1例以R波降低为主要表现的急性心肌梗死

患者，男，70岁，因“突起胸痛、呼吸困难2小时”入院，否认既往高血压、心脏病、糖尿病史，入院查体：136．5℃，P110，R28，Bp120／70mmHg（ImmHg=0．1333kPa），烦躁不安，双肺可闻及湿罗音，HR110，律齐，未闻及明显病理性杂音，腹软，无压痛，双下肢无水肿。     

汽车侧面碰撞交通伤的伤情特点实验研究

目的探讨猪轿车实车侧面90°碰撞交通伤的发生情况和伤情特点。方法分别以坐姿将大白猪固定于轿车驾驶员及前排乘员座椅上,在计算机控制下,牵引系统以50km/h的速度驱动台车碰撞正前方横停的轿车,以90°角撞击轿车左侧车体。观察现场至伤后24小时动物存活情况,采用解剖学、病理学方法观察形态改变,评判撞击伤发生和伤情特点。结果汽车侧撞致伤后,驾驶员座位猪的伤情重于前排乘员座位猪,24小时内死亡率75%。前排乘员座位猪伤后全部存活24小时以上。主要死亡原因为呼吸衰竭、失血性休克及多脏器损伤。结论车辆侧面90°高速碰撞,车内驾驶员位置乘员更易致伤,而且伤情较前排乘员严重且死亡率高。     

小剂量阿托伐他汀治疗老年高血压伴血脂异常的疗效观察

高血压 ,总胆固醇 (TC)及低密度脂蛋白胆固醇 (LDL C)是冠心病的主要危险因子 ,本文旨在探讨对高血压合并轻中度高胆固醇患者在降压治疗的同时给予小剂量阿托伐他汀 ,对血脂异常的治疗作用及临床意义。1　对象及方法1.1　病例选择　来自门诊的 64例原发性高血压患者 ,男 3 6例 ,女 2 8例 ,年龄 65～ 76岁 ,平均 (69 2± 3 3 )岁 ,高血压史 9～ 18年 ,平均 (14 2± 5 3 )年 ,血压 (14 5～182 ) /(94～ 118)mmHg ,平均 15 8/10 2mmHg。保持平常饮食 ,2周内空腹静脉采血 2次 ,取平均值 ,TC >5 72mmol·L-1的患者入选。排除肝肾疾病 ,…     

Animal study on Iung injury caused by simulant segmented shock waves

OBJECTIVE: To study the lung injury caused by segmented shock waves. METHODS: A total of 60 rabbits and 20 rats were used in this study. The process of transmission of shock waves was divided into three phases, i.e., the recompression phase (RP), the decompression phase (DP) and the underpressure phase (UP). And the recompression wave (RW), the decompression wave (DW) a nd the underpressure wave (UW) simulated the three phases, respectively, generated by the equipment designed by us. The RW test, DW test and UW test were respectively applied to the animals. And lung injuries caused by segmented shock waves were discussed. RESULTS: Under the experimental conditions, the RW did not cause obvious lung injury, but the DW could cause different severities of lung injuries. The greater the decompression ranged and the shorter the decompression duration was adopted, the more severe the lung injury was observed. The UW, to some extent, could cause obvious lung injury. CONCLUSIONS: It suggests that lung injury under shock waves probably occurs during the DP primarily. It probably does not cause direct obvious lung injury during the RP, but significantly influences the capability of causing lung injury during the DP.     

胸腰段脊柱节段撞击能量与几何参数变化及生物力学变化的相互关系

目的探讨胸腰段脊柱节段撞击能量与几何参数、几何参数变化与生物力学的相互关系,为评判脊柱损伤程度及稳定性变化提供相应的客观标准,为治疗中采取适宜的生物力学方法提供确切的实验依据. 方法对 18例新鲜尸体胸腰段脊柱标本进行不同能量的撞击,复制成不同损伤程度的 L1椎体爆裂骨折模型.结合脊柱三维稳定性测试,进行椎体几何参数及生物力学分析. 结果低能量撞击使节段出现结构"松弛"的现象,椎体几何参数仅角度参数部分出现变化( P< 0.05),表明椎间松弛、椎体无明显破坏.中、高能量撞击使椎体几何参数发生明显变化,中能量组后伸位时前椎体高( AVH)、畸形率 (DR)可基本恢复正常,而后椎体高 (PVH)和椎体直径 (VD)不能恢复正常( P< 0.05);高能量组 AVH和 DR后伸时也可恢复到正常,然而, PVH和 VD与正常相差更加明显( P< 0.01).牵伸作用后,中、高能量组除 VD外,其余线性和角度参数都能基本恢复至正常,表明牵伸能使椎体得到较好复位. 结论 AVH、 DR和角度参数可作为判断脊柱稳定性的指标;而 PVH、后单位高( PUH)不到正常的 85%时,预示着损伤节段结构的严重破坏,为重度爆裂粉碎骨折.牵伸力是满足椎体几何参数恢复的有效生物力学方法.重度爆裂骨折的后伸复位也有一定的危险性.     

