高压氧治疗急性一氧化碳中毒174例护理效果观察

急性CO中毒是我国北方地区冬季的常见病,多发病。若治疗不及时或不彻底又有发生CO中毒迟发性脑病的危险。自从高压氧医学产生和发展以来,目前已成为CO中毒首选的主要治疗手段,取得了很好的治疗效果。本文对近3年来用高压氧(HBO)配合临床药物治疗CO中毒及迟发性脑病174例的治疗护理效果进行了观察,认为对急性CO中毒患者的治疗护理应及早发现、及早就医、及早HBO治疗并坚持足够的疗程,可以提高CO中毒的治愈率,降低死亡率,减少或减轻迟发性脑病的发生,同时认为整个HBO治疗过程中做好每个环节的护理工作是CO中毒患者救治成功的关键。1…     

高压氧综合治疗持续植物状态30例疗效分析

目的评估高压氧综合治疗持续植物状态的疗效和探讨最佳治疗方案。方法回顾性分析了1999年—2005年应用高压氧治疗的30例持续植物状态病例,主要分析了原发病因、高压氧治疗次数以及高压氧治疗时机与疗效的关系。结果脑外伤组显效率和好转率明显高于非脑外伤组(P<0.05),开始治疗时间≤30d组及31～60d组好转率明显高于≥61d组(P<0.05)。结论高压氧综合治疗对脑外伤所致持续植物状态患者60d以内开始行高压氧治疗的患者疗效较好。     

人精子体外氧化损伤对线粒体tRNA~(LeuUUR)基因的影响

目的:探讨活性氧(ROS)对人类精子线粒体tRNALeuUUR基因的氧化损伤。方法:采用Percoll梯度离心法筛选具有正常生理功能的精子,作为正常精子模型,并分为损伤组20例和对照组20例,分别加入次黄嘌呤-黄嘌呤氧化酶体系或不予处理,37℃有氧环境中孵育60min。分别提取精子DNA,以Fpg酶切损伤碱基并采用接头介导PCR(LM-PCR)检测线粒体tRNALeuUUR基因的氧化损伤。采用Rhodamine(Rh123)荧光探针标记精子,通过流式细胞仪检测线粒体膜电位,观察精子的功能。结果:与对照组相比,损伤组精子孵育后线粒体膜电位明显降低[(116.27±11.72)%vs(64.00±4.88)%,P<0.05]。Fpg酶切和LM-PCR显示精子线粒体tRNALeuUUR基因损伤。结论:ROS可能通过对精子线粒体tRNALeuUUR基因氧化损伤而影响精子功能(线粒体膜电位明显降低),从而引起不育。     

筋膜间隔综合征的高压氧治疗与血浆纤粘素变化的关系

本文首次报道采用253kPa的高压氧治疗24例创伤后筋膜间隔综合征(PACS)病人并采用免疫单扩散法检测了治疗前后血浆纤粘素(FN)的变化与预后的关系。30例健康人作为血浆FN的对照组。结果表明:16例早期PACS病人,经3～5次高压氧治疗,症状和体征逐渐好转,无1例作筋膜切开减压。6例筋膜切开减压后行高压氧治疗者,水肿、炎症消退,体温降低,临床症状好转。2例坏死期PACS虽然临床症状好转,但效果差。高压氧治疗后,病人血浆FN显著高于治疗前。分别较治疗前高43(18.9％;P<0.01)、61(24.7％;P<0.01)、49(17.2％;P<0.01)、57(17.4％;P<0.05)和55mg/L(16.6％;P<0.05)。根据本组研究的结果,提示高压氧是治疗早期PACS的有效非手术疗法和筋膜减压后有效辅助疗法。     

Reactive oxygen species and human spermatozoa: physiology and pathology

The role of reactive oxygen species (ROS) in the pathophysiology of human sperm function has been emphasized in recent years. ROS production in semen has been associated with loss of sperm motility, decreased capacity for sperm–oocyte fusion and loss of fertility. There is a current presumption that the most prolific source of ROS in sperm suspensions is an NADPH oxidase located in leukocytes or in spermatozoa which produces superoxide which is further converted to peroxide by the action of superoxide dismutase. Hydrogen peroxide has been recognized as the most toxic oxidizing species for human spermatozoa, which are very sensitive to lipid peroxidation owing to the high content of polyunsaturated fatty acids in their plasma membrane, though this is not the sole mechanism by which sperm function might be impaired by ROS. Although the excessive production of ROS is detrimental to human spermatozoa, there is a growing body of evidence which suggests that ROS are also involved in the physiological control of some sperm functions. This review focuses on the nature and source of the ROS generated by human spermataozoa as well as their operational mechanisms and their effects, which may be detrimental or beneficial.     

Maximal oxygen uptake,anthropometry and physical activity in a randomly selected sample of 8 and 13 year old children in Sweden

Summary Maximal oxygen uptake was assessed in 101 randomly selected 8 and 13 year old children. In both age groups a significantly higher aerobic capacity was found in boys than in girls, both in absolute terms and when maximal oxygen uptake was related to body weight, lean body mass and lean leg volume. Among girls, maximal oxygen uptake per kg body weight was lower in the older than in the younger (p<0.05). Estimation of spontaneous physical activity, by means of a questionnaire and the actometry method, indicated that physical activity was greater in children with a high than in those with a low aerobic capacity.     

