大鼠全脑照射后海马肿瘤坏死因子的基因表达

目的 观察大鼠全脑照射后海马区肿瘤坏死因子α(TNF-α)的动态表达,探讨其在放射性脑损伤急性期的反应发病机理中可能的作用. 方法 制备大鼠的脑放射诱导损伤模型.利用逆转录聚合酶链反应(RT-PCR)技术半定量分析大鼠脑放射诱导损伤后海马区在不同时间、不同剂量水平TNF-α基因转录的动态表达. 结果 正常组海马区TNF-α mRNA低水平表达;全脑照射组表达上调并在1 h达峰值,是正常组的4～11倍(P＜0.001);放射诱导呈剂量依赖性(P＜0.01),30 Gy组较2 Gy组增高近2倍(P＜0.001),较15 Gy组增高近1倍(P＜0.01),15 Gy组也高于2 Gy组;各照射组在12 h后恢复到基础水平. 结论 大鼠全脑照射后海马区TNF-α基因表达上调,放射诱导呈剂量依赖性,提示参与了脑放射诱导损伤急性期的细胞反应.     

重型颅脑损伤合并创伤性湿肺的临床治疗

目的 探讨重型颅脑损伤合并创伤性湿肺的治疗方法。方法 对52例重型颅脑损伤合并创伤性湿肺患者临床资料进行回顾分析，结合文献，对其病理基础及治疗方法进行讨论。结果 52例患者治愈24例，好转16例，植物生存2例，死亡10例。治愈率46．15％，病死率19．24％。结论 重型颅脑损伤合并创伤性湿肺的病死率相当高，采用综合治疗方法可取得较好疗效。     

铝作业工人职业性慢性肌肉骨骼损伤危险因素分析

目的 了解电解铝厂工人职业性慢性肌肉骨胳损伤（ＣＭＩ）患者病情况及其危险因素。方法 采用横断面现况调查问卷与临床检查相结合的方法对各有关危险因素进行逐一询问及ＣＭＩ诊断。结果 电解铝厂工人总体ＣＭＩ患病主继６２．５％,各车间不同工种工人ＣＭＩ串病率差异无显著意义,但均高于对照组（２８．５％）。多因素Ｌｏｇｉｓｔｉｃ回归提示,ＣＭＩ患病与性别、年龄、身高、文化程度、婚姻状况、子女数、工作紧张度、工作     

Injuries in the 12th and 13th years of life

Abstract From a sample of 850 adolescents, 377 were involved in 550 separate incidents which resulted in 636 injuries requiring medical attention. The most common injuries were sprains or strains, followed by fractures and lacerations. Most injuries were of minor severity. The most common incident resulting in injury was striking against an object or person, followed by being struck by an object or person, and overexertion or strenuous movement. Almost 40% of the incidents occurred during sporting or similar physical activities. Disabilities arising from injury are described. The most common of these were recreational. The implications of long-term and permanent disability are examined. Traditional attitudes toward injury prevention were found to be held by the majority of the sample. Barriers to injury prevention are identified and the Prevention of Injury Programme contained in the Health Education Syllabus for primary school children is described.     

胫前动脉皮瓣在小儿小腿及足部软组织损伤中的应用

报道８例以胫前动脉为蒂的足背或小腿外侧皮瓣翻转移位修复小儿小腿及足部软组织损伤，所有皮瓣全部成活。该皮瓣的优点是：其血管行走方向恒定，血管蒂有足够长度，皮瓣大小、形态可自由设计选择，血供丰富，血管分支多，适合于各种小腿和足部大面积深部损伤。     

Atlanto-axial rotatory fixation: Improved demonstration using spiral CT

Atlanto-axial rotatory fixation (AARF) is an uncommon condition which is often missed at presentation because of its rarity and the relative subtlety of plain film X-ray findings, but early detection and appropriate management are vital for a cure. We describe three cases in which the use of spiral computed tomography scanning with 3D and sagittal reconstructions greatly aided diagnosis and management. The 3D images gave a more graphic picture of the overall alignment of the upper cervical spine and the skull base, while the sagittal reconstructions demonstrated the presence or absence of compensatory atlanto-occipital subluxation. The literature is briefly reviewed.     

Injuries in the tenth and eleventh years of life

Abstract From a sample of 803 children, 307 were involved in 413 separate incidents which resulted in injuries requiring medical attention. The most common injuries were lacerations, fractures, abrasions, and sprains. The majority of injuries were of minor severity. The most common incident resulting in an injury was a fall, followed by incidents where a child was struck by a person or object. A fifth of all falls was from bicycles. Sporting and playground equipment were associated with a large number of injuries, particularly at school. The study serves to highlight shortcomings in national injury data bases, in particular the absence of injury severity indices, codes for sports and recreation, and inadequate codes for falls. A case is made for integrating injury prevention within the school syllabus. The importance of bicycle injuries and the need for an injury surveillance based on accident and emergency centres is stressed.     

房水铁离子含量测定与眼铁质沉着症相关性的研究

目的 :测定眼铁质沉着症房水中铁离子含量 ,探讨其对手术预后及相关影响。方法 :对 1 7只铁质沉着症眼 ,在摘取眼内异物手术前 ,取 0 2ml房水标本 ,对照组取 1 0只正常尸体眼房水 ,采用铁试剂盒 ,亚铁嗪法测定铁离子含量。结果 :1 7例房水铁离子含量平均为 2 989μg/ml。对照组平均含量为 0 63 1 μg/ml。术后视力 0 5以上者 4例 ,0 1～ 0 4者 4例 ,0 0 1～ 0 0 9者 2例 ,手动以下者 7例 ,其中眼球萎缩 3例。结论 :眼铁质沉着症房水铁离子含量明显高于对照组 ,其对眼组织的损伤与铁离子含量有直接关系 ,同时与异物的化学成分、大小、位置与有无包裹以及异物在眼内存留的时间等因素有关。     

Depleted uranium--the growing concern

Recently, several studies have reported on the health and environmental consequences of the use of depleted uranium. Depleted uranium is a heavy metal that is also radioactive. It is commonly used in missiles as a counterweight because of its very high density (1.6 times more than lead). Immediate health risks associated with exposure to depleted uranium include kidney and respiratory problems, with conditions such as kidney stones, chronic cough and severe dermatitis. Long-term risks include lung and bone cancer. Several published reports implicated exposure to depleted uranium in kidney damage, mutagenicity, cancer, inhibition of bone, neurological deficits, significant decrease in the pregnancy rate in mice and adverse effects on the reproductive and central nervous systems. Acute poisoning with depleted uranium elicited renal failure that could lead to death. The environmental consequences of its residue will be felt for thousands of years. It is inhaled and passed through the skin and eyes, transferred through the placenta into the fetus, distributed into tissues and eliminated in urine. The use of depleted uranium during the Gulf and Kosovo Wars and the crash of a Boeing airplane carrying depleted uranium in Amsterdam in 1992 were implicated in a health concern related to exposure to depleted uranium.