Histological and enzymohistochemical observation of experimental muscle sprain

In the fields of orthopedics and sport medicine, there are more reports about injury and repair of bones, cartilages, tendons and few report about skeletal muscle injury[1－ 3].Most of the reports about skeletal muscle injury are about contusion,abrasion and delayed muscle aching pain.But in sports training, muscle sprain ,especially partial muscle sprain,is more common[4].Histological and enzymohistochemical changes after sprain were observed and the foundation of advanced research on prevent…     

中等强度冲击波负压暴露后豚鼠内耳损伤的治疗

目的 探讨豚鼠中等强度冲击波负压重复暴露后,高压氧和（或）地塞米松＋甲钴铵对内耳损伤的治疗效果。方法 32只豚鼠于实验性冲击波负压重复暴露3次后,立即分别给予高压氧治疗、肌注地塞米松＋甲钴胺治疗、肌注地塞米松＋甲钴胺＋高压氧治疗,对照组不接受任何治疗。各治疗组动物于治疗前、治疗后2小时-21天分别测试听性脑干反应（ABR）阈值,在光镜和扫描电镜下观察耳蜗毛细胞形态学改变,并将其与对照组进行对比分析。结果 实验性冲击波负压重复暴露后即刻,各治疗组动物ABR阈值明显升高（P〈0．01）,治疗21天后呈部分恢复。治疗21天后,各治疗组动物耳蜗毛细胞缺失少于对照组。在上述3种治疗方案中,以地塞米松＋甲钴胺＋高压氧联合应用对听器损伤的治疗效果最为明显。结论 在中等强度冲击波负压重复暴露造成豚鼠内耳损伤后,及时给予高压氧吸入及地塞米松和甲钴胺2种药物联合治疗,可有效促进听力功能的恢复并减轻耳蜗毛细胞损害程度。     

Rabbit lung injury induced by explosive decompression

Objective:To study the mechanism of rabbit lung injury caused by explosive decompression.Methos:A total of 42 rabbits and 10 rats were werved as the experimental animals.A slow recompression-decompression test and an explosive decompression test were applied to the animals,respectively.And the effects of the given tests on the animals were discussed.Results:The slow recompression-decompression did not cause an obvious lung injury,but the explosive decompression did cause lung injuries in different degrees.The greater the decompression range was,the shorter the decompression duration was,and the heavier the lung injuries were.Conclusions:Explosive decompression can cause a similar lung injury as shock wave does.The primary mechanical causes of the lung injury might be a tensile strain or stress in the alveolar wall and the pulmonary surface‘s impacts on the inside wall of the chest.     

豚鼠冲击波负压暴露后耳蜗毛细胞损害定量观察

目的 探讨冲击波负压（blast underpressure,BUP）暴露后豚鼠耳蜗毛细胞损害特点.方法将豚鼠暴露实验性BUP 14天后处死,硝酸银染色硬铺片法计数观察耳蜗基底膜毛细胞损伤情况.结果压力峰值介于-22.4kPa和-63.3kPa之间的实验性BUP暴露后,豚鼠耳蜗外毛细胞出现了明显的病理性改变,损伤的程度以第二转最重,第二排和第三排的病变比第一排更为严重.BUP强度越高,毛细胞损害越重.各实验组动物的外毛细胞总缺失率明显高于正常对照组（P＜0.01）;重复暴露3次的动物外毛细胞缺失率明显高于暴露1次的动物（P＜0.01）.结论BUP暴露可引起明显的豚鼠耳蜗外毛细胞缺失等损害,其损害程度与负压峰值及暴露次数密切相关;毛细胞损害越重,ABR阈移也就越明显.     

松质骨内液体渗透特性研究

通过把松质骨材料复杂结构简化形成立方框架结构,利用简化的等效单元流道,考虑固体网架表面对孔间骨髓等流体的摩擦阻力作用,得到了在高孔隙率松质骨中的压力降与流速的关系式及松质骨材料渗透率的估计式。通过专用的实验装置测定了两种不同孔径松质骨的渗透率。结果表明,根据所给模型理论预测的结果和实验值一致性较好,在松质骨力学行为研究中能够提供渗透特性的相关数据。