限制性液体复苏对肝脏缺血-再灌注损伤的影响

Objective To investigate the effects of limited resuscitation on hepatic ischernia-reperfusion in-jury in rots with hemorrhagic shock. Method Uncontrolled hemorrhagic shock was induced in 54 rats by transect-ing the middle branch of the splenic artery to produce standardized massive splenic injury. Resuscitation started when the mean arterial pressure (MAP) reached 40 mmHg. The rats were randomly divided (n = 9per group) in-to sham-operated group (SS), or one of five treatment groups in which infusion of Ringer' s solution was continually administrated to maintain MAP at 40 (RS40), 50 (RS50), 60 (RS60), 80 (RS80) or 100 mmHg (RS100) for 45 minutes (T45 point). After the bleeding was controlled, resuscitation was continued with Ringer's solution and whole blood (2:1) to increase the MAP to 100 mmHg for 120 minutes (T165 point), which was followed by obser-vation for 240 minutes (T405 point). All animals were observed for 240 minutes or until death. Blood specimens were collected at TO, T45, T165 and T405 for determination of blood lactate levels. At the end of the experiment,a small amount of hepatic tissue was collected to measure tissue blood perfusion, total antioxidative capacity (TAOC), Na+K+ ATPase activity and malondialdehyde (MDA) levels. Results At T405, the blood lactate lev-els in the RS80 and RS100 groups [(3.60±0.68) and (3.84 ± 1.09) mmol/L, respectively] were significantly higher than those in the SS, RS40, RS50 and RS60 groups [(2.00±0.66),(2.74±1.45),(2.43 +0.94) and (2.07±0.95) mmol/L, respectively;all:P < 0.05]. The MDA levels were significantly higher in the RS80 and RS100[(7.32±0.31) and (7.71±0.23) nmol/mg,respectively] than those in the SS, RS40, RS50 and RS60 groups[(4.95±0.80),(6.14±0.94),(6.42±0.48) and (6.84±0.36) nmol/mg, respeetively;all: P <0.05]. The Na+ K+ ATPase and TAOC levels were significantly lower in all of the RS groups than those in the SS group (all: P < 0.05), and those in the RS80 and RS100 groups was significantly lower than those in the RS40,RS50 and RS60 groups (all: P <0.05). Blood perfusion in the RS80 and RS100 groups was significantly lower than that in the other groups (all: P < 0.05). Conclusions If hemorrhage is uncontrolled, limited resuscitation appears to balance the needs for organ perfusion, improve the microcircttlation and decrease lactate levels. Fur-thermore, limited resuscitation could decrease ischemia-reperfusion injury in liver tissue.     

