) and persisted for at least 2 h. Starvation for 48 h did not induce any gastric mucosal lesions. Restraint alone produced petechiae in the gastric mucosa, but cold restraint induced severe haemorrhagic ulcers. It is concluded that cold restraint stress provokes a prolonged vagal hyperactivity, which is one of the causative factors for gastric ulceration.