严重脊柱侧凸矫形患者围术期的舒适护理

对28例严重脊柱侧凸患者行矫形手术，结果手术均获成功，松解术后1周行后路矫形内固定加植骨融合术，术后Cobb角平均为40．8°，侧弯矫正率平均为52．0％。术后随访6～30个月，均无并发症发生。提出在做好脊柱侧凸矫形手术常规护理的同时，加强患者心理、体位、呼吸、镇痛、排便等方面的舒适护理，可增强患者舒适感，为手术获得成功和患者顺利康复提供有力保障。     

Lithium and haloperidol differentially alter the dynorphin A (1-8) and enkephalin levels in the neurointermediate lobe of rat pituitary

Repeated administration of the antimanic drug lithium (4 mEq/kg/day for 2, 4 or 6 days, i.p.) to rats produced a progressive decline and eventual depletion of dynorphin-A (1-8) (DYN) concentration whereas Met5-enkephalin (ENK) was only marginally decreased in the neurointermediate lobe of the pituitary (NIL). Administration of a neuroleptic haloperidol neither affected ENK and DYN levels nor influenced lithium-induced changes. The study reveals that lithium produces a preferential perturbation in the dynorphin system relative to the enkephalin system. These results taken together with other evidence, indicate that dynorphin is possibly coreleased with vasopressin following lithium administration and provide a pharmacological support to the previously described colocalization and corelease of these endogenous peptides in the NIL.     

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喘息是儿童时期常见的症状之一,支气管扩张药物在年幼儿童中使用的有效性是多年来颇有争议的一个临床问题。争论的焦点在于,以往认为婴儿支气管平滑肌发育不成熟,喘息时气道动态闭合度增高和相对显著的黏膜水肿使其对支气管扩张剂的反应较弱。而近年的研究显示,虽然婴幼儿对支气管扩张剂的治疗反应弱于年长儿童和成年人,但在婴儿时期气道就存在对支气管扩张剂的反应[1],合理使用支气管扩张剂有利于改善喘息儿童的临床症状。1临床常用的支气管扩张剂1.1β2肾上腺素受体激动剂选择性β2受体激动剂是强效支气管扩张剂,支气管扩张作用是氨茶碱的…     

显微内窥镜下治疗腰椎间盘突出症和腰椎管狭窄症

目的探讨显微内窥镜(MED)治疗腰椎间盘突出症和腰椎管狭窄症的临床效果。方法MED下切除增生内聚的关节突、肥厚的黄韧带及突出的椎间盘，彻底解除对硬膜、神经根的压迫。结果随访324例，按中华骨科学脊柱学组腰背痛手术评定标准，优297例，良14例，差13例，疗效优良率达96．0％，结论MED损伤小、恢复快、疗效好。     

乳猪肝细胞的分离、培养及功能检测

目的 为构建生物人工肝进行肝细胞的准备。方法 采用胶原酶半原位灌流法分离单个乳猪肝细胞,并对其活力及单层和聚集培养后的白蛋白、尿素合成功能进行检测。结果 采用本方法从每头乳猪中分离到的单个肝细胞数为(3.1±1.5)×10~(10),活性超过95％。在加入激素和生长因子的培养基中单层培养时,肝细胞功能良好,可维持2周左右。而在未加入激素和生长因子的培养中肝细胞虽能存活1周,但功能于24h后即丧失。球形聚集培养可实现肝细胞的大量培养,且生物学活性较单层培养显著提高。结论 采用胶原酶半原位灌注法所得单个乳猪肝细胞基本能满足构建生物人工肝对肝细胞数量的要求。聚集培养接种密度大,细胞生物学活性高,可用于构建生物人工肝。     

Nuclear Factor κB and Anesthetic Preconditioning during Myocardial Ischemia-Reperfusion

Background: Volatile anesthetic preconditioning (APC) protects against myocardial ischemia-reperfusion (IR) injury, but the precise mechanisms underlying this phenomenon remain undefined. To investigate the molecular mechanism of APC in myocardial protection, the activation of nuclear factor (NF) [kappa]B and its regulated inflammatory mediators expression were examined in the current study.