限制性液体复苏对肝脏缺血-再灌注损伤的影响

Objective To investigate the effects of limited resuscitation on hepatic ischernia-reperfusion in-jury in rots with hemorrhagic shock. Method Uncontrolled hemorrhagic shock was induced in 54 rats by transect-ing the middle branch of the splenic artery to produce standardized massive splenic injury. Resuscitation started when the mean arterial pressure (MAP) reached 40 mmHg. The rats were randomly divided (n = 9per group) in-to sham-operated group (SS), or one of five treatment groups in which infusion of Ringer' s solution was continually administrated to maintain MAP at 40 (RS40), 50 (RS50), 60 (RS60), 80 (RS80) or 100 mmHg (RS100) for 45 minutes (T45 point). After the bleeding was controlled, resuscitation was continued with Ringer's solution and whole blood (2:1) to increase the MAP to 100 mmHg for 120 minutes (T165 point), which was followed by obser-vation for 240 minutes (T405 point). All animals were observed for 240 minutes or until death. Blood specimens were collected at TO, T45, T165 and T405 for determination of blood lactate levels. At the end of the experiment,a small amount of hepatic tissue was collected to measure tissue blood perfusion, total antioxidative capacity (TAOC), Na+K+ ATPase activity and malondialdehyde (MDA) levels. Results At T405, the blood lactate lev-els in the RS80 and RS100 groups [(3.60±0.68) and (3.84 ± 1.09) mmol/L, respectively] were significantly higher than those in the SS, RS40, RS50 and RS60 groups [(2.00±0.66),(2.74±1.45),(2.43 +0.94) and (2.07±0.95) mmol/L, respectively;all:P < 0.05]. The MDA levels were significantly higher in the RS80 and RS100[(7.32±0.31) and (7.71±0.23) nmol/mg,respectively] than those in the SS, RS40, RS50 and RS60 groups[(4.95±0.80),(6.14±0.94),(6.42±0.48) and (6.84±0.36) nmol/mg, respeetively;all: P <0.05]. The Na+ K+ ATPase and TAOC levels were significantly lower in all of the RS groups than those in the SS group (all: P < 0.05), and those in the RS80 and RS100 groups was significantly lower than those in the RS40,RS50 and RS60 groups (all: P <0.05). Blood perfusion in the RS80 and RS100 groups was significantly lower than that in the other groups (all: P < 0.05). Conclusions If hemorrhage is uncontrolled, limited resuscitation appears to balance the needs for organ perfusion, improve the microcircttlation and decrease lactate levels. Fur-thermore, limited resuscitation could decrease ischemia-reperfusion injury in liver tissue.     

子痫前期重度剖宫产术后的护理

目的总结子痫前期重度剖宫产术后的护理要点,预防产后子痫并发症的发生,提高护理水平及护理质量。方法2007年1-12月对60例子痫前期重度产妇实施剖宫产术,并配合做好术后护理。结果术后无1例发生子痫,有1例发生早期心力衰竭,经处理好转。结论术后细致的观察、控制血压,注意镇静、镇痛,重视产妇的心理护理及保持环境安静舒适,是减少子痫前期重度剖宫产术后子痫发生的重要措施。     

无锡县蠕形螨的调查

无锡县蠕形螨的调查江苏省无锡县人民医院无锡２１４００１童栽光，季平，胡锦本文对无锡县卫生学校男、女学生１５６人，进行了蠕形螨及其致病性的调查材料和方法使用红狮牌透明胶带纸１．２ｘ５．０ｃｍ和甘油－生理盐水混合液。方法：将透明胶带纸在学生入睡前分贴于１...     

小鼠树突细胞成熟前后的形态及其微丝蛋白的适应性改变

目的研究树突细胞(DC)成熟前后的形态及其微丝蛋白的适应性变化。方法经重组小鼠粒细胞-巨噬细胞集落刺激因子、白细胞介素-4诱导小鼠骨髓单核细胞为未成熟树突细胞,培养至第6天时,用脂多糖(LPS)诱导成熟树突细胞(mDC),在倒置相差显微镜和荧光显微镜下观察并前后对比分析细胞在成熟前后的表面突起和内部微丝蛋白的变化。结果 mDC高表达CD11c、MHC-Ⅱ和CD86。成熟前的DC体积较小,随着细胞的成熟,直径逐渐增大。成熟过程中,DC表面突起逐渐增多、变粗且变长,呈怒张状,在第7天达到高峰,以后突起逐渐松弛变软,最后又回复至短细、稀疏状态。微丝蛋白主要集中于细胞膜和触突上,其平均荧光强度在LPS刺激24h后最高,48h后明显降低;细胞内F-肌动蛋白在成熟过程中逐渐减低,LPS刺激16h后达高峰,以后细胞内又重新出现F-肌动蛋白的表达,且与细胞膜、突起间基本均匀一致。结论树突细胞体积增大,突起增多增长,密度加大,旨在尽可能地增大细胞的表面积,最大限度地发挥DC提取、抗原呈递的功能;细胞核增大,暗示细胞核在抗原的处理、加工过程中发挥着重要的作用。     

