川芎内酯A预处理对大鼠离体心脏缺血再灌注所致血管内皮细胞损伤的保护作用

目的:观察川芎内酯A预处理对大鼠离体心脏缺血再灌注所致血管内皮细胞损伤的保护作用。方法:采用Langendorff离体心脏灌流方法,在恒温恒压条件下,以0.5mL.min^-1的灌流速度给药,剂量分别为0.05,0.025,0.0125g.L^-1与K-H灌流液同时灌流心脏10min;全心停灌30min,再灌60min。结果:川芎内酯A预处理能提高大鼠离体心脏停灌再灌期的冠脉流量;降低冠脉流出液中IL-1β浓度和TXB₂/6-Keto-PGF_1α的比值;室性心动过速(VT)和心室颤动(VF)的发生率降低,VT,VF持续时间缩短;心肌匀浆液乳酸脱氢酶、丙二醛的含量降低,超氧化物歧化酶活性提高。结论:川芎内酯A预处理对大鼠离体心脏停灌再灌注损伤所致的血管内皮细胞损伤可能具有保护作用。     

Intrathecal administration of an NMDA or a non-NMDA receptor antagonist reduces mechanical but not thermal allodynia in a rodent model of chronic central pain after spinal cord injury

Spinal cord injuries (SCI) result in a devastating loss of function and chronic central pain syndromes frequently develop in the majority of these patients. The present study uses a rodent spinal hemisection model of SCI in which mechanical and thermal allodynia develops by 24 days after injury. Post-operative paw withdrawal responses to low threshold and high threshold mechanical stimuli compared to pre-operative responses (4.78, 9.96, and 49.9 mN) were increased and were statistically significant (p<0.05) for both forelimbs and hindlimbs indicating the development of mechanical allodynia. By contrast, post-operatively, the temperature at which paw withdrawal accompanied by paw lick occurred was significantly decreased (p<0.05), indicating the development of thermal allodynia. The intrathecal application of either D-AP5, a competitive NMDA receptor antagonist, or NBQX-disodium salt, a competitive non-NMDA AMPA/kainate receptor antagonist, alleviated the mechanical allodynia and lowered the threshold of response for the high threshold mechanical stimuli in a dose-dependent manner, and these decreases were statistically significant (p<0.05). By contrast, neither the D-AP5 nor the NBQX produced a statistically significant change in the thermal allodynia behavior in either forelimbs or hindlimbs in the hemisected group. No significant changes in locomotion scores, and thus no sedation, were demonstrated by the hemisected group for the doses tested. These data support the potential efficacy of competitive excitatory amino acid receptor antagonists in the treatment of chronic central pain, particularly where input from low threshold mechanical afferents trigger the onset of the painful sensation. Furthermore, these data suggest a role for both NMDA and non-NMDA receptors in the development of plastic changes in the spinal cord that provide the underlying mechanisms for central neuropathic pain.     

Age and Outcome After Severe Head Injury

The authors analyzed the relationship between patient age and the final outcome in a series of 810 patients aged 14 years or older who were consecutively admitted between 1987 and 1996 after suffering a severe closed head injury. The most relevant clinico-radiological variables were prospectively collected in a Data Bank. Stratified and logistic regression analyses were performed in order to assess the influence of age on adverse outcome and the interaction between patient age and other prognostic indicators. Our results reaffirm that the adverse outcome rate increases steadily with age in severe head injured patients and that age effect on outcome is independent of other prognostic variables. The odds of having an adverse outcome increases significantly over 35 years of age being 10 times higher in patients older than 65 years as compared to those aged 15-25 years (reference age group). The adverse influence of an advanced age on the final outcome has not yet been satisfactorily explained but an older brain may have an impaired ability to recover after a pathological insult as compared to a younger one.     

某钢铁企业职业伤害调查研究

[目的]探讨某钢铁股份公司职业伤害的发生特点、分布、主要原因及发生趋势。[方法]根据对某钢铁股份公司1999年1月至2002年12月间职工人数及发生的职业伤害事故调查资料进行分析。[结果]该公司2002年职业伤害发生率为22．39／万，职业伤害类型以物体打击(24．39％)、灼烫(17．56％)、高处坠落(17．32％)和机械伤害(15．37％)为主。而操作不当(22．20％)和安全意识不强(15．85％)是其主要原因。[结论]职业伤害防制应从提高职工安全意识和技术水平着手，针对不同类型作业场所采取相应的措施。     

急性颅脑损伤脑疝51例临床分析

目的:探讨急性颅脑损伤脑疝的临床特点及各种影响预后的因素,以提高急性颅脑损伤脑疝的诊断和治疗水平,降 低其病死率.方法:对 2000～ 2003年收治的 51例急性颅脑损伤合并脑疝患者的临床资料进行回顾性分析.结果: 收治的急性颅脑损伤合并脑疝患者 51例通过手术或非手术治疗方法,死亡 33例,住院病人病死率高达 64.7%.主要 死亡原因:颅内血肿及脑挫裂伤后脑水肿引起的 ICP增高形成脑疝和原发性或继发性脑干伤;其次是各种严重的并 发症.结论:急性颅脑损伤引起脑疝伤残、病死率极高,其预后与 GCS计分、瞳孔变化、损伤类型、年龄大小、手术时 机及手术指征的掌握密切相关.     