PTEN基因敲除降低辐射敏感性及其机制

目的 探讨PTEN基因敲除对辐射敏感性的影响及机制。方法 采用流式细胞术检测MEF1和MEF1/PTEN^－/－细胞内ROS水平;采用Western blot方法,检测H₂O₂和DPI预处理后AKT激酶的表达变化;采用细胞克隆形成率试验分析细胞对⁶⁰Co γ射线的敏感性。结果 PTEN基因敲除后细胞ROS水平增加,辐射敏感性降低。H₂O₂和DPI预处理后影响MEF1细胞AKT激酶活性,但对MEF1/Pten^－/－细胞无影响。 结论 PTEN基因敲除阻断了ROS对AKT的介导,AKT激酶持续活化,可能是辐射敏感性降低的重要原因。     

Improved haemorheology associated with a reduction in plasma fibrinogen and LDL in patients being treated by heparin-induced extracorporeal LDL precipitation (HELP)

Heparin-induced Extracorporeal LDL-Precipitation (HELP) is an effective procedure for the elimination of both plasma LDL and fibrinogen. In 10 adult patients with severe type II hyperlipoproteinemia, a single HELP treatment of 3 1 plasma led to an acute decrease in the average plasma viscosity (PV) from 1.30 to 1.1 mPas. At the same time, an even more marked decrease in the mean erythrocyte aggregation rate from a pathological value of 7.9% to a value of 3.7% (normal range less than 5%) was observed. Long-term studies on five patients demonstrated a lasting improvement in these two haemorheological variables. The acute rheological changes were also accompanied by an improvement in polarographically determined muscle oxygen tension. Mean oxygen tension values measured in both the m.biceps brachii and the m.tibialis anterior in five patients before and after a single HELP treatment increased from 30 +/- 4 to 37 +/- 7 mmHg and from 27 +/- 2 to 31 +/- 3 mmHg respectively. These results may provide an explanation for the rapid improvement in patients' clinical symptoms such as angina pectoris and in stress electrocardiogram which have been observed during HELP therapy.     

Influence of moderate hypothermia on cerebral oxygenation in pigs with intracranial hypertension

BACKGROUND: Moderate hypothermia is one of the effective therapeutic methods for head injury in recent years, there are many mechanisms of moderate hypothermia for brain protection, and its influence on cerebral oxygenation is also one of them. OBJECTIVE: To observe the influence of moderate hypothermia on cerebral oxygenation of animals with acute intracranial hypertension, and further investigate the protective mechanism of moderate hypothermia. DESIGN: A randomized controlled trial. SETTING: Department of Neurosurgery, Renji Hospital affiliated to the Medical College of Shanghai Jiao Tong University. MATERIALS: Twenty healthy little pigs, either male or female, weighing 4.5–5.5 kg, were used. Neurotrend-typed multiparameter monitoring system (Diametrics Company, British); CMA/100 micro-injection pump (Carnegie Company, Sweden). METHODS: The experiment was conducted in the Changzheng Hospital affiliated to the Second Military Medical University of Chinese PLA in November, 2001. The pigs were randomized into two groups: the normothermia group (control group, n =10) and moderate hypothermia group (n =10). ① Bilateral femoral arteries were separated, one was connected to pressometer for monitoring mean arterial pressure (MEP), and the other for analysis of blood gases [including peripheral blood pH value, arterial partial pressure of carbon dioxide (PaCO2), arterial partial pressure of carbon dioxide (PaCO2), HCO3–]. ② Rectal temperature was monitored with mercurial thermometer. ③ Intracranial pressure was monitored using Camino optic ICP probe placed in the subdural space. ④ Neurotrend multiparameter monitoring sensor was inserted into the white matter for about 4 cm to determine cerebral perfusion pressure (CPP, CPP=MAP(ICP), brain tissue partial oxygen pressure (PO2), partial pressure of carbon dioxide (PCO2), HCO3– and brain temperature. The rectal temperature of animals in the moderate hypothermia group was lowered to 34 ℃ using ice bags, and the body temperature was maintained at 33–35 ℃ for 2 hours. The changes of the parameters were observed continuously, and the pigs in the normothermia group were not treated with cooling. MAIN OUTCOME MEASURES: ① MAP, ICP, rectal temperature, CCP; Indexes of cerebral oxygenation detected with Neurotrend-typed multiparameter monitoring system; ② Results of blood gases analysis in the moderate hypothermia group. RESULTS: All the 20 pigs were involved in the analysis of results. ① MAP, ICP, rectal temperature, CCP and indexes of cerebral oxygenation: In the moderate hypothermia group, the ICP after cooling was obviously lower than that before cooling [(3.31±1.19), (5.33±0.95) kPa, P < 0.05], CCP was higher, brain tissue PCO2 [(12.03±1.73), (10.59±2.01) kPa, P < 0.05], and brain tissue pH value was higher [(7.03±1.63), (9.40±1.30) kPa, P < 0.05], whereas the brain temperature was decreased as compared with that before cooling [(34.9±0.3), (37.2±0.2) ℃, P < 0.05]. ② Results of blood gases analysis in the moderate hypothermia group: There were no significant differences in the parameters of peripheral arterial blood gases analysis before and after cooling in the moderate hypothermia group (P > 0.05) CONCLUSION: Moderate hypothermia will not impair the cerebral oxygenation, and it can reduce brain tissue CO2 and decrease brain tissue acidosis.