利用T7噬菌体展示技术构建人舌鳞癌细胞多肽文库

目的:本研究拟构建人舌鳞癌细胞株Tca8113的T7噬菌体展示多肽文库,为进一步筛选和鉴定与舌鳞癌相关的蛋白或多肽打下基础.方法:人舌癌细胞株Tca8113,QiaGen法提取细胞mRNA,逆转录合成双链cDNA后与T7Select 10-3载体连接,体外包装并扩增得到1-7噬菌体展示多肽文库.结果:构建了人舌鳞癌细胞株Tca8113的T7噬菌体展示多肽文库,原始文库重组滴度为鳞癌1.7×106 pfu,扩增后滴度为3×1010 pfu/mL.随机从文库中抽取10个克隆PCR扩增插入片断,电泳结果显示构建的文库中均有插入片段,文库插入率高达100%.所构建的文库插入片断大小在(0.4～1.0)kbp之间.结论:成功构建了人舌癌细胞株Tca8113的T7噬菌体展示多肽文库,为下一步筛选和鉴定与舌癌相关的蛋白或多肽奠定了基础.     

神经外科患者术后颅内感染的护理探讨

目的：探讨综合护理应用在颅内感染患者中的护理效果。方法：选取2020年3月至2022年1月我院收治的神经外科术后颅内感染患者56例,根据护理方案分组。常规组应用传统护理,实验组结合应用综合护理。对比两组患者康复效果与护理服务满意度。结果：实验组躯体、认知、角色以及社会功能显著高于常规组,<0.05;实验组护理满意度明显高于常规组,<0.05。结论：综合护理的实施能够显著提高神经外科术后颅内感染患者的康复效果,能够明显提高患者预后水平,值得推广。     

颌骨与牙列同日重建的最新进展与实践

微血管化骨组织移植是颌骨肿瘤切除后颌骨重建的一个重要里程碑.传统游离骨肌皮瓣移植虽然即刻重建了颌骨,但需要6～18个月后才能完成牙列修复.牙列缺损严重影响了患者的生活质量,并给患者造成较大的心理负担.随着4P医学时代的到来,对于手术的可预测性和个体化提出了更高的要求.颌骨与牙列同日重建(jaw-in-a-day)是...     

50例小儿快速型心律失常诊治分析

回顾性分析我院儿科2008年4月～2012年2月收治的50例快速型心律失常患儿的临床资料。结果心电图检查以室上性阵发性心动过速为表现者38例,室性心动过速6例,心电图在复律后提示预激综合征4例,Ⅲ度房室传导阻滞伴室性心动过速2例。室上性心动过速患儿血压及血氧饱和度均无明显下降,室性心动过速伴有血压、血氧饱和度明显下降36例,其余2例为室性阵发性心动过速。因病情危重及窒息新生儿未实施检查8例,完成检查的13例心内结构均提示正常,室上性阵发性心动过速患儿在2个月以下者有少量心包积液伴发且心脏收缩功能显著下降。因暴发性心肌炎死亡1例,新生儿死亡3例,好转率显著高于死亡率,差异有统计学意义(P<0.05)。依据心脏彩超对病情程度及治疗的预后效果加以评估,频繁发作的年长儿可射频消融术,以全面改善患儿生活质量。     

青少年肥胖与多种疾病的关联和预防

成绩与挑战 :自从 1995年开始 ,已有 2 6个国家实施了消灭麻风病战役 (ＬＥＣ) ,覆盖了大多数高度流行的地区 ,这对于当地非卫生方面的各种组织和其他政府机构参与麻风病的斗争提供了机会 ,在增加基层群众对麻风病的认识上也是成功的。公众信息已经着重关注卫生中心麻风病免费治疗的可利用率。普通的卫生人员积极参与ＬＥＣ的各种活动 ,尤其是那些在乡村和病房实施的活动。另外 ,通过ＬＥＣ ,大量的新病人得到了诊断和多种药物疗法的恰当治疗。结果 :1999年在孟加拉国、巴西、乍得、埃塞俄比亚、印尼、老挝、马达加斯加、尼泊尔、尼日利亚及…