术前沐舒坦雾化吸入对胃肠道肿瘤患者术后肺部并发症的影响

目的 探讨术前应用雾化吸入的预防性治疗对胃肠道肿瘤患者术后肺部并发症的影响.方法 将患者随机分为实验组(26例)和对照组(32例).实验组:术前3 d和术后7 d内给予沐舒坦雾化吸入;对照组:术后7 d内给予沐舒坦雾化吸入.采用SPSS 11.0软件包对资料进行频数分析、卡方检验、t检验.结果 实验组术后肺部并发症的发生率、总住院天数和术后住院天数都低于对照组,但无统计学意义(P＞0.05).两组患者术后1～3 d、4～7 d的咳嗽、咳痰情况比较,均无统计学意义(P＞0.05).结论 术前3 d的雾化吸入不能明显地降低术后肺部并发症的发生.     

电针对颈上神经节切除脑缺血大鼠海马CGRP、NPY表达的影响

目的：观察电针对颈上神经节切除脑缺血大鼠海马降钙素基因相关肽（calcitonin generelated peptide,CGRP）及神经肽Y（neuropeptide Y,NPY）表达的影响,探讨电针水沟治疗缺血性脑血管疾病的作用机制。方法：将50只SD大鼠随机分为正常组、模型组、电针组、颈上神经节（superiorcervical ganglion,SCG）切除组、SCG切除十电针组,每组10只,采用链霉亲合素-生物素酶复合物法检测各组大鼠海马CGRP和NPY表达。结果：正常大鼠海马CGRP阳性神经细胞数量较少,模型组及SCG切除组CGRP阳性神经细胞数量显著增加;电针组、SCG切除＋电针组大鼠海马CGRP阳性神经细胞数量显著高于正常组、模型组和SCG切除组（P〈0．01）。模型组大鼠海马NPY阳性神经细胞数量较正常组明显增加（P〈0．01）,电针组、SCG切除组及SCG切除＋电针组大鼠海马NPY阳性神经细胞数量显著低于模型组（P〈0．01）。结论：SCG对海马NPY表达具有调控作用,电针可通过调节脑缺血大鼠海马神经肽的表达达到抗脑缺血损伤的作用。     

Time-dependent effects of electroacupuncture at the Ren channel on extracellular signal-regulated kinases 1/2 expression in focal cerebral ischemia rats

BACKGROUND: The onset of focal cerebral ischemia activates extracellular signal-regulated kinases 1 and 2, regulates cell cycle, promotes cell proliferation and differentiation, and affects the normal stage and function of brain cells.OBJECTIVE: To observe the effects of electroacupuncture at the Ren channel on extracellular signal-regulated kinases 1/2 expression in the lateral cerebral ventricle wall of rats with focal cerebral ischemia. The effects were analyzed at different time points after intervention.DESIGN: Randomized controlled study.SETTING: Department of Anatomy, Sun Yat-Sen University. MATERIALS: A total of 60 healthy adult male Wistar rats weighing (250±10) g were provided by the Experimental Animal Center, Medical College of Sun Yat-Sen University. The animal experiment was conducted with confirmed consent by the local ethics committee. The GB6805-Ⅱ electric acupuncture apparatus was provided by Shanghai Medical Equipment High-techno Company. METHODS: The experiment was performed at the Laboratory of Anatomy, Sun Yat-Sen University, from February to July 2007. All experimental animals were randomly divided into the following groups: normal group (n = 6), sham operation group (n = 18), model group (n = 18), and electroacupuncture group (n = 18). Middle cerebral artery occlusion (MCAO) was performed in the model group and electroacupuncture group. Zea Longa's grading standard was used to assess neurological impairment after reperfusion; animals whose grades were between 1 and 4 were included in this study. The normal control group was not exposed to MCAO. In sham operation animals, the right common carotid artery (CCA) was isolated, and the external carotid artery (ECA) was damaged, but no embolism was induced. The electroacupuncture group was given acupuncture on the second day after surgery. The acupoint locations were chosen according to Experimental Acupuncture (People's Publishing House; 1997; First Edition). The Chengjiang, Qihai, and Guanyuan acupoints were labeled and connected to a G6805 electroacupuncture apparatus with sparse-dense waves (sparse waves were 30 Hz, dense waves were 100 Hz), with a frequency of 6-15 V. The duration was 20 minutes. Two days after surgery, the model and sham operation groups were placed with their backs on the operating table, but they received no acupuncture. However, the normal group received acupuncture. The experimental animals under anesthesia were sacrificed on days 7, 14, and 28 post-surgery. Western blot analysis was used to measure expression of extracellular signal-regulated kinases 1/2 in the inferior region of the lateral cerebral ventricle wall. Expression was measured in the normal group at time points corresponding to the sham operation group. MAIN OUTCOME MEASURES: Expression of extracellular signal-regulated kinases 1/2 in the inferior region of the lateral cerebral ventricle wall at different time points after intervention.RESULTS: All 60 rats were included in the final analysis, without any loss. Seven days after MCAO, there was no significant difference in extracellular signal-regulated kinases 1/2 expression in the electroacupuncture group compared to the model group (P > 0.05). However, extracellular signal-regulated kinases 1/2 expression significantly increased in the model group at 14 and 28 days after treatment (P < 0.05).CONCLUSION: Electroacupuncture at the Ren channel can enhance extracellular signal-regulated kinases1/2 expression in the inferior region of the lateral cerebral ventricle wall of rats with focal cerebral ischemia. However, this effect is not apparent until 14 days after electroacupuncture intervention.     