Methods: Hearts from male rats were isolated, Langendorff perfused, and randomly assigned to one of three groups: (1) the control group: hearts were continuously perfused for 130 min; (2) the IR group: 30 min of equilibration, 15 min of baseline, 25 min of ischemia, 60 min of reperfusion; and (3) the APC + IR group: 30 min of equilibration, 10 min of sevoflurane exposure and a 5-min washout, 25 min of global ischemia, 60 min of reperfusion. Tissue samples were acquired at the end of reperfusion. NF-[kappa]B activity was determined by electrophoretic mobility shift assay. The NF-[kappa]B inhibitor, I[kappa]B-[alpha], was determined by Western blot analysis. Myocardial inflammatory mediators, including tumor necrosis factor [alpha], interleukin 1, intercellular adhesion molecule 1, and inducible nitric oxide synthase, were also assessed by Western blot analysis.

Results: Nuclear factor [kappa]B-DNA binding activity was significantly increased at the end of reperfusion in rat myocardium, and cytosolic I[kappa]B-[alpha] was decreased. Supershift assay revealed the involvement of NF-[kappa]B p65 and p50 subunits. APC with sevoflurane attenuated NF-[kappa]B activation and reduced the expression of tumor necrosis factor [alpha], interleukin 1, intercellular adhesion molecule 1, and inducible nitric oxide synthase. APC also reduced infarct size and creatine kinase release and improved myocardial left ventricular developed pressure during IR.     

关节镜下改良张力带固定治疗髌骨骨折患者的康复护理

对38例新鲜髌骨骨折患者行关节镜直视下骨折复位,改良张力带固定,术前和术后给予及时有效的功能康复和护理指导,取得满意的效果。平均随访18.6个月,骨折平均愈合时间7.5周,所有病例愈合良好,无并发症出现。关节镜治疗髌骨骨折为髌骨骨折提供了一种新的治疗方法。应针对其解剖特点制订科学、有效的护理方法。     

不同负荷运动训练对大鼠红细胞膜特性的影响

本文采用实验研究方法,通过对大鼠运动后红细胞数量,Hb浓度及体重等一般情况的检测,拟对其施加不同负荷的训练,观察训练后大鼠红细胞膜流动性及红细胞膜脂质成分的变化,进一步讨论运动后红细胞功能及机体机能所发生的变化。实验结果表明,小负荷的运动训练通过改善RBCM脂质组成,增加p/c比值、增强其抗氧化能力等增加RBCM流动性,使红细胞的变形能力增加,有利于其运氧功能的发挥。大负荷训练后RBCM流动性下降,提示不同负荷的运动训练会引起机体产生不同的变化,进而导致机体运动水平上的差异,整体携氧能力下降。     

Serial CT findings of Paragonimus infested dogs and the Micro-CT findings of the worm cysts.

OBJECTIVE: To investigate the serial CT findings of Paragonimus westermani infected dogs and the microscopic structures of the worm cysts using Micro-CT. MATERIALS AND METHODS: This study was approved by the committee on animal research at our institution. Fifteen dogs infected with P. westermani underwent serial contrast-enhanced CT scans at pre-infection, after 10 days of infection, and monthly thereafter until six months for determining the radiologic-pathologic correlation. Three dogs (one dog each time) were sacrificed at 1, 3 and 6 months, respectively. After fixation of the lungs, both multi-detector CT and Micro-CT were performed for examining the worm cysts. RESULTS: The initial findings were pleural effusion and/or subpleural ground-glass opacities or linear opacities at day 10. At day 30, subpleural and peribronchial nodules appeared with hydropneumothorax and abdominal or chest wall air bubbles. Cavitary change and bronchial dilatation began to be seen on CT scan at day 30 and this was mostly seen together with mediastinal lymphadenopathy at day 60. Thereafter, subpleural ground-glass opacities and nodules with or without cavitary changes were persistently observed until day 180. After cavitary change of the nodules, the migratory features of the subpleural or peribronchial nodules were seen on all the serial CT scans. Micro-CT showed that the cyst wall contained dilated interconnected tubular structures, which had communications with the cavity and the adjacent distal bronchus. CONCLUSION: The CT findings of paragonimiasis depend on the migratory stage of the worms. The worm cyst can have numerous interconnected tubular channels within its own wall and these channels have connections with the cavity and the adjacent distal bronchus.