神经元特异性烯醇化酶在颅脑损伤中的意义

目的　探讨血清神经元特异性烯醇化酶 (NSE)与颅脑损伤及其预后之间的关系。方法　用RIA法测定了 70例急性颅脑损伤患者的血清NSE含量 ,结合Glasgow昏迷和预后分级进行比较分析。结果　⑴重型 (a)、轻型 (b)颅脑损伤患者与对照组(c)的血清NSE水平分别为 ( 2 5 8± 10 8)ng/ml、( 19 6± 8 9)ng/ml和 ( 9 5± 2 8)ng/ml ,存在显著性差异 (Pa -b<0 0 5 ,Pa -c<0 0 1,Pb -c<0 0 1) ;⑵死亡植物生存组 (e)、残废组 (f)和恢复良好组 (g)的血清NSE水平分别为 3 1 3± 11 0ng/ml、2 3 0± 8 7ng/ml和 16 3±7 5ng/ml ,两两对比差异明显 (Pe-f<0 0 5 ,Pe -g<0 0 1,Pf-g<0 0 5 ) ;⑶血清NSE≥ 2 2ng/ml组和NSE <2 2ng/ml之间 ,死亡植物生存率、残废率和恢复良好率有显著性差异 ( P <0 0 5 )。结论　伤后早期血清NSE水平在一定意义上反映了脑损害的程度 ;同时在颅脑损伤的预后评估上 ,是较重要的指标之一     

小儿内科急诊意外伤害分析

目的:为增强人们对小儿意外伤害的预防意识和探索有效防治措施。方法:对珠海市妇幼保健院小儿内科急诊从1994～2003年收治的意外伤害小儿208例,按不同伤害类别、性别、年龄、临床转归进行统计,作回顾性综合分析。结果:各类中毒在小儿内科急诊意外伤害中占绝大多数,以药物中毒为主。结论:预防药物中毒是小儿意外伤害的预防重点,幼儿及学龄前儿童的预防尤其重要,应引起人们的重视。     

1987～2000年安庆市居民意外伤害死因调查分析

目的　了解安庆市居民意外伤害死亡的流行趋势 ,预防和控制意外伤害死亡发生。方法　采用死亡率 (MR)、标化减寿率 (SYPLLR)等指标对 1 987～ 2 0 0 0年 1 4年间的意外伤害死亡资料进行分析。结果　1 4年间 ,安庆市居民意外伤害死亡率为 6 5 .4 3/ 1 0万、SYPLLR为 2 2 .96‰ ;意外伤害死亡的前 3位死因分别为自杀、溺水和机动车车祸 ,其死亡率分别为 2 4 .72 / 1 0万、1 3.1 0 / 1 0万和 9.78/ 1 0万 ;机动车车祸死亡率呈波动上升趋势。结论　意外伤害死亡是安庆市居民的主要死因之一 ,必需加强意外伤害死亡的预防和控制     

玻璃体切除术治疗严重眼外伤34例观察

目的:观察玻璃体切除术治疗严重眼外伤的临床效果。方法:应用玻璃体切除术治疗严重眼外伤34例(35眼)。结果:本组34例(35眼)中,术后视力提高者29例(30眼,86%),在0.05以上者18例(18眼,51%),4例复发视网膜脱离,3例再手术成功。结论:玻璃体切除术是目前治疗严重眼外伤较为理想的方法,对恢复视功能起到一定作用。     

大鼠视网膜缺血再灌注后细胞间粘附分子-1的表达

目的　探讨大鼠视网膜缺血再灌注后不同时间视网膜细胞间粘附分子 1(inter cellularadhesionmolecule 1,ICAM 1)表达和白细胞浸润的变化。方法　选择健康成年Wistar大鼠 70只 ,随机分成 7组 :正常组和再灌注 0、2、6、12、2 4、4 8h组 ,每组 10只。用眼内灌注法建立视网膜缺血再灌注动物模型。制作大鼠视网膜冰冻及石蜡切片 ,分别作免疫组化SP染色和常规HE染色 ,并对SP染色结果作计算机图像分析。结果　ICAM 1在正常视网膜血管内皮细胞胞膜微量表达 ,缺血 6 0min后 ,ICAM 1表达上调 ,至再灌注2 4h达高峰 ,在再灌注 4 8h仍维持较高水平。再灌注 6h ,视网膜开始有白细胞浸润 ,随再灌注时间延长而增多 ,再灌注 2 4、4 8h组 ,视网膜中发现较多浸润的白细胞。结论　视网膜缺血再灌注早期 ,视网膜血管内皮细胞ICAM 1表达上调 ,继而 ,视网膜中白细胞浸润增多 ,这一过程是视网膜缺血再灌注损伤的重要机制之一。