脂氧素A4对心肌缺血再灌注损伤的保护作用

Objective To investigate the roles of lipoxin A4, an endegenous lipid mediator with wide anti-inflammatory fea- tures, in attenuating myocardial ischemia-reperfusion injury and the possible mechanisms. Methods Thirty male KM mice were divid- ed randomly into three groups, 10 in each: ischemia-reperfusion group (group A), lipoxin A4 (0.1 mg/kg) group (group B) and Zn- PP (Zinc protoporphyrin Ⅸ, 25 mg/kg)phus lipoxin A4 (0.1 mg/kg)group (group C). A ischemia-reperfusion heart model was de- veloped by ligating the lift anterior descending branch of the coronary artery. A dine of 10% dehydrated alcohol in 0.2 ml for group A, a dose of isochoric lipoxin A4 for group B and a dose of isochoric ZnPP + lipoxin A4 for group C was infused into the ascending aorta through a catheter, which was kpassing the right common carotid artery, 30 minutes after reperfusion. The concentration of serum TNF-α, activities of serum crestine kinase(CK) and lactate dehydrogenase (LDH), activities of myeloperoxidase (MPO) and malond- ialdehyde (MDA) and the cell apoptosis rate in the myocardial tissue were measured 5 hours after reperfusion. Pathological features of the inflammatory infiltration in the myocardium were also observated.Results As compared with group A, the inflammatoryry infiltra- tion in the ischemic and necrotic regions tithe myocardium was reduced, with group C in the intermediate range. The serum activities of CK and LDH wine significantly lower in group B and C than that in group A, and the lowest activities were detected in group B. Similar findings were observed for MPO, an indicator for neutrophil infiltration, and MDA, an indictor for cell injury caused by oxy- gen radicals, in the myocardium. The concentration of TNF-α and the rate of cadiocyte apoptosis were decreased significantly in group B(P < 0.01). ZnPP, an inhibitor of heine oxygenase (HO)-1, attenusted the above protective effects of lipoxin A4 significantly (P<0.05). Conclusion Lipoxin A4 has protective effects against myocardial ischemia-reperfusion injury, and HO-1 may have a potential role in the protectve mechanisms of lipoxin A4, probably pertly by means of reducing the production of reactive oxygen spe- cies and TNF-α, decreasing the activation and infiltration of neutrophils, alleviating inflammatory damage and avoiding apoptosis.     

开展护理查房的体会

随着护理学科的不断发展和整体护理模式的推广，护理内涵发生了巨大的变化。但总体上护士的理论水平还是不能满足患者及家属的健康要求，因此，提高整体护理素质。遵循“以病人为中心，以质量为核心”的准则，护理查房不失为一有效手段，近年来我科将护理查房每月2次成为一个制度。认真贯彻执行，收到了良好的效果。     

消毒供应中心质量管理及实施效果探讨

目的探讨医院消毒供应中心以《广东省消毒供应中心评审验收标准》为指南进行质量整改和管理（以下简称为新标准）的效果。方法以《新标准》为指南制订可行的整改计划，包括对硬件改建、设施增置、人员培训、完善制度和职责、质量标准、工作流程及严格的PDCA质量控制方法等。结果按照新标准对问题进行整改和质量监控。结论通过全面质量整改和质量监控，使供应室质量有了根本性的改变，基本达到了新标准的要求，并顺利通过评审验收。     

0～2岁小儿早期教育的效果

为评价正常儿早期教育的效果，本研究选择62名正常新生儿自出生后至2岁通过家长接受早期教育，并设116名正常新生儿作为对照组。两组小儿一般情况无明显差别，均随诊至2岁，由未参加随诊者给予智力发育测验。结果显示，2岁时智力发育指数早教组比对照组平均高8.7分，差别显著。对照组中6．2％小儿2岁时智力发育低下，早教组中无1例低下。     

南充市女工生殖健康现状分析

<正> 随着生产力的发展和社会的进步,人们的生活水平不断得到改善,妇女的健康状况及其保健要求也在不断地提高。为了解我市女职工的生殖健康状况,我们于2002年对顺庆区内的纺织等行业女职工共868人进行了职业健康状况调查,现报道如下。1 对象与方法     

重度妊高征临床治疗分析

妊娠期高血压综合征(妊高征)是妊娠后期最常见的并发症之一,病因至今未明。基本病理改变为全身小动脉痉挛,各脏器灌流量减少,造成心、脑、肾损害,临床表现除高血压、蛋白尿、水肿外,部分患者有头痛、视物不清,严重者可失明,甚至威胁母婴的生命安全。早期诊断和治疗对降低孕产妇死亡率、提高孕产妇生命质量是至关重要的。现将我院近年收治的60例重度妊高征患者治疗体会报道如下:     

饮食服务从业人员病毒性肝炎的血清流行病学监察

<正> 病毒性肝炎是当前严重危害人类健康的一种传染病,也是我国法定监察的传染病之一。我国每年对饮食服务行业人员进行体检,并进行肝功能和HBsAg的检测来筛检可疑肝炎患者,对减少病毒性肝炎的传播起了一定的作用。但有关监察效果的报道却不多,为此,我们于1986年3～5月在太原南城区随机抽1945名饮食服务从业人员,进行     

丽珠肠乐、参苓止泻汤合治婴幼儿腹泻

目的：探讨丽珠肠乐、参苓止泻汤治疗婴幼儿迁延性或慢性腹泻的疗效。方法：将62例患儿随机分为两组，均补液、维持水电解质及酸碱平衡。治疗组用丽珠肠乐、参苓止泻汤，对照组用蒙脱石。7d为1个疗程，观察两组疗效。结果：治疗组的显效率、有效率、总有效率明显优于对照组（P〈0．01）。结论：丽珠肠乐、参苓止泻汤合治婴幼儿迁延性或慢性腹泻疗效满意。     

Propofol and Sevoflurane in Subanesthetic Concentrations Act Preferentially on the Spinal Cord: Evidence from Multimodal Electrophysiological Assessment

Background: Animal experiments in recent years have shown that attenuation of motor responses by general anesthetics is mediated at least partly by spinal mechanisms. Less is known about the relative potency of anesthetic drugs in suppressing cortical and spinal electrophysiological responses in vivo in humans, particularly those, but not only those, connected with motor responses. Therefore, we studied the effects of sevoflurane and propofol in humans using multimodal electrophysiological assessment.

Methods: We studied nine healthy volunteers in two sessions during steady state sedation with 0.5, 1.0, and 1.5 [mu]g/l (targeted plasma concentration) propofol or 0.2 and 0.4 vol% (end-tidal) sevoflurane. Following a 15-min equilibration period, motor responses to transcranial magnetic stimulation and peripheral (H-reflex, F-wave) stimulation were recorded, while electroencephalography and auditory evoked responses were recorded in parallel.

Results: At concentrations corresponding to two thirds of C50 awake, motor responses to transcranial magnetic stimulation were reduced by approximately 50%, H-reflex amplitude was reduced by 22%, F-wave amplitude was reduced by 40%, and F-wave persistence was reduced by 25%. No significant differences between sevoflurane and propofol were found. At this concentration, the Bispectral Index was reduced by 7%, and the middle-latency auditory evoked responses were attenuated only mildly (Nb latency increased by 11%, amplitude PaNb did not change). In contrast, the postauricular reflex was suppressed by 77%.     

Oxygen Reverses Deficits of Cognitive Function and Memory and Increased Heart Rate Induced by Acute Severe Isovolemic Anemia

Background: Erythrocytes are transfused to improve oxygen delivery and prevent or treat inadequate oxygenation of tissues. Acute isovolemic anemia subtly slows human data processing and degrades memory, increases heart rate, and decreases self-assessed energy level. Erythrocyte transfusion is efficacious in reversing these effects of acute anemia. We tested the hypothesis that increasing arterial oxygen pressure (Pao2) to 350 mmHg or greater would supply sufficient oxygen to be equivalent to augmenting hemoglobin concentration by 2-3 g/dl and thus reverse the effects of acute anemia.

Methods: Thirty-one healthy volunteers, aged 28 +/- 4 yr (mean +/- SD), were tested with verbal memory and standard, computerized neuropsychologic tests before and twice after acute isovolemic reduction of their hemoglobin concentration to 5.7 +/- 0.3 g/dl. Two sets of tests were performed in randomized order at the lower hemoglobin concentration: with the volunteer breathing room air or oxygen. The subject and those administering the tests and recording the results were unaware which gas was administered. As an additional control for duration of the experiment, 10 of these volunteers also completed the same tests on a separate day, without alteration of hemoglobin concentration, at times of the day similar to those on the experimental day. Heart rate, mean arterial blood pressure, and self-assessed sense of energy were recorded at the time of each test.

Results: Reaction time for digit-symbol substitution test increased, delayed memory was degraded, mean arterial pressure and energy level decreased, and heart rate increased at a hemoglobin concentration of 5.7 g/dl (all P < 0.05). Increasing Pao2 to 406 +/- 47 mmHg reversed the digit-symbol substitution test result and the delayed memory changes to values not different from those at the baseline hemoglobin concentration of 12.7 +/- 1.0 g/dl, and decreased heart rate (P < 0.05). However, mean arterial pressure and energy level changes were not altered with increased Pao2 during acute anemia.