自体大隐静脉移植治疗周围血管损伤22例分析

目的：探讨周围血管损伤自全大隐静脉移植治疗的方法。适应证和治疗效果。方法：回顾性分析22例周围血管损伤自体大隐静脉移植治疗的临床资料，并阐述了术中注意事项，提出最佳手术时机及预后情况。结果：22例均采用自体大隐静脉移植，痊愈19例（86.4%)。截肢3例（13.6%），22例患者无死亡，随访2-9年，20例肢体功能恢复满意，2例移植段狭窄，但肢体功能良好。结论：自体大隐静脉移植是治疗周围血管损伤行之有效的方法之一。血管吻合的时间应在24h以内，最佳为8h以内。     

神经干细胞静脉移植治疗脊髓损伤的实验研究

[目的]观察神经干细胞静脉移植对损伤大鼠脊髓功能的治疗作用。[方法]取孕14—16dSD胎鼠的脑室下区组织，体外培养后鉴定细胞。制作脊髓全切模型，伤后1周将Brdu标记好的神经干细胞通过尾静脉注射移植到大鼠体内，移植后及8周行皮层体感诱发电位（CSEP）检测和BBB功能评分，并留损伤脊髓处作病理切片及免疫组化染色。[结果]（1）移植后8周BBB评分损伤组、移植组都有所恢复，但都未达到正常水平，移植组恢复较好；（2）模型制作后，CSEP波均消失，细胞移植后8周移植组的波形有不同程度的恢复，但潜伏期延长；（3）移植组大鼠脊髓损伤处存在大量Brdu染色阳性细胞，表明移植的细胞在体内可到达损伤脊髓处并能存活；脊髓损伤部位NF-200及GFAP染色阳性的细胞表明移植的细胞可以分化为具有神经元和胶质细胞特性的细胞。[结论]静脉移植的神经干细胞能到达损伤区代替受损的神经元及神经胶质细胞，使损伤的脊髓功能得到一定程度的恢复。     

中药对大鼠辐射损伤防护作用的实验研究

目的探讨中药当归、川芎、黄芪、丹参提取液对大鼠放射性骨髓损伤的防护作用.方法雄性SD大鼠60只,随机分为正常对照组、模型组、中药组,每组6只,在相同条件下饲养2周,模型组和中药组大鼠给予6.0 Gy 60Co γ射线一次性全身照射,继续饲养1周处死全部动物并取材.用骨髓细胞计数法计数骨髓有核细胞数,用Western blot法测定血管内皮生长因子（vascularendothelialgrowth factor,VEGF）、血小板衍生生长因子（ptatelet derived growth factor,PDGF）的蛋白含量.结果与正常对照组比较,模型组大鼠的骨髓有核细胞数、VEGF、PDGF蛋白含量明显减少（P＜0.01）,与模型组比较,中药组大鼠的骨髓有核细胞数、VEGF、PDGF蛋白含量明显增加（P＜0.01或P＜0.05）.结论中药当归、黄芪、川芎、丹参对大鼠放射性骨髓损伤有一定防护作用.     

Functioning and disability 6–15 years after traumatic brain injuries in northern Sweden

Objectives –  To assess long‐term functioning and disability after traumatic brain injury (TBI). Material and methods –  Individuals (n = 88) in Norrbotten, northern Sweden, who had been transferred for neurosurgical care were assessed with internationally established TBI outcome measures 6–15 years post‐injury. Results –  There was an improvement in overall outcome from discharge from inpatient rehabilitation to follow‐up. Many individuals had a high degree of motor and cognitive functioning, which enabled them to live independently in their own home without assistance, but there remained a disability related to community reintegration and social participation. This affected their productivity and to some degree their marital stability. The remaining disability and reduced productivity were related to the age at injury and the injury severity. Conclusions –  Our data showed that individuals with a TBI can achieve and maintain a high degree of functioning many years after the injury. Increasing age and a greater injury severity contributed to their long‐term disability.     

Time for sport and health to be formally linked in a positive way

Preventing sports injury has rarely been cited as an appropriate action to respond to the obesity epidemic, and in fact a recent letter has suggested that those playing sport are as responsible for their predicament as those who are obese. This opinion piece argues that it is time for better prevention and management of sports injury to be seen as part of the complex solution to preventing obesity, rather than being a self-inflicted problem that governments should continue to ignore.     

Die traumatische Pneumatocele — Ein Fallbericht

Zusammenfassung Die posttraumatische Pneumatocele ist eine seltene intrapulmonale Veränderung nach stumpfem Thoraxtrauma. Anhand eines gut dokumentierten Falles wird diese seltene Form der Lungenkontusion dargestellt und die klinisch bedeutsame Differentialdiagnose diskutiert.

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Traumatic pneumatocele — a case report

Summary The posttraumatic pneumatocele is a rare intrapulmonary lesion following blunt thoracic injury. By means of a well documented case report this rare form of lung contusion is demonstrated and the clinically important differential diagnosis is discussed.

     

Spinal canal narrowing during simulated frontal impact

Between 23 and 70% of occupants involved in frontal impacts sustain cervical spine injuries, many with neurological involvement. It has been hypothesized that cervical spinal cord compression and injury may explain the variable neurological profile described by frontal impact victims. The goals of the present study, using a biofidelic whole cervical spine model with muscle force replication, were to quantify canal pinch diameter (CPD) narrowing during frontal impact and to evaluate the potential for cord compression. The biofidelic model and a sled apparatus were used to simulate frontal impacts at 4, 6, 8, and 10 g horizontal accelerations of the T1 vertebra. The CPD was measured in the intact specimen in the neutral posture (neutral posture CPD), under static sagittal pure moments of 1.5 Nm (pre-impact CPD), during dynamic frontal impact (dynamic impact CPD), and again under static pure moments following each impact (post-impact CPD). Frontal impact caused significant (P<0.05) dynamic CPD narrowing at C0-dens, C2-C3, and C6-C7. The narrowest dynamic CPD was observed at C0-dens during the 10 g impact and was 25.9% narrower than the corresponding neutral posture CPD. Interpretation of the present results indicate that the neurological symptomatology reported by frontal impact victims is most likely not due to cervical spinal cord compression. Cord compression due to residual spinal instability is also not likely.     

肠缺血后处理对兔缺血再灌注损伤小肠上皮细胞线粒体形态和功能的影响

目的观察缺血后处理对小肠缺血再灌注损伤的保护作用。方法30只大白兔随机分为3组，每组8只：A组，假手术组；B组，肠缺血再灌注损伤模型组；C组，肠缺血再灌注损伤模型肠缺血后处理组，实验结束后取小肠标本进行小肠上皮细胞形态和呼吸功能指标测定。结果A、C两组线粒体的数目、周长均大于B组，A、C两组问比较，A组较大（P〈0．05）。A、C两组线粒体的面积、最大直径、最小直径、等效直径均小于B组（P〈0．05），A、C两组间比较差异无统计学意义（P〉0．05）。B组线粒体的体积密度小于A组，面积密度、比表面和粒子数密度均小于其余两组（P〈0．05）。A、C两组间三维平面形态计量学各参数比较差异无统计学意义（P〉0．05）；B、C组线粒体呼吸控制比率（RCR）低于A组差异有统计学意义（P〈0．05），与C组比较，B组下降更为明显（P〈0．05）。结论小肠缺血后处理对缺血再灌注损伤肠上皮细胞线粒体形态和功能均有保护作用。