小型听神经瘤的显微手术

目的探讨小型听神经瘤保存面、听神经功能的显微手术方法。方法采用标准的病侧枕下经乙状窦入路开颅。病人头偏一侧卧位、显微手术,高速电钻磨除内听道后壁。术中照相/磁带记录,术后分析所见。结果术后13例保全了面神经及听神经,2例无改善,其中1例且伴有耳鸣。肿瘤与Ⅶ及Ⅷ神经的关系分为5型,其中Ⅰ、Ⅱ、Ⅳ、Ⅴ型效果良好,手术困难的是Ⅲ型。结论肿瘤大小及术前听力水平应作企图保存听神经和面神经功能的主要决策。     

汶川地震挤压伤患者获救后快速死亡的原因探讨

目的 探讨"5.12"汶川地震伤员救治过程中,挤压伤患者获救后快速死亡的原因.方法 回顾性分析我院医疗队在灾后早期救治及转运的患者共417例.所有患者均依据当时具体情况行积极现场抢救,对于病情较重者则安排转运至后方有条件的医院继续诊治.结果 救治伤员中,成人355例,儿童62例,年龄8～63岁,平均(37±9.6)岁.其中挤压伤患者117例(男79例,女38例),死亡13例(11.1%).除5例挤压伤患者因原发创伤严重于救治过程中死亡外,其余8例患者救出前一般情况均较好,神智清醒,对答切题,但于废墟下救出后短时间内(<1 h)即因呼吸心跳骤停而死亡.结论 地震后挤压伤患者快速死亡原因多为挤压综合征所致的高钾血症.积极有效地治疗挤压伤患者可减少地震后死亡人数.     

自制羊膜载体复合物植入表皮细胞修复全层皮肤缺损

摘要 背景：利用组织工程和细胞培养技术研制的复合皮肤距理想的人工皮肤尚有一定的差距,如局部皮肤薄弱、抗拉及抗摩擦能力差、无皮肤附属器等。 目的：观察含碱性成纤维细胞生长因子和维生素C的羊膜载体复合物对皮肤缺损局部真皮组织的修复作用,寻找真皮组织修复重建促进表皮生长的最佳时期。 方法：取新西兰大耳白兔36只,在每只背部建立皮肤全层缺损模型3处,分别植入含有缓释碱性成纤维细胞生长因子和维生素C羊膜载体复合物、单纯羊膜载体复合物及油纱覆盖。随机分为3组,分别于术后21,14,7 d植入自体表皮细胞混合液,1周后行大体、组织学、免疫组织化学、墨汁灌注等观察。 结果与结论：术后21 d植入表皮细胞组皮肤缺损局部新生皮肤瘢痕轻、形态结构较满意,创面愈合速度和质量均优于术后14,7 d 植入表皮细胞组,并且植入含碱性成纤维细胞生长因子和维生素C羊膜载体复合物组创面皮肤新生真皮组织完全被新生的表皮覆盖,而且表皮几乎均变为复层,其生长速度及质量优于单纯羊膜载体复合物移植组和油纱覆盖组。说明含有碱性成纤维细胞生长因子和维生素C的羊膜载体复合物植入皮肤全层缺损后,能加速真皮的修复和重建;真皮组织修复增生晚期和重建初期为促进表皮生长的最佳时期。 关键词：羊膜载体复合物;表皮细胞;碱性成纤维细胞生长因子;皮肤创伤愈合;真皮 doi:10.3969/j.issn.1673-8225.2011.16.003     

外排泵抑制剂对泛耐药鲍曼不动杆菌生物被膜的影响

目的 了解泛耐药鲍曼不动杆菌(XDR AB)生物被膜形成与外排泵基因表达的关系,比较4种外排泵抑制剂对泛耐药鲍曼不动杆菌生物被膜的作用.方法 1)微量肉汤稀释法测定4种外排泵抑制剂(EPIs)PAβN、奥美拉唑、维拉帕米、CCCP对9株泛耐药鲍曼不动杆菌的最低抑菌浓度(MIC);并分别测定9株XDR AB生物被膜